Funding awarded aims to drive up diverse participation in research
With support from Bristol Health Partners, Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB) has been awarded funding from NHS England to increase the numbers of people from under-served communities taking part in health and care research.
It is one of 17 ICBs to have received a share of £1.7 million from NHS England’s Integrated Care System Research Network Development Programme.
By increasing the diversity of people involved in research, responding to their needs and making changes to how research is done, BNSSG ICB and partners aims to help narrow the region’s health gap and make sure more people know about, and can access, services when they need them.
The new Healthier Together Research Engagement Network Increasing Diversity will be led by organisations from the region’s voluntary, community and social enterprise sector, and community groups. Work is now underway with partners to develop a network that will bridge gaps between researchers and under-served communities over the long term. It will focus first on addressing local race-related inequalities in health and care research.
People who live in the most deprived areas of Bristol, North Somerset and South Gloucestershire have 15 years less life that is lived in good health, than people who live in the least deprived areas. Deprivation disproportionately affects some Black, Asian and minority ethnic communities. Issues such as discrimination worsen this further, and these groups are more likely to report poor experiences of healthcare which often leads to worse outcomes.
For example, in the BNSSG region, pregnant women from Black, Asian and minority ethnic groups, as well as those in more deprived areas, are most likely to experience poor birth outcomes. Uptake of vaccines for flu and COVID-19 are lower in more deprived areas and in more ethnic and linguistically diverse communities, even after accounting for deprivation. A lack of trust in, and poor experience of, health services plays a big part in this.[i]
To ensure health and care provision is equitable, different people and communities require different approaches and levels of resource to meet their needs. Work is urgently needed to increase partnership working and to build trust with communities and groups that are most affected in order to better understand and address the barriers they face to improve access and uptake of services.
In BNSSG, there are many examples of projects where researchers are co-producing health and care research alongside local people, including:
- Dementia: South Asian people are more likely to be diagnosed with dementia at a later stage than white British people, when their symptoms are worse. They are therefore less likely to be given medication or receive recommended treatments. Researchers worked with South Asian communities in BNSSG to find out why, highlighting difficulties faced by patients and their families or carers, from awareness of the condition to its medical assessment, as well as support after a diagnosis. This resulted in a new online toolkit of culturally appropriate resources, created to help health care professionals support people with a South Asian heritage living with dementia. See: https://raceequalityfoundation.org.uk/adapt/
- Sexual health: A disproportionate number of people of African and Caribbean heritage living in Bristol are unaware they are HIV positive, and only diagnosed once their infection is advanced and they have become seriously ill. Community members are working with researchers, sexual health professionals and HIV charity Brigstowe to co-design and deliver targeted ways to reduce HIV stigma in their communities, increase HIV testing and address problems with accessing sexual health care. See: https://commonambitionbristol.org.uk
These projects are excellent examples of how working in partnership with diverse communities is improving health and care in those communities. This NHS England funding should enable faster progress across commissioning, primary care, social care and public health to make research practice and culture more inclusive and better able to meet the needs and aspirations of diverse communities.
Monira Chowdhury, Head of Equality, Diversity and Inclusion (EDI) at North Bristol NHS Trust and EDI Lead for BNSSG Integrated Care Board, says:
“Taking part in health and care research is a great opportunity for people to deliver direct benefits to the communities they are from. We have examples of impressive and important work done already, but for many communities in our region, research is not providing the opportunities, benefits and experience they need to make a lasting difference.”
The COVID-19 pandemic brought the issue of health inequalities – particularly racial inequalities – into sharp focus and this funding will help us work together better, to change research practice and culture, and ultimately to reduce these inequalities in the future.”
Professor David Wynick, Director of Bristol Health Partners Academic Health Science Centre, adds:
“Bristol Health Partners was delighted to bring partners together for this funding opportunity. We know that our research leaders are committed to improving equality, diversity and inclusion to make research deliver better outcomes for everyone in our region and working in close partnership is the best way to achieve this. We look forward to seeing this network develop over the coming months.”
[i] Our Future Health, Healthier Together BNSSG ICS, September 2022