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Content ArticleHow can we ensure that health and care staff from all backgrounds feel respected, valued and listened to at work? Siva Anandaciva sits down with Karen Bonner, Chief Nurse at Buckinghamshire Healthcare NHS Trust, to talk about the value of having a diverse workforce, and how we can make the health and care system fairer for staff, patients, and communities from ethnic minority groups.
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Content ArticleTests that indicate the health of newborns, moments after birth, are limited and not fit-for-purpose for Black, Asian and ethnic minority babies, and need immediate revision according to the NHS Race and Health Observatory.
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Content Article
General Medical Council Ethical hub
Patient Safety Learning posted an article in General Medical Council (GMC)
Here you can find a collection of resources exploring how to apply GMC guidance in practice, focusing on areas doctors often ask about, or have said they find challenging. These pages will help you address important ethical issues and incorporate good practice into your work. -
Content ArticleEvidence suggests that maternal mortality has been increasing in the US. Comprehensive estimates do not exist. Long-term trends in maternal mortality ratios (MMRs) for all states by racial and ethnic groups were estimated. The objective of this study was to quantify trends in MMRs (maternal deaths per 100 000 live births) by state for five mutually exclusive racial and ethnic groups using a bayesian extension of the generalised linear model network. The study found that while maternal mortality remains unacceptably high among all racial and ethnic groups in the US, American Indian and Alaska Native and Black individuals are at increased risk, particularly in several states where these inequities had not been previously highlighted. Median state MMRs for the American Indian and Alaska Native and Asian, Native Hawaiian, or Other Pacific Islander populations continue to increase, even after the adoption of a pregnancy checkbox on death certificates. Median state MMR for the Black population remains the highest in the US. Comprehensive mortality surveillance for all states via vital registration identifies states and racial and ethnic groups with the greatest potential to improve maternal mortality. Maternal mortality persists as a source of worsening disparities in many US states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis.
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Content ArticleOn the 18 April 2023 the Women and Equalities Select Committee published a report on Black maternal health. This analysed Government and NHS activities to date in this area and made a number of recommendations for further action needed to end disparities in maternal deaths. This paper sets out the UK Government’s response to the recommendations in this report.
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Content Article
In 2022, an illustration of a Black foetus in the womb by Nigerian medical illustrator and medical student Chidiebere Ibe, went viral. The image sparked an important conversation around representation in medical imagery and the impact this has on health outcomes for patients who are Black, Indigenous and people of colour (BIPOC). Research showed that only 5% of medical images show dark skin and only 8% of medical illustrators identified as BIPOC. A collaboration between Chidiebere Ibe, Deloitte and Johnson & Johnson, Illustrate Change aims to build the world's largest library of BIPOC medical illustrations for use in medical education and training. So far, the library contains images relevant to the following specialties: Dermatology Eye disease General health Haematology Maternal health Oncology Orthopaedics -
Content ArticleIn this blog Paul Whiteing, Chief Executive of AvMA, reflects on the recent report by the House of Commons Women and Equalities Committee on Black maternal health. Paul questions why these racial health disparities, that have long been reported on, have been allowed to continue over many decades and highlights the need for more challenging conversations as to wider root causes.
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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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Content ArticleInstitutional racism within the United Kingdom's (UK) Higher Education (HE) sector, particularly nurse and midwifery education, has lacked empirical research, critical scrutiny, and serious discussion. This paper focuses on the racialised experiences of nurses and midwives during their education in UK universities, including their practice placements. It explores the emotional, physical, and psychological impacts of these experiences. The study concludes that the endemic culture of racism in nurse and midwifery education is a fundamental factor that must be recognised and called out. The study argues that universities and health care trusts need to be accountable for preparing all students to challenge racism and provide equitable learning opportunities that cover the objectives to meet the Nursing and Midwifery Council (NMC) requirements to avoid significant experiences of exclusion and intimidation.
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Content ArticleThis guide aims to help health and social care workers provide dementia care, which corresponds to the needs and wishes of people from a wide range of ethnic groups, especially minority ethnic groups.
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Content ArticleEconomist Dana Peterson estimates that the economic toll of racism against Black Americans was $16 trillion over the past two decades. Discriminatory lending, wage disparities and inequities in access to higher education, among other factors, have limited the Black community’s ability to generate personal wealth and economic growth. Other minority communities have had similar experiences, and the impact goes far beyond the economy; each of these factors also takes an enormous toll on the health and wellbeing of people of colour. This is the recording of a panel discussion hosted by Harvard T.H. Chan School of Public Health, in which economic, scientific and policy experts discuss how we can build a more equitable and healthier future for everyone.
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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
CDC is asked to release race and gender data on Long Covid
Patient Safety Learning posted a news article in News
Lawmakers say minorities may disproportionately suffer from long-term symptoms of coronavirus infection. A pair of Democratic House members asked the Centers for Disease Control and Prevention (CDC) in a letter Tuesday to release data on the number of Americans who suffer lingering symptoms of coronavirus infection, including breakdowns along race, gender and age. The National Institutes of Health and the CDC have launched detailed studies of Long Covid, but those examinations are expected to take years. In the meantime, policymakers lack good information about how many people in the United States and worldwide suffer from long-term, debilitating effects of the disease. “People suffering from Long Covid have been ignored and overlooked for far too long. Collecting and publishing robust, disaggregated demographic data will help us better understand this illness and ensure that we are targeting lifesaving resources to those who need them most,” said Rep. Ayanna Pressley, who co-signed the letter Tuesday to the CDC.“We’re calling on the CDC to publicly report this data because that which gets measured gets done — and we can’t have an equitable recovery from this pandemic without it.” Read full story Source: The Washington Post, 25 January 2022 -
News ArticleEfforts to end health inequalities should be ‘in the mix’ of metrics used to determine the NHS’ progress against key performance targets, say race inequality experts. In an exclusive interview with HSJ, NHS Race and Health Observatory (RHO) director Habib Naqvi said organisations’ performance on the issue should be scrutinised by an external body to ensure they are held accountable and “not marking their own exam answer”. It comes as the RHO publishes a report that warns the appointment of health inequalities leads across the NHS risks becoming “tokenistic” if they are not adequately supported and held accountable. The report by The King’s Fund think tank has recommended several actions to prevent the introduction of board-level leads from becoming a “hollow gesture”. In August 2020, NHS England asked all NHS organisations to have a named executive board member responsible for tackling inequalities by October that year. The RHO estimates there to be more than 450 of these named leads across the country. The report welcomed this but added “frameworks” of support and accountability should exist to “empower individuals and motivate change”. The recommendations include putting inequalities on an “equal footing” with key performance metrics, as well as a long-term policy focus that puts addressing inequalities “at the heart of system development”. Read full story (paywalled) Source: HSJ, 1 December 2021
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News Article
NHS race body commits to avoiding blanket terms such as ‘BAME’
Patient Safety Learning posted a news article in News
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 -
News ArticleThe 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
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News ArticleThe architects behind the new NHS Race and Health Observatory have vowed that it will deliver actionable recommendations within months to tackle the structural racism that exists throughout healthcare. Victor Adebowale and Mala Rao called for an observatory to tackle the ethnic health inequalities in the UK in a special issue of The BMJ that they co-edited in February (bmj.com/racism-in-medicine) and NHS England confirmed at the end of the May that the centre would go ahead. Speaking at a meeting to discuss the aims of the observatory on 12 June, Adebowlae told more than 20 assembled stakeholders that he wanted the new centre “to fire on all cylinders,” making recommendations for changes to services that are likely to affect the health outcomes of people from black and ethnic minority backgrounds “within a couple of months.” Read full story Source: BMJ, 15 June 2020
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News Article
Black and Asian people ‘up to twice as likely to be infected with Covid’
Patient Safety Learning posted a news article in News
Black and Asian people are up to twice as likely to be infected with COVID-19 compared to those of white ethnicities, according to a major new report. The risk of ending up in intensive care with coronavirus may be twice as high for people with an Asian background compared to white people, data gathered from more than 18 million individuals in 50 studies across the UK and US also suggests. The report, published in the EClinicalMedicine by The Lancet, is the first-ever meta-analysis of the effect of ethnicity on patients with COVID-19. The scientists behind it said their findings should be of "importance to policymakers" ahead of the possible roll out of a vaccine. Read full story Source: The Independent, 12 November 2020 -
News Article
Structural racism led to worse Covid impact on BAME groups
Clive Flashman posted a news article in News
Minority ethnic people in UK were ‘overexposed, under protected, stigmatised and overlooked’, new review finds. Structural racism led to the disproportionate impact of the coronavirus pandemic on black, Asian and minority ethnic (BAME) communities, a review by Doreen Lawrence has concluded. The report, commissioned by Labour, contradicts the government’s adviser on ethnicity, Dr Raghib Ali, who last week dismissed claims that inequalities within government, health, employment and the education system help to explain why COVID-19 killed disproportionately more people from minority ethnic communities. Lady Lawrence’s review found BAME people are over-represented in public-facing industries where they cannot work from home, are more likely to live in overcrowded housing and have been put at risk by the government’s alleged failure to facilitate Covid-secure workplaces. She demanded that the government set out an urgent winter plan to tackle the disproportionate impact of Covid on BAME people and ensure comprehensive ethnicity data is collected across the NHS and social care. The report, entitled An Avoidable Crisis, also criticises politicians for demonising minorities, such as when Donald Trump used the phrase “the Chinese virus”. The report, which is based on submissions and conversations over Zoom featuring “heart-wrenching stories” as well as quantitative data, issued the following 20 recommendations: Set out an urgent plan for tackling the disproportionate impact of Covid on ethnic minorities Implement a national strategy to tackle health inequalities Suspend ‘no recourse to public funds’ during Covid Conduct a review of the impact of NRPF on public health and health inequalities Ensure Covid-19 cases from the workplace are properly recorded Strengthen Covid-19 risk assessments Improve access to PPE in all high-risk workplaces Give targeted support to people who are struggling to self-isolate Ensure protection and an end to discrimination for renters Raise the local housing allowance and address the root causes of homelessness Urgently conduct equality impact assessments on the government’s Covid support schemes Plan to prevent the stigmatisation of communities during Covid-19 Urgently legislate to tackle online harms Collect and publish better ethnicity data Implement a race equality strategy Ensure all policies and programmes help tackle structural inequality Introduce mandatory ethnicity pay gap reporting End the ‘hostile environment’ Reform the curriculum Take action to close the attainment gap Read full story Source: The Guardian, 28 October 2020 -
News ArticleSeeking help for mental health is never easy but for some members of London's Punjabi community, the shame and stigma associated means they have struggled more than most. Anyone having "problems of the mind" is often considered a burden upon the family says Dr Rakish Rana, founder of the Clear Coach, who added that a lack of education on mental health means it is considered a taboo subject. "To support those with mental health issues, there needs to be more awareness in the South Asian community, whether that's through religious or community leaders, schools and families," he said. "As with all cases of mental health, it needs to be openly discussed and normalised." Shuranjeet Singh, the founder of Taraki, a not-for-profit mental health organisation, said its research carried out into the Punjabi community found more than half of respondents reported a decline in their mental health as a result of Covid-19. "I can see stigma slowly reducing and I hope that community-focused solutions are well researched and funded, because no community is truly 'hard to reach'." Read full story Source: BBC News, 3 October 2020
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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 -
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 -
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
