Evidence map›Paper›PMID 41814338›Full record

ArticleBMC health services research2026

Mapping strategies for reducing inequalities in adult elective surgical care in the United Kingdom: a living scoping review.

Katherine-Helen Hurndall, Tetiana Lunova, Jonathan Clarke, Ana Luisa Neves, Ara Darzi

Abstract readScoping Review
In one paragraph

Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Katherine-Helen HurndallInstitute of Global Health Innovation, Imperial College London, Exhibition Road, London, SW7 2AZ, UK. khurndal@ic.ac.uk.
Tetiana LunovaInstitute of Global Health Innovation, Imperial College London, Exhibition Road, London, SW7 2AZ, UK.
Jonathan ClarkeThe Health Foundation, London, UK.
Ana Luisa NevesInstitute of Global Health Innovation, Imperial College London, Exhibition Road, London, SW7 2AZ, UK.
Ara DarziInstitute of Global Health Innovation, Imperial College London, Exhibition Road, London, SW7 2AZ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth inequalities persist within the National Health Service (NHS), with pre-existing disparities in health outcomes exacerbated by the COVID-19 pandemic. To mitigate further inequality, the NHS seeks to recover its elective backlog inclusively, particularly in surgical care. This review aims to examine interventions, across the elective surgery patient pathway, aimed at mitigating inequalities. Interventions, and their impact on inequalities, are described, while identifying existing knowledge gaps.

methodsOnline peer-reviewed academic databases and grey literature resources were searched with no time limit set. Articles were screened by two independent reviewers, with data extraction performed by one reviewer and verified by a second. Included articles described interventions successful in, or aiming to, reduce inequalities in elective adult surgery in the United Kingdom with description of the intervention’s impact on patient outcomes. A qualitative content analysis of the primary focus of interventions was performed to identify core themes of intervention.

resultsTwenty-two studies were included with interventions predominantly targeting secondary care, particularly orthopaedics. Across the patient pathway, four foci of intervention were identified: patient choice (n = 4); waiting list management (n = 7); treatment accessibility (n = 5), and alternative care delivery models (n = 4). National interventions (n = 11) included patient choice and waiting time initiatives, and increased utilisation of the independent sector, however there were minimal reductions in inequalities. Local interventions (n = 8) showed potential for reducing inequalities, particularly for marginalised groups, through local waiting list initiatives (n = 3) and improving treatment accessibility (n = 5).

conclusionSpecifically designed, targeted interventions seemed effective in addressing inequalities in elective surgery. Several gaps in the literature were evident, however, particularly the effectiveness of interventions in non-orthopaedic specialties and the impact of emerging care models, including surgical hubs, on equality of access and outcomes. REGISTRATION: This living scoping review is registered with the Open Science Framework ( https://osf.io/z3k76 ). The study protocol was published in advance.

Indexed as

COVID-19Elective Surgical ProceduresHealthcare DisparitiesAdultHumansSARS-CoV-2State MedicineUnited KingdomWaiting ListsElective surgeryHealth inequalitiesNHSScoping reviewUKUnited Kingdom

Identifiers

PMID41814338
PMCPMC13094166

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.