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Content ArticleResearch has shown Black adults experience significantly worse patient safety events when compared with White adult patients. Previous research examined how race can affect the quality of care and how it could be attributed to the differences in the quality of hospitals that Black patients are admitted to when compared to White patients. Now, new analysis suggests these disparities exist among patients treated in the same hospital.
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Content ArticlePast research, some dating as far back as 1990 has highlighted a number of inaccuracies in readings when measuring oxygen levels in ethnic minorities. Especially now with the outbreak of coronavirus, further assessment is needed to ensure accurate measurements are being taken. The NHS Race and Health Observatory is now calling for further action and research alongside a rapid review includes a series of recommendations for national healthcare, regulatory and research bodies.
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News Article
Major trust faces bullying concerns from hundreds of senior doctors
Patient Safety Learning posted a news article in News
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 -
Content ArticleThe NHS Race and Health Observatory, supported by three regulators, has called on healthcare leaders to ensure that policies and processes are fair, inclusive and in line with the 2010 Equality Act. Leaders should ensure that health and care staff across the country are protected from racism, or any other form of discrimination, as they go about their vital work. Read the statement in link below.
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News ArticleThe Labour Party will call on the government to commit to a target of ending the Black maternal mortality gap during a landmark debate about the topic later on Monday. This comes as shocking figures show Black women are over four times more likely than white women to die during or after pregnancy or childbirth in the UK. MPs will debate a petition relating to Black maternal healthcare and mortality. Scheduled to take place at 6.15pm this evening, the session will be led by Petitions Committee Chair Catherine McKinnell MP. Read full story Source: The Independent, 19 April 2021
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News Article
Sickle cell patients are being ignored because they’re black, warn campaigners
Patient Safety Learning posted a news article in News
Public services are dismissing sickle cell patients because the illness disproportionately affects Black people, campaigners have warned. The blood disorder is prevalent among African and Caribbean communities and advocacy groups say this means it remains poorly understood within state institutions, often leading to the needless suffering and even death of those diagnosed. The issue has gained wider attention following the high-profile cases of two Black men, Richard Okorogheye and Evan Nathan Smith, who lived with the disease and died amid claims their vulnerabilities were overlooked by the NHS and police. Chris Abdullahi, co-founder of charitable initiative Sound of Sickle, told The Independent it is common for sickle cell patients’ painful symptoms to be ignored by healthcare practitioners. He said he has heard similar accounts “well over 100 times” from across the UK. “Just last week someone else mentioned that they were in hospital and had to battle their nurses for pain medication from opioids to something as simple as ibuprofen,” the 27-year-old, who also lives with sickle cell, said. These experiences serve to further entrench the “massive sense of distrust” in the healthcare system which is evidenced through lower vaccine uptake in Black communities, Mr Abdullahi explained. A lack of awareness about the disease has led sickle cell patients to often form informal support networks, through which information can be exchanged about the best hospitals at which to maximise the chances of their condition being taken seriously. Read full story Source: The Independent, 18 April 2021 -
Content Article
CDC's Racism and Health website (8 April 2021)
Patient Safety Learning posted an article in Health inequalities
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. -
News Article
‘I felt humiliated’: parents respond to NHS maternity care racial bias inquiry
Patient Safety Learning posted a news article in News
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 -
Content ArticleThis study, published in Midwifery, concludes: "An analysis of retrospective Albany Midwifery Practice statistics over 12.5 years has shown positive outcomes for women and babies in socially disadvantaged and BAME groups, including those with complex pregnancies and perceived risk factors. This study adds weight to a growing body of evidence linking relational midwifery continuity of carer with improved outcomes and policies identifying that all pregnant women should receive midwifery continuity of carer throughout the continuum of pregnancy, birth and new motherhood."
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Content Article
ECRI: Top 10 patient safety concerns 2021
Patient Safety Learning posted an article in International patient safety
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. -
Content ArticleThis report from the NHS Race and Health Observatory, acknowledges the growing evidence suggesting there may be drawbacks when using pulse oximetry on darker skin. Whilst the picture on racial bias in pulse oximetry is still mixed, as a worst-case scenario, the application of this intervention can potentially have negative outcomes for patients with more pigmentation in their skin. To help counter potential health inequalities in this area, the report outlines a number of recommendations for healthcare, regulatory and research bodies.
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Content ArticleThis study, published by the Proceedings of the National Academy of Sciences (PNAS), found that Black Americans are systematically undertreated for pain relative to white Americans.
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Content ArticleThis blog, written by Rageshri Dhairyawan and Darren Chetty for the Cost of Living website, argues that we must reframe conversations on racialised health inequalities. Drawing on COVID-19 as an example, they state: "How we choose to frame conversations about racialised health inequalities is crucial to ensure that historically underserved communities are not further disadvantaged."
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Content ArticleThe Workforce Race Equality Standard (WRES) programme has now been collecting data on race inequality for five years, holding up a mirror to the service and revealing the disparities that exist for black and minority ethnic staff compared to their white colleagues. The findings of this report do not make for a comfortable read, and nor should they. The evidence from each WRES report over the years has shown that our black and minority ethnic staff members are less well represented at senior levels, have measurably worse day to day experiences of life in NHS organisations, and have more obstacles to progressing in their careers. The persistence of outcomes like these is not something that any of us should accept. It is in recognition of these realities that the People Plan 2020/21 has ‘belonging’ as one of its four pillars.
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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 ArticleOnly a little over half of British Indians say they would get a coronavirus vaccine, according to research. Some 56% of British Indians said they would take up a vaccine when asked by the 1928 Institute, a new think tank led by academics from the University of Oxford. However, 31% per cent were unsure, while 13% said they would decline a jab, the online poll of 510 respondents found. The think tank said much of this stemmed from people feeling they were not informed enough about the vaccines, while a significant proportion felt other people deserved to receive a vaccine more. The researchers are calling for an urgent public health campaign and funding, with messaging in different languages and co-produced with community leaders to assuage doubts. The government should also widely share information on how it is helping poorer countries distribute vaccines, given that several participants said vulnerable people and those in poorer countries should take priority, they said in their report. Read full story Source: The Independent, 21 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 ArticleWhen pharmacist Ifeoma Onwuka, known to her friends as Laura, went into hospital to have her daughter, she and her husband hoped the delivery would go smoothly, and that they would soon be able to take their new arrival home to meet her siblings. Onwuka's labor was induced at James Paget University Hospital in Great Yarmouth in late April 2018. Things progressed quickly and there were soon signs that her baby was in distress, causing staff to begin preparations for an emergency Caesarian section, but Onwuka's daughter was born in the recovery room. Shortly after the birth, Onwuka's condition began to deteriorate. According to the family's lawyer, Tim Deeming, she began to bleed heavily, and was taken into surgery where attempts were made to stem the loss of blood. Hours later, and only after a second consultant had been called in, she was given an emergency hysterectomy. The mother-of-three died three days later. The coroner, Yvonne Blake, said an expert had told Onwuka's inquest that the delay to surgery contributed to her death, since acting early could have controlled the bleeding. Black mothers have worse outcomes during pregnancy or childbirth than any other ethnic group in England. According to the latest confidential inquiry into maternal deaths (MBRRACE-UK). Black people in England are four times more likely to die in pregnancy or within the first six weeks of childbirth than their White counterparts. Read full story Source: CNN. 14 January 2021
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News Article
USA: What is the healthcare cost of racial health disparities, inequity?
Patient Safety Learning posted a news article in News
There is a considerable human and healthcare cost that could have been avoided at the onset of COVID-19 had more been done to ameliorate eventual racial health disparities, amounting to thousands of lives lost and billions of dollars spent, according to analysis from Altarum on behalf of Episcopal Health Foundation. Using figures up until the end of September 2020, the researchers found that had Black and Hispanic people in Texas been hospitalised at the same rate as their White counterparts, the state would have seen 24,000 fewer hospitalisations. That would have amounted to $550 million in healthcare cost savings, the analysis showed. That is not to mention the human costs associated with racial health disparities during the pandemic. Had Black and Hispanic patients had the same COVID-19 mortality rates as White people, the state of Texas would have seen about 5,000 fewer deaths, cutting the total number of COVID-19 deaths in the state by 30%. “These numbers are a glaring reminder of how non-medical factors like economic status and living conditions impact health and how COVID-19 is highlighting that in the worst way,” Elena Marks, president and CEO of the Episcopal Health Foundation, said in a statement. “The human and economic costs of health disparities continue to grow during the pandemic and we’re learning why we can’t address them through medicine alone. Something has to change in Texas.” Read full story Source: Patient Engagement HIT, 13 January 2021 -
News ArticleRachel Hardeman has dedicated her career to fighting racism and the harm it has inflicted on the health of Black Americans. As a reproductive health equity researcher, she has been especially disturbed by the disproportionately high mortality rates for Black babies. In an effort to find some of the reasons behind the high death rates, Hardeman, an associate professor at the University of Minnesota School of Public Health, and three other researchers combed through the records of 1.8 million Florida hospital births between 1992 and 2015 looking for clues. They found a tantalising statistic. Although Black newborns are three times as likely to die as White newborns, when Black babies are delivered by Black doctors, their mortality rate is cut in half. "Strikingly, these effects appear to manifest more strongly in more complicated cases," the researchers wrote, "and when hospitals deliver more Black newborns." They found no similar relationship between White doctors and White births. Nor did they find a difference in maternal death rates when the doctor's race was the same as the patient's. Read full story Research paper Source: The Washington Post, 9 January 2021
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Content ArticleAs the UK emerges from the COVID-19 pandemic ‘Build Back Better’ has become the mantra. Important, but we need to Build Back Fairer. The levels of social, environmental and economic inequality in society are damaging health and wellbeing. The aim of this report from the Institute of Health Equity is three-fold: To examine inequalities in COVID-19 mortality. Focus is on inequalities in mortality among members of BAME groups and among certain occupations, alongside continued attention to the socioeconomic gradient in health – the more deprived the area, the worse COVID-19 mortality tends to be. To show the effects that the pandemic, and the societal response to contain the pandemic, have had on social and economic inequalities, their effects on mental and physical health, and their likely effects on health inequalities in the future. To make recommendations on what needs to be done.
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Content ArticleIn this analysis, published by the BMJ, professor of public health, Sarah Salway and colleagues, argue that the UK health system must take urgent action to better understand and meet the health needs of migrants and ethnic minority people.
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Content Article
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Pain is spoken about often within health and social care. Patients might be asked to locate our pain during examinations, to rate our level of pain or to describe the type of pain we are feeling. They may be forewarned of the possibilities of pain occurring during or after procedures or operations. Medical consent forms often include reference to the risk of pain and require a signature to confirm they have been appropriately ‘informed’. Pain can be acute (lasting less than 12 weeks) or chronic (lasting more than 12 weeks), and the way we experience it, our thresholds, can also vary. It can be our body’s way of warning us of potential damage, yet it can also occur when no actual harm is happening to the body.[1] It can cause trauma, physiological reactions, mental health difficulties and chronic fatigue, and can have a huge impact on someone’s quality of life and ability to perform daily tasks.[2] Pain is undoubtedly complex, but is it a patient safety issue?[3] -
Content ArticleIn medical schools, students seek robust and mandatory anti-racist training. Activists especially want to see their institutions recognise their own missteps, as well as the racism that has accompanied past medical achievements. Read Elizabeth Lawrence's article in the Washington Post.
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Content ArticlePatients from ethnic minority groups are disproportionately affected by Coronavirus disease (COVID-19). Sze et al. performed a systematic review and meta-analysis to explore the relationship between ethnicity and clinical outcomes in COVID-19. They found that individuals of Black and Asian ethnicity are at increased risk of COVID-19 infection compared to White individuals; Asians may be at higher risk of ITU admission and death. These findings are of critical public health importance in informing interventions to reduce morbidity and mortality amongst ethnic minority groups.
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