The Care Quality Commission (CQC), in partnership with National Voices and the Point of Care Foundation, has developed a self-assessment and improvement framework.
The aim of the framework is to support integrated care systems (ICSs) to improve how they tackle health inequalities through honest conversations, gathering insights and developing practical actions through engagement linked to people and community strategies. The project was supported by funding from the Regulators’ Pioneer Fund (RPF).
Why we developed the framework
The framework was developed to provide a voluntary, supportive and flexible tool to help ICSs work more effectively with people and communities, focusing on those who experience the greatest health inequalities. By offering a structured approach, the framework aims to empower ICSs to improve health outcomes and create fairer, more inclusive systems of care.
Co-design and testing
The framework is the result of extensive co-design, involving input from public health practitioners, ICS leaders, engagement experts, voluntary, community and social enterprise (VCSE) partners, and people with lived experience. Following its initial development, 4 ICS pilot sites carried out testing to ensure that ICSs can apply the framework in a practical and meaningful way. This collaborative process shaped the framework into a comprehensive resource that supports systems in reflecting, learning, and planning tangible actions to address inequalities through 7 phases:
- Check
- Challenge
- Prepare
- Plan
- Engage
- Involve
- Evaluate
The framework supports a whole-system approach, and it is underpinned by a set of core principles that reflect the values and approaches needed to tackle health inequalities through effective, inclusive, and sustainable engagement practices.
Accessing the framework
The framework, along with a range of supporting resources including case study videos from the ICSs who undertook testing of the framework, is now available to all ICSs to consider and implement across their health and social care services. It focuses on those people and communities that are affected by health inequalities and identified in the CORE20PLUS5 approach.
Following the launch of the framework, CQC will continue to engage closely with ICSs, as they embed meaningful engagement practices and monitor progress in reducing health inequalities.
Chris Day, Director of Engagement at CQC, said:
"Health inequalities continue to affect access to care, experiences of care, and outcomes for people and communities.
"This framework is the result of many months work with our partners National Voices and the Point of Care Foundation to provide support for ICSs, who play a vital role in addressing these challenges. From start to finish, the development of this framework has been collaborative, underpinned by the voices of people with lived experience as well as feedback from stakeholders and the 4 ICSs that participated in the testing phase.
"I look forward to hearing how ICS have implemented this framework in the coming months and how it supports them to measure and demonstrate improved outcomes for health inequalities within their systems and services."
Sarah Massie, Programmes Director the Point of Care Foundation said:
"We are delighted to share this framework and hope it will help develop truly inclusive and compassionate services. By empowering integrated care systems to work closely with people in their communities, it is paving the way for more equitable, impactful, and inclusive health and care services.
"A massive thank you to everyone involved in the framework's co-production, and to the Regulators’ Pioneer Fund for the investment."
Jacob Lant, Chief Executive, National Voices said:
"We are delighted to see the health inequalities framework, developed with CQC and the Point of Care Foundation launch today.
"The publication of this important work could not be more timely, with the 10-Year Plan underway, ICSs will have a major role to play in addressing inequity in access, patient experience and outcomes to help build an NHS fit for the future.
"This project has demonstrated what meaningful co-production looks like, with people, the voluntary sector and ICSs, and as a result we have produced a tool that works well for anyone who picks it up. We are very proud of this end result, and look forward to seeing its implementation and the impact it will make in tackling health inequalities and in improving people’s experiences and outcomes of care. We would like to take this opportunity to thank everyone who was involved, and the Regulators’ Pioneer Fund for the investment."
Science Minister, Lord Vallance, said:
"Backing innovators to experiment with and develop new ideas is essential in bringing technologies to market which can make a real difference for businesses, consumers and our public services.
"Our funding for 24 pioneering projects – from this framework to reduce healthcare inequalities, benefiting patients and services, to drone deliveries for remote communities – will help UK regulators and local authorities to accelerate innovation and make it a success across the country."
Regulators' Pioneer Fund (RPF)
The Regulators ' Pioneer Fund (RPF) is a grant-based fund to enable UK regulators and local authorities to help create a regulatory environment that encourages business innovation and investment. The current £12m round is being delivered by the Department for Science, Innovation and Technology (DSIT).
We would like to thank everyone who has contributed to the development of the framework. We welcome your feedback through our dedicated mailbox: icshealthinequalities@cqc.org.uk.