Category: Ethnic Minorities

Public Health

Current awareness updates

Drug users urged to be extra careful following a high number of likely heroin overdoses.
Public Health England (PHE); 2021.
[Public Health England (PHE) has issued a warning of a sharp rise in the number of overdoses linked to people using drugs in several areas across England. To date, there have been at least 46 poisonings resulting in 16 deaths but investigations are still ongoing. The areas affected include South London, the South East, South West and East of England.]

Mental Health Crisis Care Profile.
PHE Fingertips; 2021.
[The Crisis Care Profile collates and analyses a wide range of publicly available data on associated prevalence of mental health crisis. Risk factors include access to care, treatment, and outcomes. Includes risk factors around age, deprivation, illness and disabilities, crime and social isolation. Other topics – urgent and emergency care, quality of treatment, access to support. Data available by local authorities.]

Dental health: migrant health guide.
Public Health England (PHE); 2021.
[Advice and guidance on the health needs of migrant patients for healthcare practitioners. 17 August 2021: New model of care to support refugees and asylum seekers to access NHS dental services.]

Cervical screening: support for people who find it hard to attend.
Public Health England (PHE); 2021.
[Guidance on support for people who find it hard to attend cervical screening due to having a mental health condition, or having experienced trauma or abuse. 16 August 2021: Clarification that this guidance is based on research conducted with users of mental health services and addition of signposting to guidance to support other underserved groups.]

Oral healthcare: model for asylum seekers and refugees.
Public Health England (PHE); 2021.
[This model of care provides professionals with guidance to support access to NHS dentists. Asylum seekers and refugees can face barriers when accessing NHS dentists. This model of care details the processes, rights and entitlements to care and includes supporting information and links to forms and guidance. It is designed for local authorities, support services and health professionals who work with asylum seekers and refugees.]

Antenatal care.
National Institute for Health and Care Excellence (NICE); 2021.
[This quality standard covers care for healthy women and their babies during pregnancy (up to 42 weeks). It covers routine antenatal care in primary, community and hospital settings. It describes high-quality care in priority areas for improvement. In August 2021, changes were made to align this quality standard with the updated NICE guideline on antenatal care.]


Service specification: Cystinosis diagnosis and co-ordination of management (all ages).
NHS England; 2021.
[This service specification covers the provision of services for patients with Cystinosis, all ages.]

Continuous positive airway pressure for the treatment of obstructive sleep apnoea/hypopnoea syndrome.
National Institute for Health and Care Excellence (NICE); 2021.
[Evidence-based recommendations on continuous positive airway pressure for treating obstructive sleep apnoea/hypopnoea syndrome in adults. August 2021: The recommendation on continuous positive airway pressure (CPAP) for mild obstructive sleep apnoea/hypopnoea syndrome (OSAHS) has been updated and replaced by recommendation 1.5.2 on CPAP for mild OSAHS in the NICE guideline on obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.]

Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s.
National Institute for Health and Care Excellence (NICE); 2021.
[This guideline covers the diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome (OSAHS), obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease with OSAHS (COPD–OSAHS overlap syndrome) in people over 16. It aims to improve recognition, investigation and treatment of these related conditions.]

Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study.
Woolf K. The Lancet Regional Health – Europe 2021;8(-):100180.
[Using a nationwide prospective cohort study and qualitative study in a multi-ethnic cohort of clinical and non-clinical UK healthcare workers (HCWs) researchers analysed ethnic differences in SARS-CoV-2 vaccine hesitancy. Of the 11,584 HCWs included in the cohort analysis, 23% (2704) reported vaccine hesitancy. Ethnicity was a significant predictor of hesitancy.]

Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019–20 data.
Addiction; 2021.
[Following the March 2020 COVID-19 lockdown, smokers and high-risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high-risk drinking prevalence increased post-lockdown and use of evidence-based support for alcohol reduction by high-risk drinkers decreased with no compensatory increase in use of remote support.

Everybody active, every day: 5 years on.
Public Health England (PHE); 2021.
[Summary of the 5 year review to the national physical activity framework, ‘Everybody active, every day’ and the PHE response.]

Quality in Qual: a proposed framework to commission, judge and generate good qualitative evaluation in wellbeing impacts.
whatworkswellbeing; 2021.
[Based on interviews with ten leading organisations and individuals who have in-depth evaluation and methodological expertise this report sets out why work on qualitative evaluation is valuable and important, what resources already exist. The report identifies six prompts for potential uses of qualitative research in evaluations.]

Genomics nation: A benchmark of the size and strengths of the UK genomics sector.
UK Bioindustry Association; 2021.
[The NHS Long Term Plan promised greater focus on prevention to help people stay healthy and ease the burden on the health service. The early detection of disease, rather than merely the diagnosis and treatment of illness, will be critical to achieve this objective. The NHS Genomic Medicine Service (GMS), launched in 2018, provides a single, national coordinated approach to genomic testing and genomic research in the NHS.]

A joint thematic inspection of community-based drug treatment and recovery work with people on probation.
HM Inspectorate of Probation (HMIP); 2021.
[Probation services across England and Wales supervise nearly 156,000 people in the community. HM Inspectorate of Probation estimates that almost 75,000 of these individuals have a drugs problem, yet fewer than 3,000 people were referred by probation services to specialist drug misuse treatment in 2019/2020. HMIP partnered with the Care Quality Commission to examine how probation services supervise this cohort and found probation services are responding poorly to drugs misuse and addiction cases.]

Public Health

Current Awareness Updates

Care homes: visiting restrictions during the Covid-19 pandemic House of Commons; 2021

(This report calls on the government to make the existing requirements for individualised assessment for visits mandatory by laying its draft regulations, as soon as possible. Government guidance now makes clear that care home providers should not impose blanket bans on visiting but should instead conduct individualised risk assessments for each resident. However, without statutory force, there is no legal recourse for residents to require their providers to implement the guidance.)

Racism and discrimination: the experience of primary care professionals in the Humberside region Humberside LMC: April 2021

(This report highlights discrimination faced by staff and patients from ethnic minority backgrounds in general practice. It finds that respondents reported experiences of discrimination in a wide range of areas such as training, working patterns and complaints, and it calls for a zero-tolerance approach to tackle racism in all its forms. )

Pandemic patient experience II: from lockdown to vaccine roll-out The Patient’s Association; April 2021

(In 2020, patients told the Patients Association about their experiences of living with health and care needs during the Covid-19 pandemic. Their testimony painted a bleak picture in many ways. This follow-up survey (drawing on 453 responses, submitted over February, March and early April 2021) finds that many aspects of their experiences are not much better, and some are worse. Accessing general practice services remains difficult for many, and patients overall do not regard remote consultations as an adequate replacement for in-person appointments.)

Outpatient appointments intended but not booked after inpatient stays Healthcare Safety Investigation Branch (HSIB); April 2021

(This investigation explores the patient safety risk of outpatient appointments that are intended but not booked following an inpatient stay. It also considers opportunities for building resilience into the process to ensure timely appointments. It concludes with two safety recommendations that are aimed at reducing the chance that patients will be lost after an inpatient stay and supporting the staff within trusts who are responsible for arranging appointments and tracking patients.)

Unemployment and mental health The Health Foundation; April 2021

(This analysis estimates that an increase of 900,000 people in unemployment expected by the end of the year, compared with before the pandemic, will lead to 200,000 more people with poor mental health in the UK. It acknowledges that while government action to reduce a rise in unemployment by extending the furlough scheme to September will support mental health, it suggests that the benefits system and employment support programmes currently fail to properly account for the mental health needs of those who are unemployed. It concludes that there is now an opportunity to ensure that efforts to tackle unemployment in the pandemic recovery are designed to better support mental health.)

Skin cancer awareness month toolkit Skin Cancer Foundation; May 2021

(A social media toolkit giving you downloadable skin cancer images and resources to help you share the facts during Skin Cancer Awareness Month)

Commission on Race and Ethnic Disparities

The Report

Source: The King’s Fund Health Management and Policy Alert

This report includes a chapter on health that looks at life expectancy, cancer, diabetes, obesity, maternal mortality as well as access to health care, Covid-19 and more.

The Commission’s report sets out a new, positive agenda for change. It balances the needs of individuals, communities and society, maximising opportunities and ensuring fairness for all.

The Commission has considered detailed quantitative data and qualitative evidence to understand why disparities exist, what works and what does not. It has commissioned new research and invited submissions from across the UK.

Its work and recommendations will improve the quality of data and evidence about the types of barriers faced by people from different backgrounds. This will help to inform actions and drive effective and lasting change.

Ethnic diversity in fertility treatment 2018

Human Fertilisation and Embryology Authority Report

Source: The King’s Fund Health Management and Policy Alert

This report looks at how access to, and outcomes of, fertility treatment differed by ethnic group between 2014 and 2018. It finds disparities in the experience of patients from ethnic minority backgrounds and makes recommendations for the HFEA, fertility clinics and commissioners to help better understand the root of these inequalities so that action can be taken to improve access and outcomes for ethnic minority groups.

Covid

Current Awareness Updates

Covid-19 recovery and resilience: what can health and care learn from other disasters? The King’s Fund

What do communities need to be able to recover from Covid-19 and build resilience? This long read identifies key insights from people involved in disaster recovery around the world.

Covid-19: rapid point of care or near-person testing for service providers Public Health England

(This guidance, aimed at service providers, describes the main types of coronavirus (Covid-19) tests currently available for use in point of care or near-person settings.)

Factors influencing COVID-19 vaccine uptake among minority ethnic groups, 17 December 2020.
Scientific Advisory Group for Emergencies (SAGE); 2021.

(Paper by the ethnicity sub-group on factors influencing COVID-19 vaccine uptake among minority ethnic groups. It was considered at SAGE 73 on 17 December 2020. The paper is the assessment of the evidence at the time of writing.)

COVID-19 Clinical management: living guidance.
World Health Organization (WHO); 2021.

(This document is the update of interim guidance published in May 2020. This guideline now also includes Best Practice Statement on caring for COVID-19 patients after their acute illness and 5 new recommendations.)

Prioritising the first COVID-19 vaccine dose: JCVI statement.
Department of Health and Social Care (DHSC); 2021.

(Statement from the Joint Committee on Vaccination and Immunisation (JCVI) about increasing the short-term impact of the COVID-19 vaccination programme. Updated 26 January 2021: Added document ‘Annex B: comparison between 1 and 2 dose prioritisation for a fixed number of doses’.)

COVID-19: Ensuring a quality patient experience with the rise of digitisation in a healthcare setting.
Mobiquity; 2021.

(This report, commissioned by Mobiquity and conducted by Censuswide, reveals that half of UK patients aged over 55 preferred digital tools instead of in-person consultations during COVID-19. The most preferred digital tools used by over 55s included remote monitoring (50%) and video examinations (50%).)


Covid Virtual Ward (secondary care).
Wessex Academic Health Science Network (AHSN); 2021.

(The Covid Virtual Ward model is a secondary care led initiative to support early and safe discharge (step down) for Covid patients and builds on the Covid Oximetry @home model. NHS England and Improvement has now written out to all ICSs and trusts in the country; outlining why this work must be implemented, and how to do it.)

Covid 19

Current awareness updates

Ethnic inequalities in Covid-19 mortality: a consequence of persistent racism Runnymede Trust

(This briefing (published in collaboration with the Centre of Dynamics of Ethnicity) discusses the reasons for ethnic minority people experiencing a much higher risk of Covid-19-related death. Ethnic inequalities in relation to Covid-19 mirror longstanding ethnic inequalities in health. A large body of evidence has shown that these inequalities are driven by social and economic inequalities, many of which are the result of racial discrimination.)

PPE portal: how to order COVID-19 personal protective equipment (PPE) – Public Health England; Updated 26th January 2021

(Eligible health and social care providers can order PPE through the portal to meet the increased need that has arisen as a result of the COVID-19 pandemic)

COVID-19 variants: genomically confirmed case numbers Public Health England; Updated 28th January 2021

(Genomically confirmed case numbers for SARS-CoV-2 variants of concern and variants under investigation.)

Risk related to the spread of new SARS-CoV-2 variants of concern in the EU/EEA – first update European Centre for Disease Prevention and Control

(This risk assessment presents the latest available information on the recent emergence of three variants of concern, VOC 202012/01 identified in the United Kingdom (UK), 501Y.V2 identified in South Africa, and P.1 identified in Brazil and Japan)

COVID-19 in children and the role of school settings in transmission – first update European Centre for Disease Prevention and Control

(The aim of this document is to provide an update on the knowledge surrounding the role of children in the transmission of SARS-CoV-2 and the role of schools in the COVID-19 pandemic, based on the experience in the EU from August–December, 2020. This document also addresses transmission to and from staff in school settings, school-related mitigation measures including risk communication, testing, contact tracing and the efficacy of partial and full school closures. This document draws upon and updates evidence presented in the previous report from ECDC on this topic, which was published on August 6, 2020 [4]. This report does not consider educational settings related to young adults or adults, such as universities or vocational schools or any school with overnight stays, such as boarding schools. This report does not consider the epidemiology of COVID-19 in relation to new variants of SARS-CoV-2, for which robust evidence on the potential impact in school settings is not yet available, such as one recently observed in the United Kingdom [2].)

COVID-19 rapid evidence summary: Sarilumab for COVID-19.
National Institute for Health and Care Excellence (NICE); 2021.

(Preliminary evidence from the REMAP‑CAP study has suggested that sarilumab is beneficial in adults with severe COVID‑19 who are critically ill and receiving respiratory or cardiovascular organ support in an intensive care setting. Sarilumab was given within about 24 hours of starting organ support.)


COVID-19 rapid evidence summary: Tocilizumab for COVID-19.
National Institute for Health and Care Excellence (NICE); 2021.

(Unpublished preliminary evidence from the REMAP‑CAP study has suggested that tocilizumab is beneficial in adults with severe COVID‑19 who are critically ill and receiving respiratory or cardiovascular organ support in an intensive care setting (all randomised within 24 hours of starting organ support).)

Perspectives from the front line: The disproportionate impact of COVID-19 on BME communities.
NHS Confederation BME Leadership Network; 2020.

(A report into the disproportionate impact of coronavirus on BAME communities based on interviews with BME NHS leaders, clinicians, community organisations and service users, as well as a survey of more than 100 members of the BME Leadership Network. Overwhelmingly, participants point to long-standing inequalities and institutional racism as root causes.)

Communications Toolkit

Improving communication with black, Asian and minority ethnic women and local maternity teams

Source: The King’s Fund; Health Management and Policy Alert

This toolkit aims to provide helpful suggestions about how to communicate with women of different backgrounds, about the extra support that is available to them, as well as signposting to currently available publications, messaging, insights and templates.

Perspectives from the front line

The disproportionate impact of Covid-19 on BME communities

Source: King’s Fund Health Management and Policy Alert

This report finds that the effects of longstanding health and socio-economic inequalities and institutional racism lie behind the disproportionate impact of Covid-19 on people from black and minority ethnic (BME) backgrounds. It distils the findings of a research study into the underlying factors. It is based on interviews with BME NHS leaders, clinicians, community organisations and service users, and a survey of more than 100 members of the NHS Confederation’s BME Leadership Network.

For more information click here.

Podcast

Why are people from ethnic minorities disproportionately affected by Covid-19?

Black people are two to three times more likely to have been diagnosed with Covid-19 compared to white people, after adjusting for age. But what is causing this shocking disparity and how does systemic racism play a role? 

In this podcast, Helen McKenna sits down with Natalie Creary, Programme Delivery Director at Black Thrive, and James Nazroo, Professor of Sociology at the University of Manchester.

King’s Fund Podcast

To listen to the Podcast, click the image above.

Caring alone: why Black, Asian and Minority Ethnic young carers continue to struggle to access support

Barnardo’s, April 2019
This report finds that young Black, Asian and Minority Ethnic children who care for ill or disabled relatives are more likely than other young carers to be isolated from support services.  The concept of a young carer is unfamiliar to many BAME communities as helping your family and extended family is often expected and there is stigma within many BAME communities in acknowledging mental health and disability issues and in seeking support.  The report makes recommendations including ensuring that allpatients who don’t speak English should have access to a translator instead of relying on children to translate for their family.  The NHS should work with communities to tackle stigma around within BAME communities to reduce the stigma of mental illness, special needs and disability and improve access to services.
Click here to view the full report.