Social inclusion

Social inclusionWelcome to this social inclusion resource devised by the Royal College of Nursing.

This online resource is for all nurses and health care assistants in all settings to support practice with excluded people and ‘hard-to-reach’ communities. Health issues are key as it is well known that people who are socially excluded have poor physical and mental health compared to the general population.

The report, from the Data and Research Working Group of the National Inclusion Health Board (NIHB) identifies where to find good data and where there are gaps in information. It also highlights where the burdens of ill health and untimely death are greatest for vulnerable groups including vulnerable migrants, gypsies and travellers, homeless people, and sex workers.

The report provides data for providers, healthcare professionals, commissioners and others working to improve the health of the vulnerable groups

  • Obtaining a comprehensive picture of the different vulnerable groups’ and the  health needs of some of the most vulnerable people in society is almost impossible. The needs of such groups continue to be invisible to health commissioners and the wider health system planners.
  • The health needs of the vulnerable groups sometimes place heavy and unpredictable demands on the health service, which may result in multiple avoidable visits to hospital.
  • The data gaps prevent effective monitoring of health care use and seriously undermine local efforts  by NHS and local government  to understand and prioritise the local needs of the vulnerable groups.

In 2010 the Social Inclusion Task force highlighted the impact of social exclusion on health and the challenges facing health and social care practitioners

“People from socially excluded groups experience poor health outcomes across a range of indicators including self-reported health, life expectancy and morbidity.

  • Just 30 per cent of Irish Travellers live beyond their 60th birthday.
  • 85 per cent of street sex workers reported using heroin and 87 per cent using crack cocaine.
  • People with learning disabilities are 58 times more likely to die prematurely than the
    general population.
  • Hepatitis B and C infection among female prisoners are 40 and 28 times higher than in the general population."

    (Social Exclusion Task Force 2010, p.4).

In addition there are people who face multiple needs and exclusions, for example they may have been in prison at some point and may have mental ill health, may be addicted to drugs or alcohol and be experiencing homelessness. The issues around this are discussed in a publication, described as a vision paper, from  Making Every Adult Matter (MEAM) and Revolving Doors which argues that  “most public services are designed to deal with one problem at a time and to support people with single, severe conditions”  (MEAM and Revolving Doors 2011, p.4). The vision is for better coordinated services and central government support for this.

This resource covers the social inclusion agenda in each of the four UK countries and highlights issues faced by a number of vulnerable groups. It signposts sources of support in the form of agencies, guidance and policies

The site is designed to introduce you to a broad range of activity relating to social inclusion. It looks in greater detail at what inclusive practice means in nursing.

Since the development of the principles of inclusive practice, the RCN has published the Principles of Nursing Practice which describe what everyone can expect from nursing practice whatever the setting or context.  Inclusive practice is implicit in all of these Principles – see Principles of Nursing Practice.

However the more specific statements in the principles of inclusive practice can be helpful in providing further thinking and ideas on what needs to be considered to enhance socially inclusive practice in the delivery of nursing care. This is particularly so when dealing with vulnerable groups who may be more likely to be socially excluded and, as a result, have poor health and limited access to services appropriate to their needs - see inclusive practice.

The resource covers the social inclusion agenda in each of the four UK countries and currently has areas devoted to the following groups of people:

Each of these areas includes the following information

  • There are sections on the policies affecting these groups and guidance and tools designed to help implement them.
  • You will also find a listing of agencies that work alongside these groups, often in partnership with them.
  • You can get an insight into the efforts being made through good practice examples. Some of these have been taken from the growing literature on the subject while others have been kindly submitted by practitioners in the field.

We would welcome submissions about your own project or service. For further details please visit your good practice examples.

We would also like to hear your thoughts about this resource. Please email your ideas to: qualityandsafety@rcn.org.uk.

Related RCN resources

You will also find the following resources useful
Diversity and equality pages
RCN Dignity resource
RCN Principles of Nursing Practice

It also looks in detail at what inclusive practice means in nursing – see inclusive practice.

We have used published definitions of social inclusion and health inequalities.

Acknowledgement: Photo by Charlotte Morse - The Power of Positive Images (www.flickr.com/photos/charlottemorse/collections/)


These references were last accessed on 12 May 2015. 

Social Exclusion Task Force (2010) Inclusion health (PDF 1.19MB), London: Cabinet Office.

MEAM and Revolving Doors (2011) Turning the tide: a vision paper for multiple needs and exclusions. London: MEAM.

Data and Research Working Group of the National Inclusion Health Board (2014) Hidden needs: identifying key vulnerable groups in data collections: vulnerable migrants, gypsies and travellers, homeless people, and sex workers. London: Department of Health. 

If you have any comments or enquiries regarding this resource please contact us at: qualityandsafety@rcn.org.uk.