In our 2021 report, we described how people living in more deprived areas have poorer access to planned hospital care than their more affluent counterparts. These deficits are widespread, substantial, and worsening. In this report, we move beyond describing and explaining the problem, providing practical support for those keen to address it. We start from the premise that inequities are not immutable. Tackling the issue will not be easy, but it is essential if the NHS is to be true to its founding principles. Efforts to date have clearly not been sufficient. Bolder action and more potent interventions are required.

The report is primarily aimed at integrated care board (ICB) members. Is addressing inequities in planned hospital care a priority for your organisation? If it is, then we hope this report will help. How much additional care, and of what type, would be required to ‘level-up’ access to planned hospital procedures? Is levelling-up the only solution? What interventions exist that might help reduce inequities? How might an ICB go about setting its strategy? And once set, how should the strategy be monitored? These are the questions addressed by this report.