Haref: Cultural Competency Training and Haref Allies Membership

Draft Principle: Develop the Workforce for inclusion Health

Organisations involved:

Haref strives for health equity for ethnically marginalised communities in Newcastle and Gateshead.

Our Haref Network is made up of over 80 community organisations working with ethnically marginalised communities in Newcastle and Gateshead. As a network we identify barriers to good health, come together to be a stronger voice and work in collaboration, identify ways to be involved in research, and work with local health services.

Information from the Network feeds into the work we do with our Haref Allies, health and wellbeing service providers working in Newcastle and Gateshead. We work with our Haref Allies to improve their understanding and confidence to work with diverse communities, supported by our Cultural Competency Training. We share good practice and information about health, research, and local events through our monthly Haref Bulletin, which has over 850 subscribers.

Haref is a service area of Connected Voice, the infrastructure organisation for the VCSE sector across Newcastle and Gateshead.

The challenge:

Our focus at Haref is on health equity for ethnically marginalised communities and refugees and people seeking asylum. We know members of these groups often face inequalities in health from accessing health services, receiving accessible health information, registering at GPs, receiving culturally competent care, and experience inequalities in the wider social determinants of health.

We look at the issue of health equity from many perspectives but in this case study we are focussing on the challenges of cultural competency in health services, providing training for health and wellbeing services to improve service delivery for diverse communities, and connecting health services and community groups together to build stronger relationships.

We try to influence change across many levels, from individual practitioners to changes in policy.

The approach/solution:

Cultural Competency training:

We deliver Cultural Competency – working with ethnically marginalised people in health settings to increase cultural sensitivity in the workforce and raise understanding for practitioners of the barriers to achieving equitable outcomes.

This is funded by Newcastle Public Health and we are able to deliver this training to health and wellbeing service providers (both statutory and VCSE) for free in Newcastle. We also deliver our Cultural Competency training on a paid-for basis both regionally and nationally.

Connected Voice’s Haref Network provide lived experience of barriers to achieving health equity in the training both in the form of short videos incorporated into the training and generally informing the content. This brings the training to life as it is relevant, local and in real time.

Haref Allies:

In 2022, we developed the Haref Allies membership in consultation with health services to strengthen our current work, engage better with health services, and forge stronger links between the Allies and the Haref Network. Our annual membership fee is kept deliberately low to ensure cost is not a barrier, but increases commitment to the issues we are tackling.

Between May 1 2022 and April 30 2023, 111 Allies from 60 organisations joined. From May 2023 we already have had 28 Allies renew their membership.

Allies meet throughout the year. At Allies meetings we bring information from the network and invite network speakers to share information about communities and their health needs. Allies meetings are themed around the network’s health priorities and we ask the Allies to work together to develop solutions and ideas.

By becoming members, our Allies pledge to:

• Support the Haref Network, and respond with solutions to the experiences of ethnically marginalised communities accessing health services
• Commit to improve health and wellbeing services for ethnically marginalised communities in Newcastle and Gateshead
• Support other Haref Allies to improve their service provision and share good practice for service delivery

Examples of these pledges in action are:

• Setting up and facilitating health information sessions on topics requested by the Network and delivered by the Allies (i.e. mental health support, navigating the NHS for new arrivals, providing health checks) along with running good practice sessions with Allies on how best to run health information sessions.
• Working with the Allies and the Network to develop a public leaflet on peoples’ rights to an interpreter in health settings.
• Facilitating external partner training for the Haref Allies on issues such as how to work better with interpreters in a work setting.

Required Cultural Competency Training

Allies are required to complete Cultural Competency training within 6 months of signing up for membership to encourage health and wellbeing services to deliver their service information in culturally sensitive ways.

We offer additional internal training such as: ‘Best practice on delivering health information’, ‘Understanding the Causes of Health Inequalities’, and direct them to external training from our partners.

Insights and Impacts:

Total number of health and wellbeing practitioners delivering services in Newcastle who received cultural competency – working with ethnically marginalised people in health settings as part of the public health contract:

1 Aug 2021 to 31 July 2022: 301

1 Aug 2022 to 5 June 2023: 211

94.6% of participants feel their confidence has increased following the course.

What People Said:

Quotes from Allies

• ‘Being a part of that network brings integrity and quality to our work. It makes our involvement work meaningful. We have been able to do outreach. Haref is brilliant at introducing people. They speed up the process. They are like a trusted bridge. They help organisations think about how they work with communities in a meaningful and accessible way’
• ‘The Allies and Network, that makes so much sense. The building up of the network and Allies is useful, and can be built on as an organic progress. Things can spin off from communication between organisations.’

Quotes from Cultural Competency Training Evaluation

• ‘The course was great, a good mix of information as well as discussion. I feel this has prompted myself, and in turn our organisation to consider and take action on ways we can improve our work with ethnically minoritised communities and in removing barriers to using our service. I appreciated the experiences that were shared as well. Thank you for the course.’
• ‘The video clip in particular highlighted the sheer number of issues which people face any one of which can lead to them having a poor experience’.

Tips for Success:

The facilitator attends all Network meetings and incorporates the key concerns of the Network into the session delivery. This makes this Cultural Competency unique as it is local, relevant and continually evolving. Participants really appreciate this and can connect it directly to their service provision. We work collaboratively so there is a feedback loop from the Allies and Network officer, research that we are involved with, and key health information from the Health Equity and Inclusion Lead.

The training facilitator brings over 12 years’ experience working in Newcastle through health-funded third sector projects. This has enabled quality service-specific facilitated discussions and a problem-solving focus when delivering directly to organisations, enhanced by knowledge of services in the Locality.

The learning outcomes are measurable through the evaluation process and consistently achieved:

• Explore what do we mean by culture?
• Understand the diverse and intersecting characteristics of local communities
• Develop skills to identify barriers to accessing services
• Recognise good practice
• Feel more confident in working with different communities

The Allies membership is promoted through the training and our social media and website. Frequently, a participant will attend the session, enquire about Allies membership post course and request session delivery to their whole organisation. This has led to a wait list for delivery and regular signups for Allies membership as the model is gaining traction.

What’s Next?

This year we will start offering skills-building sessions outside of regular meetings, focussing on a key area for concern for the Network. The first session will be on best practice in health services for access to interpreters and translators. We hope this will encourage services to work together to build capacity to offer a holistic approach to tackling health inequalities locally.

We will continue to expand the Haref Allies to other health services in Newcastle and Gateshead. We do this by attending conferences and events, delivering presentations in order to raise the profile of the Haref Allies membership, as well as following up on all new leads and introductions presented to the Allies officer. We actively look out for new services and organisations to sign up and directly approach them.

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