Inequalities Experienced by BAME Communities
Since June 2020, we have engaged in active local discussions about the experiences of local BAME communities through a series of online listening events in our three alliances and an ICS-wide event about racism and inequality in health and care. These discussions have shown us that if we are to address racism and inequality in our ICS then we need to listen and learn, change what we do and stand together. This means ‘Thinking VERY Differently’ indeed.
In summary what we can learn from across these events is that addressing inequalities for people from BAME communities requires:
- Knowledge and understanding of the issues – commissioners and providers do not have detailed data on needs among different BAME groups, or a good understanding of lived experience e.g. pressures on children to translate for adults in their family, impact of Covid on multi-generational households, isolation among young and older BAME people, access to the right foods for ethnic minority people in poverty.
- Attitudes of professionals and services – BAME people and communities find health and care staff lacking sensitivity, not inclusive, intimidating, leading to fear and mistrust. Accessibility of services – BAME people and communities do not all have the right information in the right format/language, knowledge about services and how to access them, or knowledge about their rights.
BAME people and families experience barriers to services due to a lack of cultural competence:
- Listen to lived experience – of those on the frontline, both staff and people using services.
- Plan and deliver care together – ‘with us not to us’, and enabling self-advocacy
- Co-produce services – full involvement at all stages from design to monitoring and review
- Ensure representation of BAME people at all levels in the system – including BAME representation in delivering training programmes, and enabling more BAME people to become leaders.
BAME people and communities feel invisible, so different ways must be found to hear their voices:
- Recognise our shortcomings – recognise privilege, develop allyship, solidarity, empathy, compassion and acceptance.
- Build bridges – create connections and meaningful partnerships with BAME leaders and community groups that build trust.
- Be accountable – to each other and to BAME people, families and communities.
To make real change, we need to change our own personal, professional and organisational cultures:
- Gather and use the right data – to understand the differences in experiences of BAME groups and communities and the impact of levels of deprivation, as well as gaps in local community assets
- Change services in response to what we have learned – develop programmes that recognise cultural needs and the importance of affordability, and ensure people know about them and how to access them.
- Invest more, and target investment – for example BAME young people, women, elders, those at higher risk of long-term conditions and mental ill-health
- Tackle factors affecting wellbeing and wider social determinants of health and care – for example families in deprivation, those with No Recourse to Public Funds, those who cannot access faith settings due to frailty or disability, experiences of bullying and discrimination, people in debt, social isolation.
We need to work together to adapt services to be culturally inclusive: