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Tackling inequalities often not a main priority in healthcare, says CQC

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Tackling inequalities often not a main priority in healthcare, says CQC

Tackling inequalities was “often not a main priority” for local health and care systems over the past year, the care regulator for England has said.

The Care Quality Commission (CQC) said the pandemic had exposed and exacerbated inequalities, and most services demonstrated some understanding of these.

But it found that tackling inequalities “was often not a main priority for systems, or strategies to identify and tackle health inequalities were not yet well established”. Issues included poor accessibility of information in different languages for some people, varying service provision and access, and a lack of understanding of how people’s individual characteristics affected the care they needed.

The regulator said an example of this was the specific needs of people with a learning disability from black and minority ethnic groups. It also flagged that an increase in remote or digital care could be a barrier to people who cannot access technology or do not feel comfortable doing so.

The report comes as the government announces a £162.5m workforce retention and recruitment fund in an effort to hire and retain workers for the sector.

The ringfenced funding, available through the winter until the end of March, will help local authorities and care providers to go on a recruitment drive. It will also help with overtime payments, and support occupational health teams through a potentially grim winter.

The report found inequalities had also been exposed by the coronavirus vaccine rollout, with take-up lower in all minority ethnic groups compared with in the white population, and variances according to levels of deprivation.

The annual state of care report says: “Providers and representatives from the voluntary and community sector have told us that recovery needs to focus on addressing health inequalities, particularly those that were amplified by the pandemic. However, there were some concerns that a focus on waiting list backlogs for elective care will put the emphasis on clearing these at pace, instead of on where the need is greatest.”

The CQC said better use of data to understand the needs of people locally, and better NHS trust patient records and linkage with primary care data, could help reduce inequality.

It noted an NHS target that by 2024 three-quarters of women from black and minority ethnic groups – who tend to have poorer outcomes in childbirth – should receive care from the same person during pregnancy, birth and postnatal.

It said just half of the nine services it visited where it had concerns had active continuity of carer teams providing support to women identified as higher risk at the time of inspection. It said teams had been put on hold or disbanded, primarily owing to pandemic staffing issues.

The regulator said engagement by maternity services was often not targeted towards women from black and minority ethnic groups, and a lack of funding was a “major challenge to meaningful engagement”.

Jabeer Butt, the chief executive of the Race Equality Foundation, said it was “deeply worrying” that the regulator had said tackling inequalities was not often a main priority.

“Equally worrying is that many health inequalities are longstanding, with some evidence that action to address these has only been partially implemented,” he said. “It is deeply disappointing that while targets were set for ensuring pregnant black and minority ethnic women received continuity of care, the CQC found that only small numbers of women received this support and in some areas the teams were ‘put on hold or disbanded’.”

The CQC also found that the physical healthcare needs of people with a learning disability were not always taken into account. Some people struggled with access to services, which caused them distress and in some cases led to their health deteriorating.

In one care home for people with autism and/or learning disabilities, there was no assessment to consider what adaptations may be required to meet new residents’ needs. Residents were told they were being “silly” and incident reports said people were “whingeing” and “having paddies”.

The CQC said providers and systems would need to understand and manage the impact of the pandemic on people with a learning disability. “This includes ensuring that any health inequalities and specific needs relating to protected characteristics such as ethnicity, age and gender are part of a system-wide strategy,” it said.

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Health

NCDC records 832 Lassa fever, Mpox cases, 135 deaths

The Nigeria Centre for Disease Control and Prevention (NCDC) has confirmed the country has recorded 832 confirmed cases of Lassa fever and Mpox.

Speaking during a press briefing on Friday in Abuja, the agency’s Director General, Dr. Jide Idris, revealed that 132 fatalities were recorded from Lassa fever and three from Mpox.

While acknowledging a recent decline in Lassa fever infections during epidemiological week 16 (ending April 20, 2025), he warned that the overall risk remains high, particularly in endemic regions.

“Cumulatively, as of week 16, Nigeria has reported 4,253 suspected cases of Lassa fever, 696 confirmed cases, and 132 deaths, resulting in a case fatality rate of 19.0 percent,” he stated.

Dr. Idris attributed recent improvements to intensified surveillance, treatment efforts, and enhanced community engagement. He emphasized, however, the continued need for vigilance and collaboration to sustain progress.

Regarding Mpox, the NCDC boss disclosed that three deaths have been recorded in 2025—two in Abia and Ebonyi States in week 10, and one recently in Rivers State involving a patient co-infected with HIV and tuberculosis. As of week 16, 723 suspected cases and 136 laboratory-confirmed cases of Mpox have been reported across 35 states and the Federal Capital Territory (FCT). The national case fatality rate currently stands at 2.2 per cent.

“The epidemic curve reveals multiple peaks in Mpox cases, indicating ongoing transmission. While most states have reported suspected cases, confirmed infections are heavily concentrated in Nigeria’s southern and central regions,” Dr. Idris noted.

To address these outbreaks, the NCDC has activated its Emergency Operations Centre (EOC), deployed National Rapid Response Teams to affected states, and prepositioned essential medical supplies, including personal protective equipment and laboratory consumables. Five additional Mpox diagnostic laboratories have also been optimized in Bauchi, Kano, Cross River, Rivers, and Enugu States.

“Healthcare workers are undergoing specialized training in infection prevention, case management, and cerebrospinal meningitis (CSM) care. Community outreach is being reinforced through public awareness campaigns, media engagement, and targeted health communication strategies,” he added.

On cerebrospinal meningitis, Dr. Idris reported a consistent decline in new cases and fatalities over the last three weeks.

He attributed the improvement to effective vaccination, early treatment, and adaptive surveillance strategies tailored to real-time data.

“Although the situation remains serious, strong national and state-level coordination is showing positive results. The response will continue until full containment is achieved and states take full ownership of the CSM Incident Action Plan,” he said.

Dr. Idris also expressed concern about the rising Mpox trend since its reemergence in 2017, with significant spikes recorded between 2022 and 2024, positioning Nigeria among the most affected countries globally. He warned that underreporting and delayed data entry remain challenges that need urgent resolution to ensure accurate and timely outbreak response.

A national mortality review for the recent Mpox deaths is being planned to further assess response effectiveness and identify areas for improvement.

The NCDC reaffirmed its commitment to safeguarding public health through timely surveillance, transparent reporting, and coordinated national response mechanisms aimed at reducing disease burden and preventing future outbreaks.

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Health

Only 89 doctors left in Kwara Govt hospitals amid ‘Japa’ crisis – Health Board

The Executive Secretary of the Kwara State Hospital Management Board, Abdulrahman Malik, disclosed that there is an acute shortage of medical doctors in the state-owned hospitals.

Speaking at the state interministerial press briefing for the first quarter of 2025 on Tuesday, April 29, Malik said that due to the ‘Japa’ syndrome, doctors do not want to take up appointments with the state government, even when the government is ready to recruit them.

He lamented that while between 180 and 200 doctors are required in the government service, only 89 of them are available in the service.

He said the number of available doctors only recently became 89 from 86 when three who had left the service returned after the government introduced a new and improved salary for the doctors’ services.

The hospital board’s boss said the government had been trying to attract doctors to the state service with improved salaries and facilities that could encourage them to stay, especially in the rural areas where many of them do not want to go.

He also disclosed that the government has introduced an intern nurses programme for the training of nurses who would replace many nurses who had left the service for abroad.

“The mass exodus of health professionals is severely affecting our capacity to provide adequate care,” the official said.

“Gov. AbdulRahman AbdulRazaq has approved an upgrade in the salaries of our doctors to match federal pay in a bid to retain the few we have left.

“The revised salary structure has led to the return of three doctors who had previously resigned, bringing the total number on the state’s payroll to 89.

“However, the figure still falls short of the estimated 180 to 200 physicians needed to serve the state’s population effectively.

“Nigeria’s doctor-to-patient ratio is currently estimated at one doctor to over 5,000 patients, far below the World Health Organisation’s (WHO) recommended one doctor to 600 patients.”

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Health

Wike approves recruitment of 34 resident doctors for FCT hospitals

The Minister of the Federal Capital Territory (FCT), Mr Nyesom Wike, has approved the recruitment of 34 resident doctors for a seven-year residency training to enhance health-care delivery in FCT.

Mr Lere Olayinka, Senior Special Assistant to the minister on Public Communications and Social Media, made this known in a statement in Abuja on Wednesday.

Olayinka explained that the 34 doctors would be the first batch of 60 medical doctors approved for residency training in eight specialities in FCT Administration hospitals.

He said that five out of the 34 doctors would work in the psychiatric department, four in internal medicine and one in general surgery.

Others, he said would comprise one in anesthesiology, eight in family medicine, six in ophthalmology and nine in obstetrics and gynaecology.

“This is the first time this is being done outside employees of the Health Management Board, thereby, giving doctors more opportunity and bringing more competent hands into healthcare delivery in the FCT,” he said.

The spokesman added that the remaining 26 doctors would be recruited in due course by the FCTA Civil Service Commission.

He said that the 26 doctors would comprise one for psychiatry department, four for internal medicine, eight for general surgery, five in anesthesiology, and eight paediatrics.

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