A Healthwatch Enfield report reveals a lack of trust in healthcare services among some members of Black, Asian and minority ethnic communities.

Its One size does not fit all report follows a survey into the experiences of BAME communities in Enfield during COVID-19. The survey aimed to discover:

  • Areas where communities would welcome additional support
  • How communities access information
  • How they access health services
  • Preferred language for information
  • The extent of digital accessibility
  • Attitudes to the flu vaccine

Work began with an online survey, followed by outreach work with communities who helped to create more customised ways of gathering feedback.

The highest response was gained when people with similar ethnic backgrounds supported completion of the survey questions.

Some communities did not respond to any of these efforts, revealing a need for more focussed and participatory work.

Main findings

Throughout the research, Healthwatch Enfield noted specific community groups used different services in different ways.

Existing cascade methods, with a strong reliance on online communications, do not appear to be appropriate for everybody.

Key findings included:

  • 54% of Black, Asian and minority ethnic individuals said they do not get the help and support they need
  • A significant proportion prefer to access information through television or radio in their own language
  • 10% said digital access is an issue, hampering access to services
  • 40% said English is not their preferred language
  • 30% said they need a translator
  • 94% said they were aware of the flu vaccine but only 53% said they would have it this year

There were strong views on the flu vaccine with comments including:

"They don't work and are just about selling medicine for profit."

"I have had it before and it made matters worse. I don't trust it."

"Lack of trust and fearful of what I would actually be injected with."

These comments reflect a common issue of a lack of trust in the system, based on previous experiences of giving feedback without seeing results.


As a result of the survey, Healthwatch Enfield has made the following recommendations:

  1. Develop and invest in culturally competent research informed by communities and addressing areas of concern to them.
  2. Draw on good practice to understand how help and support can be targeted towards minority ethnic communities.
  3. Link with community radio and television to improve outreach.
  4. Audit the uptake of translation services in relation to primary care access to assess if further action is needed to promote these services.
  5. Consider steps which can be taken to remove digital and language barriers to accessing GP services.
  6. Address concerns from minority ethnic communties and build confidence around vaccinations.

Healthwatch Enfield partnered with Enfield Racial Equality Council and Enfield Caribbean Association for the project.

Click here to read the report in full.