Purpose Coalition & Medefer
Social Impact Report
Forewords
Rt Hon Justine Greening, Chair of the Purpose Coalition and Former Secretary of State for Education; Representative from Robertson Group
An Overview of Medefer and its Purpose
1.1 An Introduction to Medefer
1.2 Medefer’s Purpose
Breaking Down Britain’s Barriers
Mapping Medefer’s Activity Against the Purpose Goals
Rt Hon Justine Greening, Chair of the Purpose Coalition and Former Secretary of State for Education
This report arrives at exactly the right moment. In the NHS, waiting lists remain high, workforce pressures are acute and health inequalities continue to widen. It is in urgent need of solutions that strengthen the whole system, not just individual services, and the most credible innovations are the ones that improve access and outcomes, support staff and help deliver sustainable care with finite resources.
Medefer’s work speaks directly to that agenda. What stands out is not technology for its own sake, but a clinically led, digital-first model designed around three priorities: supporting the NHS, improving life for patients and communities and backing colleagues to thrive.
At its best, innovation makes the NHS work better, faster and more fairly. Combining clinical expertise with technology, Medefer’s virtual outpatient model bridges a persistent gap between primary and secondary care. Referrals move quickly into consultant-led assessment, risk is prioritised safely and patients receive timely advice, diagnostics and onward referral when needed. It reduces avoidable outpatient appointments and helps the Trusts it works with to focus face-to-face capacity on the people who need it most.
The case studies featured in the report shows how Medefer’s approach delivers for the communities it serves in practice - clearing backlogs while maintaining clinical safety, upgrading patients appropriately into urgent cancer pathways and preventing avoidable A&E admissions. These are not just abstract benefits but measurable, human outcomes which signpost to the next phase of NHS reform: earlier, smarter care that reduces downstream pressure.
That is not just operational improvement. It is social impact.
Medefer’s work doesn’t just address capacity, it addresses fairness. When waits come down and pathways speed up, outcomes improve. People stay economically active. Carers keep caring. Families avoid crisis points. Communities retain resilience. The report highlights a 44.6% access uplift for patients in the most deprived areas. That suggests a model that does not merely digitise existing pathways but actively shifts the fairness of access with a potential to reduce inequality, not deepen it. The commitment to inclusive delivery is also practical, not performative: telephone-first pathways where appropriate, face-to-face options when needed, and interpreter provision across hundreds of languages. In other words, digital becomes a doorway, not a filter.
What also stands out is the breadth of Medefer’s purpose. This is not impact limited to patients alone. Open recruitment, inclusive hiring, transparent progression pathways, flexible remote working and structured wellbeing support are treated as part of the mission, not side projects, contributing to a retention strategy which works for all colleagues, particularly for carers and parents.
The NHS does not need innovation for innovation’s sake. It needs models that reduce pressure, improve equity, cut carbon and strengthen local systems. Medefer’s approach, and the partnerships underpinning it, offer a credible blueprint for how we can modernise healthcare in a way that is patient-centred, community-led and outcomedriven, contributing to a more resilient NHS.
This report is not simply an overview of a provider. It is a case for how social impact can be designed into healthcare delivery, at scale, in the places that need it most.
Dr Bahman Nedjat-Shokouhi, PhD, FRCP
Founder & Chief Executive Officer, Medefer
Former Member, DHSC Elective Recovery Taskforce
As far back as I can remember, I had wanted to train as a doctor. One of the greatest privileges for me has been to treat my fellow humans at their time of need, in a National Health Service that is free at the point of access.
I had a transformative experience with two of my patients. One of them was a man in his 30s who had presented to A&E with jaundice (yellowing of his skin). He was found to have disseminated liver cancer. When I looked into his history, I found that he had been lost to follow-up. He had a condition that, had it been monitored and managed, would almost certainly have been treatable. His cancer was not inevitable. When I told him the news, he broke down. He told me about his dreams. He told me about his family. He was a brother, a son, a husband, and a father.
The problem was not lack of investment, or beds, or workforce. The real issue is the inefficient use of our existing resources. The real question is how do we see the right patient at the right time?
I founded Medefer in 2013 with a conviction that we can, and in fact have a moral obligation to, improve our NHS and deliver a better outcome for the patients.
Twelve years later, this report documents what that conviction has delivered in practice. More than 160,000 patients seen across 25 NHS partnerships. A 44.6% improvement in access for patients from the most deprived communities. Earlier cancer diagnoses through targeted screening programmes. Sustained reductions in waiting times, with over 95% of referrals reviewed by a consultant within 48 hours.
Much of what Medefer has built over the past twelve years, consultant-led virtual-first pathways, risk-based triage, local diagnostics coordinated through a single digital platform, is now reflected in the government’s 10-Year Health Plan.
In September 2025, the Prime Minister announced NHS Online, a national virtual hospital service due to launch in 2027. In its supporting announcement, NHS England cited our partnership with Barking, Havering and Redbridge University Hospitals NHS Trust as one of three tried-and-tested models forming its blueprint.
Behind every statistic in this report is a person whose pathway worked when it might otherwise have not. We have proved this works. The task now is to make it available to every patient who needs it.
1.1 An Introduction to Medefer
Medefer is a pioneering healthcare provider that utilises technology to transform the way patients access specialist care within the NHS, in a digitalfirst, community-led approach that reflects that envisioned in the NHS’ 10-Year Plan. Through its innovative virtual outpatient service model, Medefer bridges the gap between primary and secondary care, allowing patients to be assessed, diagnosed and managed remotely by NHS consultants. This unique approach reduces waiting times, streamlines referrals and ensures patients receive care faster and closer to home.
Founded by NHS consultants in 2013, Medefer was established with the purpose of tackling some of the most pressing challenges in healthcare: long outpatient waiting lists, inefficiencies in referral processes and the strain on frontline services. The company’s digital-first model allows GPs to refer patients directly into Medefer’s platform, where consultant-led teams provide timely reviews, advice and where necessary, onward referrals, creating a seamless system that improves patient experience while reducing unnecessary hospital visits.
Medefer’s operations extend across multiple NHS Trusts and Clinical Commissioning Groups, making it a trusted partner in rethinking the future of outpatient care. Its services are underpinned by a strong commitment to safety, quality and integration with existing NHS systems.
By alleviating pressure on hospital outpatient departments, Medefer helps the NHS to focus resources on patients requiring face-to-face intervention.
Central to Medefer’s ethos is its focus on social impact. By reducing waiting times and enhancing access to specialist care, the company contributes to improved health outcomes, equity of access and greater patient satisfaction. Its model also supports sustainability within the healthcare system, lowering the environmental impact by minimising unnecessary travel and hospital attendances.
The company’s digital-first model allows GPs to refer patients directly into Medefer’s platform
Medefer stands at the forefront of digital health innovation in the UK, combining clinical expertise with technology to deliver services that are efficient, patient-centred and socially responsible. In doing so, it continues to support the NHS in addressing systemic challenges, while advancing its mission to make healthcare more accessible and equitable for all.
At the heart of Medefer’s work is a clear purpose: to make healthcare more accessible, efficient and patient-centred, while supporting the NHS in addressing some of its most pressing challenges. Central to this mission are Medefer’s guiding values, which shape its culture and approach.
These values ensure that Medefer consistently places patients at the centre of its work, while also fostering collaboration and forward-thinking solutions that benefit both individuals and the wider healthcare system.
Medefer is committed to delivering an unrivalled healthcare experience for every patient. This principle reflects the company’s belief that healthcare must be compassionate and tailored to individual needs. By ensuring that patients are placed at the forefront of every decision, Medefer provides timely, safe and high-quality care that improves lives and strengthens trust in the system.
Medefer continually seeks ways to enhance its services. This inventive spirit has enabled the development of a pioneering digital outpatient model that reduces unnecessary hospital visits, streamlines pathways and addresses inefficiencies, creating meaningful, lasting improvements in healthcare access and delivery.
Partnership lies at the core of Medefer’s approach. By working alongside NHS Trusts, commissioners, GPs and patients, the company delivers solutions that benefit all. This collaborative ethos fosters integration across healthcare systems, helping ensure resources are used efficiently and care is delivered where it is needed most.
Whether through the timely care delivered to patients, the innovative solutions developed to support the NHS or the partnerships built across the healthcare system, Medefer ensures that its values are shaping a future where healthcare is not only more efficient, but more compassionate, equitable and sustainable.
The Purpose Coalition measures organisations against a set of sector-relevant social impact criteria. The Purpose Goals outline 15 interconnected impact barriers to opportunity. By drawing on expertise provided by academia and business, the goals are designed to specifically address some of the unique challenges facing the UK.
The Coalition’s cross-party work brings together the UK’s most innovative leaders, Parliament and organisations to improve, share best practice and develop solutions for improving the role that organisations can play for their customers, colleagues and communities by breaking down barriers to opportunity.
The Purpose Coalition is chaired by Rt Hon Justine Greening, the UK’s former Secretary of State for Education, Transport and International Development.
The Goals were designed following Justine’s experience as Secretary of State for International Development, leading the UK’s delegation to the convention of the United Nations (UN) that established the 2015 UN Sustainable Development Goals (SDGs). The Purpose Goals apply the SDGs in a UK context.
The SDGs as interlinked goals emphasised the interdependent environmental, social and economic aspects of development and centralised the role of sustainability.
At the time, Justine recognised how transformative a common set of accessible but ambitious goals could be in galvanising action to effect change. After leaving Government in 2019, Justine established the Purpose Coalition and Social Mobility Pledge with the intention of galvanising UK economic and social actors to improve social mobility in the UK.
The Purpose Goals focus on key life stages and highlight the main issues that need to be resolved to break down barriers to opportunity in the UK. The Goals are intended to guide ambition, provoke action and measure progress.
Open recruitment is essential in ensuring that all individuals have a fair opportunity to find meaningful employment and pursue fulfilling careers. By placing inclusivity and respect at the heart of its hiring practices, Medefer not only supports candidates to achieve their potential but also strengthens the organisation through comprehensive recruitment processes that identify people who are the right fit for its culture and values.
All roles at Medefer are openly advertised through a variety of platforms to ensure opportunities reach as diverse a talent pool as possible. Vacancies are posted on online platforms such as LinkedIn, as well as through local job centres, broadening accessibility for individuals from different backgrounds and at different stages in their careers. Alongside this external advertising, job opportunities are also shared internally, allowing colleagues to progress within the organisation and take on new responsibilities.
The recruitment process itself is designed to be thorough, transparent and supportive. Candidates typically take part in two to three conversations with Medefer managers and interview questions are primarily competencyand behaviour-based, with the aim of understanding how candidates align with Medefer’s culture and values. This approach helps the company identify individuals who not only have the required skills for the role but are also the right fit for the company’s ethos.
The recruitment process is overseen by Medefer’s dedicated Talent Acquisition Manager, who ensures that recruitment is carried out fairly and consistently across the organisation. This oversight reflects Medefer’s commitment to maintaining high standards in its hiring processes, ensuring that every candidate is treated with respect.
5.2
Medefer places a strong emphasis on ensuring that its recruitment process is inclusive and accessible to all. As part of this commitment, reasonable adjustments are available to be made throughout the application process, enabling candidates to request support or modifications to ensure that they can fairly participate in the process.
The company is also proud to have achieved Disability Confident Employer Level 2 accreditation, in recognition of its efforts to create an inclusive workplace where colleagues with disabilities can thrive. Medefer is actively working towards achieving Level 3 accreditation, which will further cement its reputation as a leader in inclusive recruitment and workplace practices.
By embedding inclusivity into recruitment and progression pathways, Medefer demonstrates that it is not only committed to identifying the best talent, but also to ensuring that all individuals, regardless of background or circumstance, have a fair opportunity to succeed. This commitment is reflected in Medefer’s workforce profile: 32.3% of colleagues are from minority-ethnic backgrounds (compared with 19.3% of the England and Wales working-age population) and 58% are women (against an England benchmark of 48.6% women in employment). Medefer is a Disability Confident Level 2 employer and reinforces its approach to open recruitment through strong governance signals, including Data Security and Protection Toolkit (DSPT) ‘Standards Exceeded’, Cyber Essentials Plus, and ISO/ IEC 27001 and ISO 9001 certification.
Fair and transparent career progression is central to making sure that colleagues feel motivated, supported and valued.
For Medefer, creating opportunities for colleagues to grow is about improving individual career outcomes while also ensuring that the organisation can continue to deliver services to the highest standard. Providing colleagues with clear pathways for learning, leadership and work-life balance means that they can progress in their careers while remaining engaged, supported and fulfilled in their roles.
The first weeks in a new role are critical to longterm success. To ensure that new colleagues get off to the best possible start, Medefer provides a comprehensive induction programme designed to make individuals feel welcomed and supported as they enter a new workplace.
The induction process includes an introduction to key policies and procedures, such as health and safety, ensuring that colleagues are well informed about the standards and expectations that guide the organisation. New colleagues are also provided with full technical support to be set up and trained on Medefer’s systems, enabling them to quickly become confident and effective in their roles.
Medefer provides a comprehensive induction programme designed to make individuals feel welcomed and supported as they enter a new workplace.
In addition, a series of mandatory training modules are required to be completed during the induction period to make sure that all colleagues are equipped with the essential knowledge and skills they need not only to perform their role effectively, but also to live up to Medefer’s values and commitments as an organisation.
Medefer places a strong emphasis on continuous learning, supporting colleagues to access opportunities that enable them to expand their skills and progress in their careers.
A wide range of training modules are available for employees to undertake, including mandatory programmes such as annual cyber security training and role-specific modules to ensure professional excellence. To complement this, colleagues have access to platforms such as LinkedIn Learning, offering flexibility to pursue areas that align with their personal interests and longterm career goals.
Each colleague engages in monthly one-toone meetings with their manager to assess development needs, identify tailored learning opportunities and explore progression pathways. Medefer has supported colleagues to undertake apprenticeships as part of this development assessment and the company also funds professional memberships and subscriptions relevant to employees’ roles, further reinforcing its commitment to ongoing professional growth.
Internal progression is actively supported and encouraged at Medefer. Clear job descriptions are provided for every role, alongside transparent promotion pathways and defined competencies required to advance to the next level. This helps colleagues to understand what is needed to achieve their career aspirations.
For those aiming to move into leadership of supervisory roles, Medefer provides a range of training resources and support. These include modules focused on management and leadership skills, enabling aspiring leaders to build the confidence and capabilities necessary to take on greater responsibility. By investing in leadership development, Medefer fosters a culture where internal progression is supported and encouraged.
Individuals with young families, caring responsibilities or other personal commitments can often be disadvantaged when it comes to career progression. Medefer actively counters this trend by implementing comprehensive policies that value and support a healthy work-life balance.
As a remote-first organisation, Medefer encourages flexible working arrangements, including adaptable working hours, and strives to accommodate individual requests wherever possible. This flexibility allows colleagues to balance personal and professional responsibilities without compromising on career development.
Parental leave policies are also in place to support employees as they transition into or return from family leave, ensuring that career progression remains accessible and inclusive. By embedding flexibility and family-friendly policies into its structure, Medefer ensures that all colleagues can grow in their careers without needing to sacrifice other aspects of their lives.
Medefer is committed to ensuring good health and wellbeing for both its employees and the wider communities it serves. At the heart of the company’s mission is the belief that access to healthcare should not be dependent on geography, circumstance or resources, and that colleagues delivering this mission must themselves be supported to live healthy, balanced lives.
As an organisation dedicated to expanding access to healthcare, Medefer recognises the importance of supporting its colleagues in prioritising their own health. The company has a range of healthcare support measures in place to ensure that employees can access the right care whenever they need it.
All Medefer employees benefit from access to Vitality private healthcare, which provides colleagues with the security of being able to access health checks and medical care in a time of need. Family members can also join the scheme at a discounted rate, extending the benefits of healthcare access beyond the company’s employees themselves. Vitality further incentivises healthy lifestyles through discounts linked to physical activity levels, encouraging colleagues to integrate exercise into their daily lives.
Occupational health support is provided, ensuring that every colleague is assessed and offered the opportunity to request adjustments or additional support tailored to their individual circumstances.
Examples include ergonomic chairs and office equipment to support safe working environments at home, or access to a mentor to provide guidance and encouragement. Through these measures, Medefer ensures that colleagues can carry out their work effectively, safely and with their wellbeing consistently viewed as a priority.
Psychological safety underpins Medefer’s culture. The company strives to create an environment in which colleagues feel supported, listened to and able to raise concerns with confidence. Mental health support is accessible through the 360 Wellbeing platform, which provides counselling sessions and reassurance that help is always available when required.
Financial wellbeing is also considered an important aspect of mental wellbeing. Employees are given access to the Blue Light Card, which provides discounts and savings to reduce everyday financial pressures.
Medefer assigns mentors to colleagues who need additional support, providing a trusted point of contact within the workplace. This reinforces the organisation’s culture of openness and care. The company’s Freedom to Speak Up policy further strengthens this approach, encouraging colleagues to raise concerns in company-wide meetings or through private channels. Employees can also raise issues anonymously through an app, removing barriers to speaking up.
Medefer has two Freedom to Speak Up Guardians registered with the National Guardians Office and works closely with the whistleblowing charity Protect and the Care Quality Commission, further reflecting the company’s firm commitment to transparency and trust.
Medefer’s employee representative group plays an important role in ensuring communication flows effectively across the organisation. This group gives colleagues an opportunity to voice concerns, as well as share positive feedback about people and processes. By embedding these practices, Medefer is making sure that mental health and wellbeing are prioritised at every level in its workplace environment.
Widening access to healthcare and addressing inequalities is at the core of Medefer’s mission. Its digital-first model is designed to deliver better health outcomes for patients by reducing waiting times and ensuring that the quality and speed of care is not determined by postcode.
Through its use of technology, Medefer can assess patients according to their level of risk. This ensures earlier diagnosis and intervention, which not only improves health outcomes but also increases the likelihood of successful treatment and recovery. In turn, this means individuals can return more quickly to their families and communities, whether by providing care for loved ones or contributing economically. The social impact of this model therefore extends far beyond individual patients, benefitting families, communities and wider society.
Medefer’s use of innovation to streamline patient pathways also enables care to be delivered closer to home, aligning with the NHS’ 10-Year Plan. By alleviating pressure on hospital outpatient departments, the company helps address longstanding systemic challenges in the healthcare system by allowing NHS resources to be used more efficiently on those who require face-to-face intervention.
Medefer’s healthcare model generates significant social impact across the UK. By widening access to healthcare, accelerating diagnoses and improving treatment outcomes, the organisation contributes to healthier communities and a stronger society. Within this, Medefer has demonstrated measurable gains in health equity, including a 44.6% access uplift for patients from the most deprived areas (Index of Multiple Deprivation deciles 1–2), while IBD Hot Clinics at Barking, Havering and Redbridge University Hospitals NHS Trust avoid around 50 A&E admissions each month, illustrating how proactive, virtual-first pathways can relieve urgent and emergency care while improving outcomes.
Medefer’s partnership with James Paget University Hospital (JPUH) and the Norfolk & Waveney Integrated Care System (ICS) demonstrates the impact of its digital-first model in tackling long waits and widening access to specialist care. Faced with significant backlogs in Gastroenterology and Hepatology due to consultant shortages and rising demand, the ICS commissioned Medefer under an Any Qualified Provider (AQP) contract to provide a remote-first, consultant-led service that could relieve system pressure rapidly and safely.
Medefer undertook the Inter-Provider Transfer (IPT) of 945 long-waiting patients, applying its structured Red/Amber/Green risk assessment model to ensure clinically safe prioritisation and efficient use of local diagnostic and in-person capacity. All patients received consultant-led assessment, with Medefer coordinating diagnostics through JPUH and local partner providers to expand available capacity across the system.
The outcomes were transformative. 86% of transferred patients were discharged without requiring a hospital outpatient appointment, demonstrating the effectiveness of virtual
management and the avoidance of unnecessary in-person care. Patients were reviewed quickly, with an average 6.2-day wait from transfer to first consultant assessment and 46% assessed within 48 hours. Safety processes functioned effectively, with 4.4% of patients appropriately upgraded to the Urgent Suspected Cancer pathway and one escalated directly to A&E.
Alongside backlog clearance, Medefer also delivered ongoing new-referral management, achieving an average 0.6-day (14-hour) consultant review time, with 92.6% of new referrals assessed within 48 hours. Most new referrals (83%) were completed remotely, further reducing demand on hospital outpatient departments.
The impact for JPUH and the ICS has been substantial: rapid backlog recovery, increased consultant capacity for urgent and complex cases, strengthened system collaboration and a more sustainable pathway for ongoing elective demand. Building on this success, JPUH has now commissioned Medefer as an ongoing partner to provide continued resilience and expanded specialist support across additional specialties, including Cardiology and Neurology.
The impact for JPUH and the ICS has been substantial: rapid backlog recovery, increased consultant capacity for urgent and complex cases, strengthened system collaboration and a more sustainable pathway for ongoing elective demand.
Medefer’s partnership with the Surrey & Sussex Cancer Alliance showcases how a digital-first, consultant-led pathway can drive earlier diagnosis, reduce inequality and improve outcomes in men’s health. Prostate cancer is the most common cancer among men in the UK, yet diagnosis is often delayed due to inconsistent testing and low awareness. Following the Covid-19 pandemic, the Alliance identified a shortfall of more than 3000 suspected cancer referrals, including an estimated 470 missed prostate cancer diagnoses, highlighting an urgent need for a new approach to early detection.
To address this challenge, the Targeted Prostate Health Check (TPHC) programme was launched, offering a proactive, community-based pathway designed to identify higher-risk men and support timely diagnosis without adding workload to general practice. Medefer’s digital platform enabled an end-to-end service, from invitation and consent through to results handling and referral. Eligible men were identified through GP records and invited by text or letter to access clear online information and provide consent digitally, with telephone support available for those needing additional assistance. Community phlebotomy clinics run through Primary Care Networks made testing convenient and accessible.
Normal results were automatically discharged with safety-netting advice, while elevated results triggered a structured consultation with a Clinical Nurse Specialist. Where specialist input was required, Medefer’s consultants completed urgent suspected cancer referrals directly through the NHS e-Referral System, ensuring rapid escalation and clinical safety.
The outcomes demonstrate the programme’s significant impact. Of 66,911 men invited, more than 18,000 were tested, identifying 263 cancers—84% of which were clinically significant. Most were organ-confined, representing earlier and more meaningful detection. The pathway also delivered a 30% 2-week-wait conversion rate, far exceeding the national average, while maintaining high patient satisfaction (4.7/5).
By combining proactive outreach, community testing and a seamless digital infrastructure, the TPHC model reduced GP workload, improved awareness and delivered strong value for money. It provides a scalable, prevention-first blueprint for men’s health that supports earlier diagnosis, reduces inequalities and strengthens system efficiency.
Where specialist input was required, Medefer’s consultants completed urgent suspected cancer referrals directly through the NHS e-Referral System, ensuring rapid escalation and clinical safety.
Extending enterprise 9
Medefer’s model of care does more than deliver timely specialist support for patients; it also extends enterprise and value across the wider healthcare ecosystem.
By working in partnership with NHS organisations, independent providers and local practitioners, Medefer generates benefits that ripple out into communities and businesses. Its approach strengthens supply chains, promotes growth and sets higher standards across the sector, creating a social impact that reaches well beyond the immediate delivery of healthcare.
Medefer is uniquely positioned at the top of the patient pathway, often being the first point of specialist contact during a patient’s initial consultation before then directing patients towards essential diagnostic tests. By working with both NHS organisations and independent providers across the country, Medefer ensures that patients can access these services as close to home as possible.
This approach generates tangible benefits for Medefer’s supply chain. Local healthcare providers and practitioners are supported with additional work, creating new revenue streams and opportunities to expand their practices. By anchoring patients within NHS infrastructure wherever capacity allows, Medefer places public provision at the heart of its operations; where NHS services are oversubscribed, referrals are directed to the independent sector, but the NHS always remains the first choice.
The impact of this model can be seen in partnerships such as Medefer’s collaboration with Staffordshire and Stoke-on-Trent ICB, which generated over £1 million in NHS revenue within a 12 month period. In this way, Medefer not only supports patient care but also contributes to the financial sustainability and growth of the wider healthcare system in the UK.
Medefer places public provision at the heart of its operations
Medefer’s influence extends beyond direct service delivery to the standards it sets for its supply chain partners. Rather than excluding organisations that may initially fall short of its expectations, Medefer adopts a supportive approach, encouraging partners to raise their standards in areas such as social impact and inclusivity.
For example, Medefer actively promotes the value of accreditations such as the Disability Confident Employer status, which the organisation has itself acquired. By encouraging others in its network to follow suit, Medefer fosters a culture of inclusion and responsibility across the healthcare supply chain.
Moreover, Medefer uses its platform to highlight the positive contributions of its partners, raising the profile of practices and businesses that demonstrate commitment to high standards of care and social impact.
Through these efforts, Medefer amplifies its social impact across the regions in which it operates. By setting a benchmark and encouraging partners to emulate it, the organisation has the potential to drive systemic improvements in healthcare delivery and create lasting benefits for communities across the country.
As a digitally-based company with a primarily remote workforce, Medefer understands that digital access and skills are fundamental to its model of working.
Digital and AI divides remain a significant challenge. For many, barriers to access can include the absence of reliable broadband or devices, while others struggle with affordability and limited digital literacy when using new technologies. The emergence of AI is further compounding these challenges, presenting new opportunities but also risks for exclusion if individuals and communities are unable to engage with these tools effectively.
Medefer recognises that equality of opportunity in healthcare and employment can only be achieved if digital and AI divides are addressed.
As a digital-first organisation, the company is deeply committed to ensuring that colleagues, clinicians and patients alike are empowered with the access, skills and support they need to thrive in an increasingly digital world.
Every colleague is equipped with comprehensive training in how to use the company’s platforms. This begins during induction and continues throughout their career, ensuring that employees remain confident and capable in navigating systems essential to their roles. Colleagues receive robust instruction on data security and are guided step by step through the tools and processes required in their work. Dedicated points of contact are available to provide ongoing support, helping to ensure that no one is left behind as technology continues to develop.
Medefer is also taking proactive steps in relation to artificial intelligence. The company has established an AI working group, open to all colleagues, which explores opportunities for integrating AI into day-to-day activities. The group not only identifies practical uses for AI but also works to upskill staff, enhance awareness of potential risks and promote a culture of safe, informed and effective AI use.
Supporting clinicians within the supply chain is a priority for Medefer, as they form an essential part of its healthcare delivery model. To maintain the highest standards of care, the company has developed structured programmes to ensure that clinicians are confident in using its digital platforms.
A mentorship programme pairs consultants and doctors with clinical leads, providing guidance during their initial weeks working with Medefer. This enables new clinicians to familiarise themselves with Medefer’s processes, expectations and systems, while also allowing for direct discussion of cases to ensure accuracy and consistency.
Feedback is embedded into the system, with training provided through peer review of cases. This collaborative approach not only supports continuous learning but also safeguards quality and standards across all patient interactions, ensuring the best possible outcomes.
Medefer recognises the need to ensure that patients are not excluded from care due to digital barriers. Its healthcare model has been designed to minimise technological requirements while maintaining clinical safety and, in most cases, patients only need access to a telephone for consultations, with video calls used only when necessary.
This approach also removes barriers for individuals with mobility challenges, neurodivergence or limited access to transport, while also reducing the costs and time associated with travel. Importantly, patients always have the option of a face-to-face consultation if digital methods are unsuitable.
This flexibility extends to communication preferences. While most patients receive updates and information via SMS, they can request correspondence by letter if they prefer to reduce digital requirements. Its telephone-first approach for remote pathways, where clinically appropriate, ensures that patients can access care even where broadband coverage, device availability or digital literacy are limited, further reducing the risk of exclusion from virtual care. Medefer also utilises translation technology during telephone calls and in 2025 reached its target of fulfilling 100% of interpreter requests across its services, supporting 240 languages.
By combining technological innovation with a strong focus on inclusivity, Medefer ensures that its digital-first model enhances rather than restricts access to healthcare.
Feedback is embedded into the system, with training provided through peer review of cases.
3.12 Goal 12:
In order to create fair and thriving societies, it is essential that the right infrastructure is in place across communities throughout the UK. Nobody should be prevented from accessing opportunities or enjoying a good quality of life simply because of their postcode.
This principle lies at the heart of Medefer’s vision for healthcare. The company utilises digital innovation to bridge geographic divides, connecting people with opportunitieswhether in healthcare access or employmentirrespective of where they live.
Medefer’s digital-first model ensures that access to healthcare is not dictated by location. Patients can often be seen remotely, reducing the inequalities caused by regional variations in healthcare provision. This creates a more equitable system, where all individuals have timely access to high-quality advice and care.
Through virtual or phone consultations, patients are connected with consultants based anywhere in the UK, removing the constraints of relying solely on local healthcare services and professionals and broadening access to specialist expertise.
Furthermore, Medefer’s approach to delivering healthcare reduces the burden of travel for patients, particularly those living in areas underserved by transport infrastructure.
By eliminating the need for unnecessary journeys, Medefer addresses one of the key barriers to accessing healthcare. For patients who must attend in-person appointments but face challenges due to inadequate transport links, Medefer directly funds and organises transport to ensure that no one misses vital care due to travel difficulties.
The shift towards hybrid and remote working has created new opportunities to break down geographical barriers in employment, and as a remote working company, Medefer has embraced this opportunity fully. This model enables Medefer to recruit talent from across the UK, rather than limiting opportunities to those in specific regions.
Medefer’s diverse workforce spread across a variety of locations across the UK and internationally is evidence of this approach. Medefer’s working structure empowers employees to base themselves in the location that best suits them and their families, without compromising their ability to contribute meaningfully to the organisation.
Importantly, Medefer does not apply locationbased salary weighting. Employees receive pay that is not tied to their geographic area, meaning that financial considerations do not force them into particular living arrangements. This approach supports both professional opportunity and personal choice, ensuring that location never becomes a barrier to employment at Medefer.
The transition to a low-carbon future requires coordinated action across all sectors, and healthcare has a pivotal role to play. As one of the UK’s most resource-intensive public services, the NHS contributes significantly to national carbon emissions, particularly through patient and staff travel, estate usage and clinical processes. Businesses such as Medefer are helping accelerate the drive toward Net Zero by offering models of care that are both clinically effective and inherently sustainable.
Medefer’s remote-first healthcare model shows how digital transformation can support climate objectives while simultaneously improving patient access and operational efficiency. By minimising the need for physical hospital visits, Medefer reduces emissions associated with travel and estate usage, supporting NHS Trusts in meeting their carbon reduction obligations and demonstrating the positive role innovative healthcare providers can play in building a greener, more resilient health system.
Medefer is committed to contributing meaningfully to the UK’s Net Zero ambitions, both through its internal Carbon Reduction Plan and by enabling the wider system to reduce hard-totackle emissions, particularly those classified as Scope 3. These emissions- most notably patient travel- are traditionally challenging for NHS services to mitigate. Medefer’s model directly addresses this gap by removing a substantial proportion of unnecessary journeys to and from hospital sites.
Peer-reviewed evidence underpins Medefer’s commitments. Analysis published by the organisation demonstrates that each referral managed remotely results in an average saving of around 34 km of travel and roughly 5.8 kg of CO2. Across 91,926 consultations delivered over the course of one year, this equated to approximately 3.125 million kilometres of avoided travel and 533 tonnes of CO2 saved. These results provide a robust basis for year-on-year scaling as Medefer’s activity expands.
Medefer’s environmental leadership was recognised nationally through the HSJ Partnership Environmental Sustainability Project Award in 2024, highlighting the business’ role in supporting NHS partners to meet statutory net-zero targets while maintaining high standards of care.
Crucially, Medefer’s approach is scalable. Using a specialty-weighted model to determine which outpatient appointments can safely and effectively be delivered remotely, the organisation found that around 61% of all NHS outpatient activity- equivalent to approximately 48 million appointments annually- could transition to a remote pathway. The potential environmental
impact is profound: implementing this approach nationally would eliminate an estimated 278,000 tonnes of CO2 every year, representing nearly half of all emissions currently associated with NHS patient travel.
The benefits extend beyond carbon. Traditional face-to-face outpatient appointments impose a broader economic cost, with each visit estimated to result in £84.44 in lost Gross Value Added (GVA) due to travel time, waiting and absence from work.
By shifting suitable appointments to remote consultations, Medefer’s model could return around £1.95 billion to the UK economy annually, supporting productivity and reducing unnecessary time away from the workplace.
Furthermore, the remote-first approach enhances workforce sustainability by offering clinicians greater flexibility, helping to reduce burnout and enabling senior staff to remain in practice for longer. In a period marked by workforce shortages and rising demand, this flexibility supports retention and strengthens service resilience.
The remote-first approach enhances workforce sustainability by offering clinicians greater flexibility
Together, these environmental, economic and workforce benefits illustrate how Medefer’s model embodies a sustainable future for healthcareone in which high-quality clinical care is delivered with significantly lower environmental impact and greater system-wide value.
Medefer is committed to ensuring that opportunity is available to every individual within the organisation, regardless of their background. By fostering an environment that champions inclusivity, supports employee voice and identifies and removes barriers to career progression, Medefer demonstrates its dedication to embedding fairness across the company.
At the core of Medefer’s culture is a commitment to treating every colleague fairly and equitably. This ethos is supported by a range of initiatives designed to ensure that employees can thrive while bringing their authentic selves to work. All colleagues are required to complete mandatory training modules on diversity, equality, bullying, harassment and safeguarding. These modules are designed not only to raise awareness but also to create a workplace where inclusivity is embedded into everyday practice.
Medefer also actively celebrates heritage and diversity months, as well as a number of cultural days. These occasions are used to highlight the diversity of the company’s workforce, provide visibility for different communities and reinforce the message that all colleagues are welcomed and valued.
In order to drive lasting change, Medefer takes a data-led approach to inclusivity. The organisation tracks demographic data such as gender, ethnicity and socioeconomic background. This helps identify where barriers to career progression may exist and provides a basis for action to ensure that advancement within the company is equitable and accessible to all. By doing so, Medefer works towards ensuring that every colleague has the opportunity to succeed and thrive.
Medefer underpins its ‘Opportunity for All’ ambition with clear Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) commitments, including annual WRES reporting with published summaries, an ethnicity pay-gap audit with Board oversight and time-bound actions, and an anti-racism action plan with the CEO as named champion.
Creating avenues for employee voice is a major priority for Medefer, which recognises that a truly inclusive organisation is one where employees feel empowered to share their views and influence change.
To support this, the organisation has implemented a Freedom to Speak Up policy, giving colleagues the confidence that any issues they raise will be listened to and acted upon appropriately. This framework provides assurance that transparency and accountability are embedded within Medefer’s culture.
In addition, Medefer has established an employee representative group, strengthening its commitment to listen to and act on feedback from across its workforce. Regular employee engagement surveys further ensure that colleagues have multiple platforms to express their suggestions and concerns.
Through these measures, Medefer places value on the perspectives of its people, ensuring that they are not only heard but also meaningfully involved in shaping the company’s direction and workplace culture.
Medefer’s long-standing partnership with the Isle of Wight NHS Trust demonstrates the transformative impact of sustained, collaborative working in a geographically unique health system. As the only fully integrated acute, community, mental health and ambulance provider in England, the Trust serves a population of around 140,000 residents and faces distinct challenges linked to Island geography, specialist capacity and service demand.
Since 2020, Medefer has supported the Trust through a remote-first, consultant-led virtual outpatient model originally established during the Covid-19 pandemic. Now in its fifth year, the partnership has evolved into a core element of the Island’s elective recovery strategy, enhancing resilience, expanding capacity and improving access to specialist care closer to home.
Under a subcontracted arrangement, all NHS e-Referral Service referrals across supported specialties flow directly to Medefer. Patients receive rapid consultant assessment - averaging just 0.8 days- while retaining access to on -Island diagnostics through seamless integration with local services. Medefer provides virtual management across a broad range of specialties, including Urology, Clinical Haematology, General Surgery, Gynaecology and Gastroenterology, with clear pathways for in-person escalation where needed. Joint clinical governance ensures safety, transparency and shared learning.
The impact has been significant. The partnership has managed more than 28,000 referrals to date, handling around 6000 per year. Over half of all patients (57%) have been safely managed remotely and discharged to their GP without requiring a hospital appointment, reducing pressure on outpatient services and freeing local clinicians to focus on urgent and complex cases. Across specialties, the model has supported sustained RTT improvements, rapid triage of risk and efficient utilisation of finite on-Island capacity.
Medefer’s contribution to elective recovery on the Isle of Wight was recognised nationally through the 2023 HSJ Partnership Award for Elective Recovery.
Feedback from Trust leaders and patients reflects the partnership’s value: faster access, clear communication and timely consultant-led advice. By combining digital innovation with local diagnostics and collaborative governance, the partnership provides a resilient, sustainable model of specialist care. It demonstrates how strong, long-term partnerships can break down geographic barriers, enhance operational capacity and ensure equitable access to high-quality healthcare for Island communities.
Joe Smyth, Chief Officer Isle of Wight NHS Trust“Emerging from the pandemic like so many others the Isle of Wight had a serious problemwith the number of people on the elective waiting list. We needed a solution to provide additional capacity without breaking the bank.
We found the solution in Medefer – they worked with us and supported the implementation of a digital hospital, of virtual clinics. They worked with the GP’s in our community and consultants in our clinics. They did the heavy lifting with helping us implement the technology. We now have a seamless service, where patients are referred to Medefer, treated and discharged or referred back to clinic with a full work up, and far from breaking the bank it actually saved us money.
In the Spring 2025 we cleared 65 weeks (six months ahead of the national target) –currently we have 70 patients waiting over 52 weeks. We have one of the shortest acute waiting lists in the country – a large part of that delivery has been the partnership with Medefer.
Medefer is more than just virtual care, it has fundamentally changed how we deliver care.”
Medefer’s partnership in Barking, Havering and Redbridge (BHR) is an example of how a consultant-led, digitally enabled model can reshape access to specialist care and deliver sustained improvements in elective performance. Initially commissioned in 2016 by the former BHR Clinical Commissioning Groups, Medefer was tasked with piloting a new “Virtual Hospital” to support local Gastroenterology services facing significant waiting list pressures and limited consultant capacity. Working alongside Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), Medefer introduced a remote-first outpatient pathway providing rapid consultant triage, early clinical review and virtual management for both new and long-waiting patients.
The pilot involved two key elements: direct referral from GP practices into Medefermanaged pathways, and the transfer of around 1000 long-waiting patients from BHRUT for virtual assessment. This approach ensured equitable access for the local population while relieving pressure on hospital teams already operating at capacity. Following demonstrable improvements in waiting times, diagnostic utilisation and patient outcomes, the model evolved into a full Single Point of Access (SPA) for
all Gastroenterology and Hepatology referrals across the area. Under the North East London Integrated Care Board, the service ultimately covered 120 GP practices and a population of approximately one million.
Across the lifetime of the programme, Medefer managed more than 50,000 patients, with referrals reviewed on average within 31 hours and 90% assessed within 24 hours. The majority of patients- 86%- were managed entirely through the virtual pathway, avoiding the need for a hospital outpatient visit. Over 1500 individuals were appropriately upgraded to the Urgent Suspected Cancer pathway, demonstrating the safety and effectiveness of consultant-led triage. The model supported BHRUT to maintain RTT compliance throughout the pandemic and beyond, enabling the expansion of endoscopy capacity from three to five rooms and contributing to the Trust becoming one of the top three JAG-accredited units nationally.
The programme gained national recognition, winning the 2023 HSJ Partnership Award and being highlighted in 2025 by NHS England and the Health Service Journal as a leading example of virtual elective care supporting the NHS’s “Online Hospital” vision. Although no longer active, the BHR Virtual Hospital remains a benchmark for digitally enabled pathways that improve access, strengthen system capacity and deliver earlier, safer clinical decision-making.
Under the North East London Integrated Care Board, the service ultimately covered 120 GP practices and a population of approximately one million.
June 2026
Winner, SME News UK Enterprise Awards: Best Virtual Health Services 2025 - London
Mar 2024
Winner, SME News UK Enterprise Awards: Best in Patient-Centric Virtual Health Services (London)
Mar 2024
Winner, HSJ Partnership Awards: Environmental Sustainability Project of the Year (with North East London ICB / Barking, Havering & Redbridge University Hospital Trust)
Dec 2023
Winner, EU Business News European Enterprise Awards: Most Innovative Specialist-Led Virtual Healthcare Provider (UK)
Oct 2023
Winner, Acquisition International: Best Patient-Focused Virtual Health Service (UK)
Mar 2023
Winner, HSJ Partnership Awards: Best Healthcare Provider Partnership with the NHS (with North East London ICB / Barking, Havering & Redbridge University Hospital Trust)
Mar 2023
Winner, HSJ Partnership Awards: Most Effective Contribution to Clinical Redesign (with Surrey & Sussex Cancer Alliance) Mar 2023
Highly Commended, HSJ Partnership Awards: Most Effective Contribution to Improving Cancer Outcomes (with Surrey & Sussex Cancer Alliance);
Winner, HSJ Partnership Awards: Best Elective Recovery Initiative (with Isle of Wight NHS Trust).
Medefer’s work clearly demonstrates how a clinically led, digital-first model can be used as a powerful driver of social impact.
Across its patient pathways, workforce practices and partnerships with the wider health and care system, the organisation is breaking down
structural barriers to opportunity and helping to build a more equitable, sustainable NHS. The activity outlined in this report shows a business that is not only delivering safe and effective care, but also using its influence to widen access, support its colleagues and strengthen communities.
The organisation is breaking down structural barriers to opportunity and helping to build a more equitable, sustainable NHS.
4.1 Supporting the NHS
Medefer’s social impact is amplified through the value it creates for the wider healthcare ecosystem. Positioned at the top of the patient pathway, Medefer directs patients towards diagnostics and care delivered by both NHS and independent providers, generating new revenue streams and supporting local capacity. Its commitment to prioritising NHS services wherever possible and anchoring activity within public infrastructure
ensures that its model strengthens, rather than replaces, core public provision. The example of Staffordshire and Stoke-on-Trent, where Medefer’s pathways generated over £1 million in NHS revenue in a single year, demonstrates the wider system benefits of this approach.
The organisation also leads by example in raising standards across its supply chain and partnerships. By encouraging partners to pursue accreditations and by championing those who demonstrate strong social impact, Medefer uses its influence to promote inclusive, responsible practice across the sector. Long-standing collaborations with NHS partners, such as the Isle of Wight NHS Trust and the Surrey & Sussex Cancer Alliance, show how sustained, trust-based partnerships can deliver transformative change in geographically or structurally challenged systems.
Medefer’s record of recognition through national awards underlines its role as a leading partner to the NHS.
Medefer’s core social impact is delivered through its role in widening access to timely, high-quality healthcare. By offering a virtual outpatient model that reduces waiting times and brings specialist care closer to home, the organisation is directly addressing some of the most entrenched inequalities in the health system. Its risk-based digital pathways and consultant-led triage ensure that patients are assessed and treated according to clinical need rather than geography or local capacity, supporting earlier diagnosis and better outcomes. In places like James Paget University Hospital and Barking, Havering and Redbridge, Medefer’s model has cleared backlogs, accelerated cancer pathways and ensured that thousands of patients receive rapid, appropriate care without unnecessary hospital visits.
The organisation is directly addressing some of the most entrenched inequalities in the health system.
Medefer also understands that health outcomes are shaped not only by clinical care but by wider social and economic conditions. By reducing unnecessary travel and coordinating diagnostics in local settings, it lessens the financial and time burden on patients and carers, enabling people to remain in work, continue caring responsibilities and stay connected to their communities. Targeted initiatives, such as the Targeted Prostate Health Check pathway, illustrate how a proactive, community-based approach can reach atrisk groups, tackle undiagnosed disease and deliver earlier, more effective treatment. The organisation’s data demonstrates tangible equity gains, including a 44.6% access uplift for patients from the most deprived communities, underlining the potential of its model to support a fairer healthcare system.
Medefer’s approach to closing the digital divide further reinforces this impact. By designing pathways that, in most cases, require only access to a telephone, offering alternatives such as letters and interpreters in over 200 languages and guaranteeing face-to-face care where needed, the organisation ensures that digital innovation enhances rather than restricts access.
Medefer’s social impact extends inward, through a clear commitment to being a fair, inclusive and supportive employer. Its open recruitment practices, including multi-channel advertising, competency-based interviews and dedicated talent oversight, are designed to attract a diverse range of candidates and ensure that hiring decisions are transparent and values-led. This is reflected in a workforce that is more diverse than national averages, with strong representation of women and colleagues from minority-ethnic backgrounds, and underpinned by Disability Confident Level 2 accreditation and robust governance standards.
Once in role, colleagues benefit from comprehensive induction, regular one-to-one meetings and access to extensive professional development opportunities. Clear role descriptions, defined promotion pathways and leadership development resources provide visibility and structure for progression, helping colleagues
understand how they can shape their careers within the organisation. Medefer’s remote-first, flexible working model, parental leave provision and focus on work-life balance are particularly important in ensuring that carers, parents and those with other responsibilities are not disadvantaged when it comes to career development.
The organisation also places considerable emphasis on health, wellbeing and psychological safety for its colleagues. Access to private healthcare, occupational health support, wellbeing platforms and financial wellbeing initiatives help ensure that employees are supported holistically. Freedom to Speak Up Guardians, whistleblowing routes, an employee representative group and regular engagement surveys provide multiple avenues for employee voice, building a culture in which concerns can be raised safely and staff feel able to influence how the organisation evolves.
Using the Indices of Multiple Deprivation (IMD) Medefer has partnered with The Purpose Coalition have mapped out communities facing the greatest opportunity barriers across its footprint.
The IMD is the UK government’s official tool for measuring relative deprivation, drawing on data from seven key domains:
These insights are used to:
• Guide targeted interventions.
• Collaborate with key partners.
• Address specific deprivation domains most relevant to each community.
• Target the Recommendations in Section 6 to those most in need.
For example: Barking & Dagenham ranks 2nd out of 317 for deprivation in Housing and Access to Services, reflecting significant barriers like overcrowding and poor access to vital services.
Each domain reflects an aspect of deprivation and feeds into an overall deprivation score, used to rank small geographical units known as Lower Super Output Areas (LSOAs). With each LSOA comprising roughly 1,000–3,000 residents, this enables fine-grained analysis of deprivation across England’s more than 32,000 LSOAs.
The IMD ranks each LSOA nationally. A lower rank indicates higher deprivation, with rank 1 being the most deprived. LSOAs are also categorised into deciles:
Decile 1: Among the 10% most deprived in the country.
Decile 10: Among the 10% least deprived.
For example, Blackpool ranks 1st overall, marking it as the most deprived local authority in England. Averaged LSOA scores for each local authority give a clear picture of regional deprivation, helping to identify strategic areas for intervention and support.
This data-driven approach enables Medefer to deepen its reach into vulnerable areas and tailor its access and service programmes accordingly.
The IMD looks at seven key domains, each showing a different kind of deprivation:
Income: measures the number of people with very low incomes, including those who struggle to pay for basics like food and housing.
Employment: measures how many people of working age are out of work due to unemployment, health problems, or other reasons they can’t control.
Education, skills and training: focuses on low school results, limited qualifications, and a lack of learning of training opportunities for adults.
Health deprivation and disability: checks how poor physical and mental health, or a higher chance of dying early, affects people’s lives in an area.
Crime: measures how often people and property are affected by crime like violence, theft, or vandalism in the community.
Barriers to housing and services: looks at how hard it is for people to afford housing or access important services like shops, schools, or doctors.
Living environment: assesses the quality of homes and the local area, including housing conditions, air quality, and road safety.
There is also an ‘overall’ measure, which combines the information from all seven domains to give a complete picture of how deprived and area is compared to others.
NHS Staffordshire and Stoke-on-Trent Integrated Care Board Integrated Care Board Code: E54000010
The below tables offer a summary of the domains of deprivation across NHS Staffordshire and Stoke-on-Trent Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 8.90% of NHS Staffordshire and Stoke-on-Trent Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 18.74% of NHS Staffordshire and Stoke-on-Trent Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Greater Manchester Integrated Care Board Integrated Care Board Code: E54000057
The below tables offer a summary of the domains of deprivation across NHS Greater Manchester Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 23.03% of NHS Greater Manchester Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 38.98% of NHS Greater Manchester Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS North East London Integrated Care Board Integrated Care Board Code: E54000029
The below tables offer a summary of the domains of deprivation across NHS North East London Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 5.80% of NHS North East London Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 27.16% of NHS North East London Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS North West London Integrated Care Board Integrated Care Board Code: E54000027
The below tables offer a summary of the domains of deprivation across NHS North West London Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 4.48% of NHS North West London Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 18.86% of NHS North West London Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS South East London Integrated Care Board Integrated Care Board Code: E54000030
The below tables offer a summary of the domains of deprivation across NHS South East London Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 0.48% of NHS South East London Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 12.92% of NHS South East London Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Birmingham and Solihull Integrated Care Board Integrated Care Board Code: E54000055
The below tables offer a summary of the domains of deprivation across NHS Birmingham and Solihull Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 37.83% of NHS Birmingham and Solihull Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 49.79% of NHS Birmingham and Solihull Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Herefordshire and Worcestershire Integrated Care Board Integrated Care Board Code: E54000019
The below tables offer a summary of the domains of deprivation across NHS Herefordshire and Worcestershire Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 3.87% of NHS Herefordshire and Worcestershire Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 10.62% of NHS Herefordshire and Worcestershire Integrated Care Board’s population live within the most deprived 30% of communities.
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Cheshire and Merseyside Integrated Care Board Integrated Care Board Code: E54000008
The below tables offer a summary of the domains of deprivation across NHS Cheshire and Merseyside Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 20.11% of NHS Cheshire and Merseyside Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 30.45% of NHS Cheshire and Merseyside Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS South Yorkshire Integrated Care Board Integrated Care Board Code: E54000061
The below tables offer a summary of the domains of deprivation across NHS South Yorkshire Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 21.98% of NHS South Yorkshire Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 36.47% of NHS South Yorkshire Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Nottingham and Nottinghamshire Integrated Care Board Integrated Care Board Code: E54000060
The below tables offer a summary of the domains of deprivation across NHS Nottingham and Nottinghamshire Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 11.99% of NHS Nottingham and Nottinghamshire Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 24.73% of NHS Nottingham and Nottinghamshire Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Northamptonshire Integrated Care Board Integrated Care Board Code: E54000059
The below tables offer a summary of the domains of deprivation across NHS Northamptonshire Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 3.16% of NHS Northamptonshire Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 11.41% of NHS Northamptonshire Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Cambridgeshire and Peterborough Integrated Care Board Integrated Care Board Code: E54000056
The below tables offer a summary of the domains of deprivation across NHS Cambridgeshire and Peterborough Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 3.98% of NHS Cambridgeshire and Peterborough Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 11.36% of NHS Cambridgeshire and Peterborough Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
NHS Kent and Medway Integrated Care Board Integrated Care Board Code: E54000032
The below tables offer a summary of the domains of deprivation across NHS Kent and Medway Integrated Care Board. Each community within has been individually scored in the below domains of deprivation. The scores have been averaged, after weighting for population, and then ranked. A lower rank means the area is more deprived. For instance, the most deprived Integrated Care Board in England using this methodology is NHS Birmingham and Solihull ICB, with a rank of 1.
Overall, we can say that 6.78% of NHS Kent and Medway Integrated Care Board’s communities fall within the most deprived 10% of communities nationally. We also use a weighted sliding scale that considers the most deprived 30% of areas nationally, in order to provide a clearer picture of deprivation across deciles. Using this measure, we can see that 16.85% of NHS Kent and Medway Integrated Care Board’s population live within the most deprived 30% of communities.
Technical points:
• We define communities as meaning Lower Super Output Areas, a type of statistical geography comprising between 400 and 1,200 households that usually have a resident population of between 1,000 and 3,000 persons.
• Please note that although there are 42 Integrated Care Boards in England, ranks are not always out 42. This is because some Integrated Care Boards contain none of the most deprived communities, meaning there are tied results in the least deprived Integrated Care Boards.
Medefer’s significant and growing contribution to widening access to healthcare, supporting its workforce and strengthening the wider health and care system is clear. As the organisation continues to scale its impact, there are opportunities to build on this strong foundation through targeted action that deepens its leadership in digital, equitable and sustainable healthcare. The following recommendations outline areas where Medefer could further enhance its social impact and extend the reach of its purpose-led model.
Medefer’s digital-first model already delivers demonstrable improvements in access, particularly for patients facing geographic, socioeconomic or mobility-related barriers. Building on this progress, Medefer could further strengthen its contribution to reducing health inequalities by expanding proactive and preventative care pathways in partnership with Integrated Care Systems.
The success of programmes such as the Targeted Prostate Health Check shows the potential of structured early-detection models to identify unmet need, reduce late diagnosis and improve public health outcomes. Medefer is well positioned to co-design similar targeted initiatives in other
high-need clinical areas, such as cardiovascular disease, respiratory conditions or women’s health, working closely with primary care, community providers and local public health teams. Prioritising rollout in communities experiencing the greatest deprivation would maximise impact and help shift the health system towards a more preventative, equitable model of care.
Embedding community engagement more deeply into pathway design, including patient focus groups, lived-experience panels and place-based workshops, would also help ensure that services reflect the needs, preferences and barriers of diverse population groups, strengthening inclusivity and trust.
Medefer has cultivated a supportive and inclusive workplace culture, with clear structures for induction, ongoing learning and career progression. To enhance this further, the organisation could build a more formalised leadership and skills development framework that supports colleagues at all levels to grow and specialise as Medefer continues to evolve.
Developing structured leadership programmes, particularly for aspiring managers and underrepresented groups, would help ensure a strong pipeline of future leaders equipped to deliver high-quality, digitally enabled care. Increasing opportunities for cross-team shadowing and structured mentorship could also broaden colleagues’ experience and strengthen understanding.
By deepening its data-led approach to tracking progression, representation and pay equity, Medefer can continue to identify and remove barriers to advancement. This would reinforce its commitment to fairness, inclusion and transparency, while ensuring that its workforce reflects the communities it serves.
Medefer’s digital model already mitigates many of the challenges associated with digital exclusion. As digital and AI technologies advance, there is an opportunity to play a national leadership role in shaping inclusive innovation that actively benefits patients.
Working with patient groups, voluntary sector organisations and digital inclusion charities, Medefer could expand support for those who may struggle to engage with remote care, such as older people, individuals with disabilities or communities with limited digital literacy. This could include developing simple digital guidance materials, offering support calls to explain pathways and strengthening partnerships with local community hubs that provide digital assistance.
As AI becomes increasingly present in healthcare, Medefer’s internal AI working group provides a strong foundation for safe and equitable adoption. Future activity could involve publishing accessible patient-facing information on how AI is used within pathways, setting out safeguards and ensuring transparency that builds trust.
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