CCG Packs: Local equity data packs for all 195 clinical commissioning groups (at 2016 boundaries) in England for calendar years 2009 to 2018.
LA Packs: Local equity data packs for 324 local authority districts (all but two) in England for calendar years 2009 to 2018. We exclude Isles of Scilly and West Somerset due to small population sizes and narrow deprivation ranges.
NB: The summary equity indicators (AGI and RGI) are unreliable for localities with a narrow deprivation range (fewer than 3 quintile groups) such as Bradford City CCG. In such cases, it is more helpful to look at trends in the worst-off quintile group(s).
These data packs illustrate how local NHS equity indicators can be produced and communicated using graphs and summary measures of inequality (see our 1-page primer on the AGI and RGI summary indices of inequality (PDF , 73kb)). The packs focus on inequality in one high level quality indicator – potentially avoidable emergency admissions – but the basic analytical approach can be used for other indicators.
People living in more deprived neighbourhoods are more likely to have an emergency stay in hospital that could potentially have been avoided by high quality care outside the emergency hospital setting (“avoidable emergency admissions”, AEAs). In 2015 there were over 250,000 AEAs linked to living in poorer neighbourhoods in England.
The cost of inequalities in hospital admissions due to socio-economic differences is at least £12.5 billion a year. CCGs have a statutory responsibility to “have regard to the need to reduce inequalities between patients in access to health services and the outcomes achieved” (Health and Social Care Act 2012, s.14T). This statutory responsibility is likely to remain with CCGs with the move to Integrated Care Systems (ICSs).
Equity indicators are not (yet) systematically used to identify local equity trends and learn lessons about the local health and care system and its improvement. These local equity data packs contain summary information about socioeconomic inequality in potentially avoidable and all-cause emergency admissions within 324 local authority districts (all but two) and 195 clinical commissioning groups (at 2016 boundaries) in England for calendar years 2009 to 2018.
These packs provide analytical information, in particular for NHS and LA managers, on how inequalities in emergency admissions have changed (or not) over time in their area. This kind of information could be considered when developing health inequalities strategies, Joint Strategic Needs Assessments, and commissioning services.
The packs were produced by a research team at the University of York, drawing on underpinning data supplied by NHS England and using methods described in the report cited below. The summary information contained in these packs is independent research published by the University of York and does not represent official information from NHS England or the Department of Health and Social Care. Our summary information is similar but different to the official NHS local equity indicators published by NHS England at CCG level – for example, we use ONS population data rather than GP registration data.
Full methods details are contained in this technical report:
Ana Cristina Castro Avila performed the analyses and produced the data packs under the supervision of Richard Cookson, Tim Doran and Karen Bloor.
We thank Ben Barr, John Brittain, John Ford, Julia Knight, Ieva Skarda and Sarah Sowden for useful advice, but our errors and omissions are our own.
These data packs were produced as part of a pilot study funded by the National Institute for Health Research (NIHR) Policy Research Programme (project reference PR-X06-1014-22005) under the auspices of the Partnership for Responsive Policy Analysis and Research (PREPARE). PREPARE is a collaboration between the University of York and the King’s Fund, producing fast-response analysis and review to inform developing policy. The views expressed are those of the authors and not necessarily those of the NIHR, NHS England, or the Department of Health and Social Care.
Tim Doran and Richard Cookson are funded by the Wellcome Trust (Grant No. 205427/Z/16/Z).
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