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Following the Government’s announcement of a new NHS funding settlement, NHS England’s Director for Experience, Participation and Equalities and SRO for the Prevention, Personal Responsibility and Health Inequalities work stream of the NHS Long Term Plan, highlights how we can address health inequalities and some of the critical opportunities and challenges:
Health inequalities are deep and persistent.
Healthy life expectancy at birth varies from 52 for the most deprived areas, to 70 for the least deprived.
On average, people in disadvantaged areas have multiple long-term conditions 10 – 15 years earlier than those in better off neighbourhoods and over half of the equality gap is from deaths from heart disease, stroke and cancers.
The NHS can’t resolve inequality on its own, but it is believed that 20% of health inequalities relate directly to health service provision and there is more we can do to prevent or delay ill health and treat people quicker.
I was delighted to be asked to be one of the leads for this part of the new NHS Plan, and in recent weeks I have been listening to a lot of patients, carers, clinicians and managers who have shared invaluable insights and advice.
It’s clear that some of the big killers have common causes, notably smoking, alcohol and diet. Some of the most significant gains, therefore, stand to be made by helping people give up smoking, cut back on alcohol and improve their diet and exercise.
I saw this in action yesterday when I visited a hub in Warrington, which had GP practices in the same building as a leisure centre, public library and community facilities. Family doctors there prescribe people with mild depression with swimming, yoga or reading groups, which are often much more effective than pills. The use of this kind of social prescribing, supported by local Voluntary and Community organisations, is especially effective for people with more than one condition and will be a significant part of the new NHS plan.
We also need to make sure that our NHS is genuinely there for all of us. That means we need to understand the perspectives of people who have been excluded from healthcare.
Over recent weeks we have held a series of workshops with patients, carers and voluntary organisations representing these communities, who have shared their experiences and helped us to identify solutions. As my colleagues look to improve cancer diagnosis or prevent diabetes, we have been looking to see how these programmes will be adapted to suit the needs of different groups. Diabetes is more common among South Asians, for example, and people from Black and other Ethnic Minorities are often diagnosed with cancer late. The NHS needs to match service to need.
As well as clinical interventions, there is also a major role for the NHS to play in local communities. One in five jobs in Middlesbrough is in the health sector compared with just 6% of jobs in London. We are exploring how NHS organisations can widen opportunities in their communities by giving people more routes into employment, apprenticeships and volunteering, which can be used to develop skills.
It’s been striking how pleased people have been that health inequalities will be a core part of the new NHS long term plan. However, we can only make the best of the opportunity if we have the right insight and ideas.
You can see the kind of questions we are asking in this discussion guide, and there is still time to make your voice heard. Take a moment to share your views and help us make the NHS the best it can be at reducing inequality and providing excellent care for all.