Cultural Communities and Health Inequalities – Q&A Summary

As part of the Connect Health Change webinar series, we present the Q&A summary from our panel who discuss the barriers different cultures face within the healthcare system.

Connect Health “Change” brings you the fourteenth in a series of webinars to make and embed transformation in healthcare. Aimed at system leaders and clinicians across the NHS, the webinars provide practical solutions to the challenging issues we are all grappling with.

This webinar included patients, third sector, change experts, patient representatives and academics, who debated how to increase access to healthcare and improve communication for patients from different cultures.

The webinar covered:

  • For those delivering services in the heart of the community, how can we bring about appropriate outcome measurements for people from different cultures
  • For the third sector, how do we work better in partnership for patients from BAME communities
  • For service providers, how do we adapt physio, pain management and psychology services for different cultures
  • For patients, how do we give them a voice to speak about their experiences
  • For commissioners, how do we make sure cultural issues are high on commissioners priorities and how do we improve access to healthcare

Delegate feedback included:

  • “A great range of speakers & topics. It linked in well with the overall theme of the webinar.”
  • “More in-depth – either by having less speakers or increasing length of the webinar.”
  • “I really enjoyed the speakers with personal experience, it was very interesting and eye opening.”

 

Watch the Webinar in Full

 

 

Chaired by:

Dr Graeme Wilkes, Chief Medical Officer, Connect Health

 

Q&A

 Sandeep Saib, Mental Health Advocate, Philanthropist and public speaker

 View a video of Sandeep’s talk

 

Question 1: What tips would you give others in your situation?

Answer: A few that jump to my mind are, not giving up, having self-hope. It’s great that we’ve had help or are looking for help in the healthcare domain but we’ve got to really look at ourselves too. We are our own best therapists at the end of the day so we’ve got to think about self-hope, self-empowerment and start from there. Look within yourself and see what you need to do to help yourself, before helping others. That’s the biggest tip but do not lose hope. Lastly, please continue to talk, use your voice and amplify that.

 

Question 2: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: Echoing this particular session there’s a running theme around collaboration and empowerment so I would leave it with that. Collaboration and empowerment, moving forward.

 

 

Jyoti Jadav, Patient and Health Care Professional

View a video of Jyoti’s talk

 

Question 1: Have you made any changes to the way you carry out your professional physio role, as a result of your experience of being a patient?

Answer: Once you’re a patient and you’ve experienced the pain, the mental health, the treatments whilst going in and out of hospital, you actually think about all those things when treating a patient. It’s more that you have a real connection with that patient, you’re not just being a physiotherapist you actually have this bond, you’re supporting them, empathising with them and educating the patients. There is a difference, as you understand the realness of being a patient, it’s not just what you have learned from a textbook. You can apply it and be softer in the way that you approach things.

 

 

Naina Patel, Mother, carer

View a video of Naina’s talk

 

Question 1: What advice do you have for other parents in your position?

Answer: You have to continue knocking on doors. I found social services absolutely fantastic. If it is as desperate as my situation was, you have to think about sectioning – I’ve actually researched sectioning in black communities and in South Asian communities and it was not a step that I took lightly at all, so you need to keep knocking on doors.

 

Question 2: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: Looking at the ways in which we can empower different communities within a particular ethnic group and how they can take control of their own health.

 

 

Kirit Mistry, Chair, South Asian Health Action

View a video of Kirit’s talk

 

Question 1: How do we truly get leadership teams (in all organisations) to represent the populations they serve?

Answer: The last 18 months has given us a real challenge. Since George Floyd, we’ve got racism and race back on the agenda. A lot of organisations are now trying to look at how they can bring more equity, in terms of their workforce and how they can be engaging more in the communities. It starts from leadership and people, it’s just not one person trying to drive this from the board level. We need to see more diversity on the boards and people with live experiences. From a workforce point of view, we need to see greater numbers of people from our communities coming into these kinds of professions and taking up roles within those organisations. If an organisation is wanting to recruit it’s about forward planning that recruitment strategy, holding information days to enable people who may not be applying for these roles to better understand what you’re looking for as an organisation.

Finally, as organisations, we have to collaborate with specialist organisations. There are a number of race equality organisations and national charities who could help too but you’ve got to be honest with yourself and have that internal safe dialogue first before you can think about going out publicly to say ‘we’re failing on our diversity; we’re failing on equality strategies or we’re failing on working and engaging with protected characteristic groups’. Once you’ve had that internal dialogue and you’ve realised that you need to do more, that’s the honest dialogue with organisations to take that work forward. It’s about doing that internal review, then working from there and creating a clear plan of action.

 

Question 2: Are there any specific stigmas in your culture that worsens situations and how can you overcome stigmas?

Answer: The current stigma is mental health and that’s been around for many years. The only way to get past that is to have more messengers. We’ve created this ambassador committee Mental Health Ambassadors, so people are trained to be in the community, to support, handhold, signpost, tackle stigma and hopefully that will start to build confidence within the community, to start reaching out. Lastly, it is really about the organisations that are currently working on mental health, the mental health trusts for example or the Clinical Commission Groups (CCGs). They need to have those trusted voices from the communities to be able to bridge that gap between the communities and faith leaders are a great asset as well. We need to utilise these better and use country-wide networks and faith organisations, who could be engaged as well.

Comment: Connect Health have developed a public health campaign around chronic pain, called Flippin Pain™. Kirit, patient contribution has been invaluable and has tangible value. We couldn’t have done it without patients sharing their experiences.

 

Question 3: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: Our mission is, ‘Engage, Educate, Empower, Explore’ and in order to get there we need to add another ‘E’ around equality… and all of those lead to better collaboration.

 

 

Mohammad Shoiab, Clinical Lead, Huddersfield and North Kirklees, Connect Health Pain Services

View a video of Mohammad’s talk

 

Question 1: How could we help physio undergrads appreciate the experience of “suffering” to help them be more empathetic and effective?

Answer: To help students become more empathetic will really come when once they start their 100 hours of clinical placement experience and they get to see that first-hand experience of patients in pain on the ward or in whichever clinical setting they may be placed.

Some students may have entered university at the age of 18 or 19 and within a couple of weeks they can be launched into a placement. It can help give them some insights into how pain is perceived, how it’s expressed and that can be reinforced with academic units and modules. There needs to be a greater focus on the undergraduate curriculum around cultural awareness or cultural competency, what the differences are and how they should bridge those gaps with patients. Which will further improve as they go from their first year to their third, and they graduate into the real world.

 

Question 2: How do we all get better at listening to ethnically diverse communities and improve outcomes for all?

Answer: At a service delivery level, look at feedback or where there’s gaps in provision. For example, if a certain treatment is only provided to patients in English, yet the local population is 80% non-English, then there’s a clear gap in the service provision to try and improve the suitability and access to patients in that local region. It’s knowing what your local demographics are and looking at what service provisions are and if there are ways to improve things.

Moving forward, technology has allowed that to accelerate quite a lot by having access to online mediums such as audio material and video material, which we didn’t really have a couple of years ago. That has really helped patients in certain cultures and certain groups in which patients are unable to read English or their own native language. If they can’t read, having audio or video material to get that patient information across, really helps them to break that barrier down.

 

Question 3: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: Providing patients with a greater variety of tools and treatment modalities so they can break down those inequalities, as well as providing an equitable service so there’s equality but it’s about equity of outcome and providing custom tools for adaptability.

 

 

Geoff Brown, Chief Executive, Healthwatch Hertfordshire

View a video of Geoff’s talk

 

Question 1: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: Look at short-term improvement but long-term change in what people are trying to do in their work with communities. Fix immediate needs but looking at the longer term, how to get that fundamental change in those relationships.

 

 

Priya Vaithilingam, Head of Research and Engagement, Healthwatch Hertfordshire

View a video of Priya’s talk

 

Question 1: What are the next steps?

Answer: We’re looking to split the work into two strands. One is focusing on developing that good practice engagement model and working with the local university and other universities to research more around inequalities within black and Asian communities, to look at specific projects there.

Another pilot was working with public health locally and Behavioural Change Unit, to look at messages in regards to the vaccine, as well as their ‘Engage to Empower’ conversation tool.

 

Question 2: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: We could have tailored interventions but based on deeper understanding, would be the kind of key takeaway.

 

 

Prof Gurch Randhawa, Professor of Diversity in Public Health and Director, Institute for Health Research at the University of Bedfordshire

View a video of Gurch’s talk

 

Question 1: What are some of the challenges of partnership working in tackling health inequalities?

Answer: The problem is that there’s a rhetoric around co-design and collaboration but what tends to happen is providers in public sector and voluntary sector have a model in mind and then consult on that model – that’s not co-design – co-design is starting from a blank page.

The challenge is that providers feel a loss of control. The best example I’ve seen is, I’ll put you in the direction of the Community Investment Scheme and that’s related to organ donation. Here is the link if people would like to see it. That’s 50 community-led & community design projects all across England amongst diverse, ethnic and faith communities, where community organisations have designed their own projects. I have to be honest that’s been quite a nervous process for NHS Blood Transplant because they’ve had to relinquish some of their brand messaging but it’s worked because they’ve now got, trusted messengers, tailored messages and people are engaging with that conversation.

 

Question 2: What is the one thing you would change to improve health inequalities across cultural boundaries?

Answer: My reflection is that I think nothing is unique to the UK, it happens in many other countries as well. We still have a challenge in that governments especially still see communities as having a deficit model rather than an asset. If we viewed communities as assets, we would want to tackle inequalities through public engagement and that would mean that we would stop talking about these things but start acting on it.

 

 

Watch the webinar again, which includes further insight from the speakers including a full Q&A session, and read more about the speakers here:

Wednesday 14 July 2021

View our speakers’ biographies

 

Read more about transformation at Connect Health:

Transformation