Council of Ethnic Minority Voluntary Sector Organisations

• COLLEGE OF HEALTH - CHOICE AND SOCIAL EXCLUSION UNIT
• Patient and Public Involvement Project
• Key achievements
• CEMVO's Conference on Patient Choice : Promises and Opportunities

COLLEGE OF HEALTH - CHOICE AND SOCIAL EXCLUSION UNIT

CEMVO’s College of Health’s Choice and Social Exclusion Unit was created to carry out evidence-based research into the healthcare needs of Britain’s minority ethnic communities and disadvantaged groups. The Unit regularly contributes to further our knowledge of the specific health issues affecting these groups - particularly as users of NHS services - as well as using its research to influence Government policy.

The Unit was recently commissioned by the Department of Health’s Directorate of Access, Policy Development, Plurality and Choice to produce Guidelines on how NHS organisations can best contract and work with Voluntary and Community Sector (VCS) organisations in providing advocacy and support for patient access to Hospital Choice. It was recognised that equal access to hospital and to NHS services generally is uneven and unequal. Unequal access is often the result of lack of knowledge, or resources, in the NHS. How, for instance does one support those without an adequate knowledge of English - namely those who belong to Asian or African Cultures. In 2003, the Unit’s research showed that Patient Care Advisers (NHS advisers linked specifically to the Choice of Hospital programme) was patchy. This was particularly true of people with learning difficulties and sensory and physical impairments. Our report: Equity Issues relating to the Access and Choice Programme (2003), prepared by Susan Barber and Vanessa Gordon-Dseagu made this absolutely clear. Contracting advocacy and support from the voluntary sector is one way that the NHS can offer services tailored to the needs of the groups of NHS users who complained of unequal access. The Unit carried out research into best practice and consulted with a range of stakeholders including many from within the VCS sector, and also members of the public, and NHS staff. The Guidelines were adopted and produced by the Department of Health under the title: Choice of Hospital, Promoting Equal Access: Developing partnerships among NHS and Voluntary and Community Sector organisations - Guidelines for Contracting Advocacy and Support Services for Patients (2005).

The Unit has also worked with the Greater Manchester Strategic Health Authority to design a project to monitor patient satisfaction with the Choice of Hospital Programme. The Authority sought a better understanding of the needs of users of the programme for additional support in deciding choice of hospital. Susan Barber, Vanessa Gordon-Dseagu and Joe Rafferty conducted a baseline survey Patients offered Choice of Hospital in the Greater Manchester Area (2004). The report was produced jointly by College of Health-CEMVO and Greater Manchester Strategic Health Authority, and was the rationale for continuing research being carried out during 2005.

Our report published in 2006, `Supporting Patient Choice: Learning from Stakeholders’ builds on the 2004 report. It provides an in depth analysis of issues from the points of view of relevant stakeholders and it contributes to national learning about patient choice.

Members of the Unit regular partake in Government and stakeholders consultations and policy tables, having recently participated in a national Task Group convened by the Department of Health. The purpose of which is to consider the information needs of different types of NHS users, in the context of broadening the Choice agenda in Health and Social Care. The Task Group made a valuable in-put to the Department of Health’s Better Information, Better Choices, Better Health Programme.

Patient and Public Involvement Project

As part of CEMVO’s drive to provide a voice to minority ethnic and disadvantaged communities users of healthcare services, a Patient and Public Involvement Project was piloted during 2003-04. The project was aimed to widen participation among minority ethnic and socially excluded patient groups by providing them with a platform from where they concerns could be considered. The programme involved 34 forums in an area extending from the Essex Suffolk borders in the north, Tower Hamlets and Lambeth in the west, Bromley in the south to Havering in the east. By mid-January 2004, all of the forums were in operation and by the end of the year over 400 meetings of forums had taken place.

A diverse and highly skilled team of 25 dedicated staff worked to support the forums throughout the programme. Most of our team members belonged to minority ethnic community themselves and were therefore aware of the healthcare needs of their target groups; their knowledge-based included over 25 different spoken languages and their age composition ranged from early 20s to early 60s.

Key achievements

The work of the Forums contributed to the following outcomes:

• Guy’s and St Thomas’ Trust members succeeded in having clinical waste disposal points available in all male toilets in the trust.
• St Bartholomew’s and the London Trust members worked with the team in developing the New Hospitals – the biggest construction project in the NHS to date.
• A group of forums in South East and South West London surveyed and contributed to the realignment of urology services in these two Strategic Health Authorities.
• Witham, Halstead and Braintree Care Trust members managed to have the dispensing arrangements for oncology (cancer) drugs altered to be more convenient for patients, at the same time saving money from their dispensing budget.
• London Ambulance Service Forum contributed to the Greater London Assembly’s scrutiny of the ambulance services in the Capital.
• Princess Alexandra’s Hospital Trust Forum (Harlow) campaigned successfully for a more hygienic design of over bed table, and was part of the purchasing team for the new table.
• Newham University Hospital NHS Trust Forum members worked with the hospital and the Primary Care Trust to improve Accident and Emergency services, helping the Newham Hospital to be the first in the North East London Strategic Health Authority to reach the target of seeing 98 percent of patients within four hours.

In addition, Forum members have regularly conducted hospital and GP monitoring visits as well as taking part in the governance of their respective Trusts by seating on Executive Boards, Clinical Governance Committees and Professional Executive Committees. In order to achieve this, CEMVO’s team has been extremely pro-active in providing a great deal of support and training need by our Forum members. We have indeed supported members in carrying out qualitative and quantitative surveys of residents in their areas, including providing the survey materials in languages other than English. We have also offered forum members training courses in a wide range of subjects, complimenting the training already offered by the Patient and Public Involvement Project. Towards the end of 2004, we commenced the production of our monthly Newsletter – Update. The main purpose of this newsletter was to make Forum members aware of developments in health policy, to showcase some of the work carry out by Forums, while sharing good practice. One of the key features of this publication has been the depth and breadth of contributions made by Forum members.