Equity of access to NHS cancer services for members of minority ethnic groups. Report of findings of surveys of hospital medical and nursing staff at the Royal Marsden Hospital

Executive Summary 1. The NHS Cancer Plan draws attention to the inequity of access to cancer services for members of minority ethnic groups, according importance to such matters as culturally-sensitive information and different approaches to giving information. The Department of Health's latest Cancer Services: Update states that 'to improve the experience of patients from an ethnic background' is a significant area of risk within the development of cancer services. Again, improving access and providing information and more informed choice to ethnic minority communities is identified as a priority . 2. This research study focuses on one particular dimension of access: the attitudes of hospital medical and nursing staff to inequity of access to NHS cancer services for members of minority ethnic groups. 3. Postally-administered questionnaire surveys for hospital doctors and nurses achieved overall response rates (omitting exclusions) of 52% and 69%, respectively (valid responses, 44 and 55%, respectively). 4. 16% of doctors and nurses thought that patients from minority ethnic groups usually or sometimes presented with disease at a more advanced stage than the general population. Research is needed to establish whether members of minority ethnic groups are diagnosed in later disease stages than other patients, after controlling for socio-economic status and other confounding factors. 5. While only 5% of nurses and doctors thought that clinicians were less willing to recruit members of minority ethnic groups into clinical trials compared with other patients, 16% of doctors and 12% of nurses thought that members of minority ethnic groups were not as willing to participate in clinical trials. Significant proportions of doctors and nurses had greater concerns (compared with other patients) with respect to obtaining informed consent, fulfilling safety requirements, and ensuring follow-up. Linguistic and cultural constraints upon the participation of members of minority ethnic groups in cancer trials were identified by respondents. The extent to which ethnic minorities are excluded from trials requires investigation. 6. Between a quarter and a third of respondents perceived their gender as a barrier in treating/caring for members of minority ethnic groups, especially with respect to Muslim and Asian women and Arab/Middle Eastern men. 10% of nurses found their ethnicity a barrier.