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Clinical leadership is ‘mission critical’ to narrowing the health gap

Professor Bola Owolabi, Director of the National Healthcare Inequalities Team at NHS England gave a rallying cry to more than 200 health leaders gathered at the Royal Society of Medicine’s inaugural Tackling Inequalities conference on Wednesday 11 January 2023.

Urging conference participants to “use the power of our voices, the power of our advocacy, our ability to be the voices of those with little or no voice,” keynote speaker Professor Owolabi called on clinicians to leverage their voices and their spheres of influence to narrow the healthcare inequalities gap.

“Refuse to collude in despair that assumes that the problem is so complex, that there is not a lot we can do, and actually make a decision that there is a huge amount that we can absolutely do, not just as individuals, but as a collective,” she said.

The event, hosted by the Royal Society of Medicine in partnership with NHS England, brought together inspirational speakers and experts to raise awareness among healthcare professionals of the importance of addressing health inequalities and their impact from both a social and an economic perspective.

“Socially because poorer health reduces the quality of life and duration of life, and economically because we know that health is wealth, impacting economic growth and testing the resilience of our systems,” said Professor Nik Patel, RSM Council Trustee and Chair of the Academic Board, in his opening remarks at the start of the conference programme.

One of the most influential experts on healthcare inequalities in the UK, Professor Sir Michael Marmot, Professor of Epidemiology at University College London and Director of the Institute of Health Equity, gave the second keynote lecture of the day, offering participants an eye-opening and sometimes shocking summary of the issues at stake.

“We think a great deal about the healthcare system. And the state of the NHS rightly exercises us. But my concern is with the conditions that make people sick in the first place, the social determinants of health,” said Professor Marmot. “We see that playing out in the social gradient in health. Classify people by where they live. Classify where they live by the index of multiple deprivation and what you see is that the greater the deprivation, the shorter the life expectancy.” 

Describing how poorly prepared the UK was for the pandemic, Professor Marmot said: “Life expectancy had stopped improving. Health inequalities were increasing and health for the poorest people was getting worse.”

Going on to label the current cost of living crisis as a potential humanitarian calamity, he ended by offering his recommendations for building back fairer: “Give every child the best start in life. Education and lifelong learning, fair employment and good work for all. Everyone should have at least the minimum income necessary for a healthy life, healthy and sustainable places and communities. Take a social determinants approach to prevention.

“And”, he added, “tackle discrimination, racism and their outcomes and pursue environmental sustainability and health equity together.”

If asked to single out one recommendation above all, he would “put a fair distribution of health and well-being at the heart of all government policy.”

Throughout the conference programme there were humbling and powerful real-life stories, including ‘social prescribing in action’ sports and community-based activities, evidencing the need to engage with local businesses and charities to fund improvement initiatives.

A panel discussion focused on the importance of the key clinical areas outlined in the Core20PLUS5 approach (early cancer diagnosis, hypertension case finding, maternity, severe mental illness and chronic respiratory disease). Led by Professor Owolabi, the discussion brought together clinicians and other professionals from across England leading work on tackling health inequalities as champions, advocates and experts.

Break-out sessions on the key clinical areas were followed by panel discussions on the role of national organisations in reducing healthcare inequalities, and leadership and healthcare inequalities.

Closing the formal conference programme before the start of a networking reception, Professor Patel said: “At the Royal Society of Medicine we have been educated today. Our 55 sections are committed to raising awareness and sharing solutions to address healthcare inequalities. We look forward to continuing our collaboration with Professor Owolabi and her National Healthcare Inequalities Team at NHS England in the years ahead.”

The Royal Society of Medicine will be working in partnership with NHS England for the next five years on a multi-event and a multi-pronged Tackling Inequalities programme.

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