Addressing Healthcare Inequalities and Sustainability

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Part Two of our look into how PCNs can meet current NHS targets.

In Part One we discussed the changing NHS Targets set out for PCNs in the coming year and what GPs and PCNs need to know to effectively navigate these changes. In Part Two, we’ll take a closer look at the 5 areas of NHS focus these changes are meant to address:

  1. Improving prevention and tackling health inequalities in the delivery of primary care.
  2. Supporting better patient outcomes in the community through proactive primary care.
  3. Supporting improved patient access to primary care services.
  4. Delivering better outcomes for patients on medication.
  5. Helping create a more sustainable NHS.

What are the healthcare inequalities in primary care and what can be done about them?

Healthcare inequalities in primary care can arise from a variety of factors such as differences in access to healthcare, health literacy, and digital literacy. People who are more digitally enabled and healthcare literate may be more likely to access healthcare services early on, potentially preventing more serious health conditions down the line such as advanced-stage heart disease and cancer. Additionally, financial constraints contribute to healthcare inequalities, as some patients may be unable to afford certain medications or treatments, resulting in a higher burden on the healthcare system.

To address these inequalities, the NHS needs to implement a more uniform minor ailment scheme where patients can access commonly prescribed medications for free, directly through their pharmacists, rather than needing to go through General Practitioners for prescription costs to be covered. Additionally, efforts should be made to improve health and digital literacy among underserved populations empowering patients to take a more proactive role in their healthcare and ensuring access to general healthcare services when needed.

Addressing these inequalities would potentially reduce the workload on PCNs and GPs by empowering patients to take responsibility for their own healthcare needs and moving us towards a more equitable healthcare system providing quality care to all.

How can PCNs and Healthcare teams be proactive in helping to address these inequalities?

First, it is important to understand your population and be ready to work together with other healthcare professionals and networks within your locality to disseminate information and health education through a variety of avenues. The key is to go where the population is. For example, using social media platforms such as TikTok, Instagram and YouTube to reach younger people who are not accessing healthcare information through more traditional avenues or media outlets. Or, creating pop-up clinics in places such as fishing harbours, factories, and other areas where populations who typically struggle with access to healthcare—e.g. fishermen, migrant workers facing language barriers, etc.—tend to congregate.

PCNs will need to be multi-channel and multi-faceted to bridge language and other access barriers to reach a wider range of patients. It may also be helpful to work with community leaders to increase awareness and encourage people to access healthcare services. Ultimately, a proactive approach involves being creative and innovative in how healthcare services are delivered, ensuring that they are accessible to everyone in the community.

What are the improved outcomes for patients on medication that the NHS wants to achieve?

From an NHS perspective, improving medication knowledge and adherence amongst patients can lead to significant NHS cost savings. The wastage budget for medicines is massive, and educating patients on proper medication use can prevent them from wasting medication or ordering medication they do not need. Additionally, if patients can access over-the-counter medication more easily, they are more likely to continue taking their prescription medications as directed. This, in turn, can lead to better health outcomes by helping to stabilize the health conditions of patients and reduce the need for frequent visits to healthcare services, including out-of-hours or A&E.

From a patient-centred perspective, improving outcomes for patients on medication involves helping them to live their best life despite ongoing health conditions. Accessibility of mental health support plays a crucial role in this by helping patients who may be struggling to accept that their condition may never fully resolve. Additionally, patients need to understand more about their medications and how proper compliance will help them to achieve better health outcomes. Overall, the NHS is looking to improve medication adherence to both improve patient outcomes and reduce costs associated with medication wastage and unnecessary healthcare utilization.

What role do PCNs play in supporting sustainability in the NHS?

We understand that most general practices, as independent businesses, are already doing their part when it comes to sustainability. PCNs and GPs do the majority of the work and receive very little in terms of NHS funding. They have lean staffing, are mindful of budgets and prescribing, and generate very little wastage. However, staff are now working many more hours to do the same things and are often asked to do the same work or more with fewer resources. It is not unreasonable to say that the responsibility of sustainability in the NHS should be taken on by bigger organizations, such as trusts, who get their funding come what may, receive bailouts, and are allowed to shut their doors if necessary.

General practices aren’t supported in the same way and their models and funding streams are different from those of bigger organizations. So, the burden of sustainability in the NHS should be thought of more holistically rather than being placed on the shoulders of PCNs. However, one thing that all organizations can do, including in GPs and PCNs, is to look after our staff well. Staff are the absolute foundation of any PCN or GP organization and all are run on goodwill. Often staff face difficult interactions with patients daily, so, as teams and colleagues, we need to be celebrating them, supporting them, and caring for their needs. Without our staff, we’ve got nothing.

Here at Xytal, we want to support you and your staff in facing the ongoing challenges of adapting to new NHS targets and outcome measures. To find out more about the work we do to support PCNs, visit our PCN DES Support programme page and please don’t hesitate to reach out to us at if you feel your practice could benefit.

Without our staff, we’ve got nothing.