Poorly served

 For 20 years, people with learning difficulties from ethnic
minorities in the UK have experienced insufficient and inadequate
services, despite sometimes desperate levels of need.(1) Recent
policies and legislation have raised expectations that learning
disability partnership boards will remove discriminatory barriers
preventing anyone from having access to high quality

Department of Health initiatives to help partnership boards meet
these expectations include a framework for action, leadership
training courses, prioritising ethnicity for learning disability
development fund spending, and national and regional networks for
services to share good practice.(3)

Despite these initiatives, there are questions about whether all
services are seriously committed to eradicating the inequalities
experienced by people with learning difficulties from ethnic
minorities. For example, the director of the Valuing People support
team has recently highlighted ethnicity as a key priority for
service improvement.(4)

To inform a report on ethnicity for the DH minister for community,
the Valuing People support team funded a national survey of all
learning disability partnership boards in England, conducted
between December 2004 and February 2005.

Partnership boards varied massively in their commitment to
improving services for people from ethnic minorities. Only half of
the 82 partnership boards responded, although the survey came from
the director of the Valuing People support team and stated that the
findings were to inform a report requested by a DH minister.

Some responding boards stated that strategic planning to meet the
needs of people from ethnic minorities was a low priority. This was
often in localities where few people from ethnic minorities were
known to, or were slotted reactively into, existing services or
where information systems were not seeking to identify or
accurately record people’s ethnicity.

In these areas, people with learning difficulties from ethnic
minorities are likely to have many unmet needs, be unaware of
services and how to gain access to them, and be offered services
that are far from person-centred or culturally relevant. It is
unclear how these partnership boards can claim to be fulfilling
their legal duties under the Race Relations Amendment Act 2000 to
eliminate unlawful discrimination, promote equal opportunities and
promote good race relations. Worryingly, few boards mentioned
taking action to meet these legal requirements.

About three-quarters could provide detailed information on the
ethnicity of people with learning difficulties known to local
services, although fewer partnership boards (46 per cent) could
provide estimates of the expected population of people with
learning difficulties in their locality. Where partnership boards
provided this information, white people tended to be
over-represented and south Asian people under-represented within

Electronic databases were reported to be the most useful source of
information, as long as they were integrated across services and
staff recorded information comprehensively. Having dedicated
workers to gain information from people from ethnic minorities and
to maintain the database were essential in obtaining quality

Information seemed to be such an important issue that many boards
were focusing on collecting better information through research
projects before developing strategic action plans or changing
services. It is important that once these initial research projects
have been completed, agencies develop reliable information systems
to routinely provide accurate information on ethnicity, religion,
and spoken or written languages.

Just over half of partnership boards had changed the way they
worked to address ethnicity issues, most commonly by setting up an
ethnicity subgroup, appointing an ethnicity champion, or increasing
the number of members from ethnic minorities, including staff,
local organisations and users or carers. Many boards also reported
that they had developed strategies to improve services for people
from ethnic minorities, although these were mainly focused on
gaining information and writing strategy documents rather than
changing the way services worked.

Almost a quarter spent an average £19,000 of their Learning
Disability Development Fund allocation on improving services for
people from ethnic minorities, most commonly on funding development
workers and training staff. 

Examples of good practice provided by partnership boards revealed a
narrow range of activities undertaken with people from ethnic
minorities. Most frequently mentioned examples of good practice
concerned making themselves more effective, gaining information,
supporting family carers, promoting advocacy, day service
modernisation and increasing workforce diversity. But five or fewer
boards mentioned good practice concerning important aspects of
people’s lives, including children, transition, education or
lifelong learning, employment, benefits, a place to live, health,
person-centred planning, direct payments, or leisure, friendships
and relationships.

Many seemed to be at the beginning of a cycle of improvement,
involving gaining information, improving partnership board working
and developing strategies. These boards need to build on this to
develop a broad range of service supports if meaningful changes are
to happen in the daily lives of people with learning difficulties
from ethnic minorities.

Most boards mentioned obstacles to improving services. Although
some reported that a lack of staff time and a lack of resources
were obstacles, similar numbers mentioned organisational obstacles
such as competing priorities, a lack of organisational commitment,
the operation of boards, and problems in staff recruitment,
training, retention and promotion. Other obstacles concerned the
nature of the locality, for example large rural areas with
scattered ethnic minority communities that resulted in difficulties
in working strategically.

Partnership boards in different areas may require specific
information and support depending on locality. For example, an
urban unitary authority with well-established and substantial
ethnic minority populations and a large rural authority with
scattered ethnic minority communities may need different strategies
to identify and support people with learning difficulties from
ethnic minorities.

From their responses to this survey, some boards are making
progress. But a worryingly large number of partnership boards do
not view improving services for people from ethnic minorities as a
high priority, resulting in a lack of strategic leadership and
action. While recent initiatives have been successful in helping
many boards make progress this is not universal, with some seeing
removing discriminatory barriers as an optional extra that is
irrelevant to them.
If we don’t want to be reading articles like this in 20 years’
time, all partnership boards and we as individuals need to accept
our legal and moral responsibility to do what we can to remove
discriminatory barriers wherever we find them.

Chris Hatton is professor of psychology, health and
social care at the Institute for Health Research at Lancaster
University. He has been involved in research with people with
learning difficulties for more than 15 years, with a longstanding
interest in improving services for people from ethnic

Training and learning
The author has provided questions about this article to
guide discussion in teams. These can be viewed at www.communitycare.co.uk/prtl
and individuals’ learning from the discussion can be registered on
a free, password-protected training log held on the site. This is a
service from Community Care for all GSCC-registered

Learning disability partnership boards have a
responsibility to eradicate the discriminatory barriers to services
experienced by people with learning difficulties from ethnic
minorities. A national survey of partnership boards reveals that
progress has been slow and some boards view people from ethnic
minorities as a low priority.

(1) G Mir, A Nocon, W Ahmad, and L Jones, Learning
Difficulties and Ethnicity, Department of Health, 2001
(2) Department of Health, Valuing People: A New Strategy for
Learning Disability for the 21st Century, The Stationery Office,
2001; and Home Office, Race Relations (Amendment) Act, The
Stationery Office, 2000
(3) Valuing People support team, Learning Difficulties and
Ethnicity: A Framework for Action, DH, 2004; and Association for
Real Change, The National Learning Disabilities and Ethnicity
Network Newsletter, No 5, January 2005
(4) R Greig, The Story So Far.., Department of Health, 2005

Further information
This survey was funded by the Valuing People support team,
but the views expressed in this article are those of the

Contact the author
E-mail: chris.hatton@lancaster.ac.uk

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