REFERRAL PATHWAYS BSOL NDPP: GP refers via provider referral form embedded across all clinical systems; choice of referral form or invitation letter (with NHS number, blood test reading and date) for self-registration via phone/online. Patient information leaflet shared. Automated searches developed with IT colleagues to identify eligible patients. Opportunistic case finding via NHS Health Checks. ICB supports provider engagement with PCNs, localities, GP and NHS Health Check providers via collaborative pathway development, NHS Healthcheck templates with READ codes, regular lunch-and-learn webinars, GP bulletin comms, and review of automated searches.

REFERRAL PATHWAYS BSOL T2DR: Embedded referral forms in clinical systems; only clinician or dietician (signed by GP) can refer; medication review completed by referrer. Practices encouraged to run clinical system searches and inform eligible patients; alternatives are annual diabetes reviews or upon diagnosis.

REFERRAL PATHWAYS BSOL BSOP: Provider referral form embedded in clinical systems across BSol. INCENTIVES: No local incentive scheme for NDPP, T2DR or BSOP in BSol.

REFERRAL PATHWAYS BLACK COUNTRY: Place-based integration with Dudley, Sandwell, Walsall and Wolverhampton partnerships and PCNs; align F2F site locations with local demand, travel corridors and community hubs using ICB place leads and population health datasets. Activity/outcome reporting at place and ICB level; monitoring of uptake/completion/attrition by deprivation quintile, ethnicity, age and sex. STAKEHOLDERS: BSol project leads; service providers; public health; comms/engagement; NHSEI; primary care medical directors and PCN clinical directors; place-based leads and Directors of Public Health (Dudley, Sandwell, Walsall, Wolverhampton); Black Country acute and community trusts; specialist diabetes teams; LAs and adult social care; VCSE and Black Country Anchor Network; community pharmacy; Healthwatch; LTC Commissioning, Elective and Diagnostic Commissioning, and Primary Care Commissioning teams.

KEY LANGUAGES BSOL: Urdu, Punjabi, Bengali, Arabic, Romanian, Polish and Gujarati. Also consider Black African/Caribbean languages: Somali, Amharic, Tigrinya, Yoruba, Igbo, Twi, Arabic and French.

HEALTH LITERACY: Over 56% of Birmingham residents aged 16-64 estimated to be below the threshold for low health literacy (over 641,000 people). DIVERSITY: Birmingham has 100+ languages; some wards up to 80% from minority ethnic groups. 40% of Birmingham population under 25; Solihull older with 21% over 65 (projected 25% by 2033). Birmingham is a 'City of Sanctuary' with large LGBT population and welcoming refugees. Solihull ~216,000 residents with 3.5% from ethnic backgrounds (up from 2.1%). CORE20 (BSOL): Approx 50% of population in BSol ICS falls within national Core20; deprivation highly concentrated in Birmingham (94% of ICS most deprived areas) vs Solihull (6%); Birmingham ranked 2nd most deprived LA in England.

BLACK COUNTRY: Population ~1.34m; over 40% of GP practices in most deprived national quintile; higher than national prevalence of obesity, T2D, CVD and multimorbidity; earlier onset of metabolic disease in deprived/diverse communities; significant ethnic diversity in Sandwell, Walsall and Wolverhampton.

PRIORITY GROUPS: Older people (esp. living alone, low income, non-decent housing); digitally excluded (older people, deprived, recent migrants, people with LD) - require non-digital and F2F options; Eastern European communities (translated digital content, out-of-hours sessions); Black African/Caribbean and minority groups (culturally competent messaging, faith and community engagement); people with LD and SMI registered across all four places (concentrated in deprived urban areas); limited English proficiency/low digital literacy (telephone booking, F2F, VCSE outreach).