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Showing results for tags 'Health inequalities'.
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News ArticleThe NHS Race and Health Observatory, in partnership with the Institute for Healthcare Improvement and supported by the Health Foundation, has established an innovative 15-month, peer-to-peer Learning and Action Network to address the gaps seen in severe maternal morbidity, perinatal mortality and neonatal morbidity between women of different ethnic groups. Across England, nine NHS Trusts and Integrated Care Systems will participate in this action oriented, fast-paced Learning and Action Network to improve outcomes in maternal and neonatal health. Through the Network, the nine sites will aim to address the gaps seen in severe maternal morbidity, perinatal mortality and neonatal morbidity between women of different ethnic groups. Haemorrhage, preterm birth, post-partum depression and gestational diabetes have been identified as some of the priority areas for the programme. The sites will generate tailored action plans with the aim of identifying interventions and approaches that reduce health inequalities and enhance anti-racism practices and learning from the programme. These will be evaluated and shared across and between healthcare systems. The Network, the first of its kind for the NHS, will combine Quality Improvement methods with explicit anti-racism principles to drive clinical transformation, and aims to enable system-wide change. Over a series of action, learning and coaching sessions, participants will review policies, processes and workforce metrics; share insights and case studies; and engage with mothers, parents, pregnant women and people. The programme will run until June 2025, supported by an advisory group from the NHS Race and Health Observatory, Institute for Healthcare Improvement, and experts in midwifery, maternal and neonatal medicine. Read full story Source: NHS Race and Health Observatory, 24 January 2024
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Content ArticleAuthors of this editorial, published in BMJ Quality and Safety, conclude by stating that while the use of classification to identify patients who have additional needs and/or are at increased risk of harm has potential benefits, care needs to be taken to avoid possible harm and unintended consequences. They highlight several actions that would help ensure the benefits of classification are maximised, but note that none of these are necessarily easy to achieve in practice, especially in the context of overwhelmed and under-resourced health services. However, ensuring that patients with additional needs and/or risks have these appropriately identified and responded to while receiving healthcare must be a priority. The need for healthcare to be equitable, that is, not vary in quality because of a patient’s personal characteristics, is recognised as an important quality dimension, and this issue has received increased attention in recent years. If used well, classification can be part of the move to ensuring more equitable care for those with additional needs.
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News Article
Under fives betrayed as health declines
Patient Safety Learning posted a news article in News
Worsening health among the under fives in the UK needs to be urgently addressed, experts say. The Academy of Medical Sciences highlights what it says are "major health issues" like infant deaths, obesity and tooth decay. It says society is betraying children and the problems are limiting their future and damaging economic prosperity. The report says: The UK is 30th out of 49 rich countries for infant mortality. One in five children falls short of the expected level of development aged two. One in five is overweight or obese by five. Vaccination targets are being missed for diseases such as measles. One in four is affected by tooth decay by five. One in five women struggles with their mental health during or just after pregnancy. Air pollution is linked to worsening asthma. Rising demand for child mental health services. The report calls for a cross-government vision to be developed to tackle the problems and investment in the child health workforce, including health visitors. Read full story Source: BBC News, 5 February 2024 -
Content ArticleThe Academy of Medical Sciences has released a stark report highlighting wide-ranging evidence of declining health among children under five in the UK and calls on policymakers to take urgent action to address the situation.It warns Government that major health issues like infant mortality, obesity and tooth decay are not only damaging the nation’s youngest citizens and their future, but also its economic prosperity, with the cost of inaction estimated to be at least £16 billion a year. In recent years, progress on child health in the UK has stalled. Infant survival rates are worse than in 60% of similar countries and the number of children living in extreme poverty tripled between 2019 and 2022. Demand for children’s mental health services surge and over a fifth of five-year-old children are overweight or obese, with those living in the most deprived areas twice as likely to be obese than in affluent areas. One-in-four is affected by tooth decay. Vaccination rates have plunged below World Health Organization safety thresholds, threatening outbreaks. Issues such as the COVID-19 pandemic, increased cost of living and climate change compound widespread inequality and are likely to make early years health in the UK even worse.
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News ArticleDeeply ingrained medical misogyny and racial biases are routinely putting people in need of treatment at risk, the government’s patient safety commissioner in England has warned. Dr Henrietta Hughes was appointed in 2022 in response to a series of scandals in women’s health. She outlined a “huge landscape” of biases in need of levelling, citing examples ranging from neonatal assessment tools and pulse oximeters that work less well for darker skin tones to heart valves, mesh implants and replacement hip joints that were not designed with female patients in mind. Hughes said: “I don’t see this as blaming individual healthcare professionals – doctors and nurses – for getting it wrong. It’s pervasive in the systems we have – the training, the experience, the resources. “Anatomy books are very narrow in their focus. Even the resuscitation models are of pale males – we don’t have female resuscitation models, we don’t have them in darker skin tones. This is deeply ingrained in the way that we assess and listen to patients.” She described the realisation that pulse oximeters, used to measure blood oxygen levels, work less well for darker skin tones as a “real shock to the system” when the problem was highlighted during the pandemic. More recently, the NHS Race and Health Observatory highlighted concerns about neonatal assessments. Bilirubinometers, widely used to assess jaundice in newborn babies, are less reliable for darker skin tones and some guidelines for the assessment of cyanosis (caused by a shortage of blood oxygen) refer to “pink”, “blue” or “pale” skin, without reference to skin changes in minority ethnic babies. The Apgar score, a quick test given to newborns that was rolled out in the 1950s, traditionally includes checking whether a baby is “pink all over”. “Even the names of those conditions – jaundice and cyanosis – suggest a colour. The Apgar score includes P for pink all over,” said Hughes. “There are systemic biases in that if you have a darker skin tone those conditions may not be so apparent.” Read full story Source: The Guardian, 4 February 2024
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Content ArticleSet up in January 2023, the Times Health Commission was a year-long projected established to consider the future of health and social care in England in the light of the pandemic, the growing pressure on budgets, the A&E crisis, rising waiting lists, health inequalities, obesity and the ageing population. Its recommendations are intended to be pragmatic, practical, deliverable and able to be potentially taken up by any political party or government, present or future.
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News Article
Cancer deaths in UK set to rise by more than 50% by 2050, experts warn
Patient Safety Learning posted a news article in News
Deaths from cancer in the UK are set to rise by more than 50% in the next 26 years, stark new estimates suggest. Experts from the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) have found there were 454,954 new cases of cancer in the UK in 2022 and warned this is expected to rise to 624,582 by 2050. In 2022, 181,807 people died in Britain from cancer, but researchers warned this is expected to rise to 279,004 by 2050 – a 53% increase. The estimates suggest the rising rates of cancer will be driven by the UK’s growing and ageing population. However, researchers have also called for new policies to tackle levels of smoking, unhealthy diets, obesity and alcohol to help lower the expected surge in cases. The study examined cancer data from 115 different countries and estimated global cases would rise by 77 per cent, from 20 million in 2022 to 35 million in 2050. The organisations estimate that cancer deaths around the world will almost double from 9.7 million to 18.5 million in that time. Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, said the new estimates “show the increased burden that cancer will have in the years to come”. “UK governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has in part widened health inequalities,” she added. Read full story Source: The Independent, 1 February 2024 -
News Article
Online GP access leaves patients lost, says report
Patient Safety Learning posted a news article in News
Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says. Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups. This included people with English as a second language and those less confident with technology. Online services include booking appointments, requesting repeat prescriptions and viewing test results. Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about." One Epsom and Ewell resident was asked by their surgery to book a blood test online. They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back. "I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me." Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services. She said: "People feel they're being pushed online, and that spans a range of different demographics. "It's really important for practices to identify the needs of their patients and how they can best meet those." Read full story Source: BBC News, 2 February 2024 -
Content ArticleMedicine shortages in the UK have been a regular feature on newspaper front pages in recent years. As a doctor on the frontline, Ammad Butt sees how this instability in our medicine supply chain is playing out on the ground. Ammad works in a large city hospital and is used to meeting disgruntled patients who have had to wait hours in clinic to receive treatment. But just imagine their concern when he has to explain to them that the medication they usually took to treat them with is not available, and that they will have to take an alternative instead or stay in hospital for even longer as a result. In the past year, Ammad has routinely seen patients having to go without medication for common conditions such as attention deficit hyperactivity disorder (ADHD), diabetes and even acne that would otherwise be easily managed, or being forced to take alternatives that are less appropriate. And new EU plans for its members to work together to stockpile key medicines will only worsen shortages in the UK. Patients tell Ammad they feel others are receiving better treatment than they are. And they are right, in some ways. Healthcare professionals are being put in a difficult situation having to explain why they are making compromises in their care. It all adds to the sense among patients and healthcare professionals alike that the health service is not working for the most vulnerable. Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.
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Content ArticleThe first UK geriatric oncology service at a tertiary cancer centre was established at the Royal Marsden Hospital in London. Its purpose is to conduct comprehensive geriatric assessments of patients with cancer on order to make referrals to multidisciplinary care. This descriptive study aimed to track its progress. It found that the service made a median of three referrals for each patient, most commonly to physiotherapy and occupational therapy. The frequency of referrals indicates that there is a high level of unmet need in older patients with cancer.
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Content ArticleThis statement from NHS England outlines how NHS organisations should collect and present data on health inequalities and explains the powers available to them to collect such data. Integrated care boards, trusts and foundation trusts should use the statement to identify key information on health inequalities and set out how they have responded to it in annual reports. The statement has been produced according to NHS England's duty under section 13SA of the National Health Service Act 2006.
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News ArticleTo help patients with high-risk pregnancies receive care at hospitals that are staffed and equipped to deliver care appropriate to their needs, the Department of Public Health will require licensed birthing hospitals to use a system called Levels of Maternal Care. The system classifies hospitals based on their capacity to meet the needs of patients with a range of potential complications during childbirth. The impetus is the rising levels of severe maternal morbidity, large racial disparities in outcomes, and concerns that higher-risk patients who deliver in hospitals that over-estimate the level of care they are able to provide are more likely to experience complications. Levels of care describe a hospital’s physical facilities, capabilities and staffing, indicating its ability to serve people giving birth across a range of medical needs. For example, Level 1 is appropriate for low-risk patients with uncomplicated pregnancies, including twins and labor after cesarean delivery. To that group, Level II adds patients with poorly controlled asthma or hypertension and other higher-risk conditions. Subsequent levels include patients at increasingly high risk of complications, up to Level IV, which is appropriate for patients with severe cardiac disease, those who need organ transplant and others. Established by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine in 2015, the classification system is one tool used by states across the country to improve maternal health and birthing outcomes. Read full story Source: Betsy Lehman Center. 17 January 2024
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Content ArticleIn this article, Claire Brader summarises the recent findings on the performance of NHS maternity services in England, as well as recent government and NHS policies aimed at improving the quality of maternity care.
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EventLearn from experts about Project PIVOT, a patient safety initiative led by Patients for Patient Safety (PFPS) US. According to a World Health Organization report, despite decades of patient safety improvement initiatives, approximately 134 million adverse safety events are still occurring each year. A recent report from the Office of the Inspector General revealed that 1 in in 4 Medicare patients experience avoidable adverse events - disproportionately impacting those communities who experience marginalization. A key emerging strategy to improve patient safety and equity is to incorporate patient-reported experiences and outcomes (PREs and PROs) into improvement efforts as illustrated by recent calls to action from the President’s Council of Advisors on Safety and Technology (PCAST), the WHO’s Global Patient Safety Action Plan, and in CMS’s proposed Patient Safety Structural Measure. Learn from Sue Sheridan, Martin Hatlie, and Suz Schrandt about Project PIVOT and other initiatives that are taking action to promote the implementation of patient-centered PROs and PREs to drive safer more equitable care. Register
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Content ArticleRacial and ethnic disparities in health are substantial and persistent in the USA. They occur from the earliest years of life, are perpetuated by societal structures and systems, and profoundly affect children’s health throughout their lives. This series of articles in The Lancet Child & Adolescent Health summarises evidence on racial and ethnic inequities in the quality of paediatric care, outlines priorities for future research to better understand and address these inequities and discusses policy solutions to advance child health equity in the USA. Racial and ethnic inequities in the quality of paediatric care in the USA: a review of quantitative evidence Policy solutions to eliminate racial and ethnic child health disparities in the USA
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News Article
Stark UK divide in health and wealth with sickness ‘clearly linked to poverty’
Patient Safety Learning posted a news article in News
People living in the most deprived parts of the country are more than twice as likely to be in poor health as those living in the most affluent, a new report has revealed. People in Liverpool are almost three times more likely to be in poor health than those in Oxfordshire, and twice as likely to be economically inactive, research by the cross-party IPPR Commission on Health and Prosperity found. The researchers found a “stark divide” in health and wealth throughout the UK was leaving many “bad health blackspots”, with people more likely to be out of work. Overall, people living in the most deprived parts of the country are more than twice as likely to be in poor health as those living in the most affluent – and are around 40% more likely to report economic inactivity. Read full story Source: The Independent, 18 January 2024 -
Content Article
As part of the Lancet's Child and Adolescent Health Spotlight, the journal called for young people around the world aged 18–25 years to lend their perspectives and lived experiences on the two key spotlight asks: That children must be immediately prioritised in health and social policies; children and young people deserve attention in their own right, and not only because they are an indispensable foundation for a sustainable future. That governments and health providers should prioritise health equity for children and young people, within and between countries. The Lancet received 104 submissions in Chinese, English, Portuguese and Spanish, many of which have been published as essays in Lancet publications. This article in The Lancet Child & Adolescent Health summarises the key themes that were raised in the submissions received, including: the need for honest conversations with trusted adults about less talked-about areas including sex and death. the mental health impacts of attacks on transgender young people. the issues associated with living with a chronic illness as a young person. the importance of non-tokenistic youth engagement in research. -
News ArticleFewer Americans are dying of cancer, part of a decades-long trend that began in the 1990s as more people quit smoking and doctors screened earlier for certain cancers. However, the American Cancer Society warned that those gains are threatened by an increase in cancers among people younger than 55, in particular cervical and colorectal cancer, and by the continued disparities between white Americans and people of colour. “The continuous sharp increase in colorectal cancer in younger Americans is alarming,” said Dr Ahmedin Jemal, senior vice-president for surveillance and health equity science at the American Cancer Society. “We need to halt and reverse this trend by increasing uptake of screening, including awareness of non-invasive stool tests with follow-up care, in people 45-49 years, [old]” said Jemal. Read full story Source: The Guardian, 17 January 2024
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Content ArticleHealth care algorithms are used for diagnosis, treatment, prognosis, risk stratification and allocation of resources. However, bias in the development and use of algorithms can lead to worse outcomes for racial and ethnic minoritised groups and other historically marginalised populations such as individuals with lower incomes. This study aimed to provide a conceptual framework and guiding principles for mitigating and preventing bias in health care algorithms, in order to promote health and health care equity. The authors suggested five guiding principles: Promote health and health care equity during all phases of the health care algorithm life cycle Ensure health care algorithms and their use are transparent and explainable Authentically engage patients and communities during all phases of the health care algorithm life cycle and earn trustworthiness Explicitly identify health care algorithmic fairness issues and trade-offs Establish accountability for equity and fairness in outcomes from health care algorithms.
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Content ArticleThis systematic review conducted for the Agency for Healthcare Research and Quality (AHRQ) aimed to examine the evidence on whether and how healthcare algorithms exacerbate, perpetuate or reduce racial and ethnic disparities in access to healthcare, quality of care and health outcomes. It also examined strategies that mitigate racial and ethnic bias in the development and use of algorithms. The results showed that algorithms potentially perpetuate, exacerbate and sometimes reduce racial and ethnic disparities. Disparities were reduced when race and ethnicity were incorporated into an algorithm to intentionally tackle known racial and ethnic disparities in resource allocation (for example, kidney transplant allocation) or disparities in care (for example, prostate cancer screening that historically led to Black men receiving more low-yield biopsies).
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Content ArticleThis leaflet aims to help people with type 1 diabetes decide between the different technologies available to manage diabetes. It contains summaries of devices available and infographics outlining eligibility criteria for continuous glucose monitors (CGM), insulin pumps and hybrid-closed loop systems. Diabetes care is one of the five clinical areas of focus for integrated care boards and partnerships to achieve system change and improve care as part of Core20Plus5 for children and young people with the aim to increase access to real-time continuous glucose monitors and insulin pumps across the most deprived quintiles and from ethnic minority backgrounds.
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EventuntilLondon inspire Programme (LiP) is a ground-breaking programme which was specifically developed to raise awareness and promote targeted health interventions aimed at reducing disparities faced by Black people in London. This involves working closely with Black Caribbean & African leaders and health professionals, to explore an asset-based approach to mobilising the community and improve health outcomes. This event will be an opportunity to bring together key stakeholders to explore community-based approaches and how health systems could collaborate to create sustained health improvement. The event will celebrate what is working well, share learning, and create opportunities for reflection resulting in a call to action and inclusive leadership to improving the health of Black Londoners. The Summit will feature speakers renowned for their contributions to health equity and advocates with expertise in addressing health disparities within Black communities. A special focus will be given to voices from the Black Caribbean and African community, healthcare professionals, community leaders, researchers, and lived experiences. This diversity of perspectives aims to provide a comprehensive understanding of the challenges and opportunities to reducing health inequalities at system and community levels. Confirmed keynote speakers include: Prof Bola Owolabi Prof Kevin Fenton CBE Dr Marie Gabriel Dr Habib Naqvi OBE Register for the event
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News Article
UK has some of worst cancer survival rates in developed world
Patient Safety Learning posted a news article in News
The UK has some of the worst cancer survival rates in the developed world, according to new research. Analysis of international data by the Less Survivable Cancers Taskforce found that five-year survival rates for lung, liver, brain, oesophageal, pancreatic and stomach cancers in the UK are worse than in most comparable countries. On average, just 16% of UK patients live for five years with these cancers. Out of 33 countries of comparable wealth and income levels, the UK ranks as low as 28th for five-year survival of both stomach and lung cancer, 26th for pancreatic cancer, 25th for brain cancer and 21st and 16th for liver and oesophageal cancers respectively. The six cancers account for nearly half of all common cancer deaths in the UK and more than 90,000 people are diagnosed with one of them in Britain every year. The taskforce calculated that if people with these cancers in the UK had the same prognosis as patients living in countries with the highest five-year survival rates – Korea, Belgium, the US, Australia and China – then more than 8,000 lives could be saved a year. Anna Jewell, the chair of the Less Survivable Cancers Taskforce, said: “People diagnosed with a less survivable cancer are already fighting against the odds for survival. If we could bring the survivability of these cancers on level with the best-performing countries in the world then we could give valuable years to thousands of patients. “If we’re going to see positive and meaningful change then all of the UK governments must commit to proactively investing in research and putting processes in place so we can speed up diagnosis and improve treatment options.” Read full story Source: The Guardian, 11 January 2023 -
Content Article
MBRRACE-UK: Maternal mortality 2020-2022
Patient Safety Learning posted an article in Maternity
MBRRACE have released their latest UK maternal mortality figures. The maternal death rate in 2020-22 was 13.41 per 100,000 maternities. This is significantly 53% higher than the rate of 8.79 deaths per 100,000 maternities in the previous three year period (2017-19). -
EventuntilThis online conference hosted by the Royal College of General Practitioners (RCGP) is free of charge to RCGP members and £200 for non-members. Health inequalities are differences in health across the population and between different groups in society that are systematic, unfair and avoidable. General Practice, with its unrivalled access to the heart of communities, has a key role in addressing both causes and consequences of health inequalities in the UK. General Practice is a diverse profession caring for multiple patient populations and the aim of this conference is to move from conversations to actions, improving patient care in these communities. The programme was put together by RCGP Officers, Faculty Education Leads and expert speakers, who are participating throughout the day and will include examples of best practice, relevant guidance and links to useful resources. Learning objectives: Understand the evidence linking ethnicity, protected characteristics, and health outcomes Acknowledge minority patients' perspectives of health and illness Promote the best clinical management within primary care Promote partnerships working with relevant organisations and community assets to improve patient care Areas to be covered: Health inequalities in learning disabilities Health inequalities in South Asian women in the UK Exploring and remediating unconscious bias Tackling health inequalities in African and Caribbean communities Barriers to accessing health services for migrant and ethnic minorities patients Panel discussion: improving screening uptake in minority ethnic groups End of life care and bereavement Pain management in populations with high levels of health inequality Ethnicity and disease Issues affecting the LGBTQIA+ community Keynote Speaker: Professor Kamila Hawthorne MBE, Chair of Council, RCGP Register for the conference
