R&D Equality, Diversity and Inclusion

2020-21

• The Global COVID-19 pandemic, heightened media attention around social injustices, and a recognised lack of minority group representation in organisations made us recognise the need to act as a department to address Equality, Diversity and Inclusion (EDI) issues.
• Our staff began having conversations about how we could challenge structural racism. These conversations were fully supported by our management. 
• The Reflections of Racism group was formed in the department as a safe space for ethnic minority staff to discuss ways that the department could become a more inclusive place to work. This group was widened to become the EDI Bubble.
• The EDI Bubble was created as a forum for R&D staff to collaborate towards integrating EDI within our work.  

2021-22

Our conversations about EDI led to being awarded funding by the National Institute for Health and Care Research Clinical Research Network for the West of England to support three new roles in Research and Development:

1. EDI Project Officer – Focusing on identifying service users within the Trust that could be under-served by research. This member of staff would also be responsible for informing changes to R&D processes to reflect a culture that supports EDI
2. Involvement Coordinator – Establishing more service user, carer and public Involvement within research in the Trust
3. EDI Project Support Officer – Focusing on communications, as well as special projects to make research more visible and inclusive across the Trust
    

We actively encourage our staff to undertake training opportunities, which will allow them to better support diverse service user and carer populations. Different members of our department have completed the following training opportunities:

• AWP Cultural Intelligence training (Level 1)
• Centre for Ethnic Health Research Cultural Competence training 
• Centre for Ethnic Health Research Effective Community Engagement training
• Stand Against Racism and Inequality (SARI) Cultural Awareness Tour
• Stand Against Racism and Inequality (SARI) Transgender Awareness
• Womankind and Missing Link Women's Inequalities training

We recognise that EDI requires continual learning and practice. As such, we will aim to attend further training to broaden our capacity to effectively support service users and carers participating in research.

In 2023, we aspire to offer our staff internal training in mental health, neurodevelopmental, and substance misuse issues, delivered by specialists and those with lived-experience. We hope this training will further our capacity to work sensitively and effectively with diverse service user groups. We hope that this will improve the accessibility of research opportunities and also the experience of those that choose to take part. 

We aspire to create a cultural shift towards embracing EDI within Research and Development. Our work has resulted in the following:

• We won the NIHR Clinical Research Network West of England award for Public Engagement and Inclusion for 2022.
• We incorporated the EDI Bubble activities into normal working practice, which makes EDI an ongoing consideration across our work. 
• We created the EDI Space, recognising the need to maintain a safe space for all our staff to share and learn about EDI issue affecting diverse populations.
• The majority of our staff belong to one or more of the AWP staff EDI groups, which aim to address injustice and promote equity amongst staff.
• Our colleague, Monalisa Bora-White won the AWP Annual Award for Empowering and Inclusive Practice (2022)
• Our colleague, Monalisa Bora-White, discussed our EDI work and aspirations in an interview with Nick McNally from UKRD. The transcript of this interview can be found here.
   

Throughout 2022, our staff attended various conferences and seminars to advance our learning and share good practice around EDI.

We hosted an Equality, Diversity and Inclusion in Healthcare webinar as part of our Clinical Trials Month (May 2022). During this webinar, we invited local and national speakers to discuss their EDI work and share good practice about improving inclusivity of research. This was an engaging event with lots of discussion from attendees, which helped us all consider our role in improving healthcare research for everyone. 

In August 2022, our Involvement Coordinator was invited to speak at the first EDI annual seminar held by the Centre for Ethnic Health Research (CEHR). During this seminar, our Involvement Coordinator provided feedback on the CEHR Cultural Competence training course and how this has influenced improvements within our team. It was encouraging to see what others have done to advance EDI within research. 

In January 2023, our Director and one of our Team Managers were instrumental in organising and speaking at the UKRD Inclusion Symposium 2023. This national event bought together many people with an interest in addressing health inequalities through research. This provided an excellent networking opportunity to share best practice about the things that have worked well to make research more inclusive. 

Members of our department have kept looking for opportunities to attend seminars about specific EDI matters in healthcare and research. These allow us to grow in our understanding of different groups and how we could make research opportunities accessible for diverse under-served populations. 

Our EDI Project Officer has been undertaking a detailed review of AWP service user diversity. This review is important, since we want to understand the populations that are under-served by research. Only through identifying and working with these populations can we hope to make research more accessible for everyone and reduce health inequalities. 

The National Institute for Health and Care Research (NIHR) Guidance from the INCLUDE project identified that organisations involved in the delivery of research need to identify under-served populations when working to reduce health inequalities. You can read more about the NIHR INCLUDE project here. 

Our EDI Project Officer has been working on the following two stages of a project to understand research participation amongst AWP service users:

1. Improving inclusion and access to clinical research in AWP - This stage of the project focused on investigating the demographic characteristic of AWP service users to identify under-served populations within AWP. Demographic characteristics are features that are recorded to describe a person. These characteristics often match the nine protected characteristics defined by the Equality Act (2010). This report was completed in May 2022.
2. Investigating the diversity of service users participating in research studies resulting from Everyone Included - This stage of the project focuses on investigating the diversity of service users that have responded to research opportunities promoted through Everyone Included. Everyone Included is an opt-out postal approach that we use to let service users know about potential research opportunities that might interest them. This stage of the EDI Project aims to understand the diversity of service users currently reached using Everyone Included, so that this might be improved.

We use an approach called Everyone Included to let service users know about research opportunities that might interest them. We might approach service users about possible research opportunities using a letter in the post, unless they tell us otherwise. You can find out more about Everyone Included here.  

Everyone Included works by identifying service users that might be eligible to take part in a specific research study. 

We realised that Everyone Included could go further towards reaching under-served populations with opportunities to take part in research.

We wanted Everyone Included to match AWP efforts to reduce inequalities for under-served populations. We chose to align Everyone Included with the current priority under-served populations within mental health, which have been identified by the AWP Advancing Mental Health Equalities (AMHE) group as part of a wider programme being coordinated by the Royal College of Psychiatry. More information about this programme can be found here.  

The AMHE priority groups for AWP are:

• Black Asian and Minority Ethnic (BAME) males over the age of 18
• Dual Diagnosis (substance misuse and mental health)
• Children and Adolescents

We will continue to use Everyone Included to offer research opportunities to service users who might be eligible to take part. In this process, we will focus on identifying AWP AMHE priority groups and try to improve the effectiveness of contacting these groups.

Research Capability Funding (RCF) represents a proportion of money that we take from studies that are hosted by our team. We use this money to fund researchers to take time away from other responsibilities, so that they can work on developing new ideas for research. 

Every RCF application requires the researcher to have thought about how they will work alongside those with lived experience of the research subject. We call this Patient and Public Involvement (PPI). We also ask that the researchers applying for RCF produce a feasible plan for how they intend to reduce health inequalities through their research. 

The following list provides examples of the type of questions we would expect an RCF applicant to consider:

• Who are the under-served populations in your research area?
• Do your research interests align with the priorities of affected populations?
• What feasible steps will you take to ensure that your research is accessible and inclusive?
• How might a lack of diversity in those taking part in your study affect the quality of the outcomes for diverse populations?

We actively promote the importance of EDI to researchers. We recognise that EDI is a consideration in every study, not just those that directly focus on the reduction of health inequalities. 

If you are interested in learning more about EDI in research, there are some links to useful information below:

• NIHR Equality, Diversity and Inclusion
• NIHR Research Design Service Equality, Diversity and Inclusion Toolkit
• NIHR Race Equality Public Action Group (REPAG)
• NIHR INCLUDE
• Centre for Ethnic Health Research
• UKRD