​​​​​​​Equality and health inequalities

On this page we cover a number of areas:


What are health inequalities?

Health inequalities are the differences in the health of different parts of the population. We are committed to addressing health inequalities and understand that some groups of people, including people with protected characteristics` experience different access, experience and outcomes when they use NHS services. The impact of this can be inequalities that affect broad groups of patients, families and carers. Being a member of certain groups e.g. those with a physical disability or a mental illness, Black and Minority Ethnic (BME) groups and the homeless also play a part, due to social marginalisation, poor access to services and likelihood of income deprivation.

The causes of health inequalities are complex, and include lifestyle factors, discrimination and also wider determinants such as poverty, housing and education. Health inequalities exist between socioeconomic groups, ethnic groups and between men and women.

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Demographic information of the Vale of York population

Life expectancy and other measures of health can vary strongly between different geographical areas and York has two areas ranked in the 10% most deprived in England.

Our 2017 Public Sector Equality Duty report provides further demographic information for our population, and includes information on health inequalities experienced by protected groups. Please refer here for further information http://www.valeofyorkccg.nhs.uk/data/uploads/governing-body-papers/5-january-2017/item-11-annex-a-psed-report-2016-17.pdf.

The Joint Strategic Needs Assessment  (JSNA) also provides information on our local population and their health and we work closely with our Public Health colleagues to improve the quality of data we receive for the Vale of York. Further information on the York JSNA can be found at www.healthyork.org

Promoting equality is not about taking away from one group to give to another. In the context of health, it’s about ensuring that access to good quality and appropriate services are available to all groups in our population, not just a privileged few.

The University of York is working with the NHS to develop how to measure health inequality and how this can be supported by the indices of deprivation.

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Aligning engagement and equality

Promoting equality and effective community engagement should complement each other. Systematic community engagement is an essential element of partnership working to promote equality. The engagement and involvement of patients, carers, partners and other stakeholders, including local people is intrinsic to the commissioning and procurement of services

We are therefore, committed to being proactive about seeking the views of all groups in our community; this in turn will help demonstrate we are promoting equality.  

We are committed to working in partnership with both our local communities and statutory providers and partners to ensure that different groups should not experience barriers to accessing services or, have less opportunity to live a longer healthier life due to factors beyond their control, specifically the nine protected characteristics.

We have created a range of engagement and involvement opportunities to gather the views of patients, service users and other stakeholders. This information is rich in personal experience and helps us to shape commissioning decisions, service specifications and improvement programmes.

Patients, carers and members of the public are represented through a number of channels including:

  • Close partnership working with Healthwatch York and Healthwatch North Yorkshire, East Riding and voluntary sector services
  • GP clinical lead and governing body members – providing a clinical overview and representing the patient voice at the clinical executive meetings
  • Get involved section of our website – highlights the areas where patients and the public can become involved in the work of the CCG
  • Regular updates at carers advisory group (CAG), voluntary sector, mental health service user forums
  • Attendance of voluntary and patient groups at committee meetings – such as the Maternity Voices Partnership (MVP) Wheelchair service users forum,  and  the Quality and Patient Experience committee (QPEC)

Our equality strategy

Underpinned by our vision, mission and values our Equality Strategy supports our guarantee to promote equality throughout the planning and development of service commissioning whilst respecting the diversity of our local community and staff.

We remain committed to addressing the health inequalities and understand that some groups of people, including people with protected characteristics experience different access and outcomes when they use NHS services.

We try to take a holistic approach to reducing health inequalities by:

  • considering the impact on health inequalities in every decision we make and every policy we deliver;
  • allocating our resources to where they are needed most;
  • working in an integrated way for individuals and communities who suffer poorer health outcomes;
  • working with individuals/communities to develop community based solutions to improving the health and wellbeing of our population.

    More information can be found in our Equality, Diversity and Human Rights Strategy (pgs 235 – 244).

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    Ensuring equality and reducing health inequalities through our decision making

    We want to be sure that the decisions we take make a real, positive difference to our population.

    As a CCG we should be able to demonstrate how we have tried to ensure:

    • Participation activity reaches diverse communities and groups with distinct health needs and those who experience difficulties accessing health services, including inclusion health groups.
    • People who have characteristics that are protected under the Equality Act 2010 are involved.

    Carrying out an equality and health inequality analysis can help identify people who experience the greatest health needs, those who face barriers to accessing services and to participation, and those groups of people with protected characteristics under the Equality Act 2010 who may be affected by a particular plan, proposal or decision. (NHSE 2017)

    An Equality Impact Assessment is undertaken on major strategies, policies and changes to services to ensure that they do not have a differential impact on any community group.

    In order to help support our staff to consider the equality impacts across protected characteristics, we have a matrix of questions that they can use as a tool.

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    Equality Impact Analysis (EIA)

    We measure the equality impact of our decisions to carefully consider how they affect the local population. To view EIAs on our policies click here. To view EIAs on our Governing Body papers, please click here.

    We also carry out Equality Impact Assessments as part of our Quality Impact Assessment when reviewing strategies, services, projects and policies. Here are examples of some of our latest EIAs:

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    Health inequalities toolkit and training for our staff

    We have designed a toolkit to help leading on engagement to define their involvement activities and scope the activities required for each commissioning intention. This process includes tools such as a stakeholder mapping process, guidance for equality impact assessments and a template to address if the legal duty needs to be applied.

      We provide regular updates to our staff and have invided in extranal facilitators to hold a session in 2017 and in November 2018.

      The aim of the session was to increase understanding and knowledge of the connection between equality  engagement and health inequalities duties within the NHS. 


      • To raise awareness of the Equality, Engagement and Health Inequalities duties
      • To increase awareness and understanding of equality and health inequality data and how this informs an effective Equality Impact Analysis 
      • To increase understanding of the connections between engagement and equality and how engagement activity can help to fill data gaps 
      • To apply learning to role 


      For more infromation about how we ensure equality runs through our decision making, visit our dedicated equality and diversity page