Health inequalities in our communities

Equality Delivery System (EDS2)

The CCG is using the Equality Delivery System (EDS2) to make progress on equality and inclusion. In line with NHS England guidance, this involves us inviting representatives of equality groups to score or grade the CCG against the patient related outcomes of the EDS2. Community representatives also help us to identify actions (equality objectives) to improve how our commissioning work can better advance equality and inclusion.

The CCG approach to engaging seldom heard groups and communities supports EDS2 as the relationship building and partnerships established throughout the year provide a pool of diverse representatives to draw upon when organising the EDS2 grading workshop.

We complete EDS2 on a four yearly cycle linked to the requirements of the public sector equality duty. Our last EDS2 took place in 2014/15 when communities graded us as ‘Developing’ across all nine patient related outcomes. Our next ‘Everyone Counts’ grading workshop will be held on 13 March 2019.

Groups that experience worse health outcomes and barriers to accessing services

Overall people living in West Hampshire have better health and better health outcomes compared to the national average.  However, there are some groups that do not fare as well or who face additional barriers to accessing health services: 


People with severe mental illness

  • The smoking rate among people with a severe mental illness is 40.5%, more than double that of the general population
  • Smoking is the main cause of illness and premature death among people with a mental health condition who die 10-20 years earlier than the general population


People with a learning disability

  • All-cause mortality rates among people with moderate to severe learning disabilities are three times as high as in the general population
  • Health screening of adults with learning disabilities registered with GPs reveals high levels of unmet physical and mental health needs


Gypsies and Irish Travellers

  • Gypsies and Travellers generally suffer from poor health and lower life expectancy -  between 10 and 12 years less than the settled population
  • This group also have a higher prevalence of long term conditions such as heart disease, diabetes, lung disease, and mental health problems
  • There are Gypsies and Travellers living in every district in Hampshire, with the largest number (423) in the New Forest
  • Across Hampshire three-quarters (75%) of this group are believed to be living in bricks and mortar accommodation


People from Black, Asian and Minority Ethnic (BAME) backgrounds

Across West Hampshire there are small BAME communities including Asian and Nepalese people, as well as people from Eastern European countries. These groups face additional barriers to accessing health services. Community engagement work has found that older women in the Asian and Nepali communities tend to speak less English and that language interpreters are not always made available. People from Eastern Europe have difficulties navigating the health system.


Veterans, Reservists, and Armed Forces Families

There are around 60,000 veterans in Hampshire, and in West Hampshire the greatest numbers live in the Test Valley.


Many of the health and healthcare needs of the ex-Gurkha population will be similar to those of the general veteran population, however there will be some issues that are specific to them as members of the Nepali community and their living circumstances here in the UK, and many of these will also affect their families. These include higher rates of some diseases and medical conditions such as TB and diabetes. The ex-Gurkha and wider Nepali community also have some specific issues around accessing healthcare and other services which is mostly attributable to difficulties with language and a lack of interpreters in primary care.


Although families of serving military personnel live civilian lives, there are a number of aspects of military life that will have significant impact on their health and wellbeing. Most notably, these are issues related to mobility and deployment. These can result in:

  • Isolation and mental health problems in the at-home parent partner or spouse
  • Relationship difficulties
  • A range of psychological, mental health or behavioural problems in children as they move through the stages of the deployment cycle and their family circumstances change