The Patient and Carer Race Equality Framework (PCREF) was a recommendation following the national Mental Health Act Review in 2018. In our Trust, PCREF exists to eliminate the unacceptable racial disparity in the Access, Experience and Outcomes (AEO) of Black communities and significantly improve their trust and confidence in our mental health services.
These pages will give you more detail on how our PCREF approach at South London and Maudsley NHS Trust has developed since 2020. This is an ambitious, transformative programme where partnership working is at its heart. Focusing on Lambeth, Southwark, Croydon and Lewisham, we welcome local Black led Communities, Black patients who have used or are using Trust services and their carers, along with Trust staff at all levels to learn from and get involved with our PCREF approach.
What is the Patient and Carer Race Equality Framework?
The Patient and Carer Race Equality Framework (PCREF) was a recommendation following the national Mental Health Act Review in 2018. PCREF is the NHSE accountability framework to eliminate the unacceptable racial disparity in the Access, Experience and Outcomes (AEO) of Black, Asian and Minority Ethnic communities and to significantly improve their trust and confidence in mental health services. The PCREF accountability framework comprises three components - Statutory and Regulatory Obligations; Organisational Competencies; and Patient and Carer Feedback mechanism.
South London and Maudsley NHS Trust (in common with most mental health trusts) can look at service data and clearly see which groups have the best and worst AEO in their care. Our Trust data shows that patients from Black African, Black Caribbean, Black Mixed and Black Other census categories have the worst AEO with us and in this first iteration of PCREF, we are focusing on these groups. We will talk of ‘Black communities’ which refers to all four census categories listed above.
Once developed, PCREF will be rolled out by NHS England across all mental health trusts and will form part of the Care Quality Commission (CQC) assessments. The Trust is an NHS England Pilot site for PCREF and this means we are developing our work on all three components. As part of this we will test and learn from co-produced projects to transform services locally and inform what the national roll-out to all mental health providers will look like.
In 2020, work got underway to build on existing partnership working mechanisms to welcome PCREF in on this journey of transformation with Black communities, Black Service users and their carers and with Trust staff. This ambitious programme is only possible through true partnership working, with Black Thrive Lambeth and Croydon BME forum as community Host Organisations and South London and Maudsley NHS Foundation Trust.
Find out more about our host organisations:
Dr Jacqui Dyer from the Community and Zoe Reed from the Trust are the joint strategic leads of the PCREF programme. Within the Trust, the programme of change is led by the Chief Executive, David Bradley.
South London and Maudsley is one of four national pilot sites across the country, which are working on developing PCREF to inform the national rollout. The aim of PCREF is to ensure that over time the way we deliver mental health services, eliminates racial disparity in Access, Experience and Outcomes of Black communities in our care and supports the organisation striving to lead antiracism in mental health as it has outlined in its new strategy.
The PCREF programme is a partnership between South London and Maudsley and local host organisations - Black Thrive Lambeth and Croydon BME Forum.
This Partnership brings together Trust staff, Black service users, their carers and local Black communities to jointly develop and implement PCREF into standard practice.
Get in contact to join:
- The PCREF Community Action Group
- The PCREF Black Service Users and their Carers group
- The PCREF Staff Network
Our Trust data shows that patients from Black African, Black Caribbean, Black Mixed and Black Other census categories have the worst Access, Experience and Outcomes in our mental health services.
In this first iteration of PCREF, we are focusing on these groups and in our material we talk of ‘Black communities’ which refers to all four census categories listed above.
There are three component parts to the NHS England PCREF that we are considering how we measure, these are also our priorities:
- Statutory and Regulatory Obligations
- Organisational Competencies
- Patient and Carer Feedback and Assessment tool
NHS England’s National Organisational Competencies are core competencies a culturally responsive mental health service should demonstrate. They are:
- Cultural Awareness
- Partnership Working
- Staff Knowledge and Awareness
- Partnership Working
- Leadership and Governance
- Use of Data
- Digital Inclusion
- Information and Advice
Please get in contact if you would like more information on what the PCREF Partnership Programme is doing to address these.
PCREF Partnership Teams in each of the London boroughs the Trust operates in have been working on the 'National Organisational Competencies' (NOCs) from NHS England. They are initially co-creating a definition that relates to our PCREF approach and designing 'Change Ideas' that will have a measurable impact on the Access, Experience and Outcomes of Black patients in the Trust's care.
These Change Ideas are practical projects where we can test and learn if improvements are being made. They will fit in to the PCREF metrics, a set of six indicators which will support the Trust to reach equity in specific areas.
The six agreed PCREF Metrics for the Trust are:
1: PCREF will support the Trust to achieve equity in service use by ethnicity.
2: PCREF will support reach equity in diagnosis of psychotic spectrum disorders by ethnicity.
3: PCREF will support the Trust to achieve equity in use of medication for Black people with a diagnosis of psychotic spectrum disorders.
4. PCREF will support the Trust to achieve equity in the use of detention by ethnicity.
5. PCREF will support the Trust to achieve equity in the use of seclusion and restraint by ethnicity.
6. We will develop culturally appropriate and accessible measures of recovery.
Further information on this is available through the PCREF membership newsletter. Please get in touch for more information.
'Aiming High; Changing Lives' is our Trust's five-year strategy. It sets out the organisation’s focus from October 2021 – October 2026 and we are pleased to see PCREF embedded within it. This is an important strategic step for PCREF becoming ‘business as usual’ in the way our Trust operates.
Read more about the strategy: Aiming High; Changing Lives - our strategy 2021-2026
You are welcome to attend regular six-monthly engagement events, which will update on the progress of the Trust Strategy.
Join the PCREF membership and be informed of upcoming dates to join these events and receive important PCREF updates.