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    NICE quality standards: process guide

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    6 Equality and diversity

    We are committed to ensuring that our development process:

    • fully meets duties under the Equality Act (2010) to have due regard to the need to eliminate discrimination, foster good relations and advance equality of opportunity in relation to people who share the protected characteristics of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation, including the public sector equality duty to tackle discrimination and provide equality of opportunity for all

    • enables us to meet requirements under the Human Rights Act (1998)

    • fully meets duties under the Health and Social Care Act 2012 to consider the degree of a person's need for health services or social care in England.

    6.1 Reducing health inequalities

    Health inequalities arise because of the conditions in which we are born, grow, live, work and age. Health inequalities can be considered across 4 dimensions:

    • socio-economic status and deprivation (for example, unemployment, poor housing, poor education, low income or people living in deprived areas)

    • protected characteristics defined in the Equality Act 2010

    • vulnerable groups of society, or 'inclusion health' groups (for example, vulnerable migrants, people who are homeless, sex workers, and Gypsy, Roma and Travellers)

    • geography (for example, urban or rural areas, coastal areas).

    Health inequalities can be measured through examining differences in 5 domains:

    • health status (for example, life expectancy and prevalence of health conditions)

    • behavioural risks to health (for example, smoking, diet and physical activity)

    • wider determinants of health (for example, income, education and access to green spaces)

    • access to care (for example, availability of treatments)

    • quality and experience of care (for example, levels of patient satisfaction).

    Having due consideration for groups that may be affected by equality and health inequalities issues is an aspect of our compliance with both general public law requirements to act fairly and reasonably, and human rights obligations. It is also aligned to duties placed on the integrated care systems as outlined in the Health and Care Act 2022. We also have a moral, leadership and strategic duty to address health inequalities given our reputational role in delivering robust, independent and trusted advice to the UK health and care system.

    6.2 Approaches to reducing health inequalities

    We use evidence-based approaches to help identify and address equality and health inequalities issues throughout the quality standard development process by:

    • systematically identifying population groups that may experience health inequalities using an equality and health inequalities assessment form, which considers the 4 dimensions of health inequalities

    • building on the key principles of co-design, co-production and community engagement to include diverse voices and perspectives that can help identify health inequalities and inform actions to reduce them

    • proactively considering whether quality statements can advance equality and reduce health inequalities.