Can Do Health & Care - NHS Uncomfortable Truths Report

10 | ICS System Learning: Uncomfortable Truths For many people, our system is still too complex to understand. It takes one thing going wrong in their lives to go from being a stable family to chaos, and because they are in poverty and under stress they are more likely to become ill. Nicola: When staff are under stress it can be harder to actively listen, but that is not an excuse. There are structural inequalities, but personal interactions have an impact too. A friend with fibroids has been offered a hysterectomy but is very reluctant, as Black and brown women are more likely to have fibroids but are also more likely to be recommended hysterectomies very early on. I then found that Black women are twice as likely to be given a hysterectomy as White women for benign gynaecological conditions. “Personal interactions are important to understanding why a person may not trust the information they are being given, and to recognising that the information is in fact biased.” Rebecca: If we truly want to shift left to be partners with the people we serve we need to listen at all levels. We need to think about how we listen, learn and build partnerships together and shift that culture. “We need to develop a shared philosophy and push boundaries, placing a real pressure on ourselves until everyone using our services feels physically and psychologically safe.” If we don’t listen to people and to our workforce we won’t make the progress that we need throughout our system. Dean: We need to treat the perpetrator but also empower the victim. We need to go further than simply mandatory training for our workforce, research is showing that we need to tackle equality, diversity and inclusion by co-producing with communities what we plan, what we do, what we study and how we act. Cultures are very diverse, and we cannot understand every one, so we should show empathy not just sympathy, and show compassion by asking, what am I doing wrong? We should not just say we care, but show how we are spending, and how we are sharing power with people by involving them in our decisions. This should be an iterative process so we can respond rapidly to what people tell us, and continually improve every single day. Joyce: Recently, we found our women were being given advice by health professionals on what to eat, and then coming back to us saying this was not culturally relevant to them. As community ambassadors we respond quickly, finding someone who can come into our community space to give us tips about eating the foods from home in a healthy way that will benefit the baby and mother.

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