Black and Minority Ethnic Service Monthly Report July 2013
Use of Accident and Emergency
Services
o
No of people engaged, with
specific information on:
Raw Data attached as a separate document > Pathways CIC _A&E Analysis July v.1
53participants were engaged in their usage of Accident and Emergency services within Cheshire East.
Ethnicity data for participants
Asian / Asian British - Bangladeshi
- Location of
engagement /
postcodes
Asian / Asian British - Pakistani
Asian / Asian British - Filipino
Asian / Asian British - Chinese
Asian / Aisan British - Thai
-
Age
Asian / Asian British - Indian
Black / Black British - Carribean
-
Gender
Black / Black British - Zimbabwean
Black / Black British - African
-
Black / British - South African
Ethnicity
Black / Black British - Gambian
o
o
Mixed / White & Black - Carribean
Key themes / issues raised
from the engagement
Recommended actions
/solutions to respond to
the key themes / issues
raised
White Other - Polish
White Other - Slovakian
White Other - Irish
White Other - Hungarian
White Other - Romanian
White Other - Lithuanian
Other - East Timor
1
Postcode data for participants
20-35
36-50
51-65
66-85
86 and over
total
Full breakdown per CCG:
South Cheshire 68%
Vale Royal: 8%
Eastern Cheshire: 24%
Of the 53 participants, 2 chose not to share their postcode details and referred only to the area in which they lived.
2
Age of participants:
Under 20
20-35
36-50
51-65
66-85
86 and over
From the data collection there appears no common themes between age, ethnicity, gender in relation to
either the reason for attendance (condition, illness, injury) or number of times attended.
Attendance at A&E
Child – 19
Infection – 1
Eye Injury - 3
Flu – 3
Fracture - 4
Shock - 1
Leg Injury - 1
Bells Palsy- 1
Nausea - 2
Neck Injury - 2
Heart - 3
Burns - 1
Stroke - 2
Unwell – 7
Seizure - 2
Head Injury – 2
High Temp – 1
Stomach Pain - 6
Back Pain - 3
Nose Bleed - 2
*data indicates conditions /injuries for attendance at A&E (identifies for some more than one attendance)
3
Child related attendances
Cut finger – 1
Flu – 3
Fracture - 2
P. C - 3
Sickness - 6
High Temp - 3
Seizure - 1
(P.C – Complications during pregnancy)
Almost all of the participants identified that where conditions related to their children, their immediate response
is to take seek emergency treatment from A&E. Some provided feedback such as waiting times / availability of
appointments at GP’s Surgeries and not being registered with a GP as the reasons behind their choice.
When participants were encouraged to share positive experiences responses included suitable treatment of
conditions, made patients feel comfortable, friendly staff, helpful, supportive, consultations were very clear,
made patients feel better,
When participants were asked about negative experiences responses included Waiting times, communication
(no translator available), not registered with GP therefore treated poorly, discriminatory comments / actions
from NHS staff regarding patients ethnicity, receptionists unsupportive,
Communication and provisions of interpreting appear to be a significant factor in participants commenting on
negative experiences. Due to communication / language issues, some of the participants felt that they were treated
inappropriately and that others without communication barriers were treated much sooner. As a consequence,
some felt this direct discrimination.
Attendance figures at A&E during the past 12 months
Once
33
2-5 times
15
4
5-9 times
3
10 and above
1
Not stated
1
Choose Well Campaign
o
No of people engaged, with The BME Service has this month facilitated 16 Sessions engaging a total of 43 individuals from multiple BME
communities across Cheshire East, in addition to sharing information with those participants of the A&E
specific information on:
- Location of
engagement /
postcodes
o
o
o
-
Age
-
Gender
-
Ethnicity
Key themes / issues raised
from the engagement
Identified barriers faced to
uptake of the Choose Well
message
Recommended actions
/solutions to respond to
the key themes / issues
raised / barriers faced
questionnaire. Sessions have taken place at Childrens Centres across Eastern Cheshire and Vale Royal, Multi faith
groups, churches in Crewe, Macclesfield and Sandbach
Regular monthly activity has resumed as we continue to deliver sessions weekly at Eaglebridge Health Centre (SC)
and Watersgreen Health Centre (EC) that are now directed towards Choose Well and accessing the right services.
We have recently made a further order of Choose Well materials in Bengali and Polish as all materials have been
consumed at South Cheshire based centres.
Social Inclusions Coordinators attend regular meetings with Shapla and Ocean in South Cheshire, the Gypsy and
Traveller Community at sites in Winsford and Northwich, the Polish and Slovak church groups in Macclesfield,
Northwich and Crewe.
Choose Well information boards have been updated at regular drop in centres within South Cheshire to support
BME communities in understanding / accessing the right services for conditions. We are in discussions with
surgeries / local community groups across Cheshire East to deliver ChooseWell workshops and erect display
boards with Choosewell information for patients / users. To date we have visual display boards with translated
materials at Eaglebridge Health and Wellbeing Centre, Victoria Children’s Centre (Vale Royal), Drop in Centre
(Watersgreen), Shapla, Polish Church (Northwich), Gypsy and Traveller site (Winsford).
We are in the process of agreeing support for AGE UK in the engagement of BME communities within East
Cheshire. We have identified local settlement trends within Macclesfield and Congleton of ethnicity groups and
currently looking at methodologies, such as focus groups, breakfast mornings, workshops at AGE UK premises to
engage elder generations of BME communities.
The BME Service has met with Childrens centres within Eastern Cheshire to identify opportunities to deliver
Choose Well workshops within Centres. A future invitiation for a meeting with Childrens Centre Area Manager is
currently pending.
5
Further work is underway with Age UK in East Cheshire to support elderly people from BME communities to
support information and guidance of services, self care and wellbeing.
Feedback from drop in sessions per locality
Eastern Cheshire
 Little if any information on how to access / register with GP’s
 GP’s referring patients through to A&E, however A&E staff not supportive / in agreement of referral
 Accessing A&E is only option as cant register with GP
 Poor relationships with GP’s and therefore opt to use A&E for medical advice
 No language appropriate support available on local CCG website – Information has been shared with those
that were engaged
 Access to services becomes limited when required during working hours
 A&E offers a 24 hour service
 Appointments are not accessible with GP, have to wait for appointments
 GP referred patient
 Language barriers – Children are acting as interpreters
 Did not know that pharmacists could provide support other than to give medicine
South Cheshire
 No knowledge of Choose Well and other services
 Understanding the role of pharmacists
 Cultural response / behaviours – have always used A&E
 Knowledge of services and how they can support patients. No understanding of Choose Well
 Suitability of communication / language appropriate materials
 Poor experiences with receptionists therefore reluctant to use GP
 Mistreatment by GP
 GP not supportive of conditions, advised patient to go home and rest, however patient required medical
support which they got from A&E
 Discriminatory comments made by staff, reflected negatively on services
 Services in the day non accessible due to working commitments
6



No guidance for immigrants in how to access services other than guidance to register with GP
Choice of services is informed by partner
Little interest in maintenance of health, will access A&E when required
Vale Royal –
 Understanding of local services and how / who they support. Communication within the community as to
changes in national services had led to confusion
 Negative experiences of GP treatment has impacted on future use
 Poor communication
 Lack of interpreters
 Fear of using services following a negative experience with another patient whilst in the waiting room of
surgery
 UK service are perceived as poor and therefore will travel to use private clinics in other areas (Manchester
and Chester)
 Discriminatory comments by NHS staff
Other objectives – Maternity /
Smoking / Screening / Elderly
People
o
No of people engaged, with
specific information on:
- Location of
engagement /
postcodes
Tulip Sessions are continuing on a weekly basis at Eaglebridge Health Centre and have scheduled in regular
sessions at Victoria Children’s Centre in Northwich. Tulip has enabled mothers with young children an opportunity
to access health and wellbeing support for themselves and their children through support of a health advisor and
linking in with Health Visitor teams. We have been working with Health visiting teams in Vale Royal in developing
relationships and attaching Tulip to their attendance at the Victoria Children’s Centre.
There have been 5 Tulip sessions facilitated during July with 9 attendees from BME communities, 15% of
attendees were from white – European ethnicities, further engagement work is currently being undertaken with
other BME communities to identify barriers and encourage attendance. We are using the data we collect from
7
o
-
Age
-
Gender
-
Ethnicity
Key themes / issues raised
from the engagement
Recommended actions /solutions to
respond to the key themes / issues
raised
usage of A&E to support parents with young children to consider alternative services / understand self care and
treatment of conditions for infants through Choose Well.
Health Visitors have been involved in a study with the BME Service in regards to the difficulties they encounter
when supporting BME communities or those where English is not a first language. It became apparent during
discussions that there are significant barriers where Health Professionals are unable to communicate fully with
patients. Where father may act as an interpreter, certain issues are excluded from conversations and the impact is
diluted as father acts as a partner and therefore has a personal response to what is being communicated. Where
discussing PND, fathers have interjected and suggested that it will not be an issue, however mothers are unaware
of support and coping mechanisms. Awareness of different cultures has also provided barriers. Some ethnic
communities tend to adhere to cultural practices when having children, this was suggested as a barrier as Health
Visitors are not educated or aware of such practices, creating a negative relationship between professional and
patient and have led to conflicts in treatment. Such barriers identified that although with best intentions, Health
Visitors may not be able to support to their full potential
Discussions have been held with AGE UK and Health watch Cheshire East as to how we can support in engagement
of BME communities. AGE UK are keen to further engage older people. As discussed previously we are in
discussions about the suitability of sessions. We are engaging the local populations on their views and areas of
support.
Asset Mapping
o Table of identified
community assets with
specific information on:
-
Data is continually being obtained and database updated regularly from engagement with BME communities. We
currently have information of over 40 agencies either supported or facilitated by BME groups / community groups
to support local populations within Cheshire East and Vale Royal
Name
8
-
Description
-
Location
-
Target audience
-
Contact details
- Frequency of
meetings (if applicable)
- Services offered (if
applicable
Patient Experiences
o No of patient stories
produced on film with
specific information on:
o
-
Location
-
Age
-
Gender
-
Ethnicity
Videos continue to be collected with clients / communities on what services are accessed and what were the
participant responses.
We are currently collecting patient experiences on why they access the services they do, what services are they
accessing and their responses to service delivery with a specific focus on Accident and Emergency, knowledge of
services, primary, secondary and acute and collaborating with Choose Well.
4 case studies have been attached to this report.
Type of service
commenting in (acute
9
o
hospital, primary care,
community provision,
mental health etc)
Positive or negative
experiences
10