Embedding equality

22 November 2021

Dr Habib Naqvi on the NHS Race and Health Observatory’s unique position to scrutinise the NHS and overturn deep-seated racial inequalities.

The February 2020 special edition of the BMJ, on racism in medicine, set out a robust argument for the establishment of an observatory that brings together insights on ethnic health inequalities and turns that into actionable recommendations for healthcare change.

Subsequently, NHS England and NHS Improvement fully supported and endorsed the set-up of the NHS Race and Health Observatory, and the NHS Confederation was selected as the host organisation. In October last year, I was honoured to take up the post of the Observatory’s first director.

The Observatory’s primary aim is to help tackle long-standing health inequalities affecting Black, Asian and minority ethnic patients and communities. We do this through a three-stage model of working:

  1. Bringing together insight and evidence based on research
  2. Turning that evidence base into actionable policy recommendations for change
  3. Supporting and evaluating the practical implementation of those recommendations across the health and care system.

The Observatory is in a unique position to take stock of the evidence around ethnic inequality in health and care, to identify the gaps and build a robust evidence base on which to understand the determinants of those inequalities. Crucially, we must also look forward. All the research in the world is worth nothing if people aren’t willing to act on it. We will work with a broad network of passionate experts and leaders to ensure that these insights turn into practical recommendations so that the health and care system works better for those underserved communities.

A more equitable age

There are opportunities before us. The health system in England is undergoing another restructure, putting the emphasis on integrated care across systems, places and populations, and including the reduction of health inequalities as a measure of success. We have the opportunity to embed equality at the very heart of these new ways of working.

With technological advances such as genomics and precision medicine promising to change the future of healthcare, we have the opportunity to make this new age of medicine more equitable than the last. And with the public and system leaders more comfortable than ever in talking about racism and systemic inequality, we have a chance to lead and participate in difficult, progressive conversations, without which nothing can change.

What makes the Observatory unique is its independence – it is guided by no other agenda than its own. We are funded by the NHS, and are committed to supporting it in improving, but our priorities and our work programme have been designed in collaboration with stakeholders with the appropriate expertise and lived experience. We sit alongside the NHS, adjacent but separate, and can therefore scrutinise the health and care system from a distance but remain well positioned to advise on areas for improvement.

The Observatory has a broad action-focused work programme that enables it to focus on deep-seated ethnic health inequalities; be reactive and responsive to emerging issues and challenges; keep this agenda at the forefront of leaders’ thinking and actions; and ensure stakeholder engagement and global evidence base is at the heart of what it does.

Earlier this year, we produced guidance on increasing trust and confidence in the Covid-19 vaccine. We also explored the racial bias in pulse oximetry, and produced joint reports with a number of stakeholder organisations, including The King’s Fund on ethnic health inequalities as part of a leadership agenda, and the Nuffield Trust on ethnicity data recording.

As we begin to commission out work to produce evidence-based recommendations on ethnic health inequalities in maternal health, mental illness, digital health, long Covid, genomics and precision medicine (to name just a few areas of focus), I think of the immense opportunity to make a real difference. Any difference made will not be sustained nor meaningful unless it has engagement and collaboration at its heart.

As announced earlier this year, we are looking forward to working in partnership with the US Centers for Disease Control and Prevention’s (CDC’s) Office of Minority Health and Health Equity. This unique and ground-breaking partnership will allow both organisations to share best practice on common solutions to common challenges, as well as forge new ties that help to address health inequalities for diverse communities.

Get involved

The NHS Race and Health Observatory is in the business of tackling ethnic health inequalities. To do that we know we cannot ignore the experiences of the health and care workforce – and community practitioners (CPs) are at its heart. We must tackle both inequalities in the workforce and the disparities in our communities; we are, after all, all too familiar with the clear, evidence-based link between staff satisfaction and better outcomes for patients and communities.

CPs can share their learning outcomes from the pandemic – the barriers and acceptances, and what is required to help support families during lockdowns. They can join the Observatory events and webinars, and can find out more through our animation video, subscribing to our mailing list, sharing case studies, and penning blogs that we can help amplify. They can also keep up-to-date with our work on Twitter @NHS_RHO

Lord Victor Adebowale, chair of the NHS Confederation, described the Observatory as a ‘watershed moment’ for the NHS. As we end the year reflecting on the pandemic and the inequalities that have long affected people from ethnic minority backgrounds and communities, our work will ensure that the establishment of the Race and Health Observatory is the beginning of real progress.

Dr Habib Naqvi is Director of the NHS Race and Health Observatory, which leads work nationally on identifying and tackling ethnic health inequalities. Follow him on Twitter @DrHNaqvi


Time To Reflect

How can you support the Observatory’s work to help the families you care for and to further your understanding of the needs of all the diverse communities you serve? Join the conversation on Twitter @CommPrac and use #RHOsupport


NHS Race and Health Observatory. (2021). Ethnic health inequalities in the UK. See: https://www.nhsrho.org/publications/ethnic-health-inequalities-in-the-uk (accessed 27 October 2021). 

Image credit | Shutterstock

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