How you can use data on health inequalities to change your service for the better.
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Do the people accessing your physiotherapy service reflect the local population? Does the service meet the needs of the local population?
The population health data for your locality will show what the demographics are in your area. What does this tell you about who should be accessing your services?
Steps for assessing the data
- Identify the demographics of your population using local population data
- Identify the demographics of the people accessing your service using your service data
- Are there any surprises in your data?
- Identify any other sources of data such as did not attends (DNAs), patient-reported outcome experiences (PREMs) and complaints
- Compare the data sets
Compare the population health data for your locality with the service data to determine who is and isn’t using the service. Does the service data represent all groups within your community? Identify the gaps to explore the underlying reasons. Try not to make assumptions.
We need to ensure fair access to services. Do some communities present later for treatment? Some community groups may be missing out on services entirely leading to disability and poor health. The result can be an increase cost to health services in terms of time, finance and resources.
Analysing your data about who did not attend or was not brought can reveal inequalities in service access and experience. Poor attendance may be related to issues such as childcare or caring for someone with a disability, not understanding the appointment information, travel costs, or not being able to miss work to name a few. It can also be influenced by previous or current negative experiences of healthcare.
Your service may want to explore the data on non-attendance to see if there are themes. If you are struggling to articulate who your service users are, you may need to consider whether you are capturing the data you need. For example, in the case of people with learning disabilities or vulnerable adults, does your system identify them? This data must be collected to ensure appropriate groups are given equitable access and support.
Complaints, patient satisfaction and outcome measures data should also all be analysed through the lens of health inequalities to highlight any trends that may signify unequal experiences and outcomes of care. Are there themes in this data between different patient groups? This may cause you to reflect on whether you can make service improvements. This should be done using a quality improvement approach.
Analysing the data described will help you to determine what actions you can take to improve access and reduce inequalities to benefit your practice, service and local population. For example, there may be opportunities to signpost to social prescribing or other local partners. Reflecting on the data could lead to better shared decision making as the team will understand the barriers to local patients seeking treatment.
Once you have the data to compare and can see discrepancies, work on engaging with people who are not accessing your service.
Identify the issue your wish to address, and plan how you will engage. Work with the community to make changes that will have an impact.
- Reach out to local community groups to survey or run focus groups
- Survey people using the service
- Contact patients who missed appointments
- Liaise with a charity or voluntary organisation to establish links, and identify barriers and possible solutions
- Increase signposting about stopping smoking, weight management, alcohol support, exercise groups and social prescribing
- Review trends in patient-reported experience measures (PREMs), Friends and Family Tests (FFT) and complaints
Making a change is not the end of the story – you will need to re-audit the data to ensure the implementation has been effective.
Increasing your knowledge of health inequalities can empower you to make changes that could benefit your working life, service and community in the long term. This could be through quality improvement, projects within supported study or even by implementing small changes such as Making Every Contact Count (MECC) and improved shared decision making. Collaboration with local community groups, charities and the voluntary sector can also reduce the burden on services and improve outcomes for the community.
Addressing health inequalities in your practice can increase community engagement and reduce waiting times. Understanding the population and barriers to using services effectively has the potential to improve the experience of clinicians and service users in consultations, ultimately achieving better outcomes. Tackling health inequalities in the long term can reduce the complexity and severity of patient presentations, leading to better quality of life and life expectancy.