Covid-19: BAME data must not become ‘hot potato too difficult to confront’

Analysing data on black and minority ethnic cases of Covid-19 cannot be passed between departments as a “hot potato too difficult to confront”, the Shuri Network has said.

The Network, set up to support women of black and minority ethnic (BAME) backgrounds in digital health roles, called for “stronger focus” from healthcare leaders to address inequalities highlighted in the data.

Shera Chok, GP and co-founder of the Network, told Digital Health News: “There needs to be strong and visible leadership of this issue at a national level, it cannot be passed from one department or team to another as a hot potato too difficult to confront.

“We talk about prevention, co-production and engaging communities in the Long Term Plan, this would be an excellent opportunity to demonstrate how we do this as a health and care system using data and technology to improve outcomes and safety.”

The Network is in conversation with NHS England and Improvement, third sector organisations and the media to ensure key messages are getting across to local communities, she added.

Chok’s comments come as new research revealed people of BAME background were more likely to die of Covid-19.

According to an Institute of Fiscal Studies report, published 1 May, the impacts of Covid-19 are not uniform across ethnic groups and “aggregating all minorities together missus important differences”.

For example, Covid-19 hospital deaths are highest among the black Caribbean population – three times higher than the white British group, despite white British accounting for almost 80% of the population of England.

Bangladeshi hospital fatalities were twice those of the white British group, Pakistani deaths are 2.9 times as high, and black African deaths 3.7 times as high, the report found.

The Indian, black Caribbean and ‘other white’ ethnic groups also have excess fatalities, it found. The only group to have fewer fatalities than the white British population was the white Irish group.

Areas of England with a higher BAME population appeared to be disproportionately affected, it was found.

The government faced repeated calls to publish official statistics on ethnicity, with the first dataset on BAME deaths published last week.

It has also been criticised for failing to identify the sex of patients in it’s Covid-19 data collection tool.

“What matters now is how the government responds to the evidence coming from ICNARC [Intensive Care National Audit and Research Centre] and other sources and how it directs resources to analyse the data and reduce the risks to BAME communities,” Chok added.

“Accurate data, for example on co-morbidities and the wider determinants of health like housing, is central to understanding the reasons behind the current figures.

“The system collects a huge amount of data but we need a stronger focus from the top to ensure the application of this data to address these inequalities occurs as soon as possible.

“This crisis has been called a ‘once in a career opportunity to transform the NHS and implement technology in record time’. As the data shows that BAME patients and staff are more at risk from Covid-19 we should instead be calling it a once in a career opportunity to reduce health inequalities and discrimination.”

The government launched a review into the disproportionate impact of Covid-19 on BAME communities in mid-April following pressure from the British Medical Association and campaigners.

Dr Chaand Nagpaul, BMA council chair, said the review must be informed with real-time data to have any “meaningful impact”.

“This must include daily updates on ethnicity, circumstance and all protected characteristics of all patients in hospital as well as levels of illness in the community, which is not currently recorded,” he said following the launch of the review.

Representation

Representation is key to ending inequality, not only in health care but every system. Campaigners have long been calling for better representation at leadership level, one of the key objectives behind The Shuri Network.

Co-founder Sarah Amani said any efforts to reduce BAME deaths need to include BAME representation.

“Any effort to reduce mortality of BAME people from this pandemic needs to be led by and/or with people from the BAME population,” the senior programme manager for Time4Recovery told Digital Health News.

“We know that when research or solutions are developed without the group they are intended for, those solutions often fail or have mediocre results.”

Chok has previously warned that diversity “cannot be outsourced to HR” and the NHS was in “grave danger” of losing talented staff if the organisation doesn’t get diversity right.

Speaking at the Digital Health Rewired Leadership Summit on 3 March she told the audience: “This is something we must all own, collectively, if we truly serious about improving patient care and delivering our digital health objectives and aims.”