1 December 2021

NHS Race Observatory calls for support of health inequality leads

Senior Leaders assigned to improve health inequalities in the NHS need to be supported and equipped to tackle local health inequalities with their progress mapped against key action plans.

A new report published by the independent NHS Race & Health Observatory in collaboration with The King’s Fund sets out recommendations to help ensure senior NHS officials responsible for improving health inequalities are able to make a difference.

Last year, NHS England and Improvement instructed all NHS organisations to designate a single executive board member as their senior responsible person for tackling health inequalities. Across the NHS, there should now be over 450 dedicated health equality named leads in healthcare organisations including Integrated Care Systems, NHS trusts, primary care networks and national healthcare bodies.

The report, Supporting named leads for health inequalities on NHS boards, outlines practical recommendations and next steps to ensure named leads on boards are equipped to make a difference on health inequality outcomes and held to account with system partners on progress.

According to the NHS Race and Health Observatory, which commissioned the report, named lead roles must be more than ‘just gestures’ and have a focus on addressing deep-seated inequalities, not seen as short term or tokenistic.

Director, Dr Habib Naqvi, said:

“A focus on health inequalities, and in particular on race equality, has not always been a sufficient board-level activity for everyone. But if this is to be more than tokenistic, then adequate frameworks of support and accountability must exist to empower individuals and motivate meaningful change.”

“This report presents a clear invitation to health inequalities leads to engage, share successes and challenges, and to combine their expertise for the benefit of all patients and service users.”

Anecdotal feedback from some health inequality leads – including medical directors, directors of public and population health, chief executives and chief operating officers – highlight the fact that inequalities have long, deep and complex roots, and that tackling them needs sustained, multi sector focus over a sustained period.

Kiran Chauhan, a senior consultant at The King’s Fund and main author of the report said:

“The people we spoke for this study showed us just how much passion and creativity there is for tackling health inequalities as part of a cross-sector effort. If they can count on sustained commitment from policy makers and political leaders, then access to knowledge, evidence and participative learning forums will have a real chance of enabling named leads for health inequalities to make progress on the long-standing inequalities facing communities and the NHS workforce.

The report recommends five practical steps for support:

  1. The creation of an induction offer for named Health Inequality leads, including role guides and examples of actions to be taken.
  1. The use of national and local action learning sets, which are already in place in some areas, for named Health Inequality leads.
  1. The creation of a repository of high-quality evidence, knowledge resources, methods and regularly updated case studies that reflect the progress that’s being made.
  1. Commitment to a long-term policy focus and a cross-government strategy that places addressing inequalities at the heart of system development.
  1. An enabling accountability framework that puts inequalities on an equal footing with the most important performance metrics and encourages innovation and experimentation to reflect the complex nature of inequalities.

This publication follows the Observatory’s June 2021 report on ethnic health inequalities in the NHS, also produced in collaboration with The King’s Fund, which warned the disproportionate impact of the Covid-19 pandemic on black, and minority ethnic communities, and the subsequent recognition of enduring health inequalities, must act as a clear call to action.