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EventJoin clinical experts, thought leaders, and advocates for a collaborative discussion on the issues of health disparities, structural racism, and medicine as they examine specific dermatologic diseases in a series of four free and open educational webinars from the Harvard Medical School. Structural racism and racial bias in medicine: Wednesday, October 28, 1:00-2:15 PM ET Hair disorders in people of colour: Thursday, November 12, 1:00-2:15 PM ET Pigmentary disorders and keloids: Wednesday, November 18, 1:00-2:15 PM ET COVID-19 Comorbidities and cutaneous manifestations of systemic diseases in adults and children: Wednesday, December 2, 1:00-2:15 PM ET Implicit bias and structural racism play a central role in the development of healthcare disparities. One of the critically important areas in medicine is the misdiagnosis of disease in people with darker skin types due to implicit bias and the lack of awareness among physicians in recogniszing the disease pattern. Clinicians in primary care, emergency medicine, hospital medicine, surgery, pediatrics, and other medical specialties can deliver improved care if they can recognize and diagnose medical conditions based on skin findings in patients of color. This four-part series aims to improve diagnosis in people of color, describe pathogenesis and treatment of diseases, develop cultural competency, and impact change in health care policy so more is done to reduce racial bias in medical practice and medical research. Providing this education, in turn, will ultimately help reduce health disparities and improve the lives of underrepresented minority populations. Register for one event or all four.
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News ArticleNHS leaders are being encouraged to have ‘difficult discussions’ about inequalities, after a trust found its BAME staff reported being ‘systematically… bullied and harassed’, along with other signs of discrimination. A report published by Newcastle Hospitals Foundation Trust found the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers. It claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust. The new report revealed that, in a trust survey carried out last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues; had left departments after being given no chance of progression; and been “systematically… bullied and harassed”. Read full story (paywalled) Source: HSJ, 22 September 2020
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News ArticleMore than one in four patients with severe mental health conditions are missing diagnosis when they are admitted to hospital for other reasons, new research suggests. According to data analysed by scientists at University College London, those who are missing these mental illness diagnoses are more likely to be from ethnic minority groups or have a previously diagnosed mental illnesses. However, the situation has improved – in 2006 it was found that mental health diagnoses were missed in more than 50% of cases. "We found encouraging signs that clinicians are more frequently identifying severe mental illnesses in hospital patients than they were a decade ago,” Hassan Mansour, a research assistant at UCL psychiatry, said. “But there's a lot more that can be done, particularly to address disparities between ethnic groups, to ensure that everyone gets the best care available. Training in culturally-sensitive diagnosis may be needed to reduce inequalities in medical care." The researchers have suggested these findings may be due to language barriers or stigma felt by patients. It was also suggested that clinicians may be less able to detect these conditions in people from other ethnic and cultural groups. Read full story Source: The Independent, 18 September 2020
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Content ArticleThe link below will take to you a number of case studies showing how healthcare teams have responded and made changes to improve how they protect, support and engage staff. The case studies include examples from primary care, secondary care, infection prevention and staff education programmes. Also included is information and guidance on: risk assessments protecting all staff speaking up regional support.
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Review launched after ‘injustices suffered by BAME staff’
Patient Safety Learning posted a news article in News
A clinical commissioning group (CCG) has ordered an independent review of its culture which it said was prompted by the “injustices experienced by black Asian and minority ethic colleagues” during the pandemic, HSJ has learned. The review at Surrey Heartlands CCG, due to report in the autumn, is being led by Duncan Lewis, emeritus professor of management at Plymouth University. He has led several major reviews into culture at NHS organisations, including one into bullying and harassment at South East Coast Ambulance Service Foundation Trust in 2017 and one into workplace culture at Whittington Health Trust in 2018. HSJ asked the CCG for the terms of reference of the review and the reasons why it felt it necessary to commission such an inquiry. It said the review’s scope would be determined by what staff felt was important regarding “our organisational culture, policy and practice – things we do well and things we need to improve”. It added in a statement: “We will listen to the findings of the review and we will make any changes that are necessary.” It is not yet clear if specific events within the organisation itself prompted the CCG to take the unusual step of commissioning the work. But the commissioner’s interim chief did say “feedback from staff” had been a driver. Read full story (paywalled) Source: HSJ, 26 August 2020 -
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Content ArticleRecommendations include: Employers should carry out risk assessments for staff with vulnerable characteristics, including those from black and minority ethnic backgrounds, as well as those from disadvantaged communities. Employers should ensure that all key workers in public-facing roles have access to adequate PPE. The government should establish a tailored Find, Test, Trace, Isolate and Support (FTTIS) programme which ensures that marginalised and BME communities who are more vulnerable to the coronavirus are identified and supported.Temporary housing, including hotels, bed and breakfasts, and community shelters, should be made available to individuals to facilitate self-isolation of symptomatic individuals.The social security safety net should be significantly strengthened. The government should increase Statutory Sickness Pay (SSP) and broaden eligibility for SSP.The government must address the root causes of health, housing and employment inequality.
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A new handbook for medical diagnoses on darker skin tones
PatientSafetyLearning Team posted an article in Training
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News ArticleAfrican American children are three times more likely than their white peers to die after surgery despite arriving at hospitals without serious underlying conditions, the latest evidence of unequal outcomes in health care, according to a study published in the journal Pediatrics, “We know that traditionally, African Americans have poorer health outcomes across every age strata you can look at,” said Olubukola Nafiu, the lead researcher and an anaesthesiologist at Nationwide Children’s Hospital in Columbus, Ohio. “One of the explanations that’s usually given for that, among many, is that African American patients tend to have higher comorbidities. They tend to be sicker.” But his research challenges that explanation, he said, by finding a racial disparity even among otherwise healthy children who came to hospitals for mostly elective surgeries. Out of 172,549 children, 36 died within a month of their operation. But of those children, nearly half were black – even though African Americans made up 11% of the patients overall. Black children had a 0.07% chance of dying after surgery, compared with 0.02% for white children. Postoperative complications and serious adverse events were also more likely among the black patients and they were more likely to require a blood transfusion, experience sepsis, have an unplanned second operation or be unexpectedly intubated. Read full story Source: The Independent, 20 July 2020
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‘Shameful’ data reveals NHS treatment of minority ethnic staff
Patient Safety Learning posted a news article in News
Five years after launching a plan to improve treatment of black and minority ethnic staff, NHS England data shows their experiences have got worse. Almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year, according to “shameful” new data. Minority ethnic staff in the NHS have reported a worsening experience as employees across four key areas, in a blow to bosses at NHS England, five years after they launched a drive to improve race equality. Critics warned the experiences reported by BME staff raised questions over whether the health service was “institutionally racist” as experts criticised the NHS “tick box” approach and “showy but pointless interventions”. Read full story Source: The Independent, 18 February 2020 -
News ArticleThe Office for National Statistics (ONS) has published its first figures analysis Covid-19 related deaths by ethnic group in England and Wales between March 2 and April 10. The results showed that the risk of death involving the coronavirus among Black, Asian, and minority ethnic (BAME) groups is “significantly higher” than that of those of white ethnicity. Researchers found that when taking age into account, in comparison to white men and women, black men are 4.2 times more likely to die from a Covid-19-related death and black women are 4.3 times more likely. People with Bangladeshi, Pakistani, Indian and mixed ethnicities have a raised risk of death, too. Read full story (paywalled) Source: The Telegraph, 7 May 2020
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‘Insufficient’ national response to deaths review programme, report finds
Patient Safety Learning posted a news article in News
The latest annual report into the deaths of people with learning disabilities has criticised the “insufficient” national response to past recommendations and called for “urgent” policy changes. The national learning disabilities mortality review programme has criticised the response from national health bodies to its previous recommendations. To date, just over 7,000 deaths have been notified to the programme and reviews have been completed for just 45%. There have been four annual reports for programme to date, and in the latest published today, the authors warned: “The response to these recommendations has been insufficient and we have not seen the sea change required to reassure [families] that early deaths are being prevented." “It is long over-due that we should now have concerted national-level policy change in response to the issues raised in this report and previous others. A commitment to take forward the recommendations in a meaningful and determined way is urgently required.” The latest report also warns that black, Asian and ethnic minority children with learning disabilities die “disproportionately” younger compared to other ethnicities. It also found system problems and gaps in service provision were more likely to contribute to deaths in BAME people with learning disabilities. Read full story Source: HSJ, 16 July 2020 -
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COVID-19: Many trusts have not done risk assessments for ethnic minority staff
Patient Safety Learning posted a news article in News
Some NHS trusts in England are yet to complete /cOVID-19 risk assessments for their staff from ethnic minority groups more than two months after the NHS first told them to do so, an investigation by The BMJ has found. On 29 April NHS England’s chief executive, Simon Stevens, wrote to all NHS leaders telling them to carry out risk assessments and make “appropriate arrangements” to protect ethnic minority staff, amid growing evidence that they were at greater risk of contracting and dying from COVID-19. However, The BMJ asked England’s 140 acute care trusts for details of risk assessments they had carried out and what subsequent actions they had put in place. Seventy trusts responded. Of these, 27 (39%) said that assessments were yet to be completed for all ethnic minority staff, and 43 (61%) indicated that assessments had been completed. But the other 70 trusts were unable to provide a response within the 20 day deadline, citing “unprecedented challenges” posed by the COVID-19 pandemic, so it is not known what stage they are at in risk assessing staff. Commenting on The BMJ’s findings, Chaand Nagpaul, the BMA’s chair of council, said, “Clearly, we know that a significant number of doctors have not been risk assessed. It is a shame that it has taken so long, because the risk assessments and mitigations would have been most useful and impactful during the peak of the virus.” Doctors’ leaders have suggested that systemic race inequalities in the workplace may have exacerbated delays in risk assessing staff. Nagpaul said, “The BMA survey found that doctors from a BAME [black, Asian, and minority ethnic] background felt under more pressure to see patients without adequate protection. So it does beg the question of whether there’s also been this added factor of BAME healthcare staff feeling unable to demand their right to being assessed and protected." “This is something the NHS needs to tackle. This is an issue that predates covid. It’s vital that we have an NHS where anyone is able to voice their concerns. No one should have to suffer or have fear in silence.” Read full story Source: The BMJ, 10 July 2020 -
News ArticleNHS staff from black, Asian and minority ethnic (BAME) backgrounds should be “risk-assessed” and possibly moved away from patient-facing roles during the coronavirus crisis, according to official guidance. A letter from NHS England acknowledges UK data showing these workers are being “disproportionately affected by Covid-19” and urges health trusts to make “appropriate arrangements”. Public Health England has been asked to look into the issue by the Department of Health, the letter from NHS chief executive Sir Simon Stevens and chief operating officer Amanda Pritchard said. “In advance of their report and guidance, on a precautionary basis we recommend employers should risk assess staff at a potentially greater risk and make appropriate arrangements accordingly,” he added. This could mean BAME health workers being relocated away from patient-facing roles or ensuring they are adequately fitted with personal protective equipment (PPE). Read full story Source: The Independent, 30 April 2020
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Coronavirus disproportionately affecting BAME communities in UK, new figures show
Patient Safety Learning posted a news article in News
More than 16% of people who had tested positive for coronavirus when they died were from black, Asian and minority ethnic (BAME) communities, new data shows. On Monday, NHS England released data showing the ethnic breakdown of people who have died with coronavirus for the first time. The statistics come days after a review was announced to examine what appears to be a disproportionate number of BAME people who have been affected by Covid-19. Last week Downing Street confirmed the NHS and Public Health England will lead the review of evidence, following pressure on ministers to launch an investigation. Discussing the review, Professor Chris Whitty, the chief medical officer for England, said ethnicity is "less clear" than three others factors in determining who is most at risk from coronavirus. Read full story Source: The Independent, 21 April 2020 -
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Government censored BAME covid-risk review
Patient Safety Learning posted a news article in News
The government removed a key section from Public Health England’s review (published Tuesday) of the relative risk of COVID-19 to specific groups, HSJ has discovered. The review reveals the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those with Asian, Caribbean and black ethnicities. It makes no attempt to explain why the risk to BAME groups should be higher. An earlier draft of the review which was circulated within government last week contained a section which included responses from the 1,000-plus organisations and individuals who supplied evidence to the review. Many of these suggested that discrimination and poorer life chances were playing a part in the increased risk of COVID-19 to those with BAME backgrounds. HSJ understands this section was an annex to the report but could also stand alone. Typical was the following recommendation from the response by the Muslim Council of Britain, which stated: “With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to tackle the culture of discrimination and racism. It may also be of value to issue a clear statement from the NHS that this is not acceptable, committing to introducing change.” One source with knowledge of the review said the section “did not survive contact with Matt Hancock’s office” over the weekend. Read full story Source: HSJ, 2 June 2020
