Ayub Bhayat and his team are becoming some of the most important figures in the NHS’s pursuit of equity.
Where health inequalities have often been described in broad strokes, they focus on something far more fundamental: creating the data architecture that makes fairness measurable. Their work on the Federated Data Platform is giving the health service a level of visibility it has never possessed, linking primary care, hospital and community data into a coherent picture of who is accessing care, who is not and where the gaps are widening.
It is quiet work and technically demanding, but its impact is increasingly evident. Systems that once relied on incomplete records and local intuition are now basing decisions on linked, structured insight. Leaders speak of a shift from speculation to certainty, from broad national averages to precise local understanding. In a service where inequality has been both persistent and poorly understood, that shift matters.
Bhayat’s approach has become distinctive. He is not a showman or a futurist. His focus is forensic. He has been stitching together fragmented datasets, building trust in the plumbing of the system and ensuring that every Integrated Care System can see its population with accuracy and consistency. The result is a new kind of national capability, one that turns the language of fairness into something concrete and actionable.
The clearest expression of this work is the Healthcare Inequalities Improvement Dashboard. Built on the FDP, it connects GP, hospital, community and national datasets into one secure environment and transforms them into a structured view of access and outcomes. Where previous dashboards offered snapshots, HIID provides a moving, layered picture of population need, broken down by deprivation, geography and ethnicity.
The effects have been immediate. In Birmingham and Solihull, the dashboard exposed gaps in ethnicity recording that were masking cardiovascular risk in South Asian communities. The data prompted a targeted improvement programme and is now giving clinicians a clearer perspective on who needs support and why. In the North East and North Cumbria, linked asthma data revealed preventable admissions concentrated in specific neighbourhoods. This led to a school-based outreach effort that has already begun to shift local respiratory outcomes.
National metrics reinforce the urgency. The Slope Index of Inequality shows an eight-year difference in life expectancy between the most and least deprived communities. Patterns in smoking, low birthweight and immunisation track deprivation with unflinching precision. These figures are no longer abstract inequalities. They are mapped, measurable and difficult for local leaders to ignore.
Alongside the inequalities work, the NHSE team has helped lay the foundations for the next generation of population health tools. In early incubator regions such as Cheshire and Merseyside, Frimley and the North East and North Cumbria, the first version of the FDP’s population health tool has been deployed, linking GP records with patient-level costing data to create a single, accurate source of truth.
The breakthrough is not only technological but structural. Establishing the information governance to link primary care data securely at scale has been one of the most significant achievements of the programme. It allows ICSs to examine linked, longitudinal data across long-term conditions, deprivation groups and demographic profiles with a level of precision the NHS has never previously held.
These regions are now using the tool for segmentation, risk modelling and early intervention planning. The work is methodical and incremental, yet it marks a shift from asking what happened last year to anticipating what might happen next.
This architecture is now shaping responses to the national Core20PLUS5 priorities. In North Central London, connected cancer screening data revealed low uptake in eastern Haringey. Mobile units, community partnerships and focused outreach followed. In Greater Manchester, the dashboard exposed low physical health check rates for people with severe mental illness in Oldham and Rochdale. A coordinated programme involving GP practices, community mental health teams and voluntary groups is now underway.
The origins of this approach can be traced back to the vaccination programme. West Yorkshire used real-time linked data to identify low uptake among Pakistani and Eastern European communities. Similar methods are now being applied to flu vaccinations, childhood immunisations and targeted screening initiatives across Kent and Medway, Leicester, Leicestershire and Rutland and the Bristol region.
The scale of what is emerging can be easy to underestimate. The NHS has been universal in principle but uneven in reality. Decisions have often been shaped by partial datasets, structural blindspots and the limitations of legacy technology.
Bhayat and his team are helping to build a different kind of system. One that can see its population clearly, understand variation precisely and intervene early enough to change trajectories. Their work is giving the NHS the clarity it has lacked for decades and the means to direct resources where they will deliver the greatest impact.
If the programme continues to grow at the current pace, the service will be better equipped to deliver care that is not only universal but fair. The foundations are being laid for an NHS that can finally act with a level of insight that matches the scale of its ambition.
