Migration and Vulnerability during the Pandemic: Barriers to Wellbeing

Migration and Vulnerability during the Pandemic: Barriers to Wellbeing
Doctors of the World 13 September 2021

• This report reveals that refugees, asylum seekers and migrants reported higher levels of bad health and inadequate housing during the Covid-19 pandemic, as well as difficulties registering with a GP and accessing remote health care services, suggesting significant unmet health care needs. The data used in this report comes from service user data collected by DOTW UK from their clinics.

Ethnic health inequalities and the NHS

Ethnic health inequalities and the NHS
NHS Race & Health Observatory, Kings Fund June 2021

• This report represents one of many steps needed to help understand the factors that shape race inequality in health, including the forces of structural racism and discrimination, and to begin to respond to them with impactful changes.

Ethnic health inequalities and the NHS

Ethnic health inequalities and the NHS
NHS Health and Race Observatory 15 June 2021

• This report argues that the NHS has not made significant progress in reducing ethnic health inequalities in recent years because it has not acted on this issue as a clear priority. There has also been a lack of progress made in ensuring equality of experience and opportunity for the NHS workforce. It goes on to argue that there is now an opportunity to address this by taking urgent action to address critical gaps in the NHS’s capabilities to tackle ethnic health inequalities, and by building a broad health inequalities focus into new healthcare structures as a key priority, while supporting NHS staff to drive change.

What happened to English NHS hospital activity during the Covid-19 pandemic?

What happened to English NHS hospital activity during the COVID-19 pandemic?
Institute of Fiscal Studies 13 May 2021

• This briefing note uses administrative hospital data from across the NHS in England to describe how the use of inpatient (elective and emergency) and outpatient hospital care in 2020 compared with that in the previous year. It shows how overall levels of care changed in the period after the start of the pandemic in March until the end of December 2020 and then examines how changes in activity varied across regions and clinical specialties. Finally it examines how these patterns differ across patient age, ethnicity and local area deprivation.

Doing the work to end health inequalities caused by systemic racism

Doing the work to end health inequalities caused by systemic racism
BMJ 2021; 373 :n821 doi:10.1136/bmj.n821

• Report from a meeting organised by National Voices which aimed to examine ways to tackle racial inequalities in health.

The report of the Commission on Race and Ethnic Disparities

The report of the Commission on Race and Ethnic Disparities
Commission on Race and Ethnic Disparities 31 March 2021

• The Commission's report into racial and ethnic disparities in the UK.

Ethnic diversity in fertility treatment 2018

Ethnic diversity in fertility treatment 2018
Human Fertilisation and Embryology Authority (HFEA) March 2021

• This report looks at how access to, and outcomes of, fertility treatment differed by ethnic group between 2014 and 2018. It finds disparities in the experience of patients from ethnic minority backgrounds and makes recommendations for the HFEA, fertility clinics and commissioners to help better understand the root of these inequalities so that action can be taken to improve access and outcomes for ethnic minority groups.

Physical activity: understanding and addressing inequalities

Physical activity: understanding and addressing inequalities
PHE 22 February 2021

• Evidence-based guidance for addressing inequalities in physical activity locally. 
• This guidance can be used by local level practitioners and commissioners to begin tackling inequalities in physical activity across and within protected characteristic groups. It presents the findings of a review, analysis and research aimed at understanding the enablers, barriers and opportunities for increasing physical activity across inequality groups.

The health of people from ethnic minority groups in England

The health of people from ethnic minority groups in England
Kings Fund 17 February 2021

• This explainer examines the differences in health outcomes for ethnic minority groups, highlighting the variation across groups and conditions, and considers what’s needed to reduce health inequalities.

Ethnic inequalities in health-related quality of life among older adults in England

Ethnic inequalities in health-related quality of life among older adults in England: secondary analysis of a national cross-sectional survey
The Lancet Public Health 28 January 2021 DOI:https://doi.org/10.1016/S2468-2667(20)30287-5

• This study of data from five waves (July 1, 2014, to April 7, 2017) of the nationally representative English General Practice Patient Survey (GPPS) found evidence of wide ethnic inequalities in health-related quality of life and five determinants of health for older adults in England. 
• Ethnic inequalities in HRQoL were accompanied by increased prevalence of long-term conditions or multimorbidity, poor experiences of primary care, insufficient support from local services, low patient self-confidence in managing their own health, and high area-level social deprivation, compared with the White British group.

Mitigating ethnic disparities in covid-19 and beyond

Mitigating ethnic disparities in covid-19 and beyond [Analysis]
BMJ 15 January 2021; 372 :m4921

• Although socioeconomic status partly explains ethnic disparities seen with covid-19, cultural and structural racism also adversely affect health.

Ethnicity, Race and Inequality in the UK

Ethnicity, Race and Inequality in the UK
Policy Press 2020

• A free to download commentary by some of the UK’s foremost scholars of race and ethnicity on data relating to a wide range of sectors of society, including employment, health, education, criminal justice, housing and representation in the arts and media.
• Chapter 4 Health inequalities by Karen Chouhan and JamesNazroo

Build Back Fairer: The COVID-19 Marmot Review

Build Back Fairer: The COVID-19 Marmot Review
UCL Institute of Health Equity December 2020

• This report examines inequalities in Covid-19 mortality, focusing on ethnic minorities and certain occupations as well as paying continued attention to the socio-economic gradient in health. It shows the effects that the pandemic, and the societal response to contain the pandemic, have had on social and economic inequalities, their effects on mental and physical health, and their likely effects on health inequalities in the future.

Maternity high impact area: Reducing the inequality of outcomes for women from Black, Asian and Minority Ethnic (BAME) communities and their babies

Maternity high impact area: Reducing the inequality of outcomes for women from Black, Asian and Minority Ethnic (BAME) communities and their babies
PHE December 2020

Part of: 
Supporting public health: children, young people and families
Documents to help local authorities and providers commission and deliver maternal and child public health services from preconception up to 24 years.

Tackling health inequalities for Black, Asian and minority ethnic communities and colleagues

Tackling health inequalities for Black, Asian and minority ethnic communities and colleagues
West Yorkshire and Harrogate health and Care Partnership 22 October 2020

• The COVID-19 pandemic has affected every child, adult, family and community in West Yorkshire and Harrogate with some of the biggest impacts experienced by the most economically disadvantaged and those from Black, Asian and minority ethnic communities (BAME).
• This review specifically aimed to understand this impact on BAME communities and staff. The aim was to review existing work, to explore if this work was sufficient to address this impact and to identify recommendations for action to reduce this impact.

Workforce Race Equality Standard (WRES): Indicators for the NHS medical workforce

Workforce Race Equality Standard (WRES): Indicators for the NHS medical workforce
NHS England updated 7 September 2020

• A bespoke set of WRES indicators have been developed for the NHS medical workforce. This document outlines the rationale for these indicators and explains how they will work. A full set of data against these indicators will be presented as part of the annual WRES data report for NHS trusts.
• There are eleven indicators for the medical workforce. Four of the indicators reflect variation in career progression and pay, six represent medical staff perceptions of how they are treated by colleagues, employing organisations and patients, and one highlights the diversity of the councils and boards of medical institutions.

Building back health and prosperity

Building back health and prosperity
Health Devolution Commission 17 August 2020

• This cross-party commission believes there is now a fundamental choice to be made between greater centralisation of NHS and social care services or a comprehensive health devolution approach that incorporates national entitlements and targets but embeds the delivery of an integrated NHS, social care and public health service within broader, powerful, democratically led local partnerships.YouTube of launch

Third phase of NHS response to COVID-19 and implementation guidance

Third phase of NHS response to COVID-19
NHS England 31 July 2020
Update on the latest Covid national alert level; priorities for the rest of 2020/21; and an outline of financial arrangements heading into Autumn as agreed with Government.

• A: Accelerating the return of non-Covid health services, making full use of the capacity available in the window of opportunity between now and winter
• A1. Restore full operation of all cancer services.
• A2. Recover the maximum elective activity possible between now and winter
• A3. Restore service delivery in primary care and community services.
• A4. Expand and improve mental health services and services for people with learning disability and/or autism
• B: Preparation for winter alongside possible Covid resurgence
• C: Doing the above in a way that takes account of lessons learned during the first Covid peak; locks in beneficial changes; and explicitly tackles fundamental challenges including support for our staff, action on inequalities and prevention.
• C1. Workforce
• C2. Health inequalities and prevention.
• Financial arrangements and system working 
• Financial arrangements for CCGs and trusts set out in Annex Two.

Implementing phase 3 of the NHS response to the COVID-19 pandemic
DHSC 7 August 2020
1. Urgent actions to address inequalities in NHS provision and outcomes

• 8 actions
• Details of Task and finish group on accelerating NHS progress on tackling health inequalities during the next stage of COVID-19 recovery

2 Mental health planning

• Focus – IAPT services, community mental health teams, children & young people, support for NHS staff.

3. Restoration of adult and older people’s community health services

• Supersedes the prioritisation guidance for community health services first published on 20 March 2020 and updated on 2 April 2020,

4. Using patient initiated follow-ups as part of the NHS COVID-19 recovery.

• “Individual services should develop their own guidance, criteria and protocols on when to use PIFUs. PIFU pathways can be used for patients of any age, provided the patient and their clinician agree that it is right for them.” Includes example implementation checklist adapted from work by Somerset CCG and other case studies.

5. 2020/21 Phase 3 planning submission guidance
6. COVID-19 data collections: changes to weekend collections .

Over-Exposed and Under-Protected: The Devastating Impact of COVID-19 on Black and Minority Ethnic Communities in Great Britain

Over-Exposed and Under-Protected: The Devastating Impact of COVID-19 on Black and Minority Ethnic Communities in Great Britain
Runnymede Trust 5 August 2020

• Report of a survey (conducted by the Runnymede Trust and ICM in June 2020) which illuminates why BME groups are at greater risk from Covid-19: they are more likely to be working outside their home, more likely to be using public transport, more likely to be working in key worker roles, less likely to be protected with PPE and more likely to live in multigenerational, overcrowded housing, so much less able to self-isolate and shield.

Health inequalities and COVID-19

Health inequalities and COVID-19
Public Health England (PHE) in collaboration with the LGA, Association of Directors of Public Health (ADPH), and NHS England and NHS Improvement, have collated a suite of resources relating to health inequalities and COVID-19 to support place-based approaches to planning and responding to the pandemic, while mitigating against potential impacts on those with the poorest health outcomes.

• COVID-19: understanding the impact on BAME communities
• COVID-19 place based approach to reducing health inequalities overview
• COVID-19 Summary of Guidance and support for vulnerable groups
• COVID-19 Suggestions for mitigating the impact on health inequalities at a local level
• COVID-19 Health Equity Assessment Tool (HEAT) for local areas
• COVID-19 Data tools to support local areas
• COVID-19 Estimated population at risk by LA
• GOV.UK – disparities in the risks and outcomes of COVID-19 (pdf, 2020)
• Equality and Human Rights Commission – inquiry into the impact of coronavirus on ethnic minorities

Part of the COVID-19: public health collection