"Things seem to be moving in the right direction … we need to do things differently and embed HI into our BAU work asap so it doesn't become another strand of things to do."

Strategy director, acute trust    

Our research looked at the extent to which trusts have made progress on tackling health inequalities in recent years. Findings show that there is considerable variation between the levels of progress trusts have made in acting on health inequalities. Action in this area began in earnest around two to three years ago, as health inequalities were prioritised in the wake of Covid-19. During that time frame, some trusts have developed strategies for addressing health inequalities, plans for operational delivery and metrics for measuring progress. While other trusts are at the start of their development journey and require more advice and guidance.

Over half of respondents (59%) said that their trust board’s response is well developed (8% very well developed and 51% fairly well developed). There has been an increase in trusts reporting that their response is fairly well developed from 42% in 2021, to 51% in 2024 – indicating that more trusts are taking steps in the right direction. It is positive that the number of trusts reporting that their response to health inequalities is undeveloped has remained low (3%).

However, it is concerning that a lower proportion of respondents viewed their trust response to be 'very well developed', declining from 13% in 2021 to 8% in 2024. There also remains a considerable number of trusts in the developing stage (38%). These trends highlight the scale of the challenge of addressing health inequalities and that more support is required to translate board intent and strategic plans into action - without this there is a risk that inequalities may worsen over time.

"Work is beginning in all areas but has to mature."

Chair, combined mental health/learning disability and community trust    

"Moving the culture of the organisation to more proactively focus on population health and inequalities is something that we are addressing but will take time to deliver, not least at board level."

Chief executive, combined mental health/learning disability and community trust