The NHS Future Forum has completed a new phase of consultation, gaining further feedback from patients, service users and professionals on four themes relating to the proposed reform of UK health services (information, integration, education and the role of the NHS in public health).
This page looks at the report on information, and considers the implications its findings and recommendations may have on black and minority ethnic communities.
The full report is available from the Department of Health website.
- See education and training report (external website)
- Find out more about our work with the NHS Future Forum
- See this text as a Word document.
Key issues for black and minority ethnic communities
- The NHS should ‘recruit for values, educate for knowledge and train for skills’: selection criterion should not form a barrier to those from lower income or minority ethnic groups
This emphasis on values was raised at our Future Forum 2 listening events, with the belief that as well understanding the role, candidates should have a vocational commitment to healthcare. In particular, it was felt that the careers of midwives and nurses have become highly ‘academised’, and that this removal from basic caring principles is a key factor behind examples of unacceptable patient care and experience.
Delegates also believed that this shift in emphasis could also lead to greater diversity and equity across all levels of healthcare careers, in terms of school selection and career progression. At present, an emphasis on academic qualifications may disproportionately exclude affect those from lower income or minority ethnic groups (and in many cases, candidates who fit into both of these ‘categories’).
Furthermore, community workers/champions from black and minority ethnic communities have been successfully employed to increase access to communities which may be traditionally seen as ‘hard to reach’. For example, NHS Wirral’s Quit and Win campaign employed community ambassadors who employed local knowledge and networking skills to encourage black and minority ethnic residents to give up smoking (Tobacco use among minority ethnic populations and cessation interventions- external website).
- Care, compassion and the ability to treat people with dignity, together with communication skills, teamwork and leadership training, should be essential parts of every curriculum.
Feedback from a patient and public involvement meeting held as part of Future Forum 2 suggested that this is a key issue, with a clear sense that a lack of training and vocation in medicine and nursing has led to problems such as poor bedside manner/infrequent attention for elderly patients. These problems may be exacerbated for black and minority ethnic patients, who may also feel that their personal, cultural or spiritual needs are being neglected. Our briefings, Effective communication with service users (external website) and The health and social care experiences of black and minority ethnic older people (external website) provide guidance for practitioners working with black and minority ethnic patients.
The Foundation is a member of the Dying Matters Coalition, which argues that only by speaking about death, dying and end of life care can we ensure that family, friends and health practitioners understand our cultural, religious or personal needs at the end of life. Our briefing, Improving the quality of palliative care (external website), also provides guidance on palliative and end of life care for black and minority ethnic communities.
- The positive and direct contribution patients and the public can make to education and training should be formally recognised
Participants at both our informed conversations and Future Forum listening events keenly felt that medical schools and training bodies should have training units that involved placements in the third sector (patient or/and community groups).
- Those who challenge organisations locally should have the appropriate support from clinical commissioning groups (CCGs) and local HealthWatch
It must be ensured that these groups not only support black and minority ethnic communities to scrutinise health service, but also include members of these groups, as emphasised in our response to the Democratic Legitimacy in Health report.
- Selection and career development should encourage wider participation, to allow a workforce that is representative of its patients as well as having wider societal benefits in promoting fairness
We welcome this call for wider participation, with our Better Health briefings, Experiences of bullying and racial harassment among minority ethnic staff in the NHS (external website) and The recruitment and retention of black and minority ethnic staff in the National Health Service (external website), outlining evidence that black and minority ethnic groups may miss out on promotions and be poorly represented at the top of health and social care. We have also carried out preliminary work as part of the Department of Health Strategic Partners programme and our informed conversations on the importance of better representation and diversity of members as non-executive board members at national, regional and local level.
- The current workforce in training is the workforce of the future and, without a systematic approach to developing their skills, attitudes and behaviours, the NHS will be unable to deliver high quality care in the future
We welcome this emphasis on training and development as the key to a strong and competent workforce. Equally though, we must acknowledge that the workforce of the future will be caring for the patient population of the future. Practitioners need not just take into account the care needs of an aging population, but also the care needs of a more ethnically diverse aging population. Training must therefore emphasise the increasing shift towards care in the community as well as an understanding of patients as a “whole person” (cultural, socio-economic, personal needs context).