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About this report
This report explores how people in Medway experience equity, discrimination and inequality in health and social care. It examines how these experiences affect people’s health and wellbeing, their trust in services and their willingness to seek care.
For detailed findings, lived experience examples, demographic information, partner responses and recommendations, please read the full report.
Introduction
People from ethnic minority groups often report poorer experiences of health and care and worse health outcomes than White British people. This project was undertaken following two important local developments: Medway Council’s plans to make Medway a Marmot place, and Medway NHS Foundation Trust’s independent cultural review. The report aims to understand how Medway residents perceive fair treatment, what discrimination looks like in practice and how it shapes access to services.
Methodology
Between March and June 2026, Healthwatch Medway gathered 233 responses through face-to-face and online engagement. People from White British, Asian and Black backgrounds were asked: “Do you feel health and social care treat all people with equity (fair treatment for all)?” Detailed semi-structured interviews were then completed with 36 participants by telephone or online.
Summary of findings
Of the 233 people who answered the initial question, 50% felt health and social care treated all people with equity and 50% did not. White British respondents were almost twice as likely as Black, African, Caribbean or Black British respondents to perceive services as equitable.
Of the 36 people who took part in an in-depth interview, 12 felt health and social care treated all people with equity and 24 did not. Among those with negative perceptions, ethnic discrimination was the dominant theme.
Ethnic discrimination
Participants described being dismissed, not listened to or not taken seriously, as well as microaggressions that were described as ‘subtle’ and ‘hard to explain’, with some referencing a difference in treatment compared to White patients or loved ones
Others described assumptions or unfair treatment from professionals within the same broad ethnic group. Some participants also told us about experiences of unfair treatment from people within the same broad ethnic group, this was more commonly shared by people from Asian backgrounds. Concerns were also raised around a lack of cultural competency, and a perceived lack of workforce diversity, with some participants comparing the workforce in Medway to London hospitals, highlighting that they were more likely to have positive experiences in London due to the representative workforce.
Impact of ethnic discrimination
Past experiences changed how some participants used services. Of those who experienced ethnic discrimination, 72% said they actively avoided healthcare, 50% said their trust in health services had been negatively affected, 22% had chosen to pay for private healthcare and 22% felt they needed to prepare extra evidence before appointments to be taken seriously.
Other experiences of discrimination
Participants also shared experiences of gender discrimination, age discrimination and discrimination by weight. Across almost all ‘other’ experiences of discrimination, participants referenced being treated unfairly due to multiple intersecting factors including age, gender and ethnicity, demonstrating that people’s experiences cannot always be understood through a single characteristic.
Positive perceptions of equity
67% of participants who felt health and social care treats all people with equity do not feel they are treated differently to others. While some highlighted waiting times in healthcare services as a concern, they viewed this as a system-wide issue affecting everyone, rather than unequal treatment between specific groups. Participants also shared positive examples of adjustments that were made to make services feel inclusive and accessible. These included support for additional needs, cultural inclusion and age-friendly access to primary care.
Recommendations
EK360 facilitated a co-production workshop that brought together people with lived experience and professionals with relevant expertise to develop practical recommendations to improve people’s experiences of health and social care in Medway. The group identified practical priorities: improve ethnicity data and staff confidence in collecting it; strengthen cultural competence and professional development; establish Health Inequalities Champions and accountable leads; share effective practice across organisations; review equality, diversity, inclusion and staff wellbeing approaches; address wider determinants such as discrimination, safety and hate crime; and combine lived experience with service, population and research data to guide action.
Limitations
The findings provide valuable insight into the experiences of those who took part, but the interview sample is not statistically representative of all Medway residents. Some ethnic backgrounds were not represented in the interviews, and the project heard mainly about healthcare rather than social care. The findings should therefore be read as emerging and indicative themes alongside the wider quantitative evidence.
For further detail, including first-hand experiences, full demographic breakdowns, analysis, partner responses and recommendations, please read the full report.
