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Primary Care: Why don’t we talk about Racism?

 

Blog headlines

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

  • Virtual Consultations– the patient perspective
    1 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article - Virtual Consultations– the patient perspective.

  • Celebrating innovation in eye research
    24 September 2020

    This week Julian Jackson from VisionBridge has shared a report on eye research.

  • Link of the week: Comprehensive Spending Review and Covid-19
    24 September 2020

    This week we are sharing a blog that outlines the funding pressures and uncertainties faced by the health and care system

  • Risk stratifying elective care patients
    10 September 2020

    This blog has been shared by MBI healthcare technologies. As services are starting to treat routine patients those on waiting lists are making enquiries as to where they are on the list, and if they are still on the list.

  • Link of the week
    4 September 2020

    This week the link we would like to share are reflections from physiotherapy students on placement at Alzheimer Scotland https://letstalkaboutdementia.wordpress.com/

  • Link of the week
    28 August 2020

    This week we would like to share a blog published on the Mind website about being a BAME health worker in the pandemic.

  • Remote clinical triage model
    20 August 2020

    This week we are sharing how a remote clinical triage model was implemented at Tollgate Medical Centre. This has been shared with us by Sarah Portway, a Nurse, and Clinical Services Manager at Tollgate Medical Centre.

  • Can the Community Pharmacy become the gateway to integrated care in the NHS?
    13 August 2020

    The NHS is a continually evolving innovative demand led public service the role of the Community Pharmacist is becoming the public face on a journey to the more responsible public engagement in the personal care of individuals and their family. There are currently over 11000 Pharmacies many are single or small chain service providers, while multiples occupy the urban shopping centres and more densely populated conurbations, the value of the rural High Street can’t be understated.

  • Crunch time for patient involvement
    7 August 2020

    There are new challenges for primary care, which could really do with patient input. Mike Etkind, chair of a PPG and founding member of his PCN’s patient group, recognises the size of the task clinical directors have managed over the last few months but identifies two particular issues where patients have a necessary and valuable contribution, that need to be addressed now – the 2020 vaccination programme and primary care from a distance- total triage, remote consultations, and the use of telemedicine.

  • Link of the week - Visionbridge
    31 July 2020

    The link we are sharing this week was submitted by Julian Jackson, Visionbridge.

  • Links of the week
    23 July 2020

    This week we are sharing two articles with you.

 
 
Friday, 20 November 2020

Primary Care: Why don’t we talk about Racism?

Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

It seems like the world has shifted on its axis in 2020. One of the events that has reverberated around the world is the killing of George Floyd in Minneapolis on 25th May 2020 at the hands of the police, sparking a worldwide response and an increased profile for the #BlackLivesMatter movement.

From a personal point of view, having spent a large part of my life in denial about the impact racism had on me, I have been drawn into the work of inclusion and have been feeling a dichotomy of hope and weariness, as I have had many more conversations about race this year. For me, the realisation that large parts of society have no understanding of systemic racism and the fact that modern society has privilege or denial of privilege built into every aspect of our lives has been shocking.

And primary care and medicine more generally have not been untouched by this movement. The BMA have launched their ‘Equality Matters’ programme and in part due to positive pressure from Professor Mala Rao and Lord Victor Adebowale, the NHS Race and Health Observatory, hosted by the NHS Confederation was launched in June 2020. This feels like an important step in helping us understand the facts and prioritise action, recognising the determining factors in health status and outcomes. In 2018 the Health Foundation stated ‘The answers lie in the circumstances in which people are born, grow, live, work, and age: the social determinants of health. These can enable individuals and societies to flourish, or not.’

So why do we find it so hard to accept the evidence around racism and discrimination and what is the work that needs to be done in primary care? I am left with a deep curiosity about why there has been so little focus on the impact of race, both for staff and with respect to health outcomes for the communities we serve.

There is irrefutable evidence that despite the aim of the NHS to deliver universal, fair healthcare, outcomes for people from BAME communities are significantly poorer. Covid 19 has shone a light on this disparity and led to much debate. The differential health outcomes cover a range of services, for example, infant mortality rates in Bangladeshi women are twice the national average and black men are four times more likely to be detained under the Mental Health Act. We need to recognise, however, there are nuances and this is not just about colour, as in many cases, white traveller and gypsy communities have the worst outcomes of all. As well as outcomes, there is evidence of differential perceptions of treatment, for example, the 2017 Cancer Survey found 14 % of Asian patients felt staff talked over them as though they weren’t there, compared with 4 % for white patients. Clearly more radical solutions need to be considered as part of Primary Care Network development to capitalise on closer links to communities and start to address some of these inequalities.

So what of staff in the NHS? In July 2020 the King’s Fund published a report on the lived experience of BAME staff in the NHS. To anyone who has worked in the NHS for any length of time this was probably not a surprise; we know BAME doctors are more likely to be referred to the GMC for fitness to practice reviews and anecdotally in my own coaching with doctors in training, there are a number of trainees where race undoubtedly played a part in them receiving a poor experience and poor ARCP ratings.

So what, if any are the solutions? The first, I believe is clear and welcome in the NHS People Plan. Organisations need to ‘acknowledge existing and deep rooted inequalities’. There also needs to be a commitment and courage in acting and having difficult conversations. As a coach, I strongly believe even systemic change happens one conversation at a time We need leaders who are prepared to both commit personally to work on their biases and model vulnerability and to create an environment where everyone feels safe to speak their truth, without fear of consequence. I know these leaders exist in the NHS so I remain hopeful. Ultimately, it is about accepting and celebrating our shared humanity.