One size does not fit all: Moving towards delivering culturally competent services

Our latest report, looks at the impact of Coronavirus on local Black, Asian and Minority Ethnic communities across Enfield.
Graphic image of a microscope

As the saying goes ‘one size does not fit all’ and a key lesson from this report is that specific community groups used different services in different ways and as a result had different views about the support they need. It is also clear that the existing methods of cascade with a strong reliance on online communication do not work for everybody in Black, Asian and Minority Ethnic (BAME) groups.

A common issue is the lack of trust in the system, based on people’s previous experiences of giving feedback, only to see no action resulting from their efforts.

Over half the people we surveyed from BAME groups in Enfield said that they have not received the help and support they needed during the coronavirus pandemic. This sobering statistic is just one of the key findings from the work we did with individuals from BAME communities during September and October this year.

Emerging issues

  • 54% said that they have not received the help and support they need.
  • A significant proportion of respondents prefer to access information through television or radio in their own language. 
  • 1 in 10 people told us that accessing services online had stopped them from getting the help they need. 40% told us that English is not their first language.
  • 30% said that they need a translator to communicate during health appointments, so using a telephone to do this was a problem for them.
  • 53% of people reported that they would not be having the flu vaccine this year, and their comments gave us clear reasons for this decision.


Based on our findings, our report makes six recommendations to ensure that individuals from BAME communities in Enfield are able to access the care and support they need in the future.

  1. There is a need to develop and invest in culturally competent research which is informed by communities and address areas of concern to them.
  1. More work is needed to draw on good practice so that we become more successful in providing help and support to BAME communities.
  1. There is a need to link with community radio and television to improve our reach in some BAME communities. We have made a start towards collecting contact information for community media channels.
  1. There is a need to audit the take up of translation services in relation to primary care access in order to assess if further action is required to promote these services.
  1. There is a need to consider steps which can be taken to remove the digital/language barriers to accessing GP services.
  1. There is an urgent need to address BAME concerns and build confidence about the vaccines including the flu vaccine.

We are keen to discuss these recommendations with local service providers to ensure that the voice of local BAME residents helps to shape future planning of services. We will share this report with the Enfield Integrated Care Partnership to facilitate this discussion.

195 individual people from BAME communities took time out of their day to speak to Healthwatch Enfield. We want to work with anchor institutions so that we can improve access to commissioned services.

We will also try to contact the groups from whom there was little response.  Links are already being established with Eastern European communities.

We are grateful to Enfield Racial Equality Council (EREC) and Enfield Caribbean Association (ECA) for partnering with us in this work to reach out to local communities.

Download our report

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