CDE Appendix 1 Literature Review - Central East Local Health ...

The Culture, Diversity and Equity Project: Literature Review
Box 4.6: The London Health Observatory
The London Health Observatory (LHO) is part of a network of twelve public health observatories (PHOs) across the UK and
Ireland that together form the Association of Public Health Observatories (for further information on the LHO and APHO network
and its work see http://www.lho.org.uk/Default.aspx and www.apho.org.uk respectively).The LHO works closely with the Public
Health Directorate of NHS London (the regional Strategic Health Authority), as well as other local authorities and bodies,
including Primary Care Trusts, the Greater London Council, researchers/research institutions, and national agencies.
As the national lead among UK’s PHOs in monitoring health inequalities, ethnicity and health, the LHO provides NHS London,
and others, with critical up-to-date information, data and intelligence on the health and heath care of London’s 7.8million citizens.
Such intelligence includes information on a wider variety of determinants of health and health inequality which assists NHS
London (and others) with commissioning and policy decisions. The LHO also runs training programmes in health intelligence
training and capacity-building programmes for health practitioners in London.
As a hosted organisation within NHS London, the LHO also benefits from NHS London’s core services including facilities, human
resources and training opportunities, and is governed by its policies on these and other areas. NHS London has the responsibility
for ensuring that the LHO complies with its legal equality duties.
Sources: NHS London, 2007; and http://www.lho.org.uk/Default.aspx [Retrieved 02/09/09])
Partnerships with research institutions (e.g. Wellesley Institute Health Equity Roundtable) and other governmental
and arms-length research bodies (e.g. MOHLTC Health Equity Unit, Ontario Health Quality Council, CIHR, etc.)
are another crucial means of building research capacity in the service of heightening service quality and
accountability (Exworthy et al., 2006; WHO, 2008; Gardner, 2008a; Rachlis, 2007; Raphael & Bryant, 2006).
Target Setting
The development of performance indicators in relation to policy initiatives and strategic objectives also needs to be
accompanied by the development of concrete performance targets which should include not only process measures
but also, importantly, outcome measures (Gardner, 2008a; Mackenbach et al., 2002b). Developing appropriate
methods of measuring progress against targets must be an integral component of any such target setting exercise
(ibid.).
Judge and Mackenzie (2002), more specifically, warn against the politically motivated tendency to set unrealistic,
aspirational goals and targets that ‘promise to change the world before the next election.’ Instead they recommend
that targets be set only “in terms of the genuinely expected consequences of well specified interventions”, even if
these look “very modest and rather piecemeal to politicians” (p.310; see also Gardner, 2008a). Persons involved in
target setting should clearly articulate the specific “pathways of expected change” by which strategic interventions
are expected to help realize policy targets (ibid.; also see Exworthy et al., 2006).
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