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CCGs rated best and worst for tackling health inequalities

264,000 excess hospitalisations linked to socioeconomic inequality

Adrian O'Dowd

Wednesday, 24 August 2016

New indicators have revealed large variation in CCGs’ performance in tackling health inequalities in their area, which are said to have led to 264,000 excess hospitalisations over the past financial year.

The indicators of how well the NHS is tackling health inequality across the country have now been adopted by the NHS and have just been rolled out as part of the NHS Clinical Commissioning Group Improvement and Assessment Framework, launched earlier this year.

They focus on emergency hospitalisation for patients with long-term conditions such as dementia, diabetes, respiratory and heart diseases, and are designed to help local NHS managers reduce potentially avoidable A&E admissions arising from social inequality.

From the newly published indicators, which were developed by researchers at the University of York’s Centre for Health Economics, results show large differences in inequality performance between different CCGs across the country.

In addition, they show that between April 2015 and April 2016, there were 264,000 excess hospitalisations associated with socioeconomic inequality.

Central Manchester CCG had the greatest health inequalities in England in the past year as the difference in rate of hospitalisations between the richest and poorest areas was 2,136 for every 100,000 people.

Second worst was Blackburn and Darwen with a rate of 2,029 followed by North Manchester (2,017), Islington (1,954) and South Manchester (1,889).

On the other end of the scale, NHS City and Hackney CCG ranked number one on the best CCG list.

However, deprivation was not automatically an indicator of poor performance as Liverpool CCG and Tower Hamlets CCG both look after some of the most deprived areas in England, but the former was on the worst performers list, while the latter was on the best performers list.

Lead investigator, Professor Richard Cookson from the Centre for Health Economics, said: “NHS policymakers and managers have a legal duty to consider reducing inequalities.

“However, reliable information on healthcare inequalities is currently scarce: national monitoring focuses on the average patient, and little attention is given to local monitoring of healthcare inequality.

“These indicators could be used to help managers learn quality improvement lessons, to help regulators and others hold the NHS to account, and to help inform the public about healthcare inequalities within their local area.”

Ruth Passman, head of equality and heath inequalities at NHS England said: “For the first time, NHS managers can now find out how well their local CCG area is doing in tackling these inequalities, compared with similar CCG areas, and see how these inequalities are responding to local healthcare initiatives.”

Dr Mark Spencer, co-chair of the NHS Alliance, said: “While we welcome anything that throws a spotlight on health inequalities, we would argue that York University’s findings do not adequately address the complex issues behind the increased number of people from deprived areas admitted to hospital.

“It’s not about worse treatment by GPs, it’s about the significant and complex health needs of those communities including a higher prevalence of long-term conditions, and combined physical and mental health issues.

“Areas of high deprivation require more resources to achieve the same outcome as others – yet the reverse is happening. There is serious under resourcing of primary care in these areas, and significant recruitment and retention issues across primary care professionals.”

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