369 The role of children’s hospitals in reducing health inequalities: a review of organisational policies
Published Date: 19th June 2023
Publication Authors: Brennan L
Abstract
Objectives
Health inequalities are ‘avoidable, unfair and systematic differences in health between different groups of people’, including differences in access to care and quality of healthcare received.1 The Children’s Hospital Alliance (CHA) is a group of English children’s hospitals, collaborating through the National Paediatric Accelerator Programme.2 This document review was commissioned by the CHA, as part of a larger piece of work to understand the role its member trusts can play in reducing health inequalities.
Methods
The ‘READ’ (Ready your materials; Extract data; Analyse data; and Distil your findings) methodology of document analysis3 was chosen due to its creation specifically for health policy research. Multiple emails requesting trust documents related to inequalities were sent to key contacts at all ten member sites over a three-month period in summer 2022. Two researchers independently analysed the documents against the project’s aim and objectives. The researchers met to agree and finalise key themes, good practice, areas for improvement, and early recommendations.
Results
Eight hospitals responded, with seven returning a total of 25 documents for analysis. Documents varied in length, from one to ten pages, and were in a variety of formats, as seen in table 1. Key themes were identified across the documents, including evidence of trusts’ focus on local population need. Several organisations reported a clear health inequalities strategy and governance structure, the use of monitoring and dashboards, or recognition of the trust as an anchor institution.
There were several areas of good practice identified, with examples including: a joint public health role between the trust and local authority, patient and public involvement programmes, clinical priority tools, and practical examples of support for inpatient families such as food packages.
Some areas of variation were noted between trusts, notably the lack of a patient or paediatric specific ‘voice’ in the strategies and documents provided in summer 2022, and almost no reference to the inequalities experienced by staff within these substantial local employers.
Conclusion
This work provided a mid-2022 snapshot of children’s hospitals and their host trusts, with regards to their role in health inequalities. Future work includes completion of a scoping review, as well as qualitative work with staff, where we will explore the changing inequalities landscape. Early recommendations to trusts include developing clear health inequalities strategies, as well as involving paediatric patients in conversations around inequalities, and recognising issues experienced by their own workforce from the local community.
Hindocha, A; Brennan, L; et al. (2023). 369 The role of children’s hospitals in reducing health inequalities: a review of organisational policies. Disease in Childhood. 108(Suppl 2). [Online]. Available at: https://dx.doi.org/10.1136/archdischild-2023-rcpch.187 [Accessed 3 January 2024].