Saving Lives, Improving Mothers’ Care Report

Saving lives, improving mothers’ care: lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017-19
National Perinatal Epidemiology Unit 11 November2021

• This report finds that pregnancy remains safe in the UK, with the overall maternal death rate showing a slight decrease. Among 2,173,810 women who gave birth in 2017-2019, 191 died during or up to six weeks after pregnancy, and 495 during or up to one year after their pregnancy. However, the findings show a continued inequality in the mortality rates for women of different ethnic backgrounds, ages and socio-economic circumstances.

Ethnic and Socio-economic Inequalities in NHS Maternity and Perinatal Care for Women and their Babies
National Perinatal Epidemiology Unit 11 November2021

• This report describes inequalities in maternity and perinatal care for women and their babies in England, Scotland and Wales during the period 1 April 2015 to 31 March 2018. Using routinely collected data, care and outcomes experienced by women and babies using NHS maternity services are measured and stratified by ethnicity and by Index of Multiple Deprivation (IMD), a proxy for socio-economic deprivation. 
• The results demonstrate differences in outcomes of maternity and perinatal care among women and birthing people, and their babies, via comparisons between those living in the most deprived and the least deprived areas in Great Britain, and in those from ethnic minority groups versus white ethnic groups.

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study
The Lancet 1 November 2021 DOI:https://doi.org/10.1016/S0140-6736(21)01595-6

• Analysis of data compiled by the National Maternity and Perinatal Audit (women with a singleton birth between 1 April 2015 and 31 March 2017) indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with fetal growth restriction in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile.

Ethnic health inequalities and the NHS

Ethnic health inequalities and the NHS
NHS Race & Health Observatory, Kings Fund June 2021

• This report represents one of many steps needed to help understand the factors that shape race inequality in health, including the forces of structural racism and discrimination, and to begin to respond to them with impactful changes.

Less noise and more light: using criteria-driven analysis to tackle inequalities

Less noise and more light: using criteria-driven analysis to tackle inequalities
The Strategy Unit June 2021 

• Analysis produced for the Black Country and West Birmingham addressing the steps needed to address health inequalities.
• It covers 21 clinical areas and looks at inequalities across ethnic and socioeconomic groups. But it does so using a single outcome measure: emergency hospital admission rates. This outcome is distressing for individuals; expensive for systems; and indicative of broader problems. It simplifies inherent complexity.
• We show both the scale (numbers affected) and the degree (the relative unevenness of admission rates across subgroups) of the problem. Applying these criteria cuts through the noise often generated by the proliferation of ever-fuller data sets. It shows Black Country and West Birmingham where the gains are.
• We find that people from specific ethnic minority groups are far more likely to be discharged from hospital without a firm diagnosis coded in their record. There are many possible explanations, but we have ruled out data quality. This requires attention: ICSs cannot address what they cannot see.

The report of the Commission on Race and Ethnic Disparities

The report of the Commission on Race and Ethnic Disparities
Commission on Race and Ethnic Disparities 31 March 2021

• The Commission's report into racial and ethnic disparities in the UK.

Ethnic diversity in fertility treatment 2018

Ethnic diversity in fertility treatment 2018
Human Fertilisation and Embryology Authority (HFEA) March 2021

• 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.

The health of people from ethnic minority groups in England

The health of people from ethnic minority groups in England
Kings Fund 17 February 2021

• This explainer examines the differences in health outcomes for ethnic minority groups, highlighting the variation across groups and conditions, and considers what’s needed to reduce health inequalities.

Ethnicity, Race and Inequality in the UK

Ethnicity, Race and Inequality in the UK
Policy Press 2020

• A free to download commentary by some of the UK’s foremost scholars of race and ethnicity on data relating to a wide range of sectors of society, including employment, health, education, criminal justice, housing and representation in the arts and media.
• Chapter 4 Health inequalities by Karen Chouhan and JamesNazroo

Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis.

Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis. Public Health Res 2020;8(10)

• Researchers identified eight different types of intervention that can potentially reduce loneliness among ethnic minority and migrant groups. Three were common: befriending (a one-to-one supportive relationship), shared-identity social support groups (similar people coming together to support each other and engage in meaningful activities) and intercultural encounters (people interacting across ethnic or cultural difference). Evidence on whether or not these initiatives work in practice was limited. 

Plain English summary

Caring alone: Why BAME young carers continue to struggle to access support

Caring alone: Why Black, Asian and Minority Ethnic young carers continue to struggle to access support
Barnardo's 25 April 2019

• Research has found that BAME young carers are more likely than other young carers to be isolated from support services.

Digital patients: myth and reality

Digital patients: myth and reality
Nuffield Trust 10 September 2018

• A look at five common claims about the use of digital services in the NHS concludes that those likely to continue to have low digital access are people over 75, carers, those over 55 in lower social grades, and people with dementia, stroke and learning disabilities. 
• The five issues are:  
• Older people don’t use technology
• Digital services are less accessible to people with complex health needs
• Socially excluded people are also digitally excluded
• Ethnic groups are digitally excluded
• Internet access is worse in rural areas

Health inequalities: reducing ethnic inequalities

Health inequalities: reducing ethnic inequalities
PHE 6 August 2018

• Guidance to support local and national action on ethnic inequalities in health.
• This report provides:
• a summary of information and data by ethnic group in England
• examples of practical approaches to address ethnic inequalities in health
• case studies of local action to address ethnic health inequalities

Quality Standard: Promoting health and preventing premature mortality in black, Asian and other minority ethnic groups

Promoting health and preventing premature mortality in black, Asian and other minority ethnic groups, Quality standard [QS167]
NICE May 2018

• This quality standard covers promoting health and preventing premature mortality among black, Asian and other minority ethnic groups. It is relevant to all age groups and all settings.
• Statement 1 People from black, Asian and other minority ethnic groups have their views represented in setting priorities and designing local health and wellbeing programmes.
• Statement 2 People from black, Asian and other minority ethnic groups are represented in peer and lay roles within local health and wellbeing programmes.
• Statement 3 People from black, Asian and other minority ethnic groups at high risk of type 2 diabetes are referred to an intensive lifestyle change programme.
• Statement 4 People from black, Asian and other minority ethnic groups referred to a cardiac rehabilitation programme are given a choice of times and settings for the sessions and are followed up if they do not attend.
• Statement 5 People from black, Asian and other minority ethnic groups can access mental health services in a variety of community-based settings.
• Statement 6 People from black, Asian and other minority ethnic groups with a serious mental illness have a physical health assessment at least annually.

NHS workforce race equality: a case for diverse boards

NHS workforce race equality: a case for diverse boards
NHS England 12 March 2018

• This report highlights the importance of inclusive boards in the NHS (including CCGs) and provides guidance on working towards creating inclusive cultures.

Ethnicity facts and figures and Race Disparity Audit

Ethnicity facts and figures
HM Government Launched 10 October 2017

• Information gathered from a range of government sources about the different experiences of people from a variety of ethnic backgrounds under topics - Crime, Justice and the law; Culture & Community, Health; Housing, Education skills and training; Work, pay and benefits.
• The Health topic includes Access to treatment, Patient experiences, Patient outcomes, Physical and mental health and Preventing illness.

Race Disparity Audit

Cabinet Office October 2017

• In addition the first release of a Race Disparity Audit which reviews each topic on the Ethnicity Facts and Figures website, as well as an overview of disparities that have most impact across all aspects of people’s lives. The intention is that other audits will follow in due course.

Barriers and enablers to commissioning that addresses ethnic healthcare inequalities

Obstacles to "race equality" in the English National Health Service: Insights from the healthcare commissioning arena.
Soc Sci Med. 2016 Mar;152:102-10.

• An exploration of English PCT commissioning in 2010-12, to identify barriers and enablers to commissioning that addresses ethnic healthcare inequities found limited and patchy attention to ethnic diversity and inequity.
• Locally, consideration of ethnicity was often treated as a matter of legal compliance rather than integral to understanding and meeting healthcare needs. Many managers and teams did not consider tackling ethnic healthcare inequities to be part-and-parcel of their job, lacked confidence and skills to do so, and questioned the legitimacy of such work. 

Abstract