• Opportunities to share positive and negative experiences of care
• Information on rights under the Accessible Information Standard
• Stories from 6,200 people about their experiences of healthcare information
• Healthwatch's findings around whether NHS organisations are meeting the Accessible Information Standard
• Recommendations on how to fix the issues.

1. Teach back
2. Chunk and check
3. Use simple language
4. Use pictures
5. Routinely offer help with paperwork

It also includes information and training on these topics:

• Access to healthcare
• Communication strategies
• Encouraging patient questions
• Informed consent
• Long term conditions
• Medicine Management
• Self-management

• Inequalities in age-standardised mortality rates
• International life expectancy at birth by sex
• Proportion of population reporting good health by age and deprivation
• Life expectancy and healthy life expectancy at birth by deprivation
• Map of healthy life expectancy at birth
• Local healthy life expectancy at birth by region and sex
• Cohort survival curves

In the survey of GP practices, ethnic minority-led practices were more likely to report that GPs in their practice experienced adverse impacts on their physical and mental health, a negative impact on their personal and/or family life, and had seen an increase in staff sickness as a result of the inspection process.

However, in this survey, ethnic minority-led practices were more likely to report that the quality of care improved following a CQC inspection.

Most ethnic minority-led practices in the GP practice survey served populations with a high proportion of socio-economic deprivation. Both GPs and CQC colleagues identified socio-economic deprivation as a challenging factor, as it can affect the practices’ ability to achieve national targets that we use in assessments of quality, such as the uptake of immunisations or screening among patients. Some inspectors and specialist advisors felt our approach did not recognise enough the surrounding context of practices, and that some practices are disadvantaged for not achieving similar outcomes to those with very different contexts and patient communities.

A few months ago, a friend of mine began to experience some worrying symptoms; he was diagnosed by his GP with anxiety and depression, and prescribed antidepressants. Like around half of the UK population,[1] my friend identifies with a faith tradition, and when he felt hesitant about taking the medication he’d been prescribed, his first port of call was to talk to a faith leader he trusted, who listened to his concerns and encouraged him to pursue the treatment he had been prescribed by his doctor. My friend did feel able to begin his treatment, and is doing much better.

Supporting people through treatment is just one of the ways that faith communities facilitate patient safety. Here are three reasons why faith groups play an important role in the health of their communities:

1.   Faith can reach to the heart of communities who struggle to access services

I was at a meeting last year where an NHS director said he thought the rollout of the Covid-19 vaccine would not have been such a success were it not for the involvement of faith groups.

Why? The willingness of so many mosques, churches, gurudwaras and temples countrywide to support messaging and open their doors as vaccine centres, meant healthcare crossed from the domain of waiting rooms and blue scrubs into spaces of commitment, familiarity and trust. People were able to begin having conversations about the efficacy and safety of vaccines in spaces that felt safe to them.

The vaccine rollout is an example of just one area in which faith groups have been employed as trusted messengers within communities. The reality is, there are population groups in England who, for one reason or another, are insulated from much health messaging. It’s not that they are ignoring or misunderstanding the messages, they are simply not getting them. To give just one example, a faith organisation I know runs a befriending scheme in a deprived part of East London. I was talking to one of the organisers last October and she told me that she had just been explaining how to take a lateral flow test to a local couple. It was the first time this couple had seen or heard of these tests. For whatever reason, they hadn’t been able to access government and NHS messaging about rapid testing - but they had accessed this faith-based support group, and that made the difference.

It is often said that no one is “hard to reach”, we just aren’t finding the right ways to reach them. Given the success of using faith centres in the Covid-19 vaccine rollout, what would be the potential in forging partnerships around such things as cancer screening or pregnancy and antenatal care, areas where huge health inequalities persist?

2.   There is a link between faith groups and health inequalities

Whilst it may be difficult to say a lot about the health inequalities that people of faith experience (very little data is routinely collected around faith and health) there are clues that indicate a link between faith and health outcomes.

For example, the correlation between poverty and health inequality is well documented, and, after accounting for ethnicity, certain religions are at higher risk of experiencing poverty.[2] Just under half (46%) of the Muslim population, for example, live in the 10% most deprived, and 1.7% in the least deprived, Local Authority Districts in England.[3] Sikhs are also shown to be at greater risk of poverty than people from other faith traditions.[4]

The pandemic has highlighted these trends, with ONS data demonstrating disproportionality in Covid-19 outcomes not just according to ethnicity but also faith, in part owing to socio-economic factors.[5]

What can we conclude? If there are meaningful links between faith and inequality, then part of the way to tackle inequality must surely be to involve faith organisations. Faith organisations’ assets for health promotion (things like space, transport, time and willing volunteers) mean they are ideal places to run interventions and be involved in prevention initiatives. As we’ve seen, where this approach has been adopted in the pandemic it has been effective, suggesting the potential for more targeted work going forward.

3.   Faith groups are often ‘first in and last out’ at the point of need

Last year I was involved in surveying over 100 FaithAction members to build a picture of what work they had been doing in support of the NHS during the pandemic.

I expected to discover a long list of activities (my conversations with faith groups this past year has left me in no doubt that they have been very busy). What I wasn’t expecting was that much of this activity was already well underway even before the pandemic hit.

To give a few examples, over a third of the organisations surveyed were already helping patients with telephone or digital consultations before the pandemic. Just over 32% were already helping people make contact with health and care organisations, and 36% were providing transport to and from appointments.

What this indicates is that when GP consultations became primarily digital in April 2020 these charities were already poised to help their beneficiaries connect. The survey also revealed faith groups delivering food and medication, offering support with mental health, supplying PPE and tackling misinformation.

That faith-based organisations are “first in and last out” where need arises is a bit of a catchphrase at FaithAction. And yet it rings true, never more so than during the pandemic. We’ve witnessed faith-based organisations up and down the country respond with characteristic compassion, agility and innovation. And they continue to respond, even against a backdrop of funding shortages, limited resources and disruptions to normal activity and worship practices.

You could say that the role of faith-based organisations during the pandemic has been something of a microcosm for the kind of cross-sector partnerships that might be built across the wider health and care landscape looking ahead. I think it shows the potential for a kind of creative thinking that seeks to strengthen partnerships across sectors for the benefit of our diverse communities.

References

1 J Curtice, E Clery, J Perry et al. British Social Attitudes: The 36th Report. The National Centre for Social Research, 2019
2 M Marmot, J Allen, P Goldblatt et al. Fair Society, Healthy Lives – The Marmot Review: Strategic review of health inequalities in England post-2010. Institute of Health Equity, 2010;p38
3 Beckford, J. Review of the Evidence Base on Faith Communities. Office of the Deputy Prime Minister, 2006. Accessed 25 June 2021
4 Reducing poverty in the UK: A collection of evidence reviews. Joseph Rowntree Foundation, 2014. Accessed 25 June 2021
5 Rates of deaths involving COVID-19 by religious group, England and Wales. Office for National Statistics website. Last accessed 18 January 2022

• 47% of Black, Asian and ethnic minority patients and 43% of white patients were referred to rheumatology services within three working days of presenting (Quality statement 1)
• 43% of Black, Asian and ethnic minority patients and 42% of white patients were assessed within three weeks of referral 2013 version of QS33 (Quality statement 2)
• A higher proportion of Black, Asian and ethnic minority patients (60%) received timely treatment compared to white patients (57%) (Quality statement 2)
• A high proportion of both groups of patients were provided with disease-related education (93% of Black, Asian and ethnic minority patients and 94% of white patients) (Quality statement 3)
• A high proportion of both groups of patients were able to access care in case of emergencies (91% of Black, Asian and ethnic minority patients and 93% of white patients) (Quality statement 4)
• 34% of Black, Asian and ethnic minority patients and 46% of white patients received a formal annual review (Quality statement 5).

• Digital access and health literacy
• Communities
• Prevention
• Children and young people
• Data
• Waiting lists
• Care gap
• Status of MSK

• people living in ‘left behind’ neighbourhoods were 46% more likely to die from COVID-19 than those in the rest of England and 7% more likely to have died of the virus than those living in deprived non-LBN areas.
• in ‘left behind’ neighbourhoods men live 3.7 years fewer than average and women 3 years fewer. People in these neighbourhoods can both expect to live 7.5 fewer years in good health than their counterparts in the rest of England.
• people living in local authorities that contain ‘left behind’ neighbourhoods work more hours on average than those elsewhere in the country, at 36.9 hours a week, compared to 36.8 hours a week for those living in local authorities that contain deprived non-left-behind neighbourhoods.
• tackling the health inequalities facing local authorities with ‘left behind’ neighbourhoods and bringing them up to England’s average could add an extra £29.8bn to the country’s economy each year.

Please see link at the bottom of this page for the source of the graphic.

Related reading

• Health Education England's All Our Health: Health disparities and health inequalities (5 October 2022)
• NICE and health inequalities (October 2022)
• Caring for people and our planet: Dr Dominique Allwood on health inequalities and climate change (The King's Fund, 16 December 2022)
• RCPCH: Child health inequalities – a toolkit for paediatricians (September 2022)
• Centre for Mental Health - Briefing 58: Poverty, economic inequality and mental health (26 July 2022)