Discovering and understanding underserved communities


Please select any of the folllowing buttons to view further information related to this learning resource.



Black, Asian and Minority Ethnic is the terminology normally used to describe people of non-white communities in the UK

Equality Act 2010

The Equality Act 2010 legally protects people in the UK from discrimination in the workplace and in wider society. There are nine protected characteristics (age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; sexual orientation). Any discrimination that occurs because of one or more of these characteristics is unlawful under the Act.

General population

The term 'general population' is used in this resource as all individuals without reference to any specific characteristic

Health inequalities and health inequities

The term health inequality refers to differences in the health of individuals or groups. Any measurable aspect of health that varies across individuals or groups can be called a health inequality. In contrast, a health inequity, or health disparity, is a specific type of health inequality that denotes an unjust difference in health. Health differences here are preventable and unnecessary and allowing them to persist is unjust. The key distinction between the terms inequality and inequity is that the former is simply a description employed whenever quantities are unequal, while the latter requires passing a moral judgment that the inequality is wrong.

Arcaya MC. et al (2015). Inequalities in health: definitions, concepts, and theories. Global Health Action 8:27106

Impairment and disability

The term impairment refers to 'any loss or abnormality of psychological, physiological or anatomical structure or function'. Whereas a disability is the restriction or limitation caused by the impairment: 'any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being'.

Institutional discrimination

Institutional discrimination typically refers to the unjust and discriminatory mistreatment, through unequal selection or bias, intentional or unintentional, of an individual or group of individuals that exists within the structures, processes and procedures of an organisation.


LGBTQ is a more commonly used acronym that stands for Lesbian, Gay, Bisexual, Transgender (sometimes abbreviated to Trans) and Questioning and/or Queer.

Medicines Use Reviews

The Medicines Use Review (MUR) is an Advanced Service within the English NHS Community Pharmacy Contractual Framework. It consists of accredited pharmacists undertaking adherence-centred reviews with patients on multiple medicines, particularly those receiving medicines for long-term conditions.


Multi-morbidity is the presence of two or more chronic medical conditions in the same individual.

Person-centred care

Person-centred care supports people to develop the knowledge, skills and confidence they need to more effectively manage and make informed decisions about their own health and health care. It is coordinated and tailored to the needs of the individual. And, crucially, it ensures that people are always treated with dignity, compassion and respect.

There are four principles of person-centred care:

  1. Affording people dignity, compassion and respect
  2. Offering coordinated care, support or treatment
  3. Offering personalised care, support or treatment
  4. Supporting people to recognise and develop their own strengths and abilities to enable them to live an independent and fulfilling life

[Health Foundation (2014) Person-centred care made simple. London, The Health Foundation]

Prejudice and Discrimination

Prejudice is an irrational or unjustified opinion or attitude towards an individual based solely on their membership of a social group. Prejudices can either be positive or negative; the negative form of prejudice can lead to discrimination.

Discrimination is the behaviour or actions (usually negative), towards an individual or group of people to deny access to those whom they believe do not deserve the same treatment as everyone else. Discrimination, therefore is an action that denies the rights of a person due to their membership of a social group.


Stereotyping involves identifying features that a group of individuals is supposed to have, making such features the dominant characteristic and then suggesting that every member who belongs to the group possess such features. This can be harmful as it can lead to errors in decision making that carry the potential for negative (discriminatory) consequences. It is therefore important that we don’t stereotype people but rather seek to view them as individuals.

Medically underserved community

Groups of people who are eligible to receive a health service (such as the Medicines Use Review) but for whatever reason, do not end up receiving the service despite them being potentially most in need.


ResourceResource Description
Age UKAge UK is the country's largest charity dedicated to helping everyone make the most of later life.
Consultation skills for pharmacy practiceThe Consultation skills for pharmacy practice website has been created to support pharmacists and their staff to improve patient consultation skills. The website provides easy access to a range of resources, including guidance, a set of practice standards, learning options, assessment tools and signposting for additional support as well as offering advice to employers and trainers.
Continuing Professional Development (CPD) (pharmacists and pharmacy technicians)Begin a CPD entry about your awareness of underserved communities has improved and on the importance of effectively approaching, engaging and enabling patients to become empowered to take up the offer of a Medicines Use Review.
Introduction to the National Health ServiceThis fact sheet has been written to explain the role of UK health services, the National Health Service (NHS), to newly-arrived individuals seeking asylum. It covers issues such as the role of GPs, their function as gatekeepers to the health services, how to register and how to access emergency services.
Making health and social care information accessibleA short video of the NHS England's 2016 update on the Accessible Information Standard (in British Sign Language (BSL) with subtitles).
Medicines Optimisation: Helping patients to make the most of medicinesThis good practice guidance provides principles for medicines optimisation that help healthcare professionals to support patients to get the best outcomes from their medicines use. The principles describe how healthcare professionals can enable patients to improve their quality of life and outcomes from medicines use by having a sustained focus on the need to optimise patients’ medicines.
Medicines Use Review Online ResourceMedicines Use Review (MUR) training for pharmacists: an online resource that helps pharmacists to develop their MUR skills.
MindMind is a menal health charity that provides advice and support to empower anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding.
NHS Choices: How your pharmacist can helpNHS Choices is the UK's biggest health website. It provides a comprehensive health information service to help put patients in control of their healthcare. The website helps them to make choices about their health, from decisions about lifestyle, such as smoking, drinking and exercise, to finding and using NHS services in England.
Project ProtocolBMJ Open online journal: Supporting underserved patients with their medicines: a study protocol for a patient/professional coproduced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews (MURs).
Related LearningThis educational resource is one of three such resources and you can access the other two via the following linked images:
The Disability Partnership’s Pharmacy ProjectResources for pharmacists, people with disabilities, family members and carers: this resource booklet has been created by Mencap’s pharmacy project and includes resources that have been created by Mencap staff, in consultation with people with disabilities.
The National LGB&T PartnershipThe National LGB&T Partnership was established in order reduce health inequalities and challenge homophobia, biphobia and transphobia within public services.
What do Community Pharmacists do? Medicines Use ReviewA You Tube clip produced by the The Royal Pharmaceutical Society about Medicines Use Reviews.
Learn Basic Greetings in British Sign Language A You Tube clip produced by Exeter Deaf Academy that demonstrates how to sign 'Hello' 'Good morning', 'Good afternoon' and 'Good evening' in British Sign Language (BSL).

Learning outcomes

By completing this resource you will be able to:

  1. Identify individuals who are 'under-served'
  2. Highlight the poorer health status of individuals who are under-served when compared to the general population
  3. Gain a better understanding about people's life circumstances and reflect on how Medicines Use Reviews can be made more accessible to them

Resource development

Content Author: Asam Latif

Author biography: Asam Latif has been a UK registered pharmacist since 1999 and has worked in both community and hospital pharmacy. He has been a researcher for over 10 years principally investigating community pharmacy medicines management services. Specifically, his interest lies in developing e-learning resources designed to change the behaviour of professionals to improve service provision to patents. He is passionate about improving care to individuals who are underserved giving voice to people who are seldom heard.

Patient and Public Representatives: Mahomed Khatri, Abida Malik

Contributors: Kristian Pollock, Claire Anderson, Justin Waring, Josie Solomon, Li-Chia Chen, Emma Anderson, Sulma Gulzar, Nasa Abbasi

Project Mentor: Heather Wharrad

Project developers: Michael Taylor and Simon Riley

Video production/development: Simon Riley, Michael Taylor

Acknowledgements: This e-learning resource has been co-produced with patients and representatives from underserved communities, pharmacists, pharmacy support staff and organisational representatives. We gratefully acknowledge support of all the patients and pharmacy team members who took part.

Funding: The project was funded by the Department of Health through the Health Education England (HEE) and National Institute for Health Research (NIHR) Integrated Clinical Academic (ICA) Programme.

Learning Object Copyright and Terms of Use

All Learning Objects developed by the University of Nottingham School of Health Sciences, and their aggregate parts (eg text, animations), are copyright of the School of Health Sciences, University of Nottingham. Learning Objects are available for use under the Creative Commons 2.0 licence (BY-NC) and the conditions below.

Terms of Use

Private individuals, and publicly-funded educational and other institutions, may link to and use the Learning Objects on this site without restriction for non-commercial educational purposes. Use of any Learning Objects for any commercial purpose, or by any profit-making commercial entity, is not permitted without our express permission. If you wish to use a Learning Object for any commercial, revenue-generating or non-educational purpose, you must contact us to negotiate terms of use and payment.

We much prefer that you use this and other Learning Objects by linking to them on this website as:

  • this ensures you're always using the most up-to-date version
  • we gain data on usage of the Learning Objects, from access statistics and user feedback forms

Local circumstances, such as network security policies, may constrain your ability to link to external sites, or may impair the usability of our objects. If you're unable to run our Learning Objects 'from source' for these or other reasons, please contact us with a brief explanation of your circumstances and we may provide you with specified Learning Objects as an IMS Content Package.


Modification to adapt Learning Objects to local circumstances is permitted, with the following restrictions:

  1. The modified version must clearly display the University of Nottingham logo, and the School copyright notice.
  2. The modified version must not be distributed outside the modifying institution without the express permission of the School.


If you have any queries about our Learning Objects, please contact


Please use the attribution below if you wish to refer to our learning objects. If you use Firefox, you can install the useful OpenAttribute add-on to allow you to easily copy and reference these and other materials marked as Creative Commons.

Creative Commons logo Learning Objects for Healthcare by School of Health Sciences, University of Nottingham is licensed under a Creative Commons Attribution-NonCommercial 2.0 UK: England & Wales (CC BY-NC 2.0 UK)