COVID-19 and inequalities

A new report from the Institute for Fiscal Studies aims to bring together what has emerged so far about the impacts of the COVID-19 crisis on inequalities across several key domains of life.

A key finding is how the nature of the economic shock associated with COVID-19 has interacted with many old and deep inequalities. 

Excluding key workers, most people in the bottom tenth of the earnings distribution are in sectors that have been forced to shut down, and 80% are either in a shut-down sector or are unlikely to be able to do their job from home – compared with only a quarter of the highest-earning tenth. 

Young people and those of Pakistani, Bangladeshi or black ethnicity are also more affected than others. 

The report highlights 'sharp differences' in deaths from COVID-19. 

Between the start of March and the middle of April, age-adjusted death rates in the most deprived tenth of areas in the UK were more than double those in the least deprived tenth of areas. 

It also highlights that a greater burden of childcare is likely to have fallen on women, potentially inhibiting work and career progression for mothers, and how school shutdowns are likely to accentuate the socio-economic divide in educational attainment.

The report calls on policymakers to turn their attention to longer-term effects to prevent a persistent widening of inequalities in health and education.

Click on the link below to read the report in full.

Institute for Fiscal Studies

Data on deaths in care homes broken down by ethnicity

The Care Quality Commission, supported by the Office for National Statistics,  has completed a targeted piece of work to analyse the impact of coronavirus on different ethnic groups in care settings.

The data indicates a disproportionate number of deaths among people from Black, Asian and minority ethnic groups.

The proportion of deaths in all adult social care services due to confirmed or suspected COVID-19 was higher for Black (49%) and Asian (42%) people compared to white people (41%) and people from mixed or multiple ethnic groups (41%).

This difference increases when looking at care home settings only, where 54% of deaths amongst black people and 49% of deaths amongst Asian people are related to COVID-19 compared to 44% of deaths of white people and 41% for​ mixed or multiple ethnic groups.


Tackling the UK’s mortality problem

In this article for the BMJ, Veena S Raleigh argues we cannot reduce excess deaths unless we know what is causing them.

The article highlights how the high number of deaths from COVID-19 in the UK comes on the heels of the historical legacy of stalling improvements in life expectancy. 

Veena argues the development of evidence-based policies and interventions for tackling both COVID-19 and other causes of death is imperative if the UK’s mortality problem is to improve. 


COVID-19 impact on women from Black, Asian and minority ethnic groups

New polling analysis has revealed the pressure on women from Black, Asian and minority ethnic groups during the coronavirus lockdown.

The analysis from the Women’s Budget Group, Fawcett Society, Queen Mary University London and London School of Economics shows health is just one of many impacts disproportionately affecting people from Black, Asian and minority ethnic backgrounds during the COVID-19 crisis.

Forty-three per cent of disabled or retired women from Black, Asian and minority ethnic groupd and 48% of men from Black, Asian and minority ethnic groups said they had lost government support compared with 13% of white women and 21% white men in the same group. 

More than half (51%) of disabled or retired women from Black, Asian and minority ethnic groups also said they were not sure where to turn to for help compared with 19% of white women.

Fawcett Society

New NICE rapid guidelines and resources

NICE has published a new COVID-19 rapid guideline on renal transplantation.

The guideline aims to minimise the risk of infection for patients and living donors before, during and after transplantation. 

The recommendations emphasise the importance of communication between patients and their specialists to ensure they can make informed decisions and understand the implications of transplantation and donation during the COVID-19 pandemic.

NICE has also published an evidence standards framework for COVID-19 diagnostic tests, a COVID-19 rapid evidence summary on remdesivir and updated its evidence collection guide for medicinal products to prevent or treat COVID-19.


GPs predict 'huge surge' in PTSD

The Royal College of GPs has reworked its post traumatic stress disorder learning materials to create resources for doctors helping their patients come to terms with the pandemic and its aftermath.

The materials were initially developed to help GP practices provide targeted support to military veterans returning from war zones and trying to adjust to civilian life. 

GPs are adapting the techniques they use to diagnose and care for people with PTSD in readiness for a ‘huge surge’ in patients with the condition as a result of COVID-19.

Royal College of General Practitioners

Learn My Way resources – looking after your health online

The learning team at Good Things Foundation has put together a step-by-step video outlining how people can access information about their local GP, dentist and opticians, as well as demonstrating the benefits of the NHS app. 

Learn My Way features an Improving your Health Online topic which demonstrates how you can make GP appointments online, order repeat prescriptions and find advice about specific symptoms and conditions. 

The course is also split into two subjects – GP services online and The NHS website.

Learn My Way

Updated guidance for people receiving direct payments

The government has updated its advice for people who buy care and support through a direct payment, as well as local authorities, clinical commissioning groups and those who provide care and support.

The guidance was updated earlier this month and an easy-read version of the information is available.


Integrating mental and physical health: Insights from experience

In partnership with the Centre for Mental Health, National Voices is looking to understand people’s experiences of managing the emotional and psychological impact of living with health conditions. 

National Voices wants to understand whether and how people’s emotional support needs are recognised, whether they are met, and how support can be improved. 

It would like to hear from:

  • People who are living with one or more long-term physical health conditions
  • Family members and partners of people with long-term physical health conditions
  • Health and social care professionals who support people with long-term physical health conditions

More information on the project and how to take part is available by clicking on the link below.

National Voices

One-click patient experience data access

The Patient Experience Library has launched a new tool allowing all the patient experience data for a trust to be accessed in one place.

The tool was developed in response to a 2019 report from the Health Foundation which looked at quality measurement – including patient experience – across a range of healthcare services.  

It described a 'measurement maze' and 'hard to locate' data, with numerous national bodies presiding over data collection.  

The new tool allows every trust to get all its data with a single click.

To improve insight, the Patient Experience Library has also developed one-click cross-referencing, to pull out common themes across the survey data.  

The team would like to hear people's views on the surveys and feedback tool, which can be viewed by clicking on the link below. Email your feedback to [javascript protected email address].

Patient Experience Library

Study: Patient work and their contexts

A new scoping review aims to provide insight into the work burden of health management from a patient perspective and how patient context influences such work. 

The study aimed to review the characteristics of patient work in adult patients. 

Patient work refers to tasks that health conditions impose on patients, for example taking medications, within a system of contextual factors.

Authors said having patients self-manage their health conditions is a widely promoted concept, but many struggle to practice it effectively. 

Their results indicate most patient work was done alone, in private, and often imposing cognitive burden with low amounts of support.

They concluded, for many patients, health-related work is ever present, invisible, and overwhelming. 

When researchers and clinicians design and implement patient-facing interventions, it is important to understand how the extra work impacts one’s internal state and coping strategy, how such work fits into daily routines, and if these changes could be maintained in the long term.


Patient record flag can positively affect care of people with learning disabilities

Healthcare for people with a learning disability can be improved by a new flag on patient records, a pilot scheme has suggested.

NHS Digital introduced the Reasonable Adjustment Flag, which lets doctors, nurses and other health and care staff know a patient has a disability or other impairment and has specific needs that require adjustments.

These could include communication requirements, such as how to be contacted for appointments, or changes to the environment, for example the use of particular music to help reduce anxiety.

NHS Digital published initial results from the Reasonable Adjustment Flag pilots, which took place in Gloucestershire and Devon between June 2019 and March this year, as part of Learning Disability Week.

During the pilot, which took place in various care settings, more than 70 flags were created by clinicians in conjunction with patients and carers. 

There were a wide range of adjustments identified, which could positively affect the experience and outcomes for patients and the experiences of carers and staff. 

Adding the Reasonable Adjustment Flag could also lead to other benefits, such as financial savings through reducing the number of missed appointments.

NHS Digital

Support package to help manage patients with long-term conditions

UCLPartners has launched a package of digital resources and practical support to help improve care for patients with long-term conditions.

The support can help stratify care for patients according to level of risk, using new models of care that are virtual by default, mobilise the wider workforce, draw on digital innovation and support patient self-management. 

The support package focuses on the management of asthma and COPD, with resources for the management of type 2 diabetes and cardiovascular disease being added soon.