A Data-driven Approach to address Health Inequality
- Ben Sadler
- Sep 16
- 5 min read
Updated: Sep 17
The COVID-19 pandemic led to record hospital admissions, staff shortages and an increased backlog of patients for the NHS to manage. More deprived areas of the country were the most impacted which has led to a legacy of widening health inequality.1 On the 3rd July 2025, the Department of Health & Social Care released the NHS 10 Year Health Plan, Fit for the Future, with a roadmap to get the NHS back on its feet and presenting an opportunity to investigate how Principle One could contribute. 2
Each summer we run a ten week internship where students explore new ideas, concepts, and technologies, considering how these could make a real impact for our customers. This year, we were joined by Physics student Khushi Radia from University College London, Biomedical Engineering student Jasper Ferguson from Imperial College London, and Biochemistry student Edie Allden from the University of Oxford.
While previous internships focused on technology innovation within law enforcement, it felt timely to focus on our work in Health this year. Over the last few years, we have worked within the Health sector, supporting increased digital access to healthcare services. For this project, however, we partnered with Fylde Coast Medical Services (FCMS), a not-for-profit healthcare provider based in the northwest of England. They provide services for patients such as NHS 111 call handling, out of hours GP services and place-based care. We focused on their services in Blackpool, with high levels of social deprivation and as a result high levels of health inequality and centred our intern work on assessing whether taking a data-driven approach could identify ways in which FCMS could target their services to reduce this gap.
Our work was underpinned by the hypothesis that we could combine information about the local area gained from open-source data such as local census data, housing quality, car ownership and local indices of deprivation with FCMS case data for the last five years. This included demographic characteristics, diagnoses and patient interactions with the healthcare system, enabling the creation of a comprehensive dataset with over 1.5million entries. This dataset allowed our intern team to review health trends against the wider socio-economic characteristics of the Blackpool area to identify patterns but also to consider preventative interventions.
FCMS identified five initial healthcare challenges that represent a significant proportion of their interventions: respiratory infections, dental emergencies, infectious gastroenteritis, bloodwork processes, and existing service support.
Oral care, respiratory infections, and gastroenteritis emerged as the primary areas of interest. Oral care accounted for just over 7% of FCMS cases over 2.5 years, reflecting both high demand and limited access to dental provision in Blackpool, where ten practices are not accepting new patients and only one dentist is treating children under ten.3 Respiratory infections made up 13.5% of diagnoses, with 40% affecting children aged 0-5, and cases peaking at up to three times the average number of cases retrieved from the FCMS data in winter. Gastroenteritis accounted for fewer cases (1.3% of all cases) but showed a clear geographic pattern: central Blackpool, particularly the Layton ward, experienced an 80% increase compared to the wider Fylde Coast average. These findings underlined a common pattern across all three conditions: high volumes of preventable conditions combined with localised disparities that require targeted, place-based interventions.
Analysis of the two additional healthcare challenges identified, bloodwork processes and existing service support, revealed fewer specific insights, but still offered some learning. Analysis of bloodwork revealed individuals repeatedly contacted FCMS for samples over the course of 2.5 years, with some individuals accounting for more than 40 samples, suggesting potential opportunities for optimisation. Regarding wider services, many FCMS offerings such as wound care were found to be well utilised and fulfilling local gaps in care, demonstrating the effectiveness of these services amid rising NHS budget pressures.
Given the initial three findings, we developed a series of hypotheses to direct further analysis:
For oral care, could supervised toothbrushing schemes help reduce dental emergencies in areas with high case numbers, and how could access to out-of-practice services be improved to free up capacity for vulnerable or remote patients?
For respiratory infections, focusing on wards with the highest caseloads, could establishing an Acute Respiratory Infection (ARI) hub, a separate treatment hub for respiratory infections, in central Blackpool or Fleetwood make a difference? Additionally, could FCMS help to increase flu vaccine uptake among under five-year-olds, and could collaboration with local authorities reduce residential mould in private housing to tackle geographic health inequalities?
To address the high concentration of cases of gastroenteritis, could home-based meal schemes and online school resources encourage parents to keep children at home when unwell, supported by early years handwashing initiatives and improved community food hygiene to help limit transmission?
These hypotheses provided structure for the next phase of research, enabling prioritisation of the most feasible and impactful interventions for reducing health inequalities, working closely with FCMS.
Firstly, a focus was placed on tackling respiratory cases, through a deeper dive into the data to assess the potential impact of the introduction of ARI hubs. We were able to build on the insights from the FCMS-run ARI hub in Doncaster, which accepts GP and NHS 111 referrals, to understand how the implementation of a hub in Blackpool could impact respiratory cases. Secondly, a focus was placed on dental care around the potential to introduce supervised toothbrushing in areas with high dental cases with the aim to prevent oral health decline to the point it becomes an emergency.
Further analysis around the spikes in gastroenteritis did not demonstrate a clear correlation between the data that was available and cases of gastroenteritis per ward - suggesting rotavirus (a stomach infection) to be a more likely cause of gastroenteritis than environmental factors. Without clear indicators and a lower proportion of cases within FCMS’s overall workload, this was deprioritised.
With two promising interventions identified, the next step was to undertake more detailed geographic analysis to turn these hypotheses into an action plan. The team developed a mapping algorithm to link wards and map individual cases within these defined areas. This enabled the plotting of FCMS cases on heat maps which show different categories of open-source demographic information, including population density, deprivation, and car ownership, which could help shape the potential location and nature of interventions.
To tackle respiratory cases, the first step was to identify potential ARI hub locations, where Fleetwood and central Blackpool emerged as candidates. To test whether the success of Doncaster’s ARI hub could be replicated, these areas were compared against Doncaster using open-source socioeconomic data. All three showed similar age profiles and deprivation levels, but Blackpool had higher population density and lower car ownership while Fleetwood also had low car ownership, though surrounding areas had higher rates. These insights help determine whether mobile or stationary hubs would be most effective and where best to locate them. They could also enable FCMS to build a business case around investment in a hub, alongside a case to monitor infections to prevent future gaps in provision.
Supervised toothbrushing involves children brushing their teeth with fluoridated toothpaste at school or nursery under staff supervision. Analysis showed a hot spot in dental emergencies among asylum seekers, with a cluster around sites used for contingency accommodation. While support is provided through FCMS’s Complex Lives service, no dental pathway currently exists as part of that service.4 A domiciliary van offering on-site check-ups and oral hygiene packs could reduce emergencies and increase access to reduced or no-cost routine care via the NHS Low Income Scheme, enabling the realisation of long term savings. Expanding this service through initiatives such as People First Lancashire, which links asylum seekers with local advocates, could support other needs outside FCMS’s remit, such as accommodation or applications.5
Over the last ten weeks, our intern team have shown the potential interventions that a deep dive into FCMS data can identify. They’ve developed a broad range of new skills, both from a technical perspective, exploring different hypotheses iteratively, working as consultants to present their findings and coming together effectively as a team. In parallel, it provides FCMS a different lens on the challenges they face in dealing with the reality of health inequality and offers fresh insight around simple interventions that can have lasting impact.
For more information about FCMS, visit https://www.fcms-nw.co.uk.
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