Variation in emergency admissions within CCG areas

NHS England has published Challenging Health Inequalities: support for CCGs. This document aims to help identify areas of variation in emergency admissions in more and less deprived CCGs, and to promote a discussion where variation occurs. It is designed to support the CCG Improvement and Assessment Framework (IAF) health inequalities data on the myNHS website.

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Deprivation strongly linked to mortality

Report from the Office for National Statistics reveals “sizeable and highly significant” absolute and relative inequalities in avoidable mortality between those living in the most and least deprived areas.

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Main points

  • Avoidable, amenable and preventable mortality is strongly related to area deprivation in England and in Wales.
  • In England in 2015 there were 16,686 deaths from avoidable causes in the most deprived areas whereas there were less than half that number (7,247 deaths) in the least deprived areas.
  • In the most deprived areas of Wales there were 1,054 deaths from avoidable causes in 2015, compared with 509 deaths in the least deprived areas.
  • Absolute and relative inequalities in avoidable mortality between those living in the most and least deprived areas were sizeable and highly significant, but the excess was larger for males than females in all cases.
  • The largest relative inequality in avoidable mortality was for deaths from respiratory diseases which were 4.8 times (males) and 7.7 times (females) more likely in the most deprived populations compared with the least deprived.
  • The largest absolute difference in avoidable mortality between the most and least deprived deciles was from cardiovascular disease and cancer.

Full report: Measuring Socioeconomic inequalities in avoidable mortality in England and Wales: 2015

Variation in access to healthcare

The Medical Technology Group has published The north–south NHS divide: how where you are not what you need dictates your care.

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Image source: http://www.mtg.org.uk

This report examines CCG indicators to find how effective CCGs are at giving patients access to medical technology.  Providing each CCG with a grading based on how they scored in comparison to other CCGs, the report finds wide variation in access between the north and south of England and argues that CCG performance against access indicators should be clearer to patients.

Additional link: The Medical Technology Group press release

Bridging The Health Care Gap Through Telehealth

This case study looks at two telehealth models in Mexico and the U.S. targeting low- to middle-income parts of the population | Commonwealth Fund

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In many developing nations, the public health system is unable to meet demand for services, driving people to seek costly services in the private sector. Telehealth can expand access to care while, in some cases, reducing unnecessary use of services, such as immediate acute care for non–health emergencies.

Using a call centre as the point of access, these models have reduced unnecessary use of services and supported patient navigation of local health services.

North-South health divide bigger than ever

Dying early (under age 75) is 20% more likely in northern compared with southern England according to research led by The University of Manchester

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The study uncovers a North-South divide in deaths among middle aged adults, which has been rising since the mid-90s and is now at alarming levels:

  • 49% more deaths among 35-44 year olds in the North in 2015
  • 29% more deaths among 25-34 year olds in the North in 2015

The team shows that a sharp increase in premature deaths among middle aged adults in the North first emerged in the mid-90s, increasingly quickly but consistently until the end of the study period in 2015.

Podcast: What’s going on with life expectancy?

The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contributor | BMJ Talk Medicine

In this podcast Michael Marmot, director at University College London’s Institute of Health Equity, joins us to discuss what might be causing that drop off, and why a decrease in early life chances is particularly problematic.

Read more about the report here

Reducing health inequalities: Marmot indicators 2017

This briefing provides an update on progress since the 2008 Marmot Review into the most effective evidence-based strategies for reducing health inequalities in England. | The Institute of Health Equity 

This update finds that improvements on life expectancy at birth and remaining life expectancy at 65 have slowed since 2010. The analysis also finds that inequalities within and between local authorities have persisted.

Full document: Marmot Indicators Briefing 2017 – updated

Additional links: BBC News report | AgeUK