Healthcare quality worse for the worse off

  • Date: 29 January 2020

PEOPLE living in the most deprived areas of England experience a worse quality of NHS care and poorer health outcomes than people living in the least deprived areas, according to research undertaken by QualityWatch.

This joint Nuffield Trust and Health Foundation programme looked at 23 measures of healthcare quality and found that in every single indicator, care is worse for people experiencing the greatest deprivation - and for 11 measures the inequality gap is widening.

Researchers accessed NHS and the Index of Multiple Deprivation data and found where quality of care has grown worse over time so has the inequality gap widened between the most and least deprived.

The study found that in 2017/18, 14.3 per cent of people from the most deprived areas of England who attended A&E were not seen within target compared to 12.8 per cent of people from the least deprived areas. There was almost no gap in 2014/15.

The proportion of GP Patient Survey respondents from the most deprived areas reporting a 'very good' or 'fairly good' experience of making an appointment decreased from 77 per cent to 64 per cent between 2011/12 and 2017/18 compared to a 81 per cent to 72 per cent fall reported by those from the least deprived areas.

The researchers also reported that the inequality gap is greatest for measures that are heavily affected by issues beyond the control of the NHS, such as poor housing and social care. These measures include avoidable deaths, smoking prevalence and emergency admissions to hospital and measures relating to children and young people.

In those areas where quality of care is improving the inequality gap has narrowed – such as in unplanned hospital admissions for asthma, diabetes and epilepsy in children, recovery rate following psychological therapy and people being able to die at their usual place of residence.

Health Foundation assistant director of policy, Ruth Thorlby, said: "Poverty is bad for your health, and people in the poorest parts of England face a vicious cycle. Poor living conditions, low quality work, and underfunded local services lead to worse health. These findings show that added to this, those in the most deprived areas are routinely experiencing longer waits in A&E, lower satisfaction and more potentially avoidable hospital admissions.

"Relieving growing pressure on the NHS must be part of the solution, but as important for the new government is investing in housing, education and good work to keep people healthy in the first place."

Link: Quality and inequality: How have inequalities in the quality of care changed over the last 10 years

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