Health equality: Equity and endurance

The King’s Fund recently published Equity and endurance: how can we tackle health inequalities this time? The case for tackling health inequalities is clear and overwhelming, it argues. Yet attempts to do so in recent decades have had mixed success, and none have translated into the enduring focus on addressing health inequalities that is needed.

The authors propose three fundamental realities that have to be hard-wired into the implementation of any approach to addressing health inequalities:

  • Endurance: inequality reduction needs a long-term programme that takes it beyond planning cycles, political attention spans and leadership tenure.


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Integration: It takes time to turn a tanker

On 11 February a policy paper, Health and social care integration: joining up care for people, places and populations, was published. BestMSK Health with its focus on cross-system, whole-pathway working including prevention seems to me to embody everything the White paper is talking about. I was pleased to see that it includes a commitment to improve pathways for MSK, but there is so much more to integration and MSK health than that. Here’s how I see the principles of the integration White paper playing out in MSK.…

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#SolvingTogether hip and knee replacement challenge

#SolvingTogether is an initiative to capture, assess, test and share ideas that support elective recovery. It was initiated by Director of Transformation for NHS England and Improvement Tim Ferris. It takes the form of a crowdsourcing platform where people can post ideas, backed up by tweet chats.

The major phase of #SolvingTogether will start in mid-February 2022. It will consist of six challenges that we will ask a huge range of people to respond to: people working at the point of care, service users and families, clinical and managerial leaders, partners in other sectors and clinical innovators and entrepreneurs.…

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FLS amendment to the Health and Care Bill

Lord Black’s amendment to the Health and Care Bill calling for equal access to FLS

On 20 January 2022, the House of Lords were again debating the Health and Care Bill and Lord Black of Brentwood put forward an amendment to the Bill which would make Fracture Liaison Services (FLS) a core service offered by the NHS in England.

Lord Black’s amendment received cross-party support and was co-signed by Lord Hunt of Kings Heath, Lord Rennard and Baroness Masham of Ilton.…

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Rheumatology PIFU guidance

The updated rheumatology PIFU (Patient Initiated Follow-Up) guidance is now on NHS England and NHS Improvement’s FutureNHS platform. The document is aimed at clinicians, service managers and commissioners the guidance supports the appropriate, safe, and sustainable implementation and delivery of PIFU for people with rheumatological conditions who are under the care of adult rheumatology services. 

See it on the FutureNHS platform (account required).

The guidance can be viewed in “draft” form at this link, once signed off, it will be published on the NHSE website.…

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APPG for Osteoporosis and Bone Health Inquiry Report

osteoporosis reportThe All Party Parliamentary Group (APPG) for Osteoporosis and Bone Health published a report into the long-standing postcode lottery in the NHS for osteoporosis care. The report highlights the scale of under-diagnosis, under-treatment and missed opportunities in the NHS, with a blueprint for change. Implementation of the blueprint in England and Wales could save the NHS around £287m over five years – a return on investment of around 3:1 – according to the Royal Osteoporosis Society (ROS), which has supported the Inquiry.…

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National Voices Timely Access to Care

A new publication from National Voices Timely access to care: Principles for recovery argues for an inclusive, equitable and person-centred recovery, focusing on the whole person, in the context of their lives, and the whole system, and the context within which it is operating. There are three sets of recommendations: one for government and system leaders, one for people planning and delivering services and one for the VCSE.

Access the document here.

Building back inclusively

NHS reportThe NHS Confederation has published a briefing on Building back inclusively: Radical approaches to tackling the elective backlog.

There is evidence suggesting that waiting lists have grown more rapidly in more deprived areas during the pandemic. There are good reasons to believe that the current approach to elective care, whereby patients are treated in the order they present for care, exacerbates inequalities and worsens health outcomes. The briefing sets out a package of measures, including the politically uncomfortable step of proactively growing the waiting list to address this.…

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Impacts of COVID-19 on deconditioning and falls

Public Health England has published a report on the wider impacts of COVID-19 on physical activity, deconditioning and falls in older adults. The study modelled the likely effect of the decrease in strength and balance activity observed during the pandemic on people who experience a fall, the number of falls and associated health and social care costs.

Key findings

Some of the key findings were:

  • 32% of older people were inactive between March to May 2020. This has increased from 27% in the corresponding period in 2019;
  • average duration of strength and balance activity decreased from 126 to 77 minutes per week, with the greatest change in the 70 to 74 age group;
  • without mitigation, modelling predicts that 110,000 more older people (an increase of 3.9%) are projected to have at least one fall per year as a result of reduced strength and balance activity during the pandemic.


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