Duty to have regard

South West Lincolnshire CCG has a duty to have regard to the need to reduce inequalities between patients in access to services that they commission. This involves:

 Knowing the local population and local needs, particularly for groups with poor access or outcomes, commissioning through the use of joint strategic needs assessments (JSNAs) and additional supporting data and evidence, such as local health profiles and qualitative sources.

  • Identifying the local health inequalities and commissioning for all of the population in the area, not just relying on General Practice registrations.

  • Identifying evidence of what has previously worked in reducing inequalities and evaluating good practice, whilst also considering the ‘clustering’ of risk factors in some groups. Universal services should aim to reduce inequalities by being progressively aimed at those who need them the most.

  • Carrying out evidence-based service reviews.

 This requires considering whether:

  • services are universal and should reach all members of society, which may be achieved by explicitly targeting specific population groups;

  • services are commissioned on the basis of need, which may be achieved by ensuring the quantity and quality of services in deprived areas is adequate

We also have a duty to have regard to the need to reduce inequalities and this involves:

  • Effective monitoring and evaluation that identifies health inequalities and to support action to overcome inappropriate variations in outcomes for all people.

  • Looking at how the outcome is distributed across society by area of deprivation and by different groups, rather than focusing on average outcomes for all people.

  • Considering how services can be commissioned to reduce inequalities and prevent undesirable outcomes. For example, targeting life-style factors in health and compliance with treatment, and developing key provider indicators with health inequality outcomes.