Patient Carer Race Equality Framework (PCREF) at SLaM
Why are we developing PCREF in South London and Maudsley (the Trust)? As an organisation, we know that we need to significantly improve the trust and confidence of Black communities in our services and look to eliminate the unacceptable racial disparity we (in common with most Mental Health Trusts) see in Access, Experience and Outcomes (AEO).
PCREF was a recommendation from the national Mental Health Act Review to help achieve this, and once developed, will be rolled out by NHS England across all Mental Health Trusts by 2022. Once in place it is likely to form part of the Care Quality Commission (CQC) Well Led assessment.
Led by our Chair, Norman Lamb and Chief Executive, David Bradley, the Trust is one of four national pilot sites, which are working on developing PCREF to inform the national rollout. As such, PCREF is the Trust’s strategic approach to achieving its commitment to becoming an anti-racist organisation and delivering equity of AEO. It is a central part of the Trust’s new Strategy which is currently under development.
What is the PCREF approach?
PCREF is not a final product. It is an opportunity to co-create the Trust’s approach with local Black communities, Black Service Users and their Carers and staff together to look at how we implement the national PCREF competencies, with the aim of identifying the priority actions that will help eliminate disparity in AEO. The competency framework will be signed off by the Trust Board and then implemented within the Trust, supported by an outcomes framework so we will know over time if PCREF is leading to the change that is so greatly needed.
What are the core areas of work that are the foundation of our PCREF approach?
As one of four national pilot sites, we will work alongside NHS England to:
Improve our implementation of Statutory and regulatory duties, which impact racial disparity, as a minimum baseline requirement
Implement nationally identified organisational competencies, in a way that reflects our local communities
Identify and implement Trust-level determined organisational competencies
Implement the national patient and carer rated experience tool
Why do we need PCREF and who should be involved? Our data and experience show that Black African, Black Caribbean, and Black Other, including Mixed ethnic groups, are most disadvantaged in terms of AEO. We will initially focus on addressing the imbalance for these groups.
If you identify as part of this group, we would like to invite you to join this journey, particularly Community members, Service Users and their Carers. Equally, the invitation is open to staff with frontline work experience to join this journey bringing their valuable knowledge and ideas to improve services to better meet the needs of the diverse communities we support.
What has already been done.
We have completed our first phase which focused on the development of the baseline assessment and data analysis and where we bedded down the governance structures which were signed off by the Partnership Group in March 2021. The Partnership Group is a large group including members from the local Independent Advisory Groups (IAGS) and local Trust Management and Clinicians who together comprise the Borough-based Joint Working Groups (JWGs); partner organisations who are supporting the IAGs; senior Management, Clinicians and PCREF Project Team staff.
At the beginning of the year (Jan-Feb 2021), the Trust and partner organisations – Croydon BME Forum and Lambeth Black Thrive - worked together with our local Black communities and Black Service Users and their Carers and Trust staff to design and deliver the first phase of the engagement events as part of the data and need assessment process. These included getting ‘Fit for Partnership’ events held separately for each of our three constituencies - Black community members, Black Service Users and their Carers and the Trust’s staff, followed by borough-wide events across our four Boroughs, with the process culminating in a Trustwide event at the end of February 2021.
This phase of events focused on definitions for AEO as well as the data required to support this. From the polls carried out during the events, it was identified that the top priorities for good Partnership working going forward, was to recognise the power imbalance, ensure diversity amongst the Trust’s staff groups and understand and acknowledge systemic racism in the UK. There was also an initial discussion around the nationally identified Organisational Competencies which forms part of the framework for phase 2. The Trust and the PCREF partnership both aspire to be anti-racist and feedback from the events was that we needed to work together on defining what we mean by this as well as thinking about the impact colonisation has had on mental health services.
What is happening now?
We are currently in the process of defining the activities to help deliver phase two of the PCREF Programme which will run through to January 2022. Phase two focuses on the ten national Organisational Competencies identified by NHS England in addition to two local organisational competencies that were identified during the first phase. These are the skills and practices the Trust needs to focus on, to improve the way we offer and deliver services so that equity is achieved.
As part of defining the activities, we are developing a social movement within phase two where we will launch the PCREF Activists and Allies as an integral initiative to drive the next phase. We are developing the Activists and Allies offer within our three constituencies. This second phase will involve several engagement events and other activities within each constituency and bringing the constituencies together at a Borough level with the culmination at a Trustwide event.
How you can get involved!
Between May to July 2021, each constituency will begin recruitment for PCREF Activists and Allies, developing programmes of activities, opportunities and campaigns. If you are interested in joining the Partnership on this journey towards anti-racism and equity, please consider becoming a PCREF Activist or Ally (contact details below).
In June 2021, we will be inviting Black communities, Black Service Users and their Carers and Trust staff to complete an online questionnaire for NHS England, where you will be able to share experiences and views on NHS mental health services. This will help to inform the development of the PCREF programme. We will also be mapping within the community and across the Trust the readiness to make improvements on each of the Organisational Competencies.
Between August to October 2021, Work will begin in earnest to analyse each Organisational Competency and identify projects which will help us improve. Also, during this time, each constituency will be running campaigns, events and other activities to build the social movement. This will include various Activists and Ally opportunities, training, seminars and lunch and learns. During this time there will also be opportunities for constituencies to learn and contribute together on the themes of anti-racism and decolonising mental health services.
In early November 2021, we will begin the ‘Together Work’ where we will deliver our first Trustwide engagement event, bringing together all three constituencies to share thoughts, learning and analysis. Following this event, we will hold several borough-based meetings to develop shared understandings and prepare joint presentations including proposed change ideas for the public events in January 2022.
Throughout January 2022, we will hold a series of public engagement events. Firstly, we will bring together our three constituencies at four borough-based events in Croydon, Lambeth, Lewisham and Southwark and then to one culmination Trustwide Event towards the end of the month.
Working in partnership, the Trust, Croydon BME Forum and Lambeth Black Thrive are currently finalising dates for these events and will publicise these soon.
To get involved in the PCREF Activists and Allies social movement, please contact the relevant team: