News

 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 support.(2)

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 services.

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.

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 minorities.

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 professionals.

Abstract
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.

References
(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 author.

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