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Nuffield Trust research: Worse quality of NHS for deprived areas

It might have seemed self-explanatory, but for those living in the most deprived areas of England there is now analytical evidence of a worse quality of NHS care and poorer health outcomes than those in the least deprived areas.

This comes following research undertaken by QualityWatch, a joint programme from Nuffield Trust and Health Foundation, which found patients in these poorest areas suffered a number of delays or inefficiencies in healthcare, including spending longer in A&E departments and having a worse experience when making a GP appointment.

QualityWatch’s research looked at 23 measures of healthcare quality to see how they were affected by deprivation.

Across every single indicator looked at, care is worse for people experiencing the greatest deprivation. In 11 of the 23 measures, using data from the NHS and Index of Multiple Deprivation, researchers found the inequality gap was widening too.

For measures that are heavily affected by issues beyond the NHS’ control, such as poor housing and social care, the inequality gap between areas was at its greatest. These measures included avoidable deaths, smoking prevalence and emergency admissions to hospital.

Measuring relating to children and young people also showed large inequalities.

It wasn’t all negative from the research, though, as analysis showed the quality of care for some measures was improving, with the inequality gap narrowing. Unplanned admissions for asthma, diabetes and epilepsy in children, recovery rate following psychological therapy and people being able to die at their usual place of residence all appeared to be getting better according to the data.

READ MORE: Possible drop in life expectancy due to social inequality according to The Health Foundation

READ MORE: Tackling health inequalities through CVD prevention

Sarah Scobie, deputy director of research at Nuffield Trust, responding to the findings, said: “These findings show some concerning trends about the knock-on effect an overstretched NHS is having on the people in England who often need it the most. 

“My worry is that continued pressure on the NHS is only going to exacerbate inequalities, despite the very best of intentions from staff to provide fair and equal care.

“The NHS Long Term Plan, which the new Government is embracing, makes reducing inequalities a priority. This is absolutely right, but achieving this will require quite a turnaround.”

Health Foundation assistant director of policy, Ruth Thorlby, added: “Poverty is bad for your health, and people in the poorest parts of England face a vicious cycle. Poor living conditions, low quality work, and underfunded local services lead to worse health.

“These findings show that added to this, those in the most deprived areas are routinely experiencing longer waits in A&E, lower satisfaction and more potentially avoidable hospital admissions.

“Relieving growing pressure on the NHS must be part of the solution, but as important for the new government is investing in housing, education and good work to keep people healthy in the first place.”


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