When it comes to supporting these people, we now have a formal system of quality measurement For those of you who are familiar with Supporting People… QAF C1.5 on Fair access presents specific services like the ones we run in Ujima (described as Black on Black) with a dilemma…. The general discourse around fair access, diversity and inclusion is a discussion about cross cultural practice
i.e. what are the interventions that are useful, and how they contribute to a health benefit.
Serving our community does the bme sector provide the best support
Serving our community ?Does the BME sector provide the best support for BME service users ?Cashain DavidDirector of Care Services
Starting points…• When delivering support, being black is the both most important and most unimportant thing at the same time• The general discourse around fair access, diversity and inclusion is a discussion about cross cultural practice
The challenge• to extend the discourse from a conversation about the ‘other’ = difference…• to include conversations about ‘sameness’
• The current focus on improving the experience and quality for people of colour (and apparently culture) is incomplete…
(QAF) C1.5 Fair Access, diversity and inclusion• A focus on commitment to principles of equality of opportunity• Respecting difference• Involving users How does this framework recognise those who work with ‘sameness’
‘The BME sector’ Nai Zindago Project, Nottingham SACMHS, ACMHS, Manchester Sheffield Abayomi, Oremi, Hammersmith, London Kensington & Chelsea Mental Health shop, Leicester Advocacy project, Liverpool Black MH resource centre, Leeds Sathi Bolton Tamarind centre, Sahara, Coventry Bolton Black womens MHP, Brent, London Karma-Nirvana, Derby Black Orchid, Bristol Asian Health & Social Care Ass. Sahayak Asian Bristol Befriending, Gravesend, Kent Muslim Youth helpline, Qualb centre, London Leytonstone, London
• These services that have been described as;• ‘ethnic specific’• ‘culturally sensitive’,• ‘culturally appropriate’• ‘culturally competent’
How did we get here ?• Bringing ‘political’ pressure to bear on decision- makers
• A practical response to reports and inquiries when things go wrong..
• A realisation of the equality of opportunity policies translated into commissioning intentions
• Changing demographics and the rise of the visible minority (in some places the majority)
What make a BMEservice ?• Staffed by people from ‘ethnic’ community - ACCEPTABLILITY• Language skills – ACCESS• Staff have ‘Cultural’ knowledge - SENSITIVITY
The premise..• Delivered by those who understand the ‘culture’• Higher levels of empathy• Rooted in the local community (local people)= Better outcomes !
Developing cultural competence Cultural Cultural awareness Sensitivity Cultural Cultural competence knowledge The Papadopdos, Tilki & Taylor model (1998)
Question ?• If the NHS now looks like the BME sector, what is it that the BME sector still has ?• Is it still needed ?• Can I be incorporated into the NHS ?
BME sector SWOT Strengths WeaknessesTrust of service users Lack of clear models and community Poor commissioning Opportunities ThreatsShare innovation and continuation of fundingskills with mainstream
What need to be done ? • Clarify and critically analyse the theoretical underpinnings of your services • identify the value this approach adds to ‘health gain’ or ‘health economy’ • examine the ‘models’ of intervention, and their evidence base
Service Model • Be clear about the theoretical underpinnings of your services.. ‘Alternative’, ‘enhancement’ or ‘gateway’ • Is this the same as the NHS, but with rice and peas or Curry ?
• Much of the research and initiatives have centred on the ‘process or journey’ through the system with little emphasis being placed on the content
Training and skills • Select training for your staff which assists in the development of their skills in working with those who are the same. • Cultural awareness training is about difference and not sameness
• If you don’t know how you are doing it…• …how can you do it better ?
Quality assurance • examine your ‘models’ of intervention, and their evidence base. • Collect the evidence that there is a ‘health gain’ or ‘economic gain’
• Oremi service in K&C conducted Action research with Kings Fund showed that;• …following contact with the Oremi service, the cost to the local services dropped from an average of £83,000 to £15,000 per year per service user..
Pointers for future survival..• Clarify your service model• Collect information to support your assertion• Be obsessive about outcomes
If you want your eggs hatched, sit on them yourself. Haitian proverb
‘Ujima has awarded 3 PHD fellowships in partnership with theUniversity of Greenwich, School of Health & Social Care.
Ujima is the largest black-led housing association in the UK and are deeply committed to strengthening Ujima’s health and social care services through education, research and training through this pioneering scheme.