EQUITY IN THE NHS - MONITORING AND PROMOTING EQUITY IN PRIMARY AND SECONDARY CARE

Although need is often assumed to be the most important factor in dete rmining the use of health services, there are many inequities in the p rovision and use of NHS services in both primary and secondary care. F or example, existing data from district child health information servi ces have been combined with census data for small areas to show wide v ariations in immunisation rates between affluent and deprived areas. P urchasers of health care are already responsible for assessing health needs and evaluating services, and the process of monitoring equity is a logical extension of these activities. Routine data sources used to collect activity data in both primary and secondary care can be used to assess needs for care and monitor how well these needs are met. Pur chasers and providers should collaborate to improve the usefulness of these routine data and to develop a framework for monitoring and promo ting equity more systematically.