Seventeen pledges have been made by NHS Birmingham and Solihull Integrated Care Board (ICB) to improve health and race equality in health and social care in Birmingham and Solihull.
The pledges were made at a health and race summit, co-hosted by NHS Birmingham and Solihull and Birmingham Race Impact Group (BRIG), held on 7 December 2022 at Edgbaston Park Hotel in Birmingham.
The pledges, which you can read in full below, include a commitment to improve diversity of the ICB’s Board, supporting Birmingham to become the first Anti-Racist City in the UK and a commitment to a ten year race equality delivery plan for the health sector with annual targets over the next decade.
During his speech at the summit, David Melbourne, Chief Executive of NHS Birmingham and Solihull, announced the ICB’s commitment to tackling health inequalities through the seventeen pledges, which have been developed by the ICB’s Board in response to inequalities both in Birmingham and Solihull and nationally.
Locally, more than half of Birmingham’s population (51.4%) is of Black, Asian or minority ethnic origin, as are 65% of school children, and Solihull, while not as diverse, has significant pockets of diversity especially in West Solihull.
Nationally, the Black Lives Matter movement and outbreak of COVID also proved to be catalysts for reflection and action to tackle health and race inequality.
The first ten NHS doctors to die of COVID were predominantly Muslim and from either a Black, Asian or Arabic background, highlighting that ethnicity and faith could no longer be ignored.
Speaking at the summit, David Melbourne acknowledged that the NHS has not been immune from the structural racism in wider society.
He said: “Stark inequalities in access, experience and outcomes including shocking maternal and infant mortality rates have long been known about and we are committing today to address them.
“Black, Asian and minority ethnic NHS staff have long endured higher prevalence of bullying and harassment cases, higher prevalence of disciplinaries, lower pay and lack of promotion opportunities.
The pledges have been welcomed by staff in Birmingham and Solihull Integrated Care System (ICS).
Salma Yaqoob, Birmingham and Solihull ICS’s Health Inequalities Programme Director, said: “These powerful pledges from the most senior members of NHS Birmingham and Solihull are major commitments and will increase trust and confidence within our workforce, and Birmingham and Solihull’s diverse communities.
“They will come to be regarded as a significant breakthrough in embedding anti-racism into the health agenda in the Midlands.
“Whilst the race and healthcare summit showed the magnitude of the challenge ahead, it also showed the innovative solutions that are within reach when we work in genuine partnership with our communities.
“I look forward to seeing these pledges being realised, helping us to ensure that everyone in Birmingham and Solihull has a fairer future.”
Patrick Vernon, Interim Chair of NHS Birmingham and Solihull Integrated Care Board said: “It’s important to point out that focusing on race equality is not detrimental to other protected characteristics or marginalised communities.
“The evidence shows that action on one area results in ‘targeted universalism’ that benefits all groups.
“I welcome these significant commitments to measurable actions and accountability which are needed for lasting and meaningful change.”
BRIG is a consortium of activists and academics who have worked for years to promote racial justice in Birmingham.
NHS Birmingham and Solihull race and health pledges
1. We support Birmingham Race Impact Group’s Birmingham Race Equality Manifesto and commit to working with BRIG on an ongoing basis to ensure transparency and accountability with a minimum of an annual joint race and healthcare summit.
2. We support making Birmingham the first anti-racist city in the UK. Let’s be proactive in tackling the roots of systemic racism and not just the symptoms.
3. We commit to a ten year race equality delivery plan for the health sector with annual targets over the next decade. We shall ensure that ethnicity is a key focus alongside deprivation in all six priority areas of our five year Reducing Health Inequalities Strategy, as well as in our 10 year ICS Master Plan going forwards.
4. We commit to ‘mainstreaming’ tackling racial inequity in healthcare with dedicated leadership, team and governance structures. NHS Birmingham and Solihull's Deputy Chief Executive Officer, supported by a newly formed Health Inequalities Team and People Power and Health Inequalities Committee, which reports directly to the Integrated Care Board, will lead the implementation of the Health Inequalities Strategy and ensure the work is embedded in ‘mainstream’ activities and governance frameworks.
5. We commit ourselves to the three year rolling Boards Diversity Challenge to ensure our boards and management teams are reflective of the superdiversity of the populations we serve. We acknowledge that there is currently an underrepresentation of Black, Asian and ethnic minority staff at senior levels and commit to a Positive Action Strategy.
6. We shall publish our annual ethnicity pay gap data NHS Birmingham and Solihull's Equality Diversity, and Inclusion Team, and Human Resources Team will work collaboratively as the newly formed Integrated Care Board People and Workforce Team to deliver on this, and alongside all our NHS Providers shall annually publish our Workforce Race Equality Standards (WRES) and Equality Delivery System (EDS) reports.
7. We shall collect and utilise specific ethnicity data to make targeted improvements for better prevention and treatment outcomes where most needed, e.g. to reduce maternal and infant mortality, reduce prevalence of diabetes, increase access to appropriate mental health services – focusing on specific ethnic groups within Black and Asian communities who we know are currently most impacted.
8. Our service planning and delivery will be informed by communities, patient and staff lived experience in addition to using quantitative data.
9. We commit to work with relevant staff and partner networks, such as the already established NHS Birmingham and Solihull Race Equity Network, GP and Staff Allies EDI Network, and we shall support the NHS Muslim Network. We acknowledge advocating for race equality when you are from a minority community comes with personal and professional risk and commit to being supportive allies.
10. We accept that addressing racial injustice will not be comfortable for everyone and as a leadership we commit to leaning into discomfort. The evidence is clear that to address racial injustice we need to focus unapologetically on the issue of race – not because we see people as one-dimensional, but because we know that without such a focus, change cannot happen.
11. Whilst promoting education and cultural humility, we shall be accountable for changing outcomes and not hide behind phrases such as ‘we are on a journey and learning’.
12. Our COVID experience has taught us that where there is a collective will, changes in ways of working can be made very quickly. Reducing health inequalities is one of the four core aims of the ICB going forwards – in the short term as well as long term. It is not a ‘nice to do’ once other pressures are dealt with.
13. We shall build on the COVID experience of partnering with communities and local anchor institutions for effective delivery, committing to genuine co-design and co-delivery at neighbourhood, place and system levels, and not fall back to old ways that delivered an unjust status quo.
14. We commit to implementing the BLACHIR report recommendations, and Faith Covenant pledges.
15. We shall ensure that the ICB Fairer Futures Fund is deployed to reduce race/faith related health inequalities by investing in trusted grass roots organisations led by and for Black and Asian communities including faith groups, schools, voluntary and community sector organisations, to deliver community-led interventions. We shall minimise bureaucratic hurdles so that smaller groups can access it.
16. We shall formally adopt the duty requiring us to reduce socio-economic disadvantage through our decision making as laid out in Section 1 of the Equalities Act 2010. The cost of living crisis has further highlighted the importance of taking responsibility to address wider determinants of health such as poverty and housing.
17. We shall adopt the RACE Code created by Karl George in our Integrated Care System, and join the growing number of early adopters who can be audited for their progress.