World Statistic Day - Ethnicity Recording

In the Community Development Service here at Touchstone we aim to achieve a greater understanding and ownership of mental health issues facing Black and Minority Ethnic (BME) communities in Leeds.
For World Statistics Day on 20^th October, John Halsall, Community Health Development Analyst, has written the first in a series of data blogs. Please take a few minutes to take a look
Mental health services do not report ethnicity for one in eight service users across England
In June this year, a valid ethnicity was not reported for almost one in eight (12.1%) of all the people who used specialist mental health services in England, according to figures published by the Health & Social Care Information Centre (HSCIC)¹. Specialist or secondary mental health services include those provided by community mental health teams, clinical psychologists, psychiatrists, and mental health wards, often following referral by a GP or a crisis assessment.
Reporting a valid ethnicity for a service user involves:

Asking the service user their ethnicity;
Recording the service user’s response using one of the NHS national ethnic category codes² or using the more detailed categories developed by the Office for National Statistics³ (your service’s information system should help you to do this);
Each service reporting the responses using the NHS national ethnic category codes².

Commissioners, statutory and third sector providers and community groups need diversity information to be sure that mental health services are reaching all parts of the community. Relatively high rates of use of services by a community may mean that services or support can be provided better in different ways or that the causes can be identified and addressed. Diversity information also enables agencies to identify gaps in services, and trends to inform future service developments.
Public authorities have a duty to monitor ethnicity under the Equality Act 2010.
Asking service users for diversity information is also an opportunity to celebrate who they are.
Yet we know that across England, significantly higher fractions of some black and minority ethnic communities used specialist NHS mental health services than did the white British population^4,5 (chart 1).
Chart 1⁴

That’s another reason why it’s important for mental health services to record and report the ethnicity of all their service-users.
Some services are better than others at recording ethnicity
The figures for June 2015¹ published by the Health & Social Care Information Centre show that:

16 providers of NHS specialist mental health services reported a valid ethnicity for more than 95% of their service users.
Yet 8 providers reported a valid ethnicity for less than 80% of their service users, meaning that they may not have known the ethnicity of one in five of their service users.
The completeness of ethnicity reporting by each provider during June 2015 can be found in THIS excel summary table, and also in a detailed table in the data quality report available at reference one¹.

What actions can service providers take to improve?
Some service providers need to improve their recording of the ethnicity of their service users.
Directors and senior managers need to take the lead on this.
What needs to be done depends on the circumstances in each service team:

Training may be needed in the importance of recording diversity information, and how to do this confidently.
Who is responsible for recording diversity information about each service user may need to be made clear.
Recording systems may need to be improved.

Service providers can also use their records of the diversity of their service users to inform decisions about how to improve services and who to consult about the accessibility and appropriateness of services.
Top tips for staff:

If a colleague is recording diversity information well, then ask them how they do it.
Don’t assume you can tell a person’s ethnicity or age or gender or religion or sexual orientation from their appearance. The only way to know for sure is to ask them.
For each diversity question, give the option “Prefer not to say” at the end.
If you are not sure why it is important to ask all service users for diversity information, then ask a colleague or ask your manager.
Explain that your service will keep diversity information confidential, and explain why you are collecting it (as discussed above – to check that our service is reaching all parts of the community).

Resources

In Leeds and Yorkshire, the Touchstone Community Development Service can offer training to mental health service teams on the importance of recording diversity information and how to do this confidently. Email us on cds@touchstonesupport.org.uk, or call us on 0113 248 4880.

‘What’s it got to do with you?’ – Stonewall gives reassuring guidance for people concerned about completing monitoring information http://www.stonewall.org.uk/media/current_releases/3491.asp

Look out for the next data blog on our webpage in November.
Contact
John Halsall
johnh@touchstonesupport.org.uk
Community Health Development Analyst
Touchstone Community Development Service
Telephone 0113 248 4880
References

Mental Health and Learning Disabilities Statistics (MHLDDS) monthly report: Provider level data quality measures – June 2015 Final, Health & Social Care Information Centre, 22^nd September 2015 http://www.hscic.gov.uk/catalogue/PUB18473

NHS Ethnic Category Code, Health & Social Care Information Centre http://www.datadictionary.nhs.uk/data_dictionary/attributes/e/end/ethnic_category_code_de.asp?shownav=1

Ethnic Group, Office for National Statistics http://ons.gov.uk/ons/guide-method/measuring-equality/equality/ethnic-nat-identity-religion/ethnic-group/index.html#15

Presentation of Ethnic Group Data, Office for National Statistics http://www.ons.gov.uk/ons/guide-method/measuring-equality/equality/ethnic-nat-identity-religion/ethnic-group/presentation-of-ethnic-group-data.html

Mental Health Bulletin, Annual Report From MHMDS Returns – 2013-14, Health & Social Care Information Centre, 27^th November 2014, figure 1.7 http://www.hscic.gov.uk/catalogue/PUB15990