Five ways CardMedic is supporting the Core20PLUS5 framework for reducing health inequalities

Reducing health inequalities is at the heart of everything we do at CardMedic. So, when we heard about the Core20PLUS5 framework being launched by NHS England and NHS Improvement, we were delighted to see a structured, comprehensive plan put together that aligns with our purpose to help healthcare organisations reduce health inequality at scale.


What is the Core20PLUS5 framework, and why is it important?

The Core20PLUS5 framework is designed to support integrated care systems to drive targeted action to healthcare inequalities improvement. It provides a practical plan for reducing health inequality, and it’s been front of mind for me and the CardMedic team since it was published last year.

Spearheaded by Dr Bola Owolabi, the framework sets out to prioritise the most deprived areas of the population and underserved communities experiencing poorer-than-average health access, which includes people from ethnic minorities, with learning difficulties, vulnerable migrants, and other socially excluded groups.


How CardMedic is helping the NHS to deliver on the Core20PLUS5 framework

1. Improving access to care in maternity services

The framework intends to improve continuity of care for Black, Asian and Minority Ethnic (BAME) patients in maternity. This can’t be achieved without improving communication with people from these groups, who are currently up to four times more likely to die in childbirth than white women. This is a harrowing and unacceptable statistic, but it does explain why the maternity scripts are one of the most frequently used in the CardMedic library.

Teri Gavin-Jones, Clinical Lead Midwife at Suffolk and North East Essex Integrated Care System (SNEE) agrees. She said, “As an early adopter of the Core20PLUS5 framework, we will be using CardMedic to help deliver the maternity departments five-year equity plan, focused on reducing the mortality rate for BAME women.” We’re incredibly humbled to be introducing CardMedic to the maternity department at the ICS and helping to combat such an important issue.

We’ve seen improvements being made to services at University Hospitals Sussex too, which has introduced Alternative Language Antenatal Classes (ALAC) using CardMedic, improving access to care for non-English speaking mums-to-be.


2. Providing accessible healthcare content in multiple languages

The framework states that ‘vulnerable migrants’ should be a focus group within the Core20PLUS5 cohort. For us, this includes refugees, in light of what is currently unfolding in Ukraine and other parts of the world. In our flashcard library, content is available in 44 languages, including those most commonly spoken by refugees arriving in the UK, including Ukrainian, Arabic and Pashto.

This will enable refugees and vulnerable migrants to have greater access to the tailored healthcare approach they need. We are incredibly grateful to our translation volunteers who have been working with us from the very beginning who have made this possible.


3. Improving communication with people with learning difficulties and cognitive impairment

Another group identified by the framework is those living with learning difficulties, who often require an alternative approach to communicating with care teams. By continuously working to make all of our content available in EasyRead and Read Aloud formats, we are helping to bridge this gap.

We have an amazing team of speech and language therapists who help us to develop our content. This process of co-creation enables us to create content that’s patient safety certified, accessible, and most importantly, inspires people to engage with their care. Dr Rachael Grimaldi, our Co-Founder, reminded us just how important this is: “If a person doesn’t understand the information they’re receiving about their care or their condition, they aren’t going to engage. I’ve experienced this first-hand as a clinician. We need to make sure the way we communicate with different groups of people is tailored ot their specific needs, or we risk them never utilising health and care services when they need them.”


4. Enabling better care for cancer patients

Another clinical area of focus for the framework is early cancer diagnosis. Again, a communication barrier can manifest as a physical barrier to healthcare services, as people are unable to engage. Equally, diagnosis, which is a very scary and often overwhelming experience, is more complicated when communication barriers are involved. This can lead to patients relying on family members to translate for them, which isn’t ethical and can result in litigation. Of course, we still have to resort to this method because there is often no other option, especially in urgent cases when there aren’t translators available. In cancer care however, this method often can’t be used as patients are immunocompromised and strict infection prevention measures are in place.

We have been working with The Christie to develop tailored oncology scripts for the CardMedic library, so more people are better equipped to understand their diagnosis, treatment, and management of their health during their care. Beth Allen, who is a digital nurse at The Christie has been using CardMedic and says it provides “a completely different experience” when interacting with her patients. “I was caring for a patient who could only speak Italian. Having CardMedic in my pocket meant I could successfully communicate with them and be sure they understood what I was doing and why at every point during their care.”


5. Supporting integrated care

The framework has been created to support integrated care systems (ICSs) to drive targeted action in health inequalities improvement. It is only by looking at all determinants of health that we can understand the true extent of health inequality, and the groups of people that need most attention. Through the use of CardMedic at ICS level, we will continue to report on the most frequently used scripts, both in terms of language and clinical area, to identify areas of need and hopefully contribute to an even more comprehensive understanding of the Core20PLUS5 framework and how NHS organisations can adhere to the approach. We’re already working with three ICSs in England and hope to support many more in the future.

Teri from SNEE explained how the trust will be using CardMedic to support Core20PLUS5 objectives and provide more personalised care: “To have real success, awareness and use of solutions like CardMedic is important not just by clinicians, but patients too. It’s a brilliant tool, and we want them to request its use when they come to us with healthcare needs.”


A tool, but not a sole solution for reducing health inequalities

Of course, solutions like CardMedic are not the single answer to health equity problems, and will not enable organisations to adhere to the Core20PLUS5 framework alone. Investing in teams dedicated to the equality, diversity, and inclusion agenda, such as race equity leads and equality officers will be essential to fulfilling the health inequalities agenda, having seen first-hand how powerful these teams can be at trusts like University Hospitals Sussex NHS Foundation Trust. We hope there is the bandwidth within the rest of the NHS to make the same commitments and have the structures in place to support the health equity agenda.

Are you an early adopter of the Core20PLUS5 framework, or want to find out how we can help you reduce health inequalities at your organisation? Then please do get in touch.


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