Can Do Health & Care - NHS Uncomfortable Truths Report

8 | ICS System Learning: Uncomfortable Truths • Lack of choice and consent around care options. • Ethnic minority women not being listened to by health professionals, their health concerns being dismissed, being ignored and disbelieved. • Racism by caregivers, microaggressions and negative stereotypes about ethnicities, such as Black women being strong and they don’t feel pain as much as their white counterparts. Sometimes medical records are inaccurate, their backgrounds are missed so that affects their healthcare. • Dehumanisation and lack of physical and psychological safety, structural barriers, culture, and lack of support for trauma due to the quality of care that they have received in the past. • Accessibility of services and staff shortages that lead to having to wait for help. Uncomfortable Truth 3: In 2020, approximately 23% of deaths in the UK were considered avoidable. Of these, 69% were preventable and the remaining 31% were considered treatable. Office for National Statistics Nicola: The data is clear, and the responses in our system will be mixed. I felt a range of emotions and wanted to find out more about the reasons behind the data. Some of the deaths are preventable through secondary prevention and immediate care and treatment, and then there are deaths that are part of our structural inequalities, such as the maternal deaths data. I don’t believe that most people in health and care get up in the morning intending to be racist or intending to give worse care than they should. The structural inequalities in the NHS exist because we are an inequitable society, and internationally there is bias too. “The people experiencing inequalities aren’t ‘others’, they are ‘us’, part of our community. Their experiences are linked to the context around them, the bias in how systems are designed and how care is delivered, and societal structural inequalities.” The Marmot report in 2020 highlights that between 2009 and 2020 the expenditure per person in local authorities in the 10% most deprived areas fell by 31% compared with only 16% in the least deprived areas. What drives that is structural inequality. Rebecca: Both listening and acting are really important. Recently, hearing on the news from the mother of a child who died from sepsis and Martha’s Rule on listening to families, the response came that implementing new structures might take longer than the set target date. This made me angry: why should it take me so long to listen?. I watched the Dispatches programme and felt a pressure on my chest. We must not reduce the lives and experiences of people in physical or mental health crisis solely to assessing risk, we need to start to believe and understand their truth. I am on a journey of passion about how we