Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society. Reducing health inequalities is key to our strategy and underpins our purpose of turning great ideas into positive impact. In recent years this has been evidenced through our close partnerships within the NHS and the NIHR Applied Research Collaboration (ARC) in our region.
The Innovation for Healthcare Inequalities Programme (InHIP) project has been commissioned by NHS England’s Accelerated Access Collaborative (AAC) in partnership with the the Health Innovation Network. The programme offers funding and programme support to integrated care systems (ICS) to enable the identification and adoption of innovations and technologies that address the five clinical priorities within the national Core20PLUS5 strategy – maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and cardiovascular disease.
Innovations and technologies include medicines, diagnostics, devices, and digital products approved by NICE since 2017.
Core20PLUS5 is a national NHS England and NHS Improvement approach to support the reduction of health inequalities at both national and system level. Core20PLUS5 populations in England suffer from poorer health outcomes, accentuated by the same patients suffering from inequitable access, experience and outcomes from health and care services and treatment pathways.
The approach defines 2 target population cohorts – the ‘Core20 (nationally defined) PLUS (ICS defined) – and identifies ‘5’ focus clinical areas requiring accelerated improvement.
InHIP has two desired outcomes:
Working closely with our ICS partners, four projects have been launched. Three aim to improve the detection and management of cardiovascular disease (CVD) including atrial fibrillation (AF) and lipid management in our Core20PLUS5 populations and the other supports the access of quantitative faecal immunochemical tests (FIT) to screen for bowel cancer.
Suffolk and North East Essex and Herts and West Essex are focusing on AF detection in our Core20PLUS 5 populations.
Suffolk and North East Essex
In partnership with Suffolk GP Federation, Suffolk and North East Essex ICB will initially target a small number of practices to further refine the process of identifying, effectively engaging and optimising treatment for people who have already been diagnosed with Atrial Fibrillation (AF).
The focus will be on clinically reviewing and supporting those with an AF diagnosis who are not currently receiving optimised treatment. The project will look to understand reasons for non-optimisation to share learning into the future.
Herts and West Essex
Hertfordshire and West Essex ICS will be working through primary care networks (PCNs) in their most deprived areas. They will engage with local voluntary, community, faith and social enterprise organisations (VCFSE’s) to co-develop a community outreach approach to raise awareness of AF in black, Asian and other ethnic groups through in primary care settings. It is hoped that this will improve detection and subsequent management with direct oral anticoagulants (DOAC’s) where appropriate.
Lipid is the scientific term for fats in the blood, more commonly referred to as cholesterol. High levels of cholesterol is one of the most significant risk factors for CVD. Around 43% of adults have raised cholesterol in the UK which can be reduced with appropriate management, saving lives.
Cambridgeshire and Peterborough
Cambridgeshire and Peterborough ICS will be working with practices in some of their most deprived areas to identify and optimise patients with poorly managed lipids, enabling access to novel treatments in line with the NICE AAC lipid management pathway.
Nearly 43,000 people are diagnosed with bowel cancer every year in the UK. Screening aims to find cancer or changes in your bowel that could lead to cancer early when treatment is more likely to work. A FIT (faecal immunochemical test) is used to screen for tiny traces of blood in poo that may be an early indication of cancer.
Norfolk and Waveney
Norfolk and Waveney ICS is focusing on improving bowel cancer screening. They are working with community champions and connectors in voluntary, community, faith and social enterprise groups and local government to screen for bowel cancer in higher risk people within Core20 and PLUS groups. A targeted community outreach programme using Quantitative Faecal Immunochemical Tests (FIT) will be used to engage people who have not responded to the national screening programme, looking to understand their reasons for not engaging and enabling proxy ordering to reach homeless populations.
For more information about our work on the InHIP programme, please contact firstname.lastname@example.org.
The University of Cambridge and Health Innovation East (Academic Health Sciences Network) have collaborated to create a report that sets out an approach to inequalities, outlines the inequalities in CVD across the East of England and describes how equity-focussed quality improvement in primary care could be used to address them.
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