England's poorest people get worse NHS care than its wealthiest citizens, including longer waiting for A&E treatment, and worse experience of GP services, a study shows. While 134 per 100,000 of the least deprived were admitted to hospital because of pressure sores, the rate among the poorest was three times higher, 394 per 100,000 people.
The findings show that poorer people’s health risks being compounded by poorer access to NHS care. Moreover, previous evidence showed that, while life expectancy is still improving for the best-off, it has stalled or gone backwards among the poorest.
The research found large disparities between richest and poorest in measures of children and young people’s health, including take-up of the MMR vaccine in five-year-olds, teenage pregnancy and admissions for self-harm for under-18s.
Those from the most deprived areas have fewer hip replacements and are admitted to hospital with bed sores more often than people from the least deprived areas.
With regard to emergency care, 14.3% of the most deprived had to wait more than the supposed maximum of four hours to be dealt with in A&E in 2017-18, compared with 12.8% of the wealthiest. Similarly, just 64% of the former had a good experience making a GP appointment, compared with 72% of those from the richest areas.
Research by the Nuffield Trust and Health Foundation thinktanks found that the poorest people were less likely to recover from mental ill-health after receiving psychological therapy and be readmitted to hospital as a medical emergency soon after undergoing treatment.The findings show that poorer people’s health risks being compounded by poorer access to NHS care. Moreover, previous evidence showed that, while life expectancy is still improving for the best-off, it has stalled or gone backwards among the poorest.
The research found large disparities between richest and poorest in measures of children and young people’s health, including take-up of the MMR vaccine in five-year-olds, teenage pregnancy and admissions for self-harm for under-18s.
“Poverty is bad for your health, and people in the poorest parts of England face a vicious cycle,” said Ruth Thorlby, a co-author and assistant director of policy at the Health Foundation. “Poor living conditions, low quality work and underfunded local services lead to worse health. These findings show that, added to this, those in the most deprived areas are routinely experiencing longer waits in A&E, lower satisfaction and more potentially avoidable hospital admissions,” she added.
“These findings show some concerning trends about the knock-on effects an overstretched NHS is having on the people in England who often need it most,” said Sarah Scobie, deputy director of research at the Nuffield Trust and the other co-author. “My worry is that continued pressure on the NHS is only going to exacerbate inequalities, despite the very best of intentions from staff to provide fair and equal care.”
Dr Stephen Jivraj, an associate professor in the faculty of population health sciences at University College London, said: “These findings point to an inverse care law where those most in need of health services are experiencing the poorest quality. They provide context to why the gap in health between rich and poor is getting larger, as shown in recent research from UCL. The increase in the gap between deprived areas and less deprived areas is worrying.”
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