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NHS response to the COVID-19 pandemic

COVID-19 has brought to light many of the health and wider inequalities that persist within our society. As with nearly every health condition, it has become increasingly clear that COVID-19 has had a disproportionate impact on many who already face disadvantage and discrimination. NHS England has devised urgent actions to address these health inequalities COVID-19 exacerbated.

Our role within the Health and Wellbeing Alliance allowed us to weigh in and advise on necessary actions to reduce the particularly detrimental impact the virus had on BAME communities. The following actions will be rolled out nationally to stop COVID-19 further escalating the already worsening inequalities;

Protect the most vulnerable from COVID-19, with enhanced analysis and community engagement, to mitigate the risks associated with relevant protected characteristics and social and economic conditions; and better engage those communities who need most support.

Restore NHS services inclusively. This will be guided by new, core performance monitoring of service use and outcomes among those from the most deprived neighbourhoods and from Black, Asian and minority ethnic communities. If implemented effectively, we believe this will be beneficial in ensuring the needs of individuals from BAME communities are met.

Develop digitally enabled care pathways to increase inclusion, including reviewing who is using new primary, outpatient and mental health digitally enabled care pathways. This will help reduce marginalisation toward certain communities.

Accelerate preventative programmes to proactively engage with those at greatest risk of poor health outcomes; including better targeting of long-term condition prevention and management programmes.

Strengthen leadership and accountability, with a named executive board member responsible for tackling inequalities in place in every NHS organisation, alongside action to increase the diversity of senior leaders. We believe a diversification of senior leaders will be helpful as this will allow for the practises to better anticipate and consider the concerns and perspectives of those from all communities.

Ensure datasets are complete and timely to underpin an understanding of, and response to, inequalities. All NHS organisations should proactively review and ensure the completeness of patient ethnicity data, with general practice prioritising those groups at significant risk of COVID. This will aid in helping reduce the disproportionate effect of COVID-19 felt by BAME communities.

Another action we welcome, is for practices to increase collaborations with locally in planning and delivering action to address health inequalities, including incorporating in plans for restoring critical services; better listening to communities and strengthening local accountability; deepening partnerships with local authorities and the voluntary and community sector; and maintaining a continual focus on implementation of these actions, resources and impact.

Although NHS England has taken a substantial amount of time to publish the above response to COVID-19, if implemented correctly, these actions will focus on the paramount task of protecting those at greatest risk. They will also restore services inclusively, accelerate targeted prevention programmes, and improve accountability and leadership, collaborative planning, data and insight.

It is worth noting there has unfortunately been no mention of the funding allocated to address these health inequalities, an issue we have raised and also raised when the NHS Long Term Plan was developed. It is to be hoped that this omission does not undermine the achievement of the other actions.