Menu of evidence-based interventions and approaches for addressing and reducing health inequalities

We know that the social and economic environment in which we are born, grow up, live, work and age, as well as the decisions we make for ourselves and our families collectively have a bigger impact on our health than healthcare alone.

These conditions are not fixed, but are amenable to change through interventions which address:

  • risk and protective factors such as smoking, diet and physical activity;
  • through addressing unwarranted variation in access, experience and outcomes from treatment and care in conditions such as cancer, mental health, cardio-vascular disease (CVD), respiratory disease and diabetes
  • the wider determinants of health including through the NHS as an ‘anchor institution’ – as an employer and procurer of services;
  • the gap in health access and outcomes experienced between the least and most deprived populations, and other population groups such as inclusion health and protected characteristic groups most likely to experience health inequalities, and as a key enabler, this will include levelling-up access to high quality primary and community care.

The NHS Long Term Plan (LTP) sets out specific ambitions for the NHS, through local planning and national programmes to take a ‘more concerted and systematic approach to reducing health inequalities’ In support of this ambition, NHS England, collaborating with Public Health England (PHE) and partners in the voluntary and community sector and local government, has worked to develop a ‘menu of evidence-based interventions for addressing health inequalities – (Menu). The Menu provides a catalogue of interventions that local healthcare systems and commissioners, working with partners across the system, can draw on to take effective action at neighbourhood, place and system-level to reduce health inequalities.

The Menu is being developed through a phased approach, which will run through the life of the NHS Long Term Plan.

Alongside developing the Menu, Public Health England (PHE), the Local Government Association (LGA) and the Association of Directors of Public Health have published complementary guidance to this work, entitled Place Based Approaches for Reducing Health Inequalities (PBA). The PBA focuses on how the system can work together through civic, service and community centred approaches to reduce health inequalities; the Menu identifies specific evidence-based interventions that can support this holistic approach. A summary of the PBA guidance and recommended approach is provided in the first part of the Menu.

The Menu will also enable NHS England NHS Improvement to identify where there are gaps in evidence and to further develop or commission work to fill these gaps.

Phase 1 of the Menu

Content and development process

Phase 1 has been published to help inform local system 2019/20 planning. Through these plans local areas will set out how they will specifically reduce health inequalities by 2023/24 and by 2028/29. Content has been provided by NHS England and Public Health England. Interventions:

  • relate specifically to priorities and commitments already signalled in the NHS LTP;
  • specifically address the gap in health access and outcomes experienced between the least and most deprived populations, and other population groups such as inclusion health and protected characteristic groups most likely to experience health inequalities, and as a key enabler, this will include levelling-up access to high quality primary and community care;
  • are identified by NHS England and PHE leads and subject experts as supported by a strong existing evidence-base;
  • enable local areas to identify the specific factors which are driving health inequalities in their area, including not just clinical risk, but behaviours and the underlying causes of health inequalities, also known as the wider determinants of health.

Phase 1 of the Menu was based on a rapid review with national programmes, of the current and available evidence-based interventions that will support you to begin to address health inequalities in your system plans. We aimed to capture as many interventions as possible, and the tabs below outline the current interventions gathered. However, we are also aware that there are many other interventions that you may be aware of which can form part of Phase 1. As phase 1 is developmental, please contact us and share information with us, and we will continue to upload additional interventions as we receive them and promote these through our LTP communications channels with you.

We are also keen to hear from you, as leaders of local healthcare systems, on how you can share models and interventions that your healthcare economy has been developing, which have a robust evidence base in addressing health inequalities.

We welcome your suggestions on key areas that you want additional information on and we can include your thoughts and comments into the current thinking and planning for the development of Phase 2 of the menu work.

Please contact us on england.ltphimenu@nhs.net.

Supporting commissioners to translate interventions into practice – ‘How to Guides’

Alongside the interventions, national programmes have been asked to provide a range of ‘how to’ implementation guidance to aid commissioners in translating evidence-based interventions into services, policies and approaches. These specifically relate to actions addressing health inequalities through delivery.

We will continue to update the webpages as we develop the menu and share the updates through our ongoing menu communications messages to the regions and the systems.

Menu hosted on the Academy for Population Health Management Hub

The Menu is also being hosted on the Population Health Management (PHM) Academy which was launched at NHS Expo 2019, as a joint offer to the systems on interventions for reducing health inequalities, as well as engaging with healthcare systems to share evidence-based approaches and interventions being developed locally, with us. This information and approach is helping us formulate the planning for Phase 2 of the Menu.

Webinars and support

The national equality and health inequalities unit, in partnership with Public Health England’s (PHE) national health inequalities unit will be hosting a range of support webinars for mid November. We will share webinar dates shortly.

For more information

If you want to contact us about this work, or you want to share evidence with us, please email the Menu planning team on: england.ltphimenu@nhs.net.