NHS Outcome Framework Indicators

The NHS Outcomes Framework, Indicators for Health Inequalities Assessment (DH, 2015) set out 11 indicators identified for health inequalities assessment which have been used to guide reporting in 2016/17 using data available on NHS Digital’s website. The data in this paper highlight health inequalities between the most deprived and least deprived areas by reference to the 11 indicators. Some indicators are disaggregated by ethnicity, sexual orientation and age.  These show where there may be change by reference to protected characteristics over time.

11 indicators

In order to report on health inequalities by area of deprivation, a slope index of inequality has been calculated for each of the 11 health inequalities indicators in the NHS Outcomes Framework. These are based on deprivation decile data (quintile data for infant mortality) published on the NHS Digital indicator portal.  For each year, a regression line has been calculated across indicator values for the deciles (or quintiles).  The gradient of this regression line, measured as the difference between the fitted values on the regression line for the most and least deprived areas, is the slope index of inequality (SII).  The bars in the charts below show the SII for each year.  A narrowing of the inequalities gap can be seen on these charts when the trend line moves towards 0.

The lines in the charts below show the relative index of inequality (RII) ratio.  This is the ratio between the highest value on the fitted regression line and the lowest. This is either the most deprived fitted value divided by the least deprived, or the least deprived fitted value divided by the most deprived (specified on the chart for each indicator), depending on whether higher indicator values represent better performance (as for e.g. life expectancy at 75) or lower indicator values represent better performance (as for e.g. cancer and CVD mortality). The closer the RII ratio is to 1 the smaller the relative inequality.