Equality RULES?

To mark Black History Month, we look at progress in delivering appropriate healthcare to minority groups.Graham Clews and Matthew Limb report

More than ever before, the needs of patients from minority communities are now high up the healthcare agenda. The topic is a key priority for the NHS, with chief executive David Nicholson soon to chair a summit of senior health service managers to look at how to cut existing race health inequalities. The managers will hear how a truly patient-centred health service listens to, and understands, the needs of patients from all communities in order to deliver appropriate and first rate care. At the same time NHS Employers has chosen 20 acute and primary care trusts including Luton and Dunstable Hospital trust, the Royal Liverpool and Guy’s and St Thomas’ to be equality and diversity partners this year, to help drive forward the race health equality agenda. A further 20 trusts will be selected next year. Bradford Teaching Hospitals trust, based in one of England’s most ethnically mixed cities, is one of the partners. The trust employed its first interpreter in 1965, and its physiotherapy department is currently the biggest user of the service, with five sessions with interpreters – or liaison officers as the trust calls them – every single day.

Being aware

The trust’s head of equality and diversity Lorraine Cameron trains physiotherapy managers in running consultations where interpreters are present. She says the nature of physiotherapists’ hands-on work can add complications to the treatment of some patients, and the trust runs cultural awareness sessions for physios, featuring a number of scenarios including an older Asian woman who is uncomfortable being treated by a male physio, and an older white woman who expresses unhappiness at being treated by a black male physio. The Race for Health initiative pledges to cut race inequality in four major conditions – diabetes, mental health, perinatal mortality, and coronary heart disease and stroke.

Hands on

Mohammad Shoiab, who graduated this year from the University of Bradford, is from a British Pakistani background, and believes physiotherapy is ideally placed to lead the way in breaking down barriers to hard-to-reach ethnic groups who have high levels of conditions like diabetes and cardiovascular disease. ‘With the London Olympics, Change4Life and Move for Health all going on over the next couple of years, physios could really make a difference in some communities,’ Mohammad Shoiab says.

Improving relationships

Jaide Pascal, a band 5 physio at St George’s Healthcare trust in south London, believes the needs of the many different cultures in that part of London are well met by physio-therapists at her trust. She says there is ample access to interpreters, women-only exercise classes and, particularly, hydrotherapy provided by female physios. But she says while St George’s has an ethnicaly diverse physiotherapy workforce, services across the UK do not always reflect the patients they are treating, and more physios from different ethnic backgrounds could help reach out to black and ethnic minority patients. ‘In terms of building patient relationships, there may be groups of patients who are more comfortable with physios from their own ethnic groups,’ she says. ‘It’s a question of patient education, but it’s true that patients sometimes open up more to healthcare staff from their own ethnic group.’

Keep listening

Carol Baxter, equality and diversity spokesperson for NHS Employers, says employers have a legal requirement to carry out an impact assessment of  all their policies and make sure they don’t inadvertently discriminate against minorities, whether on grounds of ethnicity, gender, disability or sexual orientation. People from different cultural groups may have different ideas about what constitutes appropriate services, she says. Some might prefer services delivered by the same sex, particularly those relating to personal care and close handling.  This could affect whether people from BME (black minority ethnic) groups felt ‘able to present’ for services such as therapies, for which the need was not usually seen as life-threatening ‘Part of the impact assessment process is about listening to what the communities tell you and looking at the evidence for the need for the service to be appropriate,’ Carol Baxter adds. With the effort clearly being put in by physios on the ground, the service for black and ethnic minority patients can only be even better by next year’s Black History Month.


Graham Clews & Matthew Limb

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