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Found 805 results
  1. Content Article
    England is the only country in the UK to still charge patients for prescriptions, with charges having been abolished in Wales and Scotland in 2007 and 2011, respectively. However, for patients in England, the cost is rising; in March 2023, the government announced an inflationary increase of 3.21%, bringing the prescription charge up to £9.65. And the number of people eligible to pay could increase, following government proposals to raise the upper age exemption for free prescriptions from 60 to 65 years. This article looks at the impact of prescription charges on health inequalities, particularly focusing on the impact of the cost of living crisis. The reporter speaks to pharmacists who regularly see patients making difficult choices about which prescriptions to collect, as well as highlighting research that suggests many patients with long term conditions are forgoing their medications as they cannot afford them.
  2. Content Article
    This BMJ article by journalist Andrew Kersley reports on a meeting of 157 medical experts and academics held at the Royal Society of Medicine on poverty and the cost-of-living crisis, which took place in May 2023. One academic at the event warned that the long term effect of ongoing economic inequality on life expectancy was worse than six unmitigated covid pandemics. The three solutions proposed at the meeting that received the most support were: a national strategy to tackle poverty the nationwide delivery of “more affordable, quality, secure social and rental housing” urgently increasing the rate of Universal Credit as well as removing the restrictions related to total benefits and multiple children.
  3. Content Article
    These newsletters on LinkedIn from Hemant Patel are dedicated to raising the issue of health inequalities and population health management.
  4. Content Article
    This report by The King's Fund is part of new research project that explores how NHS providers and integrated care systems (ICSs) are approaching inclusive recovery. It highlights that in 2022, people in the most deprived areas were twice as likely to be waiting more than a year for elective care compared to people in the least deprived areas. The report explores three big questions health and care leaders should be asking themselves and their teams about inequalities in their elective backlog:How are we measuring inequalities and whyDo we know why inequalities existHow will we know if things are improving?
  5. Content Article
    Recently, there has been a concerning increase in the number of deaths of pregnant women, especially from Black, Asian and deprived backgrounds. In addition, there have been several investigations into safety issues in maternity services, such as the Ockenden, East Kent, and Shrewsbury and Telford report. This National Institute for Health and Care Research (NIHR) Collection highlights evidence in priority areas, identified in the East Kent report, to support high-quality care and avoid safety issues in maternity services.
  6. Content Article
    In 2022 the charities Sands and Tommy’s came together to form a Joint Policy Unit. Together they are focussed on achieving policy change that will save more babies’ lives during pregnancy and the neonatal period and on tackling inequalities in loss, so that everyone can benefit from the best possible outcomes. This first report from the Unit brings together a range of evidence to identify the key changes needed to save more babies’ lives and reduce inequalities in pregnancy and baby loss. None of the individual data it contains is new, but it gives decision makers a clear view of where we are now, and where action is required to make progress.
  7. Content Article
    This guide aims to help health and social care workers provide dementia care, which corresponds to the needs and wishes of people from a wide range of ethnic groups, especially minority ethnic groups.
  8. Content Article
    Attention deficit hyperactivity disorder (ADHD) is a condition that affects people's behaviour. It has a wide range of symptoms and can affect both children and adults—people with ADHD may find it hard to focus on or complete tasks, feel restless or impatient, experience impulsiveness and find it hard to organise their time and their things.[1] ADHD can have devastating mental health implications and research studies have linked ADHD to increased suicide and mortality rates. This means that being unable to access effective treatment can be a patient safety risk for people with ADHD. In this blog, Lotty Tizzard, Patient Safety Learning’s Content and Engagement Manager, explores the state of ADHD diagnosis and treatment in the UK. She looks at why many are concerned about the waiting times for adults and children seeking an ADHD assessment and speaks to Elsa*, who was diagnosed with ADHD in her 30s, about her experiences. *Name changed
  9. Content Article
    Economist Dana Peterson estimates that the economic toll of racism against Black Americans was $16 trillion over the past two decades. Discriminatory lending, wage disparities and inequities in access to higher education, among other factors, have limited the Black community’s ability to generate personal wealth and economic growth. Other minority communities have had similar experiences, and the impact goes far beyond the economy; each of these factors also takes an enormous toll on the health and wellbeing of people of colour. This is the recording of a panel discussion hosted by Harvard T.H. Chan School of Public Health, in which economic, scientific and policy experts discuss how we can build a more equitable and healthier future for everyone.
  10. Content Article
    In this letter to The Lancet, Thomas Cueni, Director General of the International Federation of Pharmaceutical Manufacturers and Associations argues that the need to focus on equitable rollout of vaccines in the event of a future pandemic is a key global health priority. He proposes that Governments, pharma companies and other stakeholders should focus on the challenges that led to the inequitable rollout of vaccines, which he identifies as vaccine nationalism and need for more diverse manufacturing. He highlights an industry proposal for equitable response to future pandemics supported by vaccine manufacturers and biotechnologies. the proposal involves manufacturers setting aside a percentage of pandemic tools for allocation to susceptible populations in low-income countries.
  11. Content Article
    Health literacy, defined as an individual's ability to access, understand, and use health information to make informed decisions about their health and healthcare, plays a critical role in determining health outcomes. Wider determinants of health, on the other hand, refer to a range of social, economic, and environmental factors that influence an individual's health status. This article aims to explore the relationship between health literacy and the wider determinants of health, and how understanding this connection can contribute to more effective population health management and health equity.
  12. Content Article
    When something goes wrong in health or care, patients need to understand their rights to complain and seek resolution. The Equality Advisory Support Service Helpline (EASS) supports individuals who wish to achieve an informal resolution when they feel they have experienced discrimination or want to understand their human rights. This article, written by the EASS for The Patients Association, explains an individual's rights under the Equality Act 2010 and what to do if you believe they’ve been violated.
  13. News Article
    Current models of maternity care in the UK are failing to reach pregnant women living in adverse social circumstances, research commissioned by the Royal College of Obstetricians and Gynaecologists has found. Georgina Jones, one of the report’s authors and professor of health psychology at Leeds Beckett University, told The BMJ, “Women are often living in a tangled web of complex inequalities that is beyond their control, and this impacts on the care they receive and the outcomes of that care . . .We’ve really been letting down these women in the way that our maternity and reproductive health services are currently delivered, and strategies and care pathways need to be identified and put in place to remedy this.” A number of recommendations have been made in the paper including: Understanding it is the vulnerable, minoritised and disadvantaged women in society that have an increased risk of maternal death. These women are often living in an entangled web of complex inequalities that is beyond their control, which impacts on the care they receive and the outcomes of that care. Strategies and care pathways need to be identified and put in place to improve their situation. These women have been let down in the way that our maternity and reproductive health services are currently delivered. We need to find a better way of recording social determinant data. The current way of doing this is inadequate and not fit for purpose, and it doesn’t provide us with enough information to really understand how the complex circumstances of the woman impacts on her maternal outcomes. The research shows current models of care are still failing pregnant women who have lived in adverse social circumstances prior to, during and after pregnancy. Maternal outcomes are particularly poor for socially disadvantaged women affected by pre-existing physical or mental health problems; those who misuse substances; those who have a lower level of education; those who are overweight, undernourished or poorly sheltered; and those who are at increased risk due to the threat of abusive and unsupportive partners, families and peers. Read full story (paywalled) Source: BMJ, 10 February 2022
  14. News Article
    Radical action is needed urgently to tackle “overwhelming” minority ethnic health inequalities in the NHS, leading experts have said, after a damning study found the “vast” and “widespread” inequity in every aspect of healthcare it reviewed was harming the health of millions of patients. Racism, racial discrimination, barriers to accessing healthcare and woeful ethnicity data collection have “negatively impacted” the health of black, Asian and minority ethnic people in England for years, according to the review, commissioned by the NHS Race and Health Observatory, which reveals the true scale of health inequalities faced by ethnic minorities for the first time. “Ethnic inequalities in health outcomes are evident at every stage throughout the life course, from birth to death,” says the review, the largest of its kind. Yet despite “clear”, “convincing” and “persistent” evidence that ethnic minorities are being failed, and repeated pledges of action, no “significant change” has yet been made in the NHS, it adds. From mental health to maternity care, the sweeping review led by the University of Manchester paints a devastating picture of a healthcare system still failing minority ethnic patients despite concerns previously raised about the harm being caused. “By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system,” said Habib Naqvi, the director of the NHS Race and Health Observatory, an independent body established by the NHS in 2020 to investigate health inequalities in England. Read full story Source: The Guardian, 13 February 2022
  15. News Article
    Research shows black women are at a 40% higher risk of pregnancy loss than white women. It is an urgent problem, which the Royal College of Obstetricians and Gynaecologists says needs greater attention, with many complex reasons driving this higher risk. These include a lack of quality research involving all ethnicities - but RCOG head Dr Edward Morris says implicit racial bias is also affecting some women's experience of care. Isabel Gomes Obasi and her husband, Paulson, from Coventry, are expecting a baby boy in March. They are extremely anxious as almost a year ago their baby boy Andre died four months into Isabel's pregnancy. Giving birth to Andre was extremely traumatic, Isabel says, but how she was treated when in severe pain and bleeding, in the days before her loss, made the experience worse. "We knew something was wrong, so we went into hospital and waited five hours to be seen by a doctor," she says. "I remember being laughed at by one of the nurses, who said, 'Just go home. Why do you keep coming in?'" Isabel was checked over and told the baby was fine but says her intuition and pain were belittled and ignored. Within 48 hours of going home, Isabel began bleeding heavily. There is little doctors can do at this relatively early stage of pregnancy to save a baby's life. But the feeling of not being listened to has stayed with Isabel ever since. "I just shut down," she says. "The experience made me anxious and depressive, if not suicidal." Asked why she was not listened to, she said: "The colour of my skin," the attitude of some staff was: "'You have black skin - you are not from here - you can wait.'" Dr Morris says it is "unacceptable" women belonging to ethnic minorities face worse outcomes than white women - especially in maternity care. "Implicit racial bias from medical staff can hinder consultations and negatively influence treatment options," he says. This can stop some women engaging with healthcare. Read full story Source: BBC News, 8 February 2022
  16. News Article
    The number of people who try suicide has risen steadily in the U.S. But despite gains in health coverage, nearly half are not getting mental health treatment. Suicide attempts in the United States showed a “substantial and alarming increase” over the last decade, but one number remained the same, a new study has found: Year in and year out, about 40% of people who had recently tried suicide said they were not receiving mental health services. The study, published in JAMA Psychiatry, traces a rise in the incidence of suicide attempts, defined as “self-reported attempts to kill one’s self in the last 12 months,” from 2008 to 2019. During that period, the incidence rose to 564 in every 100,000 adults from 481. The researchers drew on data from 484,732 responses to the federal government’s annual National Survey on Drug Use and Health, which includes people who lack insurance and have little contact with the health care system. They found the largest increase in suicide attempts among women; young adults between 18 and 25; unmarried people; people with less education; and people who regularly use substances like alcohol or cannabis. Only one group, adults 50 to 64 years old, saw a significant decrease in suicide attempts during that time. Among the major findings was that there was no significant change in the use of mental health services by people who had tried suicide, despite the passage of the Affordable Care Act in 2010 and receding stigma around mental health care. Over the 11-year period, a steady rate of about 40%t of people who tried suicide in the previous year said they were not receiving mental health care, said Greg Rhee, an assistant professor of psychiatry at the Yale School of Medicine and one of the authors of the study. The Affordable Care Act, which took effect fully in 2014, required all health plans to cover mental health and substance abuse services, and also sharply reduced the number of uninsured people in the U.S. However, many respondents to the survey in the new report said the cost of mental health care was prohibitive; others said they were uncertain where to go for treatment or had no transportation. “It is a huge public health problem,” Dr. Rhee said. “We know that mental health care in the U.S. is really fragmented and complicated, and we also know not everybody has equal access to mental health care. So, it’s somewhat not surprising.” Read full story (paywalled) Source: New York Times,19 January 2022
  17. News Article
    Lawmakers say minorities may disproportionately suffer from long-term symptoms of coronavirus infection. A pair of Democratic House members asked the Centers for Disease Control and Prevention (CDC) in a letter Tuesday to release data on the number of Americans who suffer lingering symptoms of coronavirus infection, including breakdowns along race, gender and age. The National Institutes of Health and the CDC have launched detailed studies of Long Covid, but those examinations are expected to take years. In the meantime, policymakers lack good information about how many people in the United States and worldwide suffer from long-term, debilitating effects of the disease. “People suffering from Long Covid have been ignored and overlooked for far too long. Collecting and publishing robust, disaggregated demographic data will help us better understand this illness and ensure that we are targeting lifesaving resources to those who need them most,” said Rep. Ayanna Pressley, who co-signed the letter Tuesday to the CDC.“We’re calling on the CDC to publicly report this data because that which gets measured gets done — and we can’t have an equitable recovery from this pandemic without it.” Read full story Source: The Washington Post, 25 January 2022
  18. News Article
    The significantly longer waiting times suffered by patients from minority ethnic groups and in more deprived areas for a range of elective procedures have been laid bare in NHS analysis shared with HSJ. The problem of waiting time disparities between different patient groups has been highlighted by health leaders for several years. But the NHS chief who oversaw this new work quantifies the issue for a local NHS trust, provides a template for others to follow, and has led to an improvement in waiting times disparities in response. The analysis of elective waiting lists by Calderdale and Huddersfield Foundation Trust found that in October last year patients from a minority ethnic background were waiting three weeks longer on average than white patients for a “priority two” operation – which must be done within a month. It also found patients from the most deprived communities were waiting 2.5 weeks longer than those from the least deprived areas. However, Owen Williams, who led the trust when the analysis was carried out, said the analysis, which began early last year, contributed to these disparities being cut significantly over the course of 2021. In May last year the trust’s patients from the most deprived areas were waiting 8.5 weeks longer on average for priority two operations than those from more affluent areas, while patients from minority ethnic groups were waiting 7.8 weeks longer than white patients. Mr Williams said NHS trusts boards must be proactive in undertaking similar analysis to reduce health inequalities. Read full story (paywalled) Source: The Guardian, 24 January 2022
  19. News Article
    Women are being forced to wait longer for operations and healthcare appointments in the wake of the pandemic, according to a new report. Research carried out by the Care Quality Commission, England’s regulator of health and social care, found 53% of women experienced longer waiting times for appointments or healthcare procedures during the Covid crisis. The report also found 3 in 10 women experienced appointment cancellations. More women report grappling with these issues than men – with some 44% of men saying they have experienced longer waiting times for appointments or procedures. Helena Mckeown, a GP who previously specialised in women’s health at the British Medical Association (BMA), told The Independent she is not surprised by the findings. "Our world is full of sexism and we know of other examples of sexism and biases in healthcare. Some of them are racial biases. To stop unconscious biases, they need to be recognised and addressed. Ms Mckeown, one of the directors of the Menopause Expert Group, a non-profit which provides education about menopause, said female patients are treated differently to men. She added: “We need to make sure we are not taking women saying they are in pain differently to men saying they are in pain. It is really important that we address this problem of women waiting longer for operations and appointments.” Read full story Source: The Independent, 22 January 2022
  20. News Article
    A GP’s ethnicity has an impact on the level of leadership support it gets from regulators and external bodies, a new Care Quality Commission (CQC) report has suggested. In 2021, the CQC conducted research looking at concerns raised by some doctors that ethnic minority-led GP practices were “more likely to have a poorer experience or outcomes” from regulation. In a final report, the CQC has admitted ethnic minority-led practices are “not operating on a level playing field”, due to several factors including the fact they are more likely to care for populations with higher levels of socio-economic deprivation and poorer health. This can affect their ability to achieve some national targets used in assessments of quality, and increase challenges around recruitment and funding. The evidence gathered by the CQC also suggested that practices led by ethnic minority doctors “often lacked leadership support from other bodies and suffered from low morale”. Read full story (paywalled) Source: HSJ, 19 January 2022
  21. News Article
    Endemic ill-health in England’s “left behind” neighbourhoods costs the country almost £30bn a year because people are often too ill to work and die earlier, a report claims. The cost of lost productivity results directly from those very deprived areas having much worse health than the rest of the country, according to parliamentarians and academics. Experts from the Northern Health Science Alliance (NHSA) have calculated that the economy would grow by that amount if health in those areas was improved to such an extent that local people began to enjoy the same health as those in better-off places. The report, by the NHSA and all-party parliamentary group for left behind neighbourhoods (LBNs), highlights the scale of the challenge Boris Johnson faces in meeting his pledge to level up England’s poorest and richest areas. “The health of people living in left behind neighbourhoods is considerably worse than the health of people living in the rest of the country,” said Dr Luke Munford, the report’s lead author and a lecturer in health economics at the University of Manchester. “This is true across all measures of health.” The report shows rates of obesity, lung conditions, high blood pressure, mental health problems and other diseases are much higher than the national average in the 225 LBNs. This means people there have less “healthy life expectancy” and also shorter lives and thus are less productive over their lifespan than those elsewhere. Read full story Source: The Guardian, 13 January 2022
  22. News Article
    Women who are operated on by a male surgeon are much more likely to die, experience complications and be readmitted to hospital than when a woman performs the procedure, research reveals. Women are 15% more liable to suffer a bad outcome, and 32% more likely to die, when a man rather than a woman carries out the surgery, according to a study of 1.3 million patients. The findings have sparked a debate about the fact that surgery in the UK remains a hugely male-dominated area of medicine and claims that “implicit sex biases” among male surgeons may help explain why women are at such greater risk when they have an operation. “In our 1.3 million patient sample involving nearly 3,000 surgeons we found that female patients treated by male surgeons had 15% greater odds of worse outcomes than female patients treated by female surgeons,” said Dr Angela Jerath, an associate professor and clinical epidemiologist at the University of Toronto in Canada and a co-author of the findings. “This result has real-world medical consequences for female patients and manifests itself in more complications, readmissions to hospital and death for females compared with males. “We have demonstrated in our paper that we are failing some female patients and that some are unnecessarily falling through the cracks with adverse, and sometimes fatal, consequences.” Read full story Source: The Guardian, 4 January 2022
  23. News Article
    Ministers have pledged to “reset the dial” on women’s health to tackle decades of gender inequality in England, with plans to appoint a women’s health tsar, eradicate medical taboos, boost menopause support and ban harmful “virginity repair” operations. The Department of Health and Social Care has published its Vision for Women’s Health strategy after 100,000 women came forward to share their healthcare concerns. Maria Caulfield, the minister for women’s health, described some of their experiences as “shocking”. The vision document sets out initial government commitments on women’s health, recognising that “systemwide changes” are needed to tackle “decades of gender health inequality”. The final plan – the Women’s Health Strategy – will be published in spring 2022. On Wednesday night, ministers pledged to introduce legislation criminalising hymenoplasty or any procedure to rebuild or repair the hymen. Such surgery creates scar tissue so that a woman will bleed the next time she has intercourse, making it appear she has never had sex. Young women can be forced to prove they are “pure” on their wedding night. Doctors have called for a ban on the surgery for years, saying it can never be justified on health grounds and is harmful. Separately, the government will appoint a women’s health ambassador to raise the profile of key issues and boost awareness of taboo topics. Ministers will also establish a UK-wide menopause taskforce to investigate how women going through the menopause can be better supported. The cost of hormone replacement therapy (HRT) prescriptions will also be cut by implementing longer prescribing cycles so women will need fewer prescriptions and therefore pay less. The consultation provided “stark and sobering insights” into women’s experiences of health and care and highlighted entrenched problems within the NHS, officials said. Ministers are also considering compulsory training for GPs on women’s health after the idea was raised by women who came forward. The vision document said: “We also heard about a lack of awareness amongst some GPs of the causes of infertility, miscarriages and their relationship with infertility, and the reasons for in vitro fertilisation (IVF) failure.” Read full story Source: The Guardian, 22 December 2021 Related reading Gender bias: A threat to women’s health (August 2020) Dangerous exclusions: The risk to patient safety of sex and gender bias Patient Safety Learning: Women’s Health Strategy Consultation Response
  24. News Article
    Lessons learnt in relation to increasing uptake of the COVID-19 vaccine among ethnic minority groups should now be applied to the booster programme, a government progress report recommends. This includes continuing to use respected local voices to build trust and to help tackle misinformation, the report from the government’s Race Disparity Unit says. Such approaches should also be carried over to the winter flu and childhood immunisation programmes and be applied to the work to tackle longer standing health disparities. In June 2020 the minister for equalities was asked to look at why COVID-19 was having a disproportionate impact on ethnic minority groups and to consider how the government response to this could be improved. This latest report is the final one of four. Taken together the reports identified that the main factors behind the higher risk of COVIDd-19 infection for ethnic minority groups include occupation, living in multigenerational households, and living in densely populated urban areas with poor air quality and high levels of deprivations. Read full story Source: BMJ, 3 December 2021
  25. News Article
    Deaf people are twice as likely to suffer mental health problems than those with hearing, a report has found. The All Wales Deaf Mental Health and Wellbeing Group said help in Wales was behind the rest of the UK and it wants to see significant improvements. It also described the inequalities faced by deaf people trying to access mental health support as "really frustrating". The Welsh government said it would consider the findings of the report. Ffion Griffiths, 23, from Neath, has been deaf since birth, and accessing child and adolescent mental health services in Wales has been a problem over the years. She had to travel to England to get the support she needed. "It's really frustrating because deaf people in England have more opportunities," she said. It means they can be treated and get better quicker but for us, how can we do that?" "How can we expect to recover if we don't have access to the services or any pathways for us to follow to get the treatment that we need in Wales?" Read full story Source: BBC News, 8 December 2021
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