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Showing results for tags 'Health Disparities'.
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Content ArticleThis training documentary by the South East Perinatal Mental Health team explores race inequalities within the NHS maternity system. It uncovers the stories behind the MBRRACE report figures and looks for answers from leading race and diversity health professionals and campaigners. In the film, midwives and mothers talk frankly about the issues and how individuals can make a difference to create a positive impact on race inequality outcomes for mothers and within maternity teams.
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News ArticleEfforts to end health inequalities should be ‘in the mix’ of metrics used to determine the NHS’ progress against key performance targets, say race inequality experts. In an exclusive interview with HSJ, NHS Race and Health Observatory (RHO) director Habib Naqvi said organisations’ performance on the issue should be scrutinised by an external body to ensure they are held accountable and “not marking their own exam answer”. It comes as the RHO publishes a report that warns the appointment of health inequalities leads across the NHS risks becoming “tokenistic” if they are not adequately supported and held accountable. The report by The King’s Fund think tank has recommended several actions to prevent the introduction of board-level leads from becoming a “hollow gesture”. In August 2020, NHS England asked all NHS organisations to have a named executive board member responsible for tackling inequalities by October that year. The RHO estimates there to be more than 450 of these named leads across the country. The report welcomed this but added “frameworks” of support and accountability should exist to “empower individuals and motivate change”. The recommendations include putting inequalities on an “equal footing” with key performance metrics, as well as a long-term policy focus that puts addressing inequalities “at the heart of system development”. Read full story (paywalled) Source: HSJ, 1 December 2021
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Content ArticleIn 2020, all NHS organisations were instructed to name a single executive board member as their senior responsible person for tackling health inequalities. Across the NHS, there should now be over 450 dedicated health equality named leads in healthcare organisations. This report published by the independent NHS Race & Health Observatory in collaboration with The King’s Fund sets out recommendations to help ensure senior NHS officials responsible for improving health inequalities are able to make a difference.
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News Article
One percent of the population make up a third of ambulance call outs
Patient Safety Learning posted a news article in News
The British Red Cross have found that that 367,000 people, which equates to around one percent of the population in England attend A&E up to 346 times a year. These figures accounted for nearly one in three ambulance call outs and over one in six A&E visits. The research analysis found that a fifth of those repeatedly attending A&E lived alone and also often lived in deprived areas of the country. Frequent users also accounted for 29% of all ambulance call outs and 16% of non-minor-injury A&E visits. The data also revealed that people in their twenties were more likely to repeatedly visit A&E than any other age category. Mike Adamson, chief executive of the British Red Cross, said: 'High intensity use of A&E is closely associated with deprivation and inequalities - if you overlay a map of frequent A&E use and a map of deprivation, they're essentially the same.' Read full story Source: National Health Executive, 29 November 2021 -
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).
