Deprivation in leafy Staffordshire provided an interesting challenge for Dr Zafar Iqbal

Deprivation in leafy Staffordshire provided an interesting challenge for Dr Zafar Iqbal

In an era when most healthcare organisations are strapped for cash, partnership, ingenuity and sheer willpower are keeping innovation alive, as demonstrated by efforts to tackle health inequalities in a pocket of deprivation in leafy Staffordshire.

The targeted area suffered from high levels of substance misuse, crime and obesity. Teenage pregnancy was three times the national average.

But there was no willingness to fund a solution. Despite the fact that a lot of national money goes into deprived areas, this was 'middle England' and did not qualify. It was completely off the radar of the health inequalities agenda.

South Staffordshire primary care trust public health consultant Zafar Iqbal felt something had to be done. Armed with statistics, he convinced people there was a problem and signed them up to providing services - without any extra money.

An alternative model to bring services to the area - 'tackling health inequalities on a shoestring' - was developed by the PCT's public health department.

The first step was to convince NHS organisations and other service providers that a problem existed. 'A lot of people didn't want to know,' says Dr Iqbal. 'It took a long time to get everyone involved and for people to accept there was a problem.'

A workshop was organised for statutory services and partners. One hundred people turned up, from organisations ranging from the council to schools to the local Tesco. Ideas were batted about and people became interested in the issue. Local politicians sat up and took notice.

A health needs assessment identified that some of the areas to target were aspirations and achievement: parenting; economic development; sense of community; mental health; and lifestyle.

Much of the subsequent work has been about targeting existing services in a different way rather than creating new ones.

The council contributed a run-down building, formerly an area housing office, and the lease is being taken on by the mental health trust. A local church group has successfully bid to manage the building and will be supported by a committee representing the lead partner organisations.

The set-up and running costs have been kept to a minimum and statutory partners are contributing to them from within existing resources. The county council is managing the pooled budget.

The building was due to open for use by the end of 2006, with existing programmes moving in to host healthy living activities.

Many organisations will be providing services from this building. The list includes the youth service, adult and community learning, teenage advice agency Connexions, health visitors, midwives, the Citizens' Advice Bureau, the community mental health team, charity Age Concern, Staffordshire Police and the university.

Dr Iqbal believes the involvement of educational bodies is important since encouraging people to go into further education will help lift the area out of deprivation.

The project has been given the green light by politicians and has a high priority in the area. It is run by a sub-group of the Stafford local strategic partnership, which includes representatives from health, local government, education and the voluntary sector.

Work is under way to incorporate objectives of the project into local area agreements.

Dr Iqbal describes his own role as 'pulling everyone together', getting them to see that deprived groups can be reached and improvement made despite a lack of new funds.

The impact is already measurable. In the past year, the crime rate has fallen sharply - burglary has gone down by two-thirds.

Things would have been simpler with new, dedicated funding. But by working in partnership and making smart use of existing resources, the project is attracting a high level of commitment and achieving results.