2. Our city and vision

The Healthy Leeds Plan sets out the health and care contribution towards achieving this vision. The plan outlines our five year strategic vision and focuses on equitable access, excellent experience, and optimal outcomes for people living in Leeds, ensuring we get the best value from Leeds public money.

Leeds Health and Care Partnership

Leeds is a great, forward looking, northern city with strong innovation, creativity, and commitment from partners to work together to improve our population’s health and wellbeing outcomes and to address health inequalities. It is a richly diverse city with people of different ages, backgrounds, cultures, and beliefs working alongside each other.

The Leeds Health and Care Partnership consists of organisations across Leeds including:

  • Leeds and York Partnership NHS Foundation Trust
  • Leeds Teaching Hospital NHS Trust
  • Leeds Community Healthcare NHS Trust
  • NHS West Yorkshire Integrated Care Board
  • Leeds City Council
  • Leeds GP Confederation
  • Healthwatch Leeds
  • Forum Central
  • St Gemma’s Hospice
  • Sue Ryder Wheatfields Hospice

The Leeds Health and Care Partnership exists to improve the health and wellbeing of the 880,000 people in our city. It operates in a city with a unique combination of assets and ways of working, which gives us a firm foundation for continuous improvement and innovation. We strive to be inclusive in our partnership, starting with people and bringing together a network of statutory and non-statutory third sector, health, local government, academic and industry partners.

We also have a role beyond the boundaries of the city, by delivering services regionally and as a key partner within the West Yorkshire Health and Care Partnership alongside the four other places in West Yorkshire (Bradford District and Craven, Calderdale, Kirklees, and Wakefield District). Following the principle of subsidiarity, we work together at West Yorkshire level where it makes sense to do so, where there is a challenge or concern and to share good practice.

The third sector is the collective term for the Voluntary, Community and Social Enterprise (VCSE) organisations and networks which add so much value to the lives of the people in Leeds, particularly in deprived areas and communities of interest (groups of people who have a shared identity or experiences). Leeds has a challenged but comparatively thriving third sector and inspiring community assets, which is a fundamental part of our integrated health and social care system.

Forum Central represents this diverse sector in Leeds, as part of the Health and Care Partnership – connecting third sector organisations with decision makers across health and social care. This strong third sector voice helps influence our strategy, policy and ways of working across our Population and Care Delivery Boards, Local Care Partnerships (LCPs), and the executive meetings of the West Yorkshire ICB.

In addition to our thriving third sector, Leeds has many anchor organisations within the city. These anchor organisations are an important presence as either large employers, purchasers of goods and services locally or as owners of important buildings, parks, and similar assets in local communities. They include the national organisations that allow us to influence and engage national decision-making and policy for health and wellbeing. Also included are the three leading universities who, as part of the Leeds Academic Health Partnership, can help us solve some of the city’s hardest health and care challenges and work with industry partners to accelerate the adoption of innovation.

Our health and care providers are equally important anchor organisations, and Leeds’ anchor organisations are committed to providing good-quality employment, training, skills, and careers for the diverse population of Leeds and the region, positively impacting some of the critical determinants of health and wellbeing.

 

Our city vision

The Leeds Health and Wellbeing Strategy has set the vision for the city:

‘Leeds will be a healthy caring city for all ages, where people who are the poorest improve their health the fastest.’

We know that health and wellbeing is affected by social, economic, and environmental factors beyond good healthcare. These are often referred to as the wider determinants of health and include factors such as income, education, access to green spaces and healthy food, type of employment, and housing.

Inequalities in the wider determinants of health can lead to heath inequalities between different populations, and therefore addressing these wider socio-economic inequalities is a crucial part of reducing health inequalities for the people of Leeds (The Kings Fund).

As such, whilst the Healthy Leeds Plan represents the critical contribution health and care organisations can make towards realising the vision of the Health and Wellbeing Strategy, it also sits alongside other important strategies that will help improve the lives and wellbeing of the people of Leeds.

Our ‘Best City Ambition’ describes the three core pillars of our city’s future ambition – Health and Wellbeing, Inclusive Growth and Zero Carbon.

The Leeds Inclusive Growth Strategy sets out how we can make Leeds a healthier, greener, and more inclusive economy that works for everyone.

The Net Zero Ambition sets out our commitment to be carbon neutral.

Leeds has also committed to become a Marmot City and is working in partnership with the Institute of Health Equity to take a strategic, whole-system approach to improving health equity.

Achieving our local vision and ambition will support work taking place across West Yorkshire and will contribute to delivering the region’s 10 Big Ambitions.

 

Overview of our population trends

Notwithstanding our strong vision and ambition, not everyone in our city experiences good health and prosperity, and we are seeing increasing and unsustainable levels of demand for health and care services. Within Leeds, 26% of the population (an estimated 226,000 people), and 34% of children and young people (estimated 60,000 people aged 0-18 years), live within the 10% most deprived areas nationally (or IMD1, the lowest decile in the national Index of Multiple Deprivation). Our Joint Strategic Assessment (JSA) provided strong evidence that some inequalities are widening and will worsen following the COVID-19 pandemic. An overview of some of our changing population needs and characteristics as identified through our JSA can be found below.

 

Growing population in our areas of highest deprivation

Our population has been expanding, specifically within our inner-city areas which are often our most deprived communities. These communities experience our city’s worse health outcomes.

There is a 14-year life expectancy gap for women and a 12-year life expectancy gap for men between some of our most and least affluent areas of the city.

Whilst people are living longer, this is often in poorer health and with multiple long-term conditions. There has been progress in treating cancer, respiratory and heart disease but the premature mortality gap for these three areas have widened in our most deprived areas.

Almost 175,000 people in Leeds are living in relative poverty.

There has been a growth in in-work poverty with an estimated 74,000 working age adults across the city being from working households and living in poverty.

 

Ageing Population

The population aged over 50 has grown by around 30,000 over the last 20 years. This demonstrates a 12% to 17% increase in each of the 50 plus age bands.

Future population growth is predicted to be fastest amongst the 80+ age group which is expected to see a 50% increase over the next 20 years.

The largest concentration of older communities is found within the inner-city areas. The proportion of people living with frailty within the most deprived communities is almost three times higher than those who live in the least deprived.

At age 65, people in Leeds can expect to live half of the rest of their life free of disability or in good health, and half of it with a disability or in poor health.

 

Population of children and young people growing in our most deprived areas

The child population is growing at a faster rate than the population of Leeds as a whole, but the growth is now concentrated within secondary school-age groups. This population is growing faster in our communities most likely to experience deprivation.

In 2021, almost 24% children were estimated to live in poverty in Leeds compared to 19% nationally. We also know that 34% of children and young people in Leeds live in the 10% most deprived areas nationally.

Between 2016 and 2021 the number of pupils who have an Education Health and Care Plan (EHCP) has more than tripled.

 

Our city is increasingly diverse

According to the latest 2021 census, the population in Leeds is predominantly white (79%), with non-white minorities representing the remaining 21% of the population. Asian people were the largest minority group in Leeds accounting for 9.7% of the population.

Nearly 200 languages are spoken by children studying in Leeds schools.

63% of Black, 40% of Mixed and 36% of Asian background people living in Leeds live within IMD1 areas, making IMD1 more ethnically diverse than the Leeds average.

 

An increase in people experiencing mental health issues

The proportion of adults reporting mental health issues increased during the pandemic, with some groups particularly affected including young adults and women; shielding older adults; adults with pre-existing mental health conditions, and Black, Asian, and ethnic minority adults.

These mental health impacts are likely to continue due to the cost-of-living crisis, with concerns about job security and debt levels likely to increase.

People with severe mental illness (SMI) in England are around five times more likely to die prematurely than those that do not have SMI, of which Leeds has been identified as an outlier (UKSHA report).

 

All these factors, and more, have implications for service provision and Leeds faces a number of significant challenges. The pandemic has driven up demand for health services in most areas above that which we saw before COVID-19 along with significant backlogs. An increase in more complex conditions as well as worsening health inequalities have resulted in an unsustainable growth in demand, further exacerbated by the challenges of recruiting and retaining workforce across the health and care sector. In addition, our health and care system is under significant financial pressure which has been intensified by the current financial climate and cost-of-living-crisis.

Looking at the overall population size and age distribution (excluding deprivation effects) provides an indication of the likely future health and care demand expected in Leeds. The Office for National Statistics (ONS) provides a forecast of the population changes from 2022 to 2028. These forecasts can be combined with our existing data and insight on how much each age group currently uses health and care services and is used to create an age-weighted forecast of the average increase in healthcare demand, which shows likely changes in unplanned care utilisation (using acute admissions data). Forecasting data also indicates that the population within each deprivation decile is expected to grow but that IMD 1 is expected to grow the highest, and this is more significant within the younger age populations.

To meet our citywide vision, given these challenges, we must start to understand and respond to future population need now. In delivering our Healthy Leeds Plan, we will apply an evidence-based, population health approach to drive innovation and deliver person centred, integrated health and care for the people of Leeds, targeting those who need our support the most. We have also agreed as a Health and Care Partnership to focus our collective efforts toward a few specific goals to really drive change for the people of Leeds.

 

Contents – Explore the Healthy Leeds Plan

  1. Introduction
  2. Our city and vision
  3. Our goals
  4. Population Health infrastructure
  5. Identifying our strategic initiatives
  6. Our plans
  7. Enablers
  8. Summary and next steps
  9. Appendix One: Leeds Operational Plan – Anticipated trajectories
  10. Appendix Two: Leeds Operational Plan Implementation

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