Macmillan Equity, Diversity and Inclusion Conference 2023
Dr Anthony Cunliffe shares some key learnings from the Macmillan Equity, Diversity and Inclusion Conference 2023. The conference brought together healthcare professionals and system leaders to hear from people from marginalised communities with lived experience of cancer, as well as from the organisations advocating and championing for equitable care for these groups.
Understanding the scale of health inequity
As healthcare professionals, we are beginning to better understand the scale of inequity in healthcare, both in cancer care and more broadly across the system.
"It is crucial to ensure that the messages we hear from people experiencing inequity are heard by all the right people"
Through data and hearing directly from those who have been impacted, we know that people from under-represented populations find it harder to both access the health system and tend to report a poorer experience of care. Much work needs to be done across the system, in order to address this; one vital element being developing a robust understanding of the complex reasons driving these inequities. Without hearing from under-served groups themselves we can only make best guesses as to why people are reporting these experiences which means we cannot start to successfully address the issues and drive tangible changes that can lead to improved care.
However, it is also crucial to ensure that the messages we hear from people experiencing inequity are heard by all the right people, one fundamental group being both healthcare professionals and leaders in the health system that are in a position to implement the changes that are needed.
Bringing people together to listen and learn
Recognising this need, the London Macmillan team decided to host a conference bringing together healthcare professionals and system leaders to hear from people from marginalised communities with lived experience of cancer about their individual experiences, as well as from the organisations advocating and championing for equitable care for these groups.
Amazing organisations including Black Women Rising, OUTpatients and the Baked Bean Company gave their time to highlight the challenges faced by the people they advocate for and brought an enormous amount of insight to over 150 medical professionals, many of whom are unlikely to have heard these messages spoken so profoundly and authentically before. People with cancer also generously joined an incredibly moving and thought-provoking panel session sharing their own stories of the obstacles they faced.
The health care system has a long way to go on its journey to drive out the inequities highlighted during the conference, as well as many others that there wasn’t the time to cover. I hope conferences like this can act as seeds for change so that all people can have the high-quality experience of healthcare that they are entitled to.
Throughout the conference, there were some particularly poignant discussions that provoked some key learnings for me:
1. The importance of really listening
Unless we make time to engage and build trust with people who have faced obstacles and challenges in their healthcare due to their ethnicity, sexuality, gender expression, disability or any other characteristic that identifies them as a marginalised group, we will never truly understand what needs to change and the status quo will remain.If we do listen and genuinely analyse the problems people are experiencing, we not only can start to break down the negative root ideas that those of us working in the system may be unconsciously holding, but also scrutinise the ways in which pathways and structures in healthcare are leading to poorer experiences and outcomes for people from underserved populations.
2. Healthcare professionals need training
There was a strong consensus from those attending on the day that the training healthcare professionals (HCPs) receive both during the undergraduate process and whilst in role, falls far too short of enabling us to truly understand the inequities that exist, why they exist and the different experiences and support that every individual may need and is entitled to ensure personalised care is at the heart of their healthcare experience.There was a palpable appetite that there should be structured and regular educational opportunities for all HCPs, irrespective of role or care setting, that highlight the myriad of ways that people from many underserved populations are deprived of both equitable access to and a positive experience of health and social care, with tangible solutions for steps we can all take as individuals to address it.
3. Conversations aren’t always easy
If we want to be sincerely open to hearing what isn’t working and strive for equitable care for everyone, then challenge is essential and, by definition, challenge isn’t always easy. Unless we are willing to allow ourselves to feel uncomfortable and then take time to reflect on that discomfort, then it is less likely that it will lead to action. The importance of these issues demands that we allow ourselves to be provoked, that we own our lack of true understanding and that we use the emotions that this triggers in us to drive positive change.4. The responsibility to drive change falls to everyone working in the health and social care system
The stories we heard from people living with cancer highlighted issues from individual encounters with HCPs to wide-spread, systemic problems. This means that change has to happen at every level and by owning our own role and culpability as part of the wider system, we can start to lever change from the ground up.By taking advantage of opportunities like conferences and professional development opportunities, we can start to better understand and challenge the status quo in healthcare. By taking enlightenment back to colleagues and teams, we can start to share the learning, role-model this in practice and use our influence within the organisations in which we work to drive institutional change.
5. Getting together face to face to listen, hear, learn and network is invaluable
In the post-pandemic world so much has moved online and so many occasions have become virtual experiences. I was reminded that gathering together in person really is a very different experience and can generate different thinking and discussion, as well as leading to new connections and networks that are essential to bringing about change. And for issues like this, as long as we can ensure environments are safe and accessible for all, we should consider when enabling the possibility of convening in person may be fundamental to the objectives of an event.
Learning Hub resources for your role
If you are interested in enhancing your knowledge in reducing inequities in cancer care the Learning Hub has several key digital learning resources available which include:
- Reducing inequities in cancer care for LGBTQ+ communities - includes webinars exploring barriers to screening, and looking at how good is our care for LGBTQ+ young people.
- Developing cultural competence e-learning programme - aims to equip professionals and the wider workforce with skills and knowledge to understand more about culture and how it shapes peoples' beliefs and attitudes towards cancer, to help support people across all cultures living with or affected by cancer.
Visit the Learning Hub to access these courses.
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