We know health inequalities exist across the county and that some people have different access, experience and outcomes when it comes to both our services and workplaces.

We want to reduce those differences and remove them entirely where possible. To make sure everyone can get the best out of our services and workplaces, we need to understand the make up of our population and their individual needs as this helps us to plan our services to meet them. This will mean people will have a better experience when they access and use our services.

As a public sector organisation, we must comply with specific legal equality duties that require us to evidence how we have considered the needs of diverse and vulnerable groups when undertaking our responsibilities. This includes how we are meeting our responsibilities under relevant sections of the Health and Social Care Act 2012.

The Equality Act sets out nine characteristics who may be discriminated against because of certain characteristics they share. It provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. The groups protected by the Act include:

• Age – People of different ages including children, young and older people.
• Disability – People with a long-term condition, or with mental, physical, sensory, learning disability or impairments, or a combination of these.
• Gender Reassignment – People who have changed, or are in the process of changing, their sex.
• Marriage and Civil Partnership – People who are married or in a civil partnership.
• Race – People characterised by shared ethnicity, language or culture.
• Religion or Belief – People with or without a religion or belief.
• Sex – A man or a woman.
• Sexual orientation – Whether a person’s sexual attraction is towards their own sex, the opposite sex or both sexes.
• Pregnancy and Maternity – Women who are having or have just had a baby.

As well as these nine protected characteristics, there are additional characteristics and societal factors which contribute to health inequality. These are:

• Vulnerable or inclusion health groups – for example, vulnerable migrants, Gypsy, Roma, Irish Traveller and Boater communities, victims of modern slavery, people experiencing homelessness, offenders or former offenders, and sex workers.
• Socio-economic status and deprivation – for example, unemployment, low income, living in a deprived area, and factors associated with this such as poor housing and educational attainment.
• Geography – the characteristics of the place where we live, such as population composition, built and natural environment, levels of social connectedness, and features of specific geographies such as urban, rural and coastal.

At NHS Shropshire, Telford and Wrekin, we are proud to lead work that helps everyone live healthier lives. We know that our communities come from many different backgrounds and that some people find it more difficult than others to access healthcare. We are working to make sure that all people have a fair chance to use our services, are treated with respect, and have the best possible experience.

We have a legal duty under the Health and Care Act 2022 to reduce inequalities between patients regarding their ability to access health services, and with respect to health outcomes, as well as to ensure that services are provided in an integrated (joined up) way.

In November 2020 NHS England and NHS Improvement published Integrating care: Next steps to building strong and effective integrated care systems across England. It describes the four core purposes of an ICS, which include tackling inequalities in outcomes, experience and access:

• improve outcomes in population health and healthcare
• tackle inequalities in outcomes, experience and access
• enhance productivity and value for money
• help the NHS support broader social and economic development

The NHS can make a difference to health inequality in three ways:

1. By addressing the inequalities experienced by people in accessing health services, their experience of health services and their outcomes from health services (referred to as healthcare inequality).
2. By influencing multi-agency action to address social determinants, such as working with housing associations and local council’s on asthma health programmes by improving cleaner air and addressing damp issues within homes.
3. By using our role as an Anchor institution to have a positive impact on the local community. For example, procuring goods and services from the local area, offering inclusive employment opportunities and through our use of NHS-owned buildings and spaces. To find out more about the role of Anchor’s, visit: NHS England – Anchors and Social Value.

In Shropshire, Telford & Wrekin, we are committed to delivering the asks of the National Healthcare Inequalities Improvement Programme. To find out more about what we are currently doing to reduce healthcare inequality, please visit: NHS England » National Healthcare Inequalities Improvement Programme

In November 2023, NHS England published a Statement on Information on Health Inequalities. The Statement sets out a description of the powers available to relevant NHS bodies, including the Integrated Care Board (ICB) to collect, analyse and publish information in relation to health inequality.

Our full response to NHS England’s Statement on Information on Health Inequalities (duty under section 13SA of the National Health Service Act 2006) will be published, in line with NHS England’s requirements, on this webpage at the end of June.