Bola Owolabi, GP & Director of Healthcare Inequalities, NHS England
Explaining health inequalities and how the NHS plans to narrow the gap
Tackling health inequalities is a trending topic in the NHS. So much so that in January 2021 Dr Bola Owolabi was appointed as the Director of Healthcare Inequalities, a new role influenced by newly emerged data on health inequalities surrounding the Covid 19 pandemic.
"We've reached a tipping point. We've made the case that health inequalities exist. People have heard it."
The first medic in her family, Bola Owolabi did her medical training in Nigeria and in the UK. She has worked as a GP in the NHS for the last twenty years, during which time she has been the clinical commissioning lead for maternity, children and young people, the system lead for frailty and for end-of-life care and the national specialty advisor to NHS England and NHS Improvement.
“We've reached a tipping point,” says Bola. “We've made the case that health inequalities exist. People have heard it. Part of why I know people have heard it is the fact that I’m having this conversation with you.”
Bola adds: “In two to three years we must be able to demonstrate with data that the health inequalities gap has actually narrowed.”
“What we learned during the pandemic, as part of the COVID vaccination programme, is that the messenger is as important as the message.”
As the Director of Healthcare Inequalities, Bola’s role is three-fold. First is “to set a clear direction on the healthcare inequalities agenda for the rest of the system to follow, to ensure equitable access, excellent experience and optimal outcomes.”
Second is to promote the culture of improvement. Bola states: “It’s important that we don't just rehearse the challenge of health inequalities and how difficult health inequalities are, but that we mobilise the conversation into an improvement space.”
Third is accountability. “How do we hold ourselves and the wider system to account?” surmises Bola. “How do we prove that we’re actually delivering on the vision and the strategic priorities that we've set out for tackling health inequalities?”
The NHS England and Improvement approach to tackling health inequalities is Core20PLUS5 focusing on the 20% most deprived communities in the UK (The Core20) by the Index of Multiple Deprivation (IMD) PLUS other communities, such as people who are: experiencing homelessness; those from traveller communities; people in contact with the criminal justice system; those from segments of ethnic minority communities. The goal is to drive improvement across 5 clinical areas - Maternity, Cancer, Mental health, Chronic Respiratory Disease and Cardiovascular disease.
To narrow the gap, initiatives are being funded directly by the NHS, as well as projects that the NHS aims to amplify and support . One of the directly funded projects is the “Core 20PLUS Connectors,” a network of individuals who have been mobilised and recruited to convey clear messages about these five clinical areas to their communities. “They are the trusted voices and the trusted faces of their communities,” states Bola. “What we learned during the pandemic, as part of the COVID vaccination programme, is that the messenger is as important as the message.”
“The data show that when you have diversity of thought on your board, you are more efficient, more productive and more profitable”
Another nationally funded project is the digital health inequalities pioneer fund in collaboration with NHSx, which offers support to integrated care systems to ensure that “as we move onto a digital footing, we do so in a way that narrows, not widens, the health inequalities gap.”
An example of a project being amplified by the NHS England Healthcare Inequalities Improvement programme is a campaign run by SeaFit in Cromer (Norfolk) to raise health awareness amongst local fishing communities. In particular, it delivered on-the-quayside dental treatment and hepatitis C testing for fishermen and their families, as well as access to a mental health support worker.
Ending on the topic of diversity, Bola highlighted the need to change the current conversation and go beyond “having a moral and ethical conversation that says you need to include Black and Asian women in leadership because it's the right thing to do morally, which of course it is, and also see inclusion with an appreciative lens which recognises the strengths, experiences and expertise that people bring from their diverse backgrounds.” She cites the Harvard Business Review in relation to women on boards: “the data show that when you have diversity of thought on your board, you are more efficient, more productive and more profitable.”
Genevieve Shaw, Editor