Alicia Spence

Alicia Spence was born on 25 February 1951 in Hanover Parish, Jamaica, the third of seven children in a close-knit village community. She grew up surrounded by extended family and neighbours, where nearly everyone was related or well known to one another. This environment fostered a strong sense of safety, freedom, and belonging; she recalled roaming the village freely, often under moonlight, and forming lifelong bonds with peers. Her parents migrated to England her father in 1955 and her mother around 1960 leaving Alicia, then aged three and later nine, in the care of aunts and uncles. She described her childhood as happy and stable, with no significant traumatic experiences, thanks to the support of her extended family. Her upbringing instilled deep pride in her heritage, resilience, and a strong sense of community, values reinforced by her parents and the cultural environment of rural Jamaica.

In February 1965, shortly before her fourteenth birthday, Alicia travelled by aeroplane to Wolverhampton with her younger brother to reunite with her parents. Influenced by colonial education, she had imagined England as a land of wealth and opportunity “the streets paved with gold” but the reality was starkly different. She encountered biting cold, cramped housing, and a lack of familiar Caribbean foods, and she missed the open freedom of village life. Nevertheless, her mother’s home cooking and the emerging local Caribbean community provided some continuity and comfort during the adjustment.

At Penn Manor School in Wolverhampton, Alicia and most other Caribbean pupils were placed in classes designated as educationally subnormal (ESN), a practice that reflected widespread institutional bias against immigrant children at the time. Despite her solid foundation from Jamaican schooling, she found the work undemanding and unchallenging, writing to friends in Jamaica that school felt “so easy.” She later recognised this placement as a systemic barrier that limited ambition and opportunity, effectively “setting us up for failure.” Her early dream of becoming a teacher was dismissed by staff as unrealistic and beyond her reach.

At the age of 15, Alicia enrolled in a pre-nursing course at Bilston College. Within the education and training system of the period, Black students were routinely directed towards the shorter State Enrolled Nurse (SEN) qualification rather than the more advanced State Registered Nurse (SRN) pathway, restricting long-term career prospects. In 1969, at 18, she began her SEN training, embarking on a 25-year career in the National Health Service that lasted until 1994. She initially worked on medical wards, where she developed a preference for patient-centred care over surgical environments. She later pursued specialist training in learning disabilities and mental health, discovering a particular affinity for the latter, which became her main area of practice. Conversion from SEN to SRN status required two demanding years of study and advocacy, as such opportunities were not readily extended to Black nurses.

Throughout her NHS career, Alicia encountered overt racism from patients such as refusals of care with remarks like “get your black hands off me” and subtle but persistent bias from some tutors and colleagues, including unfavourable reports. One tutor’s comment, however, acknowledged potential: “Alicia will reach a very high standard if given the opportunity,” an implicit recognition of the structural obstacles she faced. Sustained by the pride and self-worth instilled by her mother — who displayed images of figures such as Muhammad Ali and Martin Luther King in the home — Alicia remained focused on delivering compassionate, professional care. She worked across various NHS settings, including hospitals in Penn and Bromsgrove, and built a reputation for dedication in mental health services.

In 1994, Alicia left the NHS to take a leadership role in a community mental health project run by the Afro-Caribbean Community Consortium Initiative (ACCI), established in Wolverhampton in 1987 to address unmet needs within the Black community. Having joined the board in 1993, she stepped into a staff position during a funding crisis, believing the service’s closure would be irreversible. Under her guidance, the project stabilised, expanded, and continued to provide culturally sensitive support that mainstream services often failed to deliver, marking a significant extension of her commitment to mental health and social equity.

Alicia married, raised a son, and later became a grandmother. She maintained strong ties to Jamaica through regular visits to family and friends, ensuring her own child and granddaughter remained connected to their heritage. Her personal life remained anchored in the values of family, cultural pride, and community responsibility that had shaped her from childhood.

Alicia Spence’s journey reflects the experience of many Jamaican nurses in the post-Windrush NHS: migration as a young person, entry into the profession amid systemic racism and unequal training opportunities, and a sustained career marked by resilience and compassion. Over 25 years, she overcame barriers to provide high-quality care, particularly in mental health, before extending her influence through community leadership. Her legacy lies in both her direct contributions to patient care within the NHS and her efforts to build culturally appropriate services outside it, embodying determination, advocacy, and an enduring commitment to dignity and support for others.