VCSE health and wellbeing alliance

The alliance's purpose is to:

• provide a co-ordinated route for health and care organisations to reach a wide range of VCSE organisations
• support collaboration between VCSE organisations and provide a collective voice for issues related to VCSE partnerships in health and care
• enable health and care organisations, and VCSE organisations, to jointly improve ways of delivering services which are accessible to everyone – making it easier for all communities to access services will reduce health inequalities
• ensure health and care decision-makers hear the views of communities which experience the greatest health inequalities
• bring the expertise of the VCSE sector and communities they work with into national policy making

Year one 2021-2022

Barriers and opportunities: improving access to mental health support for refugees and people seeking asylum

This work was done with the Improving Access to Psychological Therapies (IAPT) Mental Health Team at NHS England and NHS Improvement.

We carried out research to contribute to existing literature by exploring access to and experience of mental health support for refugees and people seeking asylum in England.

People in these groups are more likely to experience poor mental health than the wider UK population, including higher rates of depression and post-traumatic stress disorder. This is supported by the anecdotal experiences of British Red Cross colleagues working in refugee support across the UK.

This research was co-produced with the VOICES Network, a collective of refugees and people seeking asylum. The research participants were 16 professionals working within organisations providing mental health and related support to refugees and people seeking asylum who were engaged through two focus groups.

Key findings:

• There is a need for a person-centred, trauma-informed approach where the specific needs of the individual are considered and most appropriate mental health support is offered. 
• There is opportunity to improve communication with refugees and people seeking asylum in the provision of mental health support. This includes longer appointment times to overcome language barriers, preference for face-to-face appointments, written and translated communication and consistent access to professional interpreters.
• Services need to better coordinate and communicate with each other. People have concerns about needing to share their story multiple times with different public services as well as over data sharing affecting outcome of asylum application.
• Increased provision of peer support offers an opportunity to improve mental health.
• It is important to maintain continuity of care and ongoing access to the same healthcare professionals once a relationship has been established. This is especially important during dispersal. 
• Service design and delivery could be improved by effective feedback mechanisms, which are accessible and easy to understand. 

Download: Barriers and Opportunities: Improving access to mental health support for refugees and people seeking asylum - report (PDF)

Download: Barriers and Opportunities: Improving access to mental health support for refugees and people seeking asylum - presentation (PDF)

Delays to elective care: experiences of waiting for people from Black, Asian and minority ethnic backgrounds in England

This work was done with the Health Inequalities Team at NHS England and NHS Improvement

Waiting times were already a challenge before the Covid-19 pandemic but have been significantly impacted and exacerbated since March 2020. The number of people in England waiting for treatment for more than a year increased 185-fold between January 2020 and January 2021. There is growing evidence that longer waiting times for elective care disproportionately affect the most socioeconomically deprived groups in England.

A recent analysis of healthcare inequalities at an NHS trust indicated that people from Black, Asian and minority ethnic backgrounds in England wait significantly longer for elective care procedures than those from white backgrounds. However, individuals from Black, Asian and minority ethnic backgrounds are underrepresented in much of the research which explores the impact and experience of waiting for elective care. This research therefore makes a valuable contribution to existing literature in this area.

We conducted nine interviews with participants who were on waiting lists since March 2020 about their experience of waiting.

Key findings 

• Waiting for elective care often resulted in a deterioration in existing health conditions but also the emergence or worsening of other health issues.
• Waiting had an impact on the personal and professional lives of participants, with many reporting feeling uncertain, helpless and concerned about finances.
• There were concerns about the communication received from healthcare professionals while waiting – this included a lack of information and information being communicated poorly.
• Participants who were able to take an active role in managing their symptoms and conditions tended to have a better experience of waiting. 

Download: Delays to elective care: The experiences of waiting for nine people from Black, Asian and minority ethnic backgrounds - presentation (PDF)