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22.08.16

Manchester CCGs dominate list of worst for health inequality

Manchester’s three CCGs have all appeared on a list of the five worst in the country for health inequality.

New indicators of inequality in avoidable emergency admissions, used as part of the NHS Clinical Commissioning Group Improvement and Assessment Framework, show that Central Manchester CCG had the greatest health inequalities.

The CCG’s difference in rate of hospitalisations between the poorest and richest areas was rated as 2,136 for every 100,000 people.

It was followed by Blackburn and Darwen, with an indicator value of 2,029, North Manchester (2,017), Islington (1,954) and South Manchester (1,889).

The figures compare to a national average of 927 avoidable hospitalisations.

In a joint statement, the Manchester CCGs said: “The NHS results are not performance indicators – and the rankings are based on values.

“Manchester CCGs see that the tool is useful in highlighting inequality and will see it as an indicator of variables of the current picture – and will continue with their work, especially via the neighbourhood teams, to reduce health inequalities across Manchester.”

The city, which recently became the first in the country to receive devolved powers over health, is in the middle of an ambitious programme of healthcare reforms.

These include plans for all three CCGs to share power over commissioning with adult social services. Manchester City Council is also planning to integrate the city’s three hospitals into a single trust as part of a drive to tackle health inequality.

However, the plans have run into potential challenges after Pennine Acute NHS Trust, one of the hospitals involved, was recently rated ‘inadequate’ by the CQC, whilst University Hospital of South Manchester NHS Foundation Trust has been rated ‘requires improvement’.

The indicators were developed by the University of York’s Centre for Health Economics under funding from the National Institute for Health Research, which is the research arm of NHS England.

They show that there is not necessarily a correlation between the deprivation of an area and shortfalls in health inequality.

Tower Hamlets and Portsmouth, both CCGs serving areas of high deprivation, appeared on the list of the 10 best performers, with values of 237 and 310.

Overall, the best performing CCG in the country was City and Hackney, whose indicator value was at -76. This was followed by Fareham and Gosport (109), East Surrey (110), Crawley (132) and the Isle of Wight (138).

Ruth Passman, head of equality and health inequalities at NHS England, urged CCG heads to take advantage of the indicators.

“For the first time, NHS managers can now find out how well their local CCG area is doing in tackling these inequalities, compared with similar CCG areas, and see how these inequalities are responding to local healthcare initiatives,” she said.

Professor Sir Michael Marmot, director of the Institute of Health Equity at University College London, recently told MPs that NHS England and the Department of Health are failing to make progress on health inequality.

The New NHS Alliance recently called for a ‘health creation’ approach to address the growing gap in life expectancy.

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