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Showing results for tags 'Health Disparities'.
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Content ArticleIn this blog for the British Journal of General Practice comment and opinion website, BJGP Life, GP Will Mackintosh discusses the impact of health inequalities on patients' ability to play an active role in their care. He calls for training for all GPs to understand the constraints and pressures that may be affecting their patients, so that they can better assess the causes of health issues and therefore treat them more effectively. The article examines concepts of freedom for both GP and patient, and argues that a purely evidence-based approach does not help patients from deprived backgrounds overcome health issues. The author highlights that GPs operate in a 'grey zone' between the medical and the non-medical, and argues that this means they are well placed to understand and help tackle the root causes of health disparities.
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Content ArticleThe Royal College of Physicians has published a position paper setting out why we need an explicit cross-government strategy to reduce health inequalities to improve population health and address avoidable differences in health access and outcomes between certain groups. Health inequality was a problem before COVID-19 – with a gap in healthy life expectancy between the richest and poorest areas of around 19 years – but the pandemic has tragically demonstrated how these inequalities can have an impact in just a matter of weeks.
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Content Article
This blog explores men's mental health – how men are reluctant to seek support when they are struggling, why the suicide rate is so high, what initiatives exist to encourage men to seek help and what more could be done. -
News Article
NHS race body commits to avoiding blanket terms such as ‘BAME’
Patient Safety Learning posted a news article in News
An independent body set up by the NHS to tackle health inequalities has formally committed to never use blanket acronyms such as “BAME” after feedback that they are not representative. The NHS Race and Health Observatory launched a four-week consultation with the public in July on how best to collectively refer to people from black, Asian and minority ethnic groups. The Observatory said it has become the norm in public policy to use initialisms to refer to a “hugely diverse” group of people, but that renewed scrutiny has been spurred on by the Black Lives Matter movement. It said terminology that “crudely conflates” different groups “does not just erase identities; it can also lead to broad brush policy decisions that fail to appreciate the nuance of ethnic inequality in the UK”. Generic collective terms such as “BAME”, “BME” and “ethnic minority” are “not representative or universally popular”, the Observatory said after receiving responses from 5,104 people. It found no single, collective umbrella term to describe ethnic groups was agreed by the majority of respondents. The body had previously said it was committed to avoiding the use of acronyms and initialisms, but has now formalised this as one of five key principles it is adopting in its communications. Where possible it will be specific about the ethnic groups it is referring to, but where collective terminology is necessary it will “always be guided by context and not adopt a blanket term”. Read full story Source: The Independent, 26 November 2021 -
Content ArticlePulmonary arterial hypertension (PAH) is a rare disease characterised by pulmonary vascular remodelling and elevated pulmonary pressure, which eventually leads to right heart failure and death. Registries worldwide have noted a female predominance of the disease, spurring particular interest in hormonal involvement in the disease pathobiology. Several experimental models have shown both protective and deleterious effects of oestrogens, suggesting that complex mechanisms participate in PAH pathogenesis. In fact, oestrogen metabolites as well as receptors and enzymes implicated in oestrogen signalling pathways and associated conditions such as BMPR2 mutation contribute to PAH penetrance more specifically in women. Conversely, females have better right ventricular function, translating to a better prognosis. Along with right ventricular adaptation, women tend to respond to PAH treatment differently from men. As some young women suffer from PAH, contraception is of particular importance, considering that pregnancy in patients with PAH is strongly discouraged due to high risk of death. When contraception measures fail, pregnant women need a multidisciplinary team-based approach. This article from Cheron et al. aims to review epidemiology, mechanisms underlying the higher female predominance, but better prognosis and the intricacies in management of women affected by PAH.
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EventThis webinar will feature two presentations on: Lancet article - Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study NMPA report - Ethnic and socio-economic inequalities in NHS maternity and perinatal care for women and their babies There will be a Q&A guest panel featuring: Professor Eddie Morris Clo and Tinuke, Five X more Bell Ribeiro-Addy MP Professor Jacqui Dunkley-Bent Professor Marian Knight Professor Asma Khalil Join the webinar on Microsoft Teams
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News ArticlePlans to scrap tens of millions of “unnecessary” hospital follow-up appointments could put patients at risk and add to the overload at GP surgeries, NHS leaders and doctors are warning. Health service leaders in England are finalising a radical plan under which hospital consultants will undertake far fewer outpatient appointments and instead perform more surgery to help cut the NHS backlog and long waits for care that many patients experience. The move is contained in the “elective recovery plan” which Sajid Javid, the health secretary, will unveil next week. It will contain what one NHS boss called “transformative ideas” to tackle the backlog. Thanks to Covid the waiting list has spiralled to a record 5.8 million people and Javid has warned that it could hit as many as 13 million. Under the plan patients who have spent time in hospital would be offered only one follow-up consultation in the year after their treatment rather than the two, three or four many get now. “While it is important that immediate action is taken to tackle the largest ever backlog of care these short-term proposals by the health secretary have the potential to present significant challenges for patients and seek to worsen health disparities across the country,” said Dr David Wrigley, the deputy chair of council at the British Medical Association. Read full story Source: The Guardian, 25 November 2021
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Content ArticleAs well as a moral issue, tackling racism affecting NHS staff is a crucial part of improving patient safety and care, says MDX Research Fellow Roger Kline. In this blog, Roger looks at the risks of racism on patient safety.
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Content Article
Birthrights video: Speak Up, Speak Out (16 November 2021)
Patient-Safety-Learning posted an article in Maternity
This video by the charity Birthrights encourages women and birthing people to speak out when they experience poor quality care. It highlights the right to safe and appropriate maternity care that respects individuals' dignity, privacy and confidentiality and is given equally and without discrimination. -
Content ArticleMany devices in current use were marketed before the US Food and Drug Administration (FDA) began regulating devices in 1976. Thus, manufacturers of these devices were not required to demonstrate safety and effectiveness, which presents both clinical and ethical problem for patients, especially for women, as some of the most dangerous devices—such as implanted contraceptive devices— are used only in women. This article from Madris Kinard and Rita F. Redberg investigates whether and to what extent devices for women receive less rigorous scrutiny than devices for men. This article also suggests how the FDA Center for Devices and Radiological Health could more effectively ensure safety and effectiveness of devices that were marketed prior to 1976.
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Content ArticleThis report by the British Red Cross highlights the impact of deprivation and inequality on high intensity use of accident and emergency services (A&E), and the additional cost and strain this puts on these services. It shows that people from the most deprived areas of the UK and people with mental health issues are more likely to be in poor health and are most likely to attend A&E frequently. The report calls for better support for people who frequently attend A&E because they feel they have 'nowhere else to turn'.
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Content ArticleAccess to healthcare is a basic right, but refugees and people seeking asylum in the UK often face barriers to accessing health services. The Refugee Council has released this collection of guides and films for health professionals, decision-makers and NGOs to address health inequalities experienced by refugees and people seeking asylum.
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News ArticleThe system for assessing who should be asked to pay for NHS services “incentivises racial profiling”, an investigation has found. A study by the Institute for Public Policy Research found that overstretched NHS staff sometimes racially profile patients in order to determine who is not “ordinarily resident” in the UK, and therefore must pay for their care. The report is critical of the more stringent charging regime introduced by NHS England over the past decade as part of a series of measures devised to create a hostile environment for people living in the UK without the correct immigration status. Overseas visitors officers have been appointed by NHS trusts, responsible for identifying chargeable patients, as part of a cost recovery programme launched in 2014. One of the officers told the IPPR study they had felt forced to discriminate between patients based on their name. “If you’ve got a, I don’t know, Mohammed Khan and a Fred Cooper, you’re obviously going to go for [investigating] the Mohammed Khan … Even for someone who’s, you know, well I’d like to think hopefully open-minded, like myself, you’re just trying to save yourself time because there’s not enough hours in the day,” the officer said. A hospital employee also reported that discrimination on the basis of ethnicity was used to determine who should be billed for treatment. “It’s a system that is designed to benefit [white] people like me, not people like … the patient on intensive care who is black and British and was unconscious and sent a bill. So why did someone think he was not eligible for care? Given he was unconscious most of the admission, significantly unwell, probably not his accent, more likely his skin colour,” the health worker said. Under the rules, anyone “not ordinarily resident” in the UK should be charged 150% of the NHS national tariff for most secondary (non-urgent) healthcare, but the report found that processes varied across the country, with a lack of consistent training and widespread confusion over the 130-page rules for the charging system. Some healthcare staff told IPPR researchers that they disliked the extra burden of having to consider whether to refer a patient for charging, which they felt distracted them from their core medical responsibilities. Read full story Source: The Guardian, 23 November 2021
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News Article
Covid: Sajid Javid orders review of medical device racial bias
Patient Safety Learning posted a news article in News
A review into whether medical devices are equally effective regardless of the patient's ethnicity has been ordered by Health Secretary Sajid Javid. Research suggests oximeters, which are clipped to a person's finger, can overstate the level of oxygen in the blood of people from ethnic minorities. Ministers want to know whether bias could have prevented patients receiving appropriate Covid treatment. Mr Javid said any bias was "totally unacceptable". But the doctors' union the British Medical Association (BMA) said the review should not simply look at equipment, but also "structural issues" within healthcare that affect ethnic minorities. Mr Javid announced the review in the Sunday Times, saying he was determined to "close the chasms that the pandemic has exposed". Asked later on the BBC's Andrew Marr show whether he thought people had died of Covid because of pulse oximeters, Mr Javid said: "I think possibly yes, yes. I don't have the full facts." He said there was racial bias in some medical instruments, adding: "It's unintentional but it exists." "And the reason is that a lot of these medical devices, even some of the drugs, some of the procedures, some of the textbooks, most of them are put together in majority white countries and I think this is a systemic issue around this," he said. Read full story Source: BBC News, 21 November 2021 -
News ArticleThe increased risk of black and minority ethnic women dying during pregnancy needs to be seen as a whole system problem and not limited to just maternity departments, according to experts on an exclusive panel hosted by The Independent. Professor Marian Knight, from Oxford University told the virtual event on Wednesday night that the health service needed to change its approach to caring for ethnic minority women in a wider context. Campaigners Tinuke Awe and Clotilde Rebecca Abe, from the Fivexmore campaign, called for changes to the way midwives were trained and demanded it was time to “decolonise the curriculum” so it recognised the physiological differences between some ethnic minority women and white women. Dr Mary Ross-Davie, from the Royal College of Midwives, said work was underway to ensure the voices of black women and other minorities were represented in its work and it was examining how it could deliver better training to midwives. The data on maternity deaths in the UK show black women are four times more likely to die during pregnancy in the UK than white women. For Asian women, they are twice as likely to die. Read full story and watch video of event Source: The Independent, 18 November 2021
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Content Article
National Maternity and Perinatal Audit lay summaries (2021)
Patient-Safety-Learning posted an article in Maternity
The National Maternity and Perinatal Audit (NMPA) has produced lay summaries covering three of its sprint audits into: perinatal mental health services maternity care for women with a body mass index of 30kg/m2 or above ethnic and socio-economic inequalities in NHS maternity care. The NMPA is a large-scale project established to provide data and information to those working in and using maternity services. The purpose of NMPA is to evaluate and improve NHS maternity services, as well as to support women, birthing people and their families to use the data in their decision-making. -
Content ArticleThis report was triggered by the Coroner’s report into the death of Evan Nathan Smith in North Middlesex hospital. Evan was a young man with his whole life in front of him. The mistakes made in his treatment leading to his early and avoidable death brought into sharp focus the lack of understanding of sickle cell, the battles patients have to go through to get proper treatment and the terrible consequences which can come about as a result. Following the publication of the Coroner’s report, the All-Party Parliamentary Group (APPG) on Sickle Cell and Thalassaemia held three evidence sessions, hearing from patients, clinicians and politicians. This report is a result of that evidence. The findings in this report reveal a pattern of many years of sub-standard care, stigmatisation and lack of prioritisation which have resulted in sickle cell patients losing trust in the healthcare system that is there to help them, feeling scared to access hospitals, expecting poor treatment from some of those who are supposed to care for them and fearing that it is only a matter of time until they encounter serious care failings.
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News Article
Landmark sickle cell disease inquiry finds evidence of racism in patient care
Patient Safety Learning posted a news article in News
A groundbreaking inquiry into sickle cell disease has found “serious care failings” in acute services and evidence of attitudes underpinned by racism. The report by the all-party parliamentary group (APPG) on Sickle Cell and Thalassaemia, led by Pat McFadden MP, found evidence of sub-standard care for sickle cell patients admitted to general wards or attending A&E departments. The inquiry also found widespread lack of adherence to national care standards, low awareness of sickle cell among healthcare professionals and clear examples of inadequate training and insufficient investment in sickle cell care. The report notes frequent disclosures of negative attitudes towards sickle cell patients, who are more likely to be people with an African or Caribbean background, and evidence to suggest that such attitudes are often underpinned by racism. The inquiry also found that these concerns have led to a fear and avoidance of hospitals for many people living with sickle cell. Care failings have led to patient deaths and “near misses” are not uncommon, leading to a cross-party call for urgent changes into care for sickle cell patients. Read full story Source: The Independent, 15 November 2021 -
Content ArticleThis report looks at lessons that can be learned from the Covid-19 pandemic around developing culturally relevant health information for South Asian communities. The authors conclude that there is an urgent need for culturally appropriate health information for South Asian communities to help reduce inequalities in health outcomes seen prior to the pandemic and exacerbated during it. They also highlight a lack of research into optimal ways of developing culturally relevant health information resources.
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News Article
Black women four times more likely to die in childbirth
Patient Safety Learning posted a news article in News
Black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK, a review of 2017-2019 deaths shows. The MBRRACE-UK report found women from Asian backgrounds are almost twice as likely to die as white women. Some 495 individuals died during pregnancy or up to a year after birth, out of 2,173,810 having a child. The charity Birthrights is concerned that overall "this bleak picture has not changed in over a decade". University of Oxford researchers say for the vast majority of people, pregnancy remains very safe in the UK. But despite slight decreases in the maternal death rate in recent years, there have been no significant improvements to these rates since the 2010 to 2012 period. Their current report shows heart disease, epilepsy and stroke continue to be the most common causes of death. And they say in some 37% of cases, improvements in care may have made a difference to the outcome. Lead researcher, Prof Marian Knight, said: "Pregnant women get inequitable care for several reasons. "Healthcare professionals often attribute their symptoms to pregnancy alone and they do not always end up getting the treatment they need because people can be incorrectly concerned about giving them medication. "On top of that is the unconscious bias that black and Asian women can experience. It all adds up. "We know from other studies that the disparity in death rates cannot be fully explained by socio-economic factors and other medical conditions for example. We need to look for other reasons." Read full story Source: BBC News, 11 November 2021 -
Content ArticleThis report from the National Maternity and Perinatal Audit assesses care inequalities using data from births between 1 April 2015 and 31 March 2018 across England, Scotland and Wales. The National Maternity and Perinatal Audit (NMPA) is led by the Royal College of Obstetricians and Gynaecologists (RCOG) in partnership with the Royal College of Midwives (RCM), the Royal College of Paediatrics and Child Health (RCPCH) and the London School of Hygiene and Tropical Medicine (LSHTM).
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News ArticleCampaigners have called for a change in how epilepsy services are delivered after "alarming" new research revealed that nearly 80% cent of deaths in young adults could have been avoided. It comes as researchers behind the first ever national review into deaths linked to the condition warned that "little has improved in epilepsy care" despite previous findings of premature mortality. They describe the situation as a "major public health problem in Scotland", adding that deaths "are not reducing, people are dying young, and many deaths are potentially avoidable”. In particular, the Edinburgh University team found that adults aged 16 to 24 were five times more likely to die compared to the general population, a problem they said may be linked to the "vulnerable period of transition from paediatric to adult care". Overall, for adults with epilepsy aged 16 to 54, the mortality rate was more than double that for the age group as a whole, with as many as 76% of these deaths potentially preventable and the majority occurring among patients from the most deprived areas. Read full story Source: The Herald, 11 November 2021
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News Article
AI skin cancer diagnoses risk being less accurate for dark skin – study
Patient Safety Learning posted a news article in News
Artificial intelligence (AI) systems being developed to diagnose skin cancer run the risk of being less accurate for people with dark skin, research suggests. The potential of AI has led to developments in healthcare, with some studies suggesting image recognition technology based on machine learning algorithms can classify skin cancers as successfully as human experts. NHS trusts have begun exploring AI to help dermatologists triage patients with skin lesions. But researchers say more needs to be done to ensure the technology benefits all patients, after finding that few freely available image databases that could be used to develop or “train” AI systems for skin cancer diagnosis contain information on ethnicity or skin type. Those that do have very few images of people with dark skin. Dr David Wen, first author of the study from the University of Oxford, said: “You could have a situation where the regulatory authorities say that because this algorithm has only been trained on images in fair-skinned people, you’re only allowed to use it for fair-skinned individuals, and therefore that could lead to certain populations being excluded from algorithms that are approved for clinical use." “Alternatively, if the regulators are a bit more relaxed and say: ‘OK, you can use it [on all patients]’, the algorithms may not perform as accurately on populations who don’t have that many images involved in training.” That could bring other problems including risking avoidable surgery, missing treatable cancers and causing unnecessary anxiety, the team said. Read full story Source: The Guardian, 9 November 2021 -
Content Article
Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world. -
Content ArticleThis manifesto was created by the Community Rehabilitation Alliance, a collective of 50 charities, trade unions and professional bodies coming together to call on all political parties to ensure there is equal access to high quality community rehabilitation services for all patients.
