Invitation to tender: Innovation learning partner – trust-driven healthcare

Summary

Impact on Urban Health and South East London Integrated Care System (SEL ICS) are seeking a learning partner to support innovative work addressing the inequities in healthcare services experienced by Black and other ethnically minoritised people.

We have developed two innovative projects in response to these inequities, one focusing on maternal health and another on mental health. These projects include specific activities that we think will create the conditions for meaningful change. As we implement these activities over the next 18 months we want to capture, analyse and reflect on the knowledge and outputs emerging from these activities and how and why (‘what works most’). Where the evidence and the context allow, we also want to translate this learning into insights, decisions, and tangible adaptations.

We want to hear from research and evaluation specialists with the experience and expertise to capture the learning, lead the analysis and facilitate reflection that leads to actionable, shareable recommendations.

About the partnership

Workng with SEL ICS, we have formed a joint funding partnership of £5m, enhanced with further funding from the same partners as well as the National Lottery Community Fund.

These investments are focused on achieving health equity for Black communities living in South East London through fostering increased trust.

This work responds to insights from research led by Centric Community Research that highlighted feelings of distrust, apathy, and skepticism about the healthcare systems and healthcare services among people from Black and other ethnically minoritised communities. This lack of trust stems from individual and collective experiences.

The two projects we have developed aim to create the conditions where trust can be fostered between local Black communities and healthcare providers, so that these groups will experience improved services.

It seeks to bring together a wide range of health stakeholders to reimagine and co-design services that more effectively meet the needs and priorities of local Black communities, specifically in relation to the service areas of reproductive and maternal health and mental health.

The two service areas

Reproductive and maternal health

This strand aims to create and facilitate an approach which brings together communities and healthcare organisations to effectively and equitably tackle barriers to experiencing quality maternity care and design solutions which can be tested within the system.

We envisage this work will require:

1. Creating psychologically safe spaces
2. Facilitating honest and solution focused conversations
3. Identifying and filling knowledge gaps
4. Enabling equitable service transformation and systems change
5. Enabling development and testing of proposed solutions
6. Building capability of stakeholders to participate in design groups
7. Communicating insights and learning to influential system stakeholders to challenge existing approach for co-production

A project group sits at the core of this strand of work that will be supported by our delivery partners.

Project groups are expected to be made up of a wide range of stakeholders (residents, patients and carers, advocacy groups and charities, health commissioners and providers, researchers, academics, policy-makers etc).

Their role will also be to co-design an equitable process for generating and implementing solutions to tackle the identified challenges.

The project group will have the opportunity to prototype service improvements. This work has two routes to ideation, the project group who are supported to develop promising solutions alongside innovations within the community that can receive grant funding support. Emerging prototypes and recommendations will be shared with a sponsorship group made up of representatives from Impact on Urban Health, SEL ICS and Black Thrive for final sign-off.

Mental health

This strand seeks to improve early access to mental health services for people from Black and minoritised communities by bringing together a group of decision-makers at South London and Maudsley NHS Foundation Trust and a group of trusted community leaders to facilitate equitable dialogue.

Together they will explore opportunities to change the way mental health services are designed and delivered, paying particular attention to community priorities, as articulated by the community leaders. The process of dialogue will build mutual understanding, which we hope will contribute to trust, and together they will develop initiatives that can contribute to tangible changes in the ways Black and other ethnically minoritised people access mental health support.

The process of dialogue and ideation will be supported by expert facilitators and community builders, who will be recruited at the outset.

About the learning partnership

Why we want to learn

People from Black and other ethnically minoritised backgrounds living in South East London experience significant inequalities when it comes to their health. These are the result of a complex mix of inequitable social, economic and environmental factors, as well as a wider social context in which structural racism reinforces deep-rooted health inequities as well as inequities in education, employment and housing. COVID-19 has worsened these inequities.

Research conducted by Centric Community Research found increased distrust and apathy of healthcare system and services among local Black and other minoritised communities. The reasons for this distrust are diverse and range from feelings of a lack of care and empathy provided by healthcare services to traumatic or discriminatory experiences in medical settings such as being misdiagnosed or prescribed the wrong medication.

These factors are amplified by the lack of effective complaint mechanisms to signal negative experiences. These experiences lead to a feeling of disempowerment which erodes any existing trust in healthcare services.

What we want to learn about

These two projects are informed by several hypotheses:

• That decision-makers in the health system have insufficient understanding and insight into the experiences and priorities of local Black and other ethnically minoritised communities, which leads to services that fail to meet these groups needs
• That leaders of local community organisations are closer to these groups and have a better understanding of their experiences and priorities
• That community insights and community organisations are well placed to redesign services to center the needs of marginalised communities
• That we will need to commit to radically different ways of working to surface workable solutions
• That the innovations we need will require involvement from a wider range of stakeholders
• That resourcing community leaders well to participate in this collaborative effort with health leaders will foster more equitable relationships and signal the value placed on their contribution
• That by creating the conditions for community leaders and decision-makers in the health system to meet, to begin understand each other’s perspectives better, they might build relationships of trust with each other which in turn could ripple out beyond these individuals to the people they are connected to
• That the initiatives that emerge from this process will better meet the needs and priorities of local Black and minoritised groups

We want the learning partner to help us understand whether these hypotheses hold true, whether any need to be reviewed or abandoned.

We have ambitions to scale and spread this approach and the innovations that emerge, and we want the learning partner to lead the process of developing actionable recommendations in support of that growth.

Expected tasks and deliverables from the learning partnership

We are looking for a partner to lead the continuous reflection and support development of an innovative programme aimed at creating equitable health and care services in South East London.

We are interested in partners able to work collaboratively with our delivery partners (Rooted by Design, BUD Leaders and others) who will play a key role in designing and delivering the programme. The learning partner will lead on generating insights, facilitating reflections about the approach to feed into the ongoing adaptive development of the programme, and contribute to actionable recommendations.

Tasks

1. Develop a flexible learning framework
2. Ongoing analysis and sharing of insights and lessons with key programme stakeholders.
3. Document the learning process
4. Develop actionable recommendations for scaling and spreading this approach and the innovations that emerge.
5. Work closely with the partner teams across Impact on Urban Health and SEL ICS who are guiding the work, alongside the consultants who are delivering the work
6. Draft a report that summarises the learning from these projects alongside recommendations

Deliverables

1. An output that captures the learning – in a format to be discussed and agreed with the various partners
2. We also seek a partner with a flexible approach that enables iterative learning within and across the programme, leading to a programme that is shaped by ongoing reflection and learning

Expected audience and participants for our learning

• Decision-makers and others at the SEL ICS and Impact on Urban Health
• Others working to improve health outcomes for Black and ethnically minoritised communities in other parts of the country
• Other organisations funded by the National Lottery Community Fund’s Health Equality grants programme.

Who we want to partner with

To successfully support this partnership project and help us achieve the above-mentioned tasks and deliverables, the learning partner must be able to demonstrate the following knowledge and skills:

1. We are looking for a partner able to bring diverse and nuanced learning and reflection practices (such as developmental evaluation practices) and facilitation tools to support programme stakeholders to share their reflections and perspectives on the programme and document on any changes needed to improve outcomes. We expect learning partners to be comfortable with a range of quantitative and/or qualitative tools and methods, and be experienced in helping participants frame learning reflections and prioritise insights that are valuable and important
2. Equitable approach to facilitation and reflective practices
3. Understanding of systemic approaches and practices
4. Understanding of the culture and dynamics within Black and other ethnically minoritised communities in South East London and/or the local health and care space

We are looking for a learning partner who demonstrates:

1. Commitment to equitable and inclusive learning, research, and evaluation practices
2. Creativity and flexibility in responding to issues quickly and adjusting plans and approaches as needed
3. Familiarity with the UK health and care systems and strategic issues affecting racial equity in health

Budget and timeframe

Our budget for this learning work is up to £100,000 including expenses and VAT, over an 18-month period until November 2025, with the potential for an extension.

We expect this learning partnership work to begin in May 2024 with the appointment of the successful learning partner and a round of team and project inductions.

How to apply

We invite interested individuals or organisations who match the knowledge, skills and attributes above to submit a short application (up to four pages excluding CVs and budgets) by email to Radhika Bynon. Please send your application no later than 0900 on Friday 17 May.

The application must include the following:

1. A short, written statement outlining the relevant knowledge, skills, and personal attributes which you/your team possess and how you envision using these to help us achieve our learning objectives
2. A short, written summary providing details of two initiatives or projects you/your team have been directly involved in which showcases your previous experience in systems change, health justice, social justice. Details should describe your/your team’s role, the purpose or aim of each initiative/project and the major contributions you/your team personally made
3. A CV or biography for each member of the team. CVs or biographies may be written in the application below 1 and 2 above, or attached as separate documents, or hyperlinked under a “CVs and Biographies” heading in the application from your website
4. A budget summarising each team member’s daily rate of pay and your anticipated expenses for undertaking the proposed work (up to a maximum of £100,000 including VAT)

After you apply

Applications will be assessed by a team from Impact on Urban Health and SEL ICS based on the following:

1. Relevant knowledge, skills, and personal attributes
2. Demonstrated understanding and expertise based on previous work
3. Affordability of the individual partner or proposed team

We will invite preferred candidates to meet with a panel of staff members for a discussion online lasting up to 45 minutes. This discussion will focus on giving candidates more information about the learning partnership, unpacking information from candidates’ applications, and creating space for candidates and the panel to start getting to know each other. At the end of the discussion, we will ask for the names and contact details of two references who candidates have worked with previously.

For more information

If you have any questions about this brief, please email Radhika Bynon.