7. Inequalities: shared roles and responsibilities
NHS England Public Health England Local Government
Social Care
Act 2012
Screening service
providers
Equality Act
2010
Public
Services
(Social Value)
Act 2013
Accessible
Information
Standard 2016
Screening inequalities-ANNB ISF Nov 20177 PHE Screening Division’s Inequalities Strategy
8. Our responsibilities - PHE
Public Health England (PHE) exists to protect and improve the
public’s health and wellbeing and reduce health inequalities.
There are commitments to tackle inequalities in:
• the PHE remit letter 2017 – 2018
• PHE’s Strategic Plan for the next four years – better outcomes
by 2020
• PHE equality objectives 2017 - 2020
• A framework for PHE action on health inequalities, 2015 – 2020
• The Five Year Forward View for Mental Health 2018
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10. Supporting the health system to reduce
inequalities in screening
PHE Screening inequalities strategy published May 2018
vision is that all screening services can be accessed fairly by all
communities and that everyone, regardless of their social and
personal circumstance, has an opportunity to make an informed
personalised choice about screening
Aim is to maximise the health outcomes of national screening
programmes and reduce the overall burden of health inequalities.
Objectives are to provide leadership and strategic direction and
provide those responsible for the delivery and commissioning of
screening with the evidence and tools to identify and tackle
screening inequalities
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12. Who experiences screening inequalities?
Published evidence shows that the groups at
greatest risk include ..
• Those experiencing economic deprivation
• Members of minority ethnic groups
• People with learning or physical disabilities
• People with serious and enduring mental
Illnesses
• Other protected groups identified by Equality
Act 2010
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12 PHE Screening Division’s Inequalities Strategy
13. Proportionate universalism
‘To reduce the steepness of the social gradient in
health, actions must be universal, but with a
scale and intensity that is proportionate to the
level of disadvantage.’
Marmot Review 2010
Screening inequalities-ANNB ISF Nov 201713 PHE Screening Division’s Inequalities Strategy
15. Challenges for screening
• Addressing inequalities mandated in service specs
• Screening inequalities may occur at any point along the
screening pathway
• Improving uptake alone may increase inequalities
• In the past, roll out of screening has not been equitable
• Data on protected characteristics not routinely collected
• Need to think how data can be collected to show
reduction in screening inequalities
• Can programme standards help to address inequalities
• Systematic dissemination of solutions is essential
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16. Example : Serious Mental Illness
• 534,431 people on the Mental Health (MH) register of
the Quality and Outcome Framework in General Practice
for 2016/17.
• 15-20 year shorter life expectancy
• Around 700 in long term settings
• Those who are long term residents of mental health care
provider / trusts are frequently not registered with a
general practitioner
• Access to screening is largely dependant on GP
registration
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17. Serious Mental Illness
• Collective action across PHE and with partners
• Inequalities Unit
• Public mental health team ( Improving lives
and reducing mortality )
• NHS England
• Equally Well UK Charter
• Macmillan Cancer Support
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18. Screening QAService
1. Awareness raising and keeping up to date
2. Growing local expertise and champions
3. Working with wider screening division and PHE
inequalities unit
4. Programme specific screening inequalities
evidence guides
5. Consideration of screening inequalities at
programme board and visits
6. Audit of visit recommendations
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19. Summary
• Screening inequalities are all our corporate and
professional responsibilities
• PHE Screening Inequalities Strategy provides us with a
clear mandate for action
• Good progress is being made in addressing the needs of
different population groups
• Opportunities still exist at national, regional and local
level to make a difference
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20. Acknowledgments and Useful Links
Jo Taylor PHE Screening Inequalities Manager
PHE Screening inequalities strategy published May 2018
(The PHE pages are at https://www.gov.uk/government/publications/cervical-
screening-coverage-and-data
See all blogs tagged ‘inequalities’ by using this link:
https://phescreening.blog.gov.uk/tag/inequalities/
PHE Health Profile for England 2018
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