Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of health inequalities between (1) rural and coastal, and (2) urban, areas; and what steps they intend to take to address any imbalances.

We support the National Health Service’s CORE20PLUS5 approach, which targets action to reduce health inequalities in the most deprived 20% of the population, and which improves outcomes for the groups that experience the worst access, experience, and outcomes within the NHS.

The Chief Medical Officer’s 2023 annual report made clear that future health and care needs will vary significantly in different areas, with the populations of rural, semi-rural, and coastal areas ageing much faster than those in metropolitan areas. This means there will be considerable variation in health and care needs even within an integrated care system. We recognise that providing services in rural areas comes with significant additional costs, for example, in travel and staff time. That is why the funding formula used by NHS England to allocate funds to integrated care boards (ICBs) includes an element to better reflect needs in some rural, coastal, and remote areas.

NHS England is responsible for determining allocations for ICBs. In allocating budgets, they have two aims, those being equal opportunity of access for equal need, and reducing health inequalities that are amenable to NHS healthcare. There are a range of adjustments made in the core ICB allocations formula that account for the fact that the costs of providing health care may vary between rural and urban areas.

Tackling health inequalities is central to our Health Mission, which is why the Government has committed to halving the healthy life expectancy gap between the richest and poorest regions, by addressing the social determinants of health. Work is currently underway across the Department, and with NHS England and the regional directors of public health, to develop approaches to address regional health inequalities.

As part of the consultation phase of the 10-Year Health Plan, we invited people from across every NHS region in England, including people from coastal communities, to provide input on how care should be designed and delivered, providing us with rich insights into these areas.