Understanding Diversity & Inequality In Healthcare
Commissioning for diversity: where are we now? Dr Sandra Husbands for Dr Bobbie Jacobson Director www.lho.org.uk APHO and the Regional Public Health Observatories SCOTPHO NEPHO NWPHO INIsPHO YHPHO EMPHO EEPHO WCH WMPHO SEPHO SWPHO
LHO lead areas: Health inequalities Ethnicity Smoking N VI SI B E ET H NI C N E Q U A LI TI
E S Pre-Requisites for Tackling Ethnic Differentials in Health & Health Care POLITICAL ENVIRONMENT NHS CULTURE EFFECTIVE COMMUNICATION INVISIBLE ETHNIC INEQUALITIES ANALYTICAL CAPACITY KNOWLEDGE BASE GOOD DATA Political Environment Legislative National Health Priorities
Local Political Commitment National Health Policy: Which Dimensions of Inequality are covered? Target Geography Life Expectancy X Age Ethnicity X Cancers X
CHD/Stroke X Teenage Pregnancy X Mental Health DRE SEG X Infant Mortality Smoking Gender
X X X Disability Sex. Orientation NHS Cultures Input vs outcome cultures Demographic factors Commissioning a Patient-led NHS Fitness for Purpose: highlighted the need for NHS organisations to be informationled New commissioning environment PbR & PBC Value for money, e.g. Save to Invest Financial balance Smart commissioning needs good
intelligence Good Data: what is needed? Strategic approach to ethnic monitoring with key health datasets outside the acute sector with mandatory ethnicity recording 90% + complete recording of census 16 groups High quality ethnicity recording based on self assessment Data Access Issues: The London Story Ethnicity Coding Completeness in London: 2005/06 Bromley Hospitals Royal National Orthopaedic Hospital Barking, Havering & Redbridge Hospitals Royal Brompton & Harefield Epsom & St Helier University Hospitals Queen Mary's Sidcup The Lewisham Hospital St George's Healthcare
Ealing Hospital North West London Hospitals University College London Hosp Chelsea & Westminster Healthcare St Mary's Whipps Cross University Hospital Kingston Hospital Barnet & Chase Farm Hospitals Guy's & St Thomas' Barts & The London The Hillingdon Hospital Homerton University Hospital Royal Free Hampstead Hammersmith Hospitals King's College Hospital The Whittington Hospital Mayday Healthcare Queen Elizabeth Hospital West Middlesex University West London Mental Health Moorfields Eye Hospital North Middlesex University Hospital Great Ormond Street Hospital
The Royal Marsden South London & Maudsley Newham Healthcare Barnet, Enfield & Haringey Mental Health Oxleas South West London & St George's Mental Health Camden & Islington Mental Health & Social Care Trust East London & The City Mental Health Central & North West London Mental Health Acute / Specialist Trust mean Mental Health Trust mean 0 10 20
30 40 50 60 70 80 Percentage of FCEs with stated ethnicity (%) Source: Hospital Episode Statistics (HES), The Information Centre for health and social care. 2005/06 HES data provisional. Analysed by LHO. 90 100 Ethnicity Coding Completeness in London: The Big Improvers
100.0 Percentage of FCEs with stated ethnicity (%) 90.0 Mental Health Provider Trusts mean 80.0 Acute and Specialist Trusts mean 70.0 60.0 Barnet And Chase Farm Hospitals Queen Mary's Sidcup Oxleas 50.0 40.0
30.0 20.0 10.0 0.0 2002/03 2003/04 2004/05 2005/06 Source: Hospital Episode Statistics (HES), The Information Centre for health and social care. 2005/06 HES data provisional. Analysed by LHO. Knowledge Issues The Limited Evidence Base Understanding Differences in relation to need for Health Care Translation of knowledge into commissioning decisions
Using the Knowledge Base: The Example of CHD - 1 Using the Knowledge Base: The Example of CHD - 2 Using the Knowledge Base: The Example of Breast Cancer E th n i c i ty Proportional Admission Ratios by Ethnicity for London Residents: Breast Cancer 2003/04 All Ethnicities Not stated Not known Other Chinese Other Black Black African Black Other Asian
Bangladeshi Pakistani Indian Other Mixed W hite & Other White White Irish White British 0 50 100 PAR 150 200 Analytical Capacity & Expertise: Ethnic Differentials in Health & Health Care & the Workforce 1200
1000 800 600 Full Toolkit, 1040 FAQs , 736 400 200 0 Web Downloads September 06 to January 07 Full Toolkit FAQs Summary: Where are we? Ethnicity recording completeness in hospital inpatient data has improved greatly, but mandatory recording still unstrategic and of questionable quality Relationship between Equalities Legislation and Health Policy still unclear
The biggest challenge is now to move on from recording and use the data we have wisely to inform commissioning. LHO Resources on Ethnicity & Health National Full Report. Indications of Public Health in the English Regions. No.4: Ethnicity and health http://www.lho.org.uk/viewResource.aspx?id=9840 Ethnic disparities in health and health care: a focused review of the evidence and selected examples of good practice: Full Report http://www.lho.org.uk/viewResource.aspx?id=8831 How to Analyse Ethnic Differentials in Health Toolkit and Q&A http://www.lho.org.uk/viewResource.aspx?id=10625
Equal Access, Equal Care? Can London Deliver the Race Equality Action Plan for Mental Health http://www.lho.org.uk/viewResource.aspx?id=11962&rsid=http://www.lho.org.uk/ Ethnic Disparities in Health & Health Care: A focused review of the evidence http://www.lho.org.uk/viewResource.aspx?id=8831 Missing Record: The case for recording ethnicity at birth & death registration http://www.lho.org.uk/viewResource.aspx?id=7954 Search www.lho.org.uk You can find all PHO resources via this site.
The "personal pleasure" exclusion applies to travelling employees. The issue was whether Ms. Cook's injury was excluded. The Board determines both the degree to which a recreational or social activity serves the employer's work-related interests and the degree to which...
3) Identification des besoins en formation Conception des modeles climatiques regionaux, Renforcement des systemes d'observation climatique au niveau national et regional, Consolidation des acquis en matiere d'Inventaire des Gaz a effet de Serre, de definition des mesures d'adaptation et d'attenuation,...
Must internally audit with a PCI certified Internal Security Assessor (ISA) using PCI DSS. 1. Many millions (2.5+ to 6+) credit card transactions. All Card Brands have this level. Must audit either using a PCI certified external Qualified Security Assessor...
- wet tropical climate - coastal trade wind climate - wet-dry and monsoon climate ... Persistent precipitation supplied by orographic lifting as easterlies flow over the coasts In addition these regions are strongly influenced by the presence of tropical cyclones...
A Little About You. What is your role and department at Sinclair? What is your current knowledge and usage of eLearn and Turnitin? What are your concerns regarding originality and source use within student work?
Ready to download the document? Go ahead and hit continue!