Progressing the Patient and Carer Race Equality Framework – Improving mental health care for racialised communities

Last Autumn, NHS England launched the Patient and Carer Race Equality Framework (PCREF) to support mental health Trusts and providers improve experiences of care for racialised communities by embedding new practices to promote anti-racism. All mental health providers must implement the framework by March 2025 and it will become part of the CQC inspection process.

As it is Mental Health Awareness Week this week, we have been reflecting on the progress we’ve made in the last few months since we officially launched PCREF. Our two organisations have been working together to progress the roll out of the framework and formally embed its components into our work.

One of the key developments, announced in March, has been the inclusion of a new clause in the NHS Standard Contract to state that implementing the PCREF is a mandatory requirement for providers of mental health services. Trusts and mental health providers are expected to have a nominated lead at board level to drive forward and embed a local PCREF plan which encompasses the three core components (leadership and governance, organisational competencies, and patient and carers feedback mechanism).

As well as this, the development, implementation, and review of local PCREF plans must be done in equal partnership with racialised and ethnically and culturally diverse communities. This of course will be taken into account by CQC as part of the assessment process, to make sure providers are implementing the framework in their services. As we discussed in a recent blog on PCREF, it is vital that PCREF sits firmly within the single assessment framework.

CQC have produced initial guidance and learning for regulatory colleagues, and are in the process of developing full guidance on PCREF which we hope to publish later this year. This will detail how we will assess how providers are implementing the framework. In the meantime, we will continue to encourage and support services to embed the approach through our regulatory activity.

A huge part of the work at NHS England to roll out PCREF has been the testing we have done with our pilot trusts. This began in 2020 with four mental health Trusts (South London and Maudsley NHS Foundation Trust, Birmingham and Solihull Mental Health NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, and East London NHS Foundation Trust) and has progressed to where we are now – working with 13 trusts across England to test how the framework will work across different service areas and for different racialised communities. We have also started working with integrated care systems and regions on this agenda as they ascertain what role they will play in supporting mental health providers in their area to implement the PCREF.

Two trusts have come on board since the launch in October – Black Country Healthcare NHS Foundation Trust and Oxford Health NHS Foundation Trust. Over the last few months, colleagues at Black Country Healthcare NHS Foundation Trust have made great progress by embedding PCREF into their quality and safety governance structures and starting to develop a community collaborative.

Working collaboratively with communities is one of the most important parts of implementing PCREF and looks different for all trusts as it depends on the diversity of their local populations. Our ‘early implementers’ have shown us what is possible when we listen to local communities and work with them to deliver care that is culturally appropriate, trustworthy and meets their needs. It’s great to have more and more providers start this journey as we continue to enhance the participatory approach of the PCREF.

We look forward to updating you on the progress of implementing PCREF and how CQC and NHS England continue to work together on this. You can find out more here.

Jacqui Dyer

Jacqui Dyer is an independent health and social care consultant with a background in adult mental health commissioning as well as community and family social work.

Jacqui has worked with a wide range of vulnerable care groups and has a strong passion in grass roots community empowerment. As an experienced counsellor, trainer, personal and professional development coach and group facilitator, Jacqui brings many dimensions to her insights.

As a mental service user and carer for the past few decades Jacqui’s experiential knowledge of mental health services is extensive and her commitment to this agenda is personal, political and professional. Currently she is a senior management board lived experience advisor for the ‘Time To Change’ anti-stigma and discrimination campaign. Additionally Jacqui was an appointed member of the Ministerial Advisory Group for Mental Health chaired by the Minister for Care and Support, which oversaw the implementation of the national mental health strategy and a member of the Ministerial Advisory Group for Mental Health.

Jacqui was vice chair of England’s mental health Taskforce, which collaboratively developed the 5 Year Forward View for Mental Health. Jacqui is currently the Mental Health Equalities advisor for NHS England and co-chairs the Mayoral ‘Thrive London’ programme.

Jacqui is also an elected Lambeth Labour Councillor where she is cabinet member for health and adult social care and is the chair of Lambeth’s Black Thrive; a partnership for improving black mental health and wellbeing.

Jacqui is also an advisory panel member of the Mental Health Act Review and co-chair of its African & Caribbean Working Group (MHARAC).

A profile photo of Chris Dzikiti - Director of Mental Health

Chris Dzikiti joined Care Quality Commission in October 2022 as Director of Mental Health, following time as a Deputy Director for National Retention programme at NHS England. Previously Chris has also worked as a Programme Director leading on mental health transformation in London. Chris is a multiprofessional leader, registered mental health nurse and an experienced programme and project management professional with 20 years’ experience of working in healthcare transformation, delivery and commissioning.
Between 2017 and 2021, Chris was a Global Healthcare Consultant for Health Education England in India, providing technical support for Mental Health Services there.
He is also a published author, having contributed a chapter on psychiatric intensive care to the book Psychiatric and Mental Health Nursing – The Craft of Caring. Chris is passionate about coaching and mentoring colleagues and young people from a Global majority background.