CSP professional adviser Sara Glanville-Taylor calls on physios to challenge perceptions and consider how health inequalities impact local populations and highlights the difference good communication makes for patients
‘We don’t have health inequalities here’
Members have said ‘we don’t have health inequalities in our area – so it’s hard for us to evidence them for HCPC standards, or complete section 6 on a Common Placement Assessment Form (CPAF) with students’.
It is important to challenge this way of thinking – not all health inequalities are around deprivation, culture and protected characteristic demographics. It is important we address all forms of health inequality.
Let us think more broadly. Digital literacy and health literacy can impact any community and affect all populations resulting in health inequalities.
- Health literacy – 65 per cent of the population struggle to understand health information that contains words and numbers.
- One in six have low literacy skills(1,2).
- 50 per cent of the population match or are below primary school literacy(3) .
- We have an ageing population which is more likely to have lower health literacy(4).
- Nine million people are unable to use digital tools without assistance(5).
Whether you work in an NHS service, private practice, or are a student, manager or clinician, we all need to consider how to communicate with patients and take time to ensure they have a personalised care experience.
We need to ensure this runs from equity of accessing services, interactions within the service, and communication options for managing conditions through to their discharge. Can the patient read the appointment letter? Can they navigate an online portal? Do they understand the treatment plan or exercises? Do they know what to do if their condition returns or worsens?
Patients may face intersectional challenges that services must address, preventing pathways and processes from creating barriers and worsening health inequalities. Patients may have additional challenges due to cognitive impairment, learning difficulties, neurodiversity, culture, language barriers, and sensory impairment, to name but a few.
Is it surprising that many patients fail to attend appointments? Think about the reasons behind some of your patients struggling to attend an appointment? When your next patient arrives in the clinic not having completed the exercises or not having followed the advice, delve into the barriers. Take time to understand how the patient best communicates – is it visual, written, digital, other languages, or sign language? Ensure your service has options – one size does not fit all.
If we start to look at health inequalities differently within our practice, we can have a positive impact on our service users, communities, and can evidence how we are starting to address them.
Unsure where or how to start? Check out the resources and events on the CSP website here.
We want to hear of your successes and challenges. Join the conversation with the iCSP health inequalities community.
Intersectionality - a definition
The interconnected nature of social categorisations such as race, class, and gender as they apply to a given individual or group. It creates overlapping and interdependent systems of discrimination or disadvantage. Equity, diversity and belonging glossary.
‘Mr. A’ has been referred to physiotherapy. He receives a letter telling him to log on to an online portal with a password to book his appointment. Mr. A is not good with passwords and digital technology. He used to find it easier but with his cognitive impairment he forgets. He has two weeks to respond after which the service will assume he no longer needs treatment. Mr. A. thinks he will ask his daughter next time he speaks to her. The service discharges Mr. A after two weeks. His condition worsens and he is taken to hospital when his carer finds him collapsed at home. He is subsequently admitted for treatment. How would your service fare in this scenario? What actions could be implemented to avoid this outcome?
Common Placement Assessment Form (CPAF) section 6
Individuals, communities and populations
The learner recognises the impact of culture, equality and diversity on practice and practises in an anti-discriminatory and inclusive manner.
The learner identifies and understands the impact of health inequalities, promoting health and wellbeing of themselves and others.
The HCPC requires all registrants to promote health and prevent ill health. Tackling health inequalities through our practice is an important step to achieving this.
HCPC Standards of proficiency
5.1 Respond appropriately to the needs of all different groups and individuals in practice, recognising this can be affected by difference of any kind including, but not limited to, protected characteristics, intersectional experiences and cultural differences.
15.1 Understand the role of their profession in health promotion, health education and preventing ill health.
15.2 Understand how social, economic and environmental factors (wider determinants of health) can influence a person’s health and wellbeing.
15.3 Empower and enable individuals (including service users and colleagues) to play a part in managing their own health.
References
1 Survey of Adult Skills 2015.
2 Skills for Life 2011 2011 Skills for Life Survey: A Survey of Literacy, Numeracy and ICT Levels in England.
3 National_numeracy_day_2019.pdf (National Numeracy).
4 Functional health literacy and health-promoting behaviour in a national sample of British adults.
5 Patient Information Forum - Health literacy matters.
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