The ability of primary care trusts (PCTs) to understand the health needs of ethnically diverse communities and improve access to services is being undermined by a lack of data about who uses which NHS services, according to an audit published today (Friday 22 June) by the King's Fund.
As part of their Race Equality Scheme (specified by the Race Relations Amendment Act 2000), PCTs should publish their assessment of local health needs and explain how their services are structured to meet them.
But an audit of published Race Equality Schemes found that many PCTs are hampered by poor data about the ethnicity of those people who use services in their area, including in GP surgeries.
More than half of the Race Equality Schemes recognised the importance of monitoring the ethnicity of patients who use primary care services, but only 13% referred to initiatives or pilot projects to gather information about patients registered with GPs.
The research was conducted between March and August 2006, before the number of PCTs was reduced by half from 303 to 152. All types of NHS trusts (primary care, acute, mental health and care trusts) should have published, by May 2005, a second edition of a Race Equality Scheme to cover the period 2005–08. One third of the websites did not list a Race Equality Scheme, while others had out-of-date schemes.
King's Fund chief executive Niall Dickson said: "This audit highlights just how far away we are from tailoring services to individual needs. We will only achieve better commissioning competency when we have accurate data about patients and patient outcomes.
"There is a need for improved data collection and analysis so we can see if needs really are being met and inequity tackled. This will require action at both local and national level, and we know that the Department of Health is considering this issue."
Ruth Thorlby, King's Fund Fellow in Health Policy who conducted the audit said: "We wanted to find out what PCTs in England are doing to address any inequalities that patients from minority ethnic communities may be experiencing in accessing the NHS.
"A few PCTs have been very active in trying to meet local needs. But PCTs have run up against the problem of lack of data, particularly at the level of GP practices. There needs to be an agreed point at which patients are asked about their ethnicity, and a means whereby that data is brought together coherently.
Without that, it is not possible to measure who is accessing, or not accessing, a particular health provision. We must reopen the debate about what ethnic monitoring is needed in primary care. We need to ask how it should be done and who will pay for it," Ruth Thorlby concluded.