Tackling health inequalities

One of the key principles of our Integrated Care System is to ensure people have equitable access to health and care services and to good experience of, and outcomes from these services.

Health inequalities are the preventable and unfair differences in healthoutcomes such as life expectancy and years of life  spent in good health, , between groups, populations or individuals as a result of unequal social, environmental and economic conditions within societies. While people living in the least well-off areas tend to have the worst health, inequality exists across the whole population and is not confined to one area alone or one single group of people.  Therefore we will be working with others make sure that everybody has a fair chance of having the best health best possible.

In this section we describe how the Leicester, Leicestershire and Rutland Integrated Care System is working to reduce these inequalities.  It is clear from the start that if we are to be successful in reducing these inequalities that we will need to listen to communities, to people who have “lived experience” of illness, and work with other organisations such as local authorities and employers to make healthcare and its benefits easily accessible to all people, regardless of where they live.  It takes time to improve inequality but it is unfair and it is avoidable – and so we are committed to playing our part in this work.



Core20PLUS5 is a national NHS approach to reduce inequalities that has been adopted in Leicester, Leicestershire and Rutland. It focuses on the most deprived 20% of the population, as identified by the Index of Multiple Deprivation (IMD), and five  key health  areas for accelerated improvement. These areas are maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension.

Nationally, the approach aims to achieve the following:

  • Maternity:ensuring continuity of care for 75% of women from Black, Asian and minority ethnic communities and from the most deprived groups.
  • Severe mental illness (SMI): ensuring annual health checks for at least 60% of those living with SMI (bringing SMI in line with the success seen in for those with learning disabilities).
  • Chronic respiratory disease: a clear focus on Chronic Obstructive Pulmonary Disease (COPD) driving up uptake of COVID, flu and pneumonia vaccines to reduce infections and emergency hospital admissions due to difficulties in breathing.
  • Early cancer diagnosis: 75% of cases diagnosed at stage 1 or 2 by 2028.  Diagnosing cancer at an earlier stage means we have a better chance of treating it successfully.  Too many people in LLR do not attend cancer screening and so may be diagnosed later – which makes it harder to treat.
  • High Blood Pressure  case-finding: Too many people in LLR have high blood pressure but don’t know it.  We need to identify those people who would benefit  from  care and treatment  to manage  high  blood pressure and therefore minimise the risk of heart attack or   stroke.


In addition, each Integrated Care System identifies other population groups not included in the most 20% deprived, led by its local health data. This could include groups such as ethnic minority communities, people with multi-morbidities, protected characteristic groups, people experiencing homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system, victims of modern slavery and other socially excluded groups.