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Showing results for tags 'Discrimination'.
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Content ArticleThe latest NHS Workforce Race Equality Standard (WRES) data shows that it is still over twenty times more likely that a White Band 5 nurse will become a Director of Nursing compared to a Band 5 BME nurse. In this letter Roger Kline, Research Fellow at Middlesex University Business School, outlines his concerns about discrimination and bullying taking place within the NHS. Addressed to Secretary of State for Health and Social Care Steve Barclay, the letter recalls the findings of the Messenger report commissioned by Mr Barclay's predecessor Sajid Javid, which found that “acceptance of discrimination, bullying, blame cultures and responsibility avoidance has almost become normalised in certain parts of the system, as evidenced by staff surveys and several publicised examples of poor practice." Referring to recent calls to reduce spending on equality, diversity and inclusion (EDI), he outlines why patient care and frontline services cannot be detached from efforts to improve EDI. He argues that research strongly suggests how staff are treated (including whether they face discrimination) impacts on patient care, staff well-being and organisational effectiveness.
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News Article
NHS treatment algorithms ‘not taking transgender patients into account’
Patient Safety Learning posted a news article in News
A host of algorithms used by medics to assess disease risk and help make decisions on treatment are failing to take transgender patients into account, doctors have said. Many metrics and thresholds in medicine, including ideal body weight, alcohol clearance rates, kidney function and risk of cardiovascular disease vary by gender. A team of UK doctors and medical students have issued a warning over a lack of evidence as to whether trans patients should be considered for these gender-based scores according to their gender assigned at birth or the gender they have transitioned to – or whether alternative scores are required. In an effort to tackle the issue, the team have launched a research initiative called Trans Gap Project. Dr Michael Niman, a junior NHS doctor and chair of the project, said: “Currently, daily medical decisions involving gender-based scores have limited to no research for the trans community. This means that trans patients are often forgotten about or not considered in the medical world, leading to a significant gap in their access to appropriate medical care.” “When scores that haven’t considered trans people are used, patient autonomy is impaired for trans and gender-diverse patients, as they can’t make true informed decisions on their care – which is one of the bioethic pillars,” Niman said. In some cases, there could be safety concerns. “Clinicians are currently faced with uncertainty regarding the best clinical practice to address these scenarios, owing to a lack of evidence-based guidance,” Niman said. “It is vital clinicians take a vested interest in the research of gender-based scores for the trans community due to the importance of safe practice considerations within the NHS.” Read full story Source: The Guardian, 5 May 2023 -
Content ArticleWhen something goes wrong in health or care, patients need to understand their rights to complain and seek resolution. The Equality Advisory Support Service Helpline (EASS) supports individuals who wish to achieve an informal resolution when they feel they have experienced discrimination or want to understand their human rights. This article, written by the EASS for The Patients Association, explains an individual's rights under the Equality Act 2010 and what to do if you believe they’ve been violated.
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News Article
Discrimination ‘biggest cause of staff leaving’
Patient Safety Learning posted a news article in News
Discrimination and inequality are bigger factors for staff wanting to leave acute trusts than burnout, new analysis of this year’s NHS staff survey has found. Researchers at LCP compared 12 summary indicators within the survey to answers on intention to leave, to build a “relative importance model” to explain “nearly 85% of the variation in intention to leave”. LCP said: “Approximately 30 per cent of that explained variance is attributable to the diversity and equality score (compared to less than 10 per cent attributable to the burnout summary indicator score).” Natalie Tikhonovsky, an analyst in LCP’s Health Analytics team, said: “Our analysis reveals a grim picture of low satisfaction levels and higher staff turnover rates currently facing the NHS acute sector. Understanding what is driving this will be key to the success of the government’s new workforce plan and to the overall aim of reducing steadily increasing wait lists.” Read full story (paywalled) Source: HSJ, 28 April 2023 -
Content ArticleThis new report from the British Red Cross describes how asylum seekers struggle to access the internet and lack digital tools. The British Red Cross explained that the report aims to improve understanding of the experiences of digital exclusion among people seeking asylum, and how these experiences may impact access to, and experience of, healthcare. Researchers conducted interviews with 30 people currently seeking asylum across England for the report. The researchers themselves also had lived experience of seeking asylum.
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Content ArticleThe COVID-19 Recovery Committee has published its report on Long Covid and post-Covid syndrome, urging the Scottish Government to take action to address the stigma surrounding the condition and improve awareness among the public and healthcare professionals. The inquiry focussed on the awareness and recognition, therapy and rehabilitation, and study and research linked to Long Covid, with the Committee noting “concern” in their findings over reports of patients being unable to get the correct diagnosis and the lack of treatment for common conditions associated with the condition. The Committee said it was “deeply saddened” to learn about the stigma faced by those with lived and living experience of Long Covid, and the report highlights the impact that the lack of awareness and recognition of Long Covid can have on those with the condition.
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Content ArticleThis BMJ Leader article from Roger Kline looks at how to tackle structural racism in the NHS, discussing psychological safety and inclusion, and the role leaders need to play.
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News Article
End racial disparities in maternal deaths
Patient Safety Learning posted a news article in News
An MPs' report is calling for faster progress to tackle "appalling" higher death rates for black women and those from poorer areas in childbirth. The Women and Equalities Committee report says racism has played a key role in creating health disparities. But the many complex causes are "still not fully understood" and more funding and maternity staff are also needed. The NHS in England said it was committed to making maternity care safer for all women. The government said it had invested £165m in the maternity workforce and was promoting careers in midwifery, with an extra 3,650 training places a year. Black women are nearly four times more likely than white women to die within six weeks of giving birth, with Asian women 1.8 times more likely, according to UK figures for 2018-20. And women from the poorest areas of the country, where a higher proportion of babies belonging to ethnic minorities are born, the report says, are two and a half times more likely to die than those from the richest. Caroline Nokes, who chairs the committee, said births on the NHS "are among the safest in the world" but black women's raised risk was "shocking" and improvements in disparities between different groups were too slow. "It is frankly shameful that we have known about these disparities for at least 20 years - it cannot take another 20 to resolve," she added. -
Content ArticleIn the wake of the Covid-19 pandemic, we are all too aware of the urgent health inequalities that plague our world. But these inequalities have always been urgent: modern medicine has a colonial and racist history. Here, in an essential and searingly truthful account, Annabel Sowemimo unravels the colonial roots of modern medicine. Tackling systemic racism, hidden histories and healthcare myths, Sowemimo recounts her own experiences as a doctor, patient and activist. Divided exposes the racial biases of medicine that affect our everyday lives and provides an illuminating - and incredibly necessary - insight into how our world works, and who it works for.
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Content ArticleCervical cancer disparities persist for Black women despite targeted efforts. Reasons for this vary; one potential factor affecting screening and prevention is perceived discrimination in medical settings. This US study in the Journal of Racial and Ethnic Health Disparities aimed to describe experiences of perceived discrimination in medical settings for Black women and to explore the impact on cervical cancer screening and prevention. The authors concluded that Black women engaging in healthcare are experiencing perceived discrimination in medical settings. They suggest that future interventions should address the poor quality of medical encounters that Black women experience.
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Content ArticleA just and learning culture is the balance of fairness, justice, learning–and taking responsibility for actions. It is not about seeking to blame the individuals involved when care in the NHS goes wrong, nor the absence of responsibility and accountability. This report by NHS Resolution aims to promote the value of a person-centred workplace that is compassionate, safe and fair.
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News Article
Whistleblowers ‘frustrated and disappointed’ by CQC, review finds
Patient Safety Learning posted a news article in News
The Care Quality Commission’s follow-up of whistleblowing concerns from health and care staff has been poor and inconsistent, and there is a “widespread lack of competence and confidence” on dealing with race and racism at the organisation, two reviews have found. A “Listening, learning, responding to concerns” review was published by the Care Quality Commission, alongside a linked independent review into how the regulator failed Shyam Kumar, a consultant orthopaedic surgeon in the North West, who was also a CQC specialist professional adviser. The wider review looked at a range of issues including how the CQC deals with racism; how well it listens to whistleblowers in providers; and how it deals with its own staff, including as part of a recent restructure, and its internal “Freedom to Speak Up” process. It followed concerns bring raised, in addition to Mr Kumar’s case, about these issues. Scott Durairaj, a CQC director who joined it last year and led the review work along with a panel of advisers, reported there was “clear evidence, during the scoping, design phase and throughout the review, of a widespread lack of competence and confidence within CQC in understanding, identifying and writing about race and racism”. Read full story (paywalled) Source: HSJ, 29 March 2023 -
Content ArticleThe concerns that health and care workers and the public share with the Care Quality Commission (CQC) about health and care services are critical to its work. It is also vital that CQC listens to its own staff. This review explores whether there are areas of culture or process within CQC that need to be improved in relation to listening, learning, and responding to concerns. The review focused on these key areas: Organisational findings Reviewing how well we listen to whistleblowing concerns. Reviewing our Freedom to Speak Up policy. Learning from the tribunal case. Reviewing how we listen to our staff. Reviewing the expectations and experiences of people who raise concerns with us.
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News Article
‘Deliberate attempts’ to conceal racism at NHS agency, says leaked report
Patient Safety Learning posted a news article in News
Deliberate attempts were made to “conceal the extent of racial discrimination” at a national NHS agency, according to a report leaked to HSJ. A highly critical internal report at NHS Blood and Transplant (NHSBT) also said fewer than half the recommendations made in 2020 by external mediation experts, around issues of racism, had so far been actioned. A review conducted by Globis Mediation Group in 2020 found “systemic racism” among management at the agency’s large Colindale site in north London, with ethnic minority staff being “ignored, being viewed as ineligible for promotion and enduring low levels of empathy”. It made nine recommendations, including exploring whether similar issues existed at the other 15 NHSBT sites. Read full story Source: HSJ, 16 March 2023 -
News Article
Trust CEO apologises to staff subjected to racist behaviour
Patient Safety Learning posted a news article in News
A chief executive has apologised after a survey of his trust’s staff from minority ethnic backgrounds found many had been subjected to racist behaviour by colleagues. The staff at East of England Ambulance Service Trust said peers had made monkey noises and referred to banana boats in front of them, excluded them from social events, and assumed they could speak Middle Eastern and Asian languages just because of their skin colour, they told researchers. The trust has had substantial cultural problems for several years, and commissioned the survey to “better understand the experience, perceptions and realities of the trust BME staff”, a board paper said. The report on its findings, published this week in trust board papers, warns: “There are risks that a minority of EEAST employees are demonstrating behaviours or using language which could be perceived as racist. Reports of subsequent inaction by managers further risk this behaviour being normalised.” Read full story (paywalled) Source: HSJ, 15 March 2023 -
Content ArticleThis letter to NHS mental health trusts, Integrated Care Boards and Commissioners outlines NHS England's position on the use of Serenity Integrated Mentoring (SIM) in NHS mental health services. SIM is a model of care that has been used with people with mental health issues who are considered high-intensity users of emergency services. It is a controversial approach as it instructs services providing emergency care not to provide support to these individuals.
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News Article
Age discrimination leading to avoidable eating disorder deaths, government warned
Patient Safety Learning posted a news article in News
The government must end “age discrimination” against eating disorder patients that is causing avoidable deaths, experts have warned. A cross-party parliamentary group and the Royal College of Psychiatrists are calling for access targets to make sure adults with eating disorders get treated within a set time. The demands come after the healthcare watchdog said patients were dying while waiting to be seen. Wera Hobhouse, chair of the All Party Parliamentary Group, and Agnes Ayton, chair of the Royal College of Psychiatrists’ eating disorder committee, said the targets must be equal to those for children, which were set in 2016. According to the Health Service Journal, 19 patients under the care of inpatient and community eating disorder services have died since 2017. A senior coroner in Norfolk also highlighted failings in 2019 and sent a warning to both NHS England and the Department for Health and Social Care, over the deaths of five young women. Read full story Source: The Independent, 1 March 2023 To support Eating Disorders Awareness Week, we have pulled together eight useful resources to help healthcare professionals, friends and family support people with eating disorders: Top picks: Eight resources on eating disorders -
News Article
‘Toxic working environment’ exposed at troubled unit
Patient Safety Learning posted a news article in News
Staff endured a “toxic and difficult working environment” at a maternity unit an employment tribunal has found. The tribunal panel said that the case of a black midwife, Kemi Akinmaji, who partially won her case against East Kent Hospitals University Foundation Trust for racial discrimination showed “there were wider issues beyond the specific allegations before us and which were possibly related to race”. The tribunal judgment said: “The evidence we heard reflected a toxic and difficult working environment generally where the claimant and colleagues were shouted and sworn at over differences of professional opinion. There was some evidence before us that there were wider issues beyond the specific allegations before us and which were possibly related to race… “There is evidence of wider bullying of the claimant in the way the group of colleagues treated the claimant… We’ve also heard that the previous grievance had highlighted risks in respect of unconscious bias and identified recommendations which were not actioned. “The race champion was not appointed and the unconscious bias training not sufficiently followed through. We also heard evidence of staff being wary of further such complaints. These matters were all concerning but we had to limit ourselves to the specific allegations brought by the claimant and which the respondent had been given an opportunity to address.” Read full story (paywalled) Source: HSJ, 1 March 2023 -
Content ArticleIn light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
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News ArticleNHS Ambulance service have a “fear of speaking up” amid pervasive “cliquey”, sexist, racist and homophobic cultures, a watchdog has warned. A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations. The review into whistleblower concerns, by the Freedom to Speak Up Guardian’s office, has found widespread cultural issues including clique-like behaviour and bullying and harassment. Dr Jayne Chidgey-Clark, the NHS National Freedom to Speak Up Guardian, has now called on ministers and the NHS to independently review ambulance services, after speaking with ambulance staff across five NHS trusts. The report has called for a cultural review of the ambulance service by NHS England, the Care Quality Commission, the Association of Ambulance Chief Executives and ministers. Read full story Source: The Independent, 24 February 2023
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Content ArticleThe National Guardian’s Office has published Listening to Workers – the report following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
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Content ArticleThe 2022 Workforce Race Equality Standard (WRES) report enables organisations to compare their performance with others in their region and those providing similar services, with the aim of encouraging improvement by learning and sharing good practice. It provides a national picture of WRES in practice, to colleagues, organisations and the public on the developments in the workforce race equality agenda The WRES provide detailed analysis to enable employers to understand how their staff experience compares with others in their region and with similar specialism.
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News Article
NHSE wrongly dismissed discrimination claim from black nurse, tribunal finds
Patient Safety Learning posted a news article in News
NHS England has lost an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, and has been criticised for serious flaws in its own investigations. A judgement published today found Michelle Cox, a black woman who was an NHS continuing healthcare manager based in NHSE’s North West regional team, was excluded by her manager “at every opportunity”. The case centres on problems between Ms Cox and her line manager, then regional head of continuing healthcare, which took place from around April 2019 to November 2020. The tribunal ruled Ms Cox's line manager– who is now an associate director of nursing in the West Yorkshire integrated care system – had created an “intimidating and hostile and humiliating environment” for Ms Cox, which had the purpose and effect of unlawful harassment. The tribunal also upheld Ms Cox’s complaint of detriment for whistleblowing, including for raising concerns that members of her team were sitting on continuing healthcare “independent review panels”, which she pointed out was a breach of independence and legal obligations. Read full story Source: HSJ, 22 February 2023 -
Content ArticleIn this opinion piece for the BMJ, Partha Kar, consultant in diabetes and endocrinology, argues that in spite of extensive research and discussion around the need to tackle race inequalities in the medical workforce, little progress has been made at a system level. He highlights the importance of ensuring the Medical Workforce Race Equality Standard (WRES) Action Plan is implemented effectively, with special attention being paid to tracking GMC referrals and competency reviews that appear to be based on ethnicity.
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News ArticleBlack people have the highest rate of sexually transmitted infections in Britain and officials are not doing enough to address the issue, sexual health experts have warned. Black Britons have “disproportionally high rates” of various STI diagnoses compared to white Britons, with those of Black Caribbean heritage specifically having the highest rates for chlamydia, gonorrhoea, herpes and trichomoniasis. Experts have told The Independent that healthcare providers are failing to address these disparities in STIs. They have called for more research to fully understand the complicated reasons why STIs are higher among people of Black ethnicity. Research conducted through the Health Protection Research Unit (HPRU) found that there were no clinical or behavioural factors explaining the disproportionately high rates of STI diagnoses among Black people. But higher rates of poverty and poor health literacy among marginalised communities are all linked with higher STI rates, according to a 2016 study, which found that behavioural and contextual factors are likely to be contributing. Moreover, experiences of racism among Black people can fuel a reluctance to engage with sexual health services and test frequently, according to HIV activist Susan Cole-Haley. She told The Independent: “I very much believe that it is linked to socioeconomic disadvantage and racism, often in healthcare settings, which can be a significant barrier for people accessing testing, for instance, and feeling comfortable engaging with care.” Read full story Source: The Independent, 19 February 2023
