Health outcomes in the UK aren’t distributed evenly. People in the most deprived parts of the country are more likely to develop serious conditions earlier, and less likely to access the services that could catch those conditions in time. Core20PLUS5 is NHS England’s answer to that gap: an approach that names, specifically, who is being underserved and which health conditions need the most urgent attention, rather than leaving “reducing health inequalities” as a vague aspiration.

For comms and engagement teams, Core20PLUS5 matters because it turns a broad ambition into something you can actually plan around: a defined population to reach and a defined set of health topics to prioritise. Here’s what it actually means, and how Orlo’s platform supports the engagement side of it.

Core20PLUS5 launched in 2021 as part of the NHS Long Term Plan, and it has three parts. Core20 is the most deprived 20% of the national population, identified using the Index of Multiple Deprivation. PLUS covers population groups experiencing worse than average access, experience or outcomes, defined locally rather than nationally, since the groups facing the biggest barriers vary by area. And 5 is a set of clinical priority areas chosen because they offer the clearest opportunity for rapid, measurable improvement.

There are two versions of the 5. For adults, the priorities are maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and cardiovascular disease prevention. For children and young people, a separate version launched in 2022 covers asthma, diabetes, epilepsy, oral health and mental health.

This is the part most likely to get missed. Core20 is a fixed, national definition, but PLUS is deliberately left open for local systems to define based on their own population, and it can include groups such as people experiencing homelessness, people with learning disabilities, ethnic minority communities, people with language or communication barriers, coastal communities, or looked-after children. That means the first job in applying Core20PLUS5 well isn’t a clinical one, it’s an engagement one: understanding who your local PLUS groups actually are, which usually means listening to your community rather than assuming.

Core20 and PLUS populations are, almost by definition, less likely to be reached by a single default communication channel. Digital exclusion, language barriers and low trust in institutions are all common reasons a community might not engage with a standard NHS newsletter or press release, even about a service designed to help them.

The five clinical priorities exist because they offer the clearest opportunity for improvement, but that improvement depends on people in Core20 and PLUS communities actually knowing the relevant services exist. A cardiovascular prevention campaign or an early cancer diagnosis push only works if it reaches the specific communities it’s aimed at, not just a general audience.

Core20PLUS5 gives healthcare comms teams something concrete to plan around: a defined population and a defined set of priorities, rather than a general commitment to reducing inequality. The PLUS element in particular depends on genuine local listening, which makes it as much a community engagement task as a clinical one.

Core20PLUS5 tells you who to prioritise and which health topics matter most. For a way to actually raise those topics in routine contact with your community, our guide to Making Every Contact Count covers the other half of the picture.

Orlo works with over 45 NHS and healthcare providers, helping them capture the voice of their communities, respond in real time and turn feedback into service changes that matter, exactly the kind of engagement Core20PLUS5’s PLUS element depends on.

If you want to see how Orlo supports patient and public involvement duties alongside Core20PLUS5, take a look at our healthcare solutions, or a demo is the fastest way to see it in your context.