Agenda item

System Health Equity

A verbal presentation will be provided by Health Partners for the Commission on System Health Equity conducting a deep dive into longer waits at both the Emergency department and patients waiting for ambulances to assess the impact against protected characteristics.

 

Minutes:

The Director of Health Equality and Inclusion for UHL, gave a gave verbal presentation update on the Accident and Emergency Department’s waiting times: 

  • The update was requested following a question relating to ambulance hand over times and the potential impact based on protected characteristics for patients waiting for ambulances at a previous meeting. To assess this question, data was examined from October 2025 which analysed sex, ethnicity, frailty and deprivation status of 1,800 patients and how these factors affected people waiting for ambulances. The findings were that there was no significant difference based on a protected characteristic and that clinical need and acuity of illness being the driving factor.  
  • Further work was done to examine the experiences of patients and how different groups of people might experience waiting as well as how they might attend the Emergency Department. UHL Emergency Department (ED) data between 2022 and 2024 was investigated for the research, with wait times and frequency of attendance being examined. The Director hoped that this extra information would further add to conversation around the previous item on winter pressures. 
  • Between July 2022 to November 2024 there was an 11% increase in ED attendance. This was fuelled by a 21% increase in Paediatrics and 7% increase in adults. While there was a noted increase in children's attendance, adult attendance outnumbered children by nearly a factor of 3.   
  • There was an overall goal of simplifying the data so interventions can be had with specific groups and populations as well as what service changes need to be made to support this. There are different needs for different population groups with a clear need around deprivations status and age. The data showed that the most prominent groups in the Emergency Department were older patients of a white ethnicity, Black and Asian individuals and deprived groups. Black and Asian individual as well as deprived groups were all overrepresented in the Emergency Department, but their average patient acuity was lower. Older patients who are of a white ethnicity tend to wait longer but this was due to the complexity of their needs.  
  • Emergency Department usage was becoming less concentrated amongst traditional high use groups. A broader, more complex patient mix was emerging across the population.  
  • The data was collated on to maps, so the areas of LLR with particularly high Emergency department attendance can be identified. This was with the aim of passing this information on to primary care and community partners, so they can engage with the identified communities and develop interventions. Thus, driving down Emergency Department attendance in the future.  

 

In response to Members comments:

  • The utility of the slides in relation to the previous topic was echoed by members and that it was stated that it would have been useful to see the slides before the meeting. It was commented how factors such as vaccinations and GP access in deprived and rural communities, ultimately accumulates in the Emergency department
  • The GP to patient ratio in the City and its subsequent impacts on the Emergency Department was notably raised by members. It was stated that until the issue of the high GP to patient ratio is tackled, then it will continue to contribute to the high Emergency Department numbers. The fact that high levels of complex health cases in the City, were monopolising GP’s resources was also highlighted. In response, the Chief Medical Officer for the ICB acknowledged that the lower levels of GPs in the City was an issue which they were working to improve. The ICB was also offering extra support and funding to GP practices in the City to help tackle the health inequality issues.        
  • The topic of longer wait times for older white patients was commented on and further details were requested about what the underlying causes of this difference were. It was suggested by members that it would perhaps be better if the data focused on more subdivided sections such as the City and County separately to provide more accurate information on the factors that were assessed. In answer to this, it was explained that the wait times for elderly white patients was due the complexity of their needs and not how sick they were.

 

Agreed:

1.    The presentation was noted.