Exploring the policy and research implications for the British National Health Service and its customers

• Published in: Equal Opportunities International 2007-05, Vol.26 (4), p.305-318
• Main Authors: Fearfull, Anne, Kamenou, Nicolina
• Format: Article
• Language: English
• Subjects: Accountability; British; Culture; Customer services; Customers; Decentralization; Equality; Ethnicity; Fines & penalties; Gender; Health; Health care delivery; Health services; Methodology; Minority & ethnic groups; National Health Service; Performance evaluation; Performance management; Performance measurement; Performance measurement quality; Policies; Public sector; Quality of service; Race; Race relations; Racial discrimination; Racism; Receiving; Religion; Studies; Systemic racism
• ISSN: 0261-0159; 2040-7149; 1758-7093; 2040-7157
• DOI: 10.1108/02610150710749412

Purpose - The paper aims to explore tensions around race, ethnicity, culture and religion and discusses the potential impact on the delivery of quality health care in the UK through the National Health Service (NHS).Design methodology approach - This is a conceptual paper that examines how individual and collective resistance may compromise the provision of quality care and performance targets in the NHS with regard to equality and change. Existing literature and previous empirical work by the authors are utilised in order to discuss pertinent issues and propose further research in the area, suggesting appropriate methodologies and research designs.Findings - The performance measurement agenda does not address issues of racism and discrimination faced by NHS staff and customers, effected by both colleagues and the public, which impact upon the delivery and receipt of care within the NHS. Performance measurement methods that do not take into account socio-cultural conditions for those delivering and receiving care are futile. To make such measurement meaningful it is necessary for the NHS to acknowledge and challenge the racism inherent in its service delivery.Research limitations implications - Problems or limitations of conducting primary research in this field are discussed. Nevertheless, key issues around the need and type of further research in this under-researched area are presented.Practical implications - The paper challenges current performance management practices and suggests alternative ways forward.Originality value - The paper focuses on an under-researched area and examines the performance measurement literature through "equality lenses" and investigates how racism and stereotyping can affect the delivery of quality care.