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Updated: Jan 22, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
How fair is our service? Evaluating access to specialist paediatric care
Francesca K Neale1, Edward J Armstrong1, Jonathan M Cohen2,3
1Medical School, University College London, London, UK.
Objective:
To assess equity of access to paediatric outpatient clinics in our hospital.
Design/Setting:
Retrospective analysis of consecutive accepted referrals to allergy, asthma, epilepsy, general paediatrics, rapid access, chronic fatigue syndrome, diabetes and endocrine outpatient clinics.
Patients:
32 369 new patients, April 2007 to June 2018.
Results:
Among local patients (58.1%) 0.2%-2.5% of patients referred to each clinic lived in the least deprived quintile, and 43.5%-48.4% in the most deprived quintile-similar to inpatient admissions and the local population. Tertiary clinics showed a much higher proportion of patients from the least deprived quintiles (15.9%-26.2%).
Conclusions:
Local outpatient referrals broadly reflected the socioeconomic distribution, although not necessarily the distribution of need, of our local population. A relatively high proportion of patients in tertiary clinics were from more affluent postcodes, highlighting the need for referral inequalities to be evaluated across networks or regions.
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