This page contains information and resources to help health and care professionals to understand health inequalities, and ways in which you can address them through your work.

Health inequalities are ‘unfair and avoidable differences in health across populations and between different groups within society’ (The King’s Fund 2020).

The unequal distribution of the social factors which affect our health – such as education, housing and employment – drives inequalities in physical and mental health, reduces people’s ability to prevent sickness, or to get treatment when ill health occurs.

These inequalities are complex and rooted in society, but they can also be prevented. The dimensions of health inequalities are overlapping, as shown in the illustration pictured above right.

As a result of the pandemic, we are all more aware of what is meant by health inequalities and the ways in which they impact on people’s lives.

Therefore, it is vital to act now and drive forward work programmes that reduce inequalities, prevent poor health and improve people’s opportunities for better health.

It is vital too that the structural inequalities in our society – unemployment, overcrowded housing, and a lack of green space, as a few examples – are tackled because it is changes at the root cause that will reduce health inequalities in the long term.

Health inequalities are the result of a complex range of interrelated causes – and the causes of those causes.

In some cases, actions will be primarily in the hands of one partner within the local health and care system.

In other cases, reducing inequality will require close collaboration between several organisations across the system.

Integrated Care System (ICS) partners are committed to taking action at all levels and these are set out in Northamptonshire’s Population Health Management Strategy.

At each level, the partners within the Integrated Care System (ICS) – not just the NHS and the local authorities, but the voluntary and community sectors too – will need to come together to plan in ever finer detail the actions they are going to take, individually and collectively, to reduce health inequality.

The actions will involve working together to ensure effective action on:

  • Determinants of health: education, employment, housing and poverty-reduction programmes
  • Health and wellbeing services: smoking, alcohol, nutrition, physical activity and recreational drug use, promoting parity between mental and physical health
  • Ill-health prevention programmes: vaccinations, screening programmes
  • Health care services (mental and physical health): diagnostic, treatment and rehabilitation programmes
  • Social care programmes: care in the community including hospital at home, domiciliary support and residential care support
  • End of life support: services that support a dignified and pain-free death.

Core20PLUS5 is a national NHS England and NHS Improvement approach to support the reduction of health inequalities at both national and at Integrated Care System level. The approach defines a target population cohort – the ‘Core20PLUS’ – and identifies ‘5’ focus clinical areas requiring accelerated improvement, as shown in the illustration below. Click here for further information about Core20PLUS5.

The Core20PLUS5 approach to addressing health inequalities

A graphic showing the overlapping dimensions of health inequalities

The overlapping dimensions of health inequalities

Infographic showing how the social determinants of health inequalities are a diverse range of social, economic and environmental factors.

The social determinants of health inequalities

Information and resources

To enable partners across our health and care system to consider health inequalities in everything that they do, a suite of information and resources are available.

Please click on the expandable headings below for full details.

There are a range of data sources to help you understand the local population and to ensure that your services are appropriate to meet local needs.

Northamptonshire local health reports

Primary care data

Primary Care Network profiles

These Primary Care Network (PCN) profiles have been produced by Public Health Northamptonshire, with support from the NHS Northamptonshire Clinical Commissioning Group Primary Care team, in order to support PCNs to deliver strategies that promote illness prevention and address health inequalities.

Health Equity Assessment Tool (HEAT)

The Health Equity Assessment Tool (HEAT) is a practical framework that enables multiple audiences to systematically embed action on health inequalities and equalities in their work programme or service. The resources consist of:

  • HEAT executive summary
  • HEAT tool – full version
  • HEAT tool – simplified version
  • Case studies demonstrating practical application of the tool and the main benefits of applying it in different work areas.

Click here to access the Health Equity Assessment Tool from Gov.UK.

Health inequalities: placed-based approaches to reduce inequalities

These guidelines to support local action on health inequalities aim to:

  • Reinforce a common understanding of the complex causes and costs of health inequalities
  • Provide a practical framework and tools for places to reduce health inequalities

Community-centred public health: taking a whole system approach

These resources enable local systems to implement and embed community-centred approaches to health and wellbeing at scale. They are intended for use by local authority, NHS and voluntary and community sector (VCS) decision makers, to help them to:

  • improve the effectiveness and sustainability of action to build healthy communities
  • embed community-centred ways of working within whole systems action to improve population health

Understanding and tackling inequalities in healthcare provision

Guidance from the Midlands Health Inequalities Unit including how to assess the likelihood of inequalities in healthcare provision, the ways in which healthcare provision can help tackle inequalities and useful tools to support action.

Leadership Framework for Health Inequalities Improvement | NHS Confederation

The Leadership Framework for Health Inequalities Improvement programme is an NHS England and Improvement (NHSEI) programme to ensure that the NHS better prevents and responds to the health inequalities which many communities experience.

It include seminars on:

  • National priorities Dr Bola Owolabi, National Director of Health Inequalities, NHSEI, shares the work of the Health Inequalities Improvement Programme and the national priorities for systems and providers, with a focus on the role of leaders.
  • Leadership support The NHS Confederation’s EDI Group sets out the importance of the non-executive’s role in leading this agenda and how providers can take practical action to tackle health inequalities, introducing the tools and resources that have been developed to support this programme.
  • Data for improvement NHSEI’s Health Inequalities Improvement Team show how data can be used to drive improvement, supported by the Health Inequalities Improvement Dashboard and Core20PLUS5.

To support board members to assess any strategies, delivery plans or other initiatives for their impact on health inequality, the NHS Confederation has also developed some key resources:

Health equity and inequalities assessments (pdf)

These slides will help you to understand the different types of health equity and inequalities assessments that are available and when to use them.

Local guidance – how to complete a Health Equity Audit

This slide deck from Northamptonshire Health and Care Partnership sets out useful guidance on how to complete a Health Equity Audit.

VCSE Inclusion Health Audit Tool

This online tool will helps organisations to audit their engagement with Inclusion Health groups. These are the groups identified as experiencing the worst health inequalities in the UK.

The tool consists of five sections and takes around 15 minutes to complete. Once you have completed the audit tool, you will be provided with a unique and tailored guide which will help your organisation to embed action on tackling health inequalities into its everyday activities.

Start the conversation – an NHCP guide to community engagement

Northamptonshire Health and Care Partnership has created a guide to help colleagues across our Integrated Care System to understand and lead engagement activities effectively and productively, with the support of the NHCP communications and engagement team. It has been created by a wide variety of community members, in collaboration with the team.

Six principles for engaging people and communities | National Voices

The six principles were developed by the People and Communities Board, in conjunction with the new models of care ‘vanguards’ sites, to give practical support to services as they deliver the ‘new relationship with people and communities;’ set out in NHS England’s Five Year Forward View. These ‘six principles’ set out the basis of good person-centred, community-focussed health and care.

Think Local Act Personal – support for co-production

Co-production can improve people’s wellbeing and has a positive impact on the workforce. The National Co-production Advisory Group supports TLAP, councils and providers to co-produce their work.

Healthwatch – your spotlight on health and social care

Northamptonshire Healthwatch listen to the issues that really matter to local communities and hear about your experiences of using health and social care services. The website contains information and resources on engagement as well as reports and insights from their engagement activity.

For information and support, including training, on health inequalities, please contact Chloe Gay by emailing chloe.gay@northnorthants.gov.uk

NHCP Leadership Matters Conversations – Health Inequalities

Health Education England elearning for healthcare (elfh) modules

Health Education England provides a whole range of training on topics relevant to health inequalities. These include the modules listed below. Please note you will need a Health Education England elfh log-in to access these training modules.

Other e-learning

The Future NHS Equality and Health Inequalities Network is a highly recommended resource hub for information and updates about health inequalities.

Follow the link below to join the workspace and you can sign up to receive updates when new information is added to the space.

Click here to access the Future NHS Equality and Health Inequalities Network

If you have any information which you think would be useful to include on this page, please contact Chloe Gay by emailing chloe.gay@northnorthants.gov.uk