As a Bradford Alumnus, Global Ambassador, Honorary Visiting Professor, and Bradfordian, Professor Mahendra Patel, International Fellow of the Indian Pharmaceutical Association is championing the call for action in the fight against inequalities in health care provision for Black and Asian Minority Ethnic (BAME) communities.
We asked Dr Mahendra Patel for his views on the crucial lessons we are learning during the pandemic.
What are we learning about how COVID-19 is affecting BAME communities?
‘We have known about the health inequalities faced by BAME communities for decades, but they have been laid bare by the current crisis. However, the very scale of this crisis also means we have a once in a lifetime opportunity to actually overturn these inequalities with a vengeance.’
Professor Patel, who is also a member of the Royal Pharmaceutical Society’s English Pharmacy Board, has years of experience working with different BAME communities.
He has recently joined the world leading University of Oxford and its Nuffield Department of Primary Care Health Sciences and its team of researchers, as Co-Investigator and is holding the role as National BAME Community and Pharmacy Lead for the flagship treatment trial – PRINCIPLE TRIAL. This is one of the UK Government’s national priority platform trials on treatments for COVID-19, with over 900 participants already signed up and contributing. While developing grassroots partnerships has been a major focus of the trial’s recruitment strategy so far, recruiting people from Black, Asian and minority ethnic communities has been a particular challenge.
Thousands of volunteers are still needed for research studies into coronavirus treatments, especially amongst British Asian communities, who are often underrepresented in this type of research but can be at higher risk of developing more serious COVID-19 illness. His role will focus on strengthening recruitment from across the BAME communities.
The trial is evaluating whether treatment early can help people aged over 50 recover quickly from COVID-19 illness, without the need for hospital admission.
Professor Patel has also recently been appointed as Faculty and Teaching Member to the United Nations Educational, Scientific and Cultural Organisation’s (UNESCO’s) Department of Education’s International Programme of the UNESCO Chair in Bioethics.
In his role as Teaching Faculty Member, he will be leading on pharmacy bioethics in the International Programme of the Department of Education of the UNESCO Chair of Bioethics Australia Asia Pacific Division.
Professor Patel described the appointment as a “great privilege and honour” and said he wanted to use the position in the first instance to help highlight, at an international level, the ethical issues faced by the pharmacy profession in responding to COVID-19.
He said: “The appointment is not something I have shouted about but it’s a hugely significant role in terms of the level of influence it can bring and the ability to reach a global audience. Part of my national work at present is largely focused around educating people in relation to COVID-19 and the novel corona virus, particularly those from Black and Asian Minority Ethnic (BAME) and underprivileged communities, where I think we need to be much more proactive in terms of effectively engaging with people from various religious and cultural backgrounds.”
Professor Patel said he was advocating the wider “mobilisation” of local pharmacists to help “build bridges between communities and government health advice”, with a view to improving people’s health in general and reducing health inequalities.
During the COVID-19 crisis he has been working hard to spread the message and, through religious places of worship, including mosques within Dewsbury and Batley, where he was able to reach out to more than tens of thousands of Gujarati Muslim members virtually via Zoom to include a Q&A session, relayed in Gujarati and English. He has delivered important health messages and information around COVID-19, on a constant basis, through various television and radio stations, including a faith TV channel aimed at a largely those of Punjabi origin with an estimated audience of over 60,000 viewers, as well as numerous regional ITV and BBC news programmes.
Links to some of Dr Patel’s articles and interviews can be found below.
Why is Bradford important to you and how has it influenced your career?
I remember the Harold Wilson statue outside the University as I used to play here as little boy during the early construction of the University in the late ‘60s. Little did I know, that years later, I would also be studying there, teaching there, and researching there.
After graduating in Pharmacy, I completed my pharmacy pre-registration training programme with Boots the Chemists in Kirkgate market, thinking one day, I would head into taking up some form of advanced management role within the Company. I always thought that Boots was the gold standard in Pharmacy. I was living in Leeds during my finals and subsequently during my pre-registration training programme. There was a newly opened 
pharmacy opposite where I used to pop in regularly and chat with the pharmacist owner and his staff. I remember vividly even to this day, that about four weeks before completing my training with Boots the Chemists, on my way home I randomly popped into the pharmacy to see ‘my old friends’ in the pharmacy. That day, the owner me asked when would I be qualifying as he was looking for a newly qualified pharmacist to manage his pharmacy. I replied in four weeks time. He then asked me if I would I work for him as a pharmacist manager, as I would be perfect for the role? I was so much in awe and taken aback (and hugely immature at the time aged only 21 years of age), I immediately took up his offer. He asked if I would come back next week to simply ‘sign on the dotted line’. So, I handed in my notice at Boots the next day. However, when I went in to sign the contractual papers the following week all very excited, he said he was sorry and he had found someone else! You can imagine how deflated I was and just froze to the ground at the time – utterly speechless.
But I did bounce back. I returned to Boots the next day, embarrassingly and shamefully telling them what had happened, and so glad they welcomed me back, saying they had never taken my resignation seriously! Thankfully.
Soon after, there was a pharmacy in Bramley In Leeds advertising for a newly qualified Pharmacist. Having been unnerved and highly unsettled from the earlier disappointment, I wanted to prove to myself that there was nothing wrong with me. So I applied for this post where I was offered the job. After a year, he offered to sell me his business – so after being a community pharmacy manager for one year, I became a business owner.
It was not long after this that I was offered a job in Alabama USA, so I sold that business and went to America. After a year I came back although I really enjoyed working there, as I was feeling home sick and missing my family lots. I started looking for a job as a pharmacist locum, and was offered to cover maternity leave for someone, but I explained I could only do 3 months. The Pharmacy owner asked me, why only 3 months? I replied, ‘Because I hope to buy my own business’ and he said – ‘why don’t you buy my mine’ as he wanted to focus more on his acupuncture work than pharmacy. So, I did just that! That employment interview actually turned out to be a business transaction! I feel that opportunities are not always apparent, nor obvious but at times may manifest when you start talking about your aspirations to people and being open and honest.
However, as my academic and research work continued to grow sharply so did my pharmacy businesses in parallel, becoming owner of three community pharmacies, and eventually something had to give way so I sold the businesses and decided academia was going to be the way forward for me.
When I joined the University as a lecturer, Bradford was the one of the biggest school of pharmacy in the country and I was proud to be part of the cogs. The huge variations in practice and access to healthcare according to different socioeconomic status that I had witnessed through my own pharmacies in Leeds and Bradford, led me to research into the wider issues around health and health inequalities and how pharmacy could play a vital role in helping to address some of those inequalities. My pharmacies were situated in two very contrasting areas, varying from inner city Bradford serving a largely deprived and South Asian population to a completely white and significantly more affluent population in two villages on the outskirts of Leeds. Looking back on my life it was these unacceptable differences that pushed me into working to make a difference.
Bradford utilised its uniqueness, and the school of health started growing, with the Innovation Centre and Institute of Cancer Therapeutics. I was seeing in front of my eye’s huge growth in just a matter of years. After a significant period away from Bradford, getting married and having family and helping to build a new pharmacy course at Huddersfield, it is an honour to now come full circle back to Bradford. I have a personal pride in this University. I can bring knowledge and skills through the phenomenal and exciting journey that I have had, but social inclusion and supporting communities to help address health inequalities, will always be at my heart.
Bradford was great and supported me in every way possible through a range of staff having different skillsets and expertise. They allowed me the breathing space to research into the area that I was passionate about and share that learning to students through my teaching. I carry Bradford with me on my sleeves throughout my travels.
How important is the role of pharmacy in making healthcare provision equal and in combatting COVID-19?
The significant BAME pharmacy workforce itself is also perfectly positioned to deliver services tailored to meet the health needs of the different communities. Many of us are based in pharmacies at the heart of some of the most deprived areas in the country, as well as serving densely populated BAME communities.
Being sensitive to the needs of the different BAME communities will help break down some of the invisible and traditional barriers of culture and religion to improving health. This could pave way for an effective means to reduce some of the wide variations in health and health inequalities that exist.
How can we help make this happen?
I am often talking to various health organisations and institutions as well as pharmacists and pharmacy staff across a range of settings varying from academia, hospital, primary care and community at a national and local level, but there is something we can all do, for example:
Develop a meaningful and closer understanding of your local BAME communities in terms of their religious and cultural beliefs and attitudes. Building cultural awareness can be a bridge to reliable and trusting relationships
Find out when the major religious and cultural events are celebrated by different faiths – often a time when relations may be more easily developed, making way for greater trust to be built up
And for those in a position to:
Identify the main BAME communities and their respective community leaders in your area – bearing in mind some religious leaders work with larger communities than others and therefore have greater reach
Wherever possible, make best use of the valuable BAME skillset within pharmacy teams – this is crucial in helping to develop stronger relationships with different patients of BAME origin, especially where language and cultural issues may be a barrier
Make community outreach work a regular activity – this will allow you to build community links and start to see results, mindful that they may not be overnight. Councils and other local authorities can be useful here too.
Use BAME media such as radio and TV, and get in touch with BAME social media influencers, to get key health messages out there. All of this helps reach out to a wide range of age groups, men and women, whole communities, and potentially in their own language.
Understanding different religious and cultural behaviours and attitudes is certainly a lifelong 
learning. However, as healthcare professionals on the front line of delivery it is vital to understand our communities better if we are to truly help address the health inequalities staring us in the face. Bigger factors such as poor housing, access to education and job opportunities are obviously central to affecting health, but beginning at ground level in our communities, we can really make a difference.
And what is the biggest risk at this point of the pandemic?
Easing any kind of lockdown does not mean to say we are going to stop wearing facemasks or stop washing our hands. This has got to be part of our everyday practice as we continue to face widespread lockdown with time.
I am worried about that. I am worried about the complacency. I am worried about indifference.
I do feel like people are not as vigilant now in terms of touching surfaces and using sanitisers. You couldn’t be vigilant enough.”
We do need to change the style, the way we deliver our messages because people are getting tired and people also thinking ‘Well, we’ve heard that’ and perhaps become indifferent. We need to be even more meaningful.
We need people out there as champions, not just the people knocking on the doors but we need the people that engage with the communities, the leaders, the religious leaders, to continue to work with these people on a regular basis.
The community pharmacists are the perfect place for great investment and support to be able to deliver those messages to the communities they know best and continue to serve day in day out.
Any final message to our Alumni across the world?
Proper and regular hand washing seems to have slipped from the messages over time but is as important now. We must remain vigilant at all times.
You have created and are pioneering a new message; how will that work? –
Whilst we wait for a safe and effective vaccine for the prevention COVID-19 to come to the market, remember we still have our Human Vaccine ….‘We ARE our OWN VACCINES’
We can wash our hands can wear the masks, and we can social distance and self-isolate if we have symptoms’ – we must take some control.
We do not know when these vaccines will be available and efficacious – in the meantime we must take every step to protect ourselves and our loved ones.
Biography:
Current occupation: Senior lecturer/academic
Year of registration: 1981
Academic qualifications: BPharm and PhD, University of Bradford
Professional awards: Fellow of the RPS, Fellow of NICE, Fellow of HEA- Higher Education Academy
Professional experience and particular interests:
University lecturer interested in health promotion and working with communities from minority ethnic groups to help reduce health inequalities. Enhance engagement of pharmacists in research to help develop evidence-based practice through my role with the NIHR. Member of NICE accreditation committee. Education accredited organisations and their processes for developing guidelines. Working with the British Heart Foundation and South Asian Health Foundation to promote healthy lifestyles and reducing risk for developing diabetes and CVD. Interested in engaging pharmacists and the RPS more with NICE as an advocate for NICE.
Professional appointments: Adjunct Professor Wilkey University, Pennsylvania, USA
Articles on external websites:
https://www.pharmaceutical-journal.com//news-and-analysis/opinion/we-must-tear-down-the-barriers-to-equality-for-bame-communities-highlighted-by-covid-20208060.fullarticle?firstPass=false
https://www.yorkshirepost.co.uk/interactive/health-inequalities-yorkshire#main-page-section-1
https://www.yorkshirepost.co.uk/interactive/health-inequalities-yorkshire#main-page-section-2
https://www.itv.com/news/calendar/2020-05-04/nhs-takes-steps-to-ensure-minority-ethnic-staff-safety-amid-higher-death-rate-data/
https://www.rpharms.com/blog/details/Connecting-with-BAME-communities-to-improve-health
https://www.chemistanddruggist.co.uk/news/lloydspharmacy-joins-senior-pharmacist-BAME-risk-assessment-work
https://www.pharmaceutical-journal.com//news-and-analysis/news/well-pharmacy-to-risk-assess-all-staff-for-covid-19-from-next-week/20208084.fullarticle?firstPass=false
https://www.chemistanddruggist.co.uk/news/covid-19-well-introduce-risk-assessments-a-staff
https://www.bradford.ac.uk/news/archive/2020/bradford-academic-working-to-mitigate-bame-covid-risk.php
https://www.yorkshirepost.co.uk/health/coronavirus/major-pharmacy-chains-trying-reduce-risk-covid-19-bame-staff-help-yorkshire-university-2900634
https://www.pharmaceutical-journal.com/opinion/blogs/supporting-black-pharmacy-students-how-can-we-improve/20205443.blog
https://www.yorkshirepost.co.uk/education/teachers-forgotten-return-school-warns-yorkshire-health-and-education-leaders-2951545
https://www.thetelegraphandargus.co.uk/news/18685722.leading-bradford-professor-shares-plea-virus-measures-eased/
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