Innovative trial launched to test digital answer to identifying health inequalities
22 October 2025
A new trial has begun to modernise data capture and decision making on health and social care inequalities in Wales.
The three-month trial will explore a digital version of the Health Equality Framework+ (HEF+), an outcome measure used by specialist practitioners in learning disability services.
HEF+ assessments are completed by health practitioners along with people with a learning disability and their families or carers. The assessments can help to inform decisions for an individual on important issues, such as where they live, how they keep active, the food they eat, and services they need access to.
The digital version of HEF+ was created by software developers at Hywel Dda University Health Board, in collaboration with Learning Disability Nursing staff. These nurses will lead the initial trial across Community Learning Disability Teams. Following the completion of the trial, the digital HEF+ will be shared with all health boards in Wales. This rollout will be co-ordinated through a national working group facilitated by NHS Wales Performance and Improvement, ensuring consistency and alignment with broader service improvement goals.
The trial is aiming to modernise the HEF+ from an enhanced spreadsheet to a streamlined digital application, improving its uptake and usability across Wales. The HEF+ gives services the tools to collect and track health equality impact data, turning insights into practical improvements that shape service delivery and design for individuals, communities, or whole regions.
The data collected by the HEF+ is monitored and gathered over a period of time to identify variation, identify inequalities and improve health outcomes. By understanding these factors, it helps to proactively prevent and intervene, minimising and reducing inequalities for people with a learning disability.
Rebecca Temple-Purcell, Assistant Director of Nursing, Patient Safety, Quality and Experience at Hywel Dda University Health Board, said:
“This trial is an important step forward in making the HEF+ more accessible and easier to use. By digitising the tool, we can better capture and act on the needs of individuals, ensuring their voices are heard. Ultimately, this will help improve outcomes for people with a learning disability and provide stronger support for their families and carers.”
The Learning Disability Programme at NHS Wales Performance and Improvement supports Health Boards and Trusts to use the HEF+, and is involved in several projects to further its effectiveness.
Bethany Kruger, Senior Improvement Manager at NHS Wales Performance and Improvement, added:
“Launching the digital HEF+ trial marks a key milestone in our commitment to person-centred care. It strengthens how we listen to and act on the needs of individuals with a learning disability, while promoting closer collaboration between professionals, families, and service users to drive meaningful change.”
Visit the NHS Wales Performance and Improvement website for more information on the development of the HEF+.