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Showing results for tags 'Health inequalities'.
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News Article
If a female doctor gets treated like this, is there hope for any women?
Patient Safety Learning posted a news article in News
The agonising pains came midway through Dr Rageshri Dhairyawan’s third cycle of IVF, ten years ago. “I felt as if a heavy metal shovel was scraping away at the lining of my abdomen,” she recalls. “It was like nothing I’d ever felt before,” she says. Her fear was ovarian torsion — “when the ovaries become so big from all the follicle stimulation that they twist on their stalk, which is excruciating and needs to be repaired surgically because the ovary becomes starved of oxygen.” Her husband rushed her to A&E where she was given morphine, then admitted to a gynaecology ward. As a scan revealed no ovarian torsion, “It was thought the hormones had flared up my endometriosis.” Dhairyawan was in so much pain she couldn’t move, and yet she recalls being treated as though she was an attention-seeker “trying to get strong opioids through dishonest means” and “as a nuisance for pressing my buzzer”. It was as if, she says, “I didn’t have something they thought was very serious so why was I still there? I just remember not wanting to feel like more of a nuisance because I knew what being a nuisance on a ward can look like — I’d been a doctor for ten years.” Dhairyawan’s husband demanded pain relief for her. She left hospital shaken. “It massively changed me,” she says. “The experience of not being listened to as a patient, not being taken seriously — it really shocked me. Because I thought, I’m a senior doctor, I know exactly how the NHS works, I know my medical condition, I now what to ask for. And I still can’t speak up and advocate for myself.” Read full story (paywalled) Source: The Times, 2 July 2024 -
Content Article
This blog is part of a series written by Dr Charlie*, taking a closer look at some of the patient safety issues affecting people lives today. In this blog Dr Charlie describes how their homeless friend Robbie* has struggled to access the care and clarification he needed around his liver abscesses. Dr Charlie explains how important it is for healthcare professionals to take into account individual circumstances if they are to provide people with the information and care they need. *not their real name -
News Article
Wider use of physician associates will increase inequality, say UK doctors
Patient Safety Learning posted a news article in News
Doctors are warning the UK medical regulator that wider use of physician associates in the NHS may risk patient safety and lead to greater inequalities in care in deprived areas that struggle to recruit GPs. The government’s plan to recruit 10,000 physician associates – healthcare professionals supervised by doctors – has angered many clinicians who consider the roles ill-defined and a potential threat to patient safety. The General Medical Council (GMC) is to regulate physician and anaesthesia associates, who also work under doctors’ supervision, from December. The doctors’ union, the British Medical Association, last week announced it was seeking a judicial review of the GMC over the “dangerous blurring of lines” between doctors and medical associate professions. It argues physician and anaesthesia associates need regulating, but not by the GMC. Other professional membership organisations want clarification of associates’ roles. The Royal College of General Practitioners (RCGP) told the GMC that regulation is a “significant step forward”, but the scope of practice needs to be urgently developed. Read full story The Guardian, 30 June 2024 -
News Article
Midwives call women in labour ‘Asian princesses’ amid ‘hostile’ environment fears
Patient Safety Learning posted a news article in News
The NHS Race and Health Observatory has raised fundamental concerns about racism towards maternity patients after several cases have come to light in recent months, including midwives branding patients as “Asian princesses”. The watchdog’s intervention follows regulators identifying patterns of racist and discriminatory behaviour at the maternity departments of two large hospital trusts and a smaller general hospital in the last six months. The observatory’s CEO Habib Naqvi told HSJ he was “deeply concerned” by the seriousness of the issues raised. He added that “discriminatory behaviours and ways of working… [can] lead to hostile and unsupportive learning environments… impact patient care and safety, and also seriously undermine the NHS’s goal of attracting and retaining its workforce”. Examples given included the term “Asian princess” being used by midwives in reference to brown-skinned women requesting pain relief during labour. The students also described a “disregard” from some midwives towards black and brown-skinned women, particularly where English was not their first language. It was also reported when Asian women verbalised their pain during labour, some midwives responded with “Oh, they are all like this”, while additional derogatory comments were made towards asylum seekers, that “they are playing the system”, the NHSE team’s report said. Read full story (paywalled) Source: HSJ, 28 June 2024 -
Content ArticleThe latest report in Public Policy Project’s Medicines and Pharmacy programme calls for transformation across the pharmacy sector to unlock medicines optimisation which creates true system value. The report highlights that medicines optimisation has significant potential to contribute to delivering integrated care priorities, such as improving population health and reducing inequalities. As ICSs grapple with financial challenges, medicines, as the second highest cost to the NHS, represent a critical opportunity to improve patient outcomes and deliver better value for money.
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Content ArticleHow are community groups bridging some of the gaps between Black mothers and health and care services? What can the health and care system learn in response? Siva Anandaciva speaks to Amanda Smith, founder and Chief Executive of Maternity Engagement Action CIC, Benash Nazmeen, Professor of Midwifery and co-founder and co-director of the Association of South Asian Midwives CIC, and Chrissy Brown, founder and Chief Executive of the Motivational Mums Club CIC, to find out.
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Content Article
Welsh Health Equity Solutions Platform
Patient-Safety-Learning posted an article in Health inequalities
The Welsh Health Equity Solutions Platform is part of the Welsh Health Equity Status Report initiative (WHESRi), which supports a healthier, more equal and prosperous Wales. The platform is a gateway to data, evidence, health economics and modelling, policies, good practice, innovative tools and practical solutions to help improve population wellbeing and reduce the health equity gap in Wales and beyond. It is structured around an innovative WHO framework of ‘Five Essential Conditions’ for healthy prosperous lives for all. The platform will link with and feed into a WHO health equity gateway, providing an example and inspiration for countries to learn and follow, as well as to contribute and share. -
Content ArticleAlmost half of England’s population is male, yet inequalities in men’s health seldom get specific attention. The women’s health strategy for England shone a light on the health care needs of girls and women through their life course, highlighting areas specific to their health – such as maternity and the menopause – and inequalities in health outcomes. But the wide, and widening, health inequalities experienced by men also require focus. Related reading on the hub: 11 top picks: Men's health Why harmful gender stereotypes surrounding men’s approaches towards their feelings need challenging
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Content Article
Age UK: It’s a struggle to be seen (May 2024)
Patient Safety Learning posted an article in Older people
Results of Age UK’s research into the experience of people aged 50 and over accessing health and social care services. This research into older people’s experiences of health and care services has revealed the extent of the challenges they face in accessing and receiving them. These challenges are confronted at a time in their lives when people are likely to be most reliant on such services to keep them well, independent, connected and safe. People from across the age spectrum, from 50 to over 100 years old, told Age UK about difficulties in accessing primary care services, including GPs and dentists. Health problems that could have been quickly and easily resolved have worsened through long waits for appointments and treatment. In some cases, older people have given up seeking treatment and care as they had lost hope of being able to see a clinician at all. For those of working age the problems in accessing appointments, referrals and treatment have had an impact on their ability to maintain good health, to remain in work and to care for others. Lack of access to support for carers has led to deteriorations in their physical and mental health. -
News Article
Millions of over-50s in the UK fear they can't access healthcare
Patient Safety Learning posted a news article in News
Millions of people over the age of 50 in the UK have concerns about struggling to access healthcare, according to new analysis by Age UK. It comes as one elderly and disabled patient admitted he cannot afford to wait on hold to his GP practice for an appointment for long due to rising phone bill costs. A new report by Age UK – It’s a Struggle to be Seen – analysed the results of a representative poll, conducted for the charity by Kantar, of 2,621 UK adults over 50, as well as its own online survey which attracted more than 17,000 responses. The report claims less than half (48%) of people over 50 are confident their medical issue would be solved by NHS services. Some 49% – which Age UK equates to 12.6 million people – were concerned about their ability to access their GP, while 42% were worried about access to hospital appointments. The same proportion expressed concerns about access to emergency departments, the charity said. Caroline Abrahams, charity director at Age UK, said: “Sadly, for some older people, healthcare delayed means healthcare denied, because they do not have time on their side. “Our new analysis highlights just how many are being subjected to distress and, in some cases, enduring pain, because of their difficulties in accessing the GP services that they need.” Read full story Source: Medscape. 17 June 2024 -
Content Article
Learning Disability Week is the third week of June every year. The event, organised by the charity Mencap, is an opportunity to raise awareness about different learning disabilities and challenge some of the barriers people who have learning disabilities face. According to Mencap, a learning disability is a person's reduced intellectual ability, meaning they can face difficulty with everyday activities. People with a learning disability can sometimes need extra support to learn new skills, understand complicated information or interact with other people. It can be particularly challenging for people with learning disabilities and their families when accessing healthcare services. To mark Learning Disability Week, we are sharing 11 resources, blogs and reports from the hub for patients, their families and healthcare professionals on breaking down these barriers. -
Content ArticleIn most developed countries, substantial disparities exist in access to mental health services for black and minority ethnic (BME) populations. This study sought to determine perceived barriers to accessing mental health services among people from these backgrounds to inform the development of effective and culturally acceptable services to improve equity in healthcare. It found that people from BME backgrounds require considerable mental health literacy and practical support to raise awareness of mental health conditions and combat stigma. There is a need for improving information about services and access pathways. Healthcare providers need relevant training and support in developing effective communication strategies to deliver individually tailored and culturally sensitive care. Improved engagement with people from BME backgrounds in the development and delivery of culturally appropriate mental health services could facilitate better understanding of mental health conditions and improve access.
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Content ArticleIn this JAMA Internal Medicine article, doctors Jessica Holtzman and Rita Redberg argue that for decades, women have been inadequately represented in clinical trials of drugs and devices evaluated by the US Food and Drug Administration (FDA). Looking at existing evidence on the issue, they identify barriers and improvements to women's representation in trials. They argue that the FDA needs to take action by declining to review medical devices and drugs if the representation of women does not reflect the intended use population.
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Content ArticleMore than four million people have type 2 diabetes in the UK and the use of new technologies is becoming essential for effective diabetes care and patient empowerment. This report by Public Policy Projects (PPP) highlights the benefits of continuous glucose monitoring (CGM) for people with type 2 diabetes who use insulin, but finds that access remains limited due to stigma and financial barriers. The report contains findings that emerged during the second roundtable of PPP’s System-wide Strategies for Better Diabetes Care programme, which is designed to identify opportunities for improvements and transformation in diabetes care. The roundtable was attended by more than 30 sector leaders from primary and secondary care, pharmacy and integrated care system (ICS) and key industry representatives. The overarching theme was the opportunities and challenges brought by CGM technology to type 2 insulin users and other patient groups. The report finds that primary care staff are under-resourced to deal with the number of new guidelines published, and this is influencing willingness to adopt and push this technology. Also, financial constraints and stigma around the visibility of the sensor are slowing down the effective rollout of the technology across the UK.
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Content ArticleSuad Duale grew up as a Somali refugee. She is now a community activist, a clinician, a mother and a researcher. Every day she says she sees the Somali community suffering and being treated unfairly, which leads to a collective lack of trust in professionals, particularly in the health system. In her work, she tried to address this issue by bridging the gap between the community and health and social care professionals. Read the full article on the Kings Fund website via the link below.
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Content ArticleInspired by the work of NYC Health + Hospitals' efforts to embed health equity into their adverse event analysis, WellSpan Health shares their self-assessment so others might likewise learn from their efforts.
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Content ArticleThe United States continues to have the highest rate of maternal deaths of any high-income nation, despite a decline since the Covid-19 pandemic. And within the U.S., the rate is by far the highest for Black women. Most of these deaths — over 80% — are likely preventable. With policies and systems in place to support women during the perinatal period, several high-income countries report virtually no maternal deaths. As policymakers and health care delivery system leaders in the U.S. seek ways to end the nation’s maternal mortality crisis, these countries may offer viable solutions. This brief updates an earlier Commonwealth Fund study of differences in maternal mortality, maternal care workforce composition, and access to postpartum care and social protections between the U.S. and other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. In this edition, we have also included data on Chile, Japan, and Korea — all high-income countries with universal healthcare systems.
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News Article“Outdated” guidance on prostate cancer could be putting men’s lives at risk, a charity has said. Prostate Cancer UK said that men at high risk of the disease can get a test, but only if they request one. It said that GPs are told not to raise the issue with men unless they have symptoms. But most men with early prostate cancer – when it is easiest to treat – do not have any signs or symptoms. Chiara De Biase, director of health services, equity and improvement at Prostate Cancer UK, said: “We simply can’t continue with a system where men at high risk of prostate cancer can get a test – but only if they know to request one. “This outdated guidance is failing both men and their clinicians, making health inequalities worse and putting lives at risk. It’s about time that changed. She added: “We know that a lot of men don’t come forward because they think they’ll be invited as part of routine tests – when this simply isn’t true". Read full story Source: The Independent, 12 June 2024
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Content Article
This report from National Voices called People’s experiences of diagnosis, brings together insights from people with lived experience and our members on the entire process of diagnosis – from trying to get an appointment for a diagnostic referral, to undergoing tests, and experiences post-diagnosis. The report covers the themes of challenges in diagnosis, inequalities in diagnosis, and new innovation in diagnosis, before concluding with nine recommendations for improving patient experience of diagnosis. These nine recommendations include: Adjustments and adaptations to enable access Provide better support while waiting Listen to the patient Better communication around diagnosis Make sure people have a plan Provide access to support groups Collect better data to understand the driver of diagnostic health inequalities, and act on it rapidly Upskill, coordinate and ultimately increase the workforce Have health equity embedded into new innovations the start. -
Content ArticleThe doctor-patient relationship should be immune from bias, but growing evidence challenges doctors’ objectivity. In this study in Science, the authors analysed vast data from US military emergency departments, where active-duty doctors and patients have military ranks and some patients outrank their assigned doctor. The study found that patients who outranked their doctors enjoyed more clinician effort and better health outcomes because more resources were inequitably invested in their care. The results also showed that White physicians consistently put less effort into caring for Black patients. The authors suggest that power-driven variation in behaviour can harm the most vulnerable populations in health care settings.
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Content ArticleReducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritising interventions most likely to be effective in reducing inequalities, studies of PA interventions need to conduct equity impact assessments. The aim of this article is to describe the development of a logic model framework for equity impact assessments of interventions to promote PA. The framework was developed within the prevention research network AEQUIPA—Physical activity and health equity: primary prevention for healthy ageing, informed by an equity-focused systematic review, expert interviews, exploratory literature searches, and joint discussions within the network. The framework comprises a general equity-focused logic model to be adapted to specific interventions. The intervention-specific equity-focused logic models illustrate the key elements relevant for assessing social inequalities in study participation, compliance with and acceptance of interventions, as well as the efficacy of interventions. Equity impact assessments are beneficial for prioritising interventions most likely to be effective in reducing health inequalities.
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EventThere is currently remarkable consensus across think tanks, institutions, and political parties that a move towards a preventive state is key to creating a healthier nation. A preventive approach can help people live healthily for longer while also addressing many of the problems within the health and care system, allowing for proactive population health management and tackling of health inequalities. Creating a healthier nation needs a collaboration between people, places, the NHS, and businesses, as well as government. If the new government wants to improve the health of the nation, it should create an approach to health that spans all government departments, includes actions to reduce health inequalities, and implements measures that help people to make healthier choices. At this in-person event, the case is presented for how prevention can create a healthier nation, why it is particularly important now, and propose tangible actions for making this shift at the national, system and local levels. Join the King's Fund to understand why prevention is key to supporting healthier lives and how it can be made a reality. Join leaders and experts from across health and care, thinks tanks and politicians to explore: why moving towards a preventive state is particularly important now given the context of widening health inequalities and stalling of life expectancy how to make the shift to prevention a reality at national, system, and local levels the importance of measuring preventive expenditure the role of prevention when taking a population health approach the link between health and housing and how healthier communities can support a wider approach to prevention. how place-based approaches to prevention are key. Register
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Content ArticleSohier Elneil, surgeon, expert in women’s pain, and founder of the first NHS vaginal mesh removal centre, speaks to the Rebecca Coombes about fighting for better care for her female patients.
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Content ArticleThe maternity disadvantage assessment tool (MatDAT) is a standardised tool for assessing social complexity during maternity care based on women and birthing people’s broad social needs. Developed by the Royal College of Midwives (RCM), it provides a guide for midwives to identify the woman’s care level (Level 1–4) and develop a personalised care and support plan (PCSP), as well as facilitating smooth communication with the multidisciplinary team. The tool and the MatDAT Planning Guide also support maternity services to plan and allocate resources to level of care pathways.
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News ArticleMore hospital patients with learning disabilities will die if politicians do not tackle the “devastating collapse” in specialist nurse numbers, a leading charity and a union have warned. The number of specialist learning disability nurses working in the NHS has dropped by 44 per cent over the course of the Conservative party’s time in government, a new analysis by the Royal College of Nursing (RCN) has revealed. The nursing union found a 36 per cent drop in applicants for specialist nursing degrees, while applicants are so low some universities have stopped funding courses altogether, according to a report shared exclusively with The Independent. The RCN and the charity Mencap have warned specialist nurses are vital in keeping patients with learning disabilities in hospital safe, as they are trained to spot life-threatening illnesses, such as sepsis, which can present differently. Dan Scorer, head of policy at Mencap, said: “Learning disability nurses have that in-depth training and understanding about the complexity of how people with a learning disability can present, and about how they will show they are experiencing pain. They’ve got vital expertise and insights to make sure that we don’t miss things.” He said the government must increase the number of training places available, and warned some universities have stopped courses altogether. He added: “I think the government removing bursaries for nurse training was pretty devastating. The impact of that was really significant, and whilst that’s been partially reversed, it significantly impacted the undergraduate training capacity that was available.” Read full story Source: The Independent, 4 June 2024
