'You Said, We Did' - NHS responds to ethnic minority women's feedback on health services
We met up again with North Central London Integrated Care Board staff (the local NHS) on 7 November 2022 to find out what they have done to improve ethnic minority women's experiences of these two crucial services in Haringey.
Below we set out the feedback we received and reported in May 2022, the recommendations we made, and the responses we received at the 'You Said, We Did' meeting in November.
Full details of the feedback from Roj Women and Middle Eastern Women and Society organisation (MEWSo) and our recommendations.
GP services
Feedback from Roj Women's Association and MEWSo
Women expressed a lot of dissatisfaction around GP services to start with, and the level of unhappiness increased dramatically once the COVID-19 pandemic began. Women felt they were being discriminated against if they could not speak English well and interpreter provision was inadequate. Doctors didn't have much time to talk to them and there were not enough face to face appointments available. Sometimes it was difficult to get through to the practice on the phone and digital exclusion was a real issue, especially amongst older women.
Healthwatch Haringey's key recommendations
- Unconscious bias (anti-racism) training for receptionists, practice staff and GPs
- Polite friendly helpful receptionists who have completed customer service training,
- Reinstate face to face appointments.
- Provide good quality interpreting services for all who need them.
- Be mindful of digital exclusion and provide alternatives for those who have no access to the internet or do not know how to use it.
North Central London ICB's response in 'You Said, We Did' meeting
- NCL CCG has been in touch with practices with long telephone waiting times to ensure they are taking action to address this, and most practices have introduced a phone queuing system
- All practices offer routine appointments, not only same day appointments, and patients can also book in for for out of hours appointments.
- Training for reception staff on having difficult conversations is provided and if the patient is not satisfied they can complain to NHS England.
- For patients unable to book online, all Haringey practices should make appointments available to book by telephone or by visiting the practice.
- All Haringey practices offer face to face appointments where clinically necessary or if specifically requested by the patient.
- Over 50% of Haringey practices have signed up to the Safe Surgeries scheme. NCL ICB will continue to encourage the remaining practices to register for the scheme.
- All practices should have access to social prescribers who can advise and refer patients to other local services or activities. Patients can get further information about social prescribers from their practice.
- NCL ICB is planning and delivering more place based support for some therapies and services to improve access to care, particularly in areas of high deprivation.
Mental health services
Feedback from Roj Women's Association and MEWSo
Women had done many things for themselves and as a group, to help manage their own mental health and wellbeing and to help get them through this difficult time. They said GPs had very little time to listen and would often just prescribe anti-depressants. Women wanted better access to counselling and talking therapies. Women felt there was a clear benefit from activities like group physical exercise and community socialising. There was some awareness of the mental health support available in the voluntary sector, such as Mind, but most women did not mention any alternative to the GP as a first port of call.
Healthwatch Haringey's key recommendations
- GPs should explore a range of treatment options with patients, not just anti-depressant medication.
- Free physical activity sessions or vouchers should be funded to make them accessible to all.
- Free Community Centre activities should be provided.
- Mental health support services, and how to access them, should be promoted and publicised, through grassroots and community networks.
- GPs should refer women with mental health issues to social prescribers.
North Central London ICB's response in 'You Said, We Did' meeting
- Mental health teams have been rolled out in GP practices. In September, the service saw 69.1% of patients there referred within 28 days, 48% of whom were from Black, Asian and other minority ethnic communities.
- There is recruitment to expand the workforce in primary care based and core teams.
- There are more group based sessions.
- The Haringey Let’s Talk Adult Improving Access to Psychological Therapies programme (IAPT) is exploring how to provide additional same language therapies.
- NCL ICB continues to monitor waiting times for those needing interpreters.
- There is a range of more culturally informed talking / psychological therapies for BAME communities.
- NCL ICB enables the use of trained interpreters and Language Line.
- NCL ICB raised over £800,000 funding in the last two years to invest in improvements.
- Most of the funds have gone to voluntary sector and grassroots organisations
- Mind in Haringey has been commissioned to develop and deliver a continuous programme of Mental Health First Aid training to Voluntary and Community Sector (VCS) staff who support BAME communities.
- Barnet Enfield and Haringey Mental Health Trust has developed an eight week activity programme including physical activities for people with dementia and their carers.
- Funding has been given to VCS organisations to run physical and wellbeing activities, for example walking groups.
- Mind in Haringey has been funded to provide bereavement counselling targeted at the groups disproportionately impacted by the COVID-19 pandemic.
- There has been investment in VCS and grassroots organisations to recruit community navigators and people with lived experience from BAME communities.
Downloads
NCL ICB Presentation: Engagement with ethnic minority women - primary care and mental health
NCL ICB Update: Mental health services
