NHS cannot stop social factors behind CHD rate

Variation in CHD mortality is largely caused by population factors, rather than quality of healthcare, a study has shown.

CHD: affected by social factors (Photograph: SPL)
CHD: affected by social factors (Photograph: SPL)

Researchers from the University of Leicester found risk of death from CHD was strongly linked to the level of deprivation, smoking, white ethnicity and diabetes in a PCT's population.

In comparison, only one service characteristic - the level of detected hypertension - improved this outcome.

The research supports NICE's warning that DoH plans to judge commissioning on outcomes may be unfair because outcomes are affected by factors outside the control of the NHS (GP, 5 November).

Evidence linking service characteristics to risk of CHD mortality could help inform improved healthcare, the authors explained.

They correlated population characteristics, including social and health determinants, with levels of CHD death in the UK between 2006 and 2008.

The findings showed programmes to reduce mortality 'should address those characteristics of populations amenable to intervention, including smoking and deprivation', the authors said.

The link between detected hypertension and reduced CHD mortality shows the importance of monitoring population level factors, they said. But they added: 'The extent to which primary healthcare services can affect these population factors is not certain.'

Responding to the research, NICE said the study was 'the latest in a significant number' to highlight the importance of focusing on inequalities caused by socioeconomic factors.

Commenting on plans to assess consortia on outcomes, GPC deputy chairman Dr Richard Vautrey said practices in deprived areas had always struggled to hit targets.

'The important thing is to understand that health inequalities can only truly be tackled by investing in education, housing, employment opportunities and a better environment,' he said.

'Tackle these and it is also likely that there will be falls in smoking, alcohol abuse and obesity, all causes of health inequality.'


Stephen Robinson

GP Online recommends

JAMA 2010; 304: 2,028-34

Read more

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Close up of hand holding sample tube with 'Omicron' handwritten on side

Government urged to 'free up' GP practices and expand steps to control Omicron

GPs have called for immediate action such as suspension of QOF to allow practices...

(Photo: Mike Kemp/Getty Images)

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...

External wall of GP surgery with wording 'medical centre'

‘Utterly toxic’: GPs speak out over abuse and physical attacks on practice teams

GPs have condemned a rise in verbal and physical attacks on practice staff - warning...

Artist's image of a spiked virus

Javid warns of 'substantial risk' from new COVID-19 variant

The highly mutated COVID-19 variant B.1.1.529 'may pose a significant risk to public...

Desk with lettering 'LMC conference'

LMCs reject 'outdated' GMS contract and demand move to item of service payments

LMCs have voted to scrap the 'outdated and inadequate' GMS contract and to replace...

GPs at an LMC conference waving green voting cards in the air

LMCs demand ringfence on enhanced services cash and clear GP representation in ICSs

LMCs have called for a ringfence on enhanced services funding, along with a guarantee...