Improving understanding
Building organisational and individual capacity to tackle ethnic inequalities
Healthcare commissioning involves planning and purchasing health services to meet the needs of local populations. Together with internal service improvement initiatives it has the potential to tackle inequalities in access, experiences and outcomes between ethnic groups.
Yet healthcare organisations often fail to meet the needs of their diverse populations. Progress is hampered by national policies that fail to provide clear guidance on standards of service provision or appropriate commissioning responses to meeting the needs of multi-ethnic populations.
Locally equality and diversity staff are often marginalised from commissioning and service improvement work, and commissioning staff are often uncertain about how to address ethnic inequalities. However there are opportunities to exploit synergies with other agendas, including quality, efficiency and wider health Inequalities and to build capacity and commitment to tackle these issues.
The Evidence and ethnicity in commissioning (EEiC) project has produced a range of resources that can support this development:
Growing understanding
Our research found that many commissioners and other managers feel confused and uncertain about engaging with issues related to ethnicity. People can be fearful of making a mistake or worry that considering ethnicity will add complexity to their work.
Meanwhile, individuals who would like to see progress on this agenda are not always confident to make a coherent argument and can struggle to convince decision-makers of the importance of addressing ethnic inequalities.
We are producing some resources to help you to clarify some basic concepts and feel more confident about why and how your work should give considered attention to ethnic diversity and inequality.
The briefing papers describe the findings of the Evidence and Ethnicity in Commissioning Research project.
Briefing papers
EEiC briefing paper no. 1 – High quality healthcare commissioning: Why race equality must be at its heart (PDF, 3.6MB)
EEiC briefing paper no. 3 – Race equality and health inequalities: towards more integrated policy and practice (PDF, 3.2MB)
EEiC briefing paper no. 4 – Knowledge Mobilisation tools can strengthen an Equality Impact Assessment (PDF, 475KB)
You may also find the following helpful: Thinking Clearly – What is ethnicity? (PDF, 306KB)
Next steps
Despite promising practice in some areas, our research identified many missed opportunities to address ethnic diversity and inequality within commissioning and service improvement work. It was also clear from our research that many people involved in commissioning and service improvement lack the skills and confidence to address ethnic diversity and inequality within their work.
We have developed a series of tools and resources designed to support attention to ethnicity within all elements of commissioning work. Mobilising knowledge effectively is at the heart of these tools.
A number of exercises have also been developed that aim to address key obstacles and missed opportunities that were observed during our research study. These exercises can be worked through individually or can be facilitated as group workshops. Most of these exercises have been developed as tools that you can use in real-world commissioning or service improvement scenarios.
We have organised the EEiC tools, exercises and related links into four sections:
Other resources and links
Sarah Bowen and colleagues in Canada have produced Promoting action on equity issues: Promoting action on equity issues: a knowledge to action handbook (PDF, 3.91 MB)
The Community Tool Box includes a resource focused on enhancing organisational cultural competence.
Various general tools to support service improvement are available here: