Equity in access
Quality statement
We expect providers, commissioners and system leaders live up to this statement:
We make sure that everyone can access the care, support and treatment they need when they need it.
What this quality statement means
- People can access care, treatment and support when they need to and in a way that works for them, which promotes equality, removes barriers or delays and protects their rights.
- People can expect their care, treatment and support to be accessible, timely and in line with best practice, quality standards and legal requirements, including those on equality and human rights. This includes making reasonable adjustments for disabled people, addressing communication barriers and having accessible premises.
- People can access services when they need to, without physical or digital barriers, including out of normal hours and in an emergency. Physical premises and equipment are accessible. People are given support to overcome barriers to ensure equal access.
- Leaders and staff are alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support, whether this is from wider society, within organisational processes and culture or from individuals.
- Providers use people’s feedback and other evidence to actively seek to improve access for people more likely to experience barriers or delays in accessing their care.
- Services are designed to make them accessible and timely for people who are most likely to have difficulty accessing care. When there are barriers, they are removed.
- When services change, equity of access is considered.
- People have equal access to care, treatment and support because the provider complies with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments.
- The provider prioritises, allocates resources and opportunities as needed to tackle inequalities and achieve equity of access.
I statements
I statements reflect what people have said matters to them.
- I am in control of planning my care and support. If I need help with this, people who know and care about me are involved.
Subtopics this quality statement covers
- Accessibility to services
- Emergency unplanned care access/out of hours arrangements
- Reasonable adjustments
- Accessible premises
- Waiting times/delays/cancellations
- Digital exclusion (communication barriers)
- Access to post treatment support
We expect providers to be aware of and follow the following best practice guidance.
Equality Act Codes of Practice (Equality and Human Rights Commission)
Equality Act 2010 (Equality and Human Rights Commission)
Human Rights Act (Equality and Human Rights Commission)
Equally outstanding: Equality and human rights - good practice resource (CQC)
Culturally appropriate care (CQC)
Integrated health and social care for people experiencing homelessness (NICE guidance [NG214])
Working definition of trauma-informed practice (Office for Health Improvement & Disparities)
The Equality and Health Inequalities Hub (NHS England)
Equality Frameworks and Information Standards (NHS England)
The NHS England Equality Frameworks and Information Standards page links to equity in access. This is because it mentions the mandatory frameworks that NHS England expects providers to use to progress equality of access.
These frameworks include:
- the Equality Delivery System, which aims to address inequalities in services
- the Sexual Orientation Monitoring Framework, which improves data to understand where access/experience issues are
- the Accessible Information Standard.
There is a new self-assessment framework coming alongside the updated standard. This is key to addressing barriers to accessing accessible communication for people using services.