Ethnic Origin Monitoring

Introduction

This protocol sets out the practice approach to the collection of ethnic origin information. This is principally designed for the collection of information on new patient registrations, however is equally relevant to collection of information at other times.

The collection of this data is in accordance with the legislation contained in the Race Relations Act and follows the recommendations of the Commission for Racial Equality (CRE). This will also enable compliance with the Ethnicity DES effective from 1st April 2008, as amended and updated March 2009. This DES is set to run until March 2011.

The categories of race origin listed below follow the recommended categories for public bodies in England and Wales, and are consistent with the presentation and collection of ethnicity detail within the 2001 Census. The Ethnicity DES also requires the collection of “First Language” and the list is given below.

Procedure

Each new registration will be asked to complete a Patient Ethnic Origin Questionnaire. The form is self-explanatory. Patients may decline to complete this, and that decision is to be accepted. For babies and children parents will define the ethnic origin, or, where a Carer is involved, the Carer.

The administrative staff responsible for registering new patients is to enter the relevant code to the clinical record. Clinical Read Codes include census based classifications and these are listed below.

Patient Queries

From time to time a patient, whether from an ethnic background or not, may query the need to collect this information, and the use to which it will be put. They may also query the statement on the Questionnaire which indicates that certain ethnic groups are at higher risk of contracting specific medical conditions. Where a refusal to supply the information is received this is to be respected and recorded and coded as a declined / not given.

The patient is the person to define their own ethnicity.

Patients can be reassured that data or statistics produced using this information will be anonymous. The information may be used on a personal basis within the practice to help in the identification of specific medical conditions which may be more prevalent in certain ethnic communities. This will be in accordance with the practice’s Data Protection Act registration. Some generalised examples are:

Diabetes ( Type 2 ) is more common in Asian, Caribbean and African groups.

CHD, Hypertension and Stroke can impact more on persons of Indian culture descent than those of white origin.

Cancers – overall rates are lower in non-European groups, however rates are increasing for those groups living in the UK due to increased exposure to other risk factors and changed lifestyle. Asian and Caribbean women are less likely to take up screening opportunities.

Higher rates of cancers of the head and neck are seen in Asians and Afro-Caribbean, but lower rates of colon, stomach, bladder, ovary and uterus cancers.

Asthma and Respiratory Diseases – higher consultation rates for asthma among those of Asian descent.

Osteoporosis – Asian women are more susceptible than average. Afro-Caribbean women have relatively low rates of this due in general to higher bone density.