Read: Addressing health and social inequalities

The NHS has always addressed health and social inequalities but is now stepping up this role amid deepening challenges, reports Rt Hon. Anne Milton.

Last year, in the darkest days of the pandemic, Britons made a weekly pilgrimage into the street to express their heartfelt thanks to the NHS.

This ever-present NHS force, so often taken for granted in less challenging times, was our frontline defence against COVID’s unprecedented threat.

We as a nation will always remember the key role the NHS played over the last 18 months. But another role of the NHS that is not so often publicly applauded, but also of significant importance to this country, is its capacity to drive social mobility.  

Sitting alongside the climate crisis and the post-pandemic economic recovery, levelling up is one of Britain’s great challenges.

Despite the best efforts of many organisations including the Social Mobility Pledge signatories, and despite the aspirations of many governments, we have failed to gain significant progress in improving social mobility in the UK.

All too often individuals’ talents and skills, their aspiration to get a good job and get on in life, is unfairly trumped in the race for the top jobs - by personal connections and stereotypes of who would be ‘right for the job’. We await detailed analysis following the pandemic but fears are that this will have worsened and existing inequalities will have become further entrenched. 

According to the Social Mobility Barometer 2021, published by the Social Mobility Commission in March, more than half (56%) of the public think the pandemic has increased social inequality. 

Three-quarters (74%) believe opportunities vary significantly across Britain. Furthermore, almost three quarters of people in London say opportunities to progress in their area are ‘good’, versus just under a third (31%) in the North East of England. 

Even before the pandemic social mobility was flagging. It was reported in 2019 that children with professional parents were 80% more likely to go into professions such as law and medicine than their less privileged peers.  

As well as the opportunity gap, we also know that there are health-related chasms. In England, for example, a North South divide is well evidenced. But we know this isn’t restricted to the North and South. All across the UK, in otherwise affluent areas, pockets of derivation mean that life expectancy can vary by as much as eight years between two council wards.  

The Office for National Statistics, and financial services company Lane Clark & Peacock, recently reported that the 10 so called ‘unhealthiest towns’ are in the North. Blackpool propped up the composite health index published in March, based on a wide range of factors and conditions. Others named were Hull, Stoke-on-Trent, Middlesbrough, Hartlepool, Knowsley, Doncaster, Nottingham, St Helens and Salford.

The picture is complex and Professor Sir Michael Marmot in his 2020 report, Health Equity in England: The Marmot Review 10 Years On, states that living in a deprived area of the North East of England results in a five-year drop in life expectancy compared to living in a similarly deprived area in London. 

In addressing these gaps – in health and wellbeing, in employment and opportunity – the NHS has a crucial role to play. Through education, training, offering easy to access services and outreach into more deprived areas, the NHS has always strived to encourage healthier communities and address health inequalities. Perhaps COVID’s acceleration of new technology and new approaches to healthcare will allow this to be scaled up even further.  

The NHS can be Britain’s great social mobility engine. With 1.16 million staff, at the last reported count in September 2020, it is one of the biggest employers in the world. 

And each individual working for the NHS has before them a wide range of jobs and opportunities for progression; within the thousands of teams and services there is a job and career for almost everyone.

I myself experienced one of the many rewarding careers within the NHS, training as a nurse at Barts Hospital, now Barts Health NHS Trust and working for the NHS in London for 25 years. Along the way, I saw first-hand the many opportunities that there are to improve social mobility,  spanning primary and palliative care and research. And there are seemingly endless more beyond the narrow prism of my own NHS career. 

Through my work with NHS trusts, it is encouraging and refreshing to see the sheer range of innovative approaches being taken to levelling up, and the leadership being shown by Chairs and Chief Executives including Dame Alwen Williams, Rt Hon Jacqui Smith and Professor Stephen Eames amongst many others. 

Every Trust serves communities with differing needs and challenges, and this is reflected in the array of activities being employed by trusts to foster universal access to opportunities. 

We will be reporting on these approaches from trusts across the country in the coming months, matching their strategies and results to our Levelling Up Goals, and ensuring that the best and most forward-looking leaders within the NHS continue to play their part in levelling up the communities they serve.

Find out more about the Levelling Up Health Coalition.