Health Inequalities

NHS Urgent actions to address inequalities

COVID-19 shone a harsh light on some of the health and wider inequalities that persist in our society.  The NHS identified a set of actions to tackle health inequalities as part of COVID-19 response and recovery, to increase the scale and pace of action to tackle inequalities to protect those at greatest risk. 

Eight urgent actions were identified:

  • Protect the most vulnerable from COVID-19.
  • Restore NHS services inclusively.
  • Develop digitally enabled care pathways in ways which increase inclusion.
  • Accelerate preventative programmes which proactively engage those at risk of poor health outcomes.
  • Particularly support those who suffer mental ill-health.
  • Strengthen leadership and accountability.
  • Ensure datasets are complete and timely.
  • Collaborate locally in planning and delivering action.

Norfolk and Waveney Clinical Strategy represents an important voice, but it is one of a number of equally important voices that include finance, strategic oversight framework improvement, digital health, estates, and the wider integration agenda. Developed during the response to the COVID-19 pandemic, our system’s strategy outlines our clinical objectives in detail for the next five years. Read more here

Overview for Norfolk and Waveney

“We are committed to addressing health inequalities across Norfolk and Waveney.    

 Utilising the national health inequality improvement ‘Core 20 Plus 5’ approach we will work to reduce the health gap for communities that live in the 20% most deprived neighbourhoods across Norfolk and Waveney and we will focus on five key clinical areas detailed in the core20plus5 health inequality improvement framework. For adults this is Maternity continuity of care, severe mental illness health checks, respiratory conditions, early cancer diagnosis and case finding and treating high blood pressure. For children and young people there will be a focus on asthma, diabetes, epilepsy, oral health and mental health.

 We will work with our 8 Health and Wellbeing Partnerships in our district council areas to help drive reductions in health inequalities at a neighbourhood level and will have a focus on the wider determinants of health, by working with our communities and other partners. We will deliver an increased uptake of screening and immunisation programmes by improving equity of access to health services particularly where there is a known low uptake of screening programmes for identified patient groups and communities, also known as our plus groups across Norfolk and Waveney”.     (Norfolk and Waveney ICS Clinical strategy)

Inclusion Health

Inclusion health is an umbrella term used to describe people who are socially excluded, who typically experience multiple overlapping risk factors for poor health, such as poverty, violence and complex trauma. This includes people who experience homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system and victims of modern slavery.

People belonging to inclusion groups, tend to have very poor health outcomes, often much worse than the general population and a lower average age of death. This contributes considerably to increasing health inequalities.

Poor access to health and care services and negative experiences can also be commonplace for inclusion health groups due to multiple barriers, often related to the way healthcare services are delivered.

Core20PLUS5 (adults) – an approach to reducing healthcare inequalities

Core20PLUS5 is a national NHS England approach to inform action to reduce healthcare inequalities at both national and locally. The approach defines a target population – the ‘Core20PLUS’ – and identifies ‘5’ focus clinical areas requiring faster improvement[WT(NAWI21] .

The approach, which initially focussed on healthcare inequalities experienced by adults, has now been adapted to apply to children and young people.

The information below outlines the Core20PLUS5 approach for adults.

Asylum Seekers

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Criminal Justice

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Gypsy Roma Traveller communities

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Sex Workers / Exploited Women

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Ukrainian Refugees

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Wellness Hubs and WOW Bus

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Health Inequalities – Case Studies

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Core20PLUS5 – Adults and Children

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