Evidence briefs

We have undertaken a series of 10 evidence reviews for NHS England and here highlight seven interventions and programmes with the strongest evidence base. 

The NHS employs over 1.7 million people in England. Empowering NHS staff to tackle health inequalities offers significant potential. However, several workforce challenges exist. In this brief, we review the international evidence on what works to empower health care staff to address inequalities.

Health care organisations can mitigate social and health inequalities by offering high-quality, equitable care. They can also improve communities’ overall wellbeing through their influence and assets to improve the economic, social, and environmental conditions in local areas. In this brief, we review academic papers on how health care organisations can effectively operate as anchor institutions to address inequalities in social determinants of health.

People from ethnic minority backgrounds and socioeconomically disadvantaged backgrounds experience consistently worse health outcomes than their white British and more affluent counterparts. Statutory guidance has recognised that community engagement and empowerment are vital to reduce these health inequalities. In this evidence brief, we summarise evidence examining the effectiveness of different community-centred strategies to improve health in disadvantaged communities.

We have decades of evidence on the clinical and cost-effectiveness of investing in prevention. However, current health and care funding mechanisms do not facilitate investment in prevention. Here we explore what works best to increase and improve funding for prevention defined as any healthcare-based initiative that enhances long-term patient outcomes by reducing harmful exposure, disease onset, and illness progression across all life stages. 

Mortality rates are higher in areas of greater deprivation, and life expectancy a decade shorter in the least affluent areas compared to most affluent areas in England. Addressing inequalities through funding is crucial given its impact on service provision, workforce distribution and consequently patient outcomes. This brief examines the evidence on how health care funding can be structured to reduce health and care inequalities.

Digital health literacy is becoming increasingly important as more health information is shared through digital platforms. However, many individuals face challenges in accessing digital devices and understanding or critically evaluating digital health information. This evidence brief examines effective strategies for improving health and digital health literacy, particularly among disadvantaged groups.

The NHS Constitution states that access to NHS services is based on clinical need, not an individual’s ability to pay. Most NHS services are free of charge. There is a large evidence base describing the problems that people with low incomes face accessing healthcare; much of the international literature relates to insurance premiums. However, there is little research describing how to ensure people on low incomes are not inadvertently excluded from healthcare services.

Tackling chronic disease risk factors requires a systemic approach that addresses the structural barriers that disadvantaged groups face in managing their health. In this evidence brief, we focus on how health care services, as part of this system, can improve behavioural interventions aiming to tackle chronic disease risk factors like smoking, obesity, or hypertension, so that they better address the needs and preferences of disadvantaged groups.