The ability of primary care trusts (PCTs) to understand the health needs of ethnically diverse communities and improve access to services is being undermined by a lack of data about who uses which NHS services, according to an audit published today by the King’s Fund.
As part of their Race Equality Scheme (specified by the Race Relations Amendment Act 2000) PCTs should publish their assessment of local health needs and explain how their services are structured to meet them.
But an audit of published Race Equality Schemes found that many PCTs are hampered by poor data about the ethnicity of those people who use services in their area, including in hospitals and at GP surgeries.
More than half of the Race Equality Schemes recognised the importance of monitoring the ethnicity of patients who use primary care services, but only 13 per cent referred to initiatives or pilot projects to gather information about patients registered with GPs.
The research was conducted between March and August 2006, before the number of PCTs was reduced by half from 303 to 152. All types of NHS trusts (primary care, acute, mental health and care trusts) should have published, by May 2005, a second edition of a Race Equality Scheme to cover the period 2005–8. One third of the websites did not list a Race Equality Scheme, whilst others had out-of-date schemes.
King's Fund chief executive Niall Dickson said:
'This audit highlights just how far away we are from tailoring services to individual needs. We will only achieve better commissioning competency when we have accurate data about patients and patient outcomes.
'There is a need for improved data collection and analysis so we can see if needs really are being met and inequity tackled. This will require action at both local and national level and we know that the Department of Health is considering this issue.
Ruth Thorlby, King's Fund Fellow in Health Policy who conducted the audit said:
'We wanted to find out what PCTs in England are doing to address any inequalities that patients from minority ethnic communities may be experiencing in accessing the NHS. While this research refers to pre-reconfiguration PCTs, the aim of it is to highlight the challenge facing PCTs now.
'A few PCTs have been very active in trying to meet local needs. But PCTs have run up against the problem of lack of data, particularly at the level of GP practices. There needs to be an agreed point at which patients are asked about their ethnicity, and a means whereby that data is brought together coherently. Without that, it is not possible to measure who is accessing, or not accessing, a particular health provision. We must re-open the debate about what ethnic monitoring is needed in primary care. We need to ask how it should be done and who will pay for it,' Ruth Thorlby concluded.
Among the key findings from PCTs and Race Equality Schemes.
- Of the 284 functioning PCT websites, 64 did not publish information about the ethnicity of their local population (22.5 per cent).
- Of the 220 PCTs that did provide ethnicity information, the 2001 Census data was the near-universal source (three PCTs cited data from the 1991 Census).
- 52 per cent of PCT Race Equality Schemes stated the importance of monitoring the ethnicity of patients using their services, but only 13 per cent referred to concrete initiatives or pilot projects to monitor the ethnicity of patients using GP services.
- 30 per cent had not published a Race Equality Scheme on their website (this does not mean they do not have one).
- Of the 184 PCTs that had published an up-to-date Race Equality Scheme on their website, only 40 per cent showed evidence of investment, in staff or projects, to improve access to services.
Notes to editors
- For further information or interviews, please contact the King’s Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
- PCTs and Race Equality Schemes is available from the press team.
- The King’s Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.