We are a multidisciplinary team of researchers and healthcare managers working to improve the commissioning and delivery of health services for multi-ethnic populations in England. We have a particular focus on improving the mobilisation of knowledge to identify, describe and understand ethnic inequalities in health and healthcare and to support evidence-informed interventions to reduce these inequalities.
Learn more about our work using the menus above or click the links below for direct access to our varied resources:
Building organisational and individual capacity to tackle ethnic inequalities:
Healthcare commissioning involves planning and purchasing health services to meet the needs of local populations, and together with internal service improvement initiatives has the potential to tackle inequalities in access, experiences and outcomes between ethnic groups.
Yet healthcare organisations often fail to meet the needs of their diverse populations. Progress is hampered by national policies that fail to provide clear guidance on standards of service provision or appropriate commissioning responses to meeting the needs of multi-ethnic populations.
Locally, equality and diversity staff are often marginalised from commissioning, and commissioning staff and teams working on service improvement are often uncertain about how to address ethnic inequalities. There are, however, opportunities to exploit synergies with other agendas, including Quality, Efficiency and wider Health Inequalities and to build capacity and commitment to tackle these issues.
The EEiC project has produced a range of resources that can support this development:
Understand: resources to help you understand key concepts
Develop: tools and resources for individual or group training
Do: tools to support service improvement and commissioning practice
Addressing ethnicity throughout the commissioning or service improvement cycle:
UK government policy emphasises the proactive and strategic nature of commissioning, which should involve both transformational (reshaping the configuration of services) as well as transactional (custodianship of the budget, contract monitoring) elements.
Provider organisations also undertake their own service improvement cycles, responding to evolving clinical guidelines and professional standards, as well as internal performance monitoring, patient satisfaction feedback and clinical audit.
There are many versions of these cycles, but NHS commissioning and provider organisations could do much more to embed attention to addressing ethnic diversity and inequality into service development work.
The EEiC project has produced a range of resources that can support attention to ethnicity throughout the commissioning or service improvement cycle:
Strategic planning: assessing needs; reviewing provision; prioritisation
Contracting and procuring: designing and specifying services; shaping supply
Monitoring and evaluating: seeking patient & public input; monitoring KPIs
Mobilising knowledge on ethnicity, health and healthcare:
Commissioners and healthcare managers must base their actions on sound evidence, using strong local intelligence and nationally agreed evidence-based guidelines to shape excellent service provision. Our research found that this emphasis on evidence-informed decision making can impede progress on ethnic inequalities as often an absence of evidence undermines the confidence of decision-makers to intervene to reduce ethnic inequalities.
The EEiC project also found that an absence of evidence is often assumed and relevant evidence sources are overlooked. Many managers simply do not ask questions about different population sub-groups. Meanwhile, those individuals who understand the needs of minority ethnic groups are not always skilled evidence users. Evidence must be presented in ways that are informative and impactful.
More effective generation and use of evidence is needed to raise awareness of the scale and nature of ethnic inequalities and to find viable solutions.
The EEiC project has produced a range of resources aimed at supporting more critical and systematic mobilisation of evidence on ethnicity, health and healthcare: