Understanding the impact of COVID-19 on ethnic inequalities in health and social care – Have your say!

Introducing a King’s College London study examining inequalities experienced by people from racial and ethnic minority groups working in health and social care during COVID-19. (570 words)

Prof Stephani Hatch

Leading the study: Stephani Hatch, Professor of Sociology and Epidemiology in the Department of Psychological Medicine, King’s College London

We have launched a study to help improve working conditions and to tackle the inequalities experienced by people from racial and ethnic minority groups working in health and social care during the COVID-19 pandemic. Based at King’s College London, we are working in partnership with NHS England Workforce Race Equality Standard, NHS Confederation and the Royal College of Nursing. The study findings will be used to develop education and training materials (e.g. Virtual Reality training) available nationally to all staff, specifically to better support and improve the workplace experiences of NHS and social care staff from Black, Asian and minority ethnic groups.

COVID-19 pandemic

The pandemic has shone a light on existing inequalities that have a great impact on Black, Asian and minority ethnic communities. These communities are approximately 14% of the population in England and Wales, yet they have had greater exposure to the virus and are more likely to have poorer outcomes, including severe health complications and death. We have also seen that higher numbers of racial and ethnic minority health and social care workers have died from COVID-19. Despite making up 21% of the NHS workforce, 63% of those who died from COVID-19 were from racial and ethnic minority groups. What is less often known and discussed is that health and social care staff from racial and ethnic minority groups experience greater levels of workplace harassment and discrimination compared to other staff and these experiences have been compounded by the pandemic. This can have long-lasting effects on their health, wellbeing, and their ability to do their job. Continue reading

Black History Month in Social Work and Social Care

Jo Moriarty (Senior Research Fellow) and Prof Jill Manthorpe (Director) of the NIHR Health & Social Care Workforce Research Unit, King’s College London. (1246 words)

In the aftermath of the pulling down of the statue of the merchant and slave trader, Edward Colston, in the June of this year, discussions took place about how best to replace it. We were intrigued to read one suggestion that it should be replaced by a statue of Paul Stephenson. Who was he and what was the boycott we wondered?

Paul Stephenson leading the Bristol bus boycott in 1963 (Photo: ITV)

We soon found out that he was the first black social worker in Bristol (BBC Newsround 2018). The Bristol Bus Company refused to employ black people on bus crews and, inspired by the refusal of Rosa Parks to give up her seat on a bus and the ensuing Montgomery Bus Boycott, Stephenson was one of a group of people who led a bus boycott in Bristol in 1963.

The cause was taken up by the wider black community and white sympathisers in Bristol. Within a few months, the company succumbed to pressure and ended its ban. The following year Stephenson refused to leave a pub until he was served. He is now widely recognised as having played an important part in the passage of the 1965 Race Relations Act and was awarded an OBE in 2009. Continue reading

Black History Month – a spotlight on Social Care in South London

Prof Jill Manthorpe and Dr Katharine Orellana both work on the NIHR ARC South London Social Care Theme from within the NIHR Policy Research Unit in Health and Social Care Research, King’s College London. (1226 words)

Many stories are being told relating Black history in and about South London. Some of them are coming from people who staffed or volunteered in local social care services. These are largely unsung stories of efforts to meet the needs of London’s new migrant populations. In this blog we highlight some of the developments that were taking place in South London over 30 years ago in older people’s day services and others outside the statutory sector (although many were supported by local council grants). South London was for many years the location for Age Concern nationally (in Mitcham) and the pan-London body, Age Concern/Age UK London (in Camberwell then Elephant and Castle) as well as Black groups that had interests in social care such as the Afiya Trust (in Vauxhall). Where possible we provide links to the items we found.

South London is still the home of one of the leading national, even international, organisations that has proven the value of oral history and reminiscence among older people of different faiths, cultures and heritages. Founded in 1983 by Pam Schweitzer MBE, Age Exchange is based in Blackheath. Her ‘Mapping Memories’ collection remains a key resource for families, volunteers and care staff working with older people from different ethnic backgrounds. Continue reading

Evaluating the Nursing Associate Role: Initial Findings

Interim Report

Ian Kessler is  Professor of International HRM at King’s Business School and Deputy Director of the Policy Research Unit in Health and Social Care Workforce (HSCWRU). Prof Kessler is lead author of the Interim Report and two case studies from the HSCWRU Nursing Associates study, published today. (1,624 words)

The introduction of the Nursing Associate (NA) role in England represents a decisive step towards changing the structure of the nursing workforce, with a view to improving the quality of health and social care. Originally proposed by the 2015 Willis report on nurse and care assistant education[1], as ‘a bridging role’ between the care assistant and the registered nurse, the NA has emerged in NHS England as a pay band 4 role, requiring a two-year level 5 qualification, registered with and regulated by the Nursing and Midwifery Council (NMC). The NA programme was launched in early 2017 in two waves 11 pilot and 14 ‘fast follower’ sites, respectively taking-on 1,000 Trainee Nursing Associates (TNA). There were subsequent waves, with 5,000 TNAs recruited in 2018 and 7,500 in 2019. It is a role which attracts interest given its capacity to address a variety of workforce and care management goals. However, as with the introduction of any new role, there are organisational challenges to be faced in ensuring that it becomes established at the workplace level and accepted by the various actors with a stake in it, including nurses, managers, healthcare assistants and service users. Continue reading

Grow your own – an idea whose time has come (again)

Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School. (869 words)

Back in 2010 I produced a paper for the Department of Health with the snappy title of Widening Participation Into Pre-registration Nursing Degree Programmes. Nursing was becoming an all degree profession and there was a concern at the time that this might narrow the pool of future recruits as vocational routes were closed. The document mapped pathways up to and into pre-registration degrees for existing support staff, including via the then current version of apprenticeships. It also set out the wider benefits of a “Grow Your Own” (GYO) approach to workforce development and recruitment. These included, not only securing future labour supply, but also helping ensure that the NHS workforce better reflected its local population, supporting diversity and reducing turnover.

Fast forward a decade and I’m having a conversation with an NHS Trust who had hoped to recruit from their existing support staff on to a degree apprenticeship. There is no shortage of candidates, but it appears the step up from support role to a pre-registration degree is too large for staff and the Trust is unable to recruit. The 2010 paper, which I repeated for Camilla Cavendish’s review three years later, made the point that GYO needs to be “end-to-end”, starting even before employment begins and delivering investment in the formal education of support staff at every level, creating clear pathways to mobilise what we called back then, the NHS “skills escalator”. GYO seeks to create progression steps creating horizontal and verticals career routes, avoiding the “gap” problem experienced by the Trust I was talking to. Continue reading

Health inequalities among older BAME groups in later life

Dr Nayyara TabassumDr Nayyara Tabassum is Evidence Officer in the Centre for Ageing Better. (917 words)

In March of this year when we were still learning about COVID-19 in the UK, I remember listening to a journalist on the telly saying the coronavirus does not discriminate – it infects and kills everyone, rich or poor, young or old. But as more news started filtering in, a pattern of who the virus infected the most began emerging. Even while scientists and public health personnel were grappling with this new virus and how it spreads, one of the earliest news trends of the pandemic is that the virus seemed to affect particular groups, such as older people, those with underlying health conditions, those living in deprived areas, lower-skilled workers, those working in social care, those living in care homes and BAME (Black, Asian and Minority Ethnic) groups more than any other group.

The COVID-19 pandemic has shone a light on health inequalities that disproportionately affect older people and BAME people, something also confirmed by the recent PHE report published in June 2020.

This blog looks at what we know about health inequalities of older BAME groups, what we need to know more about and what are some key recommendations to promote healthy ageing that is inclusive for all. Continue reading

Keeping “Everybody in” – the need to move from hotels to Housing First

Stan Burridge is an ex-rough sleeper and an HSCWRU Peer-researcher. He is Director of Expert Focus, a user-led organisation that supports the involvement of people with lived experience in homelessness research and policy. (1,029 words)

Over the past few weeks, I have been thinking about all the people who have been swept from the streets and into hotels because of the COVID-19 pandemic. The old mantra that it was impossible to house all those sleeping rough has been scotched. This event signifies how, with the right amount political will and financial investment, radical change can happen at scale and pace.

Thinking about the next steps for Everybody in (the policy of offering people sleeping rough a hotel room for duration of the lockdown) I would like to urge policymakers to continue to pursue radical change (i.e. doing the right thing). Looking for a real solution to homelessness means taking note of the ‘overwhelming evidence that highlights the effectiveness of Housing First.’[i]

Housing First affords people a permanent home (their own front door) with no requirements beyond accepting the help of a trusted worker to maintain their tenancy. There is no requirement to ‘move on’ with other areas such as addiction and mental health issues, and even if someone were to lose their home, the trusted worker will continue to work with them. Continue reading

Social care is not an intractable problem

John Burton has been working in and with social care, mostly residential care, since the mid-1960s. He has worked at all levels with all client groups and ages, and is currently consulting to therapeutic children’s homes. His most recent book is Leading Good Care (JKP 2015) and he is now writing a new book on children’s homes. Readers may also be interested in his What’s wrong with CQC? published by The Centre for Welfare Reform. (1003 words)

When designing anything it’s crucial to understand what its purpose is. When redesigning something that isn’t working as well as it should, we must study the operation of what currently exists to identify how it falls short of its purpose. To study effectively, we must get to know it in detail from the inside, look at it as a whole and make no assumptions.

So it is with what we call social care. We start and end life dependent on others, but in between the beginning and end we remain dependent to a greater or lesser extent. We are social beings and we are never fully independent. When we need more support than our family, friends and neighbours can give, we require an organised system of support which will include paid people and is likely to include supplies, buildings, equipment etc. We all need and give support, some more than others and at different times. It’s simply part of being human. Continue reading

Resource for day centres – Guide for adult day centres to ‘unlock lockdown’ safely

Caroline Green and Katharine Orellana, Post-Doctoral Fellows, National Institute for Health Research Applied Research Collaboration South London. (721 words)

On 23 March 2020, most of England’s population was placed into ‘lockdown’ due to the novel Coronavirus or COVID-19 pandemic taking hold across the UK. This was an unprecedented move by the government and meant that social care services, including day centres for older people or those with social care needs mostly closed to regular users.

Several months later, the government is taking a step-by-step approach to ‘unlocking’ society, with social clubs and community centres allowed to open again from 4 July 2020. But, with the pandemic not yet subsided, day centres are faced with the task of making their services safe and reducing the risks of infections to service users and staff. This is particularly important for day centres, as they may serve groups of people at risk of being seriously affected by the virus, such as people with underlying health conditions. Continue reading

Fair Care Work: A Post COVID-19 Agenda for Employment Relations in Health and Social Care

Ian Kessler, Stephen Bach, Richard Griffin and Damian Grimshaw introduce their new paper, Fair care work. A post Covid-19 agenda for integrated employment relations in health and social care, published yesterday by King’s Business School. Lead author, Professor Kessler, is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. (908 words)

The courage and sacrifice of the health and social care workforce have emblazoned themselves on the national consciousness as the challenge of COVID-19 continues. While classified as ‘key workers’, along with other occupations essential to the community in times of crisis, the distinctive contribution of frontline care workers, reflected in their direct and relentless engagement with the virus, has until recently been reflected in the Thursday night applause reserved for them. This public applause sits uneasily, however, with the treatment of over two million health and social care employees, mostly women, often from black and minority ethnic backgrounds, typically in undervalued, relatively low paid and insecure employment. In a new paper, we seek to kick start a policy debate on the development of fair care work, to stimulate discussion on a refreshed employment relations (ER) agenda which acknowledges and reflects the worth of care workers to our individual and communal well-being. Continue reading