Delivering Equity: A 5-Step Model for Action in Healthcare
This presentation outlines a comprehensive approach to delivering equity in healthcare, focusing on core priorities for health systems, understanding inequities, actionable insights for addressing social determinants, and a 5-step co-production model for developing solutions. By valuing data and tackling inequalities, the model aims to empower communities and improve health outcomes for all.
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Delivering Equity - Stop describing & start delivering 5 step model for action Carol Hill Assistant Director, EDI Programme NHS Confederation
Health System Priorities Systems to focus on the following tasks for 2023/24: Core20PLUS5 1. Prioritise recovering core services and productivity 1. Restore NHS services inclusively 2. Mitigate against digital exclusion 2. Return to delivering the key ambitions in the NHS Long Term Plan (LTP) 3. Ensure datasets are complete and timely 4. Accelerate preventive programmes that proactively engage those at greatest risk of poor health 3. Continue transforming the NHS for the future 5. Strengthen leadership and accountability 2
Understanding inequity Taking a social determinants view involves thinking about the root causes why people make, what may appear from the outside to be poor decisions about their lives and their health, and these relate to deprivation, exclusion and poverty. Empowering the most vulnerable communities who experience the cumulative impact of health inequalities by: Supporting primary care and wider health economy to address the social determinants of health. Address the inverse care law to allocate resources efficiently Actionable Insights Local Intelligence Build collaboration with VCSE & extend social prescribing offers to focus on the social determinants of health including referrals food and fuel security etc National data 3
Our 5-step approach Co-production Step 1. Intelligence Gathering Step 2. Analysis & Interpretation Step 3. Defining problems Step 4. Co-designing solutions Step 5. Critical actions What Build up your insights from a range of data sources Compare and cross- reference data with existing strategies and benchmarking Consolidate collected data Involve and delegate to communities Identify key actions to address inequalities for the workforce and communities Terms Sources Tools Quantitave & Qualitative data Assess, Rank, Deepen insight Co-design, Plan, Deliver Gather, Organise, Share Co-production Sessions in/output Compare, Cross-reference, Benchmark Interactions with patients & staff Filter Confirm Create How Find Resolve 4
Valuing what data you have Those served by the Trust Is everyone served fairly? Where are the service pinch-points & do we understand why? Innovative vs. traditional service? ?Performance: Access, waiting times, experience & outcomes, broken down by service & ethnicity ?Is there over-representation for services, e.g., PICU, Crisis team Workforce Staff Survey, R&R statistics Diversity by grade ? Inclusive management ? Commensurate with communities ?Culture: empowered to act and take risks, encourage innovation Resourced adequately Tackling Inequalities What are you trying to change?, Where to focus? Deep dives, options, priorities? Agreed Strategies/Priorities Vision, values, priorities x5 Transformation Programme EDI Strategy 2021/5 January 2022 Board Report Co-production priorities JSNA & Public Health strategies ICP & ICB strategies System Intelligence Activity & Quality Performance data CQC, WRES, WDES, Equality Impact Assessments, Patient survey, Workforce Surveys, Healthwatch, PCN/GP views, Complaints, Incidents, Network feedback Tools Core20+5 HEAT Clinical Priority tool, etc. 5
Core20PLUS5 an approach to reducing healthcare inequalities 6 https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/ https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/core20plus5-cyp/