Can the NHS address health inequalities?

Insights from an expert panel to shed light on how the NHS can confront these disparities effectively. 

In its third, “Thinking Differently” webinar, chair Dr Nadeem Moghal, Chief Medical and Innovation Officer at Strasys, highlighted the health inequalities and the societal choices that contribute to them.

Dr Nadeem Moghal
Chief Medical and Innovation Officer, Strasys

Dr Nadeem Moghal began by reflecting on the historical roots of health inequalities. Drawing from Karl Marx’s critiques and recent research on the impact of poverty in Blackpool, Nadeem concluded that how we organise society is a choice with consequences, including the acceptance of structural inequalities that contribute to health disparities.

He argued that COVID exposed and exacerbated existing inequalities, hitting the most disadvantaged the hardest. This revelation has spurred initiatives such as Inclusive Recovery, 20PLUS5, and Access, urging healthcare providers to rethink their roles in addressing health inequalities.

Nadeem highlighted the need for healthcare to extend beyond its traditional model, questioning how employers, economic enablers, and service providers can drive local economic impact and support staff effectively.

Mr Ajit Abraham
Group Executive Director for Inclusion & Equity and Consultant Trauma & Hepato-pancreato-biliary Surgeon, Barts Health NHS Trust

Mr Ajit Abraham, Group Executive Director for Inclusion & Equity and Consultant Trauma & Hepato-pancreato-biliary Surgeon, Barts Health NHS Trust, a senior leader in one of the largest hospital groups in the UK, discussed the necessity of inclusive leadership and fostering a fair, just culture.

Working in a highly deprived area, Ajit stressed that fairness and equity are central to addressing health inequalities. He invoked John Rawls’ difference principle, which asserts that systems should benefit the least privileged, guiding the work at Barts.

While the NHS is crucial in tackling health inequalities, Ajit acknowledged that it cannot resolve these issues alone. A broader societal approach involving various sectors is necessary for meaningful change.

To integrate inclusion and equity at Barts, Ajit has embedded these values in the Group operating plan and processes. Inclusion goals are part of quarterly performance reviews, and equity reporting is regularly scrutinised at board level to ensure progress.

Samira Ben Omar
Director at Samira Ben Omar Associates, Associate at the Centre for Population Health and Trustee at Nuffield Trust

Samira Ben Omar, Director at Samira Ben Omar Associates, Associate at the Centre for Population Health and Trustee at Nuffield Trust, provided insights from her extensive experience in the NHS and public sector, emphasising the need for bridging the gap between the hierarchical public sector and the emergent community sector.

Samira advocated for the “community voices” approach, which emerged from crises like COVID and the Grenfell fire. The focus should be on fostering meaningful community engagement, ensuring ethical accountability, and being transparent in addressing local issues.

Key strategies include empowering communities to make their own decisions, investing in safe spaces for local action, addressing racism proactively, and measuring impacts based on community values.

Dr Arif Rajpura
Director of Public Health for Blackpool Council

Dr. Asif Rajpura , Director of Public Health for Blackpool Council, discussed the importance of addressing both immediate, medium and long-term factors impacting health inequalities.

For immediate action, the NHS can improve health in the short term through tackling issues such as high blood pressure, cholesterol and maximising uptake of vaccinations and screening in marginalised communities.

Long-term efforts must tackle root causes like unemployment, poor housing, and education, requiring substantial investments in quality jobs, early childhood services, and local economies. Effective action at the community level, supported by both local and national efforts, is crucial for achieving meaningful improvements.

Maggie Oldham
Chief Executive of Blackpool Teaching Hospitals NHS Foundation Trust

Maggie Oldham, Chief Executive of Blackpool Teaching Hospitals NHS Foundation Trust, provided an acute trust perspective, focusing on gender and deprivation issues in Blackpool. She highlighted the challenges faced by the local population, including low life expectancy, high rates of chronic illnesses, and socioeconomic factors negatively impacting women’s health. Noting that Blackpool is the second hardest place in the country for females to grow up and with a predominantly local and female workforce, Maggie stressed the importance of understanding and addressing these issues within the organisation.

Maggie highlighted specific challenges such as an ageing population, high domestic violence rates, and a significant ex-military population with health needs. Recent incidents, including high levels of misogyny and sexual assault cases among staff, underscore the importance of addressing these issues openly.The Board is committed to integrating inclusion and equity into core operations, using toolkits and charters to address biases and improve both patient and staff interactions.

When asked about the biggest challenges and priorities, Maggie emphasised that staff are both the greatest challenge and greatest asset. Organisations that successfully support their staff tend to excel in patient care, as patients are often staff members themselves. Prioritising roles in initiatives like CORE20PLUS5 is critical, and while achieving targets is challenging, focusing on staff wellbeing is essential for overall success.

Key Takeaways:

• Leaders should understand their workforce, be curious about what matters to them, and prioritise local recruitment. Every pound spent locally helps break the cycle of inequality, and boards should actively partner in health inequality efforts and regeneration.
• It’s an invitation to be a participant in what happens in the community. Presence and participation in local issues are crucial; plans and strategies come later.
• Stay relentlessly curious and listen. Focus on community partnerships, engage as an anchor organisation, and even if it was invented before, invent it again in the interests of the communities we serve.
• Adopt a person-centered approach, ensuring integration is handled by agencies rather than leaving it to individuals. We should consider the whole person and their needs, not just professional requirements.
• If we don’t understand the needs of the citizen, patient and the family, then we are failing as professionals and the idea of siloes should not hinder addressing the needs of the citizen.

Watch the webinar for further insight from the speakers, including a Q&A session.

In collaboration with our partners, we are bringing the best thinking and insight to tackle the problems that need to be solved urgently. Offering a beacon of hope, the series not only aims to solve immediate issues but also to inspire a shift towards more effective healthcare systems worldwide.

Join us for future seminars and join the conversation to aspire to catalyse change, improve healthcare delivery for patients, and create more fulfilling work environments for staff.

www.strasys.uk/events

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