It is common for me to be asked: 'What's it like heading up health inequalities and local delivery at the Department of Health?' Some people think it is tough but actually it is a privilege. I have a view of the best in good practice and work with some of the best people in the business, on the ground delivering tangible reductions in health inequalities, in policy and all the way to the DoH. To be honest we see some of the less than good as well, but that's no bad thing either - it is a learning opportunity.

It is common for me to be asked: 'What's it like heading up health inequalities and local delivery at the Department of Health?' Some people think it is tough but actually it is a privilege. I have a view of the best in good practice and work with some of the best people in the business, on the ground delivering tangible reductions in health inequalities, in policy and all the way to the DoH. To be honest we see some of the less than good as well, but that's no bad thing either - it is a learning opportunity.

Throughout the changes of recent months, what can you count on? Sustainability has to be key. Everyone has a contribution to health inequalities, from practitioners to chief executives and the chair.

You will no doubt be aware that the HSJ Awards are on 19 November. There is some really exciting work to be showcased -is there some on your patch? Think about who has a reputation for excellence and celebrate their achievements by sending in an application for the health inequalities award.

But what is the key? What makes delivering health inequalities possible when other priorities are fighting for attention? It is simple - leadership. We have all met people who can turn things round when others have given up. We have all been inspired by colleagues who create an environment that engages each player, whatever their contribution. To get buy-in from a financial director is a very different story from winning over people on the front line. Leadership requires the skill to navigate not always easy paths and still leave people feeling their contribution is worthwhile.

Here are a few examples to inspire you and show what is possible:

Life expectancy

Hammersmith and Fulham PCT and North Fulham new deal for communities initiative devised Lifestyle Fridays. It engaged local residents at increased risk of ill-health in health promotion; identified people with elevated risk factors for disease; communicated key health messages to local people; and provided motivational support with lifestyle change. It also aimed to increase uptake of local health improvement projects and service referrals.

Infant mortality

Identifying smoking families and providing support and increasing the use of smoking cessation services for pregnant women and parents has been promoted as part of routine clinical practice by North Birmingham PCT and Good Hope Hospital trust. It started because of high rates of smoking in pregnancy and infant mortality in the West Midlands..

There is sustained support for women throughout pregnancy. Midwives assess smoking status during postnatal follow-up, targeting and extending support to partners, which is vital to help mothers to stop smoking.

Communities for Health

Manchester city council, the three PCTs and community and voluntary organisations launched a Valuing Older People initiative and have developed a quality of life strategy for older people..

Maggie Rae is head of health inequalities and head of local delivery at the Department of Health.

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