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PCREF Domains Reference

The Patient and Carer Race Equality Framework asks NHS mental health services to evidence racial equity across thirteen domains. Here is how Phoenix Rising breathes life into every single one — not through compliance, but through learning that makes the evidence inevitable.

What is PCREF?

PCREF stands for the Patient and Carer Race Equality Framework. It is a national framework that asks NHS mental health trusts to demonstrate — with evidence — that their services are working towards racial equity across thirteen interconnected domains.

These domains span everything from leadership and workforce development to data, co-production, and clinical practice. Together, they paint a picture of what racially equitable mental health care actually looks like in action.

Phoenix Rising does not treat PCREF as a tick-box compliance exercise. Instead, the learning within each lesson naturally generates the reflections, actions, and evidence that PCREF domains require. When leaders grow, the evidence follows. That is the philosophy at the heart of this system.

The Thirteen PCREF Domains

Each domain below shows which Phoenix Rising lessons explore it. The learning comes first; the evidence follows naturally.

1
Leadership
Who leads matters. This domain asks whether leadership actively drives racial equity — not just signing off on action plans, but modelling the change in every interaction, every decision, every silence they choose to break.
Explored in:
L5 L6 L7 L8
2
Workforce
Are the people delivering care equipped, supported, and reflective? This domain asks whether staff at every level have the skills, supervision, and psychological safety to practise anti-racist care — and whether the workforce itself reflects the communities it serves.
Explored in:
L3 L4 L8
3
Data
Numbers tell stories. This domain asks whether your organisation collects, disaggregates, and acts on racial equity data — not as a compliance exercise, but because data makes the invisible visible and the undeniable undeniable.
Explored in:
L1 L2 L5 L6 L7
4
Co-Production
Nothing about us without us. This domain centres the voices of patients, carers, and communities in every decision — from individual care plans to organisational strategy. Co-production is not consultation; it is shared power.
Explored in:
L1 L2 L3 L4 L5 L6 L7 L8
5
Advocacy
Speaking up and speaking out. This domain asks who advocates for racialised patients and how that advocacy is structured — not as individual heroism, but as a system that ensures every voice is heard and every need is met.
Explored in:
L3 L4 L5 L6 L7 L8
6
Clinical Practice
What happens in the room. This domain examines whether assessment, treatment, and care planning are culturally responsive — whether the care delivered fits the person receiving it, not just the protocol.
Explored in:
L5 L6
7
Transparency
Honesty about where we are. This domain asks whether organisations share their data, progress, and failures openly — because trust is built not by perfection but by the willingness to be seen trying.
Explored in:
L3 L4 L7 L8
8
Collaboration
Working across boundaries. This domain looks at how organisations partner with communities, other services, and each other — because racial equity cannot be achieved in isolation.
Explored in:
L7 L8
9
Culture Change
Shifting the soil. This domain asks whether the underlying culture of the organisation is being transformed — not just its policies on paper, but the lived experience of patients and staff every day.
Explored in:
L3 L4 L5 L6 L7 L8
10
Legal & Regulatory
The frameworks that bind and enable. This domain connects anti-racist practice to the Equality Act, Mental Health Act reform, CQC standards, and regulatory requirements — because legal duties are not separate from moral ones.
Explored in:
L7
11
Safety Investigations
When things go wrong. This domain asks whether safety investigations examine racial bias as a contributing factor — because you cannot fix what you refuse to see.
Explored in:
L5 L6
12
Outcomes
What changes for patients. This domain asks whether racialised patients experience measurably better care and outcomes — because good intentions without evidence of impact are not enough.
Explored in:
L5 L6 L7 L8
13
Mental Models
The invisible scripts. This domain asks leaders to examine the assumptions, beliefs, and frameworks that shape their decisions — because the most powerful systems are the ones we cannot see.
Explored in:
L1 L2 L3 L4 L5 L6 L7 L8

Domain Distribution Heatmap

A visual overview of which PCREF domains are explored in each lesson. Coloured cells indicate coverage — the deeper the spread, the richer the evidence generated.

Domain L1 L2 L3 L4 L5 L6 L7 L8
1. Leadership
2. Workforce
3. Data
4. Co-Production
5. Advocacy
6. Clinical Practice
7. Transparency
8. Collaboration
9. Culture Change
10. Legal & Regulatory
11. Safety Investigations
12. Outcomes
13. Mental Models

Reading the heatmap: Coloured cells show where a PCREF domain is actively explored within a lesson. Domains like Co-Production and Mental Models thread through the entire programme, while others like Legal & Regulatory and Collaboration are concentrated where they have the deepest impact. Every lesson generates evidence across multiple domains simultaneously.

Build Your Evidence Portfolio

Every reflection you write, every action you take, every conversation you change — it all counts. Your Evidence Portfolio is where the learning becomes visible, where PCREF domains come alive through your own practice.

Go to Evidence Portfolio →
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