“At the Trust we are putting our emphasis on achieving equity not just equality”: Meet Hannah Franklin

The theme for this year’s International Women’s Day, Wednesday 8 March, is #EmbraceEquity. Hannah Franklin, health equity programme manager, explains what this theme means for the Trust from a staff and patient perspective, and the difference between equality and equity.

What is your role and how long have you worked at the Trust?

I have worked at the Trust for just over a year now and have recently moved into the role of health equity programme manager from a previous position in the strategy team where I was also supporting our population work. Prior to this the bulk of my career was spent in the International NGO sector, so I’ve always had a focus on driving change to improve the lives of others, particularly in the area of women’s health and rights.

What do you love most about this role?

It sounds cliché, but the potential this role has to make a difference. Within the Strategy Team we believe improving equity can be everybody’s business, but my role has some responsibility to help my colleagues get inspired by this agenda and understand what this means for them, as well as focussing my attention on patient groups who might often be less heard or left behind.

What is the difference between equality and equity?

‘Equality’ refers to individuals or groups of people having the same resources or opportunities, whilst ‘equity’ recognises that each person has a different starting position, and therefore the resources and opportunities need to be allocated based on need to reach an equal outcome. We can see this play out in outpatient appointments for example. Whilst all our patients are given the same universal opportunity to access specialist care, not everyone is able to make the appointment offered to them, or get the most out of their interaction with us to due to factors such as low English levels or confidence in healthcare settings. This is what we want to gain a better understanding of and rectify.

Why does this difference matter?

At the Trust we are putting our emphasis on achieving equity not just equality. This difference matters because it makes explicit the need for us to be putting disproportionate effort towards some specific patient groups, going further to acknowledge and act on the fact that some individuals or groups need additional help, due to their circumstances, to get to the same place.

It’s also more ‘asset based’, and we believe a more positive framing of the problem at hand. We know resources remain tighter than ever in the health sector, and we’re going to need to do more with less, but through better directing these resources towards our patients, those who need them most, we can achieve good outcomes for all, without some patients being left at a disadvantage. A good example of this would be investing in the use of technology to make us more efficient for those patients who are able to engage with it successfully, leaving resources to support those patients who are less digitally able.

What is the impact of gender inequity?

Gender inequity has a serious impact on women’s health outcomes and life chances – not just compared to men but also between different groups of women. For example, a woman’s life expectancy varies by almost eight years across England depending on where she lives, driven by circumstances such as opportunities at school and for good employment, as well healthy lifestyle behaviours and access to healthcare. We also know that black mothers in the UK are four times more at risk of maternal mortality than their white counterparts, which is something that we can do something about as a Trust.

What does this difference mean for the Trust, our services, patients and staff?

Put simply, equity is just another domain of quality; if we want to deliver the highest possible quality care for our patients it needs to equitable as well as safe, effective, and so on. But this also means that we can start to understand and improve equity in the same way you would improve any other aspect of quality, by applying QI tools and techniques. Through taking the time to truly understand our patients and their different needs, identify gaps between different groups and testing interventions which might reduce those gaps, all staff can make a positive contribution to achieving equity.