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Found 179 results
  1. News Article
    The NHS is "riddled with racism", the chair of the British Medical Association's council has told the BBC. Dr Chaand Nagpaul has spoken out in response to a survey by the BMA, shared exclusively with BBC News. At least 75% of ethnic minority doctors experienced racism more than once in the last two years, while 17.4% said they regularly faced racism at work, the survey said. NHS England said it takes a "zero-tolerance approach" to racism. Racism affects patients as well as doctors' wellbeing, by stopping talented people from progressing fairly and affecting doctors' mental health, Dr Nagpaul warned. "This is about a moral right for anyone who works for the NHS to be treated fairly," he said. Around 40% of the NHS's 123,000 doctors are from minority backgrounds, compared to about 13.8% of the general population. But despite this diversity, doctors told the BBC that there was a toxic "us versus them" culture in NHS trusts across the UK. They said they had faced bogus or disproportionate complaints from colleagues, racist comments from superiors, and even physical assault in the workplace. Some said they had tried to lodge complaints which were then ignored or dismissed without investigation. One consultant, from a black African background, told the BMA that after reporting previous incidents "no action was taken... I feel uncomfortable and anxious of reprisals". Read full story Source: BBC News, 2 February 2022
  2. News Article
    One of the NHS’ most high-profile mental health trusts has ‘multiple’ corporate governance problems and ‘deep-seated’ cultural issues, according to an external review. Tavistock and Portman NHS Foundation Trust, which provides mental health, educational and training services in London, commissioned an external firm to look into its leadership amid a period of intense public scrutiny in the latter half of 2021. Among cultural issues identified at the trust, which reviewers described as “deep seated”, was a reluctance of staff to speak up about concerns. Assessors said a recent employment tribunal, which ruled the trust’s treatment of a whistleblower had damaged her professional reputation and “prevented her from proper work on safeguarding”, had impacted the ability of staff to raise concerns. They urged leaders to review their Freedom to Speak Up and whistleblowing procedures. And while reviewers commended board members for commissioning an external review of race equality, they said it had “yielded an outpouring of emotion” which suggested many staff from minority ethnic groups do not feel consistently supported, respected or valued. Read full story Source: HSJ, 25 January 2022
  3. News Article
    The significantly longer waiting times suffered by patients from minority ethnic groups and in more deprived areas for a range of elective procedures have been laid bare in NHS analysis shared with HSJ. The problem of waiting time disparities between different patient groups has been highlighted by health leaders for several years. But the NHS chief who oversaw this new work quantifies the issue for a local NHS trust, provides a template for others to follow, and has led to an improvement in waiting times disparities in response. The analysis of elective waiting lists by Calderdale and Huddersfield Foundation Trust found that in October last year patients from a minority ethnic background were waiting three weeks longer on average than white patients for a “priority two” operation – which must be done within a month. It also found patients from the most deprived communities were waiting 2.5 weeks longer than those from the least deprived areas. However, Owen Williams, who led the trust when the analysis was carried out, said the analysis, which began early last year, contributed to these disparities being cut significantly over the course of 2021. In May last year the trust’s patients from the most deprived areas were waiting 8.5 weeks longer on average for priority two operations than those from more affluent areas, while patients from minority ethnic groups were waiting 7.8 weeks longer than white patients. Mr Williams said NHS trusts boards must be proactive in undertaking similar analysis to reduce health inequalities. Read full story (paywalled) Source: The Guardian, 24 January 2022
  4. News Article
    A GP’s ethnicity has an impact on the level of leadership support it gets from regulators and external bodies, a new Care Quality Commission (CQC) report has suggested. In 2021, the CQC conducted research looking at concerns raised by some doctors that ethnic minority-led GP practices were “more likely to have a poorer experience or outcomes” from regulation. In a final report, the CQC has admitted ethnic minority-led practices are “not operating on a level playing field”, due to several factors including the fact they are more likely to care for populations with higher levels of socio-economic deprivation and poorer health. This can affect their ability to achieve some national targets used in assessments of quality, and increase challenges around recruitment and funding. The evidence gathered by the CQC also suggested that practices led by ethnic minority doctors “often lacked leadership support from other bodies and suffered from low morale”. Read full story (paywalled) Source: HSJ, 19 January 2022
  5. Content Article
    Providers led by GPs of an ethnic minority background have raised with the Care Quality Commission (CQC) concerns that they do not receive the same regulatory outcomes from CQC as providers led by GPs of a non-ethnic minority background. To investigate and respond to these concerns, CQC started a programme of work in February 2021. The focus of this has been on how CQC's regulatory approach affects ethnic minority-led GP practices and how it can improve its methods to address any inequalities identified.
  6. Content Article
    In this article for Forbes, Dana Brownlee looks at individuals who are promoting inclusion in healthcare in practical, tangible ways. She looks at the work of Nigerian medical illustrator Chidiebere Ibe, who is depicting black skin in his medical illustrations, and of Toby Meisenheimer, who developed a business selling plasters of different skin tones. She highlights the importance of individuals who disrupt the norms of healthcare to make it more representative of the populations it serves. She also talks about the dangers to patient safety caused by lack of representation, particularly in fields such as dermatology that rely on images of skin for accurate diagnosis.
  7. Content Article
    The National Early Inflammatory Arthritis Audit (NEIAA) aims to improve the quality of care for people living with inflammatory arthritis, collecting information on all new patients over the age of 16 in specialist rheumatology departments in England and Wales. This NEIAA report presents data describing the association between ethnicity, experience of care and clinician and patient-reported outcomes. It found that Black, Asian and ethnic minority patients were less likely to achieve remission at three months (30% compared to 37%) and were more likely to report symptoms of anxiety or depression compared to white patients (33% compared to 30%), despite faster referrals and assessments than white patients.
  8. Content Article
    Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. Researchers analysed data from 10,772 HCWs who worked during the pandemic to identify demographic and household factors that contributed to infection risk. Results from the UK-REACH study, co-funded by the NIHR and UK Research and Innovation, showed that healthcare workers' risk of catching coronavirus increased in correlation with the level of exposure to COVID-19 patients. Other risk factors included a lack of PPE access and sharing living or working environments with other key workers. Geographical differences were also seen, with healthcare workers in Scotland and South West England at lower risk of infection compared with those in the West Midlands. Intensive care unit staff were also at lower risk than those in other hospital settings.
  9. Content Article
    This is the third of a short series of blogs in which we take a look back at our work in five areas of patient safety during 2021. In this blog we look at how we’ve been highlighting patient safety concerns relating to health inequalities. Through our work, Patient Safety Learning seeks to harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm. We believe patient safety is not just another priority; it is a core purpose of health and social care. Patient safety should not be negotiable.
  10. Content Article
    In 2020, all NHS organisations were instructed to name a single executive board member as their senior responsible person for tackling health inequalities. Across the NHS, there should now be over 450 dedicated health equality named leads in healthcare organisations. This report published by the independent NHS Race & Health Observatory in collaboration with The King’s Fund sets out recommendations to help ensure senior NHS officials responsible for improving health inequalities are able to make a difference.
  11. News Article
    An independent body set up by the NHS to tackle health inequalities has formally committed to never use blanket acronyms such as “BAME” after feedback that they are not representative. The NHS Race and Health Observatory launched a four-week consultation with the public in July on how best to collectively refer to people from black, Asian and minority ethnic groups. The Observatory said it has become the norm in public policy to use initialisms to refer to a “hugely diverse” group of people, but that renewed scrutiny has been spurred on by the Black Lives Matter movement. It said terminology that “crudely conflates” different groups “does not just erase identities; it can also lead to broad brush policy decisions that fail to appreciate the nuance of ethnic inequality in the UK”. Generic collective terms such as “BAME”, “BME” and “ethnic minority” are “not representative or universally popular”, the Observatory said after receiving responses from 5,104 people. It found no single, collective umbrella term to describe ethnic groups was agreed by the majority of respondents. The body had previously said it was committed to avoiding the use of acronyms and initialisms, but has now formalised this as one of five key principles it is adopting in its communications. Where possible it will be specific about the ethnic groups it is referring to, but where collective terminology is necessary it will “always be guided by context and not adopt a blanket term”. Read full story Source: The Independent, 26 November 2021
  12. News Article
    The system for assessing who should be asked to pay for NHS services “incentivises racial profiling”, an investigation has found. A study by the Institute for Public Policy Research found that overstretched NHS staff sometimes racially profile patients in order to determine who is not “ordinarily resident” in the UK, and therefore must pay for their care. The report is critical of the more stringent charging regime introduced by NHS England over the past decade as part of a series of measures devised to create a hostile environment for people living in the UK without the correct immigration status. Overseas visitors officers have been appointed by NHS trusts, responsible for identifying chargeable patients, as part of a cost recovery programme launched in 2014. One of the officers told the IPPR study they had felt forced to discriminate between patients based on their name. “If you’ve got a, I don’t know, Mohammed Khan and a Fred Cooper, you’re obviously going to go for [investigating] the Mohammed Khan … Even for someone who’s, you know, well I’d like to think hopefully open-minded, like myself, you’re just trying to save yourself time because there’s not enough hours in the day,” the officer said. A hospital employee also reported that discrimination on the basis of ethnicity was used to determine who should be billed for treatment. “It’s a system that is designed to benefit [white] people like me, not people like … the patient on intensive care who is black and British and was unconscious and sent a bill. So why did someone think he was not eligible for care? Given he was unconscious most of the admission, significantly unwell, probably not his accent, more likely his skin colour,” the health worker said. Under the rules, anyone “not ordinarily resident” in the UK should be charged 150% of the NHS national tariff for most secondary (non-urgent) healthcare, but the report found that processes varied across the country, with a lack of consistent training and widespread confusion over the 130-page rules for the charging system. Some healthcare staff told IPPR researchers that they disliked the extra burden of having to consider whether to refer a patient for charging, which they felt distracted them from their core medical responsibilities. Read full story Source: The Guardian, 23 November 2021
  13. News Article
    One quarter of women under 40 have never checked themselves for breast cancer – believing they are too young, or they don’t think it will affect them, or they are just too busy. And half of all women do not regularly check their breasts for signs of cancer. The study of 2,000 women found those aged 18 to 39 are the least likely to look for signs of cancer, with a tenth believing they are not old enough to suffer the illness. But a quarter admit they do not have the confidence to inspect themselves, while 1 in 10 put it off in case they find a lump. It also emerged women from South Asian backgrounds are the least likely to examine themselves compared to other ethnicities, with 40% admitting to never checking at all. This drops to 27% of black women and just 13% cent of those of other ethnicities. Of the South Asian women polled who don’t check themselves for signs of breast cancer, more than a third said they forget or don’t know what they are looking for. While more than 1 in 20 (7%) don’t feel comfortable checking themselves due to cultural reasons. Barriers to going to the doctor when noticing a lump or change in breasts vary – from not wanting to waste their doctor’s time, the fear of not being taken seriously, concerns that a female doctor won’t be available, and not wanting to know what caused the change. Read full story Source: The Independent, 11 October 2021
  14. Content Article
    This is the transcript of a Westminster Hall debate in the House of Commons on Black Maternal Health Awareness Week, dedicated to raising awareness about the disparities in maternal outcomes for Black women.
  15. News Article
    NHS 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
  16. Content Article
    People from Black and minority ethnic groups experience inequalities in health outcomes as well as inequalities in access to and experience of health services compared to White groups.  This report, published by the NHS Race and Health Observatory, argues that the NHS has not made significant progress in reducing ethnic health inequalities in recent years because it has not acted on this issue as a clear priority. There has also been a lack of progress made in ensuring equality of experience and opportunity for the NHS workforce. Authors go on to argue that there is now an opportunity to address this by taking urgent action to address critical gaps in the NHS’s capabilities to tackle ethnic health inequalities, and by building a broad health inequalities focus into new healthcare structures as a key priority, while supporting NHS staff to drive change. Read the report in full Suggested further reading: Health inequalities and safety resources
  17. News Article
    Concerns over bullying and discrimination have been raised in a survey of hundreds of doctors at a major hospital trust, HSJ can reveal. University Hospitals of North Midlands Trust’s medical staff committee carried out a survey of its doctors earlier this year, after bullying concerns were raised by members of the British Association of Physicians of Indian Origin at the trust. A summary of the survey findings, published in a newsletter sent to all doctors at the trust last week and seen by HSJ, showed more than two-thirds of the 348 respondents claimed to have experienced bullying, harassment or victimisation at work. Nearly 80% said they had witnessed bullying or harassment, while 50 per cent of respondents said the bullying and harassment was due to race or ethnicity. Fifty-five per cent of those answering the survey also said they had not reported concerns as they had “no confidence in the investigative process within the organisation”. Read full story (paywalled) Source: HSJ, 2 June 2021
  18. News Article
    ‘Disparity ratios’ highlighting how staff with minority ethnic backgrounds are represented at different levels in each trust have been created by the national workforce race equality standard programme to help tackle ‘racist practice’ in the NHS. NHS England head of WRES Professor Anton Emmanuel said the data had been created to indicate the differences in progression between white people and those from an ethnic minority background through the ranks of each organisation. Detail of the methodology used to calculate the ratios has not been published, but it appears they have been determined by comparing the share of staff by ethnicity in different bands. Speaking at the Ambulance Leadership Forum last week, professor Emmanuel, said: “We have gone through each of the seven regions of the country and presented to them the local disparity ratios for each trust and put that into a heatmap…The whole point is to make that data digestible and actable on.” The data can be adapted to look at different points in a trust’s progression routes and can also be used with other groups, such as disabled staff. Read full story (paywalled) Source: HSJ, 24 May 2021
  19. News Article
    Black women face a significantly higher risk of having a miscarriage than white, research suggests. The Lancet analysis of data on 4.6 million pregnancies in seven countries suggests being black increases miscarriage risk by 43%. It calls for people in the UK to be given support after their first pregnancy loss. Currently, referral to specialist clinics usually occurs after three consecutive losses only. Most countries, including the UK, do not collect statistics, but researchers estimate: 15% of pregnancies end in loss 1% of women will experience recurrent miscarriage. Some estimates of miscarriage rate are higher, but this is due to differences in how countries define pregnancy loss, which can be from a positive pregnancy test or from a scan. The report also found that women who suffered miscarriage, from all ethnic backgrounds, are more vulnerable to long-term health problems, such as blood clots, heart disease and depression. Read full story Source: BBC News, 27 April 2021
  20. News Article
    Fears that their data would be shared with the Home Office following the Windrush scandal left some people from ethnic minorities afraid to access cancer services during the pandemic, an NHS England document has revealed. The paper from the West Midlands Cancer Alliance said there was a “perception” the government was “accelerating immigration removals” and that, as a result, “individuals (particularly those affected by the Windrush scandal) are then fearful of accessing cancer treatment and may not participate in screening programmes for fear their information will be inappropriately shared with the Home Office”. The news comes after figures released last week showed the fall-off in referral and treatment of Black-British patients for cancer during the early stages of the pandemic was sharper than for their White-British counterparts. Referrals and first treatments for cancer dipped across the board in April last year. However, by July, White patients were receiving 77 per cent of the treatment volumes they had done 12 months before. The figure for Black patients was 67 per cent. This 10 percentage point difference continued in August and September, as treatment volumes for White-British patients recovered to 83 and 91 per cent respectively. Parity was achieved from October to December 2020, the latest period for which data is available. Read full story (paywalled) Source: HSJ, 22 April 2021
  21. News Article
    Infant mortality is not "openly discussed" among some communities, a charity worker in Birmingham said, as the city attempts to tackle a long-standing problem. For the last decade, Birmingham has had one of the highest rates of infant mortality in England. The city council has set up a taskforce in a bid to halve the number of deaths. It heard rates were highest in deprived areas and among Black, Pakistani, and Bangladeshi heritage families. Shabana Qureshi is the women wellbeing manager for the Ashiana Community Project, a charity which works to improve quality of life for those living in Sparkbrook. Figures from the 2011 census show 87% of its population identified as being from an ethnic group other than White British, with the largest ethnic group being Pakistani. Many of women she works with, she said "don't know how to ask the right questions" and so are "not informed" about issues. Many people in the communities they work with, she said, have low education levels and are more likely to suffer with maternity health issues, but find it difficult to access services. "[Infant mortality] is not something that is discussed openly," she said. "A lot of women live within extended families and are sometimes not aware of the risks, they live with these conditions and health inequalities." She said any services which hope to tackle these problems need to involve communities, and be designed to be relatable, culturally sensitive and maintain trust. Read full story Source: BBC News, 22 April 2021
  22. Content Article
    Rochelle P. Walensky, Director of the Centers for Disease Control and Prevention (CDC) and administrator of the Agency for Toxic Substances and Disease Registry (ATSDR), has declared racism a serious public health threat. Adding action to words, she highlighted several new efforts CDC is leading to accelerate its work to address racism as a fundamental driver of racial and ethnic health inequities in the United States. The CDC have unveiled a new website “Racism and Health” that will serve as a hub for the agency’s efforts and a catalyst for greater education and dialogue around these critical issues.
  23. News Article
    Feeling manipulated into having medical procedures, dismissed by professionals and labelled with racial stereotypes are among the complaints of parents who responded to a national inquiry into racial injustice in UK maternity care. A panel established by the charity Birthrights is investigating discrimination ranging from explicit racism to racial bias and microaggressions that amount to poorer care. It comes as parliament is due on 19 April to debate the large racial disparity in maternal mortality in British hospitals, after a petition from the campaign group Five X More gathered 187,519 signatures. Black women are four times more likely than white women to die during pregnancy or childbirth in the UK. Testimonies include that of a British Bangladeshi woman who said her labour concerns were dismissed. “I felt unsafe and like maternity professionals are not used to being challenged by brown women,” she said. “There is a stereotype of Asian women that we are tame, quiet and compliant people who have no voice and will be obedient. “I was treated like a vessel, not like a human. The experience left me feeling humiliated, disempowered and ashamed.” Read full story Source: The Guardian, 13 April 2021
  24. Content Article
    The recent UK government report on race disparities is a missed opportunity and will lead to a worsening of systemic inequalities, say Razai, Majeed and Esmail in this BMJ Opinion article.
  25. Content Article
    ECRI Institute's Top 10 patient Safety concerns for 2021 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organisations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting and involve a wide range of personnel.
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