COVID-19 and BAME Communities – the Welsh Government response Evaluation Summary Report

Public Health Network Cymru: COVID-19 and BAME Communities – the Welsh Government response Evaluation Summary Report Rebecca Winslade-Rees Public Health Network Cymru November 2020

Introduction Public Health Network Cymru is based within Public Health Wales and provides a range of support to practitioners and researchers across all sectors that influence any aspect of public health and health improvement in Wales. Amongst the services we provide is a seminar series that seeks to promote best practice based on existing and emerging evidence. The series covers a diverse range of topics and recent examples have included Nutrition in Early Years, Learning Disabilities and Homelessness.

A vision statement for the seminar series is presented below: The Public Health Wales Seminar Series will engage stakeholders on contemporary public health issues through lectures, debates and conversations, in order to enhance knowledge and understanding and contribute to present and future public health dialogue.

The aims of the seminar series are:   

To provide new opportunities for learning on a range of contemporary public health issues affecting wales; To develop public health knowledge amongst a wide audience; To share and further enhance the evidence base for public health.

Due to COVID-19 and the need to follow social distancing guidance, we have put our face-toface annual seminar series on hold. However we felt it was important to continue to share and learn during this unprecedented time. Therefore we started a series of COVID-19 related webinars in July 2020. All previous webinars and their evaluation reports can be accessed on the Public Health Network Cymru website.

This evaluation report is for the fifth webinar which will be used to further plan and improve the user experience of future webinars.

COVID-19 and BAME Communities – the Welsh Government response This webinar was held on 12 November 2020 using Microsoft Teams live events software. The webinar was facilitated by Shamala Govindasamy, Programme Engagement Manager, National Safeguarding Team and Co-Chair of Public Health Wales Black Asian Ethnic Minority (BAME) Staff Network.

The webinar was delivered by Dr Heather Payne, Senior Medical Officer, Maternal and Child Health, Welsh Government.

The session described the work of the First Minister’s Advisory Group on health inequalities due to COVID-19 in BAME communities and the Welsh Government response.

The presentation is available by contacting publichealth.network@wales.nhs.uk or can be accessed on the Public Health Network Cymru website.

Evaluation 147 people registered for the COVID-19 and BAME Communities – the Welsh Government response webinar and 72 attended on the day, 2 of which had not registered to attend. The following table illustrates which sector the delegates represented on the day: Sector Public Health Wales Central Team Public Health Wales Local Team Health Board Third Sector Local Authority NHS Other Academic Other – Housing Association Welsh Government Police Other – National Lottery Community Fund Other - Research Other - WLGA Other

Number 21 11 11 7 5 4 3 3 2 1 1 1 1 1

Attendees were asked to complete an online evaluation survey via Survey Monkey following the webinar. The response rate to the survey was 18% (N=13).

Quantitative Results Delegates we asked whether or not they were members of Public Health Network Cymru.

Nine attendees (69%) were members of the Network. In the week following the webinar the Network had 8 new member registrations many of which could be seen as a direct result of the webinar, and/or attendees promoting the Network in their areas.

Delegates were asked to rank from 1 to 5, (where 1 is not at all useful and 5 is very useful) ‘How useful did you find the webinar?’ Seven attendees answered 4 to this question with 2 attendees providing the answer of 5 and 4 attendees providing the answer of 3.

Attendees were asked to choose from a series of answers and/or provide their own response to the following question; ‘As a result of participating in the webinar which actions are you going to take (select all that apply)?’ Four respondents stated they would share the presentation with colleagues and nine wanted to find further information on the topic. Seven respondents said they would discuss contents of the webinar with colleagues to inform action and three stated they would recommend Public Health Network Cymru to colleagues. One

respondent answered ‘other’ stating they would ‘reflect on my practice and future work and change the way I discuss inequalities’.

It is important to note that attendees could choose multiple answers to this question.

Qualitative Results The evaluation survey also asked a freetext question. The responses to this question are documented below.

Do have any additional comments about the webinar or suggestions for future webinar topics?

“As and when evidence comes to light, it would be useful to have a session around the impact of COVID-19 on each of the protected characteristic groups, and taking in to account intersectionality.”

“Further information regarding George Floyd’s death and increasing BAME deaths was noted”.

“Well run, very professional - but I lost the chat during it - I'm not sure why” “The webinar was on a hugely important topic but I feel it was oversold. The data on the issue was great but the "what are we going to do about it" was sorely lacking. A risk assessment tool is not going to protect people in the workplace on the frontline. We know now the evidence is leaning towards the additional risk being due to exposure (including lack of PPE for bank staff and care home staff where senior surgical staff were fully protected) and for structural reasons relating to deprivation and overall health. These weren't addressed.”

“Homelessness” “Thoroughly enjoyed, wish there could be more engagement with the panel.”

“Really informative and the format of the session worked well” “Thank you Heather.”

“Really good oversight of work going on. Slightly longer timing for discussion/questions would be great” “So interesting. Well organised. would love to hear more”

Live Q&As During the webinar attendees had the opportunity to ask questions to the presenter. These were put to the presenter during the remaining time of the event. Attendees asked the following questions: “Covid has been shown to affect BAME communities more than others, is there a dataset showing these effects on ethnicity for other chronic conditions, such as diabetes, cancer, COPD, etc where Long COVID-19 could be added in the future?”

“How can we increase engagement with BAME communities and ensure they are accessing services in an equitable manner?”

“Why are ethnic inequalities in health given less credence when compared to the influx of interest and government emphasis on mitigating socioeconomic inequalities?”

“How best different organisations can help redress inequalities which appears to drive much of the ethnicity differences re COVID-19. My particular interest is then how obesity and overweight plays into this?”

“Are people in BAME groups seen to be a priority group? If so will they be in line to receive the vaccine first? Or will they be the last in line because they are not able to negotiate the health system?”

“Can the data on hospital registered deaths be broken down even further to compare age groups / those with underlying conditions too, etc?”

“Are there any studies looking into ethnicity alone as a risk factor for developing COVID-19 controlling for other factors and dependencies.”

“Ethnicity is often a poorly recorded variable in data collection - how have you navigated these difficulties in analysis? Are there any plans to help improve the collection of this data?”

“Are you planning to repeat the exercise looking at BAME COVID-19 risk now that there is widespread community transmission? There remains the fact that earlier in the pandemic people from BAME groups were far more likely to be exposed to COVID-19 than those from White British heritage due to occupational exposure (over 25% of black British women work in health and social care).”

“Public sector employees need to develop their own understanding of the prevalence of bias and disadvantage. This is a journey for most and starts with a willingness to understand. Most people don’t consider themselves as racist, but that should not be confused with a willingness to embrace the fact that there is systemic bias which causes disadvantage. So we need a willingness everywhere to embrace bias and its effects on disadvantage. My question, how do we create the environment where people can develop that understanding and help them with strategic to tackle systemic biases?”

“Do you think the BLM movement and up rise against structural racism in 2020 has impacted ethnic minorities willingness to comply with government imposed restrictions during COVID19?”

“Do we have a timeline for implementing the standards in Wales?”

“I'm just wondering if there is any current data or and research been done on the topic of multi-generational living and possible link to CV19?”

“Are there plans to improve ethnicity data collection and reporting in Wales?”

“Should we focus on racism as a Public Health Issue?”

“Would like to let everyone know about a Call for Evidence for the Health Foundation's Covid19 inquiry on health inequalities across the UK. https://www.health.org.uk/what-we-do/ahealthier-uk-population/mobilising-action-for-healthy-lives/covid-19-impact-inquiry/callfor-evidence It's important for Wales' evidence and stories to be heard outside Wales too so I'd really encourage people to contribute please because the interface between devolved social policy (health, social care, housing etc) and reserved policies (welfare, furlough etc) needs to be clearly evidenced. How are PHW engaging with similar comparative studies across the UK so that lessons can be learnt?”

“Could WG please make the ethnicity question mandatory in TTP, please?”

“Could you recommend any further reading on ethnic inequalities specifically in health?”

Below are additional comments captured from attendees during and immediately following the end of the webinar: “Hi, this isn't a question, but some supportive information for the question that has already been asked. The Public Health Wales Observatory website carries a lot of information about population health in Wales. For background I would recommend looking at the Health and its Determinants report from 2018 for a baseline. The link is here: http://www.publichealthwalesobservatory.wales.nhs.uk/healthanddeterminants Thanks” “I suppose when the vaccine is available, Rishi Sunak and Priti Patel will be leading that initiative” “Absolutely. This has thrown it under the spotlight but racism has never gone away. In some ways it's a positive effect of COVID-19 that discrimination and inequality of all variants has been shown to be alive and kicking and maybe something can be done about it.”

“Acknowledge rather than embrace” “Harvard University Project Implicit is an eye opener on how we are conditioned to associate bad with dark skin”

“COVID-19 and the BLM movement has allowed us to talk about certain issues we couldn’t before e.g. white privilege.”

“Something I've noticed from public sector work in Wales is that people are more pro the welsh language than racist, which is sometimes used as a measure of unconscious bias because typically BAME people aren't assumed to speak Welsh” “Welsh Govt press events have BSL interpreters and England do not – scandalous” “We need better mentoring. Many groups do not know how to navigate systems in health, education and workplaces. Networking is key and sharing of implicit knowledge which is only known within the 'in group'.”

“I'm reading this at the moment. It's fascinating. Black and British A Forgotten History David Olusoga.”

“All Screwed Up by Mike Nsonwu is a great book by a mixed race Nigerian/Scot who was brought up in Nigeria and moved to UK as a young adult in 1980s and worked as a prison officer in London. His experience and views on systemic racism from both perspectives are insightful.”

“Suggestion made recently is that Equality monitoring forms currently are full of racial bias.”

“Great session” “Great session thank you all” “Thank you everyone and Heather.”

“Thank you”

Overall Summary Overall the evaluation data from attendees who completed the survey and comments captured during and after the webinar illustrate that it was very successful and positively received. The aims of the webinars have been met in the following ways: To provide new opportunities for learning on a range of contemporary public health issues affecting wales The webinar provided an opportunity for delegates to increase their knowledge about the work of the First Minister’s Advisory Group on health inequalities due to COVID-19 in BAME communities and the Welsh Government response.

To develop public health knowledge amongst a wide audience The webinars are aimed at people not only working in Public Health Wales and the NHS but from a range of sectors. Despite the majority of attendees being Public Health Wales colleagues, both central and local teams, it was encouraging to see a wide range of sectors attending the webinar including representation from Health Board, Local Authority, and Third Sector organisations.

A number of delegates said that they would be disseminating the learning gained from these events to work colleagues to help inform action. Furthermore, the webinars allow for much larger audiences than our face to face seminars could accommodate. This combined with the webinar recordings and presentations being available to view via the website post event, enables the information from the day to be disseminated to a much wider audience from a range of sectors.

To share and further enhance the evidence base for public health The presentation from the webinar highlighted the current situation and some recently developed data highlighting health inequalities due to COVID-19 in BAME communities.

The presenter was keen for continued partnership working across sectors to develop and enhance some of the recent and emerging evidence to inform future practice.

Further information Further information and recordings of the webinars are available on the Public Health Network Cymru website or by contacting publichealth.network@wales.nhs.uk