Driving Race Equity In Health and Care: Strategy 2021 – 2024
The NHS Race & Health Observatory was established by the NHS in 2021 to examine ethnic inequalities in health across the country, and to support national bodies in implementing meaningful change for ethnic minority communities, patients, and members of the health and care workforce.
We work as a proactive investigator, commissioning new research and synthesising existing evidence to ensure that our health and care system works for everyone, regardless of their race. We make practical recommendations for national policy leaders and, crucially, we support the real-world implementation of those recommendations.
We are an independent body, sitting far enough outside the health and care system to serve as a critical ally, but close enough to ensure that our work is firmly rooted in the day-to-day realities of patients and staff members.
Our ultimate aim is to help close the gap on ethnic inequalities in health and care. We’ll do this by gathering the best possible evidence, listening to the voices of those who interact with the health and care system, and building an enduring network of passionate and influential people who share our commitment to equality.
In our first three years, we will work across five core workstreams. These areas were identified through extensive stakeholder engagement. To achieve our goal, we will need to be selective about where we focus our attention. The following areas represent our initial focus, but by no means cover the full range of areas that require attention. We have ensured that our strategy allows us to remain flexible and responsive, and we are committed to speaking to experts and listening to our stakeholders throughout this time.
- Improving health and care: Under this workstream, we will focus on areas in health and care that have long shown ethnic inequalities in access, experience, or outcomes – working to reshape policy and practice so that they support fair health and care for all. The priorities for our first three years of funding will be maternity and neonatal health; and mental health and wellbeing. Both areas have been highlighted by our stakeholders as needing concerted attention to deliver equity.
- Empowering vulnerable communities: The most vulnerable in society are often those who experience the cumulative impact of health inequalities. Our work to identify and tackle ethnic health inequalities recognises the complexity of the social determinants of health as well as the resulting effect that can have on individual personal choices. Under this workstream, we will aim to remain responsive to emerging ethnic health inequalities and seek to raise the profile of issues that are not commonly advocated for or well-funded. This means talking frankly about the persisting role of systemic and institutional racism in our health system.
- Innovating for all: Technological developments and a proliferation of data in health and care offer incredible opportunities for the future. Harnessing this technology could transform medicine forever, but we must recognise that the size and complexity of the health and care system means the adoption of new technologies is slow and often patchy. If properly adopted, these new technologies can help us eradicate ethnic inequalities in health and care. Alternatively, inattention to these new developments could further ingrain those inequalities. Under this workstream, we will look at the development and deployment of digital tools – such as video consultations, health monitoring apps, and workforce management systems – and help gather evidence on how they can be used equitably.
- Creating Equitable Environments: Despite many efforts to deliver equity, racial inequalities are still ingrained in the institutions that constitute the health and care system, and in the systems that determine how people interact with it. The health and care landscape is a complex network of providers, commissioners, regulators, and various other umbrella bodies, some funded privately, some publicly, and all serving subtly different groups of stakeholders. As seen during the pandemic, this system can be agile and reactive, adapting quickly to respond to a crisis when needed. But this model can also lead to inefficiencies and duplication, and dispersed accountability can make it unclear who, exactly, is responsible for embedding racial equity in health and care. Only by scrutinising how these systems function and interact with one another can we hope to identify and eradicate the causes of racial inequality.
- Collaborating globally: The health and care landscape is not a collection of faceless institutions, but rather a network of millions of people – workers, patients, members of the public – interacting in countless ways every day. It would be futile to attempt to achieve our mission in isolation, only speaking with a limited pool of experts in closed rooms. We are therefore committed to engaging as broadly and deeply as we can across all the above workstreams. We also acknowledge that ethnic health inequalities are persistent globally, and there are significant opportunities for collaboration across borders. We want to be transparent with the work we do, sharing our evidence freely and, through effective collaboration, make the most of international expertise to improve equality in health and care in our own system.