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.
Though patterns of ill-health are complex, people from Black and Minority Ethnic (BME) backgrounds have poorer health outcomes than the White British majority across a range of indicators. Ethnic identity influences health and wellbeing through a variety of mechanisms, particularly linked to: direct/indirect discrimination; differential access to health-promoting resources; cultural practices; migration; and some genetic factors.
While there are areas of good practice, health and social care services can exacerbate, rather than mitigate, the health disadvantages experienced by many minority ethnic people. Unmet need, poor patient-provider communication, negative service experiences and poor outcomes are common. Currently, the processes through which health services are commissioned rarely give considered attention to ethnic diversity and inequality. Therefore, opportunities for service improvement are missed and these problems persist.
We aim to challenge and support people engaged in commissioning and service improvement to embed attention to ethnic diversity and inequality throughout their work. In particular, we aim to support better use of evidence so that ethnic inequalities can be identified and understood and effective solutions found.
Through better commissioning and service improvement practices health services can be shaped to provide equitable access, experiences and outcomes for all people regardless of their ethnicity. There will also be gains in terms of efficiency and quality objectives. Our work began with a two-year research project focused on understanding how evidence relating to ethnic diversity and inequality is accessed and used within healthcare commissioning. This project was funded by NIHR HS&DR and has resulted in a suite of briefing papers, tools and resources.
Further work, supported by CLAHRC (SY), allowed some piloting of tools and resources in real-world commissioning contexts and the delivery of training and support to commissioners and other stakeholders.
Tools and resources
You will find on this website a variety of resources to support understanding and action towards better commissioning and delivery of health services for multi-ethnic populations.
We hope these resources are useful to a range of stakeholders seeking to influence the commissioning and service improvement arenas, including: clinical commissioners; commissioning managers; public health staff; health professionals and practitioners; managers of healthcare services; community groups; researchers; service users and members of the public. These tools and resources are still in development and we welcome feedback, contributions and suggestions for improvement. Please email email@example.com with any feedback.
The original research was led from Sheffield Hallam University and adopted a collaborative and participatory approach, bringing together university researchers and healthcare managers from Sheffield, Leeds and Bradford across the whole life of the project.
The project built on past work on ethnic health inequalities, commissioning and workforce development by the partners. Since completing the research, most team members have moved to new institutions and roles, but we continue to work together to take the learning into new areas of work.
Professor Sarah Salway
University of Sheffield, Sociological Studies
Sarah was the Principal Investigator on the original research project. She has 20 years’ experience of research, consultancy and teaching in the field of public health. Sarah’s programme of work is centred on understanding the social and political determinants of health with three broad themes of interest: gender, ethnicity and poverty. Her work in all three areas has included an emphasis on understanding the perspectives of service users/beneficiaries and improving the fit between services and client needs. She currently leads the cross-faculty Health Equity & Inclusion Research Group.
Dr Ghazala Mir
Leeds Institute of Health Studies
Ghazala Mir is an Associate Professor at the University of Leeds. Her research interests are in health inequalities affecting people from minority ethnic and faith communities. She has carried out research on healthcare for people with long term conditions and disability and on faith communities and social cohesion policy.
Ghazala has a particular interest in research that explores the best way of meeting identified needs in practice. She leads the interdisciplinary Inclusive Cities and Inequalities Research Network at the University of Leeds which brings together academics, third sector organisations, policy makers and practitioners from a variety of disciplines and sectors to tackle social inequalities nationally and internationally. She is also Director of the Ethnicity Training Network, which was established to make good quality training on cultural competence easily available to practitioners. She has significant experience of contributing to national policymaking boards and international Boards such as the Care Quality Commission and the Department of Health and is a member of the National Institute of Health Research Funding Board.
Dr John Skinner
Sheffield City Council, PH
At the time of the original research project, John Skinner was research and evaluation manager at NHS Sheffield, and has recently moved to a Public Health role at Sheffield City Council. John has experience of both quantitative and qualitative analysis and is also involved in analysis of patient and public feedback from consultations and from process evaluations. In his role as co-researcher at the Sheffield site, John is extending his knowledge of how evidence is used in the commissioning process.
eMBED Health Consortium
Lynne joined the Equality and Diversity team at NHS Bradford and Airedale in July 2008, her first job within the NHS, after a 23 year career in further education. She began as a teacher of ESOL (English for Speakers of Other Languages) and worked in several colleges in West Yorkshire and eventually joined the senior management team at Keighley College. There she had responsibility for equality and diversity in addition to her main job as director of teaching and learning.
In her current role she works with Clinical Commissioning Groups to embed equality & diversity in their work. Her role as co-researcher on this project helped her to gain new insights into the difficulties of mainstreaming race equality work within the NHS and learn more about how to carry out academic research.
From August 2014 to February 2018 she has been funded by the National Institute of Health Research as a knowledge mobilisation research fellow to test out the tools developed by the EEiC research team. She wants to develop her skills in mobilising knowledge about ethnic inequalities so that health care commissioning can more effectively improve the access, patient experience and health outcomes of black and minority ethnic people.
Dr Daniel Turner
Freelance researcher, founder of Quirkos
Daniel was the full time research fellow on the project, with a health geography background, and a special interest in research on health systems. Previously he was a research assistant at Oxford Brookes University, working on a mixed-methods project looking at the long-term unmet needs of the partners and family members of long-term cancer survivors. His PhD research investigated the support networks for people living with HIV/AIDS in Botswana.
Professor Kate Gerrish
Sheffield University, School of Nursing and Midwifery
At the time of the original research project, Kate Gerrish is research professor in nursing, and sits on the project management group. She brings extensive experience of knowledge mobilisation to the project.
Professor George Ellison
University of Leeds, LIGHT
At the time of the original research project, George was a Senior Lecturer in Biostatistics, but has experience in a wide array of multi-diciplinary research projects. He is a member of the project management group.
Bushara Bostan formerly worked for NHS Leeds as a Health Improvement Specialist in the Diversity Inclusion and Vulnerable Groups Team. The key aims of this role was to provide specialist public health advice and support to ensure the implementation of public health policies, strategies and work programmes across Leeds; with the overall aim of reducing health inequalities experienced by some of the city’s most vulnerable people. She has brought this experience to her new role in the national Commissioning Board.
The EEiC project complements her current role by providing a wide range of insights into the commissioning of health services for multiethnic populations, so that services better meet the needs of black and minority ethnic patients and thereby help reduce ethnic inequalities in healthcare experiences and health outcomes.