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Showing results for tags 'Health inequalities'.
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Content ArticlePrisoners have a right to the same standards of healthcare available to people in the community, and although we might suspect that people in prisons don't always receive the care they need, this is a difficult issue to get at through research. So how can we meaningfully compare hospital use between those in prison and those who are not? Miranda Davies and Eilís Keeble used a novel matched control methodology to show that prisoners use services less than people with similar health characteristics who are not incarcerated.
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News ArticlePeople in some more rural areas are missing out on specialist treatments they should be getting, while Londoners are receiving a lot more than their “fair share”, new NHS England figures suggest. NHS England has suggested the main cause is “systematic shortfalls in access [in] remote communities”, leaving “unmet need” for specialised services in these areas. However other factors, including coding and reporting practices, year-to-year fluctuation, and weaknesses in the formula, are also likely to be confusing the picture, sources said. The variation is being uncovered now because NHSE is preparing to fund many specialised services via allocations to integrated care boards. These allocations will be based on estimates of their populations’ healthcare needs, rather than NHSE negotiating payments directly with provider trusts – as it has since 2013. Read full story (paywalled) Source: HSJ, 3 January 2023
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Content ArticleIn this episode, Ruth Robertson explores how the NHS elective care waiting list can be managed in a way that improves health equity with Dr Mark Ratnarajah, UK Managing Director at C2-Ai, Sharon Brennan, Director of Policy and External Affairs at National Voices and Dr Polly Mitchell, Post Doctoral Research Fellow in Bioethics and Public Policy at King’s College London.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Sonia talks to us about how her role at NHS Confederation helps her understand the issues facing NHS staff and why she decided to start drawing graphics to communicate important information to patients and staff. -
Content ArticleThe Maternal, Newborn and Infant Clinical Outcome Review Programme has published an MBRRACE-UK Perinatal confidential enquiry report on a comparison of the care of Black and White women who have experienced a stillbirth or neonatal death. It is based on deaths reviewed in England, Wales, Scotland and Northern Ireland, for the period between 1 July 2019 and 31 December 2019. The overall findings of this enquiry were based on the consensus opinion of panel members concerning the quality of care provided for the 36 Black and 35 White mothers and their babies. This enquiry was developed to try and identify any differences in the quality of care provided to women of Black ethnicity compared with their White counterparts, and forms the main focus of this report. As such, the recommendations are targeted at trying to ensure equity for the quality of care provision for both Black and White mothers and their babies.
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Content ArticleThe Maternal, Newborn and Infant Clinical Outcome Review Programme has published an MBRRACE-UK Perinatal confidential enquiry report that compares the care of Asian and White women who have experienced a stillbirth or neonatal death. It is based on deaths reviewed in England, Wales, Scotland and Northern Ireland, for the period between 1 July 2019 and December 2019. The overall findings of this enquiry were based on the consensus opinion of panel members concerning the quality of care provided for 34 Asian and 35 White mothers and their babies. This enquiry was developed to try and identify any differences in the quality of care provided to women of Asian ethnicity compared with their White counterparts, and forms the main focus of this report. As such, the recommendations are targeted at trying to ensure equity for the quality of care provision for both Asian and White mothers and their babies.
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Content ArticleIn 2022 the Center for Medicare & Medicaid Services (CMS) launched the CMS National Quality Strategy (NQS), an ambitious long-term initiative that aims to promote the highest quality outcomes and safest care for all. This document gives an overview of the strategy, using infographics to explain its four priority areas: Outcomes and alignment Equity and engagement Safety and resiliency Interoperability and scientific advancement
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Content ArticleIn this article for the Byline Times, Saba Salman highlights the results of the latest NHS-funded annual review of deaths among people with learning disabilities. The report lays bare how people with learning disabilities are less likely to survive health problems that are preventable and treatable than those without learning disabilities. Researchers at King’s College London, the University of Central Lancashire and Kingston University London reviewed the deaths of 3,648 people with a learning disability. Overall, almost half died an avoidable death, compared to two in 10 in the general population. The median age of death in was 63 years, which is around 20 years less than for people without learning disabilities.
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News Article
‘No doctor in the country will touch you’: how the NHS is failing FGM survivors
Patient Safety Learning posted a news article in News
At least 137,000 women in the UK live with the painful and traumatic consequences of cutting, but there is no provision for reconstructive surgery. In May 2023, Shamsa Araweelo was in the A&E department of a London hospital in excruciating pain. It wasn’t the first time she had sought urgent treatment for the gynaecological damage caused by the female genital mutilation (FGM), or cutting, forced on her as a six-year-old. In fact, this was one of many such visits to emergency departments that Araweelo had made in her desperate attempt to find a surgeon who could help undo the damage done to her as a child and which has caused her so much pain and trauma as an adult. Araweelo says that in A&E she was told that she had severe nerve damage and that it could be reversed through reconstructive surgery. But not in the UK. “No doctor in the country will touch you, because you are an FGM survivor,” Araweelo says she was told. “I felt no compassion, no respect. Only in London did they tell me they wished they had the appropriate training to help me, and it breaks my heart. We are not valued in the UK.” Current NHS rules state that if a health practitioner suspects a patient has been cut, they must report the case to the police and complete a safeguarding risk assessment to determine whether a social care referral is required. Guidance for GPs also recommends referrals for mental health issues related to FGM or referrals to uro-gynaecological specialist clinics. Araweelo says that in all the years she has sought help she has never been offered any kind of support from medical professionals. Read full story Source: The Guardian, 21 December 2023 -
Content ArticleThe ethnicity data gap pertains to three major challenges to address ethnic health inequality: Under-representation of ethnic minorities in research Poor data quality on ethnicity Ethnicity data not being meaningfully analysed. These challenges are especially relevant for research involving under-served migrant populations in the UK. This study in BMC Public Health aimed to review how ethnicity is captured, reported, analysed and theorised within policy-relevant research on ethnic health inequities. The authors concluded that the multi-dimensional nature of ethnicity is not currently reflected in UK health research studies, where ethnicity is often aggregated and analysed without justification. Researchers should communicate clearly how ethnicity is operationalised for their study, with appropriate justification for clustering and analysis that is meaningfully theorised.
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News Article
Patients’ experiences of disease should be taken more seriously, says study
Patient Safety Learning posted a news article in News
Health experts say more attention should be given to patients’ experiences after research found multiple examples of their insights being undervalued. A study led by the University of Cambridge and King’s College London found clinicians ranked patient self-assessments as the least important when making diagnostic decisions. Ethnicity and gender were felt to influence diagnosis, particularly a perception that women were more likely to be told their symptoms were psychosomatic. Male clinicians were more likely to say that patients overplay symptoms. The findings prompted calls for clinicians to move away from the “doctor knows best attitude” when caring for patients. One patient shared the feeling of being disbelieved as “degrading and dehumanising”, and added: “I’ll tell them my symptoms and they’ll tell me that symptom is wrong, or I can’t feel pain there, or in that way.” Read full story Source: The Guardian, 18 December 2023 -
Content ArticleMonica is a project manager for the South East London Local Maternity and Neonatal System. In this interview she talks about her work, including setting up the perinatal pelvic health service across south east London.
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Content Article
The Cultural Awareness Hub
Sam posted an article in Safety culture programmes
The Cultural Awareness Hub is a national service which provides interactive, expert experience and sustainable workshops which offer unique insights into culture and history for all organisations working with and supporting the public. It helps organisations to understand and identify barriers to services, while providing realistic and achievable solutions to ensure effective and efficient collaborative engagement is embedded with all communities. The training is developed to transform knowledge and empower both participants and the communities they are supporting. Understanding and respecting different cultures and communities is essential to ensure all services provide personalised care. Training provided through The Cultural Awareness Hub is subject to a fee, please contact us for more information. To find out more and to discuss creating your own training package, please contact TheCulturalAwarenessHub@EELGA.gov.uk. -
News ArticleHundreds more middle-aged adults have been dying each month since the end of the pandemic, as obesity and NHS backlogs drive a surge in excess deaths. New analysis of official statistics has revealed that there were an extra 28,000 deaths in the UK during the first six months of 2023, compared with levels in the previous five years. The biggest rise in unexpected deaths has been among adults aged 50 to 64, who are increasingly dying prematurely from preventable conditions including heart disease and diabetes. The Covid inquiry is now being urged to shift its focus from “tactical decisions made by politicians” and to examine the lasting disruption that has kept deaths persistently high since the virus peaked. Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication. Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths. Professor Yvonne Doyle, who led Public Health England during the pandemic, warned that the official Covid inquiry risks “missing the point” by focusing on the drama and WhatsApps of Westminster politicians. In an article for The Times, Doyle, who gave evidence to the inquiry six weeks ago, says that the tens of thousands of excess deaths since Covid “represent an underlying pandemic of ill health” that should be addressed. Read full story (paywalled) Source: The Times, 13 December 2023
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Event
Tackling health inequalities: the need for urgent action
Sam posted an event in Community Calendar
untilMany people recognise that both the NHS and the health of the nation are in deep crisis. Whether in terms of life expectancy, levels of long-term ill health, inequalities, mental health, or the drivers of poor health such as obesity, England’s recent record is poor and often compares badly to its neighbours. Essentially, there is now a need to think differently about how to design and deliver health and care services to meet the challenge of reducing health inequalities. This two-day virtual event from the King's Fund will bring together individuals and teams who have been working on shaping, informing and implementing strategies and action plans to address health inequalities at system, regional and place levels. Ahead of the upcoming general election, sessions will also provide an opportunity to discuss and explore the need for urgent action and policy change for the new government to improve population health and implement measures that help people to make healthier choices. Showcasing both international and domestic case studies, this conference will also explore how the health and care system is working in partnership with local authorities, the voluntary, community and social enterprise (VCSE) sector and community leaders to develop a collaborative approach to health inequalities that makes the most of local assets and networks and meets the needs of local communities. Register -
Content ArticleIncreasing interest in general surgery from students who are Under-Represented in Medicine (URiM) is vital to advancing diversity, equity and inclusion efforts. This study in The American Journal of Surgery examined medical student third year surgery clerkship evaluations quantitatively and qualitatively to understand the experiences of URiM and non-URiM learners. The authors found that URiM students are less likely than non-URiM students to see surgical residents and faculty as positive role models. They highlight that integrating medical students into the team, taking time to teach and allowing students to feel valued in their roles improves the clerkship experience for trainees and can contribute to recruitment efforts.
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Content Article
D-Coded is an online resource that presents easy-to-understand summaries of diabetes research studies. It aims to make the latest knowledge and developments accessible to people who don't have a medical or scientific background. In this blog, Jazz Sethi, Founder and Director of the Diabesties Foundation and part of the global team that developed D-Coded, discusses the need for the resource and outlines how it will help people living with diabetes to better understand and manage their condition. -
News ArticleThe risk of dying from cancer in England “varies massively” depending on where a person lives, according to a study that experts say exposes “astounding” health inequalities. Researchers who analysed data spanning two decades found staggering geographical differences. In the poorest areas, the risk of dying from cancer was more than 70% higher than the wealthiest areas. Overall, the likelihood of dying from cancer has fallen significantly over the last 20 years thanks to greater awareness of signs and symptoms, and better access to treatment and care. The proportion dying from cancer before the age of 80 between 2002 and 2019 fell from one in six women to one in eight, and from one in five men to one in six. However, some regions enjoyed a much larger decline in risk than others, and the new analysis has revealed that alarming gaps in outcomes remain. “Although our study brings the good news that the overall risk of dying from cancer has decreased across all English districts in the last 20 years, it also highlights the astounding inequality in cancer deaths in different districts around England,” said Prof Majid Ezzati, from Imperial College London, who is a senior author of the study. Read full story Source: The Guardian, 11 December 2023
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Content ArticleCancers are the leading cause of death in England. This study from Rashid et al. published in Lancet Oncology aimed to estimate trends in mortality from leading cancers from 2002 to 2019 for the 314 districts in England. The study found that declines in overall cancer mortality have been unequal both geographically and among different groups of cancers. The greatest geographical inequality was observed for cancers with modifiable risk factors and potential for screening for precancerous lesions. Addressing risk factors such as smoking and alcohol use, expanding access to and utilisation of screening for prevention and early detection, and improving the quality of care should be used to reduce deaths in areas where they remain highest. High-resolution spatiotemporal data can help identify where intervention is required and track progress.
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Content ArticleThis is the fourth Health Effects of Climate Change in the UK report, which provides evidence, analysis and recommendations based on climate change projections for the UK. Climate change affects most health determinants directly or indirectly by influencing the weather conditions we experience on a day-to-day basis. Climate change can increase risks to health directly through greater severity and frequency of extreme weather events such as flooding, drought, heatwaves or wildfires. Heatwaves, for example, have already led to excess deaths in England and they can increase burden on health and care services, increase strain on water, energy and transportation infrastructure and can have implications such as crop loss and reduced air quality that can also impact health. Many infectious diseases are highly climate sensitive, and with warmer temperatures we can expect an increased risk of new and emerging infectious diseases in the UK, including those transmitted through mosquito and tick bites. The impact of climate change on individuals will vary, with the worst effects on disadvantaged and vulnerable populations, which could widen health inequalities further.
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News ArticleNew official guidance on treating menopause will harm women’s health, experts, MPs and campaigners have warned. Last month, new draft guidelines to GPs from the National Institute for Health and Care Excellence (NICE) said that women experiencing hot flushes, night sweats, depression and sleep problems could be offered cognitive behavioural therapy (CBT) “alongside or as an alternative to” hormone replacement therapy (HRT) to help reduce their menopause symptoms. But critics have castigated the guidance, saying it belittled symptoms through misogynistic language, and women’s health would suffer as a result of failing to emphasise the benefits of HRT on bone and cardiovascular health as opposed to CBT. In its response to the guidance, Mumsnet said NICE's recommendations used “patronising” and “offensive” language and would be “detrimental” to women’s health. Justine Roberts, the founder and chief executive of Mumsnet, said: “Women already struggle to access the HRT they are entitled to. We hear daily from women in perimenopause and menopause who are battling against a toxic combination of entrenched misogyny, misinformation and lack of knowledge among GPs. “Too often they are fobbed off or told they simply need to put up with severe physical and mental symptoms – often with life-changing effects. “By emphasising the negative over the positive, failing to include information about the safest forms of HRT and placing CBT on a par with hormone replacement therapy, this guidance will worsen that struggle. It will make doctors more reluctant to prescribe HRT and women more fearful about asking for or accepting it.” Carolyn Harris, the MP for Swansea East and the chair of the all-party parliamentary group on menopause, said the new guidance was “antiquated”, “naive” and “ill thought-out”. ”Talking can make you feel better, but it’s not going to take away the aches in your joints and it’s not going to change how you live your life,” she said. “Whatever a woman feels is what she needs to support her through the menopause should be readily and immediately available, and that’s not true currently [of HRT or CBT]." Read full story Source: The Guardian, 11 December 2023
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Content ArticleNational Voices is committed to tackling racial inequalities – in healthcare, health status, within their own organisations and across the charity sector. With unacceptable statistics, like Black women are four times more likely to die around pregnancy than White women, and Black babies are almost three times more likely to die than White babies – still now, in 2023 – the need for effective action could not be stronger.
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Content ArticleOver the past two years, AHRQ has examined equity and its connections to agency activities in alignment with its mission to improve healthcare for all Americans. A new special issue of Health Services Research sponsored by AHRQ summarises the state of evidence and identifies opportunities to drive more equitable care.
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Content ArticleIn this episode of the King's Fund podcast, Ruth Robertson explores how the NHS elective care waiting list can be managed in a way that improves health equity with Dr Mark Ratnarajah, UK Managing Director at C2-Ai, Sharon Brennan, Director of Policy and External Affairs at National Voices and Dr Polly Mitchell, Post Doctoral Research Fellow in Bioethics and Public Policy at King’s College London.
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News Article
UK minority ethnic transplant patients face double inequity, MPs say
Patient Safety Learning posted a news article in News
NHS “inaction” for more than a decade is causing unnecessary deaths of black, Asian and minority ethnic transplant patients, a report by MPs has concluded. An inquiry into organ donation in the UK found that minority ethnic and mixed heritage people faced a “double whammy of inequity”: they are more likely to need donors, because they are disproportionately affected by conditions such as sickle cell and kidney disease, and they are less likely to find the right blood, stem cell or organ match on donor registers. Matching tissue type is vital to the chances of successful treatment, and compatible donors who are not relations are more likely to be found among donors from a similar ethnic background. While there are more donors than in previous years, theall-party parliamentary group (APPG) for ethnicity transplantation and transfusion’s inquiry report says just 0.1% of blood donors, 0.5% of stem cell donors and less than 5% of organ donors are of minority ethnic or mixed background. As a result, white people are nearly twice as likely to find a stem cell donor and 20% more likely to find a kidney donor. The inquiry found a “staggering lack of consistent and detailed ethnicity data” within healthcare systems, which “undermines accountability and jeopardises the lives of those awaiting life-saving treatments”. Responding to the findings, Habib Naqvi, the chief executive of the NHS Race and Health Observatory, said such stark ethnic disparities in organ donor participation were of “grave concern” and required “more investment from health providers and targeted campaigns to raise awareness” to build trust in the healthcare system. Jabeer Butt, the chief executive of the Race Equality Foundation, said the inequalities were unacceptable. “Every person, regardless of ethnic background, deserves an equal chance at receiving life-saving transplants and donations when needed. This is a solvable problem, but it requires a shared commitment to action across government, health organisations and communities. Lives depend on it,” he said. Read full story Source: The Guardian, 4 December 2023
