Fairer treatment

Despite 45 years of equalities legislation health inequalities still persist, blighting patients’ lives and consigning people to early and premature deaths. According to the Marmot Review, up to 2.5 million extra years of life are lost in England each year as a result of health inequalities.

The roots of this inefficacy are increasingly apparent: unsophisticated equality models that hide the diversity within groups; the tendency of such models to reinforce cultural stereotypes and boundaries; the inability of such practice to affect behaviour on the frontline. All of these factors combine to weaken the effect of equalities practice, with the lack of progress acting as a powerful demotivator to further action.

Our work in this area aims at helping organisations see the potential for legislation and regulation to add value to the things they already want to do: deliver fairer, more equitable services. We work closely with frontline staff, showing them the relevance of equality to the day-to-day delivery of treatment and inspiring them to take ownership of their behaviour and attitudes.

The problems we’re solving

• how regulatory and legislative requirements can be designed into existing service provision to maximise effectiveness
• developing whole-system tools to identify the cause, nature, and location of discrimination at various points in the care pathway
• how equality can be measured in the provision of services, through a multi-dimensional fairness framework

What we’re doing
We’ve worked with a range of commissioning organisations to integrate fairness and human rights in all aspects of their organisation. Heart of Birmingham PCT took advantage of the breadth of our experience (research, training, policy development, community engagement) to commission the development of a bespoke human rights training and development programme for staff; an outcomes-focused equality scheme; and a healthcare-specific equality impact assessment.

We are also working with Macmillan Cancer Support to research the extent, cause and nature of discrimination faced by people from disadvantaged backgrounds, including:

• those who experience socio-economic deprivation
• people from ethnic minority groups
• older people
• people who are lesbian, gay, bisexual or transgender

The project maps the type and nature of discrimination along various points of the cancer care pathway.

We are also privileged to have worked with former Yorkshire and Humber Improvement Partnership to help establish a clinician’s network to support them to both explore and address ‘race’ equality concerns in mental health diagnosis. This work also involved us supporting the regional mental health user group and creating a toolkit to disseminate good practice in working to change pathways to care in mental health provision.

See for yourself

Download TreadingWater (129.12kB)


Download GreatExpectations (1.41MB)

What other people are saying
The work we conducted for Heart of Birmingham PCT was highlighted in a Department of Health good practice guide on the effective implementation of human rights and fairness. To read what the government had to say, click here.