This long-read by The King’s Fund draws on five years of work into health inequalities and presents a clear call to action for 10-year health plan for the NHS England. It argues that health inequalities—unfair, avoidable differences in health outcomes and care—remain wide and persistent, and require systematic change. While the NHS cannot solve all the social and economic determinants of health alone, it has a central role in delivering more equitable care, working with communities and partners, changing how it operates, and shifting from reactive care to prevention.
The Seven Priorities
- Develop a cross-government health inequalities strategy for the 10-year health plan to feed into.
- Recognises that the causes of health inequalities lie far beyond the NHS alone (housing, education, employment) and calls for a coherent strategy across government.
- Recognises that the causes of health inequalities lie far beyond the NHS alone (housing, education, employment) and calls for a coherent strategy across government.
- Reorientate the NHS to focus on prevention.
- The NHS must shift from treating illness to preventing it—particularly in the communities that experience the worst outcomes.
- The NHS must shift from treating illness to preventing it—particularly in the communities that experience the worst outcomes.
- Radically change the relationships the NHS has with people and communities, from ‘power over’ to ‘power with’.
- Encourages collaboration, listening, and co-production with communities rather than a top-down approach.
- Encourages collaboration, listening, and co-production with communities rather than a top-down approach.
- Tackle racism and discrimination in the NHS and cultivate a culture of compassion.
- Addresses how systemic bias and discrimination influence health outcomes and access to care, and calls for cultural change within the NHS.
- Addresses how systemic bias and discrimination influence health outcomes and access to care, and calls for cultural change within the NHS.
- Enable staff to identify and act on health inequalities and capture learning.
- Calls for training, data, metrics and organisational learning so that health-inequalities work becomes part of everyday practice.
- Calls for training, data, metrics and organisational learning so that health-inequalities work becomes part of everyday practice.
- Empower place-based partnerships to take more decisions about how NHS money is spent.
- Local partnerships (integrated care boards, local authorities, VCSEs) must have more agency and tailored decision-making to address local inequalities.
- Local partnerships (integrated care boards, local authorities, VCSEs) must have more agency and tailored decision-making to address local inequalities.
- Actively support local voluntary, community and social enterprise (VCSE) organisations through changes in financial planning and commissioning.
- The VCSE sector often works with marginalised communities; the report urges the NHS and commissioners to change how they fund, contract and partner with VCSEs.
- The VCSE sector often works with marginalised communities; the report urges the NHS and commissioners to change how they fund, contract and partner with VCSEs.
Access the Report
You can listen to video clips and read the full report here
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