Ways of Working
At Collective Action for Race Equity in Health and Social Care (CARE-HSC), how we work is as important as what we do. Our approach is rooted in collaboration, reflection, and collective care, principles that ensure our efforts to advance race equity in health and social care are inclusive, transparent, and accountable.
Our Foundations
Our approach builds on the work of the Health & Social Equity Collective, which brings together communities, researchers, practitioners, and policymakers to co-develop and embed equitable ways of working across health and care systems.
The Collective’s Delphi process was used to develop a set of guiding principles that inform how we collaborate across CARE-HSC:
INTERSECTIONAL TRAINING AND EDUCATION
CHALLENGING LANGUAGE AND NARRATIVES
CAPACITY BUILDING
EQUITABLE CAREER PATHWAYS
SHIFTING POWER
DATA ACCESSIBILITY AND TRANSPARENCY
INTERSECTIONAL TRAINING AND EDUCATION
- There is a need to advocate for and facilitate the consistent integration of knowledge about the interplay of structural and social determinants of health and social inequities (racism, homophobia, transphobia, sexism, ableism, ageism, etc.) in academic and professional training and curricula.
- There is a need to develop new, and evaluate and share existing tools, resources and methods which help communities to act to address health and social inequities, and to amplify the effectiveness of community engagement. **
- Opportunities for sharing knowledge and examples of good practice in reducing health inequities should be embedded within and across sectors, including those which are not directly related to healthcare.
- Methods for enabling community participation and partnership working should be standard elements of research, policy and practitioner training curricula.
** Community engagement means involving communities in decision-making and in the planning, design, governance and delivery of projects and services.
CHALLENGING LANGUAGE AND NARRATIVES
- When explaining health inequities, problems should be traced to social and structural systems of oppression * rather than located within affected individuals and communities.
- Health and social care staff should consider people’s intersecting social identities/positions when diagnosing and caring for people, without making presumptions and reinforcing stereotypes.
- It is important to understand and explicitly state how narratives, norms, processes and practices systematically benefit advantaged groups and inhibit change, including by focusing health inequities research on privileged as well marginalised groups.
- There is a need to amplify and acknowledge resistance, agency and everyday thriving as opposed to resilience and deficit-based perspectives when writing about and working with marginalised communities.
* (Social and structural oppression refers to a combination of prejudice and institutional power (manifested in norms, policies, processes, laws etc.) that regularly and consistently discriminates against some groups and benefits other groups)
CAPACITY BUILDING
- To foster healthier and more equitable ways of working, the capacity (e.g., time, energy, accessibility) needs of socially excluded groups should be considered prior to consultation. It is important to consult with them before designing their participation or involvement.
- There is need for higher standards and expectations from funders for inclusive and equitable practice around community involvement. Also, for funders to acknowledge that the level of commitment, resources, and flexibility needed exceeds those linked to traditional/conventional approaches.
- There is a need to achieve consensus on a framework underpinning the incorporation of community engagement and participatory approaches into research, policy, and service design. (This includes issues such as equitable working, trust-building, recognising capacity issues such as fatigue, engaging in reciprocity and sustainability of relations and initiating conversations around power and privilege.)
EQUITABLE CAREER PATHWAYS
- To ensure fair career progression for socially excluded groups, culture change initiatives are required to improve recruitment, retention and promotion. This includes providing better support in work and learning environments that are traditionally exclusionary/hostile.
- To ensure fair career progression, health and social care employers and research institutions should adopt explicit proactive measures/actions (e.g., which are anti-racist) that are subject to transparent and accountable evaluation and monitoring with clear communication on the consequences of falling short on these standards.
- To ensure fair career progression for socially excluded groups, there is a need to develop alternative career pipelines such as apprenticeships, paid internships, professional services secondments and placements, and flexible entry requirements that are equitable, inclusive and shaped around the needs of communities.
SHIFTING POWER
- Staff require appropriate support (e.g., with protected time, resource/tools, encouragement & direction) to help them ensure that their policies, practices and decisions are fair, meet the needs of, and are not inadvertently discriminating against any group(s).
- There is a need to embed monitoring and mechanisms of accountability for senior leadership/management to ensure that Equity, Diversity & Inclusion initiatives are not tokenistic but result in positive change.
- To tackle community hesitancy about collaborative research, transparency about data ownership (especially data sovereignty and governance), intellectual property, ethical standards, compensation, accountability mechanisms and the intentions of each stakeholder should be presented from the outset.
- Where possible health inequities research should involve and adequately support peer researchers (people with lived experience of the issues of interest direct and conduct the research) to help ensure research is meaningful and accessible to groups most affected.
- There is a need to provide researchers, policy makers, commissioners and service providers/designers with training, resources and skills to recognise existing expertise and skills amongst marginalised communities and to challenge hierarchies within decision-making processes.
DATA ACCESSIBILITY AND TRANSPARENCY
- There is a need to use a range of types of data and to adapt data presented to specific audiences (e.g., academic, health and social care, and community/voluntary sector) to be most impactful.
- To highlight the extent of inequity affecting marginalised groups, there is a need to mandate and/or incentivise collection of standardised & monitor quality of data on social demographics and where possible use finer-grain, more disaggregated categories relevant to local circumstances.
- There is a need for transparent evaluation of the implementation, monitoring and impact of Equality, Diversity and Inclusion (ED&I) initiatives within health and social care, education, research, funding practices and policymaking.
- Creative productions such as photography, drama, video, and public events are an effective way to document and disseminate evidence on health and social inequities.
- Creative mediums should complement traditional scientific methods in research about health and social inequity.
Our Ways of Working
We are committed to creating an environment where collaboration thrives, and everyone feels heard and respected. Our shared commitments are to:
These principles shape how we design, deliver, and communicate our work, fostering a culture of trust, inclusion, and shared learning.
Meet the Team
Find out more about the team involved in Collective Action for Race Equity in Health and Social Care