The NHS Long Term Plan places tackling health inequalities at the heart of the NHS’s goals for this decade.
In line with this, the Core20PLUS5 approach to handling healthcare inequalities brings into focus the most deprived 20 percent of the population, along with five clinical areas of focus which “require accelerated improvement” – maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension case-finding along with optimal management.
In addition, we’ve seen learnings from the COVID-19 pandemic relating to inequalities in health leading to the development of the Healthcare Inequalities Improvement Dashboard, which focuses on the need for good quality data in tackling healthcare inequalities.
But what actions are being taken or planned by ICSs to help improve inequality in healthcare?
Last week, Greater Manchester Integrated Care Partnership published a five-year plan aiming to improve access to primary care services, with the ICS’s director of primary care Rob Bellingham stating that the “primary care blueprint will help us respond to both a growing and ageing population and an increase in demand for our care… This plan aims to address some of the immediate pressures facing our workforce and make primary care a more attractive place to work.”
The plan highlights the Health and Care Intelligence Hub, part of the ICS’s ‘Fairer Health for All’ approach to population health. The hub hosts a range of intelligence tools and aims to consolidate date from across the region into a single portal to support public and voluntary sector partners to better understand data, capture insight from different communities, share learnings, and ensure that resources are targeted where they are most needed.
The hub will “curate intelligence about variation in access, experience and outcomes of care for inclusion health groups”, the plan notes, along with “modifiable causes of health inequalities and prevention pathways in primary care” and “social, economic and environmental impact of primary care providers”.
The plan also commits to “create the conditions for diverse leadership, workforce and talent to flourish”, including developing cross-sectoral communities of practice to share learnings on how inequalities are being tackled.
The Fairer for All fellowship programme will take on 20 fellows per year from primary care, and the ICS also pledges to develop a multimodal approach for primary care, simplifying points of access and working with communities to co-design and co-deliver an engagement plan.
In addition, the ICS will develop a strategic workforce plan “that aligns to the health needs of communities (interest, identity and geography) that is adequately resourced for inclusive recruitment, retention and workforce development”. Locality boards are also to co-produce an inequality reduction plan along with local GP/primary care boards.
In Dorset, Dorset ICS’s Cancer Programme, along with Wessex Cancer Alliance and Health Innovation Wessex have launched a pilot with digital system ‘C the Signs’, with the aim of improving cancer survival and tacking inequalities.
The C the Signs system will be used in GP practices across the region to help improve early identification of cancer. Using artificial intelligence, the system is designed to help support healthcare professionals to identify the earliest signs, symptoms and risk factors for cancer.
Dr Simon Wright, C the Signs clinical lead and GP fellow, says that the system “has the potential to really help GPs and their primary care teams in all aspects of patients’ cancer journeys. This includes detection, referral, and post diagnosis monitoring, as well as assisting with monitoring the return of diagnostic tests such as the faecal immunochemical test (a stool test that can identify patients who are a higher risk of colorectal cancer). The decision support tool assists in those cases where the correct pathway might not be so clear and will help ensure patients are referred on the right pathway at the right time.”
Early detection “offers the best chance of survival,” the ICS states, “with over 90 percent of patients surviving colorectal cancer for five years or more if detected early, compared to less than 10 percent surviving to five years following a late diagnosis.”
North East London
In North East London, a digital tool is being rolled out to help people using maternity services in the region to “play a greater role in their care”.
It is hoped that CardMedic, an app which can translate clinical conversations into different languages and formats, will help make care more personalised and improve communication.
The ICS highlights that the app can be used for different languages, including British Sign Language, as well as offering an ‘Easy Read’ mode for children or people with learning disabilities. It is hoped that this will “encourage uptake in maternity services to address the healthcare inequalities that exist in parts of NEL”.
South West London
Elsewhere in the capital, the launch of the South West London Investment Fund looks to make funding available for projects to benefit local people.
Last year, 80 projects with a focus on tackling health inequalities were awarded funding, including Battersea Youth Minds, a new pharmacy scheme to help older people stay fit for winter, and a scheme to help people experiencing homelessness access support online.
Applications for this round of funding will also focus on tackling health inequalities, and are open until midnight on the 10 November 2023.
In other news around tackling health inequalities, a new partnership is seeking to improve health outcomes for social housing residents in Black Country, bringing together the health and housing sectors with the aim of “exploring ways to best serve the needs of some of the most disadvantaged in society”.
In wider news, we recently took a look at what is happening in mental health across the NHS, considering the Major Conditions Strategy and the commitments made within the NHS Long Term Plan.