How Vanguard can support the UK Government's ‘Plan for Change’ and help improve health inequalities

One of the key subjects tackled by the UK Government in its recently published ‘Plan for Change’ is improving the health inequalities experienced by different groups of people across the country.

In Plan for Change, they set out that delivering the 18-week standard and reforming elective care must be done ‘equitably and inclusively for all adults, children and young people.’

However, it acknowledges that significant geographical variations exist in how elective care is delivered across the country. For example, 65.1% of existing waits are within 18 weeks in the North East and Yorkshire region, while this figure sits at only 55.1% in the East of England. Research tells us that people living in disadvantaged areas are 1.8 times more likely to wait more than 12 months than someone living in one of the least deprived areas of the UK.

Plan for Change sets out how the Government plans to strengthen the accountability and oversight of providers for addressing health inequalities in elective care, while providing flexibility to tackle the issues of most relevance to patients locally.

It also set out the need to review existing national health inequalities improvement initiatives to ‘develop them and increase their uptake including prioritising areas with greater health inequalities for future investment of new capacity, for example, community diagnostic centres’.

As part of Plan For Change, ICBs and healthcare providers should ‘set a clear vision for how health inequalities will be reduced as part of elective care reform, and ensure interventions are in place to reduce disparities for groups who face additional waiting list challenges.’

Often one of the key factors of health inequality can be for those who don’t have access to a car or public transport, and that can lead to having difficulty in attending appointments. Adding capacity at a local level – and therefore making it as accessible as possible to as many people as possible, is key to successfully addressing health inequalities and driving down waiting times in those areas of the country which are negatively impacted.

What are the barriers to Trusts creating additional capacity for easily accessible elective care at a local level and how can they potentially be overcome? Funding, space and adequate staffing can all be challenges for hospitals and Trusts in delivering locally available additional capacity.

But as examples such as Vanguard’s work with Gilbert Bain Hospital in Shetland show, mobile healthcare solutions – even used on a short-term basis – can have a significant impact locally, and be an affordable option for Trusts seeking to add capacity at pace and drive down waiting lists.

Using a Vanguard mobile laminar flow theatre, the hospital created additional capacity quickly and in a cost-effective way in a project which saw more than 400 people treated locally without the need to travel to the mainland, and thereby reducing the health inequality they potentially faced. The facility allowed joint replacement surgery to be carried out for the first time on the island, as well as cataract, ears nose and throat procedures.

This is just one example of mobile healthcare solutions being used to bring elective care closer to the community and add capacity at a local level. A Vanguard mobile laminar flow theatre and clinical team have also helped to reduce waiting times for orthopaedic surgery, locally and for neighbouring trusts at South Warwickshire University NHS Foundation Trust. Another Vanguard mobile facility, hosted at Milton Keynes University Hospital, has been used as a day case theatre and short-stay recovery ward, ensuring patients could be seen and treated in the same location, on the same day.

All three projects had a significant and positive impact on their local population’s waiting lists for elective procedures, and helped reduce health inequalities.