Our organisation
NHS North West London Integrated Care Board (ICB) is responsible for healthcare across eight London Boroughs: Brent, Ealing, Harrow, Hammersmith and Fulham, Hounslow, Westminster and the Royal Borough of Kensington and Chelsea. In the region, there is a collective population of 2.1 million residents, although the actual number of residents served by NHS North West London is even greater, mainly due to virtual GP registrations.
Why REMI?
NHS NW London’s motivation to use REMI was encouraged by its Race Steering Group. REMI stood out from other tools that measure racism and system readiness for anti-racism as it offered a structured opportunity to showcase and strengthen our existing work. The self-assessment tool was also a key factor. It provides clear guidance on what good progress looks like, offers practical support for improvement and functions as an interactive resource.
Although REMI has not been formally adopted across NHS North West London and Integrated Care System (ICS), NHS NW London has used it to facilitate meaningful discussions within their Race Steering Group about the use of REMI in conjecture with the
GLA and local councils.
Moreover, senior leaders at NHS NW London were active members of the Race Steering Group and the approach that REMI outlines has helped the facilitation of discussions around race across the system.
The REMI framework aligned closely with existing priorities within the Health Equity Programme. This programme focuses on understanding the interconnections between three core pillars: health inequalities, population health management and the wider determinants of health, making REMI a natural fit. While ICBs are navigating a period of change, the commitment to anti-racism and the principles of REMI will continue across the system.
How REMI fits with what we already do
The Health Equity Programme for NHS NW London has used the Core20PLUS5 framework to identify areas of need, drawing particularly on the “PLUS” element to highlight the impact of structural racism and its barrier to effective health outcomes. NHS North West London has therefore recognised race as a plus priority group, aligned to the demographics. NHS NW London has begun using REMI as a basis for self-assessment. REMI has complemented their work on race equity rather than duplicating existing frameworks. The ICB also emphasised the need for a tool that can be applied to both staff and the local population, given that many BME staff come from the communities served in North West London.
What we’ve done so far
The Health Inequalities Team within the Health Equity Programme who support the NW London Race Steering Group have been using the step-by-step REMI guidelines for reference when planning agendas and shaping their work.
The Population Health Management (PHM) Team, through the Local Integrated Needs Assessment, has highlighted the value of disaggregating data by race, and has already highlighted evidence showing significant health inequalities affecting Black and Minority Ethnic (BME) groups, particularly in mental health, maternal mortality and long-term conditions. The Health Equity Team is keen to advance this approach further, particularly in strengthening the depth and quality of their data collection.
Key discussions include the wider context, such as developments within the Greater London Authority (GLA), and how these may influence NHS NW London’s strategy for tackling racism within healthcare. Ongoing conversations are focused on determining where REMI would have the greatest impact.
Value and learning
REMI is a call to action. It goes beyond identifying issues or analysing data; it prompts the next stage of meaningful action. It is designed not only to highlight problems but to support organisations in taking practical steps toward improvement.
The value of REMI lies in its non-judgemental approach to different stages of race equity. It provides a structured way of embedding system accountability as part of the wider strategic prioritisation.
In the short term, the focus for NHS NW London is on sustaining and enhancing the cultural change. In particular the merger with the North Central London ICB brings for further scaling and collaborative learning. The North Central London ICB shares their commitment to tackling racism and promoting equity and inclusion, and there is recognition that this is an area where both organisations can learn from each other in taking forward the agenda post-merger. In the longer term, the transition needs to be built into the five-year planning process. The organisation is now looking at strengthening trust with communities, where
REMI is particularly well suited. REMI incorporates key levers of race equity including community engagement and policy and decision making processes, the staged indicators and actions of REMI align with the ambition to strengthen trust within communities.
Key takeaways for other organisations
REMI needs to be fully embedded within strategic planning and future commissioning opportunities. Large organisations should be expected to adopt an explicitly anti-racist approach and integrate this into their frameworks. There must also be open conversations about system-wide commitment and senior leaders need to feel confident and aligned. To be effective, REMI also requires clear enforcement mechanisms to ensure organisations are genuinely held to account. REMI should be reflected across all core documentation and embedded across every portfolio, including planning, commissioning, nursing, and quality.