Health equity audit

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Health equity audit

• Lindsay Forbes
• Consultant in Public Health
• 31st March 2004

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Health equity auditPurpose of this paper

• To make you aware of requirement to do it
• To make you aware of what it involves
• To recommend completing the DOHs self-assessment
  tool
• To suggest next steps towards using health equity
  audit

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Health equity auditWhy do it?

• Improvement, expansion and reform Priorities and
  planning framework 2003-2006
•  
• NHS should narrow the health gap by ensuring
  that service planning is informed by an equity
  audit
•  
• Performance indicators for the 2003/4 star
  ratings
• Health equity audit
• Assessment of the effective use of health equity
  auditing in service planning, commissioning and
  delivery in order to tackle health inequalities

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What was wrong with what we were doing before to
tackle inequalities?

• Not systematic
• Often no corporate commitment
• Often no shared commitment across organisational
  boundaries
• Did not inform mainstream commissioning and
  delivery
• Not resourced

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So what is different about health equity audit?

• Framework for systematic approach
• Tackling health inequalities integrated into
  service planning and delivery
• Not just the concern of Public Health Departments
• Common understanding within NHS organisations and
  between partners
• Resources

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Definition of health equity audit

• A process by which NHS organisations and their
  partners
• Review inequities
• Systematically review inequities in the causes of
  ill-health, in access to effective services and
  health outcomes
• Agree actions
• Ensure that action is agreed and incorporated
  into local plans, services and practices
• Evaluate action
• Evaluate the impact of the actions on inequity

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Inequality and inequity

• Health equity audits focus on how fairly
  resources are distributed according to health
  needs
• Equality suggests every group should receive the
  same
• Equity suggests that every group should receive
  resources according to need
• More need more resources

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Health equity audit cycle

• Agree priorities and partners

Do an equity profile
Review progress against targets
Secure changes in investment and service delivery
Identify local action
Agree local targets with partners
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Health equity audit a self-assessment tool

• Published by DoH 15 Jan 2004
• All PCTs asked to complete by end of March 2004
• Designed to be completed by the Board, at a
  meeting involving all of the Board and the PEC
• The tool is
• . aimed at executive and non-executive members
  of the PCT Board and the PEC. Self-assessment is
  for the Chief Executive and management team.
• If/how the completed self-assessment tool to be
  used by DoH not clear

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Next steps 1

• Complete the self-assessment tool

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Next steps 2

• A seminar for the PEC and Board to decide how to
  take Health Equity Audit forward
• How identify priorities?
• How get health equity audit into all service
  delivery plans? What about Annual Delivery Plan?
• How make managerial staff aware of
  responsibilities?
• How get health equity audit into commissioning?

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Next steps 3

• Choose topic to cut health equity audit teeth
• service already identified as needing review?
• service being set up?
• service with possible inequity issues already
  identified contraceptive services? diabetes
  services? coronary heart disease risk assessment
  clinics?