Health outcomes and experience in the healthcare system – UK Government assessment

The UK Government set out a number of actions to reduce health inequalities and improve outcomes in the NHS Long Term Plan. The NHS response to the coronavirus (COVID-19) pandemic was substantial, although the diversion of resources has led to backlogs in accessing care. Existing inequalities in health outcomes and experiences for different groups were compounded by the COVID-19 pandemic.

• Data from August 2022 showed that a record 7 million people were waiting for consultant-led elective care in England, although NHS England has made progress in eliminating the longest wait times.
• The Health and Care Act 2022 introduced new legislative measures in England that aim to make it easier for health and care organisations to deliver joined-up care for people who rely on multiple different services.
• From 2010, increases in life expectancy at birth slowed in England, especially in more deprived areas. In 2020, there was a sharp fall in life expectancy at birth – by 1.3 years for men and 1 year for women – likely related to the COVID-19 pandemic.
• There are significant inequalities regarding life expectancy, particularly for those living in the most deprived areas. From 2018 to 2020, men living in the most deprived areas were living 9.7 years fewer than men living in the least deprived areas, with a gap of 7.9 years for women.
• In 2021, the median age at death was 22 years younger for men with a learning disability than for men from the general population, and 26 years younger for women with a learning disability.
• Deaths associated with pregnancy and birth have fallen since 2010. However, the risk of maternal death is four times greater for Black women and two times greater for Asian women compared with the risk for White women in England. The UK Government’s Maternity Disparities Taskforce, announced in February 2022, aims to investigate and address these disparities in England.
• In August 2020, Public Health England found that the COVID-19 pandemic had replicated existing health inequalities and in some cases made them worse.
• Prior to the COVID-19 pandemic, there were long-standing and intersectional inequalities in health outcomes. People with a learning disability, refugees and people seeking asylum, trans people, certain ethnic minority groups, including Gypsies, Roma and Travellers, and homeless people have worse physical and mental health outcomes compared with the general population.
• Evidence shows regression in some health indicators for children. Childhood obesity and hospital admissions for malnutrition continue to rise, there is evidence of some decreasing vaccination rates, and new evidence shows that the UK has the highest rate of childhood asthma caused by air pollution in Europe.
• A report published in August 2020 found that the risk of dying from COVID-19 was higher for older people, disabled people, ethnic minorities and those living in deprived areas. The death rate among people with a learning disability in England was estimated to be up to six times higher than that of the wider population.
• The shift towards more care being delivered via digital and telephone appointments during and following the COVID-19 pandemic has been received positively by many people. However, it has created accessibility barriers for those who are digitally excluded.
• The NHS Long Term Plan commits to improving outcomes across a number of clinical priorities.