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Found 26 results
  1. Content Article
    In this BMJ Opinion piece, Amali Lokugamage and Alice Meredith propose that the foundation of any translation of Cultural Safety education to maternity services should consider these five key ingredients: A catalogue of patient experience videos explaining their encounters with structural inequity in healthcare from a diverse group of patients The creation of a basic module of education in decolonising the history of health, raising awareness of lingering colonial racial bias An educational tool is required to enhance healthcare professional’s reflective practice Access to continuity of care models for disadvantaged women Part of the Cultural Safety model is that when vulnerable patients feel culturally unsafe (due to racial discrimination), they can request carers from a similar ethnic background as themselves. In relation to the final point, the authors note: "There may not be enough numbers of appropriately trained personnel from the same cultural background requiring affirmative action in recruitment. An additional confounding consequence may be to cause “auto segregation” in society and could limit personal development in all healthcare personnel or systems in order to produce equitable healthcare for all. Also, the global phenomenon of disrespectful maternity care, described by the World Health Organisation in their document on the prevention and elimination of disrespect and abuse during childbirth, points to the existence of unjust interactions in countries where care is delivered by professionals from a similar background to their patients. Furthermore, by potentially allowing such requests to become day-to-day practice, there are recognised pitfalls as described recently by Roger Kline, including increased segregation towards healthcare providers, and even racism against doctors from ethnic minorities. So, this final element could be thorny when considering possible translation to a UK setting."
  2. News Article
    A review of a clinical commissioning group has discovered “microaggressions and insensitivities” towards Black, Asian and minority ethnic staff, and the use of derogatory slurs about other groups. The report into Surrey Heartlands CCG also uncovered incidents of shouting, screaming and bullying among other inappropriate behaviour. And it was reported some staff were unwilling to accept Black Lives Matter events as important, stating “all lives matter”. The review also discovered a culture of denial and turning a blind eye to consistent concerns, with staff fearful of speaking up. In particular, the HR department was said to have been repeatedly told about the behaviour of one staff member but had chosen to ignore or delay dealing with the issues. However, the review found “no evidence for widespread discriminatory practices” and “no clear evidence for a widespread culture of bullying and ill-treatment” — but it added the systems to deal with concerns had failed and there was a sense of “organisational inaction”. Read full story (paywalled) Source: HSJ, 27 November 2020
  3. Content Article
    With a concerted effort that encompasses multiple sectors, Egede and Walker suggest we can change the fabric of structural racism and social risk that leads to disparities in health. In this New England Journal of Medicine article, they propose that to be effective, change must occur within federal, state, county, and city governments; within private and nonprofit businesses and in the health care, food, housing, education, and justice arenas; and at the individual level. If everyone took a stand to stop racism and found a way to participate in sustainable change in one of the six suggested areas below, the result could be transformational. Recommended action items for mitigating structural racism: Change policies that keep structural racism in place. Break down silos and create cross-sector partnerships. Institute policies to increase economic empowerment. Fund community programs that enhance neighborhood stability. Be consistent in efforts by health systems to build trust in vulnerable communities. Test and deploy targeted interventions that address social risk factors.
  4. News Article
    The staff-side committee of a major hospital trust has stopped working with its leadership, with its chair alleging an ‘endemic’ culture of ‘racism, discrimination and bullying’. Irene Pilia, staff-side committee chair at King’s College Hospital Foundation Trust, told colleagues that the decision was taken “in the interests of staff”, especially black, Asian and minority ethnic workers, and expressed concerns about the organisation’s disciplinary procedures. She said the decision had the backing of staff committee officers and delegates. Ms Pilia, who is also the senior KCHFT Unite representative, said she was open to resuming partnership working again, but told trust executives: “I have lost trust and confidence in the ability of [KCHFT] to conduct fair, impartial and no-blame investigations. “Until there is tangible and credible evidence that racist behaviour at all levels is proactively eliminated, such that perpetrators face real consequences (including to the detriment of their careers) for their actions and are no longer allowed to behave in racist ways with impunity, I take a stand for the hundreds, possibly thousands of KCHFT staff whose voices are not being heard." Read full story (paywalled) Source: HSJ, 22 October 2020
  5. News Article
    Doctors from black, Asian and minority ethnic backgrounds have been hindered in their search for senior roles because of widespread “racial discrimination” in the NHS, according to a report from the Royal College of Physicians. The RCP, which represents 30,000 of the UK’s hospital doctors, found that ingrained “bias” in the NHS made it much harder for BAME doctors to become a consultant compared with their white counterparts. “It is clear from the results of this survey that racial discrimination is still a major issue within the NHS,” said Dr Andrew Goddard, the RCP’s president. “It’s a travesty that any healthcare appointment would be based on anything other than ability.” Read full story Source: The Guardian, 21 October 2020
  6. News Article
    There is growing distrust for the NHS and government in communities that are of fundamental importance to the national effort to counter covid, according to research by NHSX. People in so-called “hard to reach” communities are faced with stigma and racism due to the covid pandemic but have dwindling trust in the health service, the research found. They are worried about how their personal data will be used by the NHS and other state bodies. They are particularly concerned that their details will be passed on to the police or immigration services. Read full story (paywalled) Source: HSJ, 20 October 2020
  7. News Article
    Almost two-thirds of black Britons think the NHS does less to protect their health than that of white people, research has found. That negative view of the health service is shared by a majority of black people of almost all ages, and is held especially strongly by black women, according to findings of a study commissioned by a parliamentary committee. Overall, 64% of black people do not believe that their health is as protected by the NHS compared with white people’s. When asked if they thought it was, 34.3% disagreed and another 29.6% disagreed strongly, while just 19.9% agreed and a further 2.4% agreed strongly. The survey was commissioned by MPs and peers on the joint committee on human rights as part of its inquiry into black people, racism and human rights in the UK. The report will be published and debated with the authors at an evidence session today. Read full story Source: The Guardian, 7 September 2020
  8. News Article
    A major British medical school is leading the drive to eliminate what it calls "inherent racism" in the way doctors are trained in the UK. The University of Bristol Medical School says urgent action is needed to examine why teaching predominantly focuses on how illnesses affect white people above all other sections of the population. It comes after students pushed for reform, saying gaps in their training left them ill-prepared to treat ethnic minority patients – potentially compromising patient safety. Hundreds of other UK medical students have signed petitions demanding teaching that better reflects the diversity of the country. The Medical School Council (led by the heads of UK medical schools) and the regulator, the General Medical Council, say they are putting plans in place to improve the situation. A number of diseases manifest differently depending on skin tone, but too little attention is given to this in training, according to Dr Joseph Hartland, who is helping to lead changes at the University of Bristol Medical School. "Historically medical education was designed and written by white middle-class men, and so there is an inherent racism in medicine that means it exists to serve white patients above all others," he said . "When patients are short of breath, for example, students are often taught to look out for a constellation of signs – including a blue tinge to the lips or fingertips – to help judge how severely ill someone is, but these signs can look different on darker skin." "Essentially we are teaching students how to recognise a life-or-death clinical sign largely in white people, and not acknowledging these differences may be dangerous," said Dr Hartland. Read full story Source: BBC News, 17 August 2020
  9. News Article
    Incoming Health Education England chief executive Navina Evans said the momentum created by the death of George Floyd and the Black Lives Matter movement meant there was now increased “pressure on white leaders” to act on racism and discrimination in the service. Dr Evans praised a letter written by Birmingham and Solihull Mental Health Foundation Trust chief executive Roisin Fallon-Williams, in which she admitted to being “culpable” and “complicit” in failing to fully understand the inequality and discrimination faced by people with black, Asian or other minority ethnic backgrounds. “That was great to see, and as you can see from the reactions to her letter people were really, really pleased to have it acknowledged,” she said. However, Dr Evans added: “As well as that [acknowledgement] there needs to be action”. Read full story Source: HSJ, 22 June 2020
  10. News Article
    An independent investigation into working conditions at a unit of the NHS’s blood and organ transplant service has concluded that it is “systemically racist” and “psychologically unsafe.” The internal investigation was commissioned in response to numerous complaints from ethnic minority staff working in a unit of NHS Blood and Transplant (NHSBT) in Colindale, north London. The report, carried out by the workplace relations company Globis Mediation Group, concluded that the environment was “toxic” and “dysfunctional.” The report found evidence that ethnic minority employees had faced discrimination when applying for jobs and that white candidates had been selected for posts ahead of black applicants who were better qualified. “Recruitment is haphazard, based on race and class and whether a person’s ‘face fits,’” it said. “Being ignored, being viewed as ineligible for promotion and enduring low levels of empathy all seem to be normal,” the report noted. “These behaviours have created an environment which is now psychologically unsafe and systemically racist.” Chaand Nagpaul, BMA council chair, commented, “This report highlights all too painfully the racial prejudices and discrimination we are seeing across healthcare. We must renew efforts to challenge these behaviours and bring an end to the enduring injustices faced by black people and BAME healthcare workers here in the UK.” Read story Source: BMJ, 10 June 2020
  11. News Article
    "Structural racism and social inequality" should be taken into account when looking at the impact of COVID-19 on Britain's black, Asian and minority ethnic, according to an expert involved in a recent review. Professor Kevin Fenton was a major part of a Public Health England (PHE) report ordered by the government into why the BAME community has been disproportionately affected by coronavirus. It found people from BAME groups were up to twice as likely to die with COVID-19 than those from a white British background. The review was also meant to offer recommendations, but sources have told Sky News that these were "held back" by the government. Health Secretary Matt Hancock said coming from a non-white background was a Speaking at a public meeting for Hackney Council, Prof Fenton said: "Over the last six weeks I've worked with over 4,000 individuals to understand what are some of the contextual issues that are driving the excess risk amongst, black, Asian and minority ethnic groups." "Some of the structural issues, like racism, discrimination, stigma, distrust, fair, these are real issues that are challenging for the communities and are seen as underpinning some of the disparities we see for COVID. Any conversation about what we need to do, should take into consideration these things." Read full story Source: Sky News, 9 June 2020
  12. News Article
    Factors such as racism and social inequality may have contributed to increased risks of black, Asian and minority communities catching and dying from COVID-19, a leaked report says. Historic racism may mean that people are less likely to seek care or to demand better personal protective equipment, says the Public Health England (PHE) draft, seen by the BBC. Other possible factors include risks linked to occupation and inequalities in conditions such as diabetes may increase disease severity. The report, the second by PHE on the subject, pointed to racism and discrimination as a root cause affecting health and the risk of both exposure to the virus and becoming seriously ill. It said stakeholders expressed "deep dismay, anger, loss and fear in their communities" as data emerged suggesting COVID-19 was "exacerbating existing inequalities". And it found "historic racism and poorer experiences of healthcare or at work" meant individuals in BAME groups were less likely to seek care when needed or to speak up when they had concerns about personal protective equipment or risk. The report concluded: "The unequal impact of COVID-19 on BAME communities may be explained by a number of factors ranging from social and economic inequalities, racism, discrimination and stigma, occupational risk, inequalities in the prevalence of conditions that increase the severity of disease including obesity, diabetes, hypertension and asthma." Read full story Source: BBC News, 13 June 2020
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