Tag: inequalities

Royal College of Psychiatry

National Clinical Audit of Psychosis: England national report for the Early Intervention in Psychosis Audit 2021/2022

Source: The King’s Fund

Based on data from 10,557 case notes submitted by 54 trusts in England, this audit report presents national and organisation-level findings on services provided to people with first-episode psychosis (FEP). The report commends teams for maintaining early intervention in psychosis (EIP) service delivery at a high level in the context of the Covid-19 pandemic. It found that 66 per cent of teams had an increase in staff in the past year. The report also looked at the disparities in EIP care between different groups of people with FEP to highlight inequalities.

Public Health

Current Awareness Updates

Improving inclusion in health and care research: reflections and next steps.
HSR UK; 2022.

(In autumn 2021 HSR UK, the Nuffield Trust, The King’s Fund, The Health Foundation and PPI representatives from The Health Foundation Inclusion Panel co-developed a series of events to address improving inclusion in health and care research. This report shares insights from the expert speakers who participated in events, as well as reflections and learnings from running the series.)

Key findings from Healthwatch England’s national dental polling in 2022.
Healthwatch; 2022.

(A representative poll of 2,026 adults based in England on attitudes to NHS dentistry shows that half of the adults in England find dental charges unfair amid escalating living costs. More than two in five respondents (40 per cent) said they found it difficult to book an NHS dental appointment, while one in five (20 per cent) couldn’t access all the treatments they needed. Healthwatch England has warned decision-makers that NHS dentistry is in desperate need of reform.)

Smoking and social housing: Supporting residents, addressing inequalities.
Housing Learning and Improvement Network (HLIN); 2022.

(This report is a collaboration between Action on Smoking and Health (ASH) and the Housing Learning and Improvement Network (LIN). It outlines the case for reducing rates of smoking in the social housing sector as part of social landlords’ health and wellbeing activities and the action needed to achieve this.)

A picture of health? Bridging the gap between physical and mental healthcare in adult mental health inpatient settings.
National Confidential Enquiry into Patient Outcome and Death (NCEPOD); 2022.

(This report suggests that a physical health care plan should be developed when patients are admitted to a mental health inpatient setting. Other key messages aimed at improving care include calls to: formalise clinical networks/pathways between mental health and physical health care; involve patients and their carers in their physical health care, and include mental health and physical health conditions on electronic patient records.)


The Impact of Dementia on Women.
Alzheimer’s Research UK; 2022.

(This report calls for action to tackle dementia’s disproportionate impact on women and to ensure women can make a full contribution to research, both as participants and as researchers.)

Prevention in an ageing world

A window of opportunity

International Longevity Centre UK (ILC UK), April 7 2022

This report brings together ILC UK’s two-year global engagement programme on how to deliver prevention in an ageing world. It argues that while Covid has increased and exacerbated inequalities, it has also shown us how fast governments can act. There is a window of opportunity to build on the learnings from the pandemic. But governments need to act now.

Public Health

Current awareness updates

Weight management tier 2 interventions and their effectiveness.
Carried out by Frankie Marcelline from Sussex Health on 2/12/2021
[This evidence search report looks for recent evaluations and reports on the effectiveness of weight management tier 2 interventions for families, adults and children. A starting point might be Public Health England’s 2020 summary: Weight management services during COVID-19: phase 1 insights. Another source is Heggie’s: Tackling reporting issues and variation in behavioural weight management interventions.]

Brain tumours (primary) and brain metastases in adults.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers diagnosing, monitoring and managing any type of primary brain tumour or brain metastases in adults (aged 16 or over). It describes high-quality care in priority areas for improvement.]

Urinary incontinence in women.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers managing urinary incontinence in women (aged 18 and over). It covers assessment, care and treatment options. It describes high-quality care in priority areas for improvement.
It does not cover urinary incontinence in women with neurological disease. In December 2021, changes were made to align this quality standard with the new NICE guideline on pelvic floor dysfunction.]

Pelvic floor dysfunction: prevention and non-surgical management.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers the prevention, assessment and non-surgical management of pelvic floor dysfunction in women aged 12 and over. It aims to raise awareness and help women to reduce their risk of pelvic floor dysfunction. For women who have pelvic floor dysfunction, the guideline recommends interventions based on their specific symptoms]

Management of acute respiratory illness in prisons and places of detention.
UK Health Security Agency (UKHSA); 2021.
[This guidance will assist in the management of outbreaks of acute respiratory illness in prisons and places of detention. The guidance covers risk assessment, testing recommendations, antiviral therapies and when an outbreak can be declared over. An associated flow chart gives information for management depending on whether COVID-19 and/or influenza have been detected.]

BCG vaccination and SCID screening: patient pathway.
UK Health Security Agency (UKHSA); 2021.
[Flowchart showing the Bacillus Calmette–Guérin (BCG) vaccination and SCID screening patient pathway (updated 09 December 2021)]

Optimising chronic wound care: a human and financial necessity.
Penfold J. British Journal of Healthcare Management 2021;27(11):269-271.
[Comment highlights the importance of evidence-based practice in wound care to reduce the burden on patients and healthcare services.]

Active Lives Children and Young People Survey: Academic year 2020-21.
Sport England; 2021.
[This report contains a full year of coronavirus (Covid-19) restrictions, including comparisons back to summer term 2020, when school sites were closed to most pupils for much of the period. The proportion of children and young people in England who are active remains unchanged compared to 12 months ago. However, inequalities have increased and for some groups of children and young people, in particular teenage girls and Black children are the least likely to be physically active.]

What science has shown can help young people with anxiety and depression.
Wellcome; 2021.
[This report summarises what we’ve learned about the evidence for ‘active ingredients’ of effective interventions for youth anxiety and depression – these are the aspects of interventions that make a difference in preventing or managing anxiety and depression.]

Project ADDER.
Department of Health and Social Care (DHSC); 2021.
[Information on Project ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery), the government’s pathfinder programme combatting drugs misuse.]

Global Drug Survey (GDS) 2021 Global Report.
Global Drug Survey (GDS); 2021.
[The focus is on how COVID-19 changed people’s drug using behaviours especially with regard to alcohol, cannabis and cocaine, how people balance reducing harm and maximizing pleasure when using drugs, and whether microdosing has moved beyond those seeking to improve creativity and work performance to self-treatment for mental health issues.]

Alcohol-specific deaths in the UK: registered in 2020.
Office for National Statistics (ONS); 2021.
[Deaths caused by diseases known to be a direct consequence of alcohol misuse by sex, age, region and deprivation.]

From harm to hope: A 10-year drugs plan to cut crime and save lives.
Home Office, Department of Health and Social Care, Ministry of Justice, Department for Work and Pensions, Department for Education, and Department for Levelling Up, Housing and Communities; 2021.
[This policy paper sets out the government’s 10-year plan to cut crime and save lives by reducing the supply and demand for drugs and delivering a high-quality treatment and recovery system. Commitments are made across the government to break drug supply chains while simultaneously reducing the demand for drugs by getting people suffering from addiction into treatment, and deterring recreational drug use.]

Child of the North: building a fairer future after Covid-19.
NIHR Northern Health Science Alliance; 2021.
[This report paints a stark picture of inequality for children growing up in the north of England post-pandemic compared with those in the rest of the country. It looks at a wide range of factors, from child poverty to children in care, to build up a picture of ‘The Child of the North’. It sets out 18 clear recommendations that can be put in place to tackle the widening gap between the north and the rest of England.]

Children and young people’s mental health: Eighth Report of Session 2021–22.
House of Commons Health and Social Care Committee; 2021.
[Report highlights that the problems identified can only be addressed by government departments, local government and the health system acting together to promote good mental health and prevent new crises emerging. It recommends setting up a Cabinet sub-committee.]

Public Health

Current awareness updates

The cost effectiveness of ecotherapy as a healthcare intervention, separating the wood from the trees.
Hinde S. International Journal of Environmental Research and Public Health (IJERPH) 2021;18(-):11599.
[This paper explores the capacity for ecotherapy to be cost-effective as a healthcare intervention. We show that there is the potential for ecotherapy for people with mild to moderate common mental health problems to be cost-effective but significant further research is required.]

Community support versus health care services: time to change our definition of impact.
Evidence & Policy Blog; 2021.
[Non-profit community anchor organisations in England typically provide a range of support to local people, including wellbeing support, advocacy, social activities, and training and employment advice. This array of services takes a wider perspective on the determinants of health than the approach taken within the NHS, which generally focuses on mental and physical ill health. Despite the different approaches, the funding for organisations is often dependent on the impact on health outcomes.]

National Pregnancy in Diabetes (NPID) Audit Report 2019.
Healthcare Quality Improvement Partnership (HQIP); 2021.
[The National Pregnancy in Diabetes (NPID) Audit measures the quality of antenatal care and pregnancy outcomes for women with pre-gestational diabetes. Overall, there were 4,525 pregnant women with diabetes in 2020 – 325 fewer pregnancies than 2019 – of which, 54% had type 2 diabetes (44% had type 1 diabetes and 2% were recorded as having ‘other diabetes’). The audit includes analysis by age, ethnicity, social deprivation and weight.]

Better together: a public health model for mentally healthier integrated care systems.
Centre for Mental Health; 2021.
[According to this briefing paper, England’s 42 integrated care systems have an opportunity to protect and promote mental health in the communities they serve. The briefing explores how integrated care systems can address the social and environmental factors that affect people’s health in their communities.]

Saving lives, improving mothers’ care: lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017-19.
National Perinatal Epidemiology Unit (NPEU); 2021.
[This report finds that pregnancy remains safe in the UK, with the overall maternal death rate showing a slight decrease. Among 2,173,810 women who gave birth in 2017-2019, 191 died during or up to six weeks after pregnancy, and 495 during or up to one year after their pregnancy. However, the findings show a continued inequality in the mortality rates for women of different ethnic backgrounds, ages and socio-economic circumstances.]

Ethnic and socio-economic Inequalities in NHS maternity and perinatal care for women and their babies.
Healthcare Quality Improvement Partnership (HQIP); 2021.
[This report describes inequalities in maternity and perinatal care for women and their babies in England, Scotland and Wales during the period 1 April 2015 to 31 March 2018. Using routinely collected data, care and outcomes experienced by women and babies using NHS maternity services are measured and stratified by ethnicity and by Index of Multiple Deprivation (IMD), a proxy for socio-economic deprivation.]

Fulfilling the promise: how social prescribing can most effectively tackle loneliness.
British Red Cross; 2021.
[This report draws on practical experience of delivering social prescribing services to those experiencing or at risk of loneliness through Red Cross Community Connector schemes.]

What works when evaluating social prescribing? A realist review report.
Wales School for Social Prescribing Research; 2021.
[An analysis of approaches used to evaluate social prescribing.]

Newcastle GP Services Social Prescribing Navigator Service: an independent evaluation.
North of England Commissioning Support Network; 2021.
[The aims of this evaluation were to: • Understand the update and usage of the service across Newcastle with regards population, conditions, and sites. • Analyse trends in unplanned access to secondary care. • Understand the experience and impact from the patient as end user of this service and navigators as deliverers of the service • Recommend data collection and analysis for the ongoing service to have greater comprehension of the impact of the service.]

The role of data in unlocking the potential of social prescribing.
Open Data Institute; 2021.
[A report by Frontier Economics for the ODI concludes there are a number of barriers to social prescribing reaching its full potential, including the lack of available data, and solid data infrastructure, such as statistics, maps and real-time service-use data that could help social prescribers and the providers of services to make decisions, build services and gain insight.]


Covid 19

Current awareness updates

COVID-19 rapid guideline: managing COVID-19.
National Institute for Health and Care Excellence (NICE); 2021.
[In October, NICE added new recommendations on casirivimab and imdevimab. New data on the use of heparins (from the REMAP-CAP trial results) does not change the current recommendations.]

The consequences of COVID-19 lockdown for formal and informal resource utilization among home-dwelling people with dementia: results from the prospective PAN.DEM study.[Abstract]
Vislapuu M. BMC Health Services Research 2021;21(1):1003.
[The care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need.]

The impact of the COVID-19 pandemic on patterns of attendance at emergency departments in two large London hospitals: an observational study.[Abstract]
Vollmer MAC. BMC Health Services Research 2021;21(1):1008.
[Our study findings reflect broader trends seen across England and give an indication how emergency healthcare seeking has drastically changed. At ICHNT, we find that a larger proportion arrived by ambulance and that hospitalisation outcomes of patients without COVID-19 did not differ from previous years. The extent to which these findings relate to ED avoidance behaviours compared to having sought alternative emergency health services outside of hospital remains unknown.]

Remote schooling through the coronavirus (COVID-19) pandemic, England: April 2020 to June 2021.
Office for National Statistics (ONS); 2021.
[How remote learning has affected the amount of learning materials covered by pupils and the dependence of remote learning on parental input over the course of the coronavirus (COVID-19) pandemic.]

Inequalities in accessing dementia care and support during COVID-19.
The Mental Elf; 2021.
[Catherine Talbot reviews a recent qualitative study on accessing post-diagnostic dementia care before and since COVID-19, which highlights the need to reduce inequalities in dementia care.]

COVID-19: provision of immunisation sessions for outbreaks in schools.
Public Health England (PHE); 2021.
[Guidance for School Age Immunisation Services on the provision of immunisation sessions in schools where there are cases or an outbreak of COVID-19.]

UKHSA review into IPC guidance.
Department of Health and Social Care (DHSC); 2021.
[Recommendations for changes to COVID-19 infection prevention and control (IPC) advice to help ease pressure on the NHS.]

Impacts of the COVID-19 pandemic on youth mental health among youth with physical health challenges.[Abstract]
Hawke LD. Early Intervention in Psychiatry 2021;15(5):1146-1153.
[CONCLUSIONS: Mental health concerns are highly prevalent among youth with physical health concerns, and also appear to be exacerbated by the COVID-19 pandemic. Physical health concerns appear to constitute risk factors for heightened mental health responses to the pandemic situation. System planners striving to adapt mental health services to meet distancing recommendations are urged to consider youth with physical health conditions and ensure that integrated supports are available to them.]

NDNS: Diet and physical activity – a follow-up study during COVID-19.
Public Health England (PHE); 2021.
[This report presents the findings from a follow-up study of National Diet and Nutrition Survey Rolling Programme (NDNS RP) participants which aimed to describe and assess the impact of the COVID-19 pandemic on the diet and physical activity of people in the UK in 2020.]

Vaxzevria (AstraZeneca) Covid-19 vaccine: Recognition of batches manufactured in India.
House of Commons Library; 2021.
[This briefing provides an overview of the regulatory concerns associated with batches of the Vaxzevria (previously called AstraZeneca) vaccine which were manufactured in India.]


Public Health

Current awareness updates

Promoting the sexual health and wellbeing of gay, bisexual and other men who have sex with men.
Public Health England (PHE); 2021.
[This resource provides information to support commissioners, providers and voluntary and community sector organisations in developing interventions for improved sexual health and wellbeing among gay, bisexual and other men who have sex with men (MSM).]

Promoting the sexual health and wellbeing of people from a Black Caribbean background: an evidence-based resource.
Public Health England (PHE); 2021.
[This resource provides information to support commissioners, providers and third-sector organisations in developing interventions for improved sexual health and wellbeing in people from a Black Caribbean background.]

Mental health in prison.
House of Commons Justice Committee; 2021.
[This report finds that a disjointed and incoherent approach to care has left many prisoners suffering from mental health issues undiagnosed and unable to access care. It calls on the NHS, Ministry of Justice and the Prison and Probation Service to implement a system of integrated care that improves identification of mental health issues, provides seamless care while in prison and supports transition to care in community settings on release.]

The cost of eating disorders in the UK 2019 and 2020.
Hearts Minds and Genes Coalition for Eating Disorders; 2021.
[This report highlights the cost of eating disorders in the UK, in terms of financial costs to the NHS, the financial, social and emotional impact on individuals, families and wider society, and in terms of the ongoing loss of lives to illnesses that can be treated but that are currently subject to severe underfunding and lack of services.]

Long-term prisoners: the facts: England and Wales. October 2021.
Prison Reform Trust; 2021.
[In the last twenty years, the prison population has changed hugely. Sentences for more serious crimes have become longer and far more people will now spend 10 or more years in prison. Meeting the challenges of this change will shape the prison landscape for the foreseeable future.]

Measuring Children and Young People’s Subjective Wellbeing.
What Works Centre for Wellbeing; 2021.
[While we have very good national data on the wellbeing of adults, the national statistics on children and young people’s wellbeing in the UK, is not collected regularly, or nationally. The Measures Bank is a searchable database of measures, a resource for policy-makers and practitioners to identify appropriate measures for children’s wellbeing for use in their specific context.]

Characteristics of women who stop smoking in pregnancy.
Public Health England (PHE); 2021.
[Experimental analysis of data from the Maternity Services Data Set (MSDS), April 2018 to March 2019.]

NHS population screening: identifying and reducing inequalities.
Public Health England (PHE); 2021.
[Guidance and resources to support providers and commissioners in reducing screening inequalities.]

Physical activity: promotion within primary and secondary care.
Public Health England (PHE); 2021.
[Report and learning from the evidence base and local practice of physical activity promotion in the NHS. The report provides practitioners, commissioners and policy makers with the factors that influence successful integration and implementation of physical activity promotion in primary and secondary care. It focuses on understanding how to integrate physical activity promotion into preventative and treatment care and support for people living with one or more long-term conditions.]

Behaviour change: helping health professionals deliver brief interventions.
Public Health England (PHE); 2021.
[This report focuses on how we can use behavioural science to support healthcare professionals to deliver brief interventions for alcohol, smoking and Making Every Contact Count (MECC) programmes. It includes examples of the barriers and facilitators that affect whether healthcare professionals deliver brief interventions. The report also includes examples of behaviour change techniques (BCTs) that could be used to support and encourage healthcare professionals to deliver brief interventions.]