Healthcare inequalities are unfair and avoidable differences in health across the population, and within different groups in society. People who live in areas of high deprivation and who are from certain ethnic minority communities are at higher risk of health inequalities, which are linked to the wider determinants of health, such as where we are both and grow up and the conditions in which we live, work and age. The NHS Long Term plan has the reduction of health inequalities at its core and aims to ensure exceptional quality healthcare for all, ensuring equitable access, excellent experience and optimal outcomes. The RCGP health inequalities hub contains three eLearning courses, as well as other resources.
The first course provides an introduction to health inequalities, introducing terms such as the wider determinants of health, the index of multiple deprivation, the inverse care law and the intersectionality between multiple factors. A case study approach is used to help learners consider how they might reduce health inequalities in their area. The second module looks at leadership in this area, considering how a practice might put in place measures to reduce health inequalities among their patients and what challenges this might bring.
The second course is on inclusion health. Inclusion health groups are those who are most likely to suffer health inequalities – they include those experiencing homelessness, victims of modern slavery and vulnerable migrants. The course discusses how practices can be welcoming to these patients, how to make sure that they are not deterred from registering by unnecessary administration, and how to manage consultations with those in inclusion groups, within the confines of NHS general practice.
The third course discusses the principle of allyship and bystander intervention, how to avoid unintentional microaggressions, and the NHS’ policy towards racism. It covers situations that might arise in practice, such as what to do if a patient asks to see a white doctor, and the interventions that have been recommended to reduce the fact that black and ethnic minority doctors are more likely than white doctors to be referred to the GMC. A case study illustrates how a practice might deal with a patient who makes a racist comment.
The rest of the hub contains other resources in the area of health inequalities. This includes an interview and a webinar with Professor Sir Michael Marmot, who has led research groups on health inequalities for over 40 years and has written key reviews in this area, including ‘Fair Society, Healthy Lives’. There is also a podcast about the use of social prescribing link workers to reduce health inequalities and a section about increasing vaccine uptake to reduce health inequalities – this was linked to the COVID-19 vaccine, but many aspects are relevant to other vaccinations. Finally there are links to other resources, including on ‘missingness’, when patients do not attend appointments and may be harmed by this, and resources about addressing the increase in health inequalities that has been seen since the COVID-19 pandemic.
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