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‘Significant and avoidable’ demand on NHS due to socio-economic inequalities, warn the RCPs

Doctors are warning of a rise in patients with poor health due to their socio-economic circumstances, including mouldy or damp homes, poor air quality or issues around employment and education, which are exacerbating inequalities.

A census carried out by the Federation of the Royal Colleges of Physicians in the UK found 55% of doctors reported seeing more patients with problems relating to, or made worse by, wider determinants of health, which also include factors such as ability to heat homes, access to green spaces, and transport links.

Illness caused by socio-economic factors including poor housing, lack of access to healthy food, smoking and obesity is now significantly contributing to the workload of physicians in the UK, the survey suggests.

Almost a quarter (24%) in the latest annual census said more than half or almost all of their workload is due to illnesses or conditions related to the social determinants of health.

This often impacts the most deprived communities, exacerbating health inequalities and placing ‘significant and avoidable’ demand on the NHS, the Colleges said.

In all, 85% of doctors said they are concerned about the impact of health inequalities on their patients. 

The findings have sparked urgent calls for government to address the ‘avoidable social causes’ of ill health.  

Dr Sarah Clarke, president of the Royal College of Physicians, said: ‘In the midst of unprecedented demands on the NHS and declining public health, it should be sounding alarm bells in government that so many doctors are seeing more patients with illness related to the wider determinants of health, such as housing or poor air quality.

‘It is clear that the responsibility for good health lies not solely with the NHS nor the Department for Health and Social Care – all of government must play a role.

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‘If we are to reduce these avoidable demands on the NHS, improve general levels of health across the nation, and create a healthier labour market, we must see a comprehensive, cross-government strategy to reduce health inequalities that tackles the things that make us ill in the first place.’

She pointed to health inequality data from the Office for Health Improvement and Disparities which shows that those living Blackpool – the most deprived area in England – have a healthy life expectancy of just 53.9 years, which is more than 17 years less than Wokingham, the least deprived area.

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said: ‘The findings from this census present a stark image of public health.

‘Many doctors feel that the National Health Service is actually a national sickness service, dealing with the symptoms and signs of disease and limited in its ability to prevent that disease.

‘That will remain the case for as long as we neglect the root causes of ill health. We must confront these head-on. That means better housing, cleaner air, better nutrition, better education and ensuring equitable access to basic necessities for healthy living.’

Mike McKirdy, president of the Royal College of Physicians and Surgeons of Glasgow, added: 

‘Doctors increasingly find themselves under unprecedented strain, grappling with mounting caseloads of patients whose ailments are directly linked to their living conditions. 

‘Prevention is better than cure and we must see a concerted effort from across government and wider society to address the underlying socio-economic factors which perpetuate this cycle of illness and increased demand on the NHS.’

A version of this article was originally published by our sister publication Pulse.

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