Poor ethnicity data masks the extent of disparities in the impact of COVID-19, according to a Nuffield Trust study.
In one report on ethnic coding in English health services datasets, the independent health think tank, said the NHS was not registering the ethnicities of “an excessive and growing proportion of patients.”
Analysis of data from hospitals, emergency departments and community services revealed that in 2019/20, 13% of inpatients and 17% of outpatients had no known reported ethnicity.
Other data quality issues including incomplete coding, inconsistent use of codes, and systematic biases in data quality.
For patients with multiple contacts with the NHS, patients from ethnic minority groups were more likely to have a different code assigned on different occasions, suggesting an inaccuracy.
Nuffield Trust says these issues mean estimates of COVID-19 infections, hospitalizations and deaths could be miscounted in ethnic and white minority groups.
The report notes that the NHS guidelines on ethnic coding have not been updated since 2001 and calls for the development and implementation of updated guidelines.
WHY IS IT IMPORTANT
The Nuffield Trust says the lack of comprehensive, high-quality data on health and mortality by ethnicity is a significant obstacle to addressing health inequalities.
THE BROADER CONTEXT
Earlier this year, NHS England announced it would start publishing data on the ethnicity of people receiving the COVID-19 vaccine, following backlash and accusations of potential bias.
A report from Public Health England published in August 2020, found that people of Bangladeshi descent were the most likely to die from COVID-19 and that those from black ethnic groups were the most likely to be diagnosed with the virus.
ON THE RECORD
NHS Breed Health Observatory Director Dr Habib Naqvi said: ‘It is essential that the NHS is committed to improving the recording of data on the ethnicity of patients so that we are better informed to meet the needs and challenges of our various communities. At this critical time, healthcare providers must learn from the pandemic and be able to leverage factual information from specific data sets, such as the impact of the virus on different ethnic communities in order to that we can plan, protect and prioritize those most at risk for disease in the future.
Nuffield Trust Deputy Director of Research Dr Sarah Scobie said: ‘At a time when ethnic disparities play a big role in a terrible pandemic, and with a new inter-ministerial council supposed to tackle health inequalities, it It is unacceptable that we have obvious gaps and distortions in recording the ethnic groups to which patients belong. It is all the more disturbing as the situation seems to be getting worse.
“We will not be able to prevent the uneven impacts that we see during the pandemic from recurring unless we can accurately say what they are. We can also misunderstand the important differences in disease risks and disease patterns – and make the wrong decisions accordingly. ”
A spokesperson for NHS England said: ‘This finding is now obsolete as recording ethnicity data was one of eight urgent actions outlined in the NHS pandemic response and stepped up in March this year , and all patient registration is now almost 95% complete. But more importantly, the NHS is addressing and preventing health inequalities where we can, for example by working with communities to dramatically increase the use of the COVID-19 vaccine among all ethnic minority groups. “