The posters below were submitted to the South West London ICS Quality Improvement Conference 2023. All of the posters were reviewed by an expert panel of judges from outside of South West London ICS, with a selection being presented at the conference.
Population health and reducing healthcare inequalities QI posters
Find out more about some of the quality improvement work happening in population health and reducing healthcare inequalities across South West London ICS.
Dr Rachel Chapman, Dr Sophie Boles, Dr Andrew Combeer – Epsom and St Helier University Hospitals NHS Trust
Background:
There are proven racial inequalities in maternity care including anaesthetic care during childbirth. In addition, language barriers can impede effective communication and delivery of equitable care. Research into the impact of ethnicity and language barriers in obstetric anaesthesia is limited. The aims of this study were to describe the demographics of the population using obstetric anaesthetic services and to investigate for inequalities in anaesthetic outcomes based on patient ethnicity and preferred spoken language in St Helier Hospital.
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Nawal Hassan, Ben Wanless, Carey McClellan, Thomas Herweijer, Jayne Thorpe, Daniel McGuane, Christina Sothinathan – St George’s University Hospitals NHS Foundation Trust and NHS South West London.
Background:
The South West London MSK digital self-management app has been rolled out across SWL. Patients from more deprived and ethnic minority communities are not taking up the app or are not being prescribed the app. The digital exclusion faced by these groups results in inequalities in access, experience and outcomes of care.
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Adam Gregory, Dawn Eustace, Mary O’Hara, Dr Wallace Tan, Elaine Li, Adriana Baila,Charlotte Critchley, Samantha Conran, Dr Christopher Bell, Amy Mighalls, Sabrina Vandendris – Croydon Health Services NHS Trust
Background:
By June 2024, Community Therapy Teams will increase the identification of patients to be refer red for bone health need to Falls and bone health, Fracture Liaison Service (FLS) by >50% compared with 70 patients referred during pilot stage
Septemb er 2021 to January 2023. As an extension and part of this uplift , additional work is being undertaken to try to raise awareness and identification also via the Integrated Care System linking in with GP’s and the FLS. It is aiming to promote increased positive and proactive actions around bone health within primary and secondary care where indicated.
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Dr Poppy Allen GP Registrar, Dr Harriet Adams GP, Dr Naomi Bennet GP – Epsom and St Helier University Hospitals NHS Trust
Background:
3.7% of the UK population identify as being in the LGBTQ+ community. Discrimination and inequalities are reflected in poorer healthcare outcomes. A significant proportion of these patients had a negative experience with health services that they felt was related to their sexual orientation or gender identity. Clearly there is a need to improve services for this community to achieve better long-term health outcomes.
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Carly Dalton – Sutton Health and Care and James O’Riordan Practice
Background:
People with a learning disability will die about 24 years younger than the general population. 49% of deaths were rated as “avoidable” compared to 22% for the general population (LeDeR report, 2021). NHS England fund GPs to complete an annual health check to anyone on their Learning Disability (LD) register aged 14 and over. The national target is 75%. Sutton as an area completed health checks for 80% of their LD register (21/22) but James O’Riordan practice was the lowest performing practice with an uptake of 25%.
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Increasing uptake of learning disability annual health checks in one Sutton GP pactice (.pdf, 450kB)
Nadine Wyatt and Yvonne Evans, NHS South West London
Background:
Core 20 data identified 20% most deprived areas in Sutton where uptake of vaccination was very low among the residents especially those from minority ethnic communities and health inclusion groups.
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Increasing vaccine uptake in under served communities (.pdf, 231kB)
Antoinette Johnson, Diane Weir, Michelle Knight, Louise Emmett, Patience
Ohikenna, Maryclare Chapman – Epsom and St Helier University Hospitals NHS Trust
Background:
The Maternity Cultural Transformation Group (MCT) observed that disproportionately more maternities from the global majority attend complex pregnancy clinics; >50% form the diabetes caseload. MBRRACE and 5X More describe inequalities in maternity outcomes for this population. Staff reported language needs, patients requested more information resources and both desired cultural awareness. Since 2019, MCT has worked with women and staff to better understand and address the needs at our trust.
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Reducing maternal health inequalities in the global majority (.pdf, 191kB)
Dr Emily Tridimas, Dr Olubanke Davies, Dr Jameel Karim – Epsom and St Helier University Hospitals NHS Trust
Background:
NICE recommend universal HIV screening in high prevalence areas (>0.2%). Trust guidelines advise offering HIV tests to all patients over 16 presenting to the emergency department (ED). The local HIV prevalence is 0.25% and there is a high rate of late diagnosis. ED provides an opportunity to identify positive patients in at at-risk population. Late diagnosis leads to excess mortality, whilst unknown HIV status results in increased transmission risk.
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Routine screening for HIV in emergency departments (.pdf, 308kB)
Grace Neal, Caoimhe Bonner and Nick Downham – NHS South West London
Background:
There are unexplained levels of variation in the quality of care for people with Type 2 diabetes across South West London, with GP surgery compliance of the three treatment targets ranging from 11-57%. Our aim was to reduce variation in the
quality of care for people with Type 2 Diabetes by supporting GP surgeries to
achieve at least 45% compliance with the three treatment targets over four years, recognising that Practices often look for a single ‘solution’ rather than think of diabetes care as systemic.
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Dr Catherine Heffernan, Amit Patel, Nisha Patel and Dina Thakker – NHS South West London
Background:
Funded by the South West London Innovation Fund, ‘Winter Fit’ intervention was
delivered as a pilot scheme across the six boroughs of South West London. This was
a collaboration between LPC, South London Partnership and the ICB, with the ICB supporting governance process in terms of contract set-up and finance arrangements. Winter Fit was based on the premise that the community pharmacist has a central role in community engagement and support around the older population. Community pharmacies are highly accessible, located in the heart of
communities where people live.
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G Carr, H Clackson, M Coakley, M Fisk, N Lindner, A Oloko, H Rosol, G Schram, H Stewart, N Williams – NHS South West London
Background:
Currently there lies challenges in access to women’s health in South West London. With increasing referrals to secondary care, reduced capacity, long waiting times and a fragmented service for many. A new module recognising the Hewitt review and ‘need for a movement away from centralised care’ aims to better serve women in the community with a focus on a preventative approach to address the causes of many gynaecological health issues. Especially aimed for those most vulnerable or from deprived areas who may not readily access help for their women health needs.
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