Improving the accessibility of the Newcastle Community Team Learning Disability to people from black and minority ethnic backgrounds

The aim of this research is to identify issues around the accessibility of our community team learning disability (CTLD) to people from black and minority ethnic (BME) backgrounds. We are a team of community nurses, speech and language therapists, clinical psychologists and physiotherapists working in Newcastle. Non white ethnic groups represent 6.9% of the city’s population and many staff have concerns that our services may be inaccessible to these groups. Representatives from each profession met and, with the support of a research assistant, began a study to look at ways of improving communication with service users, cultural sensitivity and flexibility.

Part 1: Audit
An audit of all referrals to the CTLD over ten years was carried out, with the aim of identifying which BME groups were being referred most often and whether referrals had increased. The audit showed a slight increase in the number of referrals from BME groups over the 10 years, however overall uptake of services from these groups was low. In 2002 only 4% of CTLD referrals came from BME groups. Furthermore, the audit revealed that referral information on ethnicity, language and religion was often incomplete or inaccurate.

Part 2: Questionnaire
A questionnaire was given to staff to investigate their knowledge and awareness of ethnicity, culture, language and religion. Forty seven per cent of staff felt that CTLD services were inaccessible to BME groups and 44% did not know which ethnic groups were commonly referred to the CTLD.

Part 3: Training
In response to the results of the audit and questionnaires, two cultural awareness training days were organised for CTLD staff covering areas including working with interpreters, working with asylum seekers and refugees, spirituality, religion and staff attitudes. The trainers included local presenters experienced in working with people from BME backgrounds and a national presenter who had expertise in the area of learning disability and ethnicity. After the training, a questionnaire was sent to staff investigating their cultural awareness and asking them to evaluate the two training days. The results indicated some improvements in cultural awareness and some evidence of the impact of the training on clinical practice, for example staff were asking service users more questions to ensure they were being considerate in the intervention and introducing the interpreter properly to the session.

Part 4: Interviews
Despite the results of the training evaluation, many staff still felt that services were inaccessible and that this issue needed to be investigated further by talking to local people from black and minority groups. The final part of the project involves in-depth interviews with:

• approximately 15 CTLD service users or their parents/carers from BME groups, including people who do and do not use interpreters,
• approximately 15 individuals or their families from BME groups who are eligible to access CTLD services but who are not doing so
• approximately 10 CTLD professionals who work with BME groups
• approximately 10 local professionals who work with BME groups.

Interview questions were developed following a focus group held with individuals from a variety of local BME communities. It is hoped these interviews will identify ways in which the CTLD can improve its accessibility and offer a more sensitive, person-centred and flexible approach to working with people from BME groups.

We are currently in the process of interviewing CTLD service users and their families as part 4 of the research. Initial findings from the interviews have shown that families who speak English are relatively happy with the accessibility of CTLD services. However, we expect that interviews with service users and families who do not speak English and with those who are not using services will highlight issues around accessibility. An article which gives further details of the results of parts 1-3 of the study has been submitted for publication. For further details on the article or for more information on the research please contact:

Amy Hebblethwaite, Alison Woods, Anne Stokle or Annette Hames
Community Team Learning Disability
Benton House
136 Sandyford Road
Newcastle upon Tyne
NE2 1QE
0191 2106868
Email: amy.hebblethwaite@nap.nhs.uk