Westminster's Health Forum
NHS Westminster recognises that understanding the experience and concerns of local communities requires two-way conversations. It is only a part of the picture if discussions are limited to what the PCT wants to talk about. They also need to reflect on what concerns the local communities.
The local BME Health Forum is funded by NHS Westminster, as well as by Kensington and Chelsea PCT, as a way of supporting this dialogue. The Forum is an inclusive network made up of participants from BME communities, the statutory and voluntary sectors and interested individuals. Its aims are to ensure that the needs, views and experiences of BME residents are addressed effectively; identifying areas for service review and development and undertaking specific pieces of work focused upon them. Crucially the work programme is developed through dialogue ans so reflects community concerns as well as those of the two PCTs: these are usually compatible though may not be espressed in the same way. The following example of the Forum's work illustrates this.
The PCT was concerned about the significant health inequalities in the area. For example, the proportion of deaths because of stroke or coronary heart disease in the most deprived areas of the borough were double than in the most affluent areas, and, overall, there was a ten year difference in male life expectancy between the worst and the best performing areas.
The PCT also recognised that BME communities often lived in the most deprived areas and were more likely to have poorer health than the average. At the same time a key area of concern expressed by BME communities was the difficulty some had in being able to access GP services effectively. So when the Forum decided to use its team of community researchers to look in detail at the situation this made sense to everyone.. And, in practice this was an equality impact assessment of access to primary care for the black and minority ethnic population.
The subsequent report, "Primary Concern", found a complex combination of barriers to good communication in relation to access to primary care. There was not only an issue of languages and inadequate interpreting services. many BME patients also did not understand what was available to them and how the health service worked, some bringing with them expectations of healthcare from other countries, where the focus tended to be more on acute rather than primary care.
The report also found that some health providers lacked understanding of patients' cultural backgrounds and how that influenced the way they sought to access health services. The combination of all of this meant that the effectiveness of primary care services was lower than expected amoung some BME communities, and this was reflected in poorer health outcomes.
As a consequence of the report, westminster, in partnership with its neigbouring PCT covering Kensington and Chelsea, is funding work with six community organisations from different ethnic communities and a number if primary care providers including doctors and dentists. It is identifying good practice in the areas so that this can be disseminated and rolled out throughout the PCT. Good practice on interpreting, information to patients and training in cultural competane for primary care staff will all be rolled out, with a view to cutting the difference between effective take-up of services by BME communities compared with others in the PCT, and ultimately, a reduction in the health inequalities they experience as a result. There have already been measurable improvements in access to interpreting services for patients from BME communities and real improvements in the quality of the engagement with BME communities by the PCT.
More recently the Forum has produced reports on Circumcision Services and on the Dental Services, both in response to concerns in the community, and both using a team of community researchers to do the fieldwork. All BME Health Forum reports can be found at www.westminster.nhs.uk