Health inequalities continue to be one of the biggest challenges facing primary care. While practices often recognise the issue, knowing where to start and how to take practical action can be difficult.
The Royal College of General Practitioners (RCGP) has recently launched the Fairer Practice Toolkit, a practical, evidence-informed resource designed to help general practices identify and reduce health inequalities in their local population.
The toolkit provides over 100 suggested actions across 18 themes, helping practices move from awareness to meaningful change.
You can download the toolkit here: Fairer Practice Toolkit
What the Fairer Practice Toolkit Includes
The toolkit is structured into four progressive tiers, allowing practices to start with simple, achievable actions and gradually move towards more advanced approaches.
A key part of the toolkit is identifying a “Focus Patient” group. This is the population group within your local area that is most at risk of poor access to care or worse health outcomes.
Examples might include:
- Patients experiencing homelessness
- People with learning disabilities
- Patients from specific ethnic minority communities
- Patients with severe mental illness
- Those living in areas of high deprivation
Once a practice identifies its focus group, the toolkit helps teams select relevant actions tailored to their local context.
The approach is supported by evidence and draws on national work such as the Core20PLUS5 framework, which prioritises the populations and conditions where inequalities are most significant.
Practices can also use an online tracker developed by the Fairer Practice community to record and monitor their progress.
You can download this here: Online Tracker
Why This Matters for CQC Compliance
Addressing health inequalities is increasingly important within the CQC’s new assessment framework, particularly within the Safe, Effective and Well-led quality statements.
CQC inspectors are now looking more closely at how practices:
- Understand the needs of their local population
- Identify groups at risk of poorer outcomes
- Adapt services to ensure equitable access to care
- Monitor and act on health inequalities
Using the Fairer Practice Toolkit can help provide structured evidence that your practice is actively addressing these areas.
How Practices Can Use the Toolkit to Support CQC Compliance
To get the most benefit from the toolkit and demonstrate good practice during inspections, consider the following approach:
1. Identify Your Focus Patient Group
Start by reviewing local data sources such as:
- Practice population demographics
- QOF and disease prevalence data
- PCN or ICS population health insights
- Appointment access data
- Feedback from patient groups
Choose one group where inequalities may exist.
CQC evidence tip:
Record how you identified this group and why it is a priority.
2. Select Relevant Toolkit Actions
Review the toolkit actions and select a small number of realistic improvements to start with.
Examples may include:
- Improving appointment access for a specific group
- Adjusting communication methods
- Reviewing outreach or proactive care approaches
- Strengthening links with community organisations
CQC evidence tip:
Document the actions chosen and how they align with the needs of the identified group.
3. Implement Changes Through Your Practice Processes
Involve the wider team in implementing changes. This may include:
- Reception and care navigation adjustments
- Clinical pathway improvements
- Targeted health checks or reviews
- Adjusting appointment systems
CQC evidence tip:
Keep meeting notes, action plans, or audit records demonstrating progress.
4. Monitor and Review Progress
Use the online tracker or internal monitoring tools to assess whether the actions are making a difference.
Consider measuring:
- Appointment access rates
- Screening uptake
- Chronic disease outcomes
- Patient feedback
CQC evidence tip:
Show how the practice reviews results and adapts its approach.
A Practical Way to Demonstrate Equitable Care
The Fairer Practice Toolkit provides a structured and practical way for practices to turn the concept of health inequalities into clear, manageable actions.
For practices preparing for inspection, it also helps demonstrate that your team:
- Understands the needs of your local population
- Is taking action to address inequalities
- Is monitoring the impact of those actions
All of which are key expectations within the current CQC framework.