Patient and Carer Race Equality Framework (PCREF)

The Patient and Carer Race Equality Framework (PCREF) is a pivotal recommendation from the 2018 independent review of the Mental Health Act. As NHS England's pioneering anti-racism framework, PCREF empowers Trusts to enhance services for individuals from diverse ethnic, racial, and cultural backgrounds.

The PCREF’s approach focuses on race and ethnicity, but it also considers the intersectionality of patients and carers. This includes the Equality Act nine protected characteristics, lifestyles, neurodiversity and special educational needs.  

The PCREF is split into three core components:

Part 1: Legislative and regulatory obligations (Leadership and Governance)

Part 2: National Organisational Competencies

Part 3: The Patient and Carers Feedback Mechanism

The PCREF applies across all mental health pathways at our Trust, including older adults (65+), adults (18-64), and children and young people (0-25). Our Trust data shows that, while there have been positive improvements in access and experience in some areas over recent years, largely due to our ongoing QI initiatives, patients from Black, Asian, and other ethnically minoritised communities continue to face the poorest Access, Experience, and Outcomes within our mental health services.

Our Trust joined PCREF in 2023 as an early adopter, and made a commitment to embed PCREF principles across our services. Our approach focused on co-production with service users, carers, and community organisations to identify and address racial disparities in mental health care. This aligned with our broader strategy to improve equity of access, experience, and outcomes for all our service users.

Our work with the Ethnicity and Mental Health Improvement Project (EMHIP) has already begun to tackle these disparities. By collaborating with local communities, voluntary sector partners, and people with lived experience, EMHIP has enabled us to co-design culturally appropriate services and deliver meaningful change for racialised communities across South West London.

Building on this work, we are also developing our new Health Inequalities Strategic Plan 2025/30, which prioritises race equity as a core focus. This strategic plan will set out our commitment to addressing the root causes of health inequalities, improving access to culturally competent care, and ensuring all voices are heard in the design and delivery of our services.

Our approach is further strengthened through:

The Advancing Race Equity Steering Group, leading on race equity implementation and ensures alignment with PCREF and anti-racism goals.

The Health Inequalities Advisory Group, providing external and internal guidance, ensuring that lived experience and community voices are central to decision-making.

The Executive Advisory Group, advising executives on the strategic direction and governance of our race equity work.

The Lived Experience Forum, ensuring the insights of patients, carers, and communities directly inform our strategies, projects, and service improvements.

Our dedication to quality and equity is reflected in our latest Care Quality Commission (CQC) rating. As of January 2023, SWLSTG has been rated 'Good' overall, with commendations for effective leadership and compassionate care. The CQC highlighted our co-produced organisational strategy and strengthened governance structures as key strengths.

We continue to work diligently to implement PCREF across all our mental health pathways, ensuring that our services are inclusive and responsive to the needs of our diverse communities. Through ongoing collaboration and engagement, we aim to foster an environment where every individual receives equitable and culturally competent mental health care.

Advancing race equity is about creating a culture of fairness and accountability to address disparities in access, experience, and outcomes. We will approach this through robust leadership and governance, strengthening organisational competencies, and embedding the voices of racialised patients and carers. By applying the right tools—including research and development, data insights, and Quality Improvement—we will ensure our work is evidence-based, sustainable, and responsive to the needs of our communities.