Prof. Fenton’s Description of his PHE Review

Background

On May 4th 2020, the UK Government responded to concerns about the disproportionate impact upon BAME communities in the UK by announcing a Public Health England Review.

(Terms of reference)

The review was to be led by Professor Kevin Fenton, Public Health Director for London, and was to be supported by a wide group including Trevor Phillips, OBE.

At the time of the announcement Health and Social Care Secretary Matt Hancock said:

“The more we know about this virus and its impact, the more we will be able protect lives and limit the spread”

The Release of the Report

However, the Government concerned that the release of the report may be in “close proximity to the current situation in America”, and that it would be a “bad combination” if it was released amid global outrage over the death of George Floyd, proposed a delay.

Following widespread criticism though, the report was instead released on Tuesday 2nd May, with very little advance notice.

The Report

Concern

The content of the report came as surprise to many as it contained very little analysis beyond what was publicly available. The methodology and scope also seemed particularly limited and no recommendations were made.

Ladders4Action asks our readers to contrast this with the original terms of reference and statements made in the video below by Prof. Fenton when discussing the PHE Review.

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Prof. Fenton’s Talk about the PHE Review

A webinar entitled Going Beyond Statistics: Impact of COVID-19 on BAME lives was held on the 22nd May 2020.

Prof. Fenton starts talking about the PHE review on the video recording at 17.40

I have transcribed part of the video for quick reference, but please refer to the video directly to check any quotes you wish to take. I would be really happy to hear your thoughts and reflections

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The Transcript

17:40

Four weeks ago the chief officer asked Public Health England to review the surveillance data held by PHE to provide further information about COVID and its health outcomes for Black, Asian and Minority Ethnic communities.

and he was particularly keen to understand the clinical journey that BAME communities go through from the take up of testing for COVID, from being diagnosed with COVID, straight through to severity of disease and mortality to COVID.

So out primary research review the BAME research itself was looking at those different stages in the pathway and asking are Black, Asian and Minority Ethnic communities more or less likely to be affected, by taking up testing, by being diagnosed, their likelihood of having severe disease, requiring intensive care unit admission and their likelihood of dying with COVID.

[…]

19:54

The PHE review will be certainly be looking at those over arching patterns and be looking for differences between different racial groups.

But more importantly we will be able to control for key characteristics which are obtained in the hospital data including age, sex. We will be able to look at some long-term conditions, and where available occupation.

We will have area of residence so we will be able to look at indices of deprivation as well as broad geographic area  of residence in the United Kingdom to see if there are regional differences in clinical outcomes for Black, Asian and Minority Ethnic communities.

So this first Phase of the review specifically looks at Black, Asian and Minority Ethnic communities and looks at patterns of disease and outcomes and factors that might influence.

20:45

The second component of the review is our community stakeholder engagement and listening sessions. And this has been a fantastic and very humbling exercise that we embarked upon. As like so many of you I wanted to go beyond the data.

I wanted to hear the stories, the lived experiences and the hopes dreams and fears of our community, when it came to the impact of COVID on their lives. So for the past three weeks we have embarked upon an extensive programme of community and stakeholder.

We have now engaged more than a 1000, almost now coming up to 1,500 individuals. Who have participated in briefings, lectures, discussions, listening sessions on this issue.

And I have been able to engage with stakeholders across different departments, regional leaders, including Mayors in London as well as Mayors in the West Midlands, and gone deep in the communities with professional organisations and bodies, faith communities, community organisations, pharmacists, directors of public health, leaders of councils across the country etc.

 It has been an extensive exercise.

And we have done three key things. First asked about the lived experience, asked about what’s been done now because as […] said, we shouldn’t be waiting to act when we know what to do.

And then finally to hear their recommendations for what more needs to be done.

That’s the second component of the review that we are doing on inequalities and COVID.

And the final aspect of the PHE review is moving beyond race and ethnicity, because we know that inequalities exist in other domains as well.

So we are also looking at inequalities and health outcomes, according to age, according to sex, according to deprivation, we are wanting to look at various vulnerable communities.

For example gypsies,  travellers and migrants, we wanted to look at data that we have available for occupational differences for where they exist, to understand the risk that they may obtain, especially for those working in the health care setting.

Now all three of these are due to be completed by the end of the Month [May 2020] and they will be submitted to government for release.

And at that stage we are committing to going back out to the community and doing a series of dissemination efforts, to share the results of the data and to continue the conversation about what this means for our work.

So that’s the PHE review

23:25