One of London’s most culturally diverse areas / Over 150 languages spoken / Disparities in health and wealth / 15 of Westminster’s Super Output Areas are within the top 10% of deprived areas nationally, and a further 12 are within the top 20%. Life expectancy for men in Belgravia is 10 years longer than in Church Street - one of the country’s largest gaps / Seven out of ten children in primary schools come from families who speak English as a second language / Westminster has now become home to many refugees and asylum seekers.
Our BME population faces big issues…
Diverse population: There is a wide range of communities from many different areas, including the Middle East, North Africa, Asia, Eastern Europe and South America. It can be difficult to collect information on so many groups. There is also a wide range between affluence and poverty, so the correlation between disadvantage and BME status also varies. Crude ethnic monitoring does not provide a sufficiently sophisticated picture of such diversity.
Inequality: The PCT has large variations in health between different parts of the borough, with Queens Park ward having the highest levels of cancer and cardio-vascular related mortality as well as the highest percentage of BME groups in the population
Mobile populations: New communities emerge rapidly and it is difficult to keep information on them up to date.
Political agenda: It focuses on choice and local commissioning. How can that work best for BME communities?
Our workforce needs…
Cultural competence: At lower grades, the BME proportion of the workforce is higher than in the local population. But there is snow-capping going up the organisation. Also, the workforce does not reflect the diversity of the BME community. It is likely that Middle Eastern, North African, Eastern European and South American communities are not well-represented.
Opportunity: The PCT is working to improve employment opportunities for our community. We are keen to develop routes into employment for local communities and build on our experience in recruiting and training community members to undertake research into local health needs. .
Commissioning raises issues…
Lack of information: It is difficult to commission the right services for the BME population because we don’t have good enough data on such diverse communities.
Targeting certain conditions: We have opened a new diabetes centre to improve local access. We have also targeted some smoking cessation work at BME communities because of the higher incidence of smoking and of smoking-related illness among these groups. We are now focusing on cardiovascular disease, as a major health inequality in the local population.
Access: We need to make sure that BME communities understand how the NHS system works, are not hampered by language issues and receive services that meet their needs in terms of religion, language and ethnicity. That involves developing BME voluntary sector capacity, working with the PCT.
We’re proud of…
Good consultation: The BME health forums that we fund and promote are a very positive achievement. There is now an effective dialogue. The next step is to respond more effectively to the issues that come out of the process.
Reviewing primary care: Using the consultation arrangements we have on mental health, we are working to increase BME access to primary care. We are working with users – asking them their positive and negative experiences with GPs and surveying BME people who are not registered with GPs, to find out why they do not use GPs. We are also surveying professionals. All of this helps us understand better the barriers to good primary care for BME communities. We will then produce an action plan to reduce barriers and work directly with GP Practices and local community organisations to improve access to primary care. .
This year, we plan to get systems into practices to help GPs and clinical staff to monitor ethnicity of patients and then act upon what comes out of monitoring. We want to give front-line staff the results of monitoring so they know where the greatest need is. We have also developed an ‘Impact Assessment Resource’ on our staff intranet, to provide staff with backup information to interpret their findings and translate them into practice.
Head of Equality, Diversity and Human Rights
020 7150 8131