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<p>The Department through NHS England has a legal duty to have regard to reducing
health inequalities and this will be reflected in any assessment for the potential
development of national services.</p><p> </p><p> </p><p> </p><p>Diagnosing, treating
and preventing transmission of TB among under-served groups will prevent transmission
of infection to the wider population and reduce health and social inequalities. Public
Health England and NHS England will launch the Collaborative TB Strategy for England
2015-2020 this year. The strategy sets out the improvements that need to be achieved
across 10 key evidence based areas of action to reduce TB in England, and the mechanisms
by which these should be delivered. One of the key evidence based areas of action
is to reduce incidence of TB in under-served populations by providing specific and
targeted outreach interventions (informed by proven models such as “Find & Treat”
in London). These include specific services for active case finding for TB of the
lungs among homeless people and those attending substance misuse services, use of
mobile X-ray units (MXUs) with incentives for people to have chest X-rays, enhanced
case management and return to service interventions to prevent loss to follow up.</p><p>
</p><p><strong> </strong></p><p> </p><p>There are a number of actions being taken
to improve access to HIV testing and reduce late diagnosis, especially in areas with
high inequalities. These include the Terrence Higgins Trust to manage a national HIV
Prevention Contract which the Department funds; information PHE publishes on rates
of late HIV diagnoses by LA, socio-demography, and risk group; and joint PHE and DH
approaches to increase HIV testing through funding a national home-sampling service
that resulted in a large number of the most at-risk getting tested for HIV.</p><p>
</p><p> </p><p> </p><p>Clinical commissioning groups are responsible for commissioning
diabetes services, so they would decide, depending on local needs and circumstances,
whether an outreach service was appropriate. The NHS Health Check plays an important
role in reducing the risk of diabetes and identifying people earlier who have the
disease and plays a key role in tackling health inequalities.</p><p> </p>
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