COVID-19 has widened pre-existing health inequalities across society, and acted as a catalyst for a renewed policy focus on health inequalities. There is now an opportunity to build on lessons learned from the pandemic and to build on the new collective emphasis on reducing inequity in access to healthcare services, experience and outcomes.

Tackling health inequalities faced by marginalised communities has, over the past two years, been emphasised as a core ambition of the health and care service. Changes to the wider policy landscape placing a greater emphasis on joint working across systems and a stronger focus on health inequalities is reinforced by the government's Health and Care Bill. The new legislation embeds this focus further through a series of policy priorities and statutory responsibilities on both trusts and integrated care boards (ICBs) to consider how they will reduce health inequalities in their plans and decision making.

The government's levelling up white paper, published in February 2022, also set out a mission to narrow the gap in healthy life expectancy by 2030. Later this year a health disparities white paper, led by the Office for health improvement and disparities (OHID), will set out measures to tackle inequalities in health outcomes. This renewed focus, nationally and at a local level by integrated care systems (ICSs), trusts and increasingly at place level, to prioritise tackling health inequalities is clear. However the approaches adopted to address this issue varies geographically and across sectors as health leaders decide how best to serve their diverse and varying populations.

We surveyed trust leaders on race equality and health inequalities to gain a detailed understanding of how trusts are responding to this new area of focus, and how we can support them with this work. This briefing shares our analysis of the survey findings on health inequalities, exploring the many key contributions trusts are already making, and setting out trust leaders’ views on the barriers to and enablers of progress.


About the survey

Our race and health equality survey was sent to all member trust chairs, chief executives and non-executive directors (NEDs) in November 2021.

It was carried out as part of the commitment in our four year strategy to increase our focus on both race equality and wider health inequalities. This insight contributes to a broader piece of work on the complex and intrinsic link between health inequalities and race equality, which we explore in our race equality report, Race 2.0 - Time for real change.

We received 254 responses. These were from individuals at 134 providers, representing over half (63%) of the trust sector. Of these responses, 28% were from chairs, 14% were from chief executives, 45% were from non executive directors and 11% were other job roles. All trust types, including acute, community, mental health and ambulance, were represented in the responses.

The survey was comprised of a mix of quantitative questions, and open text boxes. Quotes and data from the survey are analysed throughout this briefing. Due to the breadth of responses and the full range of sectors represented in the survey, we have been able to carry out sector-specific findings, alongside rich real-world insights from trust leaders.

We are grateful to those trust leaders who responded to this survey during an extremely busy and challenging time.