We recently hosted a roundtable event with south London stakeholders on tackling racism in the health and care sector. HIN anti-racism leads Pearl Brathwaite, Adam Ovid and Catherine Dale write about the key themes from the discussion

While racism is unfortunately not a new phenomenon, since 2020 there has been increased attention paid to structural inequalities, the impact of colonialism and the racism experienced by people who are part of ethnic minorities in white-majority countries.

As an academic health science network (AHSN) much of our work involves tackling the health inequalities which exist – and which were highlighted during the pandemic. As such we are in quite a unique position of having a view which cuts across south London’s health and care sectors.

That’s why we brought together people from this community, in particular leaders with health inequality, clinical and managerial roles to discuss opportunities in tackling racism in south London. Organisations represented included South London and Maudsley NHS Foundation Trust (SLaM), Guy’s & St Thomas’ NHS Foundation Trust, Mabadaliko, the Greater London Authority GLA), NHS England London Region, and South East and South West London ICSs. Here are some of the examples of what they shared about the work they are doing.

• South London and Maudsley NHS Foundation Trust (SLaM) has developed its Patient and Care Race Equality Framework in partnership with Lambeth Black Thrive and Croydon BME Forum. This framework exists to eliminate the racial disparity in patient access, experience and outcomes. The initial focus of the work has been on issues which Black communities face. The framework aims to significantly improve trust and confidence in mental health services.
• Mabadaliko is working with senior leaders and management teams to provide advice and guidance on strategic initiatives in equality, equity and anti-racism objectives and spaces. It supports organisations to develop cultures and programmes aiming to reduce racial and ethnic inequalities in the communities that they serve.
• The Greater London Authority (GLA), in partnership with the Race Equality Foundation, is establishing a peer learning network ‘Anti-Racism Practice Learning Hub’, involving peers and organisations sharing practice, resources, and support  becoming an effective anti-racist organisation. The GLA has also developed a strategic framework to support London health and care partners to progress towards being anti-racist as an approach to address ethnic disparities.

Thank you to everyone who came and shared their views. Here are just some of the main takeaways.

Bringing together people from outside your organisation can be a highly valuable way of gaining perspective on how your organisation is doing and what can be improved. It provides fresh perspectives, highlight blind spots, and encourage critical self-reflection.

These voices can include expert consultants, community leaders, and individuals with lived experience of racism. The HIN’s work in shaping the discussions we had internally benefited from advice from external sources such as a clinical psychologist specialising in anti-racism and a workforce development consultancy, and other participants reported similar benefits.

These can help challenge existing ways of working. It is often easier for an external expert to be direct and honest about how an organisation is doing. It can be a particularly valuable way of bringing diverse voices to white-led organisations.

However, risks were also identified – external input must be balanced with internal expertise and knowledge to ensure their recommendations are relevant to your organisation. It is also essential to ensure that the involvement of external voices does not become counterproductive. But getting the balance right can provide perspectives which are instrumental in driving change.

It is crucial to acknowledge who is not present in discussions about anti-racism, as well as who is. Status threats, privilege, and discomfort often prevent people without personal experience of racism from participating.

To overcome these barriers, efforts must be made to notice who is not present and encourage them to become involved – only by doing this can we escape echo chambers and create genuine understanding between people with different experiences. Creating safe spaces, addressing power imbalances, and fostering open dialogue can help bridge this gap and ensure that all perspectives are included.

To make anti-racism efforts impactful, it is crucial to extend beyond one’s own organisation. This requires fostering an appetite for collaborative working and using existing tools and platforms.

Creating sounding boards, which provide opportunities for diverse voices to be heard, can be an effective approach. As can shadow boards, which mirror the work of decision makers and give individuals from underrepresented communities access to important discussions and decision-making processes from the start.

When implementing anti-racism organisational programmes or workforce strategies, it is important to strike a balance between empowering colleagues from ethnic minorities to speak about their experiences and challenge the way things are done, without burdening them with the difficult challenge of tackling institutional racism in addition to their normal work function. To do this there must be an environment where colleagues feel supported and included, with active participation and input from leaders and white colleagues.

Individuals with uncommon or hard-to-pronounce names are often “othered” by having to repeatedly explain how to pronounce their name. But there are simple steps which can be taken to address this.

A number of the participants identified time spent by colleagues understanding how to pronounce people’s names as a way of fostering a culture of respect and inclusivity. Some mentioned a specific workshop where staff discussed their names, correct pronunciation, and shared their experiences as a way of creating a conversation and improving awareness.

Another approach is to implement phonetic pronunciation guides as standard – for example to name badges and pronunciation guides in email signatures – to make things easier for everyone and reduce feelings of exclusion.

To ensure the effectiveness of anti-racism programmes, initiatives should start with self-reflection and dialogue to highlight the problem, clarify the focus and specificity of planned work and garner support for change. To convert this into meaningful long-lasting progress, it is essential to maintain momentum and enthusiasm. To keep the focus on substantive change organisations should set clear goals and time-bound, measurable objectives wherever possible.

Structural and institutional racism in the health and care sectors is not a problem which can be solved overnight, but it is clear there are actions we can all take within our areas of work to create an environment which is inclusive, open and focused on tackling racism.

There was a strong desire among the group for further inter-organisational work to share learning and collaborate on the wider issues of racism, and we look forward to exploring these opportunities. Racism is a current and ongoing problem, and creating an environment where we can have open and honest conversations about it is a crucial first step in changing the culture of our organisations.

• Engage in conversations in your organisation around race and racism to raise awareness and think about the impact this has on your people and the work that you do.
• Consult experts to support you, such as Mabaliko, anti-racism experts and internal or external Equality, Diversity & Inclusion consultants who have a particular focus on racial inequality and inequity.
• Generate commitments for your organisation or teams through engagement with your colleagues. Consider what resources and action you need to develop and sustain these commitments and how you will get there.
• Read our toolkit for support on how to take action and top tips for keeping focused on change.