National Institute for Health and Clinical Excellence (NICE)
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Doctors should use NICE guidance to tackle health inequalities

Doctors should focus on tackling health inequalities as part of their everyday practice, a report by the Royal College of Physicians (RCP) concludes.

Despite an increase in rates of life expectancy in recent years, there is evidence to suggest that health inequalities are still rife across the UK. In Canning Town, a deprived district in the East End of London, the average male life expectancy is 73 years, compared with 79 years in the affluent London borough of Westminster.

The report, published yesterday and developed in partnership with other Royal Colleges as well as with the NHS, identifies how doctors can take account of social inequalities in every area of their work.

Recommendations include refocusing resources towards prevention rather than the treatment of ill-health, identifying opportunities to help patients from disadvantaged backgrounds to manage their health, and encouraging patients to engage in healthy activities such as cycling. Doctors could also persuade local authorities to supply the resources and green spaces to support more active lifestyles.

NICE has published guidance to help doctors achieve a number of the recommendations set out in the report, and is committed to helping drive down health inequalities across Britain.

The Institute has already had a major impact on improving life expectancy rates in England, and is set to play a key role in continuing to reduce health inequalities, according to the commissioners of the Marmot Review - a major body of work that outlines the most effective ways of reducing health inequalities in England from 2010.

Just last month, NICE published draft guidance on the provision of contraceptive services for socially disadvantaged young people, such as teenage parents, young people living in areas with high levels of deprivation, some minority ethnic groups, and young offenders.

Current evidence suggests that socially disadvantaged young people find it difficult to access contraceptive services, for a variety of reasons, including lack of knowledge about service opening times and locations, and concerns about service confidentiality. Consequently, the draft guidance focuses on socially disadvantaged young people to ensure they receive culturally sensitive, confidential, non-judgemental and empathic advice and support tailored to their individual needs.

There are also a number of guidelines that promote the need for exercise and healthy living, as well as a suite of guidance designed to encourage doctors to offer preventative measures, such as prescribing statins to patients who are at risk of developing heart disease.

Professor Ian Gilmore, president of the RCP, described the launch of the report as a “watershed moment” in the way that doctors practice that fits in with the agenda of the new government.

“At present, many doctors and other health professionals do their best to treat the patient in front of them, but they do not always look beyond the symptoms presented, and address the patients’ social and economic background.

“This becomes a vicious cycle, where people are treated for an illness, go back into the community and fall ill again, because doctors have not been able to address the reason they were unwell in the first place.”

Sir Michael Marmot, director of the International Institute for Society and Health at University College London, warned that the cost of doing nothing about health inequalities is so large that it is simply not an option, and called on doctors to “put their house in order” by improving access to care and by becoming advocates of polices to reduce health inequalities.

 

 

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