Dr Layla McCay
Director of policy, the NHS Confederation
Many local health and care systems across England are currently tackling major short and long-term challenges — exacerbated by the disruption caused by industrial action — and these have an impact on health inequalities.
Tackling rising health inequalities and stagnating life expectancy requires sustainable cross-sectoral transformation towards prevention and health creation.
Partnerships addressing health inequalities
The establishment of 42 Integrated Care Systems (ICSs), which are partnerships of organisations in local areas established to tackle multiple complex health and care needs, across the country in July 2022 offers the opportunity of a generation to reduce regional disparities in healthcare and health outcomes.
Everyone being able to access good quality health
and social care services is essential
to ‘level up’ health outcomes.
The ICS infrastructure can allow the population’s physical and mental health to be seen through a ‘systems’ lens and allow integrated care to be better delivered in a more coordinated way across NHS primary, secondary and community care; local authorities; and Voluntary, Community and Social Enterprise (VCSE) organisations according to the health and care needs of local populations.
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Levelling up health outcomes
Everyone being able to access good quality health and social care services is essential to ‘level up’ health outcomes. People from Black, Asian and ethnic minority communities and other groups, such as migrants, disabled people, LGBTQ+ people and Gypsy Roma or Travellers have a significantly greater risk of poorer health outcomes, in part due to the barriers in getting the care they need.
Many local areas are using NHS England’s Core20PLUS5 framework to reduce health inequalities across people’s life courses, supported by national funding targeted at those areas with the greatest health inequalities.
Focusing on creating health over just treating ill health
For the NHS to improve population health outcomes equitably, it needs to transition and become a service that invests more time and energy towards prevention and health creation. Evidence exists that the NHS can help reduce health inequalities. However, this requires concerted cross-government departmental action; equitable distribution of resources, funding and workforce; and allowing local system leaders to lead on local priorities.
Given that health permeates all aspects of life, no one sector, organisation or individual can make this happen. Rather, a collective societal response is required to shift the dial on systemic local and regional health disparities.