A new lung cancer screening programme in Cumbria is already making a life-saving impact by detecting cancer at an early stage, when treatment is most effective. The programme is currently being rolled out across north and west Cumbria, with the screening team visiting GP surgeries and contacting eligible patients to offer them a free check.

Statistics released on the same day as the NHS 10-Year Health Plan highlight the programme’s success. Since its launch last year, over 6,000 people have been invited to participate, and more than 1,200 have undergone a low-dose CT scan.

One of those patients is Adrian Wilson, 70, from Workington, who was diagnosed with stage one lung cancer just before Christmas after attending his screening. Adrian is now encouraging others to take up the offer when invited. Read more here.

In Kirklees, community champions are leading a powerful campaign to raise awareness of cardiovascular disease (CVD). Between May and June 2024, they held 1,340 one-to-one conversations, 67 group visits, and performed 461 blood pressure checks—reaching over 890 people. Their efforts helped 985 residents better understand CVD and encouraged 691 to adopt healthier habits. The Champions have just run another campaign between April and June 2025 with early numbers showing that this year they have carried out over 1,000 BP checks, primarily in areas of greater deprivation. By breaking down cultural and language barriers, they’re making heart health accessible to all. This grassroots initiative is helping people “know their numbers” and take action early. Read more on West Yorkshire ICB’s website.

Led by Bradford District Care NHS Foundation Trust, the Proactive Care Team (PACT) works in collaboration with Bradford Teaching Hospitals NHS Foundation Trust, Dementia UK, primary care and the voluntary care sector.

The team was set up to target health inequalities in the city’s most deprived areas, where healthy life expectancy is significantly lower. PACT provides short-term care and support to adults with complex needs to avoid unnecessary GP appointments, unplanned hospital admissions or A&E attendances.

Its coordinated approach acknowledges the interrelationship of mental and physical health, and its multidisciplinary team has 11 disciplines, including mental and physical health nurses, physiotherapists, occupational therapists, dietitians, Admiral nurses, and speech and language therapists.

To improve access to patients, the team works with GP practices to look at caseloads and engages with community groups, including faith groups, English classes, men’s mental health groups, community centres and health promotion days, with interpreters present.

Evaluation by Bradford Institute for Health Research showed the activity of the PACT significantly reduces A&E admissions, while unplanned hospital admissions were also lower. In recognition of its work, the PACT won The Excellence in Primary Care and Community Award at last year’s NHS Parliamentary Awards.

A second Proactive Care team will shortly be introduced in nearby Keighley, a town with similar levels of health inequalities, deprivation and poor healthy life expectancy.

PACT team leader Amanda Whitley said: “We believe PACT’s success comes from proactively seeking out patients who are over or underusing other health services, then carrying out one holistic, patient-centred assessment and creating one tailored and coordinated healthcare plan delivered by a mix of professionals in one community team.”

• Watch: What difference does PACT make?
• Watch: Feedback from users of the PACT service.

People with a learning disability die, on average, 24 years earlier than the general population, with nearly half of these deaths considered avoidable (LeDeR Annual Report, 2022). Respiratory disease remains one of the most common causes. The inequalities are even more stark for people from minority ethnic backgrounds where the average age of death is just 34 years (NHS Race & Health Observatory, 2023).

These figures highlight the urgent need for targeted, preventative action. In response, the learning disability team at Bradford District Care NHS Foundation Trust developed Keeping My Chest Healthy (KMCH), an initiative designed to reduce respiratory risks and improve health outcomes for people with a learning disability.

“Our goal was simple,” says Donna Smalley, Physiotherapy Professional Lead. “We wanted to shift the focus from reacting when people became unwell to promoting health and preventing respiratory illness.”

KMCH combines lived experience with clinical best practice to deliver an evidence-based, multidisciplinary respiratory pathway. The pathway includes the KMCH scoring tool to identify respiratory risks early and support timely, targeted interventions.

The project also features a co-produced, translatable digital hub which contains inclusive and accessible health information with short explainer videos (English and Urdu) and links to easy-read person-centred respiratory care plans.

The hub also includes a dedicated area for clinical professionals, offering CPD-accredited training and clinical tools to support safe, effective respiratory care for people with learning disabilities.

A local service evaluation measuring healthcare use in the 12 months before and after implementation of KMCH identified a notable reduction in unplanned respiratory-related healthcare use. Alongside the personal impact for people with learning disabilities and their families, the programme was associated with clinical benefits and suggests a more efficient use of NHS resources, including:

• 92% reduction in hospital bed days
• 76% fewer hospital admissions
• over 40% reductions in A&E attendances, antibiotic prescribing, and GP contacts.

KMCH is being piloted across four additional NHS services, with wider rollout underway across West Yorkshire.

Keeping My Chest Healthy was named Learning Disabilities Initiative of the Year at the 2024 HSJ Patient Safety Awards where judges commented on the “simplicity and impact” of the initiative in addressing “one of the leading causes of avoidable deaths for people with a learning disability.” They praised the project’s leadership, co-production with people with learning disabilities, and its potential for scalability, describing it as a “stand-out project” with the potential for “even greater impact.”

KMCH is a practical, scalable example of how co-production, prevention and digital innovation can come together to reduce health inequalities and improve care. The team welcomes interest from other areas keen to adopt or adapt the model.

The alcohol care team (ACT) at South Tees Hospitals NHS Foundation Trust is a group of specialists who support patients with alcohol recovery and substance abuse.

Comprising four qualified nurses and three recovery navigators, the ACT aims to reduce patient admissions to hospitals by providing specialist expertise and offering tailored support and advice. The team is based at The James Cook University Hospital and supports patients seven days a week.

Jessica Beck, alcohol care team co-ordinator, said: “We are here to make a difference to a cohort of vulnerable patients who are struggling in life with various addictions.”

Since launching two years ago, the alcohol care team has successfully assessed 3,013 patients. Among them is Teesside resident Mazar Khan, aged 55, who credits the ACT with saving his life, after 30 years of addiction. Read Mazar’s story and how, following recovery, he is encouraging others to quit what he calls the ‘worst addiction’.

Lifesaving work to help more pregnant women break free of tobacco dependency has resulted in a record low for rates of smoking when they give birth in the North East and North Cumbria.

Through its 10 Year Health Plan for England the government commits to work with businesses, employers, investors, local authorities and mayors to create a healthier country (see From sickness to prevention: power to make the healthy choice). Boosting the nation’s health will ensure future sustainability of the NHS and support economic growth, the plan makes clear.

One approach under this shift from ‘sickness to prevention’ is to join up support from across work, health and skills sectors to help people find and stay in work. In our region, Barnsley Council has worked with South Yorkshire Mayoral Combined Authority to explore how to help more people into work locally and regionally. The resulting Pathways to Work initiative recognised more of the borough’s residents were economically inactive than the national average, often due to ill-health, disabilities, caring responsibilities, or low qualifications.

To pave the way for inclusive access to work in Barnsley, the council and mayoral combined authority set up the Pathways to Work commission. Chaired by former cabinet minister and social mobility advocate Rt Hon Alan Milburn, the commission enlisted leading labour-market, skills and health experts to contribute their insights to the Pathways to Work report. This explores how to reduce economic inactivity, and help more people access work.

The report recognises that supporting more people who want to work brings wide-ranging benefits — improving lives, strengthening communities, supporting businesses, and boosting the economy. Among its key findings are

• Supporting everyone who wants to work will require national changes: a clear strategy to boost labour market participation, more local powers, and new expectations for employers. It means rethinking health, education, and benefits systems,

• One-to-one professional support is crucial. A personalised approach, based on trust and understanding, empowers people to overcome barriers and find the right opportunities,

• Working with businesses to develop training and roles can create more chances for people who have been out of work, while boosting skills and reducing recruitment risks for employers,

• Supporting people before they leave work will make the system more sustainable. This also helps young people stay in education, training, or employment after school.

Down2U Health and Wellbeing, Green Tree Therapy, and Barnsley Premier Leisure are delivering health and wellbeing services, including physiotherapy and solution-focused therapy, because good health is key to getting into work—and staying in it. Read more about the Pathways to Work commission and download its report at Barnsley 2030: Pathways to Work.

South Yorkshire ICB was at the forefront of testing green social prescribing, using nature-based activities to support mental and physical wellbeing—particularly among people experiencing health inequalities. As one of seven NHS England ‘test and learn’ pilot sites, the ICB played a key role in shaping how green social prescribing could be embedded into health and care systems nationally.

Green social prescribing connected individuals with outdoor activities such as walking groups, gardening, conservation work, and nature-based mindfulness. These interventions helped reduce anxiety, depression, and loneliness, while encouraging physical activity and stronger community connections. The approach supported early intervention and prevention, enabling people to manage their wellbeing before reaching crisis point and easing pressure on NHS services.

Delivered in partnership with local authorities, voluntary and community organisations, and academic institutions, the programme ensured activities were inclusive, accessible, and tailored to individual needs. Many participants were supported to access green spaces for the first time, helping to build confidence, resilience, and social connection.

By integrating nature into care pathways, these schemes demonstrated how the environment could be a powerful tool for prevention, recovery, and long-term health. One such initiative was Fisherman’s Friends. Watch the video here.

An estimated 300,000 people in West Yorkshire are living with undiagnosed high blood pressure—a major risk factor for stroke and heart disease. Similarly, around 41,000 people may have undiagnosed type 2 diabetes, in addition to the 160,000 already diagnosed.

To address this, NHS West Yorkshire ICB partnered with local sports clubs and health organisations to launch the “Find Out How You Really Are” campaign. The initiative aims to raise awareness of hidden health risks—such as high blood pressure, irregular pulse, and type 2 diabetes—and empower people to take control of their health through early detection and lifestyle changes. Free health checks were offered at community events and sports venues, alongside online tools to help people assess their risk.

Steve, a lifelong rugby fan, discovered he had dangerously high blood pressure during a matchday health check. With no symptoms, the diagnosis came as a shock—but it may have saved his life. Since then, he’s made small but meaningful changes and now encourages others to “find out how you really are” before it’s too late. Watch Steve’s story here.

An award-winning lung cancer screening programme, delivered in partnership with InHealth, provides lung health checks to patients across the Tees Valley. The programme invites people aged 55 to 74 who smoke, or used to smoke, for a free lung health check within their community. The Tees Valley programme has delivered notable improvements in the early detection of lung cancer. As a result, higher numbers of patients are going on to have curative lung cancer surgery and treatment.

Prior to the introduction of lung cancer screening, 80% of lung cancers were diagnosed at stages 3 & 4, the programme has changed this and 80% of lung cancers are now diagnosed at stages 1& 2, making this cancer more survivable and improving outcomes for patients.

In just over two and a half years the programme has sent out 65,151 invites, 40,251 lung health checks and fully reported 24,590 CT scans. It covers 78% of the eligible population, with plans to cover the remaining 22% in the next six months. So far, the programme has identified 298 lung cancers and 41 other cancers (April 2025). The programme also actively considers health inequalities; recently delivering lung cancer screening within a local prison, and plans are in development to reach homeless patients and those in long-term mental health facilities.

For more information visit the Northern Cancer Alliance website.

As part of the shift to prevention and community-based care set out in the NHS 10-Year Health Plan, NHS North East and North Cumbria Integrated Care Board (ICB) is already putting national priorities into practice.

In early 2024, the ICB launched a pilot introducing self-check blood pressure kiosks across Hartlepool, Middlesbrough and North Tyneside. Located in trusted spaces such as community centres and local hubs, the kiosks make it quicker, easier and more accessible for people to check their blood pressure outside of traditional healthcare settings.

Supported by trained Community Champions and free returnable home monitors, this innovative initiative is designed to detect high blood pressure early – reducing the risk of heart disease, stroke and other serious conditions before they develop. The pilot reflects the NHS 10-Year Health Plan’s core ambition to shift the focus from treatment to prevention, empowering people to take a more active role in managing their health.

By embedding prevention into everyday settings and reaching people where they live and work, the ICB is showing how the NHS’s long-term vision can be delivered through practical, inclusive, community-focused care.

The 10 Year Health Plan commits to increasing uptake of human papillomavirus (HPV) vaccinations among young people who have left school, to support our ultimate aim to eliminate cervical cancer by 2040.

Northumbria Healthcare NHS Foundation Trust’s school-age immunisation service delivers all school-age vaccinations across Northumberland, North Tyneside, Gateshead, and Newcastle.

In 2022, a pilot was carried out in Newcastle upon Tyne to target unvaccinated individuals. This included a poster campaign with one QR code that would take families straight to the electronic consent page and another to take them through to the UKHSA health education publication. This was sent to all schools, 0-19 services and GP practices.

All schools had a named nurse who supported with information sharing and vaccination sessions. Using GDPR legislation, all schools were asked for their class lists with contact telephone numbers to ascertain pupils who had not submitted a consent form. The NHS No-Reply text messaging service was then used to target these families directly. The wording of the text highlighted that the vaccine was free, responding to awareness that some communities may have lower awareness of free preventative healthcare in the UK. The pilot resulted in an additional 1,569 young people being successfully vaccinated.

This strategy was then mirrored in other areas, and has since developed further to include the development of a suite of information videos targeted at young people and schools, community engagement to understand different factors affecting uptake, for example, working with Jewish community leaders in Gateshead, and partnership working with Amber’s Legacy, a charity in the region, to further raise awareness.

More information on the team’s approach is available in this case study.

Tasked with delivering sustainable improvements in the health and wellbeing of fishermen and their families, SeaFit is a joint initiative of Humber Teaching NHS Foundation Trust, the Seafarers Hospital Society and The Fishermen’s Mission. Richard Beecroft is the project’s Health and Improvement Practitioner, working from a mobile consultation unit which makes scheduled stops at harbours along the Yorkshire and North East coast, from Withernsea to Hartlepool.

Speaking at his latest harbourside location, Richard explained how SeaFit reaches out to fishermen and women and their families, with a patients ranging from children to retirees.

“Bridlington is a significant port for crab and lobster fishing so there are about 74 vessels going out from here alone – each vessels has around three fishermen, so you’re looking at nearly 200 fishermen who could access the SeaFit service. Although not all of them will engage, over the past seven or eight years I’ve probably seen 150 of them, whether to provide a general health check, a wellbeing session or address a specific healthcare need.

“We reach out by being present at the harbour, having an open door policy at the consultation unit and talking to fishermen as they’re landing their catches. Through their busy lifestyle they can be quite isolated, find it difficult to attend medical appointments and so it takes time to build a rapport. We have evidence  our flexible drop-in service helps to tackle these difficulties.

“As a group, fishermen are self-employed and if there are no crabs or lobsters that day they don’t get any income. They’ve got a boat to run and have responsibilities linked to agencies like the Marine and Coastguard Agency. All these factors mean mental health support is a key part of our service. Simply by asking how someone is feeling can prompt them to open up about their feelings in a private and confidential setting. After speaking with one fisherman, for example, I referred him to an NHS Talking Therapies service which offered him eight sessions.

“It’s highly rewarding to support people’s health and wellbeing and prevent a symptom like raised blood pressure from developing into a stroke or heart attack, or identifying that someone’s blood sugar level is elevated and advising them how through changes to their diet and activity levels they can prevent type 2 diabetes.”

In this video, Health and Improvement Practitioner Richard Beecroft explains some of the health challenges faced by the fishing community and the wide range of healthcare and wellbeing support offered through SeaFit programme.

As part of a targeted initiative to improve hypertension case finding, 14 community pharmacies across South Yorkshire delivered outreach sessions between August 2024 and January 2025. Funded by NHS South Yorkshire ICB, the project aimed to increase access to blood pressure checks—particularly in underserved communities—by supporting pharmacies to deliver off-site sessions and purchase additional ABPM (ambulatory blood pressure monitoring) devices. Outreach sessions were delivered in community settings including mosques, markets, food banks and local hubs.

Key outcomes:

• 947 patients were seen across 43 outreach sessions, with 23% found to have high blood pressure.
• 30% of those with high BP were booked for ABPM—nearly double the usual conversion rate.
• Pharmacies built new relationships with community venues, faith centres, and VCSE partners.
• Outreach helped reach people who rarely visit GPs, offering lifestyle advice and early detection.

The Infant Feeding Team is part of Humber Teaching NHS Foundation Trust’s 0-19 Service which includes health visitors, school nurses, health and development practitioners and nursing associates. The 0-19 service is universal and accessible to every family in the Hull area. The infant feeding team has three dedicated staff who can offer specialist support with breastfeeding in the home.

Infant Feeding Coordinator Debbie Jackson and Infant Feeding Lead Ellie Talbot-Imber explain the benefits for mothers and their babies of breastfeeding.

“Hull’s health visiting service offers two antenatal visits to expectant parents, allowing time to offer in-depth discussion and guidance on becoming a parent, health, infant development including brain growth, mother and baby attachment, and infant feeding choices. Having time for discussion with a trained professional on how to feed your baby is key, and knowing there is specialist support readily available from the 0-19 team, as well as in the hospital and in Family Hubs, can reduce any anxiety parents to-be may have. We offer home visits and because we’re dedicated to infant feeding we can see them the same or next day following a referral. When you are a new parent and worried about or experiencing problems with feeding it is vital you receive support and advice as quickly as possible.

“We see babies in their early weeks and months of life, offering one-to-one support with breastfeeding. We also see women antenatally to give extra support and information should this be needed. We stay involved with families until they’re confident and have met their breastfeeding goals. At the same time we work hard to ensure the wider support systems such as Family Hubs, GP surgeries and walk-in centres can identify feeding issues and know how to support or refer to our team. For GP surgeries we have offered training to staff on common issues with breastfeeding, how to support, and our referral pathway. This can help to reduce some GP appointments or calls to surgeries as support can be offered in the home by our team.

“There are so many benefits to breastfeeding for babies and mums and they start from day one. If you look at the targeted health issues within the NHS plan such as respiratory infections, heart disease, cancer, obesity, diabetes, and mental health – breastfeeding can help to reduce the risk of all those things when it’s going well and is sustained. In addition, it helps in the development of baby brains, reduction of gastro-intestinal disease and significantly reduces the risk of sudden infant death syndrome (SIDS). Breastfeeding helps develop a healthy microbiome, with metabolism, fat storage and satiety, so breastfed babies tend to be leaner and less likely to be obese. Not only that, it helps with the body’s uptake of vaccinations as mothers pass on their immunities through breastfeeding. The action of breastfeeding also helps the development of jaw muscles in readiness for speech development. There are so many benefits which is why it’s key families receive all this information when thinking about how they want to feed their baby, and they are supported to breastfeed.

“We encourage mums to breastfeed for as long as they want – ideally, as the World Health Organisation recommends, exclusively for six months, and then alongside solid foods, for up to two years and beyond to obtain the full benefits. We’re respectful of parents’ feeding choices and share evidence-based scientific information and reassure them there is a wealth of support. This often changes people’s perspectives on breastfeeding.

“We work hard on support for women when they are out and about, together with public perception and support. We have two large tents that can be taken to public events. These have been decorated by local schoolchildren and have comfortable seating, so women can see there will be somewhere to go and breastfeed in private, and they serve as a flagship that breastfeeding is encouraged and welcomed in Hull. The tents are part of an integrated approach which includes more than 130 breastfeeding friendly premises which welcome breastfeeding mums and where staff have had appropriate training, and the Hull Milk Trail – a fun free activity for families in the city.

“Both of Humber’s 0-19 services (Hull and East Riding) are accredited with UNICEF’S Baby Friendly Gold Award, which signifies a service which consistently delivers high standards in supporting breastfeeding and parent-infant relationships. When Hull began its UNICEF Baby Friendly journey in 2008, it was predominantly a formula-fed city, with only 6% of babies receiving any breast milk at six weeks. The breastfeeding figures have continued to increase through the levels accreditation. In 2024 when we achieved Gold accreditation, our highest rate of breastfeeding for babies at six weeks was 48.3%, this is huge and means nearly half of the babies in Hull are receiving all the wonderful benefits of breastfeeding.”

The team has receive some wonderful feedback from mums they have supported:

• ‘It has been very helpful and supportive. I have been getting calls and face-to face-meetings with advice to feeding my baby and how to tackle problems which really helped and resolved all the issues,’
• ‘Staff are knowledgeable and experienced,’
• ‘I’ve had great experiences with all the breastfeeding supporters I’ve come into contact with.’