The document discusses whether Black and Minority Ethnic (BME) sector services provide the best support for BME service users. It notes that being black can be both the most important and unimportant thing when delivering support. The BME sector aims to improve experiences through cultural competence, sensitivity, and involvement of users. However, the document questions if the BME sector is still needed as the NHS incorporates these principles of diversity and inclusion. It urges the BME sector to clarify models of intervention, collect evidence on health outcomes and economic impacts, and focus on skills for working with similarities not just differences.

1. Cashain David
Director of Care Services
Serving our community ?
Does the BME sector provide the best support for BME service users ?

2. • 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
Starting points…

3. • to extend the discourse from a
conversation about the ‘other’ =
difference…
• to include conversations about ‘sameness’
The challenge

4. • The current focus on
improving the experience
and quality for people of
colour (and apparently
culture) is incomplete…

5. • A focus on commitment to principles of
equality of opportunity
• Respecting difference
• Involving users
How does this framework recognise those
who work with ‘sameness’
(QAF) C1.5 Fair Access,
diversity and inclusion

6. ‘The BME sector’
SACMHS,
Sheffield
Nai Zindago Project,
Nottingham
ACMHS,
Manchester
Abayomi,
Hammersmith, London
Advocacy project,
Liverpool
Sathi
Bolton
Sahara,
Bolton
Black women's MHP,
Brent, London
Black Orchid,
Bristol
Muslim Youth helpline,
London
Qualb centre,
Leytonstone, London
Sahayak Asian
Befriending,
Gravesend, Kent
Asian Health & Social Care Ass.
Bristol
Karma-Nirvana,
Derby
Tamarind centre,
Coventry
Black MH resource centre,
Leeds
Oremi,
Kensington & Chelsea
Mental Health shop,
Leicester

7. • These services that have been
described as;
• ‘ethnic specific’
• ‘culturally sensitive’,
• ‘culturally appropriate’
• ‘culturally competent’

8. How did we get here ?
• Bringing ‘political’
pressure to bear
on decision-
makers

9. • A practical
response to
reports and
inquiries when
things go wrong..

10. • A realisation of the
equality of
opportunity policies
translated into
commissioning
intentions

11. • Changing
demographics and
the rise of the
visible minority (in
some places the
majority)

12. What make a BME
service ?
• Staffed by people from ‘ethnic’
community - ACCEPTABLILITY
• Language skills – ACCESS
• Staff have ‘Cultural’ knowledge -
SENSITIVITY

13. The premise..
• Delivered by those who understand the
‘culture’
• Higher levels of empathy
• Rooted in the local community (local
people)
= Better outcomes !

14. The changing NHS

15. Developing cultural competence
Cultural
competence
Cultural
knowledge
Cultural
Sensitivity
Cultural
awareness
The Papadopdos, Tilki & Taylor model (1998)

16. 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 ?

17. BME sector SWOT
Strengths
Trust of service users
and community
Weaknesses
Lack of clear models
Poor commissioning
Opportunities
Share innovation and
skills with mainstream
Threats
continuation of funding

18. A plea to the BME sector…

19. 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

20. 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 ?

21. • Much of the research and initiatives have
centred on the ‘process or journey’ through the
system with little emphasis being placed on the
content

22. 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

23. • If you don’t know
how you are
doing it…
• …how can you do
it better ?

24. Quality assurance
• examine your ‘models’ of intervention,
and their evidence base.
• Collect the evidence that there is a
‘health gain’ or ‘economic gain’

25. • 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..

26. • Clarify your service model
• Collect information to support your
assertion
• Be obsessive about outcomes
Pointers for future survival..

27. If you want your eggs hatched, sit on
them yourself.
Haitian proverb

28. ‘Ujima has awarded 3
PHD fellowships in
partnership with the
University of Greenwich,
School of Health &
Social Care.

29. 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.

30. Thank you
cashain.david@ujima.org.uk
http://www.ujimagroup.org.uk/