What is CORE20PLUS5?
Health inequalities remain one of the most pressing challenges in our society. To address this issue, NHS England has developed the CORE20PLUS5 approach—a targeted framework to reduce health disparities across the country. Designed for implementation at both national and local levels, this strategy is about more than just numbers; it’s about changing lives and delivering fairer outcomes for everyone.
Cayr Charity, our CEO Hannah, has been selected as an ambassador for the CORE20PLUS5 programme for the upcoming year. Over the next 12 months, Hannah will share her reflections and key learnings about this framework and its implementation. This marks an exciting milestone, as it is the first time that creative health and the arts are being integrated into the programme. Hannah’s leadership and dedication to innovation in healthcare provide a unique perspective on how the arts can play a vital role in addressing health inequalities and fostering holistic wellbeing. Her contributions promise to shed light on creative approaches to improving health outcomes within the CORE20PLUS5 framework.
This blog explores the CORE20PLUS5 approach, breaking down its components and highlighting its significance and how this framework can be embedded into a creative health context.
What Does CORE20PLUS5 Mean?
CORE20PLUS5 is a structured approach that identifies target populations and clinical focus areas to address healthcare inequalities. Its goal is simple but impactful—to ensure equitable access to healthcare for the most underserved communities.
1. CORE20
The "CORE20" refers to the most deprived 20% of the national population, as identified by the Index of Multiple Deprivation (IMD). This index accounts for various social determinants of health, including income, education, housing, and access to services. These factors have a profound impact on individual and community well-being, often widening existing health disparities.
By highlighting this specific 20%, the NHS aims to focus resources where they are most needed, ensuring those who are socially and economically disadvantaged receive timely and equitable healthcare support.
2. PLUS
The "PLUS" captures local population groups that experience unique challenges or barriers to accessing healthcare. These groups often vary by region but typically include:
Ethnic Minority Communities
People with Learning Disabilities and Autistic People
Individuals with Multiple Long-Term Conditions
Groups Sharing Protected Characteristics under the Equality Act 2010
Coastal Communities, where deprivation may be hidden amidst affluence.
Inclusivity is at the core of the "PLUS" component, recognising inclusion health groups, such as:
Homeless individuals
Drug and alcohol dependence cases
Vulnerable migrants
Gypsy, Roma, and Traveller communities
Sex workers
Victims of modern slavery
People in contact with the justice system
These groups face higher health risks and often encounter systemic barriers to accessing necessary care. The flexibility of the PLUS component allows local systems to identify and address the unique needs of their populations.
3. Five Clinical Priority Areas
The final part of the approach highlights five clinical areas that require accelerated improvement. These areas were chosen based on their potential to significantly reduce inequalities when addressed effectively:
Maternity Ensuring continuity of care for women from Black, Asian, and minority ethnic communities and the most deprived groups. Achieving this requires adequately staffed and safe care models.
Severe Mental Illness Prioritising annual physical health checks for people living with severe mental illness, ensuring this is carried out at nationally set targets.
Chronic Respiratory Disease Focusing on Chronic Obstructive Pulmonary Disease, this involves increasing the uptake of COVID-19, flu, and pneumonia vaccines to prevent exacerbations and reduce hospital admissions.
Early Cancer Diagnosis Aiming for 75% of cancer cases to be diagnosed at stage 1 or 2 by 2028, enabling earlier treatment and better survival rates.
Hypertension and Lipid ManagementIncreasing case-finding for hypertension, managing optimal blood pressure, and addressing lipid levels to minimise risks of heart attacks and strokes.
These focus areas are supported by national programmes and coordinated activity across systems to achieve measurable improvements and outcomes.
Why CORE20PLUS5 Matters
The CORE20PLUS5 approach plays a vital role in creating a fairer, more inclusive healthcare system. By focusing on both social determinants of health and clinical priorities, it recognises that health inequalities are not just medical issues but deeply rooted in societal structures.
This approach highlights the need for cross-sector collaboration. From policymakers and healthcare providers to charities, communities, and individuals, everyone has a role in turning these goals into realities.
How Creative Health Can Amplify CORE20PLUS5 Goals
Healthcare solutions don’t have to come solely from traditional methods. Creative health—using arts to improve physical, mental, and social wellbeing—offers a unique opportunity to embed the principles of CORE20PLUS5 into community-oriented initiatives.
For example, at Cayr we think it could fit with:
Maternity Services could integrate visual storytelling to educate and empower expectant mothers from minority or deprived backgrounds.
SMI Programmes might use group music projects to engage individuals in shared experiences.
Cancer Awareness Campaigns could use theatre or digital arts to communicate critical information about recognising early symptoms.
At Cayr Charity, we are already working to align creative health practices with the CORE20PLUS5 framework and over the next year using our work to write a project plan for the NHS.