Report reveals how NHS inequalities funding is used
Rows of little peg people, all different colours (eg. red, yellow, blue).

A new report from Leeds Beckett University has been published showing how Integrated Care Systems (ICS) are making use of funding targeted to address health inequalities.

The research was led by Professor Mark Gamsu and Professor Anne-Marie Bagnall in collaboration with the NHS Confederation, Clarity and the Care Quality Commission. The project looked into how the £200 million per year made available by NHS England for ICSs to tackle health inequalities is being used. The team explored examples of best practice, and areas that support and hinder positive change.

Professor Gamsu said that between 2022 and 2023, the £200 million of funding was "specifically ring-fenced to be spent on health inequalities.

"In subsequent years, it has been built into the NHS funding allocation but is not ring-fenced."

He continued: "In a climate where the NHS is under tremendous pressure in terms of demand and funding, it is particularly important that this funding is still available to support work on addressing health inequalities.”

The researchers interviewed 20 of the 42 Integrated Care Board (ICB) health inequality leads in England. 

The researchers found that almost all ICBs used all or some of the funding for its intended purpose - with half of the ICBs interviewed ringfencing it in its entirety. Seven put some of the allocation into health inequalities projects and some into the wider system budget, and three put all of the allocation into the wider system budget.

The interviews showed a wide variation in how the funding was used. In almost all cases ICBs used it to instigate a range of different actions such as setting out principles around what the money is for, using it as a catalyst for innovation around quality improvement and Commissioning pilot programmes which, for some, resulted in further funding being secured.

Professor Gamsu said: “It is important to recognise that ICBs are still very new organisations – they were established in July 2022 to replace clinical commissioning groups. Relationships are still being formed, and health inequality is a complicated issue that requires focussed strategic action over time. But, we did hear hopeful examples of action from those we interviewed.”

The report sets out a number of recommendations to government, national regulators such as the Care Quality Commission, NHS England and the ICSs.

These included developing a cross-government strategy to reduce health inequalities, calling for the Prime Minister to lead a mission for health improvement, and ensuring that central initiatives, such as NHS IMPACT, align with the four statutory purposes of ICSs, including tackling inequalities.