Black Country Healthcare strengthens community partnership to tackle racial inequalities in mental health

Black Country Healthcare NHS Foundation Trust, the lead provider of mental health, learning disability and autism services across the Black Country, has marked an important milestone in its work to tackle racial inequalities in mental health care, highlighting the central role of community leadership in implementing the NHS’s anti-racism framework for mental health services. 

The Patient and Carer Race Equality Framework (PCREF) and why it matters 

The Patient and Carer Race Equality Framework (PCREF) is the NHS’s first mandatory anti-racism framework for mental health providers. It was created in response to long-standing evidence that people from Black, Asian and other racialised communities often have very different experiences of mental health services, including barriers to accessing support, longer waits for treatment, higher use of crisis care, and lower satisfaction. 

PCREF gives mental health trusts a structured way to work with communities to: 

• Understand where inequalities exist, using data, lived experience and community insight. 
• Co-produce solutions, rather than designing services without the people who use them.
• Improve access, experience and outcomes for racialised communities. 
• Build trust, especially where fear, mistrust or powerlessness have been barriers. 
• Embed accountability, making anti-racism part of how organisations are led and governed. 

In the latest With Our Communities newsletter (PCREF Special Edition), the Trust reaffirms that PCREF is “a commitment to transforming how we listen, how we learn, and how we act,” and that the ambition is for mental health services to be “culturally informed, compassionate, and equitable – every time, in every setting.” 

Community partnership at the heart of the work 

A defining feature of the Trust’s approach has been building new ways that give real influence to community voices. 

• PCREF Community Ambassadors have been leading local engagement across Dudley, Sandwell, Walsall and Wolverhampton, creating safe spaces for people to share their experiences and bringing lived experience directly into mental health service improvement. 
• The PCREF Governance Oversight and Advisory Group brings community representatives into the Trust’s highest assurance forums, providing independent challenge, scrutiny, and fresh thinking. 
• The Trust has invested over £100,000 in trusted community roles to strengthen two-way communication and ensure feedback leads to action. 

Jessie Allen, PCREF Community Ambassador and member of the PCREF Governance and Assurance Group describes the impact of these new ways and why it matters: 

“What I value most about PCREF is its commitment to genuine co-production, where community voices are not just heard, but shape how services change. In my role as both an Ambassador and a member of the Governance Group, I have seen how honest conversations between communities and Trust leadership can challenge assumptions and lead to meaningful shifts in practice. 

“This work matters because inequalities are often experienced in everyday interactions, in whether people feel understood, respected, or safe. PCREF gives us a real opportunity to address that, but its success depends on turning commitment into lived experience. For me, that means building community self-trust, building spaces where people can express their own solutions, supporting community leadership capacity-building, strengthening accountability, and ensuring that cultural understanding and courtesy become part of standard care, not an afterthought.” 

Embedding anti-racism into everyday practice 

Major steps are being taken to ensure PCREF becomes part of how the organisation works, not a standalone initiative: 

• PCREF is now part of how the Trust plans, measures, and delivers care, shaping organisational priorities, clinical approach, and the goals it holds itself to. 
• Communities are helping to review trust policies to understand where racism may be hidden in everyday systems or processes, and to make sure they are fair, transparent, and inclusive. 
• Staff are working alongside community members to design new racial trauma awareness and cultural humility training, ensuring it reflects real experiences and builds confidence, understanding, and compassion. 
• Data is being used in a more open and meaningful way to spot racial inequalities early, so the Trust can act sooner and improve outcomes for the people it serves. 

Kuli Kaur-Wilson is the Trust’s Chief Strategy and Partnerships Officer, Deputy Chief Executive Officer and the Board lead for PCREF.  

“PCREF is not simply a framework we are implementing, it is a promise we are making to our communities. For many of us, including myself, this work is deeply personal. I know what it feels like when services don’t fully understand your culture, your identity, or the context of your life, and I know the difference it makes when they do. 

“This is why PCREF matters. It challenges us to listen differently, to act with intention, and to confront inequalities that have been allowed to persist for far too long. It asks us to be honest about where trust has been broken, and to work alongside communities to rebuild it. 

“I am incredibly proud of the courage and leadership shown by our community partners, Ambassadors, and Governance Group members. Their insight is shaping our decisions, our policies, and our culture. This is long-term work, and we are committed to it. Together, we are building a mental health system where every person feels seen, heard, and valued, not as an aspiration, but as a lived reality.” 

A growing movement  

The Trust’s first six-month review by the Trust’s Board of Directors shows strong early progress and confirms the long-term commitment to PCREF. Community‑led insight, youth involvement, and partnership models like Talking Therapies Plus are already making a difference, showing how working together leads to better, fairer care for everyone. 

Looking ahead 

Olivia Horgan and Nageena Bibi, PCREF implementation leads are hopeful for the future as Olivia describes: 

“Implementing PCREF is a long‑term commitment, and we’re proud to be building this work together with our communities. Over the coming months and years, the Trust will continue strengthening accountability, deepening partnership, and showing real improvements in access, experience, and outcomes for racialised communities. This is change we’re making with people, not to people and we’re excited about what’s already taking shape.” 

People can read more about PCREF progress, hear stories from communities, and see the actions being taken in the PCREF Special Edition of the With Our Communities newsletter. To stay connected to the PCREF work and receive regular updates, you can also sign up to become a PCREF member and be part of this growing movement for fairer, more culturally informed care. Learn more on the Black Country Healthcare website.