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Showing results for tags 'Racism'.
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Content ArticleThis short animated video explores the issue of prioritising equality in shared decision making, to ensure that all patients' and family members' values are sought and incorporated in treatment decisions.
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Content ArticleThis article in The Journal of Post-Acute and Long-Term Care Medicine looks at the issue of systemic racism in long-term services and supports (LTSS) including nursing homes and home- and community-based care in the USA. The authors highlight segregation and disparities, with Black, Indigenous, and persons of colour (BIPOC) users having less access to quality care and reporting poorer quality of life. The authors make a number of policy recommendations to address these health inequalities in LTSS: Targeted increases to Medicaid reimbursement tied to direct care, and targeted enhanced Medicare and/or Medicaid reimbursement to LTSS providers that serve a disproportionate share of Medicaid or underserved older adults. Pay for performance incentives should focus on improving care among LTSS providers who serve individuals with disadvantaged status because of systemic racism and that operate above and beyond a person's clinical severity and comorbidity. The Centers for Medicare & Medicaid Services (CMS) should develop an overall health equity measure which would help capture how well providers meet the needs of diverse populations. Care Compare quality scores by race and ethnicity should be used internally and shared with states to develop culturally appropriate policies. Race and ethnicity-specific quality measures should be included on state-level report cards to incentivise action among states and tailor solutions to the local context. Promote culture change in nursing homes, with an ultimate goal of creating a person-centred, homelike model of care. Expand access to Medicaid-waivered home- and community-based services. Ensure that home- and community-based services are culturally appropriate. Promote integrated home- and community-based programs that can be targeted to BIPOC users to address existing disparities in outcomes.
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Content ArticleRoger Kline, Research Fellow at Middlesex University Business School, comments on the Government “Action Plan” on racism.
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Content Article
ECRI: Top 10 Patient Safety Concerns 2022
Patient Safety Learning posted an article in International patient safety
ECRI's annual Top 10 list helps organisations identify imminent patient safety challenges. The 2022 edition features many first-time topics, and emphasis is on potential risks that could have the biggest impact on patient health across all care settings. The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages. Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically understaffed, while 100 more facilitates anticipated facing critical staff shortages within the following week. The list includes diagnostic and vaccine-related errors that can impact patient outcomes. In addition, several topics on this year's list reflect challenges that have arisen as a result of the stresses associated with delivering care during a global pandemic. -
News Article
GMC admits it needs to do more to reduce racial inequalities
Patient Safety Learning posted a news article in News
The General Medical Council (GMC) has achieved marginal improvements against its targets to reduce racial inequalities, it said in an annual update on the programme. However, BAME doctor representatives as well as the GMC itself said the progress was not sufficient against the targets which the regulator had set itself last year. These included stopping disproportionate complaints from employers about ethnic minority doctors by 2026, and getting rid of disadvantage and discrimination in medical education and training by 2031. According to the update, the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared to white doctors, has marginally reduced. The report also acknowledged the judgment by an employment tribunal in June last year, which found that the GMC had discriminated against a doctor based on his race. Reading Employment Tribunal upheld a complaint that Dr Omer Karim, who previously worked as a consultant urologist in Slough, had been discriminated against during an investigation by the GMC, after the body dismissed charges against a white doctor accused of the same conduct. The GMC has appealed the verdict but is still waiting for the appeal to be heard. Read full story Source: Pulse, 10 March 2022 -
Content ArticleHealthcare professionals need clearer guidance on responding to racism in paediatric settings, argue Zeshan Qureshi and colleagues.
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News Article
NHS accused of racism as black nurses report being put in Covid areas
Patient Safety Learning posted a news article in News
The NHS has been accused of “shocking and systemic” racism during the pandemic as black healthcare workers say they were given poor PPE and pushed into the Covid frontline first. Hundreds of black and brown healthcare staff across the UK have spoken to academics at Sheffield Hallam University about their experiences of racism during the pandemic. The accounts raised issues of racism within the health service which led to black and brown nurses and midwives being put at greater risk than their white colleagues, due to poorer PPE, training, workload and shift patterns. Rosalie Sanni-Ajose, a senior theatre practitioner, who worked across multiple London NHS hospitals through an agency called Yourworld told The Independent: “During the pandemic, we found that most of us (black agency nurses) have been placed in ITU to look after Covid patients are on a Continuous positive airway pressure (CPAP) machine or the ventilator." “Then when I work in A&E, they divided areas into sections - green area, red area, and the normal areas. So some of the ethnic minority staff were then put in the red areas all the time. Further some of us, we have comorbidities like asthma, or diabetes, or have an exemption that has been clearly stated they not allowed to work there.” Through its research, which involved 350 black and brown nurses, midwives and healthcare staff across the UK, Sheffield Hallam University found 77% of respondents said they’d been treated unfairly when they challenged racism. Just over 50% of the respondents said they’d experienced unfair treatment in the pandemic in relation to Covid deployment, PPE or risk assessment. One third have left their job as a result of racism, while more than half have experienced poor mental health due to the racism they experienced. The academic team, lead by Professor Anandi Ramamurthy said the healthcare professionals’ reports reveal “a story of systematic neglect and harassment which predates the pandemic.” Read full story Source: The Independent, 5 March 2022 -
Content ArticleEmployers have a duty of care to support doctors when they are faced with an abusive patient or their guardians/relatives. This guidance from the British Medical Association (BMA) gives background information and steps that all employers and healthcare workers should take when discrimination against a healthcare worker occurs.
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Content ArticleThis report by the Institute of Global Health Innovation at Imperial College London highlights the opportunities and barriers for artificial intelligence to improve the health of the UK’s minority ethnic groups. It outlines the urgent need to address issues such as biased algorithms, poor data collection and a lack of diversity in research and development, in order to prevent a worsening of health inequalities experienced by minority ethnic groups.
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News ArticlePregnancy-related deaths among US mothers climbed higher in the pandemic’s first year, continuing a decades-long trend that disproportionately affects Black people, according to a new government report. Overall in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total, numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019. Among Black people, there were 55 maternal deaths per 100,000 births, almost triple the rate for white people. The report from the National Center for Health Statistics does not include reasons for the trend and researchers said they have not fully examined how Covid-19, which increases risks for severe illness in pregnancy, might have contributed. The coronavirus could have had an indirect effect. Many people put off medical care early in the pandemic for fear of catching the virus, and virus surges strained the healthcare system, which could have had an impact on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health. He called the high rates “terrible news” and noted that the US has continually fared worse in maternal mortality than many other developed countries. Reasons for those disparities are not included in the data, but experts have blamed many factors including differences in rates of underlying health conditions, poor access to quality healthcare and structural racism. Read full story Source: The Guardian, 23 February 2022
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News Article
NHS to tackle 'unfair' maternity outcomes
Patient Safety Learning posted a news article in News
A taskforce has been set up to tackle disparities in maternity care experienced by women belonging to ethnic minorities and those living in deprived areas. Black women are 40% more likely to miscarry than white, studies suggest. Maternal death rates are also higher among black and Asian women. Royal College of Obstetricians and Gynaecologists head Dr Edward Morris told BBC News implicit racial bias was affecting some women's care. Patient Safety and Primary Care Minister Maria Caulfield said: "For too long disparities have persisted which mean women living in deprived areas or from ethnic minority backgrounds are less likely to get the care they need and, worse, lose their child. "We must do better to understand and address the causes of this. "The Maternity Disparities Taskforce will help level-up maternity care across the country, bringing together a wide range of experts to deliver real and ambitious change so we can improve care for all women - and I will be monitoring progress closely." Chief midwifery officer Prof Jacqueline Dunkley-Bent, who will co-chair the taskforce, said: "The NHS's ambition is to be the safest place in the world to be pregnant, give birth and transition into parenthood - all women who use our maternity services should receive the best care possible." The taskforce will meet every two months and focus on: improving personalised care and support plans addressing how wider societal issues affect maternal health improving education and awareness of health when trying to conceive, such as taking supplements and maintaining a healthy weight increasing access to maternity care for all women and developing targeted support for those from the most vulnerable groups empowering women to make evidence-based decisions about their care. Read full story Source: BBC News, 23 February 2022 Source: BBC News, -
Content ArticleA new report by the NHS Race and Health Observatory makes robust recommendations—we must act on them, write Mohammad S Razai and colleagues in this BMJ opinion piece. The magnitude of racial health inequalities reported in the NHS Race and Health Observatory’s recent review comes as no surprise. It highlighted the overwhelming, stark, widespread, and longstanding inequalities that people from ethnic minorities in the UK experience in access to healthcare and outcomes. The report found that this occurs “at every stage, throughout the life course, from birth to death” and is “rooted in experiences of structural, institutional, and interpersonal racism.” This evidence has been known for a long time, with the disproportionate impacts of Covid-19 on people from ethnic minorities drawing even greater attention to and wider recognition of these facts. Will evidence, however, be enough to compel those charged with the nation’s health to acknowledge and take urgent action to redress these egregious inequalities?
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News ArticleHealth officials have “paid lip service” to racism in the NHS for years, leading black, Asian and minority ethnic doctors have warned as they called for “concrete” action to tackle inequalities exposed by a landmark review. The damning study – the largest of its kind – had found “vast” and “widespread” inequity in every aspect of healthcare it reviewed, and warned that this was harming the health of minority ethnic patients in England. In response, an NHS spokesperson said the health service was “already taking action” to improve the experiences of patients and access to services and was working “to drive forward” the recommendations made in the report. However, Dr JS Bamrah, a consultant psychiatrist in Greater Manchester and national chairman of the British Association of Physicians of Indian Origin, said he was unsatisfied with the response. “This 166-page review … is a terrible indictment of the current state of the NHS,” he told the Guardian. “As many of us have often said and reported, we don’t need any further reports. It’s action we need, as there are scores of patients who are not getting optimal treatment, and many are being neglected. “It really isn’t good enough for NHS bosses to say that action is being taken and it’s even more disappointing to then not see any concrete proposals on dealing with glaring disparities despite all that we have learnt during the pandemic.” Dr Rajesh Mohan, presidential lead for race and equality at the Royal College of Psychiatrists, said it was “time for warm words to end” as he urged NHS leaders to “do everything they can to ensure patients from ethnic minority backgrounds get the care they need”. Read full story Source: The Guardian, 15 February 2022
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Content ArticleThe NHS Race & Health Observatory (RHO) has published a rapid review into ethnic health inequalities across a range of areas. This report is the first of its kind to analyse the overwhelming evidence of ethnic health inequality through the lens of racism. The NHS has longstanding problems with ethnic inequalities in terms of access to, experiences of, and outcomes of healthcare. These issues are rooted in experiences of structural, institutional and interpersonal racism. The review focussed on priorities set by the RHO relating to ethnic inequalities in: mental healthcare maternal and neonatal healthcare digital access to healthcare genetic testing and genomic medicine the NHS workforce.
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News ArticleRadical action is needed urgently to tackle “overwhelming” minority ethnic health inequalities in the NHS, leading experts have said, after a damning study found the “vast” and “widespread” inequity in every aspect of healthcare it reviewed was harming the health of millions of patients. Racism, racial discrimination, barriers to accessing healthcare and woeful ethnicity data collection have “negatively impacted” the health of black, Asian and minority ethnic people in England for years, according to the review, commissioned by the NHS Race and Health Observatory, which reveals the true scale of health inequalities faced by ethnic minorities for the first time. “Ethnic inequalities in health outcomes are evident at every stage throughout the life course, from birth to death,” says the review, the largest of its kind. Yet despite “clear”, “convincing” and “persistent” evidence that ethnic minorities are being failed, and repeated pledges of action, no “significant change” has yet been made in the NHS, it adds. From mental health to maternity care, the sweeping review led by the University of Manchester paints a devastating picture of a healthcare system still failing minority ethnic patients despite concerns previously raised about the harm being caused. “By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system,” said Habib Naqvi, the director of the NHS Race and Health Observatory, an independent body established by the NHS in 2020 to investigate health inequalities in England. Read full story Source: The Guardian, 13 February 2022
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News Article
Miscarriage: 'I was in pain and they did not listen'
Patient Safety Learning posted a news article in News
Research shows black women are at a 40% higher risk of pregnancy loss than white women. It is an urgent problem, which the Royal College of Obstetricians and Gynaecologists says needs greater attention, with many complex reasons driving this higher risk. These include a lack of quality research involving all ethnicities - but RCOG head Dr Edward Morris says implicit racial bias is also affecting some women's experience of care. Isabel Gomes Obasi and her husband, Paulson, from Coventry, are expecting a baby boy in March. They are extremely anxious as almost a year ago their baby boy Andre died four months into Isabel's pregnancy. Giving birth to Andre was extremely traumatic, Isabel says, but how she was treated when in severe pain and bleeding, in the days before her loss, made the experience worse. "We knew something was wrong, so we went into hospital and waited five hours to be seen by a doctor," she says. "I remember being laughed at by one of the nurses, who said, 'Just go home. Why do you keep coming in?'" Isabel was checked over and told the baby was fine but says her intuition and pain were belittled and ignored. Within 48 hours of going home, Isabel began bleeding heavily. There is little doctors can do at this relatively early stage of pregnancy to save a baby's life. But the feeling of not being listened to has stayed with Isabel ever since. "I just shut down," she says. "The experience made me anxious and depressive, if not suicidal." Asked why she was not listened to, she said: "The colour of my skin," the attitude of some staff was: "'You have black skin - you are not from here - you can wait.'" Dr Morris says it is "unacceptable" women belonging to ethnic minorities face worse outcomes than white women - especially in maternity care. "Implicit racial bias from medical staff can hinder consultations and negatively influence treatment options," he says. This can stop some women engaging with healthcare. Read full story Source: BBC News, 8 February 2022 -
Content Article
A case study in denial (Roger Kline, 3 February 2022)
Patient Safety Learning posted an article in Culture
A recent highly critical NHSEI External Review of The Christie NHS Foundation Trust was prompted by whistleblowers. The Review was provided with detailed evidence that there were very significant (and distressing) problems with the Trust’s approach to race discrimination, bullying and the response when concerns were raised. The External Review (Paragraph 2.2.6.) states In this blog, Roger Kline considers whether the Trust’s own data supports the assertions in the Trust Chair’s email to staff in response to the Review. He considers how the NHSEI Review addressed the issues. He suggests that the Trust’s response; the shortcomings of the NHSEI Review response to the issue of race discrimination; and the NHSEI response to the Review once published mean that further scrutiny of the Trust and NHSEI’s response is required if staff are ever again to risk raise legitimate concerns in this Trust – or rely on NHSEI to support staff who do so. -
News ArticleThe 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
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News Article
Bullying, sexism and racism ‘prevalent and tolerated’ at national regulator
Patient Safety Learning posted a news article in News
An external review into the Healthcare Safety Investigations Branch (HSIB), the national safety watchdog, has revealed ‘damaging’ cultural problems, including bullying, sexism and racism which go ‘right to the top of the organisation’. The King’s Fund was commissioned by NHS England to undertake a review of the HSIB’s leadership and culture, as it prepares to be an independent organisation. The review, seen by HSJ, concluded: “Bullying, sexism, racism and other forms of discrimination and unprofessional behaviours appear to be prevalent and tolerated – this goes right to the top of the organisation.” The result of this was found to be “very damaging to the health and wellbeing of staff, diminished the culture and undermines the potential of the organisation” The review also described a “perceived command-and-control approach to leadership, lack of openness to challenge, hierarchical approaches to management and behaviour that is out of step with the organisation’s values”. The reviewers also identified a “strong voice from staff”, which felt that senior maternity investigation team leaders were “not being held accountable for behaviours that had a very negative impact on staff”. Read full story (paywalled) Source: HSJ, 21 January 2022 -
News ArticleA nurse who was sacked by a private hospital provider treating NHS patients which believed she had deliberately tried to sabotage its Care Quality Commission inspection has won a tribunal. An employment tribunal found Care UK’s dismissal of Lorna Jarrett carried “the taint of race discrimination” and said the company had provided no evidence of any malice on her part. Ms Jarret worked at the North East London Treatment Centre. The judgment said management at the facility were convinced Ms Jarrett had deliberately faxed confidential patient identifiable data to the inspectorate instead of the GP surgery they were supposed to be sent to. This incident occurred in the week of the centre’s CQC inspection. However, the tribunal ruled Care UK “did not explore any evidence that might support the claimant’s account and disbelieved her explanation”. It added: “Finding that she sent the fax deliberately and maliciously demands an explanation.” The tribunal judgment said it was Ms Jarrett’s case that “subconscious bias was in play” and found Care UK had not explained the “lack of any motive”. Employment judge Lewis said: “Whilst we accept that Mr O’Brien did not consciously discriminate against the claimant because of her race we find that the factors relied on, her demeanour, attitude, her supposed lack of remorse, are matters that demonstrate subconscious bias and are not free from the taint of race discrimination. We find that the respondent has failed to discharge the burden on it to explain the difference in treatment.” Read full story (paywalled) Source: HSJ, 15 December 2021
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Content ArticleRacially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. Drawing on qualitative interviews with 48 healthcare staff in London (UK), Woodhead et al. identified how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies.
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Content ArticleThis training documentary by the South East Perinatal Mental Health team explores race inequalities within the NHS maternity system. It uncovers the stories behind the MBRRACE report figures and looks for answers from leading race and diversity health professionals and campaigners. In the film, midwives and mothers talk frankly about the issues and how individuals can make a difference to create a positive impact on race inequality outcomes for mothers and within maternity teams.
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Content ArticleAs well as a moral issue, tackling racism affecting NHS staff is a crucial part of improving patient safety and care, says MDX Research Fellow Roger Kline. In this blog, Roger looks at the risks of racism on patient safety.
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Content ArticleThis report was triggered by the Coroner’s report into the death of Evan Nathan Smith in North Middlesex hospital. Evan was a young man with his whole life in front of him. The mistakes made in his treatment leading to his early and avoidable death brought into sharp focus the lack of understanding of sickle cell, the battles patients have to go through to get proper treatment and the terrible consequences which can come about as a result. Following the publication of the Coroner’s report, the All-Party Parliamentary Group (APPG) on Sickle Cell and Thalassaemia held three evidence sessions, hearing from patients, clinicians and politicians. This report is a result of that evidence. The findings in this report reveal a pattern of many years of sub-standard care, stigmatisation and lack of prioritisation which have resulted in sickle cell patients losing trust in the healthcare system that is there to help them, feeling scared to access hospitals, expecting poor treatment from some of those who are supposed to care for them and fearing that it is only a matter of time until they encounter serious care failings.
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News Article
Landmark sickle cell disease inquiry finds evidence of racism in patient care
Patient Safety Learning posted a news article in News
A groundbreaking inquiry into sickle cell disease has found “serious care failings” in acute services and evidence of attitudes underpinned by racism. The report by the all-party parliamentary group (APPG) on Sickle Cell and Thalassaemia, led by Pat McFadden MP, found evidence of sub-standard care for sickle cell patients admitted to general wards or attending A&E departments. The inquiry also found widespread lack of adherence to national care standards, low awareness of sickle cell among healthcare professionals and clear examples of inadequate training and insufficient investment in sickle cell care. The report notes frequent disclosures of negative attitudes towards sickle cell patients, who are more likely to be people with an African or Caribbean background, and evidence to suggest that such attitudes are often underpinned by racism. The inquiry also found that these concerns have led to a fear and avoidance of hospitals for many people living with sickle cell. Care failings have led to patient deaths and “near misses” are not uncommon, leading to a cross-party call for urgent changes into care for sickle cell patients. Read full story Source: The Independent, 15 November 2021
