Closing the equity gap
Patients with learning disabilities are now prioritised for operations in our hospitals after equity monitoring showed they were likely to wait longer for surgery.
The number of patients with learning disabilities is small, but our public health team identified this group as potentially suffering the greatest inequity. The issue was most acute in restorative dentistry for children, so we targeted support on this specialty.
Treatment for this group was delayed during the pandemic, partly because of infection control restrictions on visitors, and partly because many of the children required a general anaesthetic (unlike routine dental patients).
The initial monitoring showed that on average patients with learning disabilities waited 125 days longer for routine procedures than other patients. Our positive action over the past year has narrowed the gap by more than 100 days, though there is still more we can do for them as we reduce waiting times generally.
The latest position – showing patients with learning disabilities are on average waiting 20 days longer than others - is reflected in the first tranche of equity data published by the Trust in Board papers this month.
Our analysis shows that the ethnicity of the patient does not make any difference to the aggregate length of waits for routine procedures. However, it appears that some patients from the most deprived local areas may wait marginally longer, particularly at Whipps Cross.
There is also emerging evidence that patients from some geographical areas are waiting longer for surgery in some specialities in our hospitals. We are investigating these issues further to ensure we can redress the balance and will report back.
Ajit Abraham, group director for inclusion and equity, said: “As we recover routine services after the pandemic, it is reassuring to find evidence that ethnic minority patients are not waiting any longer for surgery than anyone else.
“However, too many patients are still waiting too long. That itself is inequitable, especially if they live in deprived areas. So, we are increasing elective activity in our hospitals, to improve access for all and reduce waiting times across the board.
“Meanwhile, as we gradually expand the information we collect on the equity of our services, we want to better understand how ethnicity and deprivation affects the hospital experience and health outcomes of our patients.”
In keeping with the Trust’s commitment to addressing health inequalities, equity data will be an integral part of the Board’s monthly integrated performance report, using anonymised information collected on patient ethnicity, age, gender, and deprivation.
In addition to further work on waiting times for routine surgery, we are examining data on outpatient appointments, and working with partners on building a profile of the health needs of our population in north east London.