Racial inequity affects the whole of society, and tackling it means listening to the voices of as many people as possible, write Habib Naqvi, chief executive of NHS Race and Health Observatory and Sam Rodger, assistant director policy and strategy at NHS Race and Health Observatory
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Last year, while developing our new strategy, we engaged broadly and listened carefully, with a programme of work that culminated in a face-to-face event in London last November. We were joined by members of racially diverse communities, patients, carers, clinicians, academics, policymakers, allies, and more – all of whom are invested in delivering equity in healthcare.
This month, we released the outcome of that engagement – a strategy for more equitable healthcare that is aligned with the government’s three shifts in the way healthcare is delivered – shifts towards community care, prevention, and digital. It contains a set of robust, co-designed ambitions for the NHS Race and Health Observatory and for the healthcare sector. This article is an opportunity to thank all those who contributed to our strategy and to let you know what we’ve done based on your feedback.
You told us that, too often, healthcare decisions are being made without the voices of Black, Asian, and minority ethnic communities. We’ve committed to working alongside the Department of Health and Social Care to champion genuine community participation, enhance trusting relationships between communities and healthcare providers, and create practical tools to support community engagement at all levels of healthcare delivery.
We heard from you that health equity can’t be delivered without first attending to the inequity and racism experienced by the NHS workforce, more than a quarter of whom are from Black and minority ethnic backgrounds. We’re now launching a programme of work that will close the ethnicity gap in pay and progression in the NHS, that will tackle the bullying and harassment experienced by racially minoritised members of staff, and that will examine how biases are embedded in our clinical education system.
You told us that inequities don’t just exist in the delivery of healthcare, but also further upstream in research and data. Over the next two years, we’ll support the healthcare system to produce new guidance on the collection of ethnicity data. We’ll work with the National Institute for Health and Care Research to ensure that evidence on health is based on representative samples, collaborate with the Genomic Medicine Service to ensure that genomic databases are reflective of our communities, and work with the National Institute for Health and Care Excellence to de-bias clinical guidelines.
We were told that too often, access to innovation and healthcare is a postcode lottery, and that minority ethnic communities are being left behind. To tackle this disparity, we’ll be identifying and scaling innovative practices and ensuring that investment in new tech is equitable. We’ll also be promoting the use of digitised care plans for sickle cell patients and promoting user-focused, inclusive digital design across the NHS.
We heard, time and time again, the shocking fact that Black and Asian women are more likely to die during and after childbirth than White women. To reverse this unacceptable trend, we’ll be driving forward an ambitious maternal and neonatal anti-racism programme, creating an image library of diverse photography to support assessment and diagnosis for minority ethnic neonates, and we’ll also be working closely with the DHSC to help deliver the government’s commitment to close the maternal mortality gap.
Finally, we heard about the stark experiences of Black, Asian, and minority ethnic service users accessing mental health services. In response, we’ll be closely monitoring the reforms of the Mental Health Act to ensure its implementation delivers on its ambition to tackle racial inequities, including reducing the unnecessary detention of Black people. We’ll also be promoting the use of Advance Choice Documents and producing briefings and resources on trauma-informed care, dementia, and perinatal mental health.
We could not have arrived at these impactful ambitions without first listening to the people we exist to help – patients, service users, local communities, and members of the NHS workforce. Equally, we cannot deliver on these ambitions without working alongside those same people. Its vital that we create a coalition of willing and committed actors if we’re going to effectively tackle inequalities in health and healthcare.
The Observatory’s strategic ambitions will be delivered through the three shifts in the way care is delivered, as outlined by the government. Their aim is to create a more efficient, agile, and tech-enabled NHS that will deliver care closer to people and further upstream. It’s the role of the Observatory to help ensure these shifts benefit all patients and communities equitably.
