Third of people in deprived areas going to A&E when they can’t obtain appointment to see GP

One in three people in poor areas end up in A&E when they cannot obtain a GP appointment, researchers have found.

Analysis by a think tank at The King’s Fund also showed that those in deprived areas were three times more likely than those in wealthy parts of the country to face such problems, leading them to conclude that poverty was plaing a heavy burden on the NHS and cutting lives short.

The health and social care charity’s report cites figures from the Office for National Statistics (ONS) that indicate poorer people face difficulties when seeking medical help.

It found 30 per cent of people living in the most deprived areas have called 999 or 111, or attended a hospital A&E or a walk-in centre because they were unable to make an appointment with their GP. In the least deprived areas the proportion was 10 per cent.

Hospital data also reveal many more emergency admissions in places with higher levels of deprivation, the report states.

The analysis, commissioned by the Joseph Rowntree Foundation, said poorer patients may be more likely to struggle to obtain a diagnosis and treatment because of the cost of travel, difficulties accessing online services, and paying NHS charges for prescriptions, denistry, eye care and wigs and fabric supports.

Some conditions, such as dementia, were found to be more prevalent in more affluent areas, where people tended to live longer. However, deaths from such diseases were far higher in poorer areas, suggesting that the less well off were less likely to get treatment and help.

The research found dementia was 1.4 times less prevalent in the poorer areas of England, compared to the least deprived, but poorer citizens’ mortality rate from it was 1.6 times higher.

A similar trend was observed with atrial fibrillation, a heart condition: people in deprived communities were 1.3 times less likely to suffer from the condition but 1.6 times more likely to die from it.

Sarah Woolnough, chief executive of The King’s Fund, said: “One of the founding principles of the NHS is that it is free at the point of need, yet our analysis shows the cruel irony that many people living in poverty find it harder than others to access the timely care that could help them better manage their health conditions and prevent future illness.”

“The number of people living in deep poverty in the UK has risen, and recent life expectancy figures – a fundamental measure of a nation’s health – show a depressingly stark gap between the most and least deprived areas of the UK. 

“While the NHS can be a force in addressing poverty, as we head towards a general election, widening health inequalities and deepening deprivation must be tackled head on by government and policy-makers.”

Saoirse Mallorie, a senior analyst and lead author at The King’s Fund, added: “Our analysis highlights that not only do people living in poverty have shorter lives, they also spend a higher proportion of their lives with health problems. To improve the nation’s health and use NHS resources in the best way, tackling poverty must be as much of a priority as bringing down waiting lists.”

Chris McCann, campaigns director at Healthwatch England, a  patient group, said: “This research mirrors our own evidence, which shows the disproportionate impact that issues in access to healthcare are having on people already facing deprivation, homelessness, and poorer health.

“We know that people living in deprived areas are waiting longer for GP and hospital care and are more likely to experience cancelled appointments. People struggling financially are also much more affected by long waits compared to those who are very comfortable. 

“They can find themselves unable to work, they live in pain and their mental health suffers. In our poll, 93 per cent of respondents who struggled financially said they lived in pain due to delays to care, compared to 49 per cent of respondents who were very comfortable.”

NHS in danger of becoming two-tier service

He added: “We have warned that the NHS is in danger of becoming a two-tier service in dentistry and elective care. Healthcare leaders should step up to the plate on these disparities by improving measurement and understanding. 

“Data should be collected and published on the inequalities in waiting times, experiences, outcomes and improvements that diverse groups are reporting.”

Dr Layla McCay, director of policy at the NHS Confederation said: “NHS leaders will be incredibly concerned by these stark findings and the analysis once again highlights the glaring preventable inequalities often found in the most deprived areas, proving more should be done to address the root causes of poverty.

“Health teams have strived against all odds in the most challenging times, and are continuing to make progress on NHS waiting lists, despite staff vacancy gaps and industrial action. However, health inequalities in England were already stark before the COVID-19 pandemic, and the impact of the rising cost-of-living crisis equals a national public health crisis and should not be overlooked or treated as the norm.”

An NHS spokesman said: “NHS England is working hard to reduce healthcare inequalities and improve access to services and patients’ experience.

NHS ‘improving access to care’

“From mobile health checks, cancer scans and vaccinations to setting up community diagnostic centres in some of the most deprived areas in the country, the NHS is striving to improve access to care for all our patients, especially communities that, historically, struggled to access healthcare.”

A Government spokesman said: “We are putting record funding into the NHS and delivering 50 million more GP appointments per year, while there are 1.7 million fewer people living in absolute poverty compared to 2010, including 400,000 children.

“We continue to support people with cost-of-living support worth an average of £3,800 per household and, as inflation continues to come down, we are rewarding hard work by raising the National Living Wage and cutting taxes, and our Back to Work Plan will break down barriers for over a million people to find, stay and succeed in work.”