Engagement about the Health and Social Care Needs and Experiences of Black and Minority Communities on behalf of Healthwatch Worcestershire

This report summarises engagement work undertaken by Age UK Herefordshire and Worcestershire on behalf of Healthwatch Worcestershire to understand the health and social care experiences of Black, Asian and Minority Ethnic (BAME) communities across the county. The project aimed to identify concerns, improve understanding of service users’ experiences, and encourage greater involvement of BME communities in Healthwatch activities. 

Between August 2014 and March 2015, over 500 individuals were contacted and 10 awareness and engagement sessions were held across Worcestershire. The engagement involved a wide range of communities, including South Asian, Bangladeshi, Caribbean, Chinese, Filipino, Gypsy Roma Traveller (GRT), migrant worker, and mixed ethnic groups. A total of 276 people directly participated in engagement activities. 

The report found that most participants had not previously heard of Healthwatch Worcestershire. While many people valued the NHS and felt fortunate to have access to healthcare services, there was also a perception among some communities that health and social care services had let them down in the past. Participants welcomed the idea of an independent organisation helping to amplify their voices and improve services. 

A major theme was difficulties accessing GP services. Participants reported long waits to see their preferred doctor, challenges obtaining same-day appointments, difficulties getting through on the telephone, and frustration with online booking systems that were difficult to use for people with limited digital skills. Many people felt that continuity of care and being able to see the same doctor were important for building trust and confidence.

Communication barriers featured strongly throughout the findings. Some older people with limited English relied heavily on family members to arrange appointments, interpret information, and accompany them to healthcare visits. Participants felt that these barriers could delay diagnosis, treatment, and access to services. There were also concerns that some patients did not fully understand treatment instructions because of language difficulties.

Several groups expressed discomfort about being asked personal medical questions by reception staff when booking appointments. Some participants felt these questions were intrusive and preferred to discuss health matters only with clinical professionals. Others reported dissatisfaction with long waiting times at surgeries even when they arrived on time for appointments.

Mental health support was also raised as an area of concern. One participant described difficulties obtaining timely help for a family member experiencing mental health problems and reported feeling isolated and unsupported. More generally, some participants felt unable or unwilling to make formal complaints about poor experiences. 

Transport difficulties were another recurring issue. Many participants, particularly those from rural areas and Gypsy Roma Traveller communities, reported challenges travelling to hospitals and specialist appointments. Limited public transport, long travel distances, mobility issues, and inconvenient appointment times all created barriers to accessing care. 

Cultural and religious considerations were important for some communities. Participants highlighted situations where requests for female healthcare professionals had not been accommodated, particularly during maternity care and surgical procedures. Some individuals felt that healthcare providers did not always understand or respect cultural and religious preferences. Concerns were also raised about the use of post-mortem procedures and support for culturally appropriate alternatives. 

Dental services were reported as difficult to access in some areas, with some participants travelling significant distances to find an NHS dentist. One member of the Gypsy Roma Traveller community reported a particularly negative experience that left them fearful of returning to dental services. 

Migrant workers reported different experiences. Temporary workers often did not register with GPs and instead relied on pharmacies or employer support if they became ill. Some said they preferred to travel to larger cities such as Birmingham or Coventry for private healthcare where practitioners could speak their native language and better understand their culture. 

In relation to social care, participants felt there was insufficient understanding of cultural differences, family structures, and language needs. Some families reported receiving written information only in English despite known language barriers. Others felt that care workers lacked cultural awareness and did not always deliver care in ways that reflected family preferences and expectations. Concerns were also raised about late visits, short appointment durations, poor communication, and failures to document incidents appropriately. 

A strong finding was that very few participants had ever made formal complaints about health or social care services. Reasons included lack of awareness of complaints procedures, language barriers, concerns about stigma, immigration-related worries, and a belief that complaining might negatively affect future care. 

The project achieved increased engagement with Minority Ethnic communities, exceeding targets for people receiving Healthwatch information and reporting experiences of services. However, there was little interest in volunteering, with participants often citing family commitments and limited time. The report concluded that Healthwatch Worcestershire would need to demonstrate tangible improvements and provide feedback on action taken if it wished to build trust and sustain long-term engagement with minority ethnic communities.

Overall, the report found that while minority ethnic communities generally valued health and care services, they experienced barriers relating to language, communication, cultural awareness, transport, access to healthcare, and confidence in raising concerns. It recommended that Healthwatch use these findings to strengthen its understanding of minority ethnic communities and improve their influence over the design and delivery of local services