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Showing results for tags 'Health inequalities'.
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Content ArticleIn this briefing paper for the Social Market Foundation, Lord Norman Warner sets out a radical change programme that could reverse the decline in NHS services. It examines long-term issues that have been exacerbated by the impact of Brexit and the Covid-19 pandemic—the care backlog, workforce issues and loss of public confidence.
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Content ArticleThe Indian Liver Patient Dataset (ILPD) is used extensively to create algorithms that predict liver disease. Given the existing research describing demographic inequities in liver disease diagnosis and management, these algorithms require scrutiny for potential biases. Isabel Straw and Honghan Wu address this overlooked issue by investigating ILPD models for sex bias. They demonstrated a sex disparity that exists in published ILPD classifiers. In practice, the higher false negative rate for females would manifest as increased rates of missed diagnosis for female patients and a consequent lack of appropriate care. Our study demonstrates that evaluating biases in the initial stages of machine learning can provide insights into inequalities in current clinical practice, reveal pathophysiological differences between the male and females, and can mitigate the digitisation of inequalities into algorithmic systems. An awareness of the potential biases of these systems is essential in preventing the digital exacerbation of healthcare inequalities.
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Content Article
Surviving in Scrubs campaign
Patient Safety Learning posted an article in Staff safety
Sexism, sexual harassment, and sexual assault are commonplace in the healthcare workforce. Too many healthcare staff have witnessed or been subject to it… the female med student asked to stay late lone working with a senior male doctor, being looked over for opportunities at work, unwelcome touching at conferences, comments on your looks… the list goes on. A 2021 survey from the BMA reported 91% of women doctors had experienced sexism in the last 2 years and 47% felt they had been treated less favourably due to their gender. Over half of the women (56%) said that they had received unwanted verbal comments relating to their gender and 31% said that they had experienced unwanted physical conduct. Despite these statistics these issues remain endemic in healthcare. The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, aims to tackle this problem, giving a voice to women and non-binary survivors in healthcare to raise awareness and end sexism, sexual harassment, and sexual assault in healthcare. You can share your story through the Submit Your Story page anonymously and the story will be published on the Your Stories page. This will create a narrative of shared experiences that cannot be ignored. -
Content ArticleThis is the transcript of a Westminster Hall debate in the House of Commons on waiting lists for gynaecological services.
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Content Article
UK Covid-19 Inquiry Terms of Reference (28 June 2022)
Patient-Safety-Learning posted an article in Covid-19 Inquiry
This document outlines the final terms of reference for the Public Inquiry into the government's response to the Covid-19 pandemic, chaired by Baroness Heather Hallett. The Inquiry will examine, consider and report on preparations and the response to the pandemic in England, Wales, Scotland and Northern Ireland. Baroness Hallett has also recorded a video statement to the public about the Inquiry, which includes a British Sign Language translation. -
Content ArticlePretty soon there won’t be a trust without an associate director or even board level director fully dedicated to all things equality, diversity and inclusion; relatively new senior roles that must have a purpose, job description and performance indicators. They will spend energy on yet more strategies, start from the top and hope something trickles down. Or they could start where the work is done, and build the tools to make equality, diversity and inclusion (EDI) everyone’s responsibility. Trusts are full of people passionate about EDI. So many roles, so many champions. They meet, share stories, and champion the importance of EDI. All this busyness typically outside a governed frame without the necessary reporting, investigating, actions, outcomes, learning, and measurable improvement. To normalise EDI and make it everyone’s responsibility will involve enabling reporting of EDI incidents, investigating it, taking action, and learning from it, writes Dr Nadeem Moghal in an article for HSJ.
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Content ArticleThe NHS in England is about to be reorganised. In April 2022, government passed the Health and Care Act 2022 – the biggest legislative overhaul of the NHS in a decade. The centrepiece of the legislation are integrated care systems (ICSs) – area-based agencies responsible for planning local services to improve health and reduce inequalities. From July 2022, England will be formally divided into 42 ICSs, covering populations of around 500,000 to 3 million people. ICSs have existed informally since 2016, but – until now – lacked formal powers. ICSs face a mammoth task. Staffing shortages in the NHS are chronic, record numbers of people are waiting for routine hospital treatment, and health inequalities in England are wide and growing. But these challenges are not evenly distributed between ICSs – and some systems are better equipped to deal with them than others. Policymakers have allowed some flexibility in how local systems have been developed and organised, which means they vary widely in size, structure, and other characteristics. In this long read, The Health Foundation analyses publicly available data on some of the characteristics of ICSs and context in each area – including the organisational and policy context, health challenges, and capacity within the health care system to address them. It compares areas and discusses implications for policy.
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Content ArticleThe health and social care system’s long-term sustainability depends on effective digital transformation. This document outlines the government's plans to reform and develop the use of digital technologies in health and social care in order to deliver a system that will be faster, more effective and more personalised. The plan pulls together the four goals of reform for the health and care system identified by the Secretary of State for Health and Social Care: prevent people’s health and social care needs from escalating personalise health and social care and reduce health disparities improve the experience and impact of people providing services transform performance
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Content ArticleThis retrospective cohort study in JAMA Internal Medicine aimed to determine whether there are systematic racial and ethnic biases in pulse oximetry among patients with Covid-19, and whether these biases result in patients not being accurately recognised as candidates for oxygen threshold–specific therapy. The authors found that patients from racial and ethnic minority groups with Covid-19 are often subject to overestimation of arterial oxygen saturation levels. This contributes to them not being recognised, or a delay in them being recognised, as eligible to receive Covid-19 therapies.
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Content ArticleThis report by researchers at the University of Birmingham is the first granular analysis of the known and hidden waiting lists for elective procedures in England. There has been previous analysis of the NHS waiting list, but it has been based on the overall waiting list and has included patients waiting for all types of consultant-led care, including outpatient clinic visits and non-surgical treatments. The authors of this report have used procedure-level data to produce estimates for the need for elective procedures.
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Content ArticleThis white paper from the Institute for Healthcare Improvement (IHI) describes a framework to guide health care organisations in their efforts to provide safe, equitable, person-centred telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
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Content ArticleFollowing the UK's exit from the European Union, the government aims to improve how medical devices and diagnostic devices are regulated through a new framework. The MHRA held a consultation on the future regulation of medical devices in the UK in autumn 2021 and this report outlines the government's response to the consultation. The consultation received 891 responses and aimed to collect views on developing a future legislation for medical devices which delivers: improved patient and public safety greater transparency of regulatory decision making and medical device information close alignment with international best practice, and more flexible, responsive and proportionate regulation of medical devices.
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Content ArticleThe first COVID-19 vaccine outside a clinical trial setting was administered on 8 December 2020. To ensure global vaccine equity, vaccine targets were set by the COVID-19 Vaccines Global Access (COVAX) Facility and WHO. However, due to vaccine shortfalls, these targets were not achieved by the end of 2021. Watson et al. aimed to quantify the global impact of the first year of COVID-19 vaccination programmes. The study found that COVID-19 vaccination has substantially altered the course of the pandemic, saving tens of millions of lives globally. However, inadequate access to vaccines in low-income countries has limited the impact in these settings, reinforcing the need for global vaccine equity and coverage.
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Content ArticleThis survey conducted by the Care Quality Commission (CQC) explored the experiences of people who used community mental health services between September and November 2020. The results show that people are consistently reporting poor experiences of NHS community mental health services, with few positive results. Many people reported that their mental health had deteriorated as a result of changes made to their care and treatment due to the pandemic. Analysis also showed disparities in the experiences of people with different mental health diagnoses, and in the experience of people using different methods to access care, such as telephone consultations. On this webpage you can also access a benchmark report for each NHS trust, which provides detail of the survey methodology, headline results, the trust score for each evaluative question and banding for how a trust score compares with all other trusts.
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Content ArticleUnderstanding health information (health literacy) is essential for taking medications correctly, knowing which health services to use and managing long-term conditions. Around half the population struggles to understand health information, and the most disadvantaged groups in society are most likely to have limited health literacy. Improving health literacy is therefore key to tackling health inequalities and improving health outcomes for everyone. This resource collection from the National Institute for Health and Care Research (NIHR) brings together messages from research highlighted in NIHR Alert summaries. It includes research on the impact of unclear health messages, how we can help people understand health information and which groups of the population may need extra support.
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Content ArticleDespite an increased focus in maternity services on ethnic and racial inequalities resulting in poorer outcomes, the experience of migrant women is often hidden from these data, research and improvement programmes. To understand these inequalities and their impact further, Doctors of the World UK (DOTW UK) analysed data collected through provision of health support to 257 pregnant women accessing their service between 2017 and 2021
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Content ArticleThe NHS Confederation has published a new report, 'The unequal impact of COVID-19: investigating the effect on people with certain protected characteristics', which maps existing research into COVID-19 inequalities onto some of these protected characteristics, showing how the pandemic has interacted with them. The report then showcases four case studies of how different health and care systems have put in place interventions to respond to these inequalities when designing their COVID-19 response. It focuses on a number of key areas including the impact of COVID-19 on: BAME communities people with disabilities older and younger people. The report concludes with a series of recommendations for health and care systems across the UK.
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Content ArticleThis report from the BME Leadership Network spotlights the findings from a recent survey and engagement on the experience of senior black and minority ethnic leaders in the NHS.
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Content ArticleA new multinational survey, on more than 1,300 patients, caregivers and healthcare professionals in 10 countries, shines a needed light on the misunderstood realities, unseen burden and care challenges of sickle cell disease. The Sickle Cell Health Awareness, Perspectives and Experiences (SHAPE) survey, one of the largest global burden of disease surveys conducted in sickle cell disease, identified long-term health complications of sickle cell disease as a key concern among 1,300 patients and healthcare professionals surveyed from 10 countries The survey also revealed that sickle cell disease patients' caregivers face profound physical, psychosocial, and economic burdens resulting from taking care of people living with the disease. The findings of the survey were presented during a poster presentation at the European Hematology Association (EHA) 2022 Hybrid Congress. “Sickle cell disease is a lifelong condition that causes damage in the body and has a profound impact on the quality of life of those who suffer from it and their caregivers. The SHAPE survey is important because it illustrates how vital it is that we understand our patients’ needs, and it suggests what we within the medical community can do to help change perspectives, increase education and awareness, and improve care,” said Dr. Baba Inusa, professor and consultant of paediatric haematology, Guy’s and St Thomas’ NHS Foundation Trust, London and chair of the National Haemoglobinopathy Panel in England. “These results are a wake-up call, and I believe that the actions that follow can enable us to help drive a better dialogue and improved conversations around the management and care of this long-neglected and devastating disease.”
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Content ArticleWith waiting lists for gynaecology having grown by 60% since before the pandemic, many women are being left to cope with conditions like endometriosis, fibroids and prolapse on their own while waiting for NHS care. In this article, four women describe how NHS waiting lists and attitudes to gynaecological symptoms have left them living with severe pain and feeling like their health is not being taken seriously.
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Content ArticleIn this letter to the Guardian newspaper, a specialist nurse writes on an NHS service that puts women in control of pain relief, Sara Davies on the torturous pain she endured to have an intrauterine device fitted, and Lee Bennett on why it pays to speak up persistently. Have you experienced pain during a medical procedure? Share your experience along with hundreds of women to one of our community forums: Do women experience poorer medical attention when it comes to pain? Pain during IUD fitting Painful hysteroscopy
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Content ArticleIn a fundamental sense, the vision for transforming virtual care from that of an exclusive service that benefits only a few to that of a standard for providing equitable care for all echoes the age-old debate between policy variations on the zip code and the genetic code. This commentary from Esha Ray Chaudhuri aims to further develop the key theme of engaging the “reimagining” of virtual care for older ethnic adults—by considering the syndemic nature of COVID-19 and the intersection of cultural interventions in care and equity in virtual care.
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Content ArticleAccording to patient safety campaigners, hundreds of women have been forced to endure “barbaric” pain while undergoing hysteroscopy tests after being denied pain relief options and anaesthetists were not available. HSJ recently reported that campaigners have identified at least 240 women who underwent the procedure without being told they were entitled to a general anaesthetic to manage the pain of the invasive test and we have seen similar stories on the hub community forum on the topic. Guidance for doctors says pain relief should always be discussed. Instead, these women were found to be underinformed about their own rights and expected to simply endure what can be an incredibly painful process of internal investigation. Just because some women report only minimal or no discomfort, that does not mean this is a painless procedure; for those who do suffer, the experience can be very traumatic. To say these women did not need and could not be provided with a choice of anaesthetic or other analgesic is a form of medical gaslighting, writes Hannah Fearn in this article for the Independent.
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Content ArticleThe current hospital backlog has had a huge impact on many patients waiting for treatment. But if you are a woman, on a low income or from an ethnic minority background, you are more likely to have a worse experience of waiting for care. Research from Healthwatch has highlighted people were unhappy with the communications they received and the lack of support the NHS gave them to help with things like pain relief or accessing physiotherapy. These concerns were not experienced equally by all, and findings were particularly stark among disabled people, those with long term health conditions, and those on lower incomes. A new poll of 1,000 adults on NHS waiting lists shows that a poorer experience of waiting can be linked to factors such as wealth, disability, level of education, gender or ethnicity.
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Content ArticleIn this podcast for The Guardian, Madeleine Finlay speaks to Michael Marmot, Professor of Epidemiology and Director of the Institute of Health Equity at University College London, about the impact of the cost of living crisis on people's health. They talk about the ways that poverty makes people sicker and why falling income is so bad for the country’s health.
