Green Libraries Week: October 2026

Welcome to the latest key papers and publications focussing mainly on the theme, navigating mis- and disinformation in libraries.

Please click on the links below and enter your OpenAthens username and password to download the full text or contact the library at esth.hirsonlibrary@nhs.net to request the full text.

A guide to disinformation affecting local authorities and their communities
Abstract: This guide, produced for the Local Government Association (LGA), outlines definitions of mis/dis/malinformation and its impacts on communities and local authorities. It details responses and countermeasures and case studies from councils.
Source: Local Government Association, 2026

Mis- and disinformation
Abstract: The spread of false and misleading information poses significant risks to the well-being of people and society. While such content is not necessarily illegal, it can contribute to polarisation, jeopardise the implementation of policies, and undermine trust in democratic institutions and processes. Action is required to strengthen the integrity of information spaces to protect freedom of expression and democratic engagement.
Source: OECD (Organisation for Economic Co-operation and Development), 2026

Deciphering authenticity in the age of AI: how AI-generated disinformation images and AI detection tools influence judgements of authenticity
Abstract: An ongoing surge of Artificial Intelligence (AI)-enabled false content has been spreading its way through the information ecosystem, including AI-generated images, which have been used as part of political disinformation campaigns. Thus, there remains a pressing need to understand which factors individuals rely upon when determining whether images are AI-generated, particularly when they can be used to spread disinformation. AI-generated images have been characterised by their aesthetic realism, which can be leveraged to deceive users, and those who use generative AI to create deceptive content also tend to exploit its ability to convey and elicit emotion. This experimental study explored how aesthetic realism and emotional salience, as key features of both AI-generated content and disinformation, may influence authenticity judgements of AI-generated disinformation images. In this study, 292 UK-based participants were presented with both AI-generated and non-AI-generated disinformation images which varied in aesthetic realism and emotional salience. Results showed that participants were more likely to judge realistic-looking AI-generated images as being authentic compared with less realistic-looking AI-generated images, but did so with less confidence in their decision. Emotional salience was not a significant predictor of judgements. When participants were presented with the correct verdict of an AI detection tool, their reliance on the tool to update their own judgements was predicted by the aesthetic realism of the image and their confidence levels. These findings may assist with the development of disinformation detection tools, as well as strategies that mitigate the spread of deceptive, synthesised visual content in the digital age.
Source: Farooq A. AI & Society, June 2025; 41: 493-504

Generative Artificial Intelligence and Disinformation
Abstract: The impact of Generative Artificial Intelligence (Gen AI) on the information ecosystem has garnered significant attention, especially since 2024 was a critical year for elections worldwide. This chapter investigates the relationship between Gen AI and the creation, dissemination, and amplification of disinformation. It aims to debunk myths about Gen AI and to clarify its capabilities and limitations. As a technology based on mathematical and statistical theories, Gen AI does not understand the content it produces. While it does not disinform itself, it can be misused for disinformation purposes.
The chapter explores the disinformation considerations associated with the different stages of Gen AI: the input phase, the prompt stage, the output, and the use stage. It includes recent examples of disinformation involving text, images, video, and audio generated by AI. The debated risks of Gen AI for disinformation are addressed, noting that while Gen AI may not drastically alter the disinformation landscape, human actors remain the primary drivers. However, extensive research is needed to assess its full impact.
The chapter also examines how recent European Union (EU) regulatory and policy instruments cover Gen AI. Preliminary analysis focuses on the AI Act, the Digital Services Act (DSA), the Gender-Based Violence Directive, the European Media Freedom Act, the Guidelines on the mitigation of systemic risks for electoral processes, and the Strengthened Code of Practice on Disinformation.
Source: Krack N. Disinformation, January 2026: 259-291
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Implications of Artificial Intelligence for Information Systems
Abstract: This chapter argues that contemporary information systems are converging toward an information singularity, a regime in which information is predominantly generated, validated, and acted upon by machines. We distinguish classical AI agents (bounded, policy-driven executors) from agentic AI, which exhibits goal-directed autonomy by planning multi-step workflows, calling tools and APIs, using memory, and iterating on outcomes. We show how agentic architectures enhance core IS types (TPS, MIS, DSS/ESS, ERP/CRM/SCM, BI) by shifting value from isolated predictions to end-to-end operational gains: shorter cycle times, fewer escalations, and higher data quality. The same shift relocates risk from model accuracy to system-level safety, including mis-specified objectives, over-permissioned tools, prompt-/retrieval-injection, cascading failures, cross-border data issues, provenance weaknesses, and automation bias amplified by seemingly “completed” machine actions. The chapter operationalizes governance through lifecycle controls (dataset lineage, versioned pipelines, evaluation gates, least-privilege scopes, human-in-the-loop (HITL) approvals, immutable audit logs, continuous adversarial testing), linking statutory/regulatory duties (e.g., EU AI Act) with practice frameworks (e.g., NIST AI RMF). We also address debates over AI personhood and argue for human-centered accountability.
Source: Kantsepolsky B. Managing Information Singularity, August 2026: 135-186
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Multilateral Efforts on Information Integrity: Why a Clear Definition Is Needed
Abstract: How should “information integrity” be understood in the context of the information environment? The term has seen increased use by researchers and policymakers, yet its relative newness means that there is a lack of consistency in its definition and scope. This chapter provides analysis on how “information integrity” has been defined across multilateral efforts and existing literature. Using John Gerring’s framework for “conceptual goodness”, it evaluates how existing conceptualizations of the term falls short and provides guidance on how information integrity can achieve conceptual goodness. Only by doing so can information integrity fulfill its potential in supporting multi-stakeholder coordination to improve the global information environment.
Source: Yadav K. Disinformation: a multidisciplinary analysis, January 2026; 489-511
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Combating Disinformation with News Literacy Interventions: An Experimental Study on the Framing Effects of News Literacy Messages
Abstract: Despite increasing academic attention, several questions about news literacy messages (NLM) remain unanswered. First, it remains unclear how differences in the framing of the NLMs may influence their effectiveness. Second, we still know little about how NLMs work and, in particular, whether people also adopt the recommendations they are given. To answer these questions, this study conducts an experiment in the Netherlands and Belgium, where we manipulate the frames of the NLM, comparing interventions using a “fake news” frame with those using a “reliable news” frame or a mix of the two. We also manipulate elements in the false news article that participants have to evaluate afterwards. Our findings show that all three types of NLMs are effective in making people resilient to misinformation, without resulting in a general decrease in trust in accurate news (=spill-over effect). In particular, news literacy media messages with a “mixed” frame are effective, as they make people critical toward false news articles, and also result in a higher perceived accuracy of accurate news articles. Additionally, the findings provide suggestive evidence that NLMs work, at least partly, because participants also adopt (some) of the recommendations being given.
Source: Van Erkel Patrick F A. The International Journal of Press/Politics, September 2024; 31(1): 140-160

Enhancing mis- and disinformation detection and understanding its influence: leveraging communication accommodation theory and information manipulation theory
Abstract: Addressing the detection and spread of mis- and disinformation presents a complex challenge. Using the Linguistic Inquiry and Word Count (LIWC) software, we examined the defining linguistic features that distinguish fake from authentic COVID-19 news. Drawing from Communication Accommodation Theory (CAT) and Information Manipulation Theory (IMT), we analysed 70 fake and 70 true news stories. CAT proved more effective than IMT in predicting linguistic cues, with fake news found to contain moralising language, interpersonal conflict, and informal speech markers, including swearing, netspeak, assent words, and exclamation marks – patterns consistent with hate speech. In line with IMT, fake news was found to exhibit higher frequencies of causation, future focus, and certitude words. True news unexpectedly contained more discrepancy terms, markers of clout, analytical thinking, positive emotion, and tentative language which might be explained by journalistic conventions that differ from dyadic interactions. Drawing from Social Identity Theory (SIT), we make the case that fake news stories may position themselves against ‘others’ rather than aligning with a group. This study offers a novel framework for future researchers in the science of detecting mis– and disinformation, and to further understand how fake news deceives at scale and influences unwanted behaviours.
Source: Whitty Monica T. Behaviour & Information Technology, Mar 2025

Diagnosing multimodal disinformation: the integrative ‘Three-M' framework of multimodality, manipulation, and malintent
Abstract: The ubiquity of short-video platforms (e.g., TikTok, Douyin, Kuaishou) has amplified the circulation of multimodal disinformation. To address this challenge, this study proposes an integrative theoretical ‘Three-M’ framework (multimodality, manipulation, and malintent) to examine the construction, dissemination, and politicization of disinformation. Moving beyond synthetic taxonomies, the framework demonstrates that analyses confined to modal complexity, technical manipulation, or intent in isolation risk misdiagnosing how multimodal affordances are strategically mobilized to operationalize deception. By treating multimodality, layered manipulative strategies, and malintent as analytically inseparable, the model reveals how specific cross-modal configurations enable tactical credibility-building while embedding broader ideological projects. Through a case study of disinformation related to the 2023 French Riots on Chinese short-video platforms Douyin and Kuaishou, this research investigates the actors responsible for disinformation production and dissemination, the semiotic strategies underpinning its multimodal architecture, and the sociopolitical malintents driving its circulation. Findings reveal a prevalent ‘truth-weaving’ tactic, where disinformation is strategically embedded within factual elements to enhance its credibility, underscoring how multimodal coherence operationalizes both tactical deception and strategic ideological narratives.
Source: He K. Information, Communication & Society, March 2026

Informational Quarantine: Should It Be Punishable to Spread Medical Disinformation During a Pandemic?
Abstract: The effectiveness of medical measures to fight a pandemic cannot be reduced to their technical and scientific properties. For example, the success of the vaccination process depends partially on the information around them. Part of society may reject safe and effective vaccines if they are perceived as dangerous. Hesitancy to vaccines could translate into a threat to individual lives, public health, and the economy. Many measures may hinder the dissemination of harmful content related to vaccines. This chapter discusses the idea of “informational quarantine,” an ethical rule that should be applied concerning information crucial for counteracting the pandemic. It adds to the discussion about disinformation and the issue of the individual responsibility of the users for spreading it. This chapter suggests the time of a pandemic could be a circumstance that could justify introducing criminal law protection of information concerning vaccines that should be applied only during the course of a pandemic, for the most harmful ways of violating “informational quarantine.”
Source: Mamak K. Business Ethics in the Healthcare Industry, January 2026; 145-158

Artificial Intelligence, Misinformation, and Libraries: A New Frontier for Information Professionals
Abstract: Generative artificial intelligence (AI) has experienced rapid advancement, fundamentally transforming the information landscape. This technological shift has not only amplified the dissemination of misinformation but has also posed significant challenges to conventional frameworks of trust and verification. This paper explores the dual impact of AI: its potential to enhance information services while simultaneously amplifying misinformation and disinformation. Seven AI-generated misinformation cases between 2022 and 2025—ranging from deepfakes and political propaganda to impersonation and amplification were analyzed. Through thematic case analysis and interdisciplinary synthesis, the study proposes the AI-Misinformation Resilience Model (AIM-RM), a conceptual framework guiding proactive responses across verification infrastructure, digital literacy, and ethical policy engagement. Drawing on recent scholarly literature and grounded in information ethics, epistemic trust, and sociocultural literacy, the model offers a path forward for LIS professionals seeking to navigate the post-truth era.
Source: Salubi O. Proceedings of the Association for Information Science and Technology, October 2025; 62(1): 572-581
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5 Practical Ways Librarians Can Tackle Misinformation and Build Critical Thinkers
Abstract: Misinformation spreads fast and it’s getting harder to stop.
False or misleading content travels quickly because it taps into our emotions. It’s entertaining, shocking, comforting – or all three. According to a well-known MIT study, falsehoods on social media can travel up to ten times faster than the truth. It reaches us through outrage, fear, or belonging, long before we even realise we’ve been hooked.
Meanwhile, trusted systems like third-party fact-checking are being phased out, and community tools such as X’s Community Notes often struggle with anything emotional, partisan, or complex. Many misleading posts go unchallenged simply because consensus can’t be reached.
But in the middle of this information disorder, libraries and librarians stand firm.
We are the original fact-checkers. We answer questions with care and context, not algorithms or AI models. That puts us in a powerful position to help learners and communities navigate today’s information chaos. And we don’t have to do it with dry lectures or grim warnings.
Here are five engaging ways to help your library users build resilience, curiosity, and critical awareness.
Source: Bilobrk C. Simple Little Library System, September 2025; 7(2): 232-43

Addressing Mis- and Disinformation on Social Media
Abstract: The value of accessible and reliable information was made abundantly clear during the COVID-19 pandemic. Amid high levels of uncertainty, auditing the most important developments and emerging evidence from the deluge of content was no easy task. A significant proportion of all information in circulation was false or misleading, making navigating public health and policy choices even more problematic. This chapter focuses on the challenge of responding to mis- and disinformation while respecting freedom of expression, particularly in times of crisis.
Source: Canela G. Managing Infodemics in the 21st Century: Addressing New Public Health Challenges in the Information Ecosystem, May 2023: chapter 9

Misinformation
Abstract: Now, more than ever before, we are faced with an information crisis. The internet, social media and AI are all contributing factors to the influx of misinformation, disinformation and malinformation that we are all faced with.
Misinformation is the spread of incorrect or inaccurate information, but with no ill-will. The individual does not know it isn't true.
Disinformation is the intentional spread of incorrect or inaccurate information. The individual knows it isn't true.
Mal-information is the spread of accurate information, but done in a way to harm another person.
So, what can we do about it?
We've gathered a collection of resources that tackle exactly that question. Critical thinking skills have always been essential, and these resources help us to develop and deepen those skills in a time where we may need them more than ever.
Source: The Open University; 2026

Misinformation and Disinformation: Literature Review
Abstract: This briefing provides an overview of the available academic and grey literature on misinformation and disinformation, with a particular focus on the available evidence for the UK.
It seeks to answer the following questions:
• What is the nature of misinformation and disinformation?
• How do we measure the prevalence of misinformation and disinformation?
• Who is susceptible to believing misinformation and disinformation?
• What interventions and mitigations are effective against misinformation and disinformation?
Source: Ofcom, May 2025

Co-creating ways to navigate and mitigate against mis and disinformation: Report for Ofcom by Verian
Abstract: Under the Communications Act 2003, Ofcom has statutory duties to promote and to carry out research into media literacy. The Online Safety Act 2023 added clarification and specificity to our media literacy duties. Amongst other things, it requires Ofcom to build public awareness about a range of media literacy and online safety issues, and a duty to help users understand the nature and impact of disinformation and misinformation, and to reduce exposure to it. This qualitative report is the culmination of a mixed-methodology programme of research designed to add to the evidence base of understanding of mis and disinformation in the UK. Our quantitative research, published in November 2024, laid the foundations by providing evidence of how UK adults think and feel about “false or misleading” information: where they see it, why they think it’s false or misleading, and what they do and feel as a consequence. Our quantitative survey demonstrates that susceptibility to mis and disinformation is context-specific: there are differences in attitudes and behaviour across topic areas as well as the formats of information. So, rather than specific groups being more susceptible than others, it is more useful to think of groups in terms of their patterns of susceptibility. Anyone can be considered susceptible in different ways and at different times, so we took the view that the qualitative stage of the research should include participants from all segments of society. In addition, the quantitative data set allowed us to identify three groups that were of particular interest in relation to mis and disinformation, as they reported encountering it more often, were more concerned about its impacts, expressed an interest in finding out more, and/or had lower accuracy in identifying true statements on a range of topics in the survey. These groups were young people aged 16-34, those from ethnic minority backgrounds, and those for whom English was not a first language. Our sample structure for this qualitative research (set out in Appendices 1 and 2) reflected our desire to hear from a broad sample of the UK population, as well as to specifically give a voice to individuals from these 'overlap' groups* in relation to mis and disinformation. This report sets out the findings from in-depth interviews, expert roundtables and co-creative workshops, exploring the approaches, messages, and trusted voices that might be most resonant with different groups when countering mis and disinformation.
Source: Outhwaite S. Verian, May 2025

Impact of strategies to mitigate misinformation in diverse settings and populations: a protocol for a living evidence synthesis
Abstract:
Introduction
Misinformation refers to inadvertent misleading information that the public may be exposed and share without intent to cause harm, and can delay or prevent effective care, affect mental health, lead to misallocation of health resources and/or create or exacerbate public-health crises. There are many strategies to address misinformation, but there is a need to evaluate their effects. Our objective is to synthesise and routinely update evidence to assess the impact of strategies to mitigate health-related misinformation in diverse settings, and populations.
Methods and analysis
We will search seven databases in May 2023 with planned updates at 6 and 9 months, which will be supplemented with searches for grey literature and reference lists of included studies and contacting experts. Two reviewers will independently screen all search results for studies that evaluate one or more approaches to addressing health-related misinformation. One researcher will conduct data extraction and risk of bias assessments, which will be reviewed by a second reviewer for accuracy. We will include experimental, quasi-experimental and observational studies for any populations, settings and diseases without language or publication restrictions. We will conduct quantitative analysis if meta-analytical pooling is possible. If pooling is not possible, we will synthesise quantitative data according to outcomes and interventions addressed, and present a narrative summary of findings disaggregated by sex and/or gender, irrespective of whether differences were found.
Ethics and dissemination
There are no individuals or protected health information involved and no safety issues identified. Results will be published through the Global Commission on Evidence and COVID-END websites, in a peer-reviewed journal, as well as through plain-language materials.
Source: Wilson M. BMJ Open, October 2023; 13(10): e076672

Librarians as guardians of information quality: navigating the challenges of misinformation and disinformation
Abstract:
Purpose
This study aims to explore the pivotal role of libraries in combating misinformation and disinformation in the contemporary information landscape, emphasizing their significance as guardians of information integrity.
Design/methodology/approach
Drawing on a review of literature and surveying librarian perspectives, this study examines the multifaceted strategies used by libraries to address misinformation and disinformation. It delves into the roles of librarians in distinguishing between different forms of false information, promoting information literacy and fostering community engagement.
Findings
Libraries serve as bastions of knowledge, curating diverse and reliable resources while actively combating false information through educational initiatives, technological innovations and community outreach. Librarians play a crucial role in empowering users with the skills to critically evaluate information and navigate the complexities of the digital age.
Originality/value
This study contributes to the scholarly discourse by highlighting the evolving role of libraries as guardians of information integrity in the face of misinformation and disinformation. It underscores the importance of libraries in promoting a more informed and resilient society, enriching public discourse with the values of truth and understanding.
Source: Adewojo Akinade A. Library Hi Tech News, July 2024; 42(10): 9-12
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Librarian Perspectives on Misinformation: A Follow-Up and Comparative Study
Abstract: While academic librarians have been quick to respond to the crisis of misinformation through information literacy instruction and tool development, little research exists on the extent to which they are teaching news literacy skills in the classroom. This study explores academic librarians’ perspectives on misinformation and whether they are addressing misinformation in their teaching. The results are compared to a previous study on faculty perspectives. Findings show that librarians are concerned about misinformation and are integrating it into their instruction. While their concerns and activities overlap with discipline faculty in many respects, some significant differences exist which might cause barriers to further implementation.
Source: Saunders L. College & Research Libraries, 2023; 84(4)

The role of libraries in misinformation programming: A research agenda
Abstract: Misinformation, or fake news, has exploded across social media platforms and communities over the past few years, with serious social and political implications. Many library practitioners and organizations have argued that libraries can and should play a central role in educating the public about this emerging issue. However, serious gaps exist in understanding how libraries can create effective community education about misinformation. This article maps out a research agenda that researchers and public library practitioners can use to make libraries more effective sites for combatting misinformation. This research agenda is grounded in analysis of interviews and workshop discussions of public library staff from Washington State. This analysis reveals three areas in which academic partners can support public libraries: through the design of effective programming, through the development of tools that help librarians keep up-to-date on relevant misinformation, and through interventions in the political and economic contexts that hamper the freedom of librarians to engage controversial topics. Our hope is that this article can help to spur more expansive library and information science research across these areas and become the beginning of a longer and more empirically grounded conversation about how public libraries can achieve their potential for combating misinformation.
Source: Young Jason C. Journal of Librarianship and Information Science, October 2020; 53(4)

Academic Librarians and Information Literacy Practice in an Age of Mis/Disinformation
Abstract: This paper presents findings from a study exploring Australian academic librarians' concerns about the impact of misinformation and disinformation on society, university students and access to reliable information. It also investigates strategies librarians consider effective for addressing mis/disinformation through information literacy programs. Sixty-two librarians responded to a survey comprising Likert scale and open-ended questions. Respondents expressed the greatest concern about the influence of mis/disinformation on news media and social media. There was strong agreement that mis/disinformation should be regulated on social media and that librarians play a key role in addressing it through information literacy. However, views on the importance of AI solutions were more divided. Demographic analysis revealed nuanced differences: those currently not working directly with students were more likely to agree that AI has an impact on combatting mis/disinformation compared to colleagues with face-to-face teaching responsibilities. As approaches to combating mis/disinformation through information literacy continue to evolve, and with rapid technological change including AI, there is an urgent need to rethink information literacy instruction, integrating media and AI literacy, to equip students with the skills required to recognise and combat mis/disinformation.
Source: Johnston N. Journal of the Australian Library and Information Association, April 2026; 75(2): 321-339

Libraries roles and practices to enhance information resilience: Academic librarians’ perspectives 

Abstract: COVID-19 has changed the information landscape. The results were the wide spread of information of all kinds and from all sources, leading to increased information disorder (i.e. disinformation, misinformation practices). This study aimed to explore the practices of academic libraries during times of crisis from the staff perception in four public universities in Jordan to correct the information disorder and hence create information resilience among community members. Exploring these practices helps shed light on the libraries’ contribution to creating information resilience practices and hence an information-resilient community. An interview was used to collect deep insights from 26 library staff working in the Information Division at the four academic libraries. The results were mainly directed towards the importance of increasing community awareness and providing access to quality information sources. It also affirmed the importance of information skills to help individuals locate the right and accurate information. It was affirmed that developing and promoting information literacy programmes was the main pillar to countering information disorder and establishing information resilience. The findings will provide insights for other academic libraries on the best practices to create an information resilient community.
Source: Hamad F. Journal of Information Science, September 2023; 52(2): 383-397
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Clinical Governance: June 2026

Welcome to the latest key papers and publications focussing mainly on clinical governance.

Please click on the links below and enter your OpenAthens username and password to download the full text or contact the library at esth.hirsonlibrary@nhs.net to request the full text.

Clinical governance
Abstract: Clinical governance is the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence will flourish (Department of Health).
Clinical governance encompasses quality assurance, quality improvement and risk and incident management.
Source: NHS England, Feb 2026

The Seven Pillars of Clinical Governance
Abstract: In today’s ever-evolving landscape of healthcare, ensuring the delivery of high-quality clinical care is paramount, especially within the NHS. To achieve this goal, healthcare organisations must implement a robust framework known as clinical governance.
Source: Flint J. Salford Professional Development, Jan 2024

What is clinical governance?
Abstract: Our health inequalities hub shines a light on case studies focusing on health inequalities from councils across the country.
Source: Macfarlane A J R. BJA Education, Mar 2019; 19(6): 174-175

Shared clinical governance arrangements between NHS and independent acute hospitals in England: Findings from a national survey of senior leaders
Abstract:
Objectives:
To present the findings from a national survey of senior leaders in NHS and independent hospitals in England concerning the effectiveness of shared arrangements for clinical governance. To provide a comprehensive overview of shared arrangements for the oversight of consultants' practice, processes for appraisal and revalidation, and the management of significant concerns. The results from this study will improve understanding of the practical functioning of clinical governance processes at the interface between the NHS and the independent sector.
Methods:
Between December 2023 and April 2024, an online survey was distributed to senior leads with governance responsibilities in NHS and independent hospitals in England.Results320 responses were received (response rate 42%), 235 from individuals working in NHS trusts (response rate 40%) and 85 from individuals in independent hospitals (response rate 48%). Respondents reported that some clinical governance arrangements are established across both sectors, with some relationships characterised as positive and relatively strong. However, relationships often depended on goodwill, personal connections, and consultant probity, rather than the systematic implementation of recommended processes. Respondents expressed concerns regarding the non-mandatory and unregulated nature of processes for sharing concerns, believing this led to insufficient resources and challenges in verifying information. They called for improved data quality, better communication and information sharing and more robust and formalised processes.
Conclusions:
Shared clinical governance arrangements between the NHS and independent sectors are in place in some but not all of the organisations where respondents' consultants worked. This raises concerns about progress towards implementing the Paterson inquiry recommendations, including access to consultants' whole practice information and sharing concerns about consultants working across different providers. The findings may also hold relevance for international audiences where medical staff work across multiple healthcare providers. Further empirical research is needed to compare clinical governance arrangements between the NHS and independent sectors, and suggest how shared clinical governance can be organised to assure the quality and safety of care.
Source: Stringer G. Journal of Health Services Research and Policy, Mar 2026; 19: 13558196261431315

Monitoring the safe delivery of new invasive interventional procedures and devices: an analysis of NHS organisation policies
Abstract:
Background:
The introduction and monitoring of innovative invasive procedures and devices (IP/Ds) was included in the Independent Medicines and Medical Devices Safety (IMMDS) Review led by Baroness Cumberlege. Currently, innovative IP/Ds may be undertaken with local National Health Service (NHS) organisation approval via new procedure committees (NPCs) or approval from the Health Research Authority (HRA). The National Institute for Health and Care Excellence Interventional Procedures Advisory Committee (NICE IPAC) provides guidance for appropriate approvals. Outcome monitoring is performed to inform decisions about continuing with the new IP/D or abandoning/pausing if safety data show signals of harm; this is the responsibility of local hospitals. Hospital policies for this process have hitherto not been investigated.
Aim:
To explore local hospital NPC processes for monitoring clinical and safety outcomes and decision-making regarding the delivery of new IP/Ds.
Methods:
NHS organisation policies for the introduction of new IP/Ds from England and Wales were systematically examined using a standardised extraction form developed a priori. All policies and associated documents were analysed using the principles of content analysis, and information extracted included (1) the collection of safety and outcome data for approved IP/Ds; (2) requirements to adhere to NICE guidance and (3) how committees decide to abandon/pause the use of new IP/Ds.
Results:
All policies (n=113) included information about monitoring outcomes of new IP/Ds. Substantial variation between hospitals in monitoring requirements was observed. Just 66 provided details of safety reporting oversight methods. Only 72 policies explicitly recommended following NICE IPAC guidance for the IP. Information about how decisions were made to abandon/pause new IP/Ds was included in 25 policies.
Conclusion:
There is a disparity among hospitals in how outcome and safety data of new IP/Ds are monitored. This has implications for patient safety. Our findings support the IMMDS report recommendations for the need for better oversight and governance of innovative IP/Ds, including collecting and sharing robust outcome data to inform decision-making.
Source: Wallis L. BMJ Open Quality, May 2025; 14(2):

A national review of NHS policies and patient perspectives on surgical video: a prospective, mixed methods qualitative analysis
Abstract:
Background:
Robust governance policy is a fundamental requirement for the adoption of routine surgical video recording at scale. The true extent of existing local National Health Service (NHS) policies relevant to the recording of surgical video is currently not known, as are patient attitudes to the use of these videos by healthcare providers.
Methods:
This was a prospective, mixed methods qualitative analysis. All 144 NHS trusts/boards in England and Wales were asked to provide policies relating to surgical video between 20th February and 20th March 2023. Policies were assessed in accordance with United Kingdom (UK) General Data Protection Regulation (GDPR) principles. A patient and public questionnaire was performed on 14th September 2024 to analyse public views on the role of surgical video within healthcare and to identify issues surrounding video recording of surgical procedures within the NHS.
Findings:
143/144 (97.9%) NHS trusts/boards responded to the request. Relevant policies were provided by 43/144 (29.9%) trusts/boards. 35/43 (81.4%) addressed consent processes clearly, 21/43 (48.8%) provided clear statements regarding patient access, and 35/43 (81.4%) policies asserted the trust/board's copyright. 19/43 (44.2%) clearly stated data minimisation and data accuracy requirements. 11/43 (25.6%) stated storage duration and 20/43 (46.5%) specified storage location. 255 members of the public completed our surgical video questionnaire. Identified expected uses of video were education, record keeping, and research; benefits were its use as an educational tool, objective evidence of the procedure, and patient satisfaction; concerns were raised about data privacy, consent, and security. 80/255 (31.4%) of participants agreed that all surgical procedures should be recorded. 186/255 (72.9%) would be interested in their own procedure. Video use for surgical quality assurance (236/255, 92.5%), education (241/255, 94.5%), and research (242/255, 94.9%) was supported.
Interpretation:
The majority of NHS trusts/boards do not have policies governing surgical video recording, use, and/or storage. The supplied policies addressed UK GDPR principles variably, focusing mainly on consent. Patients strongly support the use of surgical video for quality assurance and education, but there is disagreement if this should be performed routinely. The discordance between patient expectation and current NHS practice for the routine recording of surgical video must be addressed when policy is revised.
Source: Yiu A. eClinicalMedicine, Oct 2025; 88: 103490

Making clinical guidelines work for people with multiple long term conditions: analysis and recommendations from review of single condition guidelines
Abstract:
Objectives:
To evaluate how UK guidelines for individual health conditions consider coexisting multiple long term conditions and to propose improvements to guideline development processes so that guidelines appropriately account for and consider coexisting multiple long term conditions.
Design:
Analysis and recommendations from review of single condition guidelines.
Setting:
Clinical guidelines developed by the National Institute for Health and Care Excellence (NICE), UK, 1 January 2013 to 31 December 2024.
Population:
56 clinical guidelines developed by NICE covering a broad range of long term conditions.
Main outcome measures:
The extent to which guideline recommendations consider multiple long term conditions and coexisting conditions, distinguishing between concordant conditions (those affecting the same organ system as the index condition) and discordant conditions (those affecting different systems).
Results:
All but one of the NICE guidelines (n=55, 98%) included some advice on managing the index condition in the presence of coexisting conditions, and 50 (89%) guidelines offered general guidance on tailoring care. Only 11 (20%) guidelines, however, explicitly referred to multiple long term conditions, and none included a dedicated section on multiple long term conditions or how care should be adapted in this context. 19 (34%) guidelines featured sections looking at specific coexisting conditions or coexisting conditions generally. Coverage of coexisting conditions varied widely across categories of conditions, with mental health guidelines dealing with the most coexisting conditions (median 10, interquartile range (IQR) 4.5-14.75) in contrast with guidelines on cancer and eye disease covering the fewest conditions (median 3, 1-4.5; median 3, 2.25-2.75, respectively). Of the 397 possible concordant pairings, 120 (30%) were referenced, whereas of the 3859 possible discordant pairings, 259 (7%) were referenced, indicating greater coverage of same system combinations. Data on the composition of guideline committees showed wide variation in size, disciplinary diversity, inclusion of generalist clinicians (eg, general practitioners, general physicians, or others with no single specialty focus), and public contributors, although lived experience of multiple long term conditions was rarely specified.
Conclusions:
Despite widespread acknowledgement of coexisting or multiple long term conditions, NICE guidelines are predominantly condition specific and offer limited tailored support for the care of multiple long term conditions. Recommendations rarely considered common condition clusters or the cumulative effect of multiple long term conditions. Structured improvements, such as clearer guidance on adapting care, broader cross condition referencing, and more transparent inclusion of lived experience could enhance the relevance and usability of guidelines for clinicians managing patients with multiple long term conditions.
Source: Pretorius S. BMJ Medicine, Feb 2026; 5(1): e001495

Report on an audit of two decades’ activities of a clinical ethics committee: the Newcastle upon Tyne Hospitals NHS Foundation Trust Clinical Ethics Advisory Group (CEAG)
Abstract:
Background:
‘The Clinical Ethics Advisory Group’ (CEAG) is the clinical ethics support body for Newcastle upon Tyne Hospitals National Health Service Foundation Trust. A significant change in CEAG’s way of working occurred over the past 5 years as a result of Court decisions, increasing public expectations and an increase in CEAG’s paediatric case flow.
Purpose:
Review historical data: (a) as a useful benchmark to look for the early impact of significant service changes and (b) to seek possible reference (‘sentinel’) cases for use with a posited practical (casuistic) case-based reasoning model.
Methods:
Audit of the minutes of the first 22 years’ meetings was undertaken by the two chairs of CEAG over that period of time.
Results:
223 matters discussed: 86 Trust policy issues; 117 clinical cases (84 adult (32 urgent), 33 child (8 urgent)); 12 CEAG procedural issues and 8 UK Clinical Ethics Network ‘round robin’ cases. The range of topic areas was wide. A broad range of ethical structures were deployed, principlism predominated. Quality was subjectively assessed by each reviewer, but different methods were used. This proved highly concordant between the two reviewers. 47% (105/223) of discussions were ‘excellent’ (*A4C4–A4C4) and 70% (156.5/223) ‘good’ or better (*A4C4–A3C3). By meeting the criteria of ‘excellent’ and ‘prospective’, 92/223 (41%) of matters were deemed potentially suitable as sentinel cases.
Conclusions:
The audit provides a rich vein of information. There is demand for CEAG’s services, workload is becoming more complex. Formal funding for such services seems justified.
Source: Mohindra Raj K. Journal of Medical Ethics, Aug 2025; 51(8)

Clinical referral to the NHS following multi-cancer early detection test results from the NHS-Galleri trial
Abstract:
Introduction:
The large, randomised, controlled NHS-Galleri trial (NCT05611632) is assessing the clinical utility of a multi-cancer early detection (MCED) test for asymptomatic cancer screening in England. We describe how we enabled the efficient referral of trial participants into existing National Health Service (NHS) urgent suspected cancer pathways for diagnostic investigations.
Methods/Results:
Participants were enrolled across eight of the 21 Cancer Alliance regions in England, served by 56 Hospital Trusts. We used the existing NHS e-Referral Service (e-RS) and a new e-referral form to enable referrals from the trial into any participating Trust, and to standardise information provided with trial participant referrals. Referrals were made by trial nurses directly into secondary care, minimising any additional burden on primary care. At most Trusts, a designated Trust-based referral coordinator triaged referrals and referred participants into the most appropriate local pathway, selected based on the tissue type or organ associated with the cancer signal (cancer signal origin; CSO). At other Trusts, trial nurses referred participants into the appropriate pathway. Guidance mapping predicted CSO(s) to NHS pathways was provided by the trial team to help clinicians understand trial referrals. The trial team and Trust referral coordinators were responsible for central and Trust-level safety netting measures, respectively.
Conclusions:
To our knowledge, the NHS-Galleri trial has established the first model for the standardised clinical referral of asymptomatic individuals from a trial into NHS standard-of-care cancer pathways. We hope insights from our work could help accelerate screening trial conduct in the UK, and support MCED population screening programme implementation in future.
Source: Lowenhoff I. Frontiers in Oncology, May 2025; 15

Clinical guidelines and pathways for the management of non-traumatic wrist disorders: A review and synthesis
Abstract:
Introduction:
Non-traumatic wrist disorders (NTWD) are commonly encountered across a range of healthcare settings. Uncertainty exists regarding optimal management and how this is reflected in care provision through clinical guidelines and pathways. We aimed to identify existing UK-based clinical guidelines and pathways and examine their quality.
Methods:
For this review, we searched MEDLINE, PubMed, Embase, CINAHL, ProQuest, Scopus, Web of Science, Google, The National Grey Literature Collection, TRIP, and the National Institute for Health and Care Excellence and undertook targeted outreach and engagement activities with healthcare professional networks. We included clinical practice guidelines and pathways for NTWD published after 2010. The AGREE II tool was used to assess guideline quality based on the domains of topic selection, best practice identification, data collection, and rigor of analysis.
Results:
Of 7017 records identified, 15 eligible clinical guidelines and pathways for NTWD management were eligible and included. De Quervain’s tenosynovitis and ganglion cyst were most frequently covered while other NTWD had few or no guidelines or pathways. Variation in the composition and nomenclature of sources was found. Quality assessment using the AGREE II tool identified variability and overall unsatisfactory quality.
Conclusion:
There is a lack of high-quality clinical guidelines and pathways for NTWD within the UK healthcare system indicating an obstacle to improvements in healthcare delivery.
Source: Myers C. European Observatory on Health Systems and Policies, 2025

Embedding equity, diversity and inclusion processes within clinical trials and health and social care research
Abstract:
The lack of diverse and inclusive clinical research populations fuels health inequalities in the UK, and there is an urgent need to reverse this. This communication provides a practical framework for positive action to integrate equity, diversity and inclusion (EDI) processes into clinical research design, protocols and implementation and to establish accountable clinical research systems that are trustworthy to the public and accessible to diverse communities.
This framework is a consensus- based guide developed by the Equality, Diversity and Inclusion working group of the National Institute for Health and Care Research’s (NIHR’s) Clinical Research Network in North West London. This work involved analysing challenges to integrating EDI within the clinical research process, such as clinical trial protocols as directed by industry sponsors and National Health Service investigator teams. It aligns with the UK government’s clinical research strategy and NIHR’s INCLUDE project.
It advises an interconnected approach to embedding EDI throughout the clinical research lifecycle. By following this framework, we aspire to guide clinical research towards a more equitable, inclusive and representative model that better serves the needs of all populations.
Source: Gedela K. BMJ Open, Mar 2025, 15(3)

Health Bill brings NHS management back into government
Abstract:
The government’s narrative is that the NHS must become more democratic to run effectively. But the legislation includes a range of changes to how the health service operates, spanning digital and data policy to the role of patients.
Source: Alderwick H. BMJ, May 2026; 393: s958

Digital Capability, Open-Source Use, and Interoperability Standards Within the National Health Service in England: Survey of Health Care Trusts
Abstract:
Background:
In 2016, the National Health Service (NHS) England sought to drive digital transformation within select NHS trusts through the Global Digital Exemplar (GDE) program. While the program did advance the NHS’s integration with digital technologies, disparities in digital maturity persisted between GDE-funded and nonfunded NHS trusts. The Department of Health and Social Care (DHSC) launched a data strategy in 2022 that aimed to develop the appropriate technical infrastructure and data architecture to enable more effective and efficient use of its data. Given the diversity in digital capabilities, open-source adoption, and interoperability standards within NHS services, official guidance has continued to struggle to provide effective unification. Data about capabilities and technologies from application development teams in the NHS trusts, crucial for advancing these areas, remains insufficient.
Objective:
This study aimed to further document the capabilities and technologies used in the NHS to develop digital capacity, comparing those with standard funding against those with additional GDE funding. This comparative analysis provides a foundational understanding for evaluating current practices and identifying potential areas for improvement in the NHS digital transformation efforts.
Methods:
This study was conducted using Freedom of Information (FOI) requests and systematic website searches. The Freedom of Information Act (FOIA) allows individuals to request information held by public authorities. This process supports transparency and accountability by ensuring public access to government data. Data were compiled from two sources: (1) FOI requests submitted to NHS trusts between July 2020 and December 2020, and (2) systematic website searches for technology conducted between August 2020 and July 2021. A series of chi-square tests was conducted to validate and strengthen the robustness of the FOI questions.
Results:
A total of 191 (84.5%) of the then 226 NHS trusts completed the FOI request, and 161 of the 191 (84%) had software and app development, website, or innovation teams. A total of 112 (69.6%) teams developed front-facing service user websites and apps. Out of 191, 150 (93.2%) worked with clinical staff to formulate innovative ideas, 55 (34.2%) carried out developments for other trusts and external entities, 35 (21.7%) had attempted to secure an innovation grant, and 138 (86%) disclosed the technologies they use. A total of 25 (15.5%) said they always used open-source technology, and 24 (17%) disclosed technologies associated with interoperability standards in their responses.
Conclusions:
The NHS must adopt a cohesive strategy and refine policies to ensure the success of its digital, open-source technology and interoperability standards initiatives. Five recommendations toward greater organizational interoperability are made by the authors. Future research should examine digital innovation across NHS trusts, focusing on barriers such as limited resources, organizational culture, and technical expertise. Identifying these challenges is essential for developing strategies to reduce disparities and promote equal progress.
Source: Elliott H. BMJ Open, Oct 2025; 15(10): e102163

Governing AI with trust: an adaptive framework for institutional legitimacy in the UK public sector
Abstract:
Purpose:
This study aims to examine the limitations of artificial intelligence (AI) regulation in the UK public sector, particularly its fragmented and non-binding nature. It argues that current regulatory approaches lack the institutional coordination, legitimacy and transparency required to foster public trust in algorithmic decision-making. The paper proposes a conceptual model that reframes trustworthy AI not as a product of compliance or ethics alone but as the outcome of adaptive, legitimacy-centered governance.
Design/methodology/approach:
The study uses a conceptual policy analysis approach, synthesizing literature from public administration, regulatory theory and AI governance. It critically assesses the UK’s “pro-innovation” regulatory model and develops a governance-oriented framework grounded in legitimacy, coordination and accountability. The framework is supported by illustrative cases from National Health Service AI applications and the GOV.UK algorithmic transparency initiative, with broader applicability discussed in relation to other public sector domains.
Findings:
The analysis finds that non-binding, sector-led regulation in the UK lacks institutional alignment and accountability mechanisms, undermining public trust. The proposed framework reframes AI governance as a dynamic process of inter-agency coordination, transparent oversight and legitimacy production.
Research limitations/implications:
As a conceptual paper, this study does not present empirical validation. However, it offers a testable framework for future research. The model can be adapted for comparative studies or case-based evaluation in other governance domains such as justice or finance, and it calls for the development of legitimacy indicators and enforcement mechanisms in AI policy.
Practical implications:
This framework provides actionable guidance for policy designers, suggesting the need for institutionalized coordination, independent review bodies and legitimacy-based metrics for public sector AI oversight. It supports the design of governance models that go beyond technical compliance and embed trust and accountability into digital systems.
Social implications:
By positioning legitimacy as a governance outcome, the framework underscores how AI policies should address not only risks but also public perception, equity and institutional behavior. It highlights the role of citizen engagement, redress mechanisms and transparency in sustaining democratic accountability in algorithmic systems.
Originality/value:
This article makes an original contribution by framing AI governance as a public trust challenge and proposing a conceptual model rooted in legitimacy, institutional coordination and adaptive oversight. Unlike principle-based or compliance-driven approaches, the model bridges legal regulation and democratic accountability, offering a realistic, governance-centered alternative for the public sector.
Source: Cojocaru A. Emerald Insight, Dec 2025; 1-22
Contact the library for a copy of this article

Implementing integrated care infrastructure: A longitudinal study on the interplay of policies, interorganizational arrangements and interoperability in NHS England
Abstract: This essay was written by the Centre for Local Economic Strategies and The King's Fund, as part of a programme of work commissioned by The Health Foundation. Strategic authorities and integrated care systems are increasingly powerful entities with the potential to tackle health inequalities and improve population health. However, achieving this will require them to work together effectively. This essay explores the changing policy context in which these bodies exist, and the way the dynamics between them could and should evolve as devolution beds in.
Source: Elizondo A. Health Policy, Oct 2025; 160: 105237

Improving productivity in the NHS
Abstract: No abstract available.
Source: Gainsbury S. BMJ, Aug 2025; 390: r1722

Reforming financing of the NHS
Abstract: No abstract available.
Source: Mays N. BMJ, Sep 2025; 390: r1948

Can a digital NHS be equitable?
Abstract: No abstract available.
Source: Morley J. BMJ, Jun 2025; 389 :r1317

Does the English NHS 10-year health plan offer transformational change and a break with the past or more of the same?
Abstract: No abstract available.
Source: Hunter D J. Journal of Health Services Research and Policy, Apr 2026; 31(2): 69-71

How Were Patient Safety Incidents Responded to, Investigated, and Learned From Within the English National Health Service Before the Implementation of the Patient Safety Incident Response Framework? A Rapid Review
Abstract:
Objective:
To understand how National Health Service organizations routinely responded to, investigated, and learned from patient safety incidents in England before the implementation of the Patient Safety Incident Response Framework, and to identify associated success criteria and barriers.
Methods:
We followed rapid review methodology and searched 2 electronic databases. We aimed to identify and synthesize literature regarding patient safety incident response, investigation, and learning within the English National Health Service, before the implementation of the Patient Safety Incident Response Framework.
Results:
Nineteen articles were included. A narrative synthesis generated 4 concepts: (1) a multifaceted reporting culture, (2) investigation processes, (3) the landscape of support and involvement, and (4) opportunities to learn. Barriers to incident reporting included time, task characteristics, a culture of blame, and lack of feedback. Root cause analysis was cited as the most common investigation method. Studies outlined points of support and involvement for patients and families, the importance of supporting and involving patients and families, and acknowledged contributions from patients and families may be overlooked currently. For health care staff, the need for timely and personalized support soon after an incident was emphasized. Studies underlined the limitations of current approaches to learning and improvement.
Conclusions:
These findings lend support to the challenges associated with health care systems' infrastructures and strategies for responding to and learning from patient safety incidents. These challenges centre on 2 interrelated issues: the investigative challenges of rigorously conducting systems analysis and learning-oriented improvement; and the relational challenges of supporting genuine relationships of care, open and honest communication, and supportive engagement after patient safety incidents.
Source: Louch G. Journal of Patient Safety, Aug 2025; 21(5): e42-e55

Patient Safety Incident Response Framework
Abstract: The Patient Safety Incident Response Framework (PSIRF) sets out the NHS’s approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety.
Source: NHS England, 2026

Introduction to PSIRF
Abstract: At its core, PSIRF helps healthcare providers investigate and respond to incidents in a way that prioritises learning, systems thinking, and meaningful involvement of patients, families, and staff. It ensures that safety investigations are focused not just on what happened, but why it happened, so that changes can be made to reduce future risks.
Source: Patient Safety Incident Response Framework, 2026

Investigating under the Patient Safety Incident Response Framework (PSIRF): sharing HSSIB learning for future development
Abstract: This report shares learning and insights from HSSIB’s education and investigation teams about patient safety incident investigation under the Patient Safety Incident Response Framework (PSIRF).
Source: Health Services Safety Investigations Body, Oct 2025

Feasibility analysis of total quality management in medical quality management and its impact on work efficiency
Abstract:
Objective:
This study aimed to analyze the feasibility of total quality management (TQM) in medical quality management (focusing on three dimensions: management work efficiency, medical service quality, and safety quality) and to evaluate its impact on the work efficiency of medical staff.
Methods:
TQM was introduced in January 2023, serving as the dividing point between the pre-management period (January-December 2022) and the post-management period (January-December 2023). Fifty medical staff members from the same cohort were chosen as study subjects. Comparisons were made between the pre- and post-management periods in terms of work efficiency (hospital culture development, reward and punishment mechanisms, communication and coordination mechanisms, environmental hygiene management mechanisms, and adverse event reporting mechanisms), medical service quality, staff satisfaction, safety quality (incidence of adverse events, unplanned returns to the operating room, qualification rate of medical device sterilization, incidence of infection events, and medical complaints), and overall medical quality (medical safety management, medical training management, and medical hygiene supervision). Data were analyzed using SPSS 29.0. Paired-sample t-tests were employed for continuous variables (scale scores), while χ2 tests were used to categorical variables (satisfaction, safety quality).
Results:
After TQM implementation, the work efficiency of medical staff significantly increased (P < 0.001). Compared to the pre-management period, the post-management period exhibited higher medical service quality scores, greater overall staff satisfaction, lower incidences of adverse events, unplanned returns to the operating room, infection events, and medical complaints, a higher sterilization qualification rate for medical device, and enhanced medical safety, training, and hygiene supervision management (all P < 0.05).
Conclusion:
TQM is feasible and effective in medical quality management. Its implementation can enhance work efficiency and medical service quality among medical staff, improve satisfaction, strengthen safety quality, and comprehensively elevate overall medical quality.
Source: Shi P. Frontiers in medicine, Dec 2025; 12: 1701801

Quality management systems
Abstract: Quality improvement, by itself, does not represent a holistic approach to managing quality.
Quality improvement needs to be used alongside quality planning, quality assurance, and quality control to create a single, consistent management system.
Source: NHS England, 2026

Case Study: Total Quality Management (TQM) at the NHS
Abstract: Total Quality Management (TQM) has played an increasingly significant role in improving healthcare delivery within the
National Health Service (NHS) in the United Kingdom. As a publicly funded healthcare system facing rising demand, financial constraints and heightened public expectations, the NHS has adopted quality management approaches to enhance patient safety, service efficiency and organisational effectiveness. This case study examines how TQM principles have been applied within the NHS, highlighting key initiatives, achievements, challenges and lessons for healthcare quality improvement.
Source: Islam Mohammad T. Smart Life Skills, Feb 2026

Health Inequalities: June 2026

Welcome to the latest key papers and publications focussing mainly on health inequalities.

Please click on the links below and enter your OpenAthens username and password to download the full text or contact the library at esth.hirsonlibrary@nhs.net to request the full text.

What are health inequalities?
Abstract: Health inequalities are avoidable, unfair and systematic differences in health between different groups of people. There are many kinds of health inequality, and many ways in which the term is used. That’s why, when we talk about ‘health inequality’, it’s useful to be clear about which measure is unequally distributed and between which people.
Source: Jefferies D. The King’s Fund, Sep 2025

The Equality and Health Inequalities Hub
Abstract: Within this hub you will find information about NHS England’s statutory responsibilities around equalities and health inequalities and the national NHS programmes in these areas.
Programmes work across the NHS and with other agencies, people and communities to advance equalities; and achieve equitable access, excellent experience and optimal outcomes for the people we serve and the colleagues we work with.
Source: NHS England, 2025

Health inequalities hub
Abstract: Our health inequalities hub shines a light on case studies focusing on health inequalities from councils across the country.
Source: Local Government Association, 2025

Reducing health inequalities in your local area: a toolkit for clinicians
Abstract: This toolkit is intended to support clinicians working across the UK.
Source: BMA, Mar 2026

How we Support Reducing Health Inequalities
Abstract: At the TU, we are committed to addressing health inequalities in all areas of our work.
Guided by our enabling ethos and focus on population health, we work with our clients to improve patient health outcomes through inclusive, data-informed approaches. Our commitment to addressing health inequalities and championing equality, diversity and inclusion involve a comprehensive and sustained effort across all our work to ensure fair and equitable health outcomes for all.
Source: Transformation Unit, Aug 2025

Social determinants of health
Abstract: Social determinants of health – broadly defined as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources – have a powerful influence on health inequities. These are the unfair and avoidable differences in health status seen within and between countries.
Source: World Health Organisation, 2026

Social security cuts and life expectancy: a longitudinal analysis of local authorities in England, Scotland and Wales
Abstract:
The UK Government's 'welfare reform' programme included reductions to social security payments, phased in over the financial years 2011/2012-2015/2016. Previous studies of social security cuts and health outcomes have been restricted to analysing single UK countries or single payment types (eg, housing benefit). We examined the association between all social security cuts fully implemented by 2016 and life expectancy, for local authorities in England, Scotland and Wales.
METHODS: Our unit of analysis was 201 upper tier local authorities (unitary authorities and county councils: 147 in England, 32 in Scotland, 22 in Wales). Our exposure was estimated social security loss per head of the working age population per year for each local authority, calculated against the baseline in 2010/2011. The primary outcome was annual life expectancy at birth between the calendar years 2012 and 2016 (year lagged following exposure). We used a panel regression approach with fixed effects.
RESULTS: Social security cuts implemented by 2016 were estimated to be 475 per head of the working age population in England, 390 in Scotland and 490 in Wales since 2010/2011. During the study period, there was either no improvement or only marginal increases in national life expectancy. Social security loss and life expectancy were significantly associated: an estimated 100 decrease in social security per head of working age population was associated with a 1-month reduction in life expectancy.
CONCLUSIONS: Social security cuts, at the UK local authority level, were associated with lower life expectancy. Further research should examine causality.
Source: Seaman R. Journal of Epidemiology and Community Health, Feb 2024; 78(2): 82-87

Black maternal health: third report of session 2024–26
Abstract: This report finds that Black women in England face disproportionately poor outcomes in maternity care, shaped by systemic failings in leadership, training, data collection and accountability. The report acknowledges that failings in care for Black women are taking place in the context of a maternity system that is failing women more broadly, with the NHS in England having paid 27.4 billion in maternity negligence since 2019, estimated at, a figure greater than the total maternity budget for the same period.
Source: Moran L. Health and Social Care Committee, Black Maternal Health, 2025

Government response to the Health and Social Care Committee’s third report of session 2024 to 2026: Black maternal health
Abstract: This is the government's formal response to the recommendations made by the Health and Social Care Committee's report on Black maternal health, which was published on 17 September 2025.
Source: Department of Health and Social Care (DHSC), 2025

Monitoring the Mental Health Act in 2024/25
Abstract: This report into the use of the Mental Health Act finds that increasing demand for services and higher thresholds for admission are leading to long waits for mental health care. The report, which was built on interviews with over 3,000 patients and over 700 family members and carers, reveals reoccurring issues of staff shortages, a lack of beds, and inconsistencies in experiences. It also finds that out-of-area placements on the rise even though there was a national commitment to end this practice by March 2021.
Source: Care Quality Commission, 2026

How ICBs are improving men’s health
Abstract: Following the launch of the Men's Health Strategy Kathy Oxtoby takes a look at the state of healthcare for men across the NHS system.
Source: Oxtoby K. Healthcare Leader, Jan 2026

Government response to Lords Select Committee's report 'Time to deliver: The Autism Act 2009 and the new autism strategy'
Abstract: The command paper sets out the government's response to the recommendations made by the House of Lords Autism Act 2009 Committee in their report 'Time to deliver: The Autism Act 2009 and the new autism strategy'. The government welcomes the committee's report and will consider their recommendations further during the development of the next strategy. It also sets out the work government is already doing to support autistic people.
Source: Department of Health and Social Care (DHSC), 2026

Reducing inequalities in cancer care: a health system approach to implementing change
Abstract: The brief highlights why inequalities remain a major barrier to progress, and why a broad health systems approach matters. It sets out practical actions across governance, financing, service delivery and workforce to translate scientific advances into more equitable outcomes.
Source: Myers C. European Observatory on Health Systems and Policies, 2025

Trends in educational inequalities in smoking-attributable mortality and their impact on changes in general mortality inequalities: evidence from England and Wales, Finland, and Italy (Turin)
Abstract:
BACKGROUND: Socioeconomic mortality inequalities are persistent in Europe but have been changing over time. Smoking is a known contributor to inequality levels, but knowledge about its impact on time trends in inequalities is sparse.
METHODS: We studied trends in educational inequalities in smoking-attributable mortality (SAM) and assessed their impact on general mortality inequality trends in England and Wales (E&W), Finland, and Italy (Turin) from 1972 to 2017. We used yearly individually linked all-cause and lung cancer mortality data by educational level and sex for individuals aged 30 and older. SAM was indirectly estimated using the Preston-Glei-Wilmoth method. We calculated the slope index of inequality (SII) and performed segmented regression on SIIs for all-cause, smoking and non-SAM to identify phases in inequality trends. The impact of SAM on all-cause mortality inequality trends was estimated by comparing changes in SII for all-cause with non-SAM. RESULTS: Inequalities in SAM generally declined among males and increased among females, except in Italy. Among males in E&W and Finland, SAM contributed 93 per cent and 76 per cent to declining absolute all-cause mortality inequalities, but this contribution varied over time. Among males in Italy, SAM drove the 1976-1992 increase in all-cause mortality inequalities. Among females in Finland, increasing inequalities in SAM hampered larger declines in mortality inequalities.
CONCLUSION: Our findings demonstrate that differing education-specific SAM trends by country and sex result in different inequality trends, and consequent contributions of SAM on educational mortality inequalities. The following decades of the smoking epidemic could increase educational mortality inequalities among Finnish and Italian women.
Source: Van Hemelrijck Wanda Monika J. Journal of Epidemiology and Community Health, Sep 2024; 78(9): 561-569

Time for action: introduction of a national planning policy to promote a healthier food environment in England
Abstract: This article is a commentary on the National Planning Policy Framework, published in December 2024 by the Ministry of Housing, Communities and Local Government (MHCLG), which breaks new ground in relation to policy on hot food takeaways and fast-food outlets with reference to health inequalities and outlines its relevance to public health as part of a whole systems approach to obesity and overweight.
Source: Bannerman A. Perspectives in Public Health, Sep 2025; 145(5): 243-245
Contact the library for a copy of this article

Equitable inclusion of patients with cancer on the palliative care register: a systematic review in primary care
Abstract:
Background: GPs are instrumental to palliative care in the UK and most practices maintain a register of patients with palliative care needs. However, many people with incurable cancer who could benefit from palliative care are not included on this register, making this a potential source of end-of-life inequity.
Aim: To identify barriers and facilitators to recognising the palliative care needs of patients with cancer in the UK and understand how these factors may have an impact on those vulnerable to end-of-life inequity.
Design and setting: A mixed-methods systematic review. Method Eight electronic databases (Alternative Medicine, CINAHL, Embase, Medline, PsycINFO, Scopus, SocINDEX, and Web of Science) and two preprint servers (medRXiv and Open Science Framework) were searched in November 2024. Qualitative, quantitative, and mixed-methods studies were included. Narrative synthesis was used to integrate study findings, with resulting barriers and facilitators mapped onto the COM-B model domains of capablity, opportunity, and motivation. The impact on equity was evaluated using the PROGRESS-Plus framework.
Results: Searches returned 7190 citations, with 24 studies included in the review. Seven themes were identified, with barriers and facilitators mapped onto COM-B domains: conceptualisation of palliative care; navigating challenging conversations; healthcare organisation; patient help-seeking; time and resource constraints; perceptions shaping practice; and cognitive associations. There was insufficient evidence about the barriers and facilitators that may be having an impact on those vulnerable to end-of-life inequities.
Conclusion: GPs experience many barriers to recognising palliative care needs. There is a need for greater understanding of the extent and nature of inequities in recognising such needs, to ensure strategies to increase recognition do not widen inequities.
Source: Henderson R. British Journal of General Practice, Oct 2025; 75(759): e659-e668

From policy to action: a document content analysis reviewing the adoption of the healthcare inequalities programme in local health system plans in England
Abstract:
OBJECTIVES: This analysis aimed to explore how local health system strategies and plans seek to tackle health and care inequalities and address national policies. Specifically, the analysis considered alignment with five national priority areas: restoring services inclusively, mitigating digital exclusion, ensuring the completeness and timeliness of datasets, accelerating preventative programmes and strengthening leadership and accountability. In addition, the analysis explored the extent to which systems are engaging with the Core20PLUS5 approach, which targets the most deprived 20 per cent of the population ('Core 20') and population groups experiencing disproportionately poor access, outcomes or experiences of care ('PLUS').
DESIGN AND SETTING: Integrated care systems (ICSs) are statutory partnerships that bring together healthcare, social care, local government and wider system organisations to collaboratively address the root causes of ill health and health inequalities. We conducted a document analysis of available ICS strategies, 5-year plans and health inequalities plans published in England between 1 January 2022 and 31 July 2023. A total of 43 strategy documents, 38 5-year plans and seven health inequalities plans were analysed. A data extraction framework was used to guide reviewers and independent quality assurance was completed to ensure internal validity, intrarater reliability, and reproducibility of the project.
RESULTS: the analysis highlighted good alignment with national healthcare inequalities policies and local approaches to tackling healthcare inequalities, with the majority of systems citing the Core20PLUS5 framework. There was notable variation between systems on the adoption of the framework with the children and young people's framework being less widely considered than the adult's framework. Across systems, equity-focused tools were widely used, and numerous systems had developed outcome frameworks to monitor progress. Leadership for health inequalities was strengthened with senior leadership roles being established to hold integrated care boards accountable for improving access, experiences and outcomes. However, competing priorities, particularly concerning implementations of new organisational models and multiple national priorities, were evident within the plans which may challenge progress on reducing health and healthcare inequalities.
CONCLUSIONS: The review concluded that while progress has been made in adopting national healthcare inequalities policies and steers, significant variation exists between systems, possibly reflecting local population needs and varying levels of maturity of the systems across England. The review highlights the need for further evaluations at both national and local levels, allowing for further development of the systems. Additionally, consistent and sustainable funding and more robust training for health inequalities leadership roles is needed to ensure equitable access, experience and outcomes.
Source: Elliott H. BMJ Open, Oct 2025; 15(10): e102163

The Maternal Care Bundle: a care bundle for reducing maternal mortality and morbidity
Abstract: The Maternal Care Bundle (MCB) sets best practice standards across five areas of clinical care, for implementation by NHS providers and commissioners across England. The aim is to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes.
Source: NHS England, 2026

Chronic pain: prevalence, demographic inequalities, and healthcare utilisation: a primary care database analysis
Abstract:
BACKGROUND: Chronic pain (CP) is an ill-defined condition, often under-recorded in primary care records.
AIM: To determine prevalence, evidence of health inequalities, primary care consultation rates, and healthcare utilisation costs of CP.
DESIGN & SETTING: Cross-sectional, retrospective study using anonymised primary care data from all GP practices in one inner-city London area.
METHOD; CP was defined on the basis of analgesic medication codes and novel inclusion of diagnostic codes for conditions known to be strongly associated with CP. CP prevalence and consultation rates were determined; comparisons were made with 31 other long-term conditions (LTCs). Consultation cost estimates were based on healthcare professional type and consultation mode.
RESULTS: In total, 358 889 adult patients were registered in sample practices, with continuous (12-month) healthcare records available for 327 800 (91.3 per cent). CP prevalence was 18.6 per cent; the second most prevalent LTC after anxiety at 21.4 per cent. CP mean annual consultation rates were 15.3 per patient, the highest LTC consultation rate. CP incurred the highest primary care consultation costs of any of the included LTCs. Age was the strongest predictor of CP, particularly in those aged >=60 years (adjusted odds ratio [AOR] for 60-69 years: 9.32; 95 per cent confidence interval [CI] = 8.83 to 9.84; compared with those aged 18-29 years). Much smaller AORs were found for ethnicity, social deprivation, sex, and non-UK country of birth.
CONCLUSION: CP represents the most demanding LTC, in terms of consultation rates and costs, managed in primary care. Yet there is considerable uncertainty about optimal management and alternatives to long-term, high-volume primary care consultation rates.
Source: Shetty S. BJGP Open, Oct 2025; 9(3): BJGPO.2024.0147

Locked out: exclusion of deaf and deafblind BSL users from health and social care in the UK
Abstract: This report presents the findings and recommendations of the BSL Advisory Board's Health and Social Care sub-group. The report examines the barriers that BSL users face in navigating the UK's health and social care systems. The report highlights the higher levels of health and social care needs within the deaf and deafblind BSL user communities, as well as the resulting health inequalities. It details how persistent challenges, such as inaccessible communication systems and a lack of qualified interpreters, lead to economic costs and cumulative trauma for BSL users. The BSL Advisory Board puts forward twelve essential priorities and additional areas for action designed to create a more inclusive and equitable future. The aim of these recommendations is to unlock access to services, improve health outcomes, and provide a strong return on investment by reducing avoidable costs in the NHS and social care budgets.
Source: Disability Unit, 2025

Recruitment, retention and reporting of ethnic representativeness in maternity trials: a scoping review
Abstract:
INTRODUCTION: Black and Asian women experience significantly higher rates of mortality and morbidity perinatally compared with white women and are more likely to lose their babies. These groups are also under-represented in clinical research, resulting in evidence that may not be generalisable. Tools have been developed to facilitate the inclusion of ethnic minority groups, but it is unknown to what extent representation and inclusion are considered in maternity trials. AIM: To provide an overview of how ethnically diverse recruitment is considered and reported in maternity trials in the UK.
METHODS: A scoping review was conducted, undertaking a systematic search to identify published trial protocols and their subsequent results papers, conducted within the UK, recruiting women during pregnancy or within six weeks postnatally between 2004 and 2024. Data was extracted from protocols on whether representation of participants was considered in the study design and if specific recruitment and retention strategies were planned for ethnic minority groups. Data extracted from results papers identified whether representation of participants was discussed and if recruitment strategies were discussed; these were compared against the protocol.
RESULTS: A total of 96 published protocols met the inclusion criteria; eight mentioned specific recruitment strategies and 5 mentioned specific retention strategies. Only two included both recruitment and retention strategies. The most common strategies included providing different types of language support and adapting interventions to be culturally appropriate. Strategies were not evaluated. 67 results papers were available. Ethnicity was reported in 57 papers, with heterogeneity of categories between papers. Only 32 papers discussed representativeness of participants.
CONCLUSION: Few maternity trials report considerations on how they ensure they are recruiting and retaining ethnically representative participants. Minimal discussion is undertaken around the extent to which trial participants reflect the population to which findings will be applied. Further work is needed to support implementation and evaluation of inclusive research guidance. Failing to ensure those from ethnic minority groups are included in research can exacerbate inequalities.
Source: Lovell H. BMJ Open, 2025;15(11): e098926

Integrated care systems and strategic authorities: coming together to tackle health inequalities and the wider determinants of health
Abstract: This essay was written by the Centre for Local Economic Strategies and The King's Fund, as part of a programme of work commissioned by The Health Foundation. Strategic authorities and integrated care systems are increasingly powerful entities with the potential to tackle health inequalities and improve population health. However, achieving this will require them to work together effectively. This essay explores the changing policy context in which these bodies exist, and the way the dynamics between them could and should evolve as devolution beds in.
Source: Tiratelli L. Centre for Local Economic Strategies (CLES), 2025

Equalities impact assessment: 10 Year Health Plan for England
Abstract: This equality impact assessment (EQIA) assesses how the Department and Health and Social Care (the department) and NHS England have worked in partnership to address the requirements of the public sector equality duty, section 149(1) of the Equality Act 2010, and related provisions under section 149 more generally, in developing the 10 Year Health Plan. It also highlights if risks have been identified that need to be mitigated as proposals are implemented. The EQIA incorporates assessments for each chapter of the plan which explores the proposals through the lens of each protected characteristic.
Source: Department of Health and Social Care (DHSC), 2025

Technical guide to allocation formulae and convergence for 2026/27 to 2028/29 revenue allocations
Abstract: This is a technical guide to allocation formulae and convergence for the 2026/27 to 2028/29 revenue allocations. The guide provides detailed information on the technical approach to the 2025/26 revenue allocations.
Source: NHS England, 2025

Strategies to improve telehealth access for culturally and linguistically diverse communities: a systematic review
Abstract:
AIMS: CaLD populations face considerable digital health inequities; strategies are needed to ensure telehealth models of care are available to all. We aimed to identify and describe interventions that enhance telehealth access for CaLD communities.
METHODS: We systematically searched four databases (PubMed, Scopus, Embase, and CINAHL). Included studies were published between 2011 and 2024 and reported on at least one of the outcomes described in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Two authors independently screened articles, solutions were synthesized qualitatively.
RESULTS: Twenty-seven articles were included in the review and primarily used videoconferencing as the predominant telehealth modality (n = 14, 52 per cent). Five strategies were identified to promote telehealth use across CaLD communities including: (i) Provide bilingual options; (ii) Enhance staff cultural competence; (iii) Provide flexible adaptions to align with consumer needs; (iv) Supply technology and technological support; and (v) Involve digital health navigators and/or health educators.
CONCLUSIONS: Culturally competent professionals supported by language services and technological support are strategies which can help improve equity of access to telehealth services for people from CaLD communities. Such strategies can support the implementation of practical solutions to overcome health inequities and prevent access gaps.
Source: Gallegos-Rejas Victor M. Journal of Public Health, Sep 2025; 47(3): e374-e390

Starting behind, staying behind: the opportunity gap facing boys from low-income families at age 5 and beyond
Abstract: This report looks beneath the headline data to focus on one group particularly at risk of being overlooked, or under-served, by policy making from an early age: boys from low-income families. It provides a data-driven picture of the opportunity gap facing this group at age five and beyond, the root causes of attainment gaps and how these are linked to systemic failings in the way government works.
Source: Metcalfe S. Institute for Government, 2025

Exploring ethnicity data use and gaps in health care
Abstract: This report identifies the barriers to the collection, availability and use of quality ethnicity data and opportunities and best practice to overcome these barriers. It makes recommendations to leverage existing ethnicity data sets and proposes long-term steps to build coherent and equitable data systems capable of driving real change.
Source: Butt J. Race Equality Foundation, 2025

Independent review into mental health conditions, ADHD and autism: terms of reference
Abstract: This publication sets out the terms of reference for an independent review into the prevalence, trends and inequalities associated with mental health conditions, ADHD and autism in children, young people and adults. The review will seek to understand: the factors behind trends in prevalence, the impact of clinical practice, including social and cultural factors and the risks and benefits of medicalisation, ways to promote the prevention of mental ill health, and ways to create resilience and improve early intervention.
Source: Department of Health and Social Care (DHSC), 2025

Tackling health inequalities together: inclusion health and co-production
Abstract: Trauma-informed approaches acknowledge the impact of trauma on the health of patients and staff, and the ways in which health care is accessed and experienced. There is growing interest in these approaches in both a UK and international primary care context. Intrinsic to a trauma-informed approach (although rarely achieved in practice) is the co-production of health services with those with relevant lived experience. Existing models of patient involvement in primary care tend to rely significantly on feedback forms or surveys, which do not facilitate an ongoing dialogue between patients and healthcare providers. Patient participation groups (PPGs) can provide a more meaningful space in which services can be truly co-produced, in particular where careful attention is given to power dynamics in the room. There is, however, an increasing understanding of the need for flexibility in our approaches to patient involvement, which should incorporate multiple models, recognising individuals' diverse experiences, preferences, and capacity for participation. The Care Quality Commission (CQC) suggests that we may have'... more effective conversations through engaging with different community groups at different times and in different places'. The need for provision of protected spaces with careful attention to sociocultural backgrounds and power dynamics is echoed within the principles of trauma-informed care. The current authors have worked proactively with specific community groups who are often poorly served by our health services. We have sought to create protected spaces and mitigate existing power dynamics to support the free communication of ideas, working together with partnership organisations to improve local primary care provision.
Source: McGeown H. British Journal of General Practice, Oct 2024; 74(747): 469-471

A realist review of how, why, for whom and in which contexts quality improvement in healthcare impacts inequalities
Abstract:
INTRODUCTION: Quality improvement (QI) is aimed at improving care. Equity is one of the six domains of healthcare quality, as defined by the Institute of Medicine. If this domain is ignored, QI projects have the potential to maintain or even worsen inequalities.
AIMS AND OBJECTIVES: We aimed to understand why, how, for whom and in which contexts QI approaches increase, or do not change health inequalities in healthcare organisations.
METHODS: We conducted a realist review by first developing an initial programme theory, then searching MEDLINE, Embase, CINAHL, PsychINFO, Web of Science and Scopus for QI projects that considered health inequalities. Included studies were analysed to generate context-mechanism-outcome configurations (CMOCs) and develop an overall programme theory.
RESULTS: We screened 6259 records. Thirty-six records met our inclusion criteria, the majority of which were from the USA. We developed CMOCs covering four clusters: values and understanding, resources, data, and design. Five of these described circumstances in which QI may increase inequalities and 15 where it may reduce inequalities. We found that QI projects that are values-led and incorporate diverse, patient-led data into design are more likely to address health inequalities. However, when staff and patients cannot engage fully with equity-focused projects, due to practical or technological barriers, QI projects are more likely to worsen inequalities.
CONCLUSIONS: The potential for QI projects to positively impact inequalities depends on embedding equity-focused values across organisations, ensuring sufficient and appropriate resources are provided to staff delivering QI, and using diverse disaggregated data alongside considered user involvement to inform and assess the success of QI projects. Policymakers and practitioners should ensure that QI projects are used to address inequalities.
Source: Johnson Lucy L. BMJ Quality and Safety, Aug 2025; 34(8): 537-546

Understanding health inequalities research capacities: insights and recommendations from comparing two high income settings
Abstract: Generating evidence on health inequalities (HI) is necessary to raise awareness of these issues, describe and monitor their evolution, analyze their causes, and inform interventions aiming to improve health equity. Yet not all cities and countries have the capacity to produce this type of research. Recent research provides new contextual and causal insights into this research production process, and in-depth understanding on why and how this type of research is produced in certain settings. This article aims to analyze two recent case studies that have uniquely explored this process in two high producers of HI research and high-income country settings to identify learning and distil recommendations, which may be insightful for other settings. Expanding and investing in this line of research is critical, particularly in places with lower HI research output and related capacity, in order to identify key contextual conditions and mechanisms that may enable or hinder this process. This new knowledge could guide the development of new HI research capacity strengthening strategies to foster this research in different settings, worldwide. More understanding is also needed on the relationship between HI research, policy, and action in order to tackle HI.
Source: Cash-Gibson L. International Journal of Social Determinants of Health and Health Services, Apr 2024; 54(2): 163-170

The U-shaped curve of health inequalities over the 20th and 21st centuries
Abstract: This article examines historical trends in health inequalities over the 20th and 21st centuries. Drawing on studies from the United States, United Kingdom, Sweden, and Western Europe, it concludes that there is evidence of a u-shaped curve in (relative) health inequalities. These trends in health inequalities broadly parallel those identified by economists with regards to the u-shaped curve of income and wealth inequalities across the 20th and 21st centuries. The article argues that-as with income inequalities-health inequalities generally decreased across the twentieth century through to the early 1980s. They then started to increase and accelerated further from 2010, particularly in the United Kingdom and the United States. The article sets out four distinct policy periods that shaped the evolution of trends in health inequalities: the Interbellum Era, 1920-1950; the Trente Glorieuse, 1950-1980; Neoliberalism, 1980-2010; and the Crisis Age, 2010-present. The u-shaped curve of health inequalities over this period suggests that social policies, health care access, and political incorporation have driven changes over time. Taking this long view of changes in health inequalities emphasizes the importance of politics and policy for future health improvement.
Source: Bambra C. International Journal of Social Determinants of Health and Health Services, Jul 2024; 54(3): 199-205

What is the state of children's health in England?
Abstract: This explainer offers a snapshot of the current state of children's health in England, drawing on the latest available evidence. It focuses on outcomes across physical and mental health, the inequalities and wider determinants that shape those outcomes, and how well the health and care system is responding. It closes with The King's Fund's view on priorities for action and a look ahead to the second explainer, which will map the system for children and young people in England - setting out who is responsible for what, how services are delivered, and the levers available to improve outcomes and reduce inequalities.
Source: Buckingham N. The King’s Fund, 2025

Health for wealth 2025: building a healthier North to boost UK productivity
Abstract: This report reveals that the relationship between health and productivity has become stronger over the last seven years, placing a huge financial burden on the economy and stagnating possible productivity growth. It finds that the scale of health-related economic inactivity is greater in the North of England, with workers more likely to lose their job due to ill health, and those without educational qualifications facing a ninefold higher risk of losing their job if they become ill.
Source: Simpson J. Northern Health Science Alliance, 2025

Affordable infrastructure: how strategic authorities can use housing and public transport to tackle health inequalities
Abstract: This essay was written by the Centre for Local Economic Strategies and The King's Fund, as part of a programme of work commissioned by The Health Foundation. Housing and public transport are critical determinants of health. Strategic Authorities (SAs) are uniquely positioned to influence the affordability of homes and transport - the levers available to them offer promising potential to reduce health inequalities, particularly for those on the lowest incomes. This essay draws on conversations with mayors and SA officers to highlight how innovative housing and transport policies like municipal housebuilding and bus franchising can be scaled and amplified to achieve greater impact on narrowing health inequalities.
Source: Goodwin Tom L. Centre for Local Economic Strategies (CLES), 2025

Structural racism as a fundamental cause of health inequities: a scoping review
Abstract:
BACKGROUND: Structural racism is increasingly recognized as a fundamental cause of health inequities. It operates through laws, institutional policies, and systemic practices that disproportionately disadvantage racially and ethnically minoritized populations. Although the body of evidence on structural racism and health is expanding, much of it remains fragmented across disciplines and sectors. This scoping review synthesized peer-reviewed research by examining the pathways through which structural racism affects health, the most frequent outcomes, and the interventions and policies implemented to address these disparities.
METHODS: The review adhered to frameworks by Arksey and O'Malley, Levac et al., and the Joanna Briggs Institute. Six databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, and Scopus) were searched for English-language, peer-reviewed studies published before February 15, 2025, examining structural, systemic, or institutional racism in relation to health. Two reviewers independently screened and extracted data, and findings were analyzed using thematic synthesis.
RESULTS: Eighty-three studies met the inclusion criteria, covering healthcare, housing, the criminal legal system, environmental exposures, and other intersecting sectors. Structural racism was consistently associated with adverse outcomes in maternal and infant health, cancer, cardiovascular disease, HIV care, mental health, and COVID-19. Key mechanisms included redlining, residential segregation, carceral practices, discriminatory clinical treatment, and environmental injustice. Intersectional burdens were most pronounced among Black, Indigenous, LGBQ, immigrant, and socioeconomically marginalized groups. Although some promising interventions were identified, including culturally tailored perinatal care, community health worker models, and equity-focused quality improvement, few had been rigorously evaluated or embedded in broader structural policy changes.
CONCLUSION: Structural racism was found to operate across institutional and societal systems to perpetuate health disparities. While targeted interventions show promise, significant gaps remain in the development and implementation of scalable, evidence-based reforms. To achieve health equity, public health strategies must prioritize cross-sectoral actions for confronting and dismantling the structural conditions that maintain racial injustice. This synthesis highlights the urgent need for scalable policy reforms and structural accountability measures across sectors.
Source: Kisa A. International Journal for Equity in Health, Oct 2025; 24(257)

Public health under threat: how our leadership must evolve in complex and uncertain times
Abstract: Public health professionals across the UK and around the world are currently grappling with a landscape of unprecedented complexity. Long-standing systemic challenges across the UK have led to stagnating-even declining-life expectancy and widening health inequalities, whilst on a global scale the very foundations of evidence-based public health programs and principles are under threat. Our leadership as public health professionals must evolve in response to these mounting challenges. We need a new paradigm in public health, one that embraces the interconnected nature of modern threats to health, and one that is disruptive, agile, collaborative, and firmly rooted in principles of equity and justice. The world is changing rapidly, and public health leadership must adapt to meet the challenges of a more interconnected and dynamic environment. Many of the population-level health challenges facing the UK stem from the deep-rooted social and economic inequalities faced by communities across England, Scotland, Wales, and Northern Ireland. That life expectancy has recently declined in some of the UK's most deprived areas speaks to a long-term failure to properly support our most vulnerable populations, including marginalized minority ethnic communities.
Source: Fenton K. Journal of Public Health, Jun 2025; 47(2): 111-113