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Lockdown: Suicide fears soar in LGBT community

There has been a significant rise during lockdown in the UK in the number of LGBT people seeking suicide-prevention support.

Support group LGBT Hero reports 11,000 people have accessed its suicide-prevention web pages - up over 44% on the first three months of the year.

The government considers LGBT people to be at higher risk of suicide but no national data on LGBT suicides is kept.

In total, eight charities told BBC News they had seen an increase in LGBT people accessing their support for suicide prevention.

The LGBT Foundation has received more calls about suicide "than ever before". 

Gavin Boyd, of The Rainbow Project, based in Northern Ireland, said: "In just the last three weeks, we know of three LGBT people who have ended their lives."

And another chief executive of a charity, in the south of England, who did not want to be named in case it affected its funding, said: "We know of two young LGBT people in the past two weeks. We're under more pressure to deliver than ever before. The government has done absolutely nothing to help regional LGBT charities cope with the demand from our already struggling service users."

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Source: BBC News, 2 July 2020

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African American children three times more likely to die after surgery than white peers

African American children are three times more likely than their white peers to die after surgery despite arriving at hospitals without serious underlying conditions, the latest evidence of unequal outcomes in health care, according to a study published in the journal Pediatrics,

“We know that traditionally, African Americans have poorer health outcomes across every age strata you can look at,” said Olubukola Nafiu, the lead researcher and an anaesthesiologist at Nationwide Children’s Hospital in Columbus, Ohio. “One of the explanations that’s usually given for that, among many, is that African American patients tend to have higher comorbidities. They tend to be sicker.”

But his research challenges that explanation, he said, by finding a racial disparity even among otherwise healthy children who came to hospitals for mostly elective surgeries.

Out of 172,549 children, 36 died within a month of their operation. But of those children, nearly half were black – even though African Americans made up 11% of the patients overall. Black children had a 0.07% chance of dying after surgery, compared with 0.02% for white children.

Postoperative complications and serious adverse events were also more likely among the black patients and they were more likely to require a blood transfusion, experience sepsis, have an unplanned second operation or be unexpectedly intubated.

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Source: The Independent, 20 July 2020

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‘White leaders under pressure’ to prove black lives matter

Incoming Health Education England chief executive Navina Evans said the momentum created by the death of George Floyd and the Black Lives Matter movement meant there was now increased “pressure on white leaders” to act on racism and discrimination in the service.

Dr Evans praised a letter written by Birmingham and Solihull Mental Health Foundation Trust chief executive Roisin Fallon-Williams, in which she admitted to being “culpable” and “complicit” in failing to fully understand the inequality and discrimination faced by people with black, Asian or other minority ethnic backgrounds.

“That was great to see, and as you can see from the reactions to her letter people were really, really pleased to have it acknowledged,” she said.

However, Dr Evans added: “As well as that [acknowledgement] there needs to be action”.

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Source: HSJ, 22 June 2020

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‘Shameful’ data reveals NHS treatment of minority ethnic staff

Five years after launching a plan to improve treatment of black and minority ethnic staff, NHS England data shows their experiences have got worse.

Almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year, according to “shameful” new data.

Minority ethnic staff in the NHS have reported a worsening experience as employees across four key areas, in a blow to bosses at NHS England, five years after they launched a drive to improve race equality.

Critics warned the experiences reported by BME staff raised questions over whether the health service was “institutionally racist” as experts criticised the NHS “tick box” approach and “showy but pointless interventions”.

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Source: The Independent, 18 February 2020

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NHS blood unit is “systemically racist” and “psychologically unsafe,” investigation finds

An independent investigation into working conditions at a unit of the NHS’s blood and organ transplant service has concluded that it is “systemically racist” and “psychologically unsafe.”

The internal investigation was commissioned in response to numerous complaints from ethnic minority staff working in a unit of NHS Blood and Transplant (NHSBT) in Colindale, north London. The report, carried out by the workplace relations company Globis Mediation Group, concluded that the environment was “toxic” and “dysfunctional.”

The report found evidence that ethnic minority employees had faced discrimination when applying for jobs and that white candidates had been selected for posts ahead of black applicants who were better qualified. “Recruitment is haphazard, based on race and class and whether a person’s ‘face fits,’” it said.

“Being ignored, being viewed as ineligible for promotion and enduring low levels of empathy all seem to be normal,” the report noted. “These behaviours have created an environment which is now psychologically unsafe and systemically racist.”

Chaand Nagpaul, BMA council chair, commented, “This report highlights all too painfully the racial prejudices and discrimination we are seeing across healthcare. We must renew efforts to challenge these behaviours and bring an end to the enduring injustices faced by black people and BAME healthcare workers here in the UK.”

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Source: BMJ, 10 June 2020

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Black people four times more likely to die from coronavirus than white people, ONS figures show

The Office for National Statistics (ONS) has published its first figures analysis Covid-19 related deaths by ethnic group in England and Wales between March 2 and April 10.

The results showed that the risk of death involving the coronavirus among Black, Asian, and minority ethnic (BAME) groups is “significantly higher” than that of those of white ethnicity.

Researchers found that when taking age into account, in comparison to white men and women, black men are 4.2 times more likely to die from a Covid-19-related death and black women are 4.3 times more likely.

People with Bangladeshi, Pakistani, Indian and mixed ethnicities have a raised risk of death, too.

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Source: The Telegraph, 7 May 2020

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‘Insufficient’ national response to deaths review programme, report finds

The latest annual report into the deaths of people with learning disabilities has criticised the “insufficient” national response to past recommendations and called for “urgent” policy changes.

The national learning disabilities mortality review programme has criticised the response from national health bodies to its previous recommendations.

To date, just over 7,000 deaths have been notified to the programme and reviews have been completed for just 45%.

There have been four annual reports for programme to date, and in the latest published today, the authors warned: “The response to these recommendations has been insufficient and we have not seen the sea change required to reassure [families] that early deaths are being prevented."

“It is long over-due that we should now have concerted national-level policy change in response to the issues raised in this report and previous others. A commitment to take forward the recommendations in a meaningful and determined way is urgently required.”

The latest report also warns that black, Asian and ethnic minority children with learning disabilities die “disproportionately” younger compared to other ethnicities.

It also found system problems and gaps in service provision were more likely to contribute to deaths in BAME people with learning disabilities. 

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Source: HSJ, 16 July 2020

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COVID-19: Many trusts have not done risk assessments for ethnic minority staff

Some NHS trusts in England are yet to complete /cOVID-19 risk assessments for their staff from ethnic minority groups more than two months after the NHS first told them to do so, an investigation by The BMJ has found.

On 29 April NHS England’s chief executive, Simon Stevens, wrote to all NHS leaders telling them to carry out risk assessments and make “appropriate arrangements” to protect ethnic minority staff, amid growing evidence that they were at greater risk of contracting and dying from COVID-19.

However, The BMJ asked England’s 140 acute care trusts for details of risk assessments they had carried out and what subsequent actions they had put in place. Seventy trusts responded. Of these, 27 (39%) said that assessments were yet to be completed for all ethnic minority staff, and 43 (61%) indicated that assessments had been completed. But the other 70 trusts were unable to provide a response within the 20 day deadline, citing “unprecedented challenges” posed by the COVID-19 pandemic, so it is not known what stage they are at in risk assessing staff.

Commenting on The BMJ’s findings, Chaand Nagpaul, the BMA’s chair of council, said, “Clearly, we know that a significant number of doctors have not been risk assessed. It is a shame that it has taken so long, because the risk assessments and mitigations would have been most useful and impactful during the peak of the virus.”

Doctors’ leaders have suggested that systemic race inequalities in the workplace may have exacerbated delays in risk assessing staff. Nagpaul said, “The BMA survey found that doctors from a BAME [black, Asian, and minority ethnic] background felt under more pressure to see patients without adequate protection. So it does beg the question of whether there’s also been this added factor of BAME healthcare staff feeling unable to demand their right to being assessed and protected."

“This is something the NHS needs to tackle. This is an issue that predates covid. It’s vital that we have an NHS where anyone is able to voice their concerns. No one should have to suffer or have fear in silence.”

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Source: The BMJ, 10 July 2020

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BAME NHS workers could be given roles reducing risk from coronavirus under new guidance

NHS staff from black, Asian and minority ethnic (BAME) backgrounds should be “risk-assessed” and possibly moved away from patient-facing roles during the coronavirus crisis, according to official guidance.

A letter from NHS England acknowledges UK data showing these workers are being “disproportionately affected by Covid-19” and urges health trusts to make “appropriate arrangements”.

Public Health England has been asked to look into the issue by the Department of Health, the letter from NHS chief executive Sir Simon Stevens and chief operating officer Amanda Pritchard said.

“In advance of their report and guidance, on a precautionary basis we recommend employers should risk assess staff at a potentially greater risk and make appropriate arrangements accordingly,” he added.

This could mean BAME health workers being relocated away from patient-facing roles or ensuring they are adequately fitted with personal protective equipment (PPE).

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Source: The Independent, 30 April 2020

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Coronavirus disproportionately affecting BAME communities in UK, new figures show

More than 16% of people who had tested positive for coronavirus when they died were from black, Asian and minority ethnic (BAME) communities, new data shows.

On Monday, NHS England released data showing the ethnic breakdown of people who have died with coronavirus for the first time.

The statistics come days after a review was announced to examine what appears to be a disproportionate number of BAME people who have been affected by Covid-19.

Last week Downing Street confirmed the NHS and Public Health England will lead the review of evidence, following pressure on ministers to launch an investigation.

Discussing the review, Professor Chris Whitty, the chief medical officer for England, said ethnicity is "less clear" than three others factors in determining who is most at risk from coronavirus.

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Source: The Independent, 21 April 2020

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Revealed: the NHS’s plan to protect BAME staff from COVID-19

The NHS faces a new set of wide-ranging requirements as part of a comprehensive plan to mitigate the impact of COVID-19 on black, Asian and minority ethnic staff, HSJ has discovered.

A draft NHS England/NHS Improvement document, seen by HSJ, proposes trusts ensure every staff member has “a risk assessment to keep them safe”. It says the centre will provide: “Guidance and support to employers on creating proactive approaches to risk assessment for BAME staff, including physical and mental health.”

The document, Addressing Impact of Covid-19 on BAME Staff in the NHS, will call for five actions:

1. Every member of staff, current and returning, will have a risk assessment to keep them safe.

2. Every organisation with a CEO, and for primary care CCGs and ICSs, needs a BAME co-leader.

3. Diversity at every level of the health and care system starts with the podium, through our senior decision-making forums and across all organisations and at all levels of the workforce.

4. A bespoke health and wellbeing (including rehab and recovery) offer for BAME staff will be developed and rolled out for the system.

5. Every part of the system will use guidance on increasing diversity and inclusion in communications will be produced, led by the system.

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Source: HSJ, 6 April 2020

 

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BAME nursing staff experiencing greater PPE shortages despite COVID-19 risk warnings

Amid warnings that BAME nursing staff may be disproportionately affected by the COVID-19 pandemic, a Royal College of Nursing (RCN) survey reveals that they are more likely to struggle to secure adequate personal protective equipment (PPE) while at work.

The latest RCN member-wide survey shows that for nursing staff working in high-risk environments (including intensive and critical care units), only 43% of respondents from a BAME background said they had enough eye and face protection equipment. This is in stark contrast to 66% of white British nursing staff.

There were also disparities in access to fluid-repellent gowns and in cases of nursing staff being asked to re-use single-use PPE items.

The survey found similar gaps for those working in non-high-risk environments. Meanwhile, staff reported differences in PPE training, with 40% of BAME respondents saying they had not had training compared with just 31% of white British respondents.

Nearly a quarter of BAME nursing staff said they had no confidence that their employer is doing enough to protect them from COVID-19, compared with only 11% of white British respondents.

Dame Donna Kinnair, RCN Chief Executive & General Secretary, said: “It is simply unacceptable that we are in a situation where BAME nursing staff are less protected than other nursing staff.

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Source: Royal College of Nursing, 27 May 2020

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RCOG launches Race Equality Taskforce

The Royal College of Obstetricians and Gynaecologists ( (RCOG) has today launched a Race Equality Taskforce to better understand and tackle racial disparities in women’s healthcare and racism within the obstetric and gynaecology workforce.

Addressing health inequalities is a key priority area for RCOG President Dr Edward Morris, who is co-chairing the Taskforce alongside Dr Ranee Thakar, Vice President of the RCOG, and Dr Christine Ekechi, Consultant Obstetrician & Gynaecologist and RCOG Spokesperson for Racial Equality.

Statistics show, for example, that black women are five times more likely to die in pregnancy, childbirth or in the six-month postpartum period compared with White women and the risk for Asian women is twice as high.

During the pandemic, 55% of pregnant women admitted to hospital with coronavirus were from a Black, Asian or other minority ethnic background despite the fact 13% of the UK population identify themselves as BAME.

It is also clear that there is a significant gap in understanding the factors that result in a higher risk of morbidity and mortality for Black, Asian and other ethnic minority women in the UK.

The Taskforce will collaborate with groups across healthcare and government as well as individual women to address these concerning trends and will ensure that the work of the RCOG is reflective of its anti-racist agenda.

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Source: RCOG, 15 July 2020

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Coronavirus: 'Structural racism' must be taken into account when dealing with BAME deaths

"Structural racism and social inequality" should be taken into account when looking at the impact of COVID-19 on Britain's black, Asian and minority ethnic, according to an expert involved in a recent review.

Professor Kevin Fenton was a major part of a Public Health England (PHE) report ordered by the government into why the BAME community has been disproportionately affected by coronavirus. It found people from BAME groups were up to twice as likely to die with COVID-19 than those from a white British background.

The review was also meant to offer recommendations, but sources have told Sky News that these were "held back" by the government.

Health Secretary Matt Hancock said coming from a non-white background was a

Speaking at a public meeting for Hackney Council, Prof Fenton said: "Over the last six weeks I've worked with over 4,000 individuals to understand what are some of the contextual issues that are driving the excess risk amongst, black, Asian and minority ethnic groups."

"Some of the structural issues, like racism, discrimination, stigma, distrust, fair, these are real issues that are challenging for the communities and are seen as underpinning some of the disparities we see for COVID. Any conversation about what we need to do, should take into consideration these things."

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Source: Sky News, 9 June 2020

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Government censored BAME covid-risk review

The government removed a key section from Public Health England’s review (published Tuesday) of the relative risk of COVID-19 to specific groups, HSJ has discovered.

The review reveals the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those with Asian, Caribbean and black ethnicities. It makes no attempt to explain why the risk to BAME groups should be higher.

An earlier draft of the review which was circulated within government last week contained a section which included responses from the 1,000-plus organisations and individuals who supplied evidence to the review. Many of these suggested that discrimination and poorer life chances were playing a part in the increased risk of COVID-19 to those with BAME backgrounds. HSJ understands this section was an annex to the report but could also stand alone.

Typical was the following recommendation from the response by the Muslim Council of Britain, which stated: “With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to tackle the culture of discrimination and racism. It may also be of value to issue a clear statement from the NHS that this is not acceptable, committing to introducing change.”

One source with knowledge of the review said the section “did not survive contact with Matt Hancock’s office” over the weekend.

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Source: HSJ, 2 June 2020

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Racism 'could play a part in BAME covid deaths'

Factors such as racism and social inequality may have contributed to increased risks of black, Asian and minority communities catching and dying from COVID-19, a leaked report says.

Historic racism may mean that people are less likely to seek care or to demand better personal protective equipment, says the Public Health England (PHE) draft, seen by the BBC. Other possible factors include risks linked to occupation and inequalities in conditions such as diabetes may increase disease severity.

The report, the second by PHE on the subject, pointed to racism and discrimination as a root cause affecting health and the risk of both exposure to the virus and becoming seriously ill.

It said stakeholders expressed "deep dismay, anger, loss and fear in their communities" as data emerged suggesting COVID-19 was "exacerbating existing inequalities".

And it found "historic racism and poorer experiences of healthcare or at work" meant individuals in BAME groups were less likely to seek care when needed or to speak up when they had concerns about personal protective equipment or risk.

The report concluded: "The unequal impact of COVID-19 on BAME communities may be explained by a number of factors ranging from social and economic inequalities, racism, discrimination and stigma, occupational risk, inequalities in the prevalence of conditions that increase the severity of disease including obesity, diabetes, hypertension and asthma."

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Source: BBC News, 13 June 2020

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Coronavirus: 70% of BAME pharmacists have had no risk assessment

More than two-thirds of black, Asian and minority ethnic pharmacists have not had workplace risk assessments for coronavirus, a survey suggests.

Of the 380 hospital and community-based pharmacists surveyed by the Royal Pharmaceutical Society and the UK Black Pharmacists Association, 236 were from a BAME background.

Of those, 166 (70%) said they had not been approached by their employer to have a risk assessment.

The RPS called the results "shocking". It has called on employers to take urgent action to ensure ethnic minority pharmacists are risk assessed.

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Source: BBC News, 26 June 2020

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NHS rolls out additional support for pregnant BAME women

After new analysis showed pregnant black women were eight times more likely and Asian women four times as likely to be admitted to hospital with COVID-19, the NHS is rolling out additional support for pregnant women of a Black, Asian and Ethnic Minority (BAME) background.

Given evidence of the heightened risk to BAME expectant mums, urgent action is being taken in England including increasing uptake of Vitamin D and undertaking outreach in neighbourhoods and communities in their area.

Research carried out by Oxford University has shown 55% of pregnant women admitted to hospital with coronavirus are from a BAME background, even though they represent only a quarter of the births in England and Wales.

In response, England’s most senior midwife, Jacqueline Dunkley-Bent, has written to all maternity units in the country calling on them to take four specific actions to minimise avoidable COVID-19 risk for BAME women and their babies.

The steps include:

  • Increasing support of at-risk pregnant women – e.g. making sure clinicians have a lower threshold to review, admit and consider multidisciplinary escalation in women from a BAME background.
  • Reaching out and reassuring pregnant BAME women with tailored communications.
  • Ensuring hospitals discuss vitamins, supplements and nutrition in pregnancy with all women. Women low in vitamin D may be more vulnerable to coronavirus so women with darker skin or those who always cover their skin when outside may be at particular risk of vitamin D insufficiency and should consider taking a daily supplement of vitamin D all year.
  • Ensuring all providers record on maternity information systems the ethnicity of every woman, as well as other risk factors, such as living in a deprived area (postcode), co-morbidities, BMI and aged 35 years or over, to identify those most at risk of poor outcomes.

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Source: NHE, 29 June 2020

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BAME safety plan not published

A report containing measures to protect ethnic minority groups from coronavirus has been drawn up for government, BBC News has learned.

Public Health England (PHE) published a review last week confirming coronavirus kills people from ethnic minorities at disproportionately high rates. But a senior academic told BBC News a second report, containing safeguarding proposals to tackle this, also existed.

And PHE now says this report will be published next week.

Labour described the decision not to immediately publish the second report as "scandalous and a tragedy".

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Source: BBC News, 11 June 2020

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COVID-19: Shielding doctors express concerns about returning to work

Doctors who have been shielding during the covid-19 pandemic have said they are worried for their safety when they return to work.

From 1 August those who are at high risk of serious illness if they contract covid-19 will no longer be advised to shield in England, Scotland, and Northern Ireland.123 But doctors who have been shielding during the pandemic have expressed concerns about their safety when they return to work, and say they feel forgotten by their employers.

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Source: BMJ, 21 July 2020

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Coronavirus may cause 3,500 deaths in England from four main cancers

About 3,500 people in England may die within the next five years of one of the four main cancers – breast, lung, oesophageal or bowel – as a result of delays in being diagnosed because of COVID-19, say the researchers in the Lancet Oncology journal.

“Our findings demonstrate the impact of the national Covid-19 response, which may cut short the lives of thousands of people with cancer in England over the next five years,” said Dr Ajay Aggarwal from the London School of Hygiene & Tropical Medicine, who led the research.

Routine cancer screening was suspended during the lockdown, the authors said. So was the routine referral to hospital outpatient departments of people with symptoms that could be something else but also might possibly be cancer. Only those deemed to need emergency care by the GP or those who go to A&E are being picked up. Inevitably, those are people with more advanced cancers. If cancer is picked up at an earlier stage, successful treatment and survival are much more likely.

“Whilst currently attention is being focused on diagnostic pathways where cancer is suspected, the issue is that a significant number of cancers are diagnosed in patients awaiting investigation for symptoms not considered related to be cancer. Therefore we need a whole system approach to avoid the predicted excess deaths,” said Aggarwal.

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Source: The Guardian, 20 July 2020

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Unit put into special measures after ‘inadequate’ rating

A low secure unit for people with learning disabilities and autism has been put into special measures after inspectors found the use of restraint and segregation affected the quality of life for some patients.

Cedar House, in Barham near Canterbury, houses up to 39 people and had been rated “good” by the Care Quality Commission early last year.

But at an inspection in February this year inspectors rated the service – run by the Huntercombe Group — “inadequate,” saying it was not able to meet the needs of many of the patients at the unit. It was issued with three requirement notices.

One patient had been subject to prolonged restraint 65 times between September and February. Each time he was restrained by between two and 19 staff, for an average of nearly two hours. On one occasion, this restraint lasted for eight hours.

But the inspectors were told that in the six months before the inspection 29 staff had been injured during these restraints, and the hospital had been trying to refer the patients to a more secure environment.

“The impact of this inappropriately placed patient was considerable for both the patients and the hospital,” the report said. “The staff who were regularly involved in restraining the patient were tired and concerned about the welfare and dignity of the patient.”

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Source: HSJ, 21 July 2020

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Have your say in shaping the future of NHS complaint handling

The Parliament and Health Service Ombudsman (PHSO) been working with the NHS and other public service organisations, members of the public and advocacy groups to develop a shared vision for NHS complaint handling. We've called this the Complaint Standards Framework. 

Now they want to hear from you.

Have your say in shaping the future of NHS complaint handling by taking part in their survey. 

Read the Complaint Standards Framework: Summary of core expectations for NHS organisations and staff

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Coronavirus vaccine: Oxford trial is ‘safe’ and produces immune reaction, first study results show

The coronavirus vaccine candidate being developed by AstraZeneca and Oxford University induces a strong immune response and appears to be safe, according to preliminary trial results.

The early stage trial, which involved 1,077 people, has found that the vaccine trains the immune system to produce antibodies and white blood cells capable of fighting the virus. It also causes few side effects.

Professor Sarah Gilbert, co-author of the Oxford University study, described the findings as promising but said there “is still much work to be done before we can confirm if our vaccine will help manage the Covid-19 pandemic”.

The results came as the UK secured 90 million doses of other promising Covid-19 vaccines, while clinical trials of a new inhaled coronavirus treatment showed it significantly reduced the number of hospitalised patients needing intensive care.

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Source: The Independent, 21 July 2020

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NHS staff to receive ‘air accident’ safety training to reduce patient harm

Frontline NHS staff will be given specialist ‘air accident investigation’ style training to help improve the way the health service learns from patient safety incidents.

Cranfield University, which has been training air, maritime and rail safety investigators for more than 40 years, is to launch the first intensive course for NHS staff responsible for investigating safety incidents in hospitals.

It is part of a growing effort to install a safety science approach to avoidable harm in the NHS, with the service increasingly looking to other industries to adopt new approaches based on the science of human factors and just culture.

Traditionally the NHS has focused on simpler investigations that too often miss systemic causes of mistakes and instead target individual nurses and doctors for blame.

The new one week intensive course, run in partnership with the charity Baby Lifeline, will start in January and will give students a basic grounding in the science of investigation and using real-life actors and a maternity based scenario, show participants how to get to the real causes of what went wrong.

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Source: The Independent, 20 July 2020

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