What would genuine strategic commissioning for Black Asian Minority Ethnic (BAME) communities look like?
I had the opportunity to speak at the Suffolk and North East Essex Integrated Care System Conference on Wednesday evening. It was a privilege to get together with diverse local leaders, to listen to lived experiences and to share ideas that can take organisations and communities forward in providing equitable health services for BAME communities.
The Conference headline was ‘Thinking Differently Together’ about….. Turning the Curve on Racism and Inequality in Health and Care” - It really shaped the stories and ideas that came through that evening and gave everyone a lot to think about and to take forward.
I spoke on what genuine strategic commissioning for BAME communities could like and I genuinely believe that removing barriers through strategic commissioning is important personally as well as professionally: I recognise that I would be at higher risk of death if I gave birth to my children in the UK as a young BAME mother today.
“I would be at higher risk of death if I gave birth to my children in the UK as a young BAME mother today. ”
In England, we have a strong legal and policy framework and a commitment to race equality across all public sectors. Still, we have a gap between the policy commitments and the realisation at the grassroots of equitable health services and racial equality in everything we provide for citizens.
Commissioning is potentially a powerful tool to address this gap. Still, in reality, it rarely considers ethnic diversity in designing and developing inclusive strategies to meet the needs of the communities highlighted in Joint Strategic Needs Assessments and place-based needs assessments. Place-based working gives the opportunity for BAME people to be seen; why changes are needed in communities is articulated well, but that does not translate to the strategies for improvement put forward. For example, in Ipswich the BAME population is 17.1% compared to the whole of Suffolk at 9.2%; there are higher rates of people with learning disabilities and mental ill-health among some BAME communities, and yet mental health and learning disabilities strategies do not specify who these BAME communities are, their intersectionality, and how to address their individual needs.
“there are higher rates of people with learning disabilities and mental ill health among some BAME communities”
Systemic change is needed. Firstly, a commitment to genuine engagement with communities to bridge the gap between the legal and policy frameworks and equitable services at the grassroots, by co-producing inclusive strategies, with co-production properly funded and involving seldom heard communities. Secondly, senior representation is needed, influential at board level to achieve change for BAME communities, to learn from past work in the Integrated Care Systems and strive to reach our goals.
“co-producing inclusive strategies, with co-production properly funded and involving seldom heard communities”
Thirdly, mapping and engagement with the BAME voluntary sector, shifting from funding conversations to value conversations, and commission services transparently based on value and evidence. This will avoid the competition and between groups which fails to address the commissioning disparities for BAME organisations. There is need to work equitably with voluntary organisations and engage with people who use services so that they get to know the statutory organisations, begin to like and to trust, but this will take time.
Let me know what you think in the comments or connect with me on LinkedIn @Beaulah M Chizimba and join the conversation there.
Beaulah Chizimba is a leadership and career development coach speaker and trainer, passionate about transformational and inclusive leadership and writes about how health and care professionals can raise self-awareness, grow leadership skills and thrive at work.