This afternoon in the Lords Baroness Tyler of Enfield will ask the Government about health and social care frameworks in England. Here she explains why change is necessary – and how it can reduce levels of health inequalities
Today I am asking an oral question about linking the current separate outcomes frameworks for health and social care. At present there are three separate frameworks – the NHS Outcomes Framework, the Public Health outcomes framework and the Adult Social Care Outcomes framework.
My concern is that this over-fragmented approach to what we all want from the health and social care system is neither helping encourage collaborative working and integration, nor helping to reduce the frankly scandalous levels of health inequalities. The alarming gap in life expectancy between the richest and poorest groups is well known, including people living cheek by jowl in major cities such as London.
The new duties on the Secretary of State, the NHS Commissioning Board and Clinical Commissioning Groups to reduce health inequalities are important and welcome, as is the fact that the draft NHS Mandate was amended to make it clear that across the entirety of the NHS Commissioning Board’s work it has specific legal duties to tackle health inequalities and promote equality. But is this enough to lead to real changes in attitude and approach on the ground?
I welcome the efforts that have already been made to align more closely the outcomes frameworks for the NHS, Public Health and Adult Social Care, including sharing various indicators on premature mortality. However, given the current inequalities in conditions such as the incidence of cancer and survival rates amongst deprived groups, what evidence is there that using common indicators will result in more integrated services, including things like smoking cessation programmes, leading to a reduction in these health inequalities?
I’d like to see the Government taking further action to improve the health of some of the most vulnerable groups in society. The National Inclusion Health Board, chaired by Prof Steve Field, is currently working to drive improvements through the Inclusion Health programme. It is looking to make sure that health services consider the needs of those with multiple problems linked to the wider social determinants of health and result in easier and more equitable access to good quality care. The early stages of this programme will place a focus on improving the health of the homeless, gypsies and travellers, sex workers and vulnerable migrants, many of whom have poor health and are often not included in mainstream NHS data systems.
By asking this question today I hope to get a clear commitment of the priority the Government attaches to this issue.
Published and promoted by Tim Gordon on behalf of the Liberal Democrats, both at LDHQ, 8-10 Great George Street, London, SW1P 3AE.