Finding the Evidence: Health inequalities, equality and diversity

Finding the Evidence: Health inequalities, equality and diversity
PHE Knowledge and Library Services Team, updated September 2021

• This briefing brings together resources to identify the best evidence for making decisions around health inequalities.

COVID-19 impact inquiry evidence library

COVID-19 impact inquiry evidence library
Health Foundation

• Evidence gathered from a wide range of sources across the UK to consider how experiences of the pandemic have been influenced by people’s existing health conditions and inequalities. The evidence has been organised across a number of themes including access to healthcare; community resilience; disproportionately impacted groups; health inequalities in a place; people with underlying conditions.

What have we learned so far about COVID-19 volunteering in the UK? A rapid review of the literature

What have we learned so far about COVID-19 volunteering in the UK? A rapid review of the literature
medRxiv 2020.11.22.20236059; 23 November 2020, [Preprint, not peer reviewed] 

doi: https://doi.org/10.1101/2020.11.22.20236059

• This article describes a systematic review of the literature focused on two broad questions: 
• What have we learned so far from COVID-19 volunteering both at the UK national level and the more local community level? 
• What have we learned from engagement with local communities and community champions during the COVID-19 period?

Abstract

Living with covid - dynamic review of the evidence

Living with Covid19
NIHR Themed review 15 October 2020

• A dynamic review of the evidence around ongoing COVID-19 symptoms (often called Long Covid). This rapid and dynamic review draws on the lived experience of patients and expert consensus as well as published evidence to better understand the impact of ongoing effects of COVID-9, how health and social care services should respond, and what future research questions might be.
• Resources will be added to the site as they become available and a substantive review of the emerging evidence will be published in February 2021.

Direct and indirect impacts of COVID-19 on health and wellbeing

Direct and indirect impacts of COVID-19 on health and wellbeing: Rapid evidence review v2
Champs Intelligence & Evidence Service, July 2020

• This rapid evidence review provides a summary of what the evidence tells us about the direct and indirect impacts of COVID-19 on health and wellbeing. It examines the impacts of COVID-19 on the ‘wider determinants of health’ - Impacts on family, friends and communities, money and resources, education and skills, our surroundings, transport, the food we eat; access to health and social care, individual health behaviours and health and wellbeing outcomes. 
• The report concludes that the impacts of COVID-19 have not been felt equally – the pandemic has both exposed and exacerbated longstanding inequalities in society.

Evidence-Based Interventions Programme

Evidence-based interventions Wave 2
Academy of Medical Royal Colleges 13 July 2020

• Recommendations from Wave 2 of the Evidence-Based Interventions programme includes 31 tests, treatments and procedures which should only be used in specific, limited circumstances. A six-week engagement process ends 24 August 2020. See the Engagement document here.

Evidence-Based Interventions Programme
NHS England 29 November 2018

• The aim of the Evidence-Based Interventions programme is to prevent avoidable harm to patients, to avoid unnecessary operations, and to free up clinical time by only offering interventions on the NHS that are evidence-based and appropriate.
• The Programme is focused on items that should not be routinely prescribed in primary care. The programme targeting 17 interventions that fall in to this category. Four that should not be routinely offered to patients unless there are exceptional circumstances and 13 interventions that should only be offered to patients when certain clinical criteria are met.

Includes:
Evidence-Based Interventions: Guidance for CCGs
NHS England 29 November 2018

• This guidance document is for CCGs, to assist them in fulfilling their duties relating to securing continuous improvements in the quality of services for patients and in outcomes, particularly regarding appropriate clinical interventions.
• In addition to publishing statutory guidance under Section 14Z8 of the NHS Act 2006, NHS England are mandating compliance to the Evidence-Based Interventions programme through the NHS Standard Contract.

Coronavirus: health and social care key issues and sources

Coronavirus: health and social care key issues and sources
House of Commons Library Briefing updated 30 June 2020

• An overview of key issues facing the NHS and social care services during the coronavirus (Covid-19) outbreak, and links to official UK and international guidance and data. It also lists other reliable sources of information in the health and social care sector, including comment from organisations representing patients, staff and service providers.

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights

Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights
BMJ Quality & Safety 04 February 2020. doi: 10.1136/bmjqs-2019-009704

• If healthcare settings are better supported to report, analyse and use complaints data in a standardised manner, complaints could impact on care quality in important ways. This review has established a range of evidence-based, short-term recommendations to achieve this.

Informing NHS policy in 'digital-first primary care': a rapid evidence synthesis.

Informing NHS policy in 'digital-first primary care': a rapid evidence synthesis.
Health Serv Deliv Res 2019;7(41) December 2019

• Evidence suggests that uptake of existing digital modes of engagement is currently low. Patients who use digital alternatives to face-to-face consultations are likely to be younger, female and have higher income and education levels. There is some evidence that online triage tools can divert demand away from primary care, but results vary between interventions and outcome measures. A number of potential barriers exist to using digital alternatives to face-to-face consultations, including inadequate NHS technology and staff concerns about workload and confidentiality. There are currently insufficient empirical data to either substantiate or allay such concerns. Very little evidence exists on outcomes related to quality of care, service delivery, benefits or harms for patients, or on financial costs/cost-effectiveness. No studies examining how to contract and commission alternatives to face-to-face consultations were identified.

NHS Collaborative Learning Library

NHS Collaborative Learning Library
FutureNHS platform

• The aim of the NHS Collaborative Learning Library is share learning and knowledge amassed by the New Care Models programme between 2015 and 2017 and which may be useful to any transformation programme or improvement project. It includes Collaborative Learning Guides, Case studies and Resources developed from the programme.

Negotiating commissioning pathways for the successful implementation of innovative health technology in primary care

Negotiating commissioning pathways for the successful implementation of innovative health technology in primary care
BMC Health Services Research (2019) 19:648, 6 September 2019

• This paper explores the process by which commissioning organisations make their decisions to commission innovative health technologies. Based on a case study of four CCGs exploring the commissioning considerations for a new photoplethysmography-based diagnostic technology for peripheral arterial disease in primary care in the UK.
• Highlights include the importance of priority setting, valuing evidence, assessing value for money, cross-organisational collaboration, and negotiating commissioning pathways.

In summary,

Centre for Homelessness Impact - evidence maps

Building a culture for ending homelessness for good
Centre for Homelessness Impact 4 June 2019

• The CHI was created in response to the need for an independent voice that can focus on ensuring that policy and practice is informed by reliable evidence. Their strategy,  Building a culture for ending homelessness for good, sets out what they will do, and how they will work with others, to make a decisive move towards ending homelessness for good.
• The website includes a range of Evidence Tools support those working in homelessness to have greater impact. The Evidence and Gap Maps bring together evidence on homelessness interventions from around the world to highlight where evidence does or doesn’t exist on what works and why they work or not.

Evidence base for models of rural primary care

What is the published evidence base for models of rural primary care (or components of models), nationally or internationally?
Healthcare Improvement Scotland May 2019

• A review the literature on models of rural primary care which could be applied in areas of Scotland. In particular multi-disciplinary team working in rural primary care.

Social prescribing: where is the evidence?

Social prescribing: where is the evidence?
British Journal General Practice 2019; 69 (678): 6-7

• This editorial briefly outlines different models of social prescribing, the current evidence base and its limitations, explore problems relating to what constitutes good evidence, and discusses some potential ways forward.

Centre for Homelessness Impact

Centre for Homelessness Impact

• A new resource compiling evidence around the impact of homelessness interventions. 
• The Evidence and Gap Maps bring together evidence on homelessness interventions from around the world to highlight where evidence does or doesn’t exist on what works and why they work or not. (Note maps may not work on IE browser)
• Read about it on the Campbell Centre website here.

Evidence review of vision for integrated care “Stepping up to the place”

2018 Integration evidence review

LGA October 2018

• A review of evidence to support the refresh of vision for integrated care “Stepping up to the place”. 
•  The review report is provided in three sections: 
• Part A: Review of the vision. This provides a summary of the findings from the evidence review and explores the implications of these for the vision. 
• Part B: Evidence review. This sets out the review of evidence in detail, providing examples to illustrate current practice, the barriers and the enablers. 
• Part C: Case studies. Six case studies describing current experience and good practice in delivering integrated care – Croydon, Dorset, North East Lincolnshire, Nottinghamshire, Plymouth and Rotherham.

How should health policy respond to the growing challenge of multimorbidity?

How should health policy respond to the growing challenge of multimorbidity?
University of Bristol October 2018

• This policy report discusses the issue of multimorbidity, and offers a summary of recommendations for health policies going forward.
• Includes a summary of recommendations from major reports and an outline of the 3D approach. 
• "There will need to be a new relationship between patients and health care professionals, which will engage patients more in managing their health conditions themselves. Health care services need to invest in better generalist care and become less focussed on care for single diseases, and closer integration of health and social care will be necessary."

Effectiveness of interventions to address loneliness- overview of evidence

An overview of reviews: the effectiveness of interventions to address loneliness at all stages of the life-course
What Works Wellbeing October 2018

• This review examines the evidence from 14 studies around ways to tackle the effects of loneliness. Interventions identified were leisure activities, social and community interventions, therapies, befriending, educational approaches, and system wide approaches but there are large gaps in the evidence base.

Understanding carers (Resource)

Understanding carers: a guide for local authorities
Nuffield Trust 8 October 2018

• Sources of information to help local authorities understand the needs of carers in their area. Includes number and characteristics of carers, services for carers, carers experiences, Carers: outcome measures.

Pharmacist services for non‐hospitalised patients

Pharmacist services for non‐hospitalised patients
Cochrane Database of Systematic Reviews 2018, Issue 9. Art. No.: CD013102. DOI: 10.1002/14651858.CD013102.

• A review of the evidence around services provided by pharmacists to non hopsitalised patients identified 116 studies (n=41,851) from community pharmacies and hospital outpatient clinics.
• Anlaysis found that some services provided by pharmacists can have positive effects on patient health, including improved management of blood pressure and physical function. The pharmacist services did not reduce hospital visits or admissions. 
• Services delivered by pharmacists produced similar effects on patient health compared with services delivered by other healthcare professionals.