Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: illustrative cases from the UK healthcare system

Date
2020-01-16
Authors
Hui, Ada
Latif, Asam
Chen, Timothy
Hinsliff-Smith, K.
Journal Title
Journal ISSN
ISSN
0168-8510
Volume Title
Publisher
Elseiver
Peer reviewed
Yes
Abstract
This paper explores how organisational structure, policies and practices in healthcare can inadvertently disadvantage marginalised populations (e.g. individuals from ethnic minority backgrounds) and reinforce health inequalities. We draw upon three diverse UK healthcare settings (long term care institutions, high security hospitals and community pharmacies) to illustrate how systemic injustices negatively impact on access to care, treatment and health outcomes. The first case study considers the care of older people within nursing homes; specifically the disempowering effects of this service structure and impacts of choice reduction upon health and their access to health provision. The second case study explores the impact of security restrictions upon patients within high security hospitals, focusing particularly on the maintenance of relationships and support networks outside of the hospital. The third and final case study, draws upon the national community pharmacy medicine management service to illustrate ways in which policies and guidelines inadvertently obstruct patients' engagement with the service within a community setting. We draw upon these settings to highlight inequalities within different contexts and to illustrate the ways in which well intended services can inadvertently disadvantage marginalised communities in multiple ways.
Description
The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
Keywords
older people, mental health, pharmacy, health policy, marginalised communities, medication reviews
Citation
Hui, A., Latif, A., Chen, T., Hinsliff-Smith, K. (2020) Exploring the impacts of organisational structure, policy and practice on the health inequalities of marginalised communities: illustrative cases from the UK healthcare system. Health Policy,
Research Institute
Institute of Health, Health Policy and Social Care