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This month we speak to Dr Binta Sultan to find out how her work in inclusion health is improving the health of the public.
What is your role and what does it involve?
I have a couple of roles across different organisations, all with the common objective of reducing health inequity and using my power and privilege to advocate for social justice in health. I am a Consultant Physician in Inclusion Health at UCLH, the first in the NHS. I support our teams, which include experts by experience, to deliver outreach healthcare to socially marginalised populations across London. I also advocate and drive for more integrated, inclusive and effective health strategies and policies for inclusion health across London, with the voice of lived experience at the centre. I am also Chair of the National Clinical Network of Sexual Assault and Abuse Services at NHS England. This involves bringing a network of frontline staff and people with lived experience together to inform NHS England's strategy and policy around sexual assault and abuse services and working towards improving access to high quality care. I am an NIHR Doctoral Research Fellow at the Centre for Research in Infection and Sexual Health at IGH and work with the Collaborative Centre for Inclusion Health, IEHC. My PhD research uses co-production methods to undertake a realist evaluation of outreach models of hepatitis C care for people experiencing homelessness.
How are you improving the health of the public?
My work focuses on social justice in health. I am interested in how we can create communities of people with lived experience of social exclusion and practitioners to organise, challenge and demand that health and social care policies are integrated, effective at improving health equity, and centre the voices of those who are most excluded. My research focuses on developing operational and evaluation frameworks to enable this to happen.
I lead a collaborative outreach health programme for street-based sex workers in London. Due to austerity, defunding of social safety nets and worsening income inequality there is an increase of people being forced into homelessness and survival sex work with increasing health needs and social vulnerabilities. We work with experts by experience, housing teams, drug services and the amazing SHOC health promotion team from Mortimer Market Centre, CNWL, to deliver this outreach programme. We provide outreach point of care diagnostics for HIV, hepatitis C, hepatitis B, sexual health testing and linkage to housing and drug services.
I led on developing large outreach programmes for inclusion health populations in London which include COVID testing, outbreak management and vaccine delivery. These include temporary accommodation settings for people experiencing homelessness and people seeking asylum. We have done a significant piece of work around identifying safeguarding issues for people seeking asylum accommodated by the Home Office in various hotels around London. This included identifying many unaccompanied children in the hotels and ensuring that local authority social care and safeguarding teams support them.
I recognise that healthcare is not an apolitical space. A key role that I have, that traverses all these strands of work, is advocating for effective and accountable systems leadership, and services that are integrated, sensitive to, and meet the needs of inclusion health populations.
What do you find most interesting or enjoyable about your work?
My work cuts across providing direct clinical care, social care, anthropology, epidemiology and politics and it challenges me to be better and to learn more about the world, which is a joy. I learn so much from those I work with everyday across different disciplines and with different lived experiences. One of the greatest privileges I have had is to work in a clinical team with people with lived experience of social marginalisation. They have shared their perspectives with me, and I have learned how privilege and language can silence their voices and experiences in the healthcare system, both explicitly and insidiously. They have given me insight and caused me to challenge who creates knowledge and the dominant narratives. It has made me think about how we must and can recognise others’ knowledge, however, it is gained, as expertise and includes those perspectives in our discourse and decision making. I’ve learned that we are not doing things meaningfully and with integrity unless our work is rooted in social justice and in the experiences of those most affected and most marginalised by our systems
How have cross-disciplinary collaborations shaped your work?
I have learned a great deal about different perspectives on the world and public health as well as about myself and what drives me to do the work that I do. Colleagues from other disciplines have challenged my thinking and made me more rigorous and transparent in my work.
We must recognise that our systems, healthcare, educational, political, and criminal justice systems, recreate violent structures that continue to harm the most marginalised and therefore harm us all. And cross-disciplinary work helps us rebuild healthier structures across systems.
Colleagues from health economics, anthropology, epidemiology, architecture, clinical care, and advocacy organisations have provided me with insights that have deeply influenced the work that I do, by recognising how each of those disciplines creates knowledge that I need, to be a better clinician, researcher and advocate.
Cross-disciplinary collaborations have shown me the importance of diverse types of knowledge and ways of thinking, and how all our work is still connected despite these differences.
What advice would you offer to others interested in developing cross-disciplinary work?
I would say embrace working across disciplines, no matter how scary it might seem or even if you don’t think it’s valuable. Differences can make us challenge our assumptions and improve the quality of our work. The intended and unintended consequence of cross-disciplinary work, although often uncomfortable, can be magical. We are stronger together; taking time to learn about each other and working together towards higher goals, and the betterment of humanity.
What's next on the research horizon for you?
I will continue to work in social justice and inclusion health, as a clinician, strategic leader and researcher. I am co-editing the first textbook on Inclusion Health. I plan to complete my PhD shortly and undertake more integrated research across health and social care. Through my NIHR fellowship, I have developed trauma informed health policy evaluation frameworks. I plan to develop these further and plan to get some funding to enable me to undertake some co-produced projects looking at improving health outcomes for sex workers and vulnerable migrants.
If you could make one change in the world today, what would it be?
For us all to look at each other with kindness and compassion first, recognising humanity in the other and demanding that is foremost in our discourse and policy making.