Tackling Health Inequalities

A focus on tackling addressing health inequalities is at the heart of all we do. The Impact team understands how health inequalities impact on patients’ health and wellbeing, and the experiences of our patients suggest that complementary interventions can be effective in helping to close the gap between rich and poor. Impact’s previous work in Radford and Hyson Green was recognised by Nottingham City Primary Care Trust as a valuable way of tackling health inequalities; in March 2007 Dr Chris Packham (Director of Public Health) referred to it (in a local BBC news interview) as a ‘gold standard service’.

In 2004, Impact partner Julie McKay carried out a study which compared patients in her West Bridgford (NG2) private chiropractic practice with those at Impact’s funded clinic (NG7). Those from NG7 were nearly ten times more likely to have psychosocial difficulties than those from NG2. Their condition was also twice as likely to be chronic, and almost three times the number of consultations were required for treatment to be completed.

The Impact service at the Waverley Health Centre took referrals from local GPs and practice nurses, as well as other health and social care practitioners and patient self referral. This service was disproportionately popular with patients from black and minority ethnic (BME) communities; 48% of Impact’s patients at the Waverley Health Centre were from BME groups, in an area where the resident BME population is 28%. For Impact, this illustrates a wider trend of the attraction of its services for groups traditionally considered ‘hard to reach’.

“You know it’s working when 38% of your patients are men. Men don’t normally get too bothered about their health, but with this they turn out. The feedback has been very good indeed and there are people using Impact who would not usually access the normal service. It’s extremely impressive.”
Roger Williams, Director of Partnerships and Health Improvement, Nottingham City PCT, 2005

The patients referred to Impact by Radford Medical Practice have also been a very diverse group, in terms of ethnicity, disability and age. Just under half completed an equal opportunities questionnaire, and of these, 57% were from Black or Minority Ethnic communities. More than a third considered they have a disability, including mobility problems or multiple disabilities.

There is a much greater need for the kind of services provided by Impact in deprived areas, to address the higher incidence of chronic and complex conditions. Furthermore, since a significant proportion of GP consultations have a mental health component, the Impact team considers that the provision of integrated care, which can offer patients several interventions tailored to their individual physical and emotional needs, is an effective way to support and complement existing services.

“Impact is an essential part of this (health) clinic and this community. It is one of the things that keeps me living in this area… There is a need for this service in the whole of Nottingham and nationwide.”