Health inequalities

The Health Service Act 2006 (amended by Health and Social Care Act 2012) introduced the first legal duties on health inequalities, with specific duties on NHS England and CCGs, as well as duties on the Secretary of State for Health

NHS commissioners have duties to:

  • Regard the need to reduce inequalities between patients in accessing health services and the outcomes achieved (s.14T);
  • Exercise their functions with a view to securing that health services are provided in an integrated way, and are integrated with health-related and social care services, where they consider that this would improve quality, reduce inequalities in access to those services or reduce inequalities in the outcomes achieved (s.14Z1)
  • Include an explanation of how they propose to discharge their duty to regard the need to reduce inequalities in an annual commissioning plan (s. 14Z11)
  • Include an assessment of how effectively they discharged their duty to regard the need to reduce inequalities in an annual report (s. 14Z15).

Under the Equality Act legislation, socially deprived communities are not defined as a protected characteristic. However, when transforming services it is common, and considered good practice, to include consideration of this group due to the very well-documented links between socioeconomic disadvantage and poorer health outcomes. There is higher prevalence of some conditions such as obesity, diabetes, and heart disease in communities with higher levels of deprivation.

Indices of deprivation 2015

The Indices of Deprivation are an important tool for identifying the most deprived areas in England. Local policy makers and communities can also use this tool for the effective targeting of resources. The ID 2015 is the fifth release in a series of statistics produced to measure multiple forms of deprivation and retains broadly the same methodology, domains and indicators as the earlier Indices of Deprivation 2010, 2007, 2004 and 2000.

The table below shows the Local Authority and Local Enterprise Partnership ranking for overall deprivation and for each of the seven domain areas that make up the indices.

Local Authority ranks: 1 = most deprived, 326 = least deprived

Local Enterprise Partnership ranks: 1 = most deprived, 39 = least deprived


The table below provides an estimate of the local population living within each deprivation decile, for each Local Authority in Cheshire & Merseyside and for the two Local Enterprise Partnerships. Figures are based on the 2013 LSOA population estimates produced by the Office of National Statistics.