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Found 54 results
  1. News Article
    A third of Black and ethnic minority health staff have suffered racism or bullying as the NHS fails to address “systemic” levels of discrimination, The Independent can reveal. Levels of bullying and harassment of minority workers have not improved in the past five years with almost 30% saying they have been targeted in the past year, compared to 20%of white staff. Despite being one-quarter of the workforce, minority ethnic staff make up just 10% of the most senior positions, the NHS’s flagship report is set to reveal. One nurse told The Independent she was forced to leave her job following a campaign of bullying, while another, who has left for the private sector, said her mental health was hugely impacted by the discrimination she experienced. Another nurse said she was left “traumatised” by bullying and harassment and she was “gaslighted” by her employer. “This incident is going to affect me for the rest of my life … when I first joined [the NHS trust] I thought I was going to retire there but ... my career [has been cut] short and it’s not fair,” she said. Equality for Black Nurses, a membership organisation founded by Neomi Bennett in 2020, has launched 200 cases of alleged racism against a number of NHS trusts since it was set up. “Racism is driving nurses out of the NHS,” Ms Bennett, told The Independent, warning that this issue had reached “pandemic levels”. Read full story Source: The Independent, 24 January 2023
  2. News Article
    Black patients wait up to six months longer for an organ transplant than the general population, new NHS data shows. The best match comes from someone of the same ethnicity - but only 2% of donors in 2021/22 were black, while black people are 4% of the population. Black families are also less likely to agree to organ donation than white families, the figures show. The NHS says there's an "urgent need" for more people from ethnic minorities to donate. Winnie Andango from NHS Blood and Transplant said, "Black people wait longer because there's less people coming forward to give their organs from their ethnic group. During covid, so many patients were suspended but those have been added back onto the list, and that means if we had less organs for this ethnic minority group, we have even less right now." Health Minister Neil O'Brien said: "We need more people, especially those from black and Asian heritage, to register their organ donation decision and share it with their family so loved ones can follow their wishes." Read full story Source: BBC News, 12 January 2023
  3. News Article
    The rate of people from black backgrounds being restrained in mental healthcare has more than doubled in the past six years, widening the gap with other racial groups, according to official NHS data. Standardised rates of black and black British people subject to restrictive interventions – including physical, chemical and mechanical restraints – have leapt from 52.1 per 100,000 people in 2016-17 to 106.2 in 2021-22. That is compared to a much smaller increase of 30% in the same period for people from white backgrounds, from 15.8 per 100,000 to 20.5. NHS race and health observatory director Habib Naqvi told HSJ he was “very concerned” at the rise. He said a “range of complex causes are likely to be presented to account for this pattern”, including disparities in care pathways, late presentation and lack of timely diagnosis, and general overuse of restrictive practice on people from minority ethnic backgrounds. He added: “It is critical we also focus on ‘causes of the causes’ of these disparities, including the impact of discrimination and bias on access, experience and therefore outcomes of mental health services.” Read full story (paywalled) Source: HSJ, 24 November 2022
  4. Content Article
    Recommendations It is always best practice, in cases where there is no immediate risk to patient safety for concerns to be raised either with one of the GMC’s Employer Liaison Advisers (ELA), where available, or a responsible officer (RO). This allows for attention to be focussed on live concerns and presents an opportunity for matters to be resolved locally. On receipt of an employer referral, the GMC should ask whether efforts have been made to liaise with the RO and, if not, encourage the referrer to consult with them before taking any further action (excluding immediate patient safety concerns). They should also consider further amending their referral form to include a requirement for the referrer to discuss with the relevant RO first. To aid with this recommendation, the GMC should consider updating their triage guidance, to guide a referrer to a local first approach via an RO, if that hasn’t already happened; and before a decision is made on whether to promote a referral to investigation. The UK’s health services, and the GMC, should collaborate to promote a local resolution first culture; and explore whether additional training on complaints handling and investigations at a local level would be beneficial. The GMC should also encourage the Care Quality Commission to include the assessment of complaints handling as a part of their ‘well led’ inspection framework. Trusts and boards across the UK should consider using a digital system to share good practice in the local resolution and handling of complaints, as a means of learning and continuous improvement. The GMC should review their investigation plan guidance to consider whether it should be expanded to say more about the aims, priorities and scope of an investigation; and what considerations should be recorded if a concern has already been the subject of a local investigation, before being referred to the GMC. The GMC should do more to embed a culture of professional curiosity, where individuals in all relevant teams actively seek to add value by raising queries about the evidence provided, and where potential concerns are flagged at the earliest opportunity. To aid with this, the GMC should consider developing an escalation policy and process, to ensure that concerns about cases are raised at the right level(s) until appropriately resolved. The GMC should ensure that all decisions are set out in full and include reference to the seriousness of the allegation(s) and the realistic prospect test. They should include a robust analysis of all of the available evidence, rather than a summary. The GMC should consider whether their low level violence and dishonesty guidance gives those making decisions enough flexibility; and/ or whether supporting information should be provided to decision makers to ensure they fully understand the discretion they have in each case in order to make the right decision. The GMC should consider expanding their existing internal review process across all relevant teams; this should include identification of issues and good practice in case handling; and through post-case discussions, looking at successful and unsuccessful outcomes, to drive continuous improvement. The GMC should consider reviewing their guidance on the process for drafting sanction submissions, to ensure that submissions include the necessary evidence for informed decision making; to reflect that approval for some submissions may be withdrawn in the event only some of the allegations are proven; and to ensure that those who approve submissions are consulted in advance of a sanction hearing, in the event that only some of the allegations are proven. Where a referrer is also a key witness in tribunal proceedings, the GMC should provide them with full details of the allegations they are taking forward. When the GMC provides a witness with a redacted statement, they should draw attention to any changes that have been made, to allow an opportunity for questions or issues to be addressed in advance of the hearing. When the GMC instructs external counsel, they should always ask them to consider the overall merits of the case, and to raise any concerns as soon as they become aware of them. They should also ensure they have an understanding of, and commitment to, the GMC’s aim of compassionate professional healthcare regulation. The GMC should ensure advice from internal or external experts and/ or training is available to relevant teams on issues linked to a doctor’s communication, attitude and/ or behaviours; cultural awareness, competence and sensitivity; diversity intelligence; and eliminating bias in fitness to practise decision making. The GMC and MPTS should consider whether their sanctions guidance should take greater account of the changing demographics of the medical workforce. This includes whether it should demonstrate sensitivity to the interpretation of values, cross cultures, and communication, through the lens of culture competence and diversity intelligence. The GMC should consider how it assures itself that its decision making is fair and unbiased, and whether the systems and processes already in place are appropriate. This includes proactive monitoring for ethnicity related variations in teams and developing frameworks to review practice. Given the small numbers involved, case mix considerations, and risk of confounding, analyses should be used as a tool for internal continuous improvement and interpreted with care. All partners involved in developing the ‘Welcoming and Valuing International Medical Graduates: A guide to induction for IMGS recruited to the NHS’, including the GMC, should encourage induction programmes to be made available to all IMGs, including those working outside the NHS. Induction should cover patient safety, professionalism, legal and ethical aspects and inform and make IMGs new to UK aware that NHS basic indemnity does not cover legal advice and support for other processes including GMC or Coroner investigations. The GMC should consider whether the level of support they offer to doctors in a fitness to practice process is sufficient. They should also encourage medical defence organisations to improve the support they provide to doctors going through a fitness to practice process and extending to a period beyond the tribunal hearing; and responsible officers to ensure local pastoral support. The UK government should bring forward legislative reform for the regulation of healthcare professionals at the earliest opportunity. This would enable our recommendations of compassionate, supportive, fair and proportionate regulation, by allowing the GMC to dispose of appropriate fitness to practise cases consensually.
  5. News Article
    Britons of black and south Asian origin with dementia die younger and sooner after being diagnosed than white people, research has found. South Asian people die 2.97 years younger and black people 2.66 years younger than their white counterparts, according to a study by academics from University College London and the London School of Hygiene and Tropical Medicine. A team led by Dr Naaheed Mukadam, from UCL’s division of psychiatry, reached their conclusions after studying health records covering the 21 years between 1997 and 2018 of 662,882 people across the UK who were aged over 65. They found that: Dementia rates have increased across all ethnic groups. Black people are 22% more likely to get dementia than their white peers. Dementia is 17% less common among those of south Asian background. But they have voiced concern about also discovering that south Asian and black people are diagnosed younger, survive for less time and die younger than white people. “The earlier age of dementia diagnosis in people of black and south Asian [origin] … may be related to the higher prevalence of some risk factors for dementia such as, in older south Asians, fewer years of education, and in both groups hypertension [high blood pressure], diabetes and obesity,” they write in their paper, published in the medical journal Alzheimer’s & Dementia. Read full story Source: The Guardian, 18 September 2022
  6. Content Article
    Key points Research conducted by public bodies has shown that COVID-19 has had a greater impact, both directly and indirectly, on people who share certain protected characteristics (such as belonging to particular ethnicities or age categories, having a disability, or being women or from the LGBTQ+ community). Health and care services have a major role to play in both identifying the extent of these impacts as well as working together to reduce them. This report showcases examples of health and care systems across the country devising innovative approaches to mitigate the direct effects of COVID-19, through targeted vaccination campaigns, and support for people to recover from indirect impacts, through wellbeing and support programmes. These examples evidence that barriers came down during the pandemic to protect staff, patients and resources both within the NHS, and between NHS organisations and external partners in local government and the voluntary sector. They also show that tackling health inequality in an inclusive way is possible. The NHS and its partners must continue to gather data both on the direct and indirect impacts of the pandemic on people with different protected characteristics, and on the effectiveness of different programmes in addressing these impacts. Building on the achievements of the past two years, we must fund voluntary and community sector partners and put processes in place to consolidate partnership working (both within the NHS and between NHS organisations and other stakeholders) to drive continued progress in reducing inequalities affecting people with protected characteristics.
  7. Content Article
    Key points Racism and inclusion have become key areas of focus for the NHS in the wake of the Black Lives Matter movement and the disproportionate impact of COVID-19 on black and minority ethnic staff and patients. With diverse leadership a key plank of the NHS’s strategy to achieve equality, improving the working life for senior black and minority ethnic staff should be a critical priority for the health service. The Messenger Review into health and social care leadership advanced this cause, placing the need for more diverse senior leadership at the top of the NHS agenda. But a greater commitment to act is needed. In spring 2022, the BME Leadership Network conducted an online survey and hosted a series of roundtables to understand the experiences of BME leaders, and to explore the challenges they faced in relation to racism and discrimination as they moved through their careers. This report captures what was found and puts forward recommendations to improve the working conditions of BME leaders. More than half of surveyed BME NHS leaders considered leaving the health service in the last three years because of their experience of racist treatment while performing their role as an NHS leader. A majority said they had experienced verbal abuse or abusive behaviour targeting racial, national or cultural heritage at least once in the past three years, with more than 20% saying this had happened five times or more. Colleagues, leaders and managers seemed to be a particular source of racist treatment, more so than members of the public. This is concerning, given that the NHS has been prioritising equality, diversity and inclusion activities in recent years. This suggests that more focused efforts are required at every level to reduce the incidence of racist behaviour and to improve awareness among all staff of the impact of this type of discrimination. Only 10% were confident that the NHS is delivering its commitment to combat institutional racism and reduce health inequalities and fewer than one in four were confident that their organisation has a robust talent management process that is enabling the development of a pipeline of diverse talent. Senior BME staff reported low levels of confidence in their own organisations’ abilities to manage and support a pipeline of diverse talent and in the ability of the system to achieve this at a national level. Moreover, only a minority were confident they could rely on the support of colleagues to challenge racial discrimination, and a smaller minority believed they would be supported by NHS England and NHS Improvement if challenging prejudice or discrimination locally. Leaders described how structural and cultural issues within the NHS led to a situation where BME leaders were not present in sufficient numbers to generate a climate of inclusivity and were sometimes siloed in particular types of role. This helped to create a situation where career progression was felt to be unduly challenging and where neither succession planning nor talent development were occurring at sufficient scale to support the next generation of diverse leaders. Being able to be authentic in the workplace was an issue that emerged powerfully. Some leaders reported policing their own behaviour in the workplace and compromising their values in order to fit in. Being able to represent their own cultures and be themselves at work was a critically important goal for many. For BME leaders, feeling secure that they will be treated equally, regardless of background, was seen to be the ultimate success measure of equality. It is essential that BME leaders are able to see effective development programmes to support diverse talent, and that they are provided with sufficient support, both locally and nationally, to feel secure in calling out unacceptable behaviour when this occurs. At such a critical juncture for the NHS, action must be taken to end cultures of discriminatory behaviour, to provide personal support to current and aspiring leaders, and to develop succession planning and talent development schemes.
  8. Content Article
    The 'Leadership for a collaborative and inclusive future' review, led Sir Gordon Messenger and supported by Dame Linda Pollard, focused on the best ways to strengthen leadership and management across health and with its key interfaces with adult social care in England. Findings Cultures and behaviours The review found that the current cultural environment does not lend itself to the collaborative leadership needed to deliver health and social care in a changing and diverse environment. Leadership is seen as a job role rather than a characteristic that runs through the workforce. Staff respond reactively rather than constructively and respond to high levels of pressure from above. There is also a lack of accountability and authority in some areas. Although not universal, acceptance of discrimination, bullying, blame cultures and responsibility avoidance has almost become normalised in certain parts of the system. Equality, diversity and inclusion (EDI), which is about respectful relationships and underpins a wider culture of respect, is partial, inconsistent and elective. In some places it is tokenistic. There is a lack of psychological safety to speak up and listen, despite progress being made. The Freedom to Speak Up initiative can be perceived as just relating to whistleblowing rather than also organisational improvement. Standards and structures The review found that management tend not to be perceived as a professional activity and there is a lack of universal standards for management competence and behaviour. There are inequities in how managers are perceived, valued and trained and inconsistencies in appraisals. Regulation and oversight There is a positive view that the Care Quality Commission (CQC) can influence collaboration across the whole of health and social care through its inspections, and welcome its increasing focus on teams and systems. However, there is sometimes an over-emphasis on metrics which can be counter-productive. The review welcomes the shift in emphasis from a punitive model to a remedial one. Clinical leadership The review found incidences of the flawed assumption that simply acquiring seniority in a particular profession translates into leadership skills and knowledge. Doctors are often not properly trained or equipped for leadership roles. Allied health professionals often highlighted that they felt their career opportunities in management were limited. Management and leadership training should be an integral part of all clinical training pathways. Leadership delivery in the future The move towards health and care integration and the work currently underway to merge the arms-length bodies and create a new NHSE offers the opportunity for a fresh approach to preparing leaders and managers in the future. Recommendations 1. Targeted interventions on collaborative leadership and organisational values A new, national entry-level induction for all who join health and social care. A new, national mid-career programme for managers across health and social care. 2. Positive equality, diversity and inclusion (EDI) action Embed inclusive leadership practice as the responsibility of all leaders. Commit to promoting equal opportunity and fairness standards. More stringently enforce existing measures to improve equal opportunities and fairness. Enhance CQC role in ensuring improvement in EDI outcomes. 3. Consistent management standards delivered through accredited training A single set of unified, core leadership and management standards for managers. Training and development bundles to meet these standards. 4. A simplified, standard appraisal system for the NHS A more effective, consistent and behaviour-based appraisal system, of value to both the individual and the system. 5. A new career and talent management function for managers Creation of a new career and talent management function at regional level, which oversees and provides structure to NHS management careers. 6. Effective recruitment and development of non-executive directors (NEDs) Establishment of an expanded, specialist non-executive talent and appointments team. 7. Encouraging top talent into challenged parts of the system Improve the package of support and incentives in place to enable the best leaders and managers to take on some of the most difficult roles. All 7 recommendations have been accepted by the government and publication of the report will be followed by a plan committing to implementing the recommendations.
  9. Content Article
    Key findings Antenatal care Engagement with antenatal care was high with 96% engaging with maternity services in the first trimester of pregnancy and 95% of women engaging fully with midwifery, doctor and sonography appointments. However, for women who experienced miscarriage or pregnancy loss, 61% report that they were not offered any additional support to deal with the outcome of the pregnancy. Labour and birth Just over a third (36%) of respondents reported feeling dissatisfied with how concerns were addressed during labour. 43% percent reported their pain relief options were not explained to them and 52% of women who did not receive their choice of pain relief said there was no explanation as to why it was not given to them. Postnatal care A third of respondents (31%) were concerned about the healthcare they received from their midwife during the birth recovery period. However, 69% of respondents said they were somewhat or very satisfied with the postnatal health check-up performed by the health visitor. While 78% with health concerns after birth those with concerns said they raised their concerns with a Health Care Professional, 36% of respondents said that they were not confident to ask for help on the postnatal ward. Recommendations The report makes the following recommendations to NHS England and NHS Improvement, the Healthcare Safety Investigation Branch, The Department for Health and Social Care and Integrated Care System leaders: An annual maternity survey targeted specifically at Black women Increased knowledge on identifying and diagnosing conditions that are specific to and Improve the quality of Ethnic coding in health records More community-based approaches must be used to improve maternal outcomes An improved system for women to submit their feedback and/or complaints specifically for maternity Ensure that individuals involved in training health care professionals are aware and have an appreciation of the disparities in maternity outcomes
  10. News Article
    People in high-risk minority ethnic groups must be prioritised for Covid immunisations, alongside a targeted publicity campaign, experts and politicians have said amid growing concerns over vaccine scepticism. With figures on Monday recording more than 4m Covid vaccine doses now administered across the UK, and the rollout being expanded to all over-70s, public health experts and MPs called for black, Asian and minority ethnic (BAME) communities to be better protected. The Scientific Advisory Group for Emergencies (Sage) has also raised concerns after research showed up to 72% of black people said they were unlikely or very unlikely to have the jab. Prof Martin Marshall, chair of the Royal College of GPs, urged Whitehall to begin a public health campaign. “We are concerned that recent reports show that people within BAME communities are not only more likely to be adversely affected by the virus but also less likely to accept the Covid vaccine, when offered it,” he said. “As such, where appropriate, we’re calling for public health communications to be tailored to patients in BAME communities, to reassure them about the efficacy and safety of the vaccine and ultimately encourage them to come forward for their vaccination when they are invited for it.” His remarks came as the vaccines minister, Nadhim Zahawi, admitted he feared some BAME communities could remain exposed to coronavirus despite high expected uptake of the jabs. Read full story Source: The Guardian, 18 January 2021
  11. News Article
    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
  12. News Article
    Nearly 100 trusts have no ‘very senior managers’ (VSM) who are declared to be from a black, Asian or minority ethnic background, HSJ analysis has revealed. According to data obtained from every NHS provider in England, 96 out of 214 (45%) did not have any VSMs declared as being from a BAME background. This includes several large providers, such as The Newcastle upon Tyne Hospitals Foundation Trust — where around 9 per cent of the workforce and 15 per cent of the city’s population are BAME — and Liverpool University Hospitals FT. Jon Restell, chief executive of the Managers in Partnership trade union, said the underrepresentation of BAME staff in leadership positions has “dangerously damaged” the NHS’ response to coronavirus, labelling it the “ultimate wake-up call”. Read full story (paywalled) Source: HSJ, 30 November 2020
  13. News Article
    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
  14. News Article
    One of the earliest signs that black, Asian and minority ethnic (BAME) people were being disproportionately harmed by the coronavirus pandemic came when the Intensive Care National Audit and Research Centre (ICNAR) published research in early April showing that 35% of almost 2,000 Covid patients in intensive care units in England, Wales and Northern Ireland were non-white. A lot has happened in the intervening six months with numerous reports, including by the Office for National Statistics and Public Health England (PHE), confirming the increased risk to ethnic minorities and recommendations published on how to mitigate that risk. However, as the second wave intensifies, the demographics of those most seriously affected remain remarkably similar. ICNARC figures show that the non-white proportion of the 10,877 Covid patients admitted to intensive care up to 31 August was 33.9% in England, Wales and Northern Ireland. This rises to 38.3% of patients admitted since 1 September, albeit of a much smaller cohort (527 intensive care admissions). The government mantra “we’re all in this together” proved to be little more than an empty rallying cry early in the pandemic and the ICNARC figures show it remains the case that people in the most deprived socioeconomic groups make up a greater proportion of patients in critical care. Read full story Source: The Guardian, 9 October 2020