Most analyses of equity in health care delivery have overlooked the principle of vertical equity. The aim of this paper is to assess and refine the techniques to investigate vertical inequity in health care utilisation. We critically review the empirical literature on vertical inequity. The most comprehensive technique identified was found to capture solely the socioeconomic status (SES) dimension of vertical equity. We suggest an extension to this measure that takes into account the full distribution of needs in a population. This is accomplished by computing the vertical equity estimates by the means of the concentration indices with respect to the need rank rather than to the socioeconomic rank. We compare our suggested approach with that based on the socioeconomic dimension. We use data from two rounds of the Health Survey for England (2003 and 2006) for individuals with a history on cardiovascular diseases (CVD). Inequities in eight types of CVD-related health care utilisation are investigated. The appropriate relationships between needs and use are estimated by imposing the effect of subgroups of the population that are less likely to be affected by unmet needs to the whole sample. Our findings indicate that there is vertical inequity in detriment to socioeconomic deprived groups and, to a larger extent, in detriment to those with larger needs. The focus on the socioeconomic dimension is thus only capable of picking up a fraction of the extent to which individuals with different needs do not receive appropriately different treatment.