The evidence from this research suggests that health and social care services in North Lanarkshire are currently perceived as not being equipped to provide a culturally inclusive service that is able to meet the needs of service users in a number of areas such as interpreting and translation, dietary, spiritual and religious needs.

This appears to concur with the situation across the UK as previously echoed by organisations such as Carers UK (2011) and Age UK (2021). The health and social care system needs to develop greater awareness of diverse cultures and provide support that is sensitive to cultural attitudes and practices if it is to meet the future needs of BAME communities. In relation to personal care in particular, the lack of a culturally appropriate care service is putting additional pressure on BAME families to plug the gap.

In line with previous studies, this investigation also reveals a familiar story of language being a barrier to access and effective engagement and uptake of health and social care services among BAME communities.

Empirical research undertaken by the Centre for Migration, Policy, and Society (COMPAS, 2006) documented how the language barrier among migrant and refugee communities can lead to less favourable outcomes in a number of domains such as health and social care. More recent research provides further credence to this and suggests that barriers related to language and communication and a lack of cultural inclusivity contribute to health inequalities for BAME people (Age UK, 2021; Oluwatosin, 2021) and can stifle attempts to achieve successful integration (Home Office, 2019).

Studies across the UK acknowledge that over the next few decades we are likely to see a rise in the number of elderly BAME people needing care (Greenwood, 2018) and if care services are not able to provide a culturally competent service, then negative outcomes are likely to persist for the foreseeable future.

Studies undertaken across the UK have identified that digital exclusion is a real problem faced by BAME groups, especially refugee communities (Refugee Studies Centre, 2021). Digital exclusion is likely to remain an issue if IT training does not meet the needs of learners and if elderly service users do not engage with training. There is already growing evidence to suggest that digital exclusion is associated with social isolation especially among the elderly and this was especially obvious during the Covid-19 pandemic (Seifert, 2020).

Furthermore, as highlighted in this research, there is a digital divide between the younger and older generations and also between those with differing levels of proficiency in the English language. Engaging older people in IT training and language support classes will help bridge the digital divide among generations.

In relation to employment and skills, this research reveals that self-mployment is a popular avenue for attaining employment for many BAME communities due to multiple reasons including discrimination and disadvantage in the labour market. In this respect, the findings validate studies that have consistently revealed the disproportionately higher rates of self- employment among BAME groups in the UK (Clark and Drinkwater, 2000). The research also concurs with literature that underscores problems encountered by BAME individuals in relation to seeking employment and being confined to low-income employment with lower prospects for promotion and progression (Kirton and Greene, 2022).

In considering the theme of community cohesion and integration, the findings indicate a general perception that the cultures of ethnic minority groups are not adequately celebrated or showcased across North Lanarkshire. Most BAME groups appear to have a better relationship with other BAME communities than the white community, with the language barrier and differing expectations and practices in relation to culture and religion the main impediment to greater cohesion with the host community.

The language barrier appears to be a key denominator in the negative outcomes for most BAME communities in relation to multiple areas. It is evident from the voices of BAME communities in this research that the language barrier is impacting negatively on the experience of services received. It is also worsening digital illiteracy and exclusion as the lack of confidence created by a poor grasp of the English language is hindering engagement with IT training and digital services. Furthermore, lack of proficiency in English is hampering employment opportunities, both in terms of applying for jobs and performance at work, and impacting on the ability to develop social bonds with the host community. These outcomes align with evidence presented in studies undertaken by the Home Office over a number of years which have consistently illustrated the detrimental impact of poor language proficiency for BAME groups (Home Office, 2010). More recent work by Morrice et al. (2021) reiterates how poor language and communication skills impede the chances of successful integration.

In relation to gender, for women from the refugee communities in particular, the lack of adequate childcare prevented them from accessing ESOL classes and thereby achieving English language proficiency. This had a subsequent effect on their ability to integrate with the local community and pursue employment. In this research, we have witnessed women from the Congolese refugee community drawing attention to the lack of childcare support. A report by the All-Party Parliamentary Group (APPG) on refugees confirmed the need to provide adequate childcare to allow women from refugee communities to access ESOL classes (APPG, 2017).

The findings reported from this research have implications for a range of stakeholders.

In addition to NLC, health and social care providers, employment agencies, business support organisations, educational authorities and voluntary and third sector organisations and community groups need to consider the implications and respond appropriately. The issues faced by BAME communities suggest that a coordinated approach among relevant stakeholders is needed to address the challenges faced by BAME groups across the key themes explored in this research. Consideration could also be given to the framework developed by the Scottish Government to support the integration of refugees (Scottish Government, 2013) and its ‘priorities plan’ for race equality (Scottish Government, 2021) when considering policy prescriptions.

Local authorities and public sector agencies, in particular, have a legal duty under the Equality Act 2010 and the public sector duty to tackle inequalities in employment and service delivery (EHRC, 2020). They also have an added moral or social justice duty to tackle discrimination and disadvantage across society (Dickens, 1999). At a national level, there may also be lessons for the Scottish Government to take on board as part of its approach to supporting BAME communities across Scotland.