Resuscitation Council UK launches landmark report to address inequalities in resuscitation

Every second counts: Tackling inequalities in resuscitation
Every second counts: Tackling inequalities in resuscitation

Resuscitation Council UK (RCUK) has launched a landmark report to address inequalities in resuscitation.

Every second counts: Tackling inequalities in resuscitation warns that socio-economic deprivation, a person’s ethnicity, or cultural background, shouldn’t determine whether a person is more or less likely to survive a cardiac arrest.

It recommends that the UK should join nearly half of the countries in Europe, who teach CPR training through the driving licence test, so that people who are less likely to receive training in the workplace – those who work in manual and ‘unskilled’ jobs - are guaranteed lifesaving skills via an alternative route. Well over half (67%) of drivers in manual or ‘unskilled’ jobs depend on a private vehicle for transport to work.

The report compiles important evidence of UK research on inequalities in resuscitation, and shows the huge disparities between rich and poor, and people from different cultural backgrounds, when facing the ultimate medical emergency.

RCUK commissioned research to understand the views and expectations of people from certain ethnic minority groups in England, around learning and performing CPR. The study found that seven in ten people didn’t know where their nearest defib was - this is in contrast to the wider UK population where six in ten did know.

Early defibrillation can more than double survival rates, yet defibs are lacking in areas where people from ethnic minority backgrounds live – over half (56%) of these areas have no defibs in comparison to 31% of areas where predominantly white British people live. They’re also lacking in the most deprived parts of the UK - almost half (44%) have no defibrillator registered on The Circuit, the national defibrillator network.

The report which is being launched today at the Houses of Parliament to key decision makers, partners, and cardiac arrest survivors, gives key recommendations on how to close the inequalities gap that currently exists when someone has a cardiac arrest.

James Cant, CEO at RCUK said: “A lack of public awareness that anyone can use a defib, as well as not knowing where these devices can be located, is a major obstacle to increasing the chances of surviving a cardiac arrest. Our research suggests that this is a particular issue among many minority ethnic groups. This is unfair as it further widens existing health inequalities. To address this, we must ensure everyone, everywhere has bystander CPR training that is tailored to their needs, and they understand that a defibrillator is there for them to use.

“Targeting public-access defibs in areas, where the data tells us they’re needed most and ensuring they’re registered on The Circuit will be a significant step in reducing inequality and ensuring everyone has an equal chance of survival.”

Many people from ethnic minority backgrounds across the UK are also facing disparities to accessing CPR training - Just 22% received training in the last ten years, compared with 41% of the UK population in the same period.

Nearly a third (32%) said they have had first or second-hand experience of cardiac arrest, yet six in ten (59%) said they lacked the knowledge and skills to perform CPR. 60% said they have never been trained in using a defibrillator, and a third (34%) mentioned a lack of awareness of training opportunities.

James continues: “Evidence shows that increasing CPR knowledge and training in the community is an effective way to give people everywhere an equal chance of surviving a cardiac arrest. Strategies to increase bystander CPR must also tailor resources to people from certain minority ethnic groups, where English is not the primary language, and where disparities in technology literacy and digital access exist.”

RCUK is recommending several initiatives to address these existing inequalities including:

Continue to collect ‘out-of-hospital cardiac arrest’ data as part of national strategy - Data saves lives. The routine collection of comprehensive data that effectively identifies and targets hotspot areas will be invaluable in tackling inequalities in out-of-hospital cardiac arrest.

Legislate for CPR training to be part of driving licence tests - The UK can significantly reduce disparities in CPR training access across occupational and ethnic groups by legislating for CPR training to be part of the driving licence test, and the DVSA’s Compulsory Basic Training for motorcycles and mopeds. This public health initiative is low cost and provides a greater foundation of CPR knowledge among the UK population who may not otherwise be trained.

Increase bystander CPR rates through targeted monitoring of CPR training in schools - Governments and local authorities across the UK have committed to giving every young person CPR training during their school career. However, some young people across the four nations are leaving school without this lifesaving skill. Governments across the four nations can work with schools, Local Authorities, and the Department for Education, to ensure CPR training is being carried out in an equitable manner across all schools. CPR training must be tailored to meet the language, cultural, and educational needs of all learners, to create a generation of lifesavers in currently underserved communities.

Every second counts outlines that if we are to tackle inequality in resuscitation it will require strategic leadership from central and devolved governments. There also needs to be successful delivery at regional and local levels, which will be dependent on healthcare professionals, and policy makers working together to play their respective parts in making these practical and achievable recommendations a reality without delay.

Dr Mohammed Khanji, British Islamic Medical Association (BIMA) Lifesavers national team and Consultant Cardiologist at Barts Health NHS Trust said: “The report suggests that understanding the different types of actions that can be taken when witnessing a cardiac arrest is low, amongst people from certain minority ethnic groups. Engaging influential community members or institutions is key to tacking inequalities in resuscitation. By reaching out to those community leaders who are trusted and influential, the value of learning CPR, and the positive impact it brings, can be effectively promoted.

“We are very proud of our growing number of volunteers and mosques supporting the BIMA Lifesavers programme, which is open to the general public. The community engagement and feedback has been humbling.”

Access the document here.

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For more information or to request for an interview or case studies please call the Resuscitation Council UK Press Office on 0207 388 4678 or email stella.hindle@resus.org.uk / tom.shearsmith@resus.org.uk / communications@resus.org.uk

1. Resuscitation Council UK is saving lives by developing guidelines, influencing policy, delivering courses and supporting cutting-edge research. Through education, training and research, we’re working towards the day when everyone in the country has the skills they need to save a life.

2. RCUK commissioned a survey to understand the views and expectations of people from certain ethnic minority groups in England around learning and performing Cardiopulmonary Resuscitation (CPR).

3. Fieldwork was conducted in February 2023, in areas with high levels of cardiac arrest in London, North East, North West, West Midland and Yorkshire and Humber.

4. The ethnic groups surveyed included people from Indian, Pakistani, Bangladeshi, African, and Caribbean backgrounds. The survey tool was designed to enable comparisons between this study and the wider population data.

5. The research had two main stages:

- Qualitative stage which was completed in November 2022 and involved 14 focus groups eliciting both breadth and depth of responses covering the main research objectives.

- Quantitative stage which was conducted in February 2023. This comprised a paperless survey conducted face-to-face of 509 respondents aged 18+ to gain a greater understanding of population level knowledge, attitudes, and perceptions.