Is your trust making real progress in overcoming health inequalities? Read Robina Shah's commentary and join the discussion by posting your thoughts below

The NHS family is currently responding to the health inequalities debate with much more vigour than it has in the past. Equity in access to healthcare is fundamental to delivering individual care pathways in an NHS that seeks to look after its patients, its staff and the community it serves.

However, there is also strong evidence to suggest that the NHS is still failing to meet the healthcare needs of some members of our communities. This message is not new but builds on significant reports from the 1980s, such as the Black report,The Health Divide and, more recently, the Acheson report.

These studies acknowledge the higher morbidity and mortality rates affecting some groups of people and explain how socio-economic position, class, housing, employment, sex, race and disability can affect access to services.

Evidence suggests inequalities are increasing as a result of recent demographic changes. These include the rising number of elderly people; the prevalence of long-term illness and disability; deprivation linked to poor housing and employment prospects; poor access to health and social care; and changes in household structure.

For example, people from minority ethnic communities, from travelling communities, people with learning difficulties and carers have been shown to have higher rates of mortality and morbidity than members of the majority population. This is because they are more likely to live in inner-city areas, in substandard housing and to suffer disadvantages in employment, education, health and social services.

Is your trust tackling these issues effectively or does it lack the resources to make a real impact? Join the discussion by posting your thoughts and experiences.