Covid has highlighted long-standing health inequalities. The Board will discuss current and future work by health and other key partners to address this in the borough.
Minutes:
Councillor Coleman referenced data analysis undertaken by the borough’s Business Intelligence Unit evidenced vaccine take up according to each ward and by ethnicity. This had comprehensively depicted the reticence of some black and Asian minority ethnic communities in being vaccinated. The underlying reasons for this varied significantly but clearly signalled the need to understand these in the context of race and health inequity.
Dr Bob Klaber explained that following the good news of the vaccines being made available it was quickly recognised that there were also some disparities around the practical considerations that local authorities were having to work with in addressing health inequity. Working with Linda Jackson, Samira Ben Omar (Head of Engagement and Partnerships, NWL Integrated Care System (ICS)) and colleagues from within the wider ICS, and supported by Hannah Fontana (Strategy, Research & Innovation Programme Manager, Imperial College Healthcare NHS Trust) a 10-week series of co-production huddles was developed. This was a weekly, hour long meeting which facilitated space for conversations between different people with the intention to co-produce concepts and share learning to comprehend the qualitive work underpinning the data. Dr Klaber shared details of the huddles and encouraged Board members to access this through a link (shared in the Zoom chat) noting that many had already done so.
Sharing his reflections on the extent of reluctance to be vaccinated Dr Klaber accepted that there was a deeper issue around structural racism and a decades long, deep mistrust of medical research. He recognised that this was a pivotal opportunity for the NHS to evolve, moving from a model that not only treated illness but also progressively advocated for health and well-being.
Councillor Coleman commented that this was a conversation that exceeded a refusal to be vaccinated. The strength and prevalence of negative views about vaccination stemmed from the knowledge that black communities had routinely been unwitting test subjects or provided with lower standards of care to ensure more effective care for other ethnic groups. It was abhorrent that 70 years after the establishment of the NHS, and, 65 years since Windrush such views were not unfounded.
Jim Grealy commented on a Department for Education requirement that schools collect student ethnicity data. He advocated that there should be greater assurance offered about data collected by the NHS as it was apparent that minority ethnic people were more likely to have experienced cultural bias often when accessing health or education services. Councillor Quigley commented on the phrase “no blacks, no dogs, no Irish”, well known in 1960’s and 70’s Britain and that conversation and dialogue with black and Asian minority ethnic communities to tackle racism was critical. Merril Hammer commented that the threat of removing local services galvanised many but there was significant mistrust of the wider NHS as an organisation and senior health managers.
Dr Cavanagh commented that greater data analysis had revealed unconscious bias within health services. Working with the Royal College of Obstetricians and Gynaecologists in July 2020, he reported that data had shown that a person of West Indian heritage was five times more likely to die during childbirth and that this was twice as likely if you were Asian. This was attributable to the inherent attitudes of the department from where the data was sourced. A task force had been established to investigate and this offered greater scope for more equitable insight highlighting opportunities for delivering real change.
Toby Hyde agreed and reported that Imperial were about to announce which grass roots community groups had been successful in their applications for grant funds to undertake work that would support communities that had been impacted by the pandemic, particularly those communities that had historically experienced worst consequences of health inequalities. The disproportionate number of successful H&F bids reflected the strength of the local voluntary sector supporting excellent but fragile organisations. Toby Hyde offered to provide an update to the Board on this progress of this project.
Bathsheba Mall outlined the virtual engagement work which had delivered twenty two, tailored Q&A sessions and webinars held with borough voluntary, faith and community groups.
Fundamental to the success of these events was the opportunity to discuss concerns about the vaccines with clinical and vaccine research experts. The events facilitated a conversation that offered assurance and generated significant trust, and this was amplified where the panel were able to communicate in minority ethnic languages. Vanessa Andreae acknowledged that engagement activities that empathised with participants through shared culture and language would be significantly more effective and that this had been evident in the work and support of a Somali practice nurse. This could also be a model that could extend beyond Covid-19 vaccination and be effective in encouraging flu and immunisation vaccine take up.
Philippa Johnson echoed similar comments and said that as a community healthcare organisation (CLCH) minority ethnic staff had 80% Covid-19 vaccine take up which compared very well to flu vaccine take up. However, achieving such a positive level of take up had been a hard and challenging process. Maisie McKenzie commented on the impressive work of the borough in engaging with communities which indicated a willingness to listen. Coupled with the co-production huddles this demonstrated the high value placed on empathising with communities and it was important for this to continue.
RESOLVED
That the report be noted.