Health creation: for now and future generations

The Health Creation Alliance – 2024

This manifesto lays out the case for a fundamental shift to health creating systems to reduce the burden of health inequities on individuals, their communities and the health and care systems. It is for politicians, systems and any organisation or individuals committed to reducing health inequity and inequalities as all these have a role in helping to ensure that creating health sits alongside treating illness and prevention of ill-health.

Further information –Health creation: for now and future generations

Addressing health inequalities across allied health professional (AHP) services: a guide for AHP system leaders

OHID – May 2024

This guide has been developed for allied health professional (AHP) system leaders working across regions, integrated care systems (ICSs), local authorities and provider organisations. The guide focuses on what AHP leaders need to know and what actions they can take at a system level to address health inequalities.

The guide emphasises using a population health approach and leading change at scale, focusing on the breadth of AHP services rather than individual services or professional groups.

Read the Guidance – Addressing health inequalities across allied health professional (AHP) services: a guide for AHP system leaders

England’s widening health gap: local places falling behind

Institute of Health Equity – May 2024

This report confirms widening inequalities in life expectancy between regions in England and within local authorities since 2010. These widening inequalities are associated with an average reduction in local authority spending power of 34%. The study looked at every local authority in England and, for each, plotted levels of health, inequalities in health, and cuts in their spending power. Local authorities fund many of the services (such as housing, education and social care) that support or ameliorate the drivers of health inequalities. The report shows that since 2010, central government spending cuts to local authorities were highest in areas with lower life expectancy and more health inequalities, further harming health in these places.

Read the report – England’s widening health gap: local places falling behind

Harnessing the potential of conversational AI to improve healthcare access and reduce inequalities

Nadarzynski, T. et al. (2024) | Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare | PLOS Digital Health 3(5): e0000492 | https://doi.org/10.1371/journal.pdig.0000492

Artificial intelligence (AI) systems like conversational chatbots are increasingly being used in healthcare settings. However, there are concerns that these AI tools may perpetuate biases and worsen health inequalities if they are not designed and implemented carefully with diverse populations in mind.

This study aimed to develop a roadmap to help ensure that AI chatbots for healthcare are created and deployed in an equitable and inclusive way. The authors reviewed existing guidelines on ethical AI use in healthcare and interviewed 33 stakeholders including community members, healthcare professionals, and AI developers. Based on this, a 10-stage roadmap is outlined covering key activities such as involving underrepresented communities in co-production, conducting research on AI biases, implementing safety protocols, evaluating real-world effectiveness, and planning for chatbot maintenance or termination while minimising disruption to care.

The roadmap emphasises the importance of close collaboration between chatbot creators, healthcare providers, policymakers, and the communities being served. It provides a checklist of equity considerations at each stage of the chatbot lifecycle. Following this roadmap can help mitigate unfair biases, increase acceptability among diverse patient groups, and harness the potential of conversational AI to improve healthcare access and reduce inequalities.

Full paper: Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare

Levelling up or levelling down: the impact of integrated care systems on the delivery of care

The Medical Technology Group – 2024

This report examines the complexities of health inequalities and variations in patient access to treatment and access to medical technology within integrated care boards (ICBs), and highlights the opportunities to share best practice across the country.

Levelling up or levelling down: the impact of integrated care systems on the delivery of care

Co-production and engagement with communities

Co-production and engagement with communities as a solution to reducing health inequalities | NHS Providers

Responding to the views of patients and local communities and involving them in decision making processes is viewed as the gold standard of healthcare design and delivery. It is understood to remove barriers to accessing services, ensuring that services are patient centred and responsive to the community’s needs.

This report outlines the principles of co-production and actions trusts can take to apply engagement methodologies across their organisation. It provides an overview of different forms of engagement and summarises the potential benefits to trusts, including improved patient experiences and outcomes, and the delivery of more inclusive healthcare services that better meet the needs of local communities. It also makes the connection between engagement, co-production and the broader health inequalities agenda, unlocking the potential for collaboratively developing solutions to address complex barriers to health services experienced by some communities.

Full report: Co-production and engagement with communities as a solution to reducing health inequalities

Tackling health inequity: observations from an investigation visit

Health Services Safety Investigation Body – April 2024

Brief report describes a visit to a PCN where at least 50% were in the poorest 20% of England’s population. Authors advocate that regions must understand their populations, work beyond traditional boundaries, and “reach in” to support people to ensure equal access to care.

Tackling health inequity: observations from an investigation visit

Health inequalities in 2040: current and projected patterns of illness by deprivation in England

The Health Foundation

This report focuses on inequalities in major illness in England, notably among working-age people. It reveals that growing ill health will continue to significantly impact people’s lives and the economy. On current trends, 3.7 million working-age adults will be living with major illness by 2040 – up from 3 million in 2019. It warns that 80% (540,000) of this increase will be in the more deprived 50% of areas, further entrenching health inequalities and having considerable implications for local and regional economies.

Health inequalities in 2040: current and projected patterns of illness by deprivation in England

Maternal health inequities persist. Can digital tools be part of the solution?

Deloitte Center for Health Solutions; 2024.

This article reports on a U.S survey that aimed to understand how digital tools can be helpful, and how maternal health–focused organisations are using technology and digital tools to reduce health care disparities during pregnancy. It finds that while digital tools can empower the maternal health ecosystem, there is a need for better cultural tailoring and increased ease of use.

Maternal health inequities persist. Can digital tools be part of the solution?

Reducing health inequalities: a guide for NHS trust board members

NHS Providers – March 2024

This is a practical guide to support NHS trust board members to address health inequalities as part of their core business. It outlines why trusts should act on health inequalities, includes a vision for what good looks like, a self-assessment tool for trusts to use to determine where they are in their journey and a list of suggested objectives for board members. It covers a wide range of trust work, from operational and clinical delivery of services, to the trust’s role as an anchor institution and as an employer of NHS staff. The suggested objectives are drawn from NHS England (NHSE) policy, guidance, and good practice from the sector.

This guide is specifically designed for NHS trusts and does not cover the roles and responsibilities for addressing health inequalities at the wider system level. We recognise that tackling health inequalities often requires system-level solutions, by working in partnership with local authorities, integrated care systems (ICSs) and voluntary, community and social enterprise (VCSE) sector organisations. Collaborative working needs to be embedded across the work of NHS trusts to deliver on this agenda. Commissioners could also make use of the guide within planning discussions and are encouraged to share it with colleagues in trusts and wider systems.

Reducing health inequalities: a guide for NHS trust board members