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News Article
Structural racism led to worse Covid impact on BAME groups
Clive Flashman posted a news article in News
Minority ethnic people in UK were ‘overexposed, under protected, stigmatised and overlooked’, new review finds. Structural racism led to the disproportionate impact of the coronavirus pandemic on black, Asian and minority ethnic (BAME) communities, a review by Doreen Lawrence has concluded. The report, commissioned by Labour, contradicts the government’s adviser on ethnicity, Dr Raghib Ali, who last week dismissed claims that inequalities within government, health, employment and the education system help to explain why COVID-19 killed disproportionately more people from minority ethnic communities. Lady Lawrence’s review found BAME people are over-represented in public-facing industries where they cannot work from home, are more likely to live in overcrowded housing and have been put at risk by the government’s alleged failure to facilitate Covid-secure workplaces. She demanded that the government set out an urgent winter plan to tackle the disproportionate impact of Covid on BAME people and ensure comprehensive ethnicity data is collected across the NHS and social care. The report, entitled An Avoidable Crisis, also criticises politicians for demonising minorities, such as when Donald Trump used the phrase “the Chinese virus”. The report, which is based on submissions and conversations over Zoom featuring “heart-wrenching stories” as well as quantitative data, issued the following 20 recommendations: Set out an urgent plan for tackling the disproportionate impact of Covid on ethnic minorities Implement a national strategy to tackle health inequalities Suspend ‘no recourse to public funds’ during Covid Conduct a review of the impact of NRPF on public health and health inequalities Ensure Covid-19 cases from the workplace are properly recorded Strengthen Covid-19 risk assessments Improve access to PPE in all high-risk workplaces Give targeted support to people who are struggling to self-isolate Ensure protection and an end to discrimination for renters Raise the local housing allowance and address the root causes of homelessness Urgently conduct equality impact assessments on the government’s Covid support schemes Plan to prevent the stigmatisation of communities during Covid-19 Urgently legislate to tackle online harms Collect and publish better ethnicity data Implement a race equality strategy Ensure all policies and programmes help tackle structural inequality Introduce mandatory ethnicity pay gap reporting End the ‘hostile environment’ Reform the curriculum Take action to close the attainment gap Read full story Source: The Guardian, 28 October 2020 -
News ArticleOne of the earliest signs that black, Asian and minority ethnic (BAME) people were being disproportionately harmed by the coronavirus pandemic came when the Intensive Care National Audit and Research Centre (ICNAR) published research in early April showing that 35% of almost 2,000 Covid patients in intensive care units in England, Wales and Northern Ireland were non-white. A lot has happened in the intervening six months with numerous reports, including by the Office for National Statistics and Public Health England (PHE), confirming the increased risk to ethnic minorities and recommendations published on how to mitigate that risk. However, as the second wave intensifies, the demographics of those most seriously affected remain remarkably similar. ICNARC figures show that the non-white proportion of the 10,877 Covid patients admitted to intensive care up to 31 August was 33.9% in England, Wales and Northern Ireland. This rises to 38.3% of patients admitted since 1 September, albeit of a much smaller cohort (527 intensive care admissions). The government mantra “we’re all in this together” proved to be little more than an empty rallying cry early in the pandemic and the ICNARC figures show it remains the case that people in the most deprived socioeconomic groups make up a greater proportion of patients in critical care. Read full story Source: The Guardian, 9 October 2020
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News ArticleNHS leaders are being encouraged to have ‘difficult discussions’ about inequalities, after a trust found its BAME staff reported being ‘systematically… bullied and harassed’, along with other signs of discrimination. A report published by Newcastle Hospitals Foundation Trust found the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers. It claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust. The new report revealed that, in a trust survey carried out last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues; had left departments after being given no chance of progression; and been “systematically… bullied and harassed”. Read full story (paywalled) Source: HSJ, 22 September 2020
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News ArticleA third of coronavirus patients in intensive care are from black, Asian and minority ethnic backgrounds, prompting the head of the British Medical Association to warn that government inaction will be responsible for further disproportionate deaths. Chaand Nagpaul, the BMA Council chair, was the first public figure to call for an inquiry into whether and why there was a disparity between BAME and white people in Britain in terms of how they were being affected by the pandemic, in April. Subsequent studies, including a Public Health England (PHE) analysis in early June, confirmed people of certain ethnicities were at greater risk but Nagpaul said no remedial action had been taken by the government. Nagpaul told the Guardian: “We are continuing to see BAME people suffering disproportionately in terms of intensive care admissions so not acting means that we’re not protecting our vulnerable communities. Action was needed back in July and it’s certainly needed now more than ever. “As the infection rate rises, there’s no reason to believe that the BAME population will not suffer again because no action has been taken to protect them. They are still at higher risk of serious ill health and dying.” Read full story Source: The Guardian, 20 September 2020
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News ArticleDevices which measure blood oxygen levels could be giving “seriously misleading” results for Black and minority ethnic people, possibly contributing to increased Covid-19 mortality, experts have warned. Pulse oximeters attach a clip-like device to a person’s finger, toe or earlobe and send a beam of infrared light to measure oxygen levels in the blood. The resulting reading can be used to monitor oxygen levels of people with a variety of conditions, including by people at home with coronavirus, and to assess patients in hospital. At the moment, coronavirus patients who call an ambulance but are not yet deemed sick enough to go to hospital are being given new home oxygen monitoring kits to help spot those who may deteriorate earlier, and over 300,000 oximeters have been sent out by NHS England. But a new paper cites a “growing body of evidence” that pulse oximetry is less accurate in darker skinned patients. This could be contributing to health inequalities such as the increased COVID-19 mortality rates of ethnic minority patients, according to a review conducted for the NHS Race and Health Observatory. It is now calling for the Medicines and Healthcare products Regulatory Agency (MHRA) to urgently review pulse oximetry products for ethnic minority people used in hospitals and by the wider public. Read full story Source: The Independent, 27 March 2021
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News Article
BAME doctors 'still waiting for risk checks'
Patient Safety Learning posted a news article in News
Many doctors from black, Asian and minority ethnic backgrounds say key risk assessments have still not taken place, or have not been acted on. About 40% of UK doctors in the UK are from BAME backgrounds, yet 95% of the medics who have died from coronavirus were from minority backgrounds. The NHS said last June that its trusts should offer risk assessments to staff, but hundreds told a poll for BBC News that they were still awaiting assessments or action. Of 2,000 doctors who responded, 328 said their risks hadn't been assessed at all, while 519 said they had had a risk assessment but no action had been taken. Another 658 said some action had been taken, with just 383 reporting their risks had been considered in detail and action put into place to mitigate them. One of those who responded was Dr Temi Olonisakin, a junior doctor in London who has Type 1 diabetes. She had her risk assessment early on in the pandemic. "It was as comprehensive as a side A4 paper can be," she says. "I think for a lot of people it felt more like a tick-box exercise, and one that could be used to say: 'We've done what we need to do to make people feel safe' - but I'm not sure in reality that's how people felt." Read full story Source: BBC News, 26 March 2021 -
News ArticleYounger adults and those living in poorer neighbourhoods and black people have the highest levels of vaccine hesitancy, new survey data from the Office for National Statistics has shown. The vast majority of Britons back the COVID-19 vaccines and are keen to be inoculated, with more than 9 out 10 people being positive about the jab. But the ONS said data from a survey between 13 January and 7 February revealed reluctance among less than 10% of the population. It found more than 4 in 10 of black or black British adults reported vaccine hesitancy, the highest of all ethnic groups, while adults aged 16-29 were most likely to report hesitancy, at around 1 in 6 or 17%. Adults living in the most deprived areas of England were more likely to report vaccine hesitancy at 16%, compared with 7% of adults in the least deprived areas of England. This has been evident in the take up of the vaccine among some deprived areas of the country which have struggled to vaccinate everyone in priority groups. Even among NHS and social care staff there has been reported hesitancy over vaccines, particularly among BAME staff. Read full story Source: The Independent, 9 March 2021
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News Article
Black over-80s 'half as likely' to have been vaccinated
Patient Safety Learning posted a news article in News
Black people over the age of 80 were half as likely as their white peers to have been vaccinated against Covid by 13 January, a large study suggests. This is despite the fact black people are four times more likely to die with COVID-19 than their white counterparts. People living in deprived areas or who have severe mental-health conditions or learning disabilities were also less likely to have received a vaccination. The study was based on more than 20 million patient records in England. The OpenSafely study, by the University of Oxford and the London School of Hygiene and Tropical Medicine, found of the million of those over 80 but not living in a care home: 43% of the white people had been given their first dose of the vaccine 30% of the Bangladeshi and Pakistani people had 21% of the black people had. Bangladeshi and Pakistani people are twice as likely to die with COVID-19 as white peple. Birmingham-based business owner Tru Powell told BBC Radio 5 Live of a "lack of trust between the government and people of colour". "People of colour have been subject to institutionalised racism within the healthcare system," she said. "We are five times more likely to be detained under the Mental Health Act and four times more likely to die in childbirth." Read full story Source: BBC News, 28 January 2021 -
News ArticlePeople in high-risk minority ethnic groups must be prioritised for Covid immunisations, alongside a targeted publicity campaign, experts and politicians have said amid growing concerns over vaccine scepticism. With figures on Monday recording more than 4m Covid vaccine doses now administered across the UK, and the rollout being expanded to all over-70s, public health experts and MPs called for black, Asian and minority ethnic (BAME) communities to be better protected. The Scientific Advisory Group for Emergencies (Sage) has also raised concerns after research showed up to 72% of black people said they were unlikely or very unlikely to have the jab. Prof Martin Marshall, chair of the Royal College of GPs, urged Whitehall to begin a public health campaign. “We are concerned that recent reports show that people within BAME communities are not only more likely to be adversely affected by the virus but also less likely to accept the Covid vaccine, when offered it,” he said. “As such, where appropriate, we’re calling for public health communications to be tailored to patients in BAME communities, to reassure them about the efficacy and safety of the vaccine and ultimately encourage them to come forward for their vaccination when they are invited for it.” His remarks came as the vaccines minister, Nadhim Zahawi, admitted he feared some BAME communities could remain exposed to coronavirus despite high expected uptake of the jabs. Read full story Source: The Guardian, 18 January 2021
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News Article
Covid vaccine: 72% of black people unlikely to have jab, UK survey finds
Patient Safety Learning posted a news article in News
Advisers from the Scientific Advisory Group for Emergencies (Sage) have raised fresh concerns over Covid vaccine uptake among black, Asian and minority ethnic communities (BAME) as research showed up to 72% of black people said they were unlikely to have the jab. Historical issues of unethical healthcare research, and structural and institutional racism and discrimination, are key reasons for lower levels of trust in the vaccination programme, a report from Sage said. The figures come from the UK Household Longitudinal Study, which conducts annual interviews to gain a long-term perspective on British people’s lives. In late November, the researchers contacted 12,035 participants to investigate the prevalence of coronavirus vaccine hesitancy in the UK, and whether certain subgroups were more likely to be affected by it. Overall, the study found high levels of willingness to be vaccinated, with 82% of people saying they were likely or very likely to have the jab – rising to 96% among people over the age of 75. Women, younger people and those with lower levels of education were less willing, but hesitancy was particularly high among people from black groups, where 72% said they were unlikely or very unlikely to be vaccinated. Among Pakistani and Bangladeshi groups this figure was 42%. Eastern European groups were also less willing. “Trust is particularly important for black communities that have low trust in healthcare organisations and research findings due to historical issues of unethical healthcare research,” said the Sage experts. “Trust is also undermined by structural and institutional racism and discrimination. Minority ethnic groups have historically been underrepresented within health research, including vaccines trials, which can influence trust in a particular vaccine being perceived as appropriate and safe, and concerns that immunisation research is not ethnically heterogenous.” Read full story Source: The Guardian, 16 January 2021 -
News ArticleNHS leaders are being urged to tackle racist abuse of staff as new figures reveal that a third of black, Asian or minority ethnic workers in mental health trusts in England have experienced harassment, bullying or attacks by patients, relatives or members of the public. One in three (32.7%) BAME staff in mental health settings have experienced abuse, according to analysis by the Royal College of Psychiatrists. For BAME workers across the NHS, the rate is more than one in four (28.9%). One medical director told the Guardian that hot tea had been thrown at them “because of the colour of my skin”. A psychiatrist told how they were left traumatised after they were racially abused – then threatened with a knife. The college is calling on health leaders to take a stand against discrimination by setting up better processes in NHS trusts to record and understand data about bullying and harassment. Dr Adrian James, president of the Royal College of Psychiatrists, said the findings were deeply concerning. He said: “NHS leaders and local health bosses must tackle this head-on.” Read full story Source: The Guardian, 9 September 2021
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Content ArticleThe NHS Confederation has published a new report, 'The unequal impact of COVID-19: investigating the effect on people with certain protected characteristics', which maps existing research into COVID-19 inequalities onto some of these protected characteristics, showing how the pandemic has interacted with them. The report then showcases four case studies of how different health and care systems have put in place interventions to respond to these inequalities when designing their COVID-19 response. It focuses on a number of key areas including the impact of COVID-19 on: BAME communities people with disabilities older and younger people. The report concludes with a series of recommendations for health and care systems across the UK.
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Content ArticleThis report from the BME Leadership Network spotlights the findings from a recent survey and engagement on the experience of senior black and minority ethnic leaders in the NHS.
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Content ArticleThis report by NHS Confederation looks at the lived experience of senior black and minority ethnic leaders in the NHS. It is based on the findings of a survey and series of roundtables conducted by the BME Leadership Network in spring 2022, which focused on the challenges BME leaders face in relation to racism and discrimination as they move through their careers. The report highlights that: More than half of surveyed BME NHS leaders considered leaving the health service in the last three years because of their experience of racist treatment while performing their role as an NHS leader. Colleagues, leaders and managers seemed to be a particular source of racist treatment, more so than members of the public. This is concerning, given that the NHS has been prioritising equality, diversity and inclusion activities in recent years. This suggests that more focused efforts are required at every level to reduce the incidence of racist behaviour and to improve awareness among all staff of the impact of this type of discrimination. Only 10 per cent of leaders surveyed were confident that the NHS is delivering its commitment to combat institutional racism and reduce health inequalities. Senior BME staff reported low levels of confidence in their own organisations’ abilities to manage and support a pipeline of diverse talent and in the ability of the system to achieve this at a national level. Only a minority were confident they could rely on the support of colleagues to challenge racial discrimination, and a smaller minority believed they would be supported by NHS England and NHS Improvement if challenging prejudice or discrimination locally. Leaders described how structural and cultural issues within the NHS led to a situation where BME leaders were not present in sufficient numbers to generate a climate of inclusivity and were sometimes siloed in particular types of role. This helped to create a situation where career progression was felt to be unduly challenging and where neither succession planning nor talent development were occurring at sufficient scale to support the next generation of diverse leaders. Some leaders reported policing their own behaviour in the workplace and compromising their values in order to fit in. Being able to represent their own cultures and be themselves at work was a critically important goal for many. The report outlines that it is essential that BME leaders are able to see effective development programmes to support diverse talent, and that they are provided with the right support to feel secure in calling out unacceptable behaviour. It highlights that the NHS needs to do more to tackle cultures of discriminatory behaviour, provide personal support to current and aspiring leaders, and develop succession planning and talent development schemes.
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Content ArticleThis report considers the extent of the gap between the diversity in the workforce and local population of London, and that visible among NHS trust boards and senior management. It highlights the impact of this gap on the effectiveness of healthcare provision and patient experience, in light of research demonstrating that a diverse workforce in which all staff members’ contributions are valued is linked to good patient care.
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Content ArticleIn October 2021 the government announced a review into leadership across health and social care, led by former Vice Chief of the Defence Staff General Sir Gordon Messenger and supported by Dame Linda Pollard, Chair of Leeds Teaching Hospital Trust. The results of the review have now been published and recommendations made.
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Content ArticleIn April 2022, Whose Shoes were invited to run a workshop in Croydon in support of the HEARD campaign - Health Equity and Racial Disparity in Maternity. Women and families from Croydon came together to talk to healthcare professionals about what makes a difference in maternity care, and raising awareness of some of the issues faced by people from Black, Asian and Minority Ethnic communities - not just the 'service users' but staff experiences too.
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Content ArticleMaternal outcomes for Black women are significantly worse than for white women - Black women are four times more likely to die during pregnancy, labour, or postpartum and are twice as likely to have their baby die in the womb or soon after birth. They are also at an increased risk of readmission to hospital in the six weeks after giving birth. This report by the organisation Five X More presents the findings of a survey into black women's experiences of maternity services in the UK. The survey aimed to understand how maternity care is delivered from the perspective of women from the Black community, and 1,340 Black and Black mixed women responded, sharing their experiences. It seeks to highlight the real life encounters behind the known disparities in maternal care. Women reported far more negative experiences than positive, and most of these experiences centred around interactions with healthcare professionals. The authors highlight three factors related to healthcare professionals that contribute to damaging interactions, to do with their attitudes, knowledge and assumptions. The report includes many quotes from Black women about their experiences of NHS care and the damaging long-term consequences of this, such as fear of having another baby, reluctance to engage with health services and mental health issues.
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Content ArticleNaaheed Mukadam and colleagues investigated the incidence of diagnosed dementia and whether age at diagnosis and survival afterward differs among the UK's three largest ethnic groups. They used primary care electronic health records, linked Hospital Episode Statistics and mortality data for adults aged ≥65 years. They compared recorded dementia incidence 1997–2018, age at diagnosis, survival time and age at death after diagnosis in White, South Asian, and Black people. The study found that dementia incidence was higher in Black people. South Asian and Black people with dementia had a younger age of death than White participants and Black participants. The authors concluded that South Asian and Black peoples’ younger age of diagnosis and death means targeted prevention and care strategies for these groups should be prioritised and tailored to facilitate take-up.
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Content ArticleThe investigation and tribunal hearing of Dr Manjula Arora generated significant anger and anxiety among the medical profession. The case raised once again the perception of a regulatory process lacking in fairness; of a system in which the stakes seem much higher if you are a black and minority ethnic doctor. The General Medical Council (GMC) acknowledged that strength of feeling, making clear it would not oppose Dr Arora’s appeal against the sanction and commissioning a review of the case to understand lessons to be learned for future cases.
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Content Article
RCPath - Medical examiners good practice series
Patient-Safety-Learning posted an article in Processes
This Good Practice Series published by The Royal College of Pathologists is a topical collection of focused summary documents, designed to be easily read and digested by busy front-line staff. The documents contain links to further reading, guidance and support, and cover the following topics: Supporting people of Black, Asian and minority ethnic heritage Urgent release of a body Learning disability and autism Organ and tissue donation Post-mortem examinations Child deaths Mental health and eating disorders Out-of-hours arrangements -
Content ArticleRacism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is firmly rooted in our professional Code and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence. This document is a resource for individuals at all levels. This resource does not replace existing NHS England policies and procedures for speaking up and managing racism. It is a resource to support best practice in line with organisational policies and procedures.
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Content ArticleIn this article for The Cut magazine, author Rae Nudson looks at the sometimes severe pain that women face when having gynaecology examinations and procedures, and how this has been accepted and normalised by healthcare professionals. She highlights a lack of understanding about the complex nature of pain, which leads to an expectation that women just need to 'put up' with pain during cervical screening, IUD fitting, hysteroscopy and other procedures. Speaking to women who have had painful and traumatising experiences, she discusses the long-term impact that these negative experiences can have, including putting women off attending potentially life-saving screening appointments. She also outlines the particular problems faced by Black women during gynaecological procedures, caused by incorrect assumptions that they feel pain less and are more able to tolerate it. These assumptions are rooted in historical oppression and racism, but research demonstrates that they still have a bearing on how healthcare professionals treat women from Black and other minority backgrounds.
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Content ArticleThe Voluntary Organisations Disability Group (VODG) has launched a commission on Covid-19, Disablism and Systemic Racism to explore how the worst impacts of Covid have fallen on Disabled people, particularly those from Black, Asian and minoritised ethnic groups. The Commission is examining the extent to systemic neglect of social care over many years has caused negative outcomes that have been worsened by confused approaches by the Government during the pandemic. This includes poor implementation of policy and conflicting guidance. The work will gather evidence, scrutinise the Department of Health and Social Care’s policies and responses to the pandemic, including ways in which systemic racism may have further worsened outcomes for disabled people of colour, and build solutions and support for transformative and sustainable change in social care, based on justice and human rights. The Commission is calling on Disabled people and people with long-term health conditions from Black, Asian and minoritised ethnic groups to share their views and experiences of the Covid-19 pandemic as part of its 'Call for Views and Experiences'. They are also keen to hear from families, carers and people who work in social care.
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Content ArticleIn a project led by the Race Equality Foundation, the Men’s Health Forum teamed up with Faith Action and Clinks to develop a community-centred programme to offer blood pressure testing and raise awareness amongst black African and Caribbean males. The programme was piloted in barbershops, a bus depot and a local church in three London boroughs. It demonstrated that offering blood pressure checks in community settings could help overcome the reluctance amongst black African and Caribbean men to have their blood pressure checked. The report, following evaluation between February-March 2020 in the London boroughs of Southwark, Hackney and Brent, concluded: 'The community blood pressure programme was welcomed in all community settings. The pilots engaged a considerable number of men in an accessible environment that they were comfortable in. There was a willingness from community stakeholders for the programme to be implemented over a longer period of time, and healthcare providers may wish to consider the practicalities of delivering blood pressure testing in similar settings for specific target groups.'
