Wednesday 7th of April is World Health Day. World Health Day was first celebrated in 1950, and each year there is s specific theme. This year the World Health Organisation is focussing on building a fairer, healthier world for everyone. WHO are calling for action to eliminate health inequities. The campaign highlights WHO’s constitutional principle that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”
I think this is an ideal opportunity to also draw a parallel with the Report of the Commission on Race and Ethnic Disparities. This report made a number of recommendations directly relating to health and care, with the intention of levelling up both the provision of health and care, and the opportunities for those employed within it. I know that right now there is a lot of political mud throwing about this report, but it contains some very practical recommendations for implementation which are worth drawing to the attention of those working in the sector. Opportunities should be equal for:
Recommendation 2: Review the Care Quality Commission’s (CQC) inspection process
The Commission recommends that the Department of Health and Social Care (DHSC) commission a review into the CQC’s approach to scoring employee diversity and inclusion in their inspections.
The Commission recommends that this review is chaired by an expert with close knowledge of the health care system and CQC internal processes, ideally a former inspector or inspector of an alternative inspection body. The review team should work closely with the NHS Workforce Race Equality Standard team and the disciplinary bodies of the medical professionals to ensure that the views of these bodies feed into this work.
Recommendation 10: Improve understanding of the ethnicity pay gap in NHS England
The Commission recommends that NHS England as a whole should commission a strategic review of the causes of disparate pay and, where discrimination is pinpointed, spell out the measures that might meaningfully address it. Such a review would shine a light on the barriers to in-work progression and how to overcome them – for example, in promotion, are foreign qualifications equally validated yet informally seen as inferior? It would ask how the NHS performs on pay gaps compared with international comparators and if other metrics than pay gaps reveal barriers better.
Recommendation 11: Establish an Office for Health Disparities
This Commission recommends that the government establish a new office to properly target health disparities in the UK. This Office would be an independent body which would work alongside the NHS, as part of, or in place of, the redesigned Public Health England, to improve healthy life expectancy across the UK and in all groups and reduce inequalities. As most of the causes of health inequalities (deprivation, tobacco, alcohol, unhealthy diet and physical inactivity) are not due to differences in healthcare, addressing them will involve multiple government departments and so the office would need to be cross-cutting across government.
- a) Increase programmes aimed at levelling up health care and health outcomes
Use existing data and evidence to target the most deprived communities for tailored health interventions, health education and communications. This function would work alongside existing local health workers and would utilise best practice examples from local authorities and public health regional offices and charities.
- b) Improve the data, guidance and expertise in the causes and solutions for health disparities for specific groups:
Fund further research into health conditions which adversely impact specific groups. This would include a large focus on research into health disparities relating to ethnic minorities, considering genetic and biological differences, cultural practices and social economic drivers.
Provide best practice for the inclusion of known health disparities, including those experienced by ethnic minorities, in clinical care guidelines. Work closely with the National Institute for Health and Care Excellence (NICE), and other bodies, to ensure all guidance includes information on disparities as standard.
Provide expertise in how the health of different ethnic minority groups are affected by underlying conditions, cultural and linguistic practices, geography, and occupation. This expertise would be disaggregated to avoid unhelpful grouping of different ethnicity and to ensure proper tailoring of health services.
I’m not sure if this report has reached my colleagues in Health and Care, so I would be interested to hear your views. Do you think this report will bring about positive change?