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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 Article
Covid inquiry: Race should be at its core, say campaigners
Patient Safety Learning posted a news article in News
Race should be made a central part of the UK's independent public inquiry into the pandemic, campaigners say. A letter seen by BBC News, sent to the chairwoman of the Covid-19 inquiry, calls for it to look at "racism as a key issue" at every stage. Ethnic minorities were significantly more likely to die with Covid-19, according to official figures. An inquiry spokesperson said the unequal impacts of the pandemic would be at the forefront of its work. People from ethnic minority backgrounds who lost loved-ones during the pandemic also told BBC News they felt "sidelined" by the process so far. The letter to Baroness Hallett, who is chairing the inquiry, has been co-ordinated by the group Covid-19 Bereaved Families for Justice and race equality think tank Runnymede. It calls for ethnic minority communities to be "placed firmly at the centre" of the inquiry. Read full story Source: BBC News, 28 February 2023 -
News Article
White candidates still 50% more likely to be recruited, says new NHSE data
Patient Safety Learning posted a news article in News
White applicants remain 54% more likely to be appointed from NHS job shortlistings compared to ethnic minority candidates, a metric that has hardly budged since 2016, a NHS England report has revealed. The 2022 NHS workforce race equality standard report, revealed a significant rise in the proportion of staff from ethnic minority backgrounds. And while there had been progress on some key targets since last year, others have stagnated. NHSE’s report showed ethnic minority staff comprise 24.2% of the workforce in 2022, up from 22.4% last year and from 17.7% six years ago. However, it also revealed the likelihood of white applicants being appointed from shortlists was 1.54 in 2022 than minority ethnic applicants – only a very small improvement on 1.57 in 2016, when WRES began Read full story (paywalled) Source: HSJ, 22 February 2023 -
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
Ethnic minority Covid death gap closes
Patient Safety Learning posted a news article in News
People from ethnic minority backgrounds are no longer significantly more likely to die of Covid-19, new Office for National Statistics (ONS) data shows. Early in the pandemic, deaths involving coronavirus were higher among black and Asian people than white people, with the highest risk among Bangladeshi, Black Caribbean and Pakistani groups. Covid mortality rates for all ethnic minorities decreased last year. The latest data shows there is no significant statistical difference between the number of Covid deaths among ethnic minorities and the white population. The ONS also said that "all cause" mortality rates - measuring how likely people are to die of any cause, including Covid-19 - have returned to pre-pandemic patterns. The reasons for this change are complex, and experts say there are "various factors" to consider. Read full story Source: BBC News, 22 February 2023 -
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 -
News Article
London Ambulance lagging behind on diversity and must improve, bosses warned
Patient Safety Learning posted a news article in News
The London Ambulance Service (LAS) failing on diversity and must implement specific targets for improvements, its leadership has been warned. According to LAS data, just 20% of the workforce is from a Black, Asian or from a minority ethnic background despite almost half of the capital’s population (46.2%) being made up of non-white communities. Of that 20%, 40.9% are in the lowest paid roles, compared to 15.9% who are in the highest wage bands, according to the LAS’ Integrated Performance report. The LAS is in the process of developing a new strategy to help attract more diverse staff, which will be published early next year. Research shows that ethnic minority groups suffer disproportionately higher levels of inadequate ambulance care due to a combination of issues such as a lack of cultural awareness among professionals, language and communication difficulties and a limited understanding of how the healthcare system operates for some minority groups. Read full story Source: The Independent, 21 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
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Content ArticleIncomplete or inaccurate recording of ethnicity will undermine attempts to address health inequalities and improve access, experience and outcomes for Black, Asian and minority ethnic communities. This report by the Race Equality Foundation and the Office for National Statistics (ONS) looks at different aspects of the recording of ethnicity in healthcare. The authors interviewed people from a range of communities across England, as well as healthcare workers from different areas and settings to understand both sides of the process of collecting ethnicity data.
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Content ArticleFor years, it has been known that pulse oximeters may present racial biases, with studies dating back as far as the late 1980s suggesting a flaw in how the device measures oxygen in people with darker skin tones. This article looks at how the Covid-19 pandemic finally brought the problem to the forefront of medicine. Ashraf Fawzy, Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, talks about how he and other doctors noticed a trend in pulse oximeter readings not matching up to patient symptoms, and how they went on to research the issue, publishing their results in a study in May 2022. Their study found that Black and Hispanic patients were 29% and 23% less likely than white patients, respectively, to have pulse oximeters recognise their eligibility for more aggressive Covid-19 treatment. The resulting delay in care for patients with darker skin tones is likely to have a significant impact on patient outcomes.
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Content Article
A Black woman is 3.7 times more likely to die in pregnancy than a white woman. [1] They are more likely to experience postnatal depression.[2] and less likely to seek support.[3]. Mental ill-health in pregnancy and beyond is an increasing cause of maternal death,[1] making it more important than ever to understand and address racial inequality. In this interview, we talk to Sandra Igwe, CEO of The Motherhood Group, and Author of My Black Motherhood: Mental Health, Stigma, Racism and the System, about the Black Maternal Health Conference UK, taking place on 20 March 2023. Sandra, who is hosting the event, explains how the day has been designed to support the rebuilding of trust between Black mothers and the healthcare system. She introduces us to the rich and interactive agenda and explains how it will provide opportunity for deeper exploration and collaboration. Sandra welcomes everyone to sign up to the event, from mothers and healthcare professionals to researchers and journalists. Event hashtag - #BMHCUK -
Content ArticleIn recorded interview, Roger Kline, research fellow at Middlesex University, and Anton Emmanuel, Head of Workforce Race Equality Standard (WRES), discuss 'No more tick boxes', progress on WRES and the need to address race equality as an organisational improvement metric.
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Content ArticleWomen and birthing people from black, Asian, or mixed ethnic backgrounds are significantly more likely to experience poor outcomes during their maternity journey. Between September 2021 and October 2022, Darzi Fellow Rosie Murphy undertook work in Croydon to explore these inequalities and what could be done to improve local services. This is the first in a series of blogs published by the Health Innovation Network, reflecting on the learnings and experiences from her Fellowship.
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Content ArticleIn this book, Sandra Igwe shares her journey as a young Black mother, coping with sleepless nights, anxiety and loneliness after the birth of her first daughter. Burdened by cultural expectations of the 'good mother' and the 'strong Black woman' trope, her mental health struggles became an uphill battle. Black women are at higher risk of developing postnatal depression but are the least likely to be identified as depressed. Sharing the voices of other mothers, Sandra examines how culture, racism, stigma and a lack of trust in services prevent women getting the help they need. Breaking open the conversation on motherhood, race, and mental health, she demands that Black women are listened to, believed, and understood.
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Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) explored the detection and diagnosis of jaundice in newborn babies, in particular babies born prematurely (before 37 weeks of pregnancy). Specifically, it explored delayed diagnosis due to there being no obvious visual signs of jaundice apparent to clinical staff. Jaundice is a condition caused by too much bilirubin in a person’s blood. Bilirubin is a yellow substance produced when red blood cells are broken down. If left undiagnosed and untreated, high bilirubin levels in newborn babies can lead to significant harm. Newborn babies have a higher number of red blood cells in their blood which increases their risk of jaundice. Jaundice can cause yellowing of the skin and whites of the eyes; however, sometimes the visual signs of jaundice are not obvious, particularly for premature or newborn babies with brown or black skin. The reference event for this investigation was the case of baby Elliana, who was born at 32 weeks and 1 day via a forceps delivery and then transferred to the Trust’s special care baby unit (SCBU). Elliana was assessed on admission to the SCBU by staff as a clinically stable premature baby and a routine blood sample was taken from around two hours after her birth to establish a baseline. Analysis of the blood sample indicated bilirubin was present and so the level was measured. This result was uploaded onto the Trust’s computer system alongside the results of the blood tests that had been requested by the clinical team. The bilirubin result was seen by a SCBU member of staff who recognised that the level was high, indicating the possible need for treatment. However, this member of staff was then required to attend an emergency and the bilirubin result was not acted upon. Another blood sample was taken when Elliana was two days old and was uploaded to the Trust’s computer system. It is unclear if this bilirubin result was seen by staff; it was not documented in clinical records and was not acted upon. Over the next two days, Elliana continued to show no visible signs of jaundice that were detected by staff and she was documented to be developing well. When Elliana was five days old, a change in her skin colour was observed and visible signs of jaundice were detected. A further blood sample was taken which showed she had a high level of bilirubin in her blood and treatment was started accordingly. Elliana’s bilirubin levels returned to within acceptable levels over the next three days and she was subsequently discharged home.
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Content ArticleDr Henrietta Hughes, England's Patient Safety Commissioner, discusses how the experiences of people from Black and minority ethnic groups has worsened since the pandemic and how this has impacted on patient safety, in a blog for the NHS Race & Health Observatory.
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Content ArticleHow did the fallout from the pandemic affect people across different ethnic groups, and was the impact of those cancelled procedures spread evenly? This Nuffield Trust analysis, supported by the NHS Race and Health Observatory, seeks to answer these questions.
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Content ArticleFor the 20th year, the Agency for Healthcare Research and Quality (AHRQ) is reporting on healthcare quality and disparities. The annual National Healthcare Quality and Disparities Report is mandated by Congress to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups. The report is produced with the help of an Interagency Work Group led by AHRQ.
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Content ArticleThis opinion piece in the BMJ by Partha Kar, Director of Equality for Medical Workforce in the NHS, explores racial inequalities in the NHS workforce. Partha is currently leading work on the Medical Workforce Race Equality Standard (MWRES), which aims to challenge trusts and systems openly and transparently about race-based inequalities faced by NHS doctors.
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Content ArticleIt is well known that pausing planned hospital care during the pandemic worsened growing waiting lists, and that waits for routine care now stand at record-breaking levels. This research from the Nuffield Trust, supported by the NHS Race and Health Observatory, looks at how the fallout from the pandemic affected people across different ethnic groups, and whether that impact was spread evenly.
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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 ArticleThis is the transcript of a Westminster Hall debate in the House of Commons on Black Maternal Health Awareness Week 2022, dedicated to raising awareness about disparities in maternal outcomes.
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Content ArticleThis article* is an update from Dr Henrietta Hughes, Patient Safety Commissioner for England.
