Tag: health inequalities

Inflation continues to loom large as 2023 gets properly underway

This week always feels like a bit of a transition every year – it starts to feel a bit late to say “Happy New Year”, and the start of the week is dubbed “Blue Monday” as people realise that those well-meaning new year resolutions have already been broken (writes Fraser of Allander Director MAIRI SPOWAGE).

One of mine was to think hard to find the optimistic news in what can sometimes feel like the unrelentingly negative economic situation we are in, which is likely to remain tricky throughout the year. I was tested hard this week as new inflation data was released on Wednesday.

Inflation falls to 10.5% – but let’s not get too excited

The ONS released the official inflation data for December, which showed CPI inflation had fallen from 10.7% in November to 10.5% in December.

The main items driving the fall in inflation are petrol and diesel prices, and prices for clothing in footwear. Prices at the pump have been falling since their peak in July, and in December they were back to roughly the levels they were at before the Russian invasion of Ukraine. Clothing and footwear has fallen really due to a lack of discounting in December 2021, so when compared to December 2022 it appears that prices have fallen.

Obviously, energy prices are still contributing hugely to this very high inflation rate (which, let’s not forget represents a 40 year high of inflation apart from the preceding three months in 2022). That increase is currently stable in the figures due to the UK Government’s Energy Price Guarantee – but this cap on unit prices is only in place until end March, when it increases to £3,000 for a household with typical use. The ONS estimate that this will add 1 percentage point to inflation when it comes into effect.

Worryingly for those on the lowest incomes, food prices continue to increase faster than the headline rate. The inflation rate for food and non-alcoholic beverages increased to 16.9% in December from 16.5% in November.

We were asked two main questions when the data came out on Wednesday.

The first was, of course – what is the outlook for inflation for the rest of 2023? The expectation by the OBR is that inflation is likely to fall to under 4% by the end of the year. But remember, this does not mean that prices will start to fall at this point – just that they will grow less quickly.

This is somewhat simply due to the definition of inflation – it compares prices now to prices a year earlier, so as we move into October, we will be comparing to the much higher energy costs from October 2022. It was therefore inevitable that growth was likely to slow down – a point to bear in mind when some try to take credit for the fall in inflation.

The second is whether we are likely to see further increases in the Bank of England’s base rate at their next meeting on 2nd February – especially given that inflation has come down a bit. Unfortunately for mortgage payers, it is still very likely that we will see further increases in the base rate.

Why? Because inflation is not just been driven by food and energy costs. CPI excluding energy, food, alcohol and tobacco (often referred to as core CPI) is at 6.3%, and has been around this level since July 2022. This is being generated by domestic factors, including the tight labour market, which means the Bank is likely to take the view that they need to continue to cool demand in the economy.

Scottish unemployment remains at 3.3%

We also got updated figures on the labour market on Tuesday, covering the three months to November. Scottish unemployment remained at 3.3%, slightly below the UK rate of 3.7%. Employment remains high, at 76.1%, with inactivity at 21.3%.

Changes in inactivity over the period of the pandemic have been a focus of much analysis – because although the level is now similar to before the pandemic, the underlying reasons why people are inactive seem to have changed – with an increasing number saying that they are not in work or seeking work because of ill health or disability.

See a great Twitter thread on this by our colleague Professor Stuart Mcintyre – as part of his monthly analysis of the labour market.

Alongside the headline labour market numbers, there is also information ONS publishes monthly on earnings and vacancies.

The vacancy level alongside the labour market data helps us understand how tight the labour market continues to be. The total number of vacancies has been falling in recent months, since the record highs in Q2 2022. However, the number of vacancies remains historically very high, with 1.0 unemployed people for each vacancy – a rate which remains indicative of a tight labour market.

Earnings (ex bonuses) grew by 6.4% in the year to the three-month period Sept-Nov. Given the inflation rate over this period, this means that earnings are continuing to fall in real terms. In the face of continuing public sector pay disputes across the UK, the split between the public and private sectors is particularly interesting. Private sector pay grew by 7.2% compared to 3.3% for the public sector.

Health Foundation publishes important research into health and health inequalities in Scotland

This week the Health Foundation published a report to provide a picture of health and health inequalities in Scotland, in order to inform future efforts to improve both.

An independent review underpins their report, and we were delighted to work with the Health Foundation on this programme of work, as one of four independent organisations to carry out supporting research. See our research here.

And finally, I don’t care if it’s too late – Happy New Year everyone! But that is the last time I’ll say it this year.

Work completes on giant mural at Glasgow Royal Infirmary

Latest addition to Glasgow’s Mural Trail shines a light on health inequalities 

A new mural has been officially unveiled at the Princess Royal Maternity Hospital at Glasgow Royal Infirmary, adding to Glasgow’s growing mural trail and raising awareness of health inequalities which exist in Scotland.

The Black mother and baby mural was developed in partnership between NHS Greater Glasgow and Clyde  (NHSGGC) and local campaigner, Rachel Dallas. The mural marks NHSGGC’s own commitment to tackling health inequalities in maternal health and baby outcomes in the UK.

The 20 x 30ft design can be seen above the main entrance to the maternity unit on Wishart Street and features the image of a real mother and baby from the local community.

It comes following research which reveals significant racial disparity in maternal care and baby outcomes within Black and ethnic minority groups across the country. A number of partnership groups within NHSGGC are helping to drive forward and further reduce inequalities by promoting diversity in all areas of healthcare, including public health and staff messaging.

Jackie Sands, senior arts and health lead at NHSGGC, said: “Art plays a powerful role in helping raise awareness of major issues in captivating and thought provoking ways.

“The Black mother and baby mural unveiled today will feature in the landscape of Glasgow for years to come, shining a light on, and reminding people of the continued drive to reduce health inequalities – particularly for Black women and babies.

“NHSGGC is delighted to play host to such a mural and to play a part in helping reduce some of those inequalities which do exist.

“A huge thanks to Artisan Artworks for painting the mural and to Rachel Dallas for joint fundraising to make the mural possible.” 

Campaigner, Rachel Dallas, said: “This mural is a tribute to the women behind the statistics on racial disparities in maternal health.

“As a mixed Black woman living in Glasgow, I hope it reminds all who enter the hospital (staff, patients, and visitors) of the right to equality of both health care and health outcomes, as well as providing a beautiful representation of the strength and resilience of motherhood.”
                                               
Frank Carty of Artisan Artworks, added: “I am honoured have been involved in painting this mural which it is hoped will highlight inequality in maternal care for Black mothers.

“The image should also be very welcoming and maternal to all visitors to the maternity Hospital, and I’m hoping it will provide a really positive focus for that part of the hospital.”

Tackling Scotland’s health inequalities requires immediate joined-up action, warns Holyrood Committee

A Scottish Parliament inquiry has concluded by calling for urgent, coordinated action across all levels of Government in the UK to tackle health inequalities in Scotland.

A wide-ranging report by the Health, Social Care and Sport Committee calls for urgent action to address health inequalities, and for tackling poverty to be considered a major public health priority at all levels of Government in order to address this.

Read the report

The Committee heard evidence that the Covid-19 pandemic and the rapidly rising cost of living have further exacerbated Scotland’s health inequalities.

The Committee is calling for action across the UK and the Scottish governments, and by local authorities, which it says is essential if these inequalities are to be tackled effectively. This includes further public service reform and strategic action across multiple policy areas.

Among its recommendations, the Committee is calling for action on education, employment and housing to improve health outcomes and better tackle health inequalities. It says safe, secure and affordable housing must be available for all and highlights the significant impact planning policy can have on health outcomes and, if implemented poorly, in widening inequalities.

In compiling its report, the majority of the Committee agreed with the recommendation by the Glasgow Centre of Population Health that, within budget constraints, the UK Government should take action to align benefits and tax credits with inflation and to reinstate the uplift in Universal Credit introduced during the Covid-19 pandemic.

The report also highlights extensive evidence submitted to the inquiry that informal and unpaid caring has a disproportionate impact on health outcomes and that informal carers face significant health inequalities as a result.

To address this issue, the Committee calls on the Scottish Government and Public Health Scotland to provide more targeted support for carers.

Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said: “The evidence is clear that health inequalities in Scotland continue to grow, while the pandemic and ongoing cost of living crisis will only exacerbate these inequalities further.

“A number of witnesses contributing to the inquiry argued that, over the past decade, UK Government policies on austerity have also had a negative impact on health inequalities in Scotland.

“We are particularly concerned that the rising cost of living will have a greater negative impact on those groups already experiencing health inequalities, including those living in poverty and those with a disability.

“Government action to date to tackle health inequalities has not been enough in the face of decades-long, major impacts on household incomes. We are calling for urgent action across all levels of government to reduce these stark inequalities which have real life and death consequences.

“There is currently no overarching national strategy for tackling health inequalities in Scotland. Meanwhile, evidence submitted to our inquiry has revealed multiple instances where the design and delivery of public services may be exacerbating inequalities rather than reducing them. We need to deliver further public service reform to ensure this doesn’t continue to happen.

“The reasons why we have failed to make progress in tackling health inequalities are many and varied. Reducing these will require bold and strategic action across all levels of government and by a range of government departments. Tackling health inequalities must be a major public health priority because lives literally depend on it.”

Other key findings in the report include:

  • The Committee express concern that certain vulnerable families report being excluded from free childcare provision, including those who care for disabled children and those who do not have a standard Monday-Friday work pattern.
  • A majority of the Committee is supportive of the concept of a universal basic income and calls on the Scottish Government to work with the relevant UK agencies to consider whether a pilot of the policy could take place in Scotland in order to begin to address health inequalities. A Committee majority would also like to see the implementation of a minimum income guarantee in Scotland.
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LGBT+ communities face significant health equalities, says new report

LGBT+ people across Scotland are continuing to face health inequalities across every measure of wellbeing, according to a major new report by NHS Greater Glasgow and Clyde, NHS Lothian and Public Health Scotland.

The findings of the Health Needs Assessment, commissioned by the Boards, found that the COVID pandemic has exacerbated issues, with significant numbers experiencing loneliness and isolation, while almost a half of LGBT+ people in the survey said they had experienced discrimination in the previous year – with trans and non-binary communities experiencing higher levels of abuse.

The assessment also revealed significantly high levels of mental ill-health, with more than half of all respondents reporting issues such as depression, anxiety and stress, with the highest rates experienced by trans and non-binary individuals.

The comprehensive assessment was undertaken to better address gaps in knowledge about the health and wellbeing of LGBT+ patient groups, to better inform approaches to public health for LGBT+ people, across seven groups: lesbian and gay women, gay men, bisexual women, bisexual men, trans women, trans men (trans masculine) and non-binary people across the Greater Glasgow & Clyde and Lothian areas.

Nicky Coia, Health Improvement Manager at NHSGGC said: “This report should serve as a wake-up call for everyone involved in the health and wellbeing of LGBT+ communities.

“Too many continue to suffer from discrimination and abuse, are experiencing social isolation and loneliness and suffering the impacts of poor mental health. This, combined with the poor socio-economic situations many find themselves in, contributes to a substantial health inequalities on every measure of wellbeing.

“While there are positives to be taken in terms of how LGBT+ experience healthcare, particularly from the GPs, there is still work to be done to improve access to, and experience of, person-centred healthcare, that treats the individual, no matter their gender identity or sexual orientation.”

Dona Milne, Director of Public Health and Health Policy at NHS Lothian, said: “We interviewed more than 200 people and over 2,500 people took part in the online survey as part of this research. Their experience is in stark contrast to the progress that many of us may feel has been made in achieving equality in Scotland.

“I want to thank everyone who took part and express our shared desire to highlight this as a key public health issue and deliver real improvements in health and wellbeing for LGBT+ communities.”

Some of the key findings include:

·       Nearly three in four (73%) survey respondents said they ever felt isolated from family and friends and nearly two in five (38%) had felt lonely all of the time or often in the previous two weeks.  Trans and non-binary people showed the highest levels of isolation and loneliness.

·       The survey showed that overall more than half (54%) of respondents said they had mental health problems e.g. depression/anxiety/stress, but this was higher for trans masculine (75%), non-binary people (72%) and bisexual women (61%).  Only one in four (25%) survey respondents rated their general mental and emotional wellbeing positively – but this was lowest for non-binary (9%) and trans masculine (12%). 

·       Of those who answered the question in the survey, nearly one in three (31%) said that they had ever made an attempt to end their life.  Although the prevalence of suicide attempts was high across all LGBT+ groups, it was highest among trans masculine and non-binary people, with nearly half of respondents in these groups saying they had made a suicide attempt.

·       Overall, nearly half (44%) of LGBT+ people in the survey said they had been discriminated against in the last year, but this was highest for non-binary (65%), trans masculine (62%) and trans women (55%).

·       The survey findings show that 37% of LGBT+ respondents had ever experienced an abusive relationship; identity groups with the highest proportion reporting abusive relationships were trans masculine (48%), non-binary (45%), bisexual women (43%) and trans women (38%). 

·       only 59% overall rated their general health positively.  Gay men and gay/lesbian women were the most likely to rate their health positively, while trans masculine and non-binary people were the least likely. A third (33%) of LGBT+ people had a long-term condition or illness that substantially interferes with their day to day activities. 

·       Most (88%) survey respondent had financial worries at least some of the time. One in six (18%) had experienced food insecurity in the previous 12 months.  One in eight (13%) had ever been homeless.

The report’s authors have made 41 recommendations, including an immediate request that all Scottish local authorities should provide or fund at least some, community-led groups or activities for LGBT+ people, with provision for cultural, sport and physical activity and social interest groups, as well as targeting specific identity groups.

Other recommendations call for improvements in LGBT+ education in schools, improved LGBT+ training and awareness for health and other staff, improvements in mental health and gender identity clinics and more visibility of LGBT+ inclusive services.

Professor Nicola Steedman, Deputy Chief Medical Officer at the Scottish Government, said: “The assessment lays bare the fact that too many LGBT+ people are subject to significant inequalities which impact every aspect of their lives. I’m grateful to everyone who took part in the research and NHS Greater Glasgow and Clyde and NHS Lothian for carrying out this important work.

“The Scottish Government is committed to reducing inequality – in all its forms – and we welcome the report. We will continue to work with, and across our partners, to improve the health and wellbeing of our LGBT+ communities.”

Mark Kelvin, Chief Executive of LGBT Health and Wellbeing, said: “This report highlights what many of our community members experience in their daily lives.

“Whilst many people believe that LGBTQ+ people have achieved equality, this report reminds us that there is still a lot of work to do. Scotland is celebrated as being a welcoming and inclusive country and whilst that is true, almost half of LGBTQ+ respondents experienced discrimination in the past year.

“The report also highlights the health inequalities that still exist for many of us and provides very useful and realistic recommendations that will help LGBTQ+ people to live well.

Speaking specifically on how COVID-19 has impacted the LGBTQ+ community, Mark pointed out the dependency on LGBT nightlife for socialisation. He added: “Whilst the closure of pubs and clubs can be seen by many as an inconvenience, for LGBTQ+ people queer-friendly spaces provide an important place of safety and belonging.

“This meant that during the months of closures, people were shut-off from contact with others like them. I’m hopeful that this report can restart conversations with local authorities and other interested parties to open LGBTQ+ Community Centres, where people of all ages can access a place of safety, information, support, and importantly connection.”

Mhairi Crawford, from LGBT Youth Scotland, said: “LGBT Youth Scotland notes the publication of the health needs assessment of LGBT research findings report. We know from our own recently published research that health care remains a significant issue for LGBTI young people in Scotland.

“In particular, we welcome the recommendations for healthcare providers and other public bodies to undergo training, which is a key part of our LGBT Charter, in which we also support organisations to undertake reviews of policies and practice to ensure that they are as welcoming as possible for the LGBTI community, whether they are staff, clients, pupils or wider stakeholders.

“We know that alcohol free spaces are highly valued by young people we work with in our youth spaces – so we welcome the recommendation for more LGBT spaces that don’t have alcohol.

“Finally, we also welcome the recommendation that schools should undertake the LGBT Charter as we know this can have a massive impact on daily lives of LGBTI young people.”

Ten years of success for Scotland’s Family Nurse Partnerships

More than 10,000 young mothers and their children have been helped by a decade-long programme since it began as a pilot in NHS Lothian.

An analysis report on the Family Nurse Partnership shows positive results for mothers and babies in areas such as breastfeeding rates and stopping smoking, with most children meeting all their milestones, and 95% receiving all their immunisations.

The Family Nurse Partnership supports young, first-time mothers to prepare for motherhood and throughout the first two years of their child’s life.

Women’s Health Minister Maree Todd met mothers and staff who have taken part. She said: “Over 10,000 young women have now received support through this programme since it started, which is a fantastic milestone.

“Family nurses help mothers to think about the future, what kind of parent they want to be and their goals and aspirations for other areas of their lives like education and employment.

“Earlier this year we committed to expanding the programme to all young first time mothers aged 21 and under by the end of 2024. Where possible, we will also target first time mothers under the age of 25 who are care experienced or from the most deprived communities. This expansion will mean we can support up to an additional 500 families per year by 2025.”

Val Alexander, service manager of the Family Nurse Partnership, who has been with the programme since it began, said: “We are so proud of the Family Nurse Partnership and everything our clients have achieved. 

“The Family Nurse Partnership programme works to support young, first-time mothers to prepare for motherhood and continues that support for them and their child through the first two years.

“FNP was first delivered in NHS Lothian and to see it extended across Scotland to reach thousands more families is something very special for all of us.

“This 10-year analysis of the delivery of the service across Scotland will help us to see how far we have come and map out our goals and ambitions for the future of the programme and young families.”

Annual health checks for people with learning disabilities

Health boards are to share £2 million to deliver annual health checks for all people with learning disabilities.

The new service will help to address health inequalities and ensure that people in this group are able to have any health issues identified and treated as quickly as possible.  

Health checks will be delivered in the local community.

Mental Wellbeing Minister Kevin Stewart said: “Unfortunately we know that people with learning disabilities can experience poorer health than the rest of the population.

“Evidence suggests that people in this group are twice as likely to die from preventable illness. This is clearly unacceptable and I hope these annual checks will help to address this and begin to reduce this health inequality.

“Health issues like respiratory disorders, diabetes and thyroid problems can become serious if picked up too late. But if they are detected and treated early there’s a much better chance of a positive outcome and a good quality of life. That is where these annual health checks will be so valuable.”

 Eddie McConnell, Chief Executive of Down’s Syndrome Scotland, said: “This is a really significant moment in the lives of people with learning disabilities and their families. 

“The rollout of the annual health checks across Scotland has the potential to be a game-changer in improving the health outcomes for this community who deserve equal access to good health.  It is no exaggeration to say that a well-implemented annual health check could save lives.”

Community Learning Disability Nurse, Sharon Bandeen, who has an adult son with Down’s Syndrome, said: “The new health checks are a welcome additional layer of good health practice for people with learning disabilities in Scotland. 

“It is so important that everyone living with a learning disability has equal access to the health checks, no matter where they live in Scotland.”

‘Significant health inequalities persist’

Latest Health Inequalities statistics published

Scotland’s Chief Statistician today announced the publication of the latest Long-term Monitoring of Health Inequalities report.

The report includes a range of indicators selected in order to monitor health inequalities over time. These indicators include: healthy life expectancy, premature mortality, all-cause mortality, baby birthweight and a range of morbidity and mortality indicators relating to alcohol, cancer, coronary heart disease and drug use. The report investigates both absolute and relative inequalities.

The COVID-19 pandemic is likely to have had an impact on the most recent data for most indicators included in this report. Where there has been analysis undertaken to assess the impact of the pandemic that is relevant to a specific indicator the details have been included in the corresponding chapter.

MAIN FINDINGS

With the exception of the healthy birthweight indicator, significant health inequalities persist for each indicator covered in the report.

Changes in the gap between the most and least deprived areas in Scotland

For a number of indicators, absolute inequalities (the gap between the most and least deprived areas) have narrowed over the longer term:

  • Heart attack hospital admissions (aged under 75 years) – the gap in 2020 (63.2 per 100,000 population) is the lowest it has been since 2008 (58.4 per 100,000). The reduction in the gap between 2019 and 2020 has been driven by a 7% decrease in admissions in the most deprived areas and an increase of 13% in the least deprived areas.
  • Coronary heart disease (CHD) deaths (aged 45-74 years) – the current gap is 47% lower than at the start of the time series (185.4 per 100,000 in 2020 compared to 347.3 per 100,000 in 1997). However, between 2019 and 2020 the CHD mortality rate increased in both the most and least deprived areas (by 14% and 40% respectively).
  • Alcohol-related admissions (aged under 75 years) – the gap was widest at the start of the time series in 1996 (613.0 per 100,000) and reduced to its lowest level in 2020 (322.0 per 100,000). Between 2019 and 2020 the rate of admissions decreased in both the most and least deprived areas (by 14% and 10% respectively). It is possible that this reduction is a result of hospital admissions policies associated with the COVID-19 pandemic.
  • Alcohol-specific deaths (aged 45-74 years) – the gap has reduced from a peak of 184.7 per 100,000 in 2002 to 71.8 per 100,000 in 2020, the lowest in the time series.
  • Low birthweight – the absolute gap in 2020 was 3.4 percentage points, the lowest it has been since 2013 (3.2 percentage points).

The gap in healthy life expectancy for males has increased since the start of the time series, from 22.5 years in 2013-2015 to 23.7 years in 2018-2020.

The gap in premature mortality rates increased to its highest point since 2004 (680.4 per 100,000 in 2020 and 683.2 per 100,000 in 2004), although the gap remains lower than at the start of the time series (648.7 per 100,000 in 1997).

In 2020 the absolute gap in cancer deaths was the highest it’s been since 2015 at 353.7 per 100,000.

Whilst the gap for all-cause mortality (aged 15-44) reduced to its lowest level in 2013 (159.6 per 100,000), it has shown an overall increase since then and was 241.1 per 100,000 in 2020.

The gap for drug-related hospital admissions has increased overall since the start of the time series to reach a high of 696.1 per 100,000 in 2019/20 before falling slightly to 625.1 per 100,000 in 2020/21. This decrease may be due to hospital admission policies associated with the COVID-19 pandemic.

For the other indicators in the report, there has either been little change or long-term trends in the absolute gap are less clear:

  • Healthy life expectancy for females
  • Cancer incidence

Relative inequalities

The relative index of inequality (RII) indicates the extent to which health outcomes are worse in the most deprived areas compared to the average throughout Scotland. It is possible for absolute inequalities to improve, but relative inequalities to worsen.

There are three morbidity indicators for which the RII can reasonably be compared with one another: alcohol-related hospital admissions; heart attack hospital admissions; and cancer incidence.

Amongst these, relative inequalities in alcohol-related hospital admissions have remained highest over the longer term, though they have been decreasing. Relative inequalities in heart attack admissions have increased in recent years and cancer incidence inequalities have remained relatively stable.

Amongst the three comparable mortality indicators (CHD deaths, alcohol-specific deaths and cancer deaths), relative inequalities in both CHD and cancer deaths have increased over the long term whilst the RII in alcohol-specific deaths have shown more year to year fluctuation and are currently lower than at the start of the time series (2.02 vs 1.80). However, relative inequalities in alcohol-specific deaths remain higher than the other comparable mortality indicators.

Of the other indicators in the report, the two indicators relating to mortality (premature mortality for those aged under 75 and all-cause mortality for those aged 15-44) and healthy life expectancy for males and females have all shown increases in relative inequality over time.

Full statistical publication

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£15 million to help improve mental wellbeing in communities

A new fund has been established to help tackle the impact of social isolation, loneliness and the mental health inequalities made worse by the pandemic. The £15 million Communities Mental Health and Wellbeing Fund aims to support adult community-based initiatives across Scotland.

Grass roots community groups and organisations will be able to benefit from the funds to deliver activities and programmes to people to re-connect and revitalise communities building on examples of good practice which have emerged throughout the pandemic.

Mental Wellbeing Minister Kevin Stewart launched the fund at Saheliya in Edinburgh, a specialist mental health and well-being support organisation for black and minority ethnic women and girls.

Mr Stewart said: “This funding reflects the importance we place on promoting good mental health and early intervention for those in distress and will help develop a culture of mental wellbeing and prevention within local communities.

“It is vital now, more than ever as we start to re-open society that we support the mental health and wellbeing of individuals. I am very keen that this benefits communities across all of Scotland.

“I was pleased to be able to visit Saheliya this morning and meet some of the people involved with running and the project, and some of the people they help.”

A range of charity-support bodies and social enterprises, known as third sector interfaces,  will manage the fund in partnership with local integrated health authorities and other partners including Community Planning Partnerships and local authority mental health leads.

The Communities Mental Health and Wellbeing Fund is part of the wider £120 million Recovery and Renewal Fund announced in February 2021 to ensure delivery of the commitments set out in the Mental Health Transition and Recovery Plan in response to the mental health need arising from the pandemic.

Latest Accident & Emergency Activity report highlights scale of health inequalities

The latest Hospital Episodic Statistics (HES): Hospital Accident and Emergency Activity 2020-21 published by NHS Digital and NHS England show that attendance rates in the most deprived areas of England were almost double the attendance rates in the least deprived areas.

The data show in 2020-21 in the most deprived areas of England there were 39,161 attendances per 100,000, while in the least deprived areas this figure is almost halved to 20,784.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The pandemic has highlighted the scale of health inequalities across the country. The data show that those from the most deprived area are almost twice as likely to visit their Emergency Department than those from the least deprived area.

“We welcome NHS England’s willingness to engage on the issue and address health inequalities, but we must see real action taken. We also look forward to the formation of the Office for Health Improvement and Disparities (OHID) and would welcome the opportunity to input into their agenda.

“The health inequalities are clear and tackling them will be a serious challenge. On a fundamental level, if the government is serious about levelling up and tackling these inequalities, the first steps must be to fund and support local authorities and Integrated Care Systems and invest in preventative health.

“The scale of health inequalities means tackling homelessness; immigrant health; domestic violence; and youth violence. While supporting those with; mental health illnesses; learning disabilities; and both drug and alcohol addiction.”

There were also 1.39 million reattendances in 2020/21 which is equal to 10.4% of all unplanned attendances. This is the highest figure on record and up 1.7 percentage points when compared to the previous year 2019/20.

Dr Henderson continued: “It is also deeply concerning that one in ten patients reattended the Emergency Department (ED), it is vital that patients have the appropriate information and support available to manage their condition following their visit to the ED. We need better data on this issue to understand what is driving people to reattend.”

In 2020/21 302,784 patients stayed in an Emergency Department for 12-hours or more from time of arrival, this is 21 times higher than the 12-hour figure from decision to admit, which is 14,150.

Dr Henderson concluded: “Utilising the right metrics in Emergency Departments is crucial to improving patient safety. It is vital that we measure health equalities, reattendances, and 12-hour stays from time of arrival across the country.

“Analysing these metrics will help us, NHS England and the government to take effective action to support the patients, communities and areas that need it most. That means fewer reattendances, closing the gap on health inequalities, reducing long stays, and improving the patient experience.

“This data paints a very real picture of the state of health and the state of healthcare in this country. We welcome the engagement of NHS England and the government’s agenda on these matters, but we must now see the tangible actions taken to tackle these issues.”

Scottish Government launches Women’s Health Plan

Plans to improve health and reduce inequalities for women in Scotland have been published today by the Scottish Government. Women’s Health minister Maree Todd said the plans are an ‘ambitious vision’.

Scotland is the first country in the UK to have a Women’s Health Plan, which outlines ambitious improvement and change in areas including menopause, heart health, menstrual health including endometriosis, and sexual health.

The Women’s Health Plan sets out 66 actions to ensure all women enjoy the best possible healthcare throughout their lives. It takes on board the real life experiences of women who have given their feedback on what is important to them.

Key actions include:

  • appointing a national Women’s Health Champion and a Women’s Health Lead in every NHS board
  • establishing a Women’s Health Research Fund to close gaps in scientific and medical knowledge
  • providing a central platform for women’s health information on NHS Inform
  • setting up a Women’s Health Community Pharmacy service
  • commissioning endometriosis research to develop better treatment and management, and a cure
  • developing a menopause and menstrual health workplace policy, and promoting it across the public, private and Third Sector
  • improving information and public awareness of heart disease symptoms and risks for women

Women’s Health Minister Maree Todd said: “Our vision for women’s health is an ambitious one – and rightly so. It is clear that wider change must happen to ensure all our health and social care services meet the needs of all women, everywhere.

“Women’s health is not just a women’s issue. When women and girls are supported to lead healthy lives and fulfil their potential, the whole of society benefits.

“Together, we are working to address inequalities in all aspects of health that women are facing. The Women’s Health Plan signals our ambition and determination to see change for women in Scotland, for their health and for their role in society. We want Scotland to be a world leader when it comes to women’s health.”

Head of British Heart Foundation Scotland James Jopling said: “Coronary heart disease is one of the leading causes of death in women in Scotland and kills nearly three times as many as women as breast cancer.

“At every stage – from the moment they experience symptoms through to their cardiac rehabilitation – women with heart disease can face disadvantages. We need to improve understanding of the risks for women and increase their awareness of the symptoms of a heart attack.

“We must also promote equality of treatment for women with heart disease within the healthcare system, at every point in their journey. The publication of the Women’s Health Plan, with heart health as a priority, is a welcome step to tackle these inequalities and we look forward to working together to help save and improve lives.”

Vice President of the Royal College of Obstetricians and Gynaecologists Dr Pat O’Brien said: “We welcome Scotland’s commitment to this ambitious and detailed plan as a key marker to making improvements to healthcare services for all women from different backgrounds. 

“We are pleased to see the Women’s Health Plan adopts an approach to prioritise the health and wellbeing of women throughout every stage of their lives, and ensure they can access care when they need it  – something we called for in our Better for Women report.

“It is important that all women are included and consulted about how health services can fit their needs. This Plan has been developed with extensive consultation with a diverse group of women, ensuring that the health service is inclusive and respectful, and can work to focus on closing inequalities in women’s health experience and outcomes.”

Read the Women’s Health Plan here.