From December 2021 to August 2022, we worked with Nuffield Trust and South East London Integrated Care System (SEL) to analyse the financial impact of health inequalities across SEL from an urgent and emergency care perspective.

Our work demonstrated that there are significant differences in spending on acute hospital services between different ethnicities, conditions, and people living in areas with different levels of deprivation. For example, Black people and those living in the most deprived areas are significantly over-represented in accident and emergency departments and “non-elective” hospital activity in South East London compared to White people. Our analysis highlighted key opportunities around improving inequalities in access, experience and outcomes for the SEL population plus the associated financial cost of failing to address these inequalities, assessed at £30m.

Our recommendations

  1. Better, earlier prevention and management of ill-health, targeted particularly at those population groups currently experiencing inequalities, would lead to less use of emergency hospital care which is better for our communities and for those supporting them.
  2. In developing future hospital avoidance strategies, multifaceted, integrated approaches to reduce admissions in specific patient populations and disease types should be prioritised over those that apply to nonspecific groups.
  3. Interventions should look at both distribution of funding and resources at a neighbourhood level and the role of cultural adaptation / competence in the way in which existing and future services are currently delivered.