Health Inequalities Leadership Framework: board assurance tool

Assisting board members to assess strategies, delivery plans or other initiatives for their impact on health inequality.

21 February 2023

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This board assurance tool is built on the Care Quality Commission’s (CQC) well led domain eight key lines of enquiry measures (KLOEs),* and the five national priorities for tackling health inequalities 2021/22:

  1. Restoring NHS services inclusively, breaking down performance reports by patient ethnicity and indices of multiple deprivation (IMD) quintile.
  2. Mitigating against digital exclusion, identifying who is accessing different modes of consultation by collecting data on patient age, ethnicity, disability status, condition, IMD quintile.
  3. Ensuring datasets are complete and timely, improving data collection on ethnicity across primary care, outpatients, A&E, mental health, community services, specialised commissioning.
  4. Accelerating preventative programmes: flu and COVID-19 vaccinations, annual health checks for those with severe mental illness and learning disabilities, continuity of carers for maternity services, targeting long-term condition diagnosis and management.
  5. Strengthening leadership and accountability, which is the bedrock underpinning the four priorities above, with system and provider health inequality leads having access to Health Equity Partnership Programme training, as well as the wider support offer, including using the new Health Inequalities Leadership Framework.

How to use this tool

The tool can be used in conjunction with other frameworks or reports already in use by boards or board sub-committees, which are based on the CQC domain measures. It can also be used as a standalone tool. It is intended to assist board members to assess any strategies, delivery plans or other initiatives for their impact on health inequality, not just those proposals that have addressing inequality as a specific purpose. The text in each box is intended to be a prompt to stimulate questioning and to act as an assurance mechanism. The tool may be supplemented by a scorecard, provided separately, so that assessment outcomes can be seen at a glance.

This tool does not remove the need for an Equality Impact Assessment (EIA), although elements of an EIA may flag up potential positive or negative impacts on health inequalities to take into account.

The tool is for collaborative use, especially with the Executive lead (SRO) for health inequalities.

Leadership action on health inequalities

The Leadership Framework for Healthcare Inequalities Improvement programme is an NHS England (NHSE) programme to ensure that the NHS better prevents and responds to the health inequalities which many communities experience. This is particularly important as the NHS continues to recover and reset from the COVID-19 pandemic, which has exacerbated and highlighted these long-standing inequalities

The NHS Confederation has been commissioned to deliver a key component of this work, to provide support and guidance on stronger NHS leadership action on health inequalities as defined in the NHS Long Term Plan. Find out more.