24 October 2025

In her latest blog, J’nelle James, CNWL’s Acting Assistant Director for Culture and Equality, Diversity and Inclusion (EDI), opens up about the Trust’s journey with the Patient and Carer Race Equality Framework (PCREF).

As NHS England rolls out the anti-racism framework, J’nelle reflects on the complexity and significance of this work.

Why this matters

We’re living through a time of geopolitical unrest, with antisemitism, islamophobia, and xenophobia rising globally. Against this backdrop, the work we’re doing through PCREF has never felt more complex.

Talking about race is uncomfortable and it can be emotional. Yet these conversations are essential if we’re to deliver high-quality, equitable care.

In 2021, research into the experiences of Black African and Caribbean patients in our services revealed deep trauma - from life experiences and from negative experiences within mental health care. People felt stereotyped, unheard, and excluded from decisions about their care.

Today, the data still tells a difficult story; Black service users are up to 2.8 times more likely to be sectioned on first admission. These aren’t just statistics. Behind every number is a person, mothers, brothers, friends and colleagues in need of our care.

Building from the ground up

PCREF is a mandatory framework designed to help NHS trusts and providers become actively anti-racist. It calls for co-produced, concrete actions to reduce racial inequalities in care. 

Since forming CNWL's PCREF Task and Finish Group in 2023, we’ve focused on strengthening data quality, building staff confidence to talk about culture and race, and we're supporting divisions to take ownership of local priorities.

Progress is visible. From improved ethnicity recording and divisional action plans, to expanding cultural consultations across services. But there’s still much more to do to embed this framework and ensure lasting change.

This work is only possible because of the dedication of colleagues like Fatima Elguenuni, leading our cultural consultation work, Dr Kenisha Jackson, leading our school's education programme, and our divisional PCREF representatives, who are helping teams put learning into practice. 

One team reflected after a consultation:

“It’s fired something up in the team. Conversations about names continued through the day, which was lovely to see.”

In Milton Keynes, those conversations inspired the Empowerment through Wellness event - a Black History Month special organised by staff for Black communities. The event sold out, demonstrating what happens when communities and services come together to design care that feels culturally safe and empowering. 

Alongside this, our community collaboration work is building trusted relationships across local communities, reaching more than 5,000 people this year including Pakistani, Somali, African, Caribbean, Arab, European, Filipino communities.

This ongoing engagement not only strengthens local partnerships but also supports the delivery of PCREF priorities. 

What part will you play?

It’s easy to think that frameworks like PCREF sit somewhere else in the organisation and that they’re led by "someone else".

But all of us have a role to play. This work is everyone’s responsibility, because creating equitable, culturally responsive care depends on all of us.