Working Together to Tackle Inequity: Reflections from the Trust-Wide Pursuing Equity Event

 14th May 2025

On 7^th May, colleagues from across East London NHS Foundation Trust (ELFT) came together for a Trust-wide session focused on advancing equity in healthcare. Hosted in collaboration with the Institute for Healthcare Improvement (IHI), the event brought together service users, staff, and leaders to explore how we can reduce disparities in access to care—particularly the stark differences in missed appointments between our most and least deprived communities.

 

 

Why This Work Matters

Across ELFT, data shows that service users from the most deprived neighbourhoods are around 4.5 times more likely to miss their appointments than those from more affluent areas. This translates to over 1,200 missed appointments every two weeks, with significant consequences—not just for service productivity, but for the people most in need of care.

The Pursuing Equity Programme is addressing this challenge by combining quality improvement methods, lived experience insight, and data analytics. Each participating team is testing ideas to close the gap and ensure that care is delivered more equitably across the system.

 

 

Insights from the Session

The event featured contributions from global and national leaders in healthcare improvement. Pedro Delgado (IHI) encouraged attendees to “go an inch wide and a mile deep” when working to understand the communities they serve. He also emphasised the importance of alignment between staff and service users—when staff feel excluded or unsupported, it can be difficult to lead equity work authentically.

Jason Leitch (Scottish Government and IHI) offered a national perspective, highlighting the expected 21% rise in Scotland’s disease burden by 2045, and underscoring the urgency of meeting people where they are—in both health and social contexts.

Both speakers stressed the importance of combining strategic ambition with locally grounded, practical action. Change, they reminded us, must be both scalable and adaptable.

 

Learning from Each Other

A highlight of the session was hearing directly from ELFT teams about the work already underway. From peer support workers making reminder calls, to community-based outreach in a homeless women’s shelter, the ideas being tested reflect the diversity of local needs.  These stories sparked reflection among attendees, many of whom were surprised to learn that other teams were working on similar challenges. There was a strong sense of opportunity in coming together as a learning community to share ideas and build on what’s working.

The programme now has 9 teams showing improvement, all who are testing a combination of the change ideas described below.

 

Key messages from the event

Several key messages emerged from the session:

• Equity needs to be part of staff experience, not just service delivery. Staff who feel unsupported may struggle to authentically lead equity efforts.
• Service user involvement is critical. Teams are encouraged to take a three-part approach to data: combining quantitative data, community insight, and lived experience from the start.
• Cross-team collaboration creates momentum. Many teams left with a renewed sense of shared purpose and practical ideas to try in their own settings.
• Locally adapted tools are essential. Teams need clear frameworks and ideas that they can tailor to their local context— ‘recipes’ that include the key ingredients but leave room for adjustment.

Building on this idea, we also got the group to discuss how we should spread successful ideas and sustain the gains we’ve made.  People emphasised:

• The value of peer learning and storytelling
• Having regular opportunities to connect—through meetings, networks, or shared platforms.
• QI leads and project sponsors were seen as key to supporting and facilitating this exchange.

To support success, teams highlighted the need for:

• Leadership buy-in and culture of openness
• Protected time to do the work
• Access to data

Sustaining gains over time would require embedding changes into routine practice, using data to monitor progress, and maintaining connections through learning forums. Ideas included:

• Peer learning sessions, site visits, and shared platforms (e.g. MS Teams, newsletters)
• Leadership support, clear goals, and time to test and share ideas
• Embedding changes into daily work through standard operating procedures, regular data review, and staff training

 

Looking Ahead

The Pursuing Equity Programme continues to provide structured support for teams, including:

• Fortnightly coaching and team meetings
• Fortnightly data updates and a real-time dashboard
• A menu of evidence-based change ideas
• Central support with spreading successful change ideas

Equity is not a separate strand of our work—it must be embedded in everything we do. By continuing to test, learn, and share, we can create services that work better for everyone, especially those who have historically been left behind.

 

GALLERY OF TEAM’S POSTERS