The Department of Health and Social Care has developed a guide for Allied Health Professional system leaders to reduce health inequalities across regions.
Designed for Allied Health Professionals (AHPs), the guide sets out what leaders need to know, and what actions they can take at a system level, across the breadth of AHP services rather than individual services or professional groups.
The guidance, entitled 'Addressing health inequalities across allied health professional (AHP) services: a guide for AHP system leaders,' recommends leaders use the guide to create an environment where addressing health inequalities is routinely incorporated into service delivery, and move from reliance on individual behaviour to collective effort.
It is divided into two sections: a four-step approach to exploring local health inequalities and co-producing interventions, and eight strategic change areas for leaders to focus on.
'Cycle of continuous improvement'
The four-step approach advises a cycle of continuous improvement:
- Understanding what problem you are trying to address
- Identifying the causes
- Working out effective solutions
- Then implementing intervention
.png?ext=.png&width=900&resizemode=force)
AHP leaders can find more aid with identifying specific local health inequalities through the Office for Health Improvement and Disparities (OHID) fingertips platform, the local authority joint strategic needs assessment (JSNA) document, and national data sets like the Healthcare Inequalities Improvement Dashboard or local links, such as the London Borough Data Explorer.
Once identified, authorities should move to identifying the causes of these inequalities. The guidance suggests using the Dahlgren and Whitehead (1991) ‘rainbow model’, which frames different determinants of health by proximity to the individual.
.png?ext=.png&width=900&resizemode=force)
To identify approaches following this step, the document emphasises the importance of innovation sessions with other stakeholders, to develop a shared understanding of the issues and a collective vision for action. It includes case studies and examples of approaches that have work in other trusts.
Scaling up
Finally, once service changes have been agreed, it advises AHP leaders on the need to carry out a trial, collecting data against the aims and expected outcomes, before scaling up.
It explains: “Once the changes to policy and practice that you have made are working well and having the desired impact, you will begin to ‘scale up’ by expanding what you’re doing to other areas and/or other services.
“For example: you have carried out a trial of easy read letters in one service, resulting in a rise in attendance rates. You then decide to implement easy read letters in all services that you lead and influence other areas of the system to implement them as well, using the data that you collected during the trial as a means of demonstrating the benefits to your service and to patients.”
Implementing change
Additionally, the eight strategic change areas included:
- Increase collaboration and partnership working
- Improve AHP education and training in health inequalities
- Ensure services are accessible to all
- Provide equitable and responsive care
- Capture outcomes and impact
- Increase visible AHP leadership
- Align AHP values and behaviours to equality and social justice
- Ensure AHP research addresses health inequalities
Each of these areas is covered in detail, including what these strategic areas could mean, the effect they could have, and ideas for implementing change.
These insights were created following conversations with ICS, provider and Regional Chief AHPs.
Additional reading
Further resources that support reduction of health inequalities are available on the RSPH allied health professionals hub. The resources include training and e-learning and profession-specific case studies.
This guide complements the King’s Fund document, “My role in tackling health inequalities: a framework for allied health professionals”, by building on the leadership and systems aspects of the framework.
While the King’s Fund report touches on systems leadership, this guide provides more detail, and practical examples of what AHP system leaders can do.
Read the full guide here: Addressing health inequalities across allied health professional (AHP) services: a guide for AHP system leaders
(Image: ER Productions Limited, via GettyImages)