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Found 295 results
  1. Event
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  2. Content Article
    At the start of 2025, the NHS Race and Health Observatory sponsored an infographic, explaining how healthcare professionals can spot the signs of jaundice in babies with dark skin tones. This infographic below, designed by Dr Helen Gbinigie and Dr Oghenetega Edokpolor, in collaboration with FiveXMore and Bliss, serves as a guide for parents' for recognising jaundice in Black and Brown babies, including where and how to seek help.
  3. News Article
    A senior figure in the health service has criticised it for deep-seated racism after his mother “got a black service, not an NHS service” before she died. Victor Adebowale, the chair of the NHS Confederation, claimed his mother Grace’s lung cancer went undiagnosed because black people get “disproportionately poor” health service care. The NHS’s failure to detect her cancer while she was alive shows that patients experience “two different services”, based on the colour of their skin, Adebowale said. His mother, Grace Amoke Owuren Adebowale, a former NHS nurse, died in January aged 92. He highlighted her care and death during his speech this week at the NHS Confederation’s annual conference as an example of “persistent racial inequalities in NHS services”. His remarks prompted fresh concern about the stark differences between the care received by those from black and other ethnic minority backgrounds and white people. “My mum, who worked for many years as a nurse, died earlier this year at the age of 92. It was difficult. It was not the dignified death that we would have wanted for her,” Adebowale told an audience of NHS bosses. “It wasn’t the death she deserved. So it makes me clear about the need to address the inequity. I think she got a black service, not an NHS service.” Read full story Source: The Guardian, 14 June 2025
  4. Content Article
    NHS England has set a target that cervical cancer will be eliminated in England by 2040. Although progress has been made in detecting and treating cervical cancer, there are still many women who are reluctant to go for cervical screening, or who face barriers to accessing screening. These barriers include perceived discrimination, lack of understanding the risk of cervical cancer and unmet access needs. This contributes to persistent health inequalities amongst particular groups. Patient Safety Learning has pulled together nine useful resources shared on the hub about how to improve access and overcome barriers to cervical screening. 1. Cervical screening, my way: Women's attitudes and solutions to improve uptake of cervical screening This research by Healthwatch explored why some women are hesitant to go for cervical screening. Based on the findings of a survey of more than 2,400 women who were hesitant about screening, it makes recommendations to policymakers on how to improve uptake, including: improvements to the way data about the disability and ethnicity of people attending screening. producing an NHS-branded trauma card for affected women to bring to appointments. ensuring staff are effectively trained on accessibility and adjustments to care. looking at the possibility of home-based self-screening. 2. Exploring the inequalities of women with learning disabilities deciding to attend and then accessing cervical and breast cancer screening, using the Social Ecological Model Women with learning disabilities are less likely to access cervical and breast cancer screening when compared to the general population. In this study, the Social Ecological Model (SEM) was used to examine the inequalities faced by women with learning disabilities in accessing cervical and breast cancer screening in England. The study highlights key barriers to access for women with learning disabilities. 3. “We’re not taken seriously”: Describing the experiences of perceived discrimination in medical settings for Black women Black women continue to experience disparities in cervical cancer despite targeted efforts. One potential factor affecting screening and prevention is discrimination in medical settings. This US study in the Journal of Racial and Ethnic Health Disparities describes experiences of perceived discrimination in medical settings for Black women and explores the impact of this on cervical cancer screening and prevention. The authors suggest that future interventions should address the poor quality of medical encounters that Black women experience. 4. Top tips for healthcare professionals: Cervical screenings This article by the Royal College of Obstetricians & Gynaecologists and the My Body Back Project offers tips for healthcare professionals to make cervical cancer screening attendees feel as comfortable as possible during their appointments. Cervical screening can be very daunting for some women, and for those who have experienced sexual violence it can be triggering and cause emotional distress. The article provides tips on communication, making the environment calm and safe, sharing control and building trust with women. 5. The Eve Appeal: What adjustments can you ask for at your cervical screening? The Eve Appeal want to raise awareness of what adaptations women and people with a cervix can ask for during their screening to make the appointment more comfortable. 6. How can reframing women’s health improve outcomes? An interview with Dr Marieke Bigg Dr Marieke Bigg is the author of a 2023 book, This won’t hurt: How medicine fails women. In this interview, Marieke discusses how societal ideas about the female body have restricted the healthcare system’s approach to women’s health and describes the impact this has had on health outcomes. She also highlights areas where the health system is reframing its approach by listening to the needs of women and describes how simple changes, such as allowing women to carry out their own cervical screening at home, can make a big difference. 7. Having a smear test. What is it about? This download A4 Easy Read booklet from Jo's Cervical Cancer Trust uses simple language and pictures to talk about smear tests. It explains what a smear test is, has tips for the person having the test and has a list of words they might hear at their appointment. 8. Health Improvement Scotland: Cervical screening standards Published by Healthcare Improvement Scotland in March, the new cervical screening standards include recommendations to ensure women receive accessible letters and information about screening and healthcare professionals are trained to support women to make informed choices. 9. Cervical cancer screening in women with physical disabilities This US study explored how the cervical cancer screening experiences of women with physical disabilities (WWPD) can be improved. Interviews with WWPD indicated that access to self-sampling options would be more comfortable for cervical cancer screening participation. The authors highlight that these findings that can inform the promotion of self-sampling devices for cervical cancer screening. Have your say Are you a healthcare professional who works in women’s health or cancer services? We would love to hear your insights and share resources you have developed. Perhaps you have an experience of cervical screening or cervical cancer that you would like to share? We would love to hear from you! Comment below (register as a hub member for free first) Get in touch with us directly to share your insights
  5. News Article
    Women, people from minority ethnic backgrounds, and those living in the most deprived areas of England are less likely to receive treatment after a diagnosis of a deadly heart disease, according to one of the largest studies of its kind. Researchers at the University of Leicester analysed data from almost 155,000 people diagnosed with aortic stenosis – a narrowing of the valve between the heart’s main pumping chamber and the main artery – between 2000 and 2022 across England, from a database of anonymised GP records. The study found that patients living in the most deprived areas were 7% less likely to be referred for secondary care after their diagnosis compared with patients in the least deprived areas, and 4% less likely to undergo a procedure to replace their aortic valve. The analysis, funded by the National Institute for Health and Care Research (NIHR) and presented at the British Cardiovascular Society conference in Manchester, also found that women were 11% less likely to be referred to secondary care, such as a hospital specialist, after their diagnosis than men. Women were also 39% less likely to have a procedure to replace their aortic valve. The study also found that black patients were 48% less likely to undergo a procedure to replace their aortic valve than white patients, with south Asian patients being 27% less likely. Both groups were more likely to be referred to secondary care, although the researchers say that this could reflect referrals for other heart issues not related to their aortic stenosis. Read full story Source: The Guardian, 5 June 2025
  6. Content Article
    NHS Race and Health Observatory Review of Neonatal Assessment and Practice in Black, Asian, and Minority Ethnic Newborns highlighted the need for educational resources to help healthcare professionals assess babies with dark skin tones, who are at higher risk of developing jaundice and experiencing delayed diagnosis and treatment. This new infographic for health care professionals, “10 Steps to spot Jaundice in Black and Brown babies” was designed by Dr. Helen Gbinigie, Neonatal Consultant at Medway Hospital and Clinical Lead for KM LMNS; and Dr. Oghenetega Edokpolor, ST5 Paediatric Trainee at Medway Hospital, in collaboration with the NHS Race and Health Observatory. It’s a vital tool in pursuing the Observatory’s aims to reduce neonatal ethnic health inequalities. Related reading on the hub: A parents’ guide to recognising jaundice in Black and Brown babies
  7. Content Article
    Race and ethnic inequalities in health are widely recognised, with much work needed to improve care, diagnosis and treatment, and outcomes for patients. Racism is also evident within healthcare organisations and the impact on staff can be devastating.  In this blog, we’ve collated a wide range of resources, including the latest research, the barriers patients face, improvement initiatives, health inequalities in maternity, and staff discrimination to evidence some of the key patient safety issues and the need for greater investment in this area. Barriers to diagnosis and treatment 1 Perceived barriers to accessing mental health services among black and minority ethnic communities: a qualitative study In most developed countries, substantial disparities exist in access to mental health services for black and minority ethnic populations. This study sought to determine perceived barriers to accessing mental health services among people from these backgrounds to inform the development of effective and culturally acceptable services to improve equity in healthcare. 2 ‘Mistreatment’ due to the colour of your skin A blog highlighting the barriers in healthcare faced by patients due to the colour of their skin. Impacting factors can include explicit racial bias, which includes discrimination and prejudice; implicit racial bias; missing data; lack of trust; and reduced access. These can lead to misdiagnoses and delays in treatment, which can ultimately cause harm and preventable death. 3 95% of healthcare professionals do not feel confident diagnosing dermatology conditions across skin tones This blog by Pastest, a provider of medical exam preparation resources, explores how different organisations are developing transformative initiatives to diversify clinical practice. It highlights the results of a global survey that reveals a critical gap in dermatological diagnosis across skin tones and explores the need for a multifaceted approach to anti-racist medicine. 4 Equity in medical devices: independent review A core responsibility of the NHS is to maintain the highest standards of safety and effectiveness of medical devices available for all patients in its care. Evidence has emerged, however, about the potential for racial and ethnic bias in the design and use of some medical devices commonly used in the NHS, and that some ethnic groups may receive sub-optimal treatment as a result. In response to these concerns, the UK Government commissioned this independent review on equity in medical devices. In its final report, the Review sets out the need for immediate action to tackle the impact of ethnic biases in the use of medical devices. 5 Skin assessment in patients with dark skin tone This article in the American Journal of Nursing provides basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure the performance of effective skin assessments in all patients. 6 “We’re not taken seriously”: Describing the experiences of perceived discrimination in medical settings for Black women Cervical cancer disparities persist for Black women despite targeted efforts. Reasons for this vary; one potential factor affecting screening and prevention is perceived discrimination in medical settings. Inequalities in maternity 1 For black women in the UK, a fear of pregnancy is far from irrational In this blog for Refinery 29, journalist L'Oréal Blackett discusses the additional risk and associated worries faced by black pregnant women in the UK. With black women four times more likely to die in childbirth than white women, and 40% more likely to suffer a miscarriage, she examines what action the government is taking to improve outcomes for black women and their babies. She speaks to a number of campaigners who highlight the importance of including black women at every stage of research and policy to tackle race-based health inequalities. 2 Five X More campaign: Improving maternal mortality rates and health outcomes for black women In this interview, Patient Safety Learning talks to Tinuke, co-founder of the Five X More campaign and founder of the mothers group, Mums and Tea. Tinuke started the Five X More campaign as a response to the MBRRACE 2018 report which highlighted that black women in the UK are five times more likely to die in pregnancy and childbirth in comparison to a white woman. 3 Review of neonatal assessment and practice in Black, Asian and minority ethnic newborns: Exploring the Apgar score, the detection of cyanosis, and jaundice The results of a commissioned review undertaken by Sheffield Hallam University highlights a number of ‘reliability concerns’ around three current neonatal assessments and perinatal practices – the Apgar score and the detection of cyanosis and jaundice. It calls for immediate update of maternity guidelines that refer to assessments by skin colour and the increased use of screening tool devices, including oximeters and bilirubinometers. Urgent research is also needed which focuses on enhancing the reliability of these tools especially for darker skinned babies. 4 Addressing critical gaps in Black maternal mental healthcare: a new partnership project is launched Sandra Igwe is the Founder and CEO of The Motherhood Group. In this interview Sandra tells us about a new partnership project, bringing together The Motherhood Group, Centre for Mental Health, and the Maternal Mental Health Alliance to address critical gaps in Black maternal mental healthcare. Staff discrimination 1 NHS Confederation - Shattered hopes: black and minority ethnic leaders’ experiences of breaking the glass ceiling in the NHS This report by NHS Confederation looks at the lived experience of senior black and minority ethnic leaders in the NHS. The report highlights that more than half of those surveyed 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. Colleagues, leaders and managers seemed to be a particular source of racist treatment, more so than members of the public. 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. 2 Resource for nursing and midwifery professionals to combat racial discrimination against minority ethnic nurses, midwives and nursing associates Racism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. 3 Too hot to handle? Why concerns about racism are not heard... or acted on This report aims to understand the NHS response to racism, what trusts and healthcare organisations do about it and how effective they are at addressing it. It brings together key learning from a number of significant tribunal cases and responses from 1,327 people to a survey about their experiences of raising allegations of racism within their organisations. 4 Closing the gap: A guide to addressing racial discrimination in disciplinaries A guide from NHS Providers to help health service trusts tackle racial discrimination in disciplinary procedures and promote inclusivity. 5 Nursing narratives: Racism and the pandemic This report describes the findings of a study that collected stories of the working lives of Black and Brown healthcare staff during the Covid-19 pandemic. The study asked them to reflect on their experiences and highlight the changes they would like to see. It highlights a number of issues around victimisation, access to PPE, speaking up and risk assessments. 6 Racism which impacts healthcare staff endangers patient care As 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. Improvement initiatives 1 How Lambeth is closing the health inequality gap for Black and minority ethnic patients with high blood pressure Black and minority ethnic patients with high blood pressure have benefited from a project which was run by two Lambeth GP practices. The project aimed to reduce the very significant difference in blood pressure control (hypertension) between Black and minority ethnic patients and white patients. The year-long project resulted in the two practices achieving some of the best outcomes ever seen in South East London for overall hypertension control, with a 12% inequality gap for blood pressure control between black and white patients completely eradicated. In addition, over 300 patients from the local community were newly diagnosed with hypertension. 2 Patient and Carer Race Equality Framework - community This video provides an introduction to Sheffield Health and Social Care NHS Foundation Trust's (SHSCFT's) Patient and Carer Race Equality Framework (PCREF). The PCREF aims to help the Trust's staff and communities understand how to have sensitive conversations with patients and carers and to get better information from them. This will mean the Trust is more culturally aware and able to offer culturally appropriate care by understanding the barriers ethnic minority communities face in getting healthcare services for diagnosis and treatment. 4 Excellence through equality: Anti-racism as a quality improvement tool This report from the BME Leadership Network comprises examples of anti-racist initiatives from BME Leadership Network members, to help advance equality within the workforce and for service users. 5 Be the Change: How to tackle racial inequalities in health and care charities A few years ago, National Voices created an inclusion action plan to try to narrow the gaps in racial inequalities by driving improvements in their recruitment practices, organisational culture, influencing activities and work with people with lived experience. A key part of that plan was convening their members to learn from each other, so they organised a series of four members-only roundtables for focused, pragmatic and open discussion. This report, highlights the main learnings in each of the areas, and draws out general advice from all these conversations. They hope it will give colleagues in the health and voluntary sectors ideas for what they could do, alongside practical tools to take action. 6 Mind the Gap: A handbook of clinical signs in Black and Brown skin Mind the Gap is a Handbook to raise awareness of how symptoms and signs can present differently on darker skin as well as highlighting the different language that needs to be used in descriptors. The aim of this booklet is to educate students and essential allied health care professionals on the importance of recognising that certain clinical signs do not present the same on darker skin. 7 The Health Foundation: Bringing an anti-racism approach to quality improvement in maternity care Black Maternity Matters is a collaboration supporting perinatal staff to reduce the inequitable maternity outcomes faced by Black mothers and their babies. Through a ground-breaking programme of training, including anti-racist education, peer support, and quality improvement, it supports maternity systems to provide safer, equitable care. In a recent episode of the Leading Improvement in Health and Care podcast, Penny Pereira, Q Managing Director, spoke to three improvement leaders from the Black Maternity Matters programme. Structural racism 1 Institute of Health Equity: Structural racism, ethnicity and health inequalities in London Racism in London is widespread and persistent causing damage to individuals, communities and society as a whole. Its impacts are experienced in different ways and to varying levels of intensity related to individual experiences, socioeconomic position and other dimensions of exclusion such as disability, age and gender. The intersections with other dimensions of exclusion can amplify the effects of racism. The focus of this review is on the effects of racism on health and its contribution to avoidable inequalities in health between ethnic groups – a particularly unacceptable form of health inequity. It is urgent that society tackle the damage to health and wellbeing as a result of racism. 2 Structural racism as a contributor to lung cancer incidence and mortality rates among Black populations in the United States Although racial disparities in lung cancer incidence and mortality have diminished in recent years, lung cancer remains the second most diagnosed cancer among US Black populations. Many factors contributing to disparities in lung cancer are rooted in structural racism. To quantify this relationship, Robinson-Oghogho et al. examined associations between a multidimensional measure of county-level structural racism and county lung cancer incidence and mortality rates among Black populations, while accounting for county levels of environmental quality. 3 Interrogating and uprooting systemic racism in the emergency department Systemic racism refers to systems in which norms and practice patterns reinforce racial and ethnic inequalities even in the absence of individual intentions to do so. Uncovering subtle, overt and pervasive instances of racism that influence and change the trajectory of patient care is important. Emergency departments (EDs) offer a distinct environment where equity is not just a concept, but a fundamental practice that should be woven through all interactions between the patient, healthcare professionals and the system. For this reason, EDs are poised to lead health equity advocacy in the delivery of high-quality care. This JAMA Health Forum viewpoint article looks at evidence relating to ED systems’ vulnerability to systemic racism and maps a path forward to dismantle racism in the ED. 4 Women from ethnic minorities face endemic structural racism when seeking and accessing healthcare Women from ethnic minorities are voicing their concerns that they face endemic structural racism when seeking and accessing healthcare, and they feel that their symptoms and signs are more often dismissed. It is vital that patients are listened to when they say that they feel this is also due to structural racism in healthcare. 5 Structural racism — A 60-year-old Black woman with breast cancer This study uses the case study of a 60-year-old Black woman with breast cancer as an example of structural racism and propose three critical strategies for addressing structural racism in health care. These strategies hinge on shifting the focus of work on racial differences in health outcomes from biologic or behavioural problems to the design of health care organisations and other social institutions. Research 1 Language-based exclusion associations with racial and ethnic disparities in thyroid cancer clinical trials Racial and ethnic disparities in thyroid cancer care may be reduced by improving enrolment of more diverse patient populations in clinical trials. This study in the journal Surgery looked at trial eligibility criteria and enrolment to assess barriers to equitable representation. 2 Differences in care team response to patient portal messages by patient race and ethnicity The use of patient portals to send messages to healthcare teams is increasing. This JAMA Network Open cross-sectional study of nearly 40,000 US patients aimed to find out whether there are differences in how care teams respond to messages from Asian, Black and Hispanic patients compared with similar White patients. The authors found that messages asking for medical advice sent by patients who belong to minoritised racial and ethnic groups were less likely to receive a response from doctors and more likely to receive a response from registered nurses. This suggests these patients receive lower prioritisation during triaging. The differences observed were similar among Asian, Black and Hispanic patients. 3 Racial implicit bias and communication among physicians in a simulated environment This JAMA Network Open study aimed to explore whether standardised patients in a simulated environment can be effectively used to explore racial implicit bias and communication skills among doctors. For this cross-sectional study, 60 doctors were placed in an environment calibrated with cognitive stressors common to clinical environments. The results reflected expected communication patterns based on prior research (performed in actual clinical environments) on racial implicit bias and physician communication. The authors believe that this simulation and the process of its development can inform interventions that provide opportunities for skills development and assessment of skills in addressing racial implicit bias. 5 Racial differences in shared decision-making about critical illness This US study looked at how critical care doctors approach shared decision-making with Black compared with White caregivers of critically ill patients. The authors found that racial disparities exist in critical care clinicians' approaches to shared decision-making and suggest potential areas for future interventions aimed at promoting equity. 6 Impact of healthcare algorithms on racial and ethnic disparities in health and healthcare This systematic review conducted for the Agency for Healthcare Research and Quality (AHRQ) aimed to examine the evidence on whether and how healthcare algorithms exacerbate, perpetuate or reduce racial and ethnic disparities in access to healthcare, quality of care and health outcomes. The results showed that algorithms potentially perpetuate, exacerbate and sometimes reduce racial and ethnic disparities. Disparities were reduced when race and ethnicity were incorporated into an algorithm to intentionally tackle known racial and ethnic disparities in resource allocation (for example, kidney transplant allocation) or disparities in care (for example, prostate cancer screening that historically led to Black men receiving more low-yield biopsies). 7 Characteristics of publicly available skin cancer image datasets: a systematic review Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world. These are just a selection of the resources we have on the hub, read more in the health inequalities section of the hub. Share your insights We'd like to hear from patients about your experiences and how it has impacted your care. Or perhaps you are clinician or researcher with a perspective to share on health inequalities? Please leave a comments below (sign up here first for free), or contact us directly at [email protected].
  8. News Article
    Although the disparity in the number of overall deaths reported between Black and white Americans has narrowed over the course of the last 75 years, researchers say that the same does not hold true for infants. Black infants are dying at twice the rate of white infants – and it’s largely thanks to healthcare inequality. “This is like a red alarm,” Harvard University associated professor Dr. Soroush Saghafian explained. “Our findings are saying: Look, we could have saved five million Black Americans if they had the same things as white Americans have,” he told The Harvard Gazette. The authors analysed mortality data collected by the U.S. Census Bureau and the Centers for Disease Control and Prevention, calculating life expectancy, mortality rates, and years of potential life lost for both white and Black Americas. Their analysis found that there was a 20.4 percent increase in life expectancy for Black Americans and a 13 percent rise for white Americans, although Black adults still have an 18 percent higher mortality rate. The American healthcare system has long been under scrutiny for its astronomical costs and hurdles to patient care. A new study released Wednesday from the West Health Institute has found that the inability to pay for healthcare in the U.S. has reached a new high. More than a third of Americans – or an estimated 91 million people – report that they could not access quality healthcare if they needed it, according to the latest West Health-Gallup Healthcare Affordability Index. Read full story Source: The Independent, 2 April 2025
  9. Content Article
    The UK has one of the lowest maternal mortality rates in the world, but black women are still twice as likely as white women to die from pregnancy related causes. Historically, this disparity has been as high as fivefold, kickstarting initiatives such as Five X More to push for improved maternal outcomes in black women. Despite improvements in recent years, racial inequalities stubbornly persist. In this BMJ feature, Samara Linton explores why—and what’s being done to improve outcomes. Related reading on the hub: Top picks: Race and ethnic health inequalities
  10. Content Article
    This article by Samantha Anderer looks at the results of a US National Center for Health Statistics report into maternal deaths. The results show that the US maternal mortality rate was more than three times higher for Black women than for those of any other racial or ethnic group in 2023. Although the overall maternal mortality rate in the US has declined every year since 2021, it remained substantially higher than in other high-income nations, with research suggesting that many such deaths are preventable.
  11. News Article
    eople from black ethnic backgrounds are being encouraged to take part in a research programme aimed at tackling health inequalities. The Improving Black Health Outcomes (IBHO) BioResource programme at University Hospital Southampton (UHS) will explore how African-Caribbean communities develop and experience different health conditions. Those taking part would be tested and matched with various research programmes into conditions including sickle cell, diabetes, heart and kidney disease. David Stockley, NIHR BioResource Southampton Manager at UHS, said the volunteers would be playing a "vital role" in developing future healthcare provision. UHS said the study was set up as historically, people from African and Caribbean heritage have been under-represented in health studies, meaning knowledge and treatments as a result of research have been predominantly based on white populations. Mr Stockley said the new initiative aimed to "close the gap". "The IBHO BioResource will help us better understand and address health conditions and their unique impacts on black people and their loved ones, ensuring everyone benefits from fair and inclusive research," he added. Read full story Source: BBC News, 20 March 2025
  12. Content Article
    Racism is a fundamental determinant of health, contributing to health inequities globally. It is a frequent experience for Aboriginal and Torres Strait Islander peoples and shapes their experience of cultural safety in healthcare and other settings. This policy brief outlines the importance of cultural safety in addressing racism, the need for clarity and understanding about cultural safety, and creating pathways for embedding cultural safety in health and human services through establishing national training standards and a linked accreditation process, combined with dedicated organisational action. 
  13. News Article
    It has been more than four decades since Devon Marston, a 66-year-old community organiser and musician, was taken to a psychiatric hospital where he was restrained, injected and forced to take medication. He was diagnosed with paranoid schizophrenia. “Everything was said around me and about me, but no one asked me how I was doing,” he said. “I had no voice, and there was no one to say: ‘Don’t do that to him,’ or: ‘Listen to him, hear what he has to say.’” The experience had a profound impact on his life and put him on a path to campaign for better care for minority ethnic people experiencing mental distress. However, progress has been painfully slow. “Nothing has changed. Everything is still the same – only it’s more covered up now by clauses in the Mental Health Act that make it look fair but the equality and justice are not there,” he said. The most recent data paints a frightening picture. Findings from the Care Quality Commission’s (CQC) latest report show that the number of adults sent for very urgent mental health care from crisis teams more than doubled between 2023 and 2024. The report, published on Thursday, also raised concerns about the overrepresentation of black people being detained under the act, finding they are 3.5 times more likely to be detained than white people. The damning report warned that people are becoming more unwell while waiting for help and are stuck in a “damaging cycle” of hospital readmission. Read full story Source: The Guardian, 13 March 2025
  14. News Article
    NHS staff are more likely than members of the public to perpetrate antisemitic abuse in hospitals and doctors’ surgeries since the October 7 Hamas attacks, according to complaints compiled by an influential charity. The file includes a Jewish doctor being given a hijab as a secret santa present and a patient having pro-Palestine stickers plastered across his room as he lay fighting for his life. Meanwhile, a group of therapists who complained about a colleague posting messages supporting Hamas online were subject to a countercomplaint for “micro-aggressions”. A patient waiting to be discharged from hospital was told: “Get your Jewish ambulance to come and get you.” Dave Rich, policy director at the Community Security Trust, said: “It is essential that hospitals and NHS trusts deal with this trend of rising antisemitism quickly and firmly and set a clear example that anti-Jewish prejudice has no place in the NHS.” Read full story (paywalled) Source: The Times, 6 March 2025
  15. News Article
    Getting tested for prostate cancer should’ve been easy for Paul Campbell. He wanted a check-up after seeing an advert on TV calling for men in their 40s to get thorough health checks. He asked his GP but was immediately questioned about why he – a man who seemed otherwise healthy – would want a check-up. “I had to fight my ground, I had to raise my voice. And eventually, I got the test,” Mr Campbell told The Independent. He was later diagnosed with aggressive prostate cancer. “Had I not been assertive and pushy, by the time I found out, it would have been stage 4.” Mr Campbell is far from being alone in his experience. New research from the NHS Race and Health Observatory found “alarming levels” of discrimination towards patients from ethnic minorities and huge levels of mistrust in the NHS system. The survey of 2,680 people found only 55% trusted primary care to meet their health needs most or all of the time, while a third of south Asian participants said they either rarely or never trusted primary care to meet their health needs. On Friday, the NHS Race and Health Observatory roundtable brought together 20 key partners from local communities, the volunteer sector, the government and broader NHS to discuss the findings. Professor Habib Naqvi, chief executive, NHS Race and Health Observatory, said: “We cannot have a two-tier NHS based upon patient ethnicity, background or circumstances. This report reflects the clear need to bring speed and urgency to reform the NHS, so that patients do not face discrimination and systemic barriers when seeking healthcare.” These issues have a real impact on health outcomes. Read full story Source: The Independent, 9 March 2025
  16. Content Article
    In this BMJ article, Mala Rao, director at the Ethnicity and Health Unit and Imperial College London, and Victor Adebowale, Chair of NHS Confederation, share their perspectives on whether racism has improved in the NHS and UK medicine since 2020.
  17. Content Article
    Patient Safety Learning stands with others around the world to celebrate International Women’s Day (8 March). The campaign theme for 2025 is ‘Accelerate Action’ and is a worldwide call to acknowledge strategies, resources and activity that positively impact women's advancement. In this blog, we explore four key areas of patient safety relating to women’s health, where we believe action needs to be accelerated: Pain management. Waiting times for elective gynaecology care. Redress for harmed patients. Disparities in maternal outcomes. Pain management Evidence shows that women are in pain more often and more severely than men.[1,2] They are also more likely to have their pain dismissed or underestimated[3], with racial biases leaving Black women particularly vulnerable.[4] These inequities can prolong women’s suffering of both acute and chronic pain, and can lead to delays in diagnoses and treatment. Women’s pain is dismissed in areas of healthcare relevant to both men and women, for example cardiology,[5] as well as in areas specific to the female body, for example gynaecology or maternity.[6] At Patient Safety Learning, we have heard too many accounts of patients attending gynaecology procedures where they have experienced unexpected high levels of pain that has not been managed or responded to appropriately.[7,8,9,10] In many cases, these experiences have led to an erosion of trust in the healthcare system and an increased anxiety in attending future appointments that may play a critical role in their outcomes. There is no nationally adopted, standardised patient feedback collection around pain experiences in gynaecology procedures. If patient-reported outcome measures were routinely collected, this data could be used by healthcare organisations to help identify the scale of harm and amplify the voices of the women affected so that pain is better managed and no one is at risk of trauma. These feedback mechanisms need to be co-designed with those who have lived experience to ensure the data being captured is meaningful, is designed to identify inequalities and used to improve care for all women. Most importantly, whatever the setting, it is critical that women’s experiences of pain whether chronic or acute, are listened to, believed and appropriately responded to. Patients should be empowered with the information, compassion and respect needed to place them at the heart of the decision making around their pain management. Waiting times for elective gynaecology care A 2022 report from the Royal College of Obstetricians and Gynaecologists showed the number of women waiting over a year for elective gynaecology care in England had increased from 66 before the pandemic to nearly 25,000.[11] Their follow up report in 2024 showed that waiting lists had worsened in all parts of the UK, with those living in areas of deprivation most likely to wait longest.[12] With debilitating conditions like endometriosis, already notorious for taking many years to diagnose,[13,14] evidence of continued setbacks in this area, rather than progress, is devastating. Women seeking help and treatment for life-limiting symptoms are being left without the support they need and fearful that their health will worsen. This often has a negative repercussion on other areas of life, including relationships, work and mental health.[15] The Women’s Health Strategy published in 2022 sets out plans for the roll-out of women’s health hubs to provide a ‘one-stop shop’, where services are centred on women’s needs, better coordination of care and reducing the elective backlog.[16] The Strategy notes the wide and varied range of stakeholders that will need to be involved in this effort and states that the Government” will develop a delivery plan for the commitments set out in this strategy”. However, there is currently no timetable for this, or indication of what resources may be allocated to support this work. Despite some early evidence of their success in reducing waiting times,[17] there are concerns that central support for the women’s health hubs has recently been removed,[18,19] and that women’s health has been deprioritised in the NHS health plans.[20] Women’s health needs to urgently be prioritised and invested in to address the worsening wait times for gynaecological care. Healthcare professionals must be given access to the resources needed to be able to provide high quality, safe care to all women so that inequalities do not continue to widen. Without this, patients will continue to suffer avoidable pain and are at risk of further harm relating to their physical and mental health outcomes. Redress for harmed patients Last year the Patient Safety Commissioner for England published The Hughes Report, which sets out options for redress for those who have been harmed by valproate and pelvic mesh.[21] Patient Safety Learning believes, like many individual patients and patient groups, that there must be redress options for patients harmed by the interventions covered by The Independent Medicines and Medical Devices Safety (IMMDS) Review.[22] There is considerable evidence that for many patients the clinical negligence route is simply not viable. In the absence of any system of redress, this leaves them with no assistance to help meet the cost of any additional care and support they may need. We also believe that redress should extend to those affected by hormone pregnancy tests, who fell outside of the scope of The Hughes Report’s recommendations. Excluding patients and family members affected by hormone pregnancy tests from redress is not acceptable or in keeping with the spirit of the IMMDS Review’s recommendations. We believe the Government must respond to this report promptly and take steps to deliver redress for all those affected by pelvic mesh, sodium valproate and hormone pregnancy tests as a matter of urgency. Disparities in maternal outcomes The ‘Saving Lives, Improving Mothers' Care annual reports include: data on women who died during or up to one year after pregnancy in the UK lessons learned from the UK and Ireland confidential enquiries into maternal deaths and morbidity.[23] The most recent report[24] highlights a continuation of inequalities with maternal mortality rates three times as high for women from Black ethnic backgrounds and twice as high for women from Asian ethnic backgrounds when compared to White women. The data also showed that women living in the most deprived areas of the UK and Ireland were twice as likely to die compared to those living in the least deprived areas. The report also highlighted barriers to accessing maternity care for women who had recently arrived in the UK. Many didn’t get the support they needed to understand how to register with a GP to start receiving maternity care and would present for the first time in an emergency setting. Language and literacy barriers were also evident, with patient needs being poorly assessed, recorded and met. The availability of interpreters and accessible written information was inconsistent. It is clear that a continued focus is needed to ensure disparities in maternity are better understood and addressed. All women have the right to access safe maternity care, free from racism, bias and a postcode lottery. Access to information in an accessible format that enables women to give consent to interventions and make decisions about their health and the health of their babies is also vital.[25] Translation capabilities within the health service must be prioritised and properly resourced across the board for these inequalities to be addressed. Summary There are many barriers to women receiving safe and equitable care. This blog has touched on just a few of the areas where action needs to be accelerated. We must recognise there are complex inter-relationships that compound these issues – intersectionality is an essential consideration. It is important to look at all variables in order to effectively identify the barriers and solutions to safer and more equitable care. In the coming months, we hope to see the importance of patient safety in women’s health emphasised and supported through the development of the NHS 10 Year Health Plan. The Royal College of Obstetricians and Gynaecologists has also recently launched a project to identify the most pressing unanswered questions in the health of women and people from the perspective of members of the public themselves.[26] We look forward to hearing more about their findings. We continue to await the Government’s response to the Hughes Report and to support the IMMDS Review’s recommendations for redress for those who have been harmed by valproate, pelvic mesh and hormone pregnancy tests. Helen Hughes, Chief Executive Officer of Patient Safety Learning says: “All patients have the right to access safe care, free from avoidable pain and harm. Women’s health has for centuries been side-lined and action must be accelerated now to address the inequities and barriers that continue to exist. This has to start with a focus on listening to and believing women when they share their experiences. Where harm has occurred, it is vital that we learn from the mistakes made and that this harm is appropriately responded to”. References Nurofen. Gender Pain Gap Index Report Year 3. Oct 2024. Editorial. Gendered pain: a call for recognition and health equity. eClinicalMedicine Mar 2024 Vol 69. C de C Williams, A. Analysis: Women’s pain is routinely underestimated, and gender stereotypes are to blame. The Conversation. Apr 2021. Hoffman KM, Trawalter S, Axt JR et al. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016 Apr 19;113. Nabel EG. Coronary heart disease in women--an ounce of prevention. N Engl J Med. 2000 Aug 24;343. J. H. Bamber, R. Goldacre, D. N. Lucas et al. A national cohort study to investigate the association between ethnicity and the provision of care in obstetric anaesthesia in England between 2011 and 2021. Anaesthesia, 78(7), 820-829. Patient Safety Learning - the hub. Painful hysteroscopy. Community forum - accessed 03/03/25. Patient Safety Learning - the hub. Pain during IUD fitting. Community forum- accessed 03/03/25. Cohen, L. The pain of my IUD fitting was horrific…and I’m not alone. Patient Safety Learning - the hub. Jun 2021. Anonymous. My experience of an IUD insertion: frozen with shock - no one was asking if I was OK. Patient Safety Learning - the hub. Jan 2025. Royal College of Obstetricians and Gynaecologists. Left for too long. 2022. Royal College of Obstetricians and Gynaecologists. Waiting for a way forward. 2024. Endometriosis UK. “Dismissed, ignored and belittled”. The long road to endometriosis diagnosis in the UK. Mar 2024. All Party Parliamentary Group (APPG) on Endometriosis. APPG on Endometriosis Inquiry Report 2020. Endometriosis in the UK: time for change. 2020. Royal College of Obstetricians and Gynaecologists. New RCOG report reveals devastating impact of UK gynaecology care crisis on women and NHS staff. Nov 2024. NHS England. Women's Health Strategy for England. Aug 2022. Crouch, H. Women's Health Hub aims to reduce wait lists for gynaecology. Barts Health NHS Trust. Nov 2024. Royal College of Obstetricians and Gynaecologists. RCOG responds to reports that central support for women’s health hubs will end. Jan 2025. Donnelly, L. Wes Streeting dumps women's health target from NHS plan. The Telegraph online. Jan 2025. NHS England. NHS England 2025/26 priorities and operational planning guidance. Jan 2025. Patient Safety Commissioner. The Hughes Report: Options for redress for those harmed by valproate and pelvic mesh. Feb 2024. Cumberlege, J. First Do No Harm. The report of the Independent Medicines and Medical Devices Safety Review. July 2020. The National Perinatal Epidemiology Unit, MBRRACE-UK. Saving Lives, Improving Mothers' Care annual reports. The National Perinatal Epidemiology Unit, MBRRACE-UK. Saving Lives, Improving Mothers' Care 2024 - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2020-22. Oct 2024. NHS England. Accessible Information Standard (updated Aug 2017). Royal College of Obstetricians and Gynaecologists. Women's Health Research Priorities (WHRP). Jan 2025. Related hub reading Top picks: Women's health inequity Dangerous exclusions: The risk to patient safety of sex and gender bias Failures of informed consent and the impact on women’s health: a Patient Safety Learning blog Gender bias: A threat to women’s health Top picks: Six resources about improving access to cervical screening The normalisation of women’s pain Top Picks: Women campaigning for patient safety TIGER UK: A new network for people passionate about improving gynaecology experiences First Do No Harm APPG public meeting on redress: Speech from Kath Sansom Fitting coils: developing a safe and supportive service
  18. Content Article
    This article in JAMA Health Forum examines how the growing use of clinical algorithms exacerbates health disparities through perpetuating discrimination. Anirban Basu discusses five critical issues that should be considered when developing and using clinical algorithms to minimise algorithmic discrimination:Should race belong in a clinical algorithm?Do we then have to develop two separate algorithms for decision-making invoking compensation vs reward?What happens if there is differential mismeasurement of race?What happens when there are differential measurement errors in other predictors, including biological variables?What happens when differential measurement errors exist in the clinical outcomes for which the algorithm is being developed?
  19. News Article
    Government must “move quickly” to address a lack of diversity in responses to its 10-year plan consultation, an adviser on the work has warned. Health and social care secretary Wes Streeting admitted last month that several groups have been heavily under-represented in the high-profile online engagement exercise, which began in October. Just 1% of responses are from Black African, Caribbean and Black British groups, who make up 4% of England’s population, while 3% are from an Asian background, who represent 10% of the population. Mr Streeting, acknowledging these “disparities and inequalities” to the Commons health and social care committee last month, said: “I want to nail [them] in the rest of this consultation period.” Jacob Lant, CEO of service user group National Voices and lead of one of the 10-year plan policy workstreams, said: “The public engagement exercise has been very ambitious in both its scale and speed, and it is good to see the [Department of Health and Social Care] actually investing in this sort of activity to ensure policy decisions are based on what matters most to patients. “It’s also encouraging the [health and social care secretary] is in reflective mode and is acknowledging the groups who have not had their say so far. It’s vital the process moves quickly now to fill those engagement gaps, and with the right support the VCSE sector can play a vital role in helping the government reach key communities over the next few months as the 10-year plan takes shape.” Read full story (paywalled) Source: HSJ, 3 January 2025
  20. Content Article
    Health disparities are systemic and deeply rooted in social and economic inequities. Patients living in deprived areas, from racially minoritised communities, or facing additional challenges such as homelessness or intellectual disabilities experience worse health outcomes. These disparities are compounded by mistrust in healthcare, low health literacy, cultural barriers, and discrimination.  This report focuses on patients with blood disorders and/or cancers who experience health inequalities, and therefore have worse outcomes and experiences of care than patients who don’t. We looked at how social and economic factors affect the health of people living with blood disorders and cancer.  Report key findings: Patients living with cancer and/or blood disorders experience significant barriers to care including delays in diagnosis, unequal access to services, and systemic discrimination, These patients also reported challenges navigating healthcare, a lack of communication, and economic burdens such as high transportation and medication costs, Social determinants of health like inadequate housing and living in deprived areas further worsened outcomes, Participants emphasised mistrust in the healthcare system, particularly among racially minoritised and LGBTQ+ communities, and highlighted the need for better coordination, cultural sensitivity training, and localised services. The project involved a literature review on health disparities and social determinants affecting patients with cancer and blood disorders. Discussions were held with local and condition-specific charities, and we conducted focus groups and a case study interview with patients and carers. These efforts aimed to gather diverse perspectives and first-hand accounts of lived experiences.
  21. Content Article
    Racial and ethnic disparities in thyroid cancer care may be reduced by improving enrolment of more diverse patient populations in clinical trials. This study in the journal Surgery looked at trial eligibility criteria and enrolment to assess barriers to equitable representation. The authors found that over the last 3 decades: 1 in 13 thyroid cancer–related clinical trials excluded patients based on language. In the fraction of published studies to report on racial and ethnic demographics, Asian/Native Hawaiian, Black and Hispanic patients were under-represented. They concluded that improving the reporting of demographics in published studies and eliminating exclusion criteria such as language could improve equitable representation of patients in thyroid cancer clinical trials.
  22. Content Article
    Black Maternity Matters is a collaboration supporting perinatal staff to reduce the inequitable maternity outcomes faced by Black mothers and their babies. Through a ground-breaking programme of training, including anti-racist education, peer support, and quality improvement, it supports maternity systems to provide safer, equitable care. In a recent episode of the Leading Improvement in Health and Care podcast, Penny Pereira, Q Managing Director, spoke to three improvement leaders from the Black Maternity Matters programme.
  23. Content Article
    Black and minority ethnic patients with high blood pressure have benefited from a project which was run by two Lambeth GP practices. The project aimed to reduce the very significant difference in blood pressure control (hypertension) between Black and minority ethnic patients and white patients. The year-long project resulted in the two practices achieving some of the best outcomes ever seen in South East London for overall hypertension control, with a 12% inequality gap for blood pressure control between black and white patients completely eradicated. In addition, over 300 patients from the local community were newly diagnosed with hypertension.
  24. News Article
    The head of an association representing Muslim health workers has said it has recorded an increase in racist abuse since the beginning of the far-right riots last week, with “unprecedented” fear among NHS staff. Dr Salman Waqar, the president of the British Islamic Medical Association (Bima), which represents about 7,000 healthcare staff, said health workers had been left in fear and affected personally and professionally. Waqar said: “I’ve seen some really terrible messages, particularly coming out from Belfast and in Greater Manchester, of people having to close up their GP surgery early, of people being trapped in their practices, of people having to take taxis back and forth from work, people not going on home visits, people working remotely from home, there’s too many to mention and to count.” He shared a video and screenshots of text messages from NHS staff, who contacted him about the abuse they had faced in the past week including being called a racial slur and an individual threatening to “kill this Muslim man”. Waqar said: “From our perspective, in terms of our members reporting how fearful they are, reporting how they’re having to think twice about what they do, international colleagues questioning whether or not they have a future in the UK. That is unprecedented, I’ve never seen anything like this before. In terms of the volume, in terms of the strength of feeling, there is no comparison to it.” Read full story Source: The Guardian, 9 August 2024
  25. Content Article
    Leading researcher, developer, and former director of the Workforce Race Equality Standard (WRES), and prominent author of guidance on race equality in the NHS, Roger Kline, has published a new report: Racist riots and the NHS: What next?  Building on his previous publications, the paper explains how little robust steps were offered to NHS practices during the riots, exposing the persistent failure of NHS leaders to deal with racism in the institution and amongst its leadership. During the riots, health and care workers were targeted physically and on social media. Despite these numerous attacks, Kline underscores the lack of concrete support provided by national bodies during the crisis and the subsequent inaction from leadership to take the necessary steps to respond to the events.  Kline calls out the riots as a ‘jolt to the system’ – but not a one off incident, rather the riots were examples of exceptional crises following years of mounting evidence that more must be done to address racism within Britain and the NHS. 
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