Bristol PCT
Profile
Bristol is the most diverse place in the West Country with long established African-Caribbean, Pakistani, Indian and Chinese populations and also substantial, and more recent, African communities, particularly Somali, with growing numbers from eastern Europe . The most recent census indicates that 10.7 per cent of Bristol’s population is from black and minority ethnic communities, however the actual figure is probably higher.
Our BME population faces big issues…
Mental health: In Bristol as elsewhere, people from BME communities are overrepresented in the take-up of mental health services. We are working in partnership with neighbouring PCTs and voluntary and public sector partners on Delivering Race Equality in Mental Health through our BME community development worker programme.
Access to services: There is a high concentration of asylum seekers and refugees with multiple complex needs living within the inner city wards of Ashley, Easton and Laurence Hill. Although we have a number of excellent specialist services, it is a challenge to meet their health needs appropriately, developing good services that cater well for minority languages, cultural sensitivities, the mobility of the population and inter-community differences.
Particular diseases: Among our BME Communities, particularly those of Asian origin there are high levels of diabetes and coronary heart disease. Sickle Cell and Thalassaemia is particular issue for people of African and African Caribbean origin. Vitamin D deficiency in pregnant women and children is of concern for people new to the country, particularly those from the African sub continent.
Our workforce needs…
We are concerned that organisational merger and agenda for change have had a disproportionate impact on our BME workforce; although we are aware that we have lost some of our BME staff to other organisations through promotion to senior roles, which we consider to be an achievement. We are now beginning to see an increase in the proportion of BME staff and are taking a number of proactive steps to encourage this trend.
- Training support to support progression for bands has been 2 – 4 identified. To address progression issues for senior management, a succession planning policy is being developed. This outlines a programme of proactive positive action in the recruitment and progression of unrepresented staff groups.
The PCT supports the BME staff Network, who are represented on a number of strategic groups. The network is represented at each induction and members of the network help deliver the equality training module on the induction. The network has an extensive information sharing system and staff are kept informed of training (e.g. Breaking Through), mentoring and other opportunities (leadership programmes, jobs, secondments).
Commissioning raises issues…
Commitment to race equality: Our commissioners are working closely with our Race Equality Scheme Manager and Public Health to make sure that race equality is at the heart of the commissioning and contracting processes. Race Equality Impact Assessment Methodology is embedded in service redesign and Race Equality compliance is part of the monitoring arrangements.
A number of dedicated services have been commissioned for example; The Haven (a primary care service for asylum seekers), the Sickle Cell Coordinator, a BME cancer support service.
Capacity in the voluntary sector: There is a need to support BME organisations to build capacity as providers, so that it is possible to commission culturally sensitive services.
We’re proud of…
Care for asylum seekers: The Haven is a primary health care service dedicated to asylum seekers. Patients get lost in the system and need such culturally sensitive, accessible, centralised services that meet people’s needs.
The Bristol Race Equality Health Partnership: Partnership between NHS organisations and BME representatives provides local leadership on race and health.
BME Customer Service Initiative: A collaboration between local NHS organisations and the BME community sector which identifies and addresses issues and improves service outcomes.
BME Salt Awareness Partnership: Public Health, Community Dieticians and the Black Development Agency collaborated on an FSA funded peer educator health education project. 10 peer educators ran a range of activities within their communities, culminating in a giant salt mountain in the city centre. The Peer educators will continue to assist the PCT in its health education work.
Next steps…
Our big challenges for the next years are:
- To improve ethnic monitoring data in primary care
- Develop and implement an integrated equality scheme
- To produce some BME top team managers
Programme lead:
Christina Gray, Associate Director of Public Health - Equality and Inclusion
christina.gray@bristolpct.nhs.uk