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ECRI has released its newest list of the Top 10 patient safety concerns confronting healthcare organisations. Healthcare providers, regardless of their practice setting, can start with our Top 10 list and use it to guide their own discussions about patient safety and improvement initiatives. This top 10 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organizations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting. Join ECRI to learn more about the identified concerns and how your organisation can begin to address them. Register- Posted
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The NHS is the biggest UK employer of Black and Minority Ethnic staff. More action needs to be taken to tackle disparities and prejudice to make our NHS more equitable for staff and patients alike. Dr Anu Obaro has recently shared her experiences through a BOB impact story, in which she has reflected on how she presented the subject to her peers at a roundtable event. Join Dr Anu Obaro and guests for a one-hour webinar as they discuss how you can take action to instil anti-racism where you work. In this webinar, you will learn: How racism can be institutionalised. How you can spread and scale the learnings from Dr Obaro’s write-up on BOB. How you can gather data to demonstrate outcomes in your workplace. Register- Posted
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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- Posted
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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- Posted
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Racial discrimination widespread in NHS job offers, says report
Patient Safety Learning posted a news article in News
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 -
News Article
Trust in NHS ‘poor and diminishing’ among communities hit hardest by covid
Patient Safety Learning posted a news article in News
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 -
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- Posted
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The medical school trying to become anti-racist
Patient Safety Learning posted a news article in News
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- Posted
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‘White leaders under pressure’ to prove black lives matter
Patient Safety Learning posted a news article in News
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- Posted
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Racism 'could play a part in BAME covid deaths'
Patient Safety Learning posted a news article in News
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 -
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- Posted
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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 -
Content Article
Convened shortly after President Trump’s inauguration in 2017, the Lancet Commission on public policy and health in the Trump era, offers the first comprehensive assessment of the detrimental legislation and executive actions during Trump’s presidency with devastating effects on every aspect of health in the USA. The Lancet Commission traces the decades of policy failures that preceded and fueled Trump’s ascent and left the USA lagging behind other high-income nations on life expectancy. The report warns that a return to pre-Trump era policies is not enough to protect health. Instead, sweeping reforms are needed to redress long-standing racism, weakened social and health safety nets that have deepened inequality, and calls on the important role of health professionals in advocating for health care reform in the USA.- Posted
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Recent work has emphasised the benefits of patient-physician concordance on clinical care outcomes for underrepresented minorities, arguing it can boost communication and increase trust. Authors of this study explored concordance in a setting where racial disparities are particularly severe: childbirth. In the United States, Black newborns die at three times the rate of White newborns. Results examining 1.8 million hospital births in the state of Florida between 1992 and 2015 suggest that newborn-physician racial concordance is associated with a significant improvement in mortality for Black infants. Results further suggest that these benefits manifest during more challenging births and in hospitals that deliver more Black babies. They found no significant improvement in maternal mortality when birthing mothers share race with their physician. You can also read the news coverage in the Washington Post here. To access the research, follow the link below. -
Content Article
Assessment of the skin is an important element of neonatal examination. Midwives need to develop knowledge and skills in this area to recognise changes in the skin and understand what these signify. Historically, teaching in this area has been skewed towards changes seen in newborns with light skin tones, resulting in a gap in clinical knowledge and resources on the assessment of skin in newborns with darker skin tones. This article, published in The Practising Midwife, on the decolonisation of midwifery education and practice, focuses on clinical assessment of the skin when examining newborns.- Posted
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BOB.health is a UK learning platform. Usually, content is only accessible to NHS staff, Academic Health and Science Networks and other verified and approved non-commercial organisations serving the NHS to ensure BOB remains a safe space to share. Given the importance of this topic and with Dr Obaro’s blessing, Bob.health has chosen to make this particular story accessible to readers beyond the NHS and the UK. "My impact story describes how I created the presentation, "Why I want to talk about racism" and how I approached sharing my experience and insight with colleagues. To date, the talk has been viewed over 4400 times and the far-reaching impact has been worth the journey it took to create. Talking about racism is painful, uncomfortable, and challenging but by tackling it, I hope we can make the NHS more equitable for staff and patients." Follow the link below to request access to the full impact story.- Posted
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Ali Raza uses the Swiss Cheese Model by James Reason to look at discrimination in the workplace.- Posted
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House of Commons Debate - Black Maternal Health Week (14 September 2021)
Mark Hughes posted an article in Maternity
This is the transcript of a Westminster Hall debate in the House of Commons on Black Maternal Health Awareness Week, dedicated to raising awareness about the disparities in maternal outcomes for Black women. Bell Ribeiro-Addy, Member of Parliament (MP) for Streatham, who secured this debate, reiterated the key statistics around black maternal health and mortality in the UK: Black women are still four times more likely to die in pregnancy or childbirth. Black women are up to 83% more likely to suffer a near miss during pregnancy. Black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death. Miscarriage rates are 40% higher in black women, and black ethnicity is regarded as a risk factor for miscarriage. Black mothers are twice as likely to give birth before 37 weeks of pregnancy. MPs contributing to the debate made several calls for Government action on these issues, asking them to: Set a target to end racial maternal health inequalities. Implement the Joint Committee of Human Rights recommendations on black maternal health, as well as those included in the Health and Social Care Committee’s report Safety of maternity services in England. Launch an inquiry into institutional racism and racial bias in the NHS and medical education field. Engage with black women in improving their experiences of maternal health services. Identify those barriers to accessing maternal mental healthcare services and increasing the accessibility of mental health services after miscarriage and traumatic maternal experiences.- Posted
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- Obstetrics and gynaecology/ Maternity
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Content Article
This report, No Patient Left Behind, has been published by The APPG on Stem Cell Transplantation and Advanced Cellular Therapies, following an inquiry into barriers which patients face when accessing treatment and care. The report draws out the barriers patients may face, which broadly fit into the following five themes: Socio-economic barriers Complex health systems, health literacy and education Cultural barriers Race, ethnicity and discrimination Geographical barriers. Nine recommendations are made within the report, which are categorised under the following five themes: Personalising care Supporting patients emotionally and financially Better demographic data capture Improving outcomes through research Investment in the stem cell register. Read the report in full by following the link below to the Anthony Nolan website, or you can access it by downloading the attached PDF. no_patient_left_behind_final.pdf- Posted
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Research has shown differential attainment by ethnicity in the medical workforce across all measures of training and career progression. In this editorial, published in the BMJ, Victor Adebowale and Mala Rao argue that a race equality observatory is needed to provide leadership and data.- Posted
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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. 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." -
Content Article
In medical schools, students seek robust and mandatory anti-racist training. Activists especially want to see their institutions recognise their own missteps, as well as the racism that has accompanied past medical achievements. Read Elizabeth Lawrence's article in the Washington Post. -
Content Article
In this blog, published by the Institute for Healthcare Improvement, Kedar Mate discusses the need to explicitly address race and racism in order to work towards health equity. "We never legislated long waiting times. We never imposed rules, regulations, customs, and norms for ineffective care. We did, however, legislate inequity."- Posted
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Over half of ethnic minority NHS leaders consider quitting due to racism
Patient Safety Learning posted a news article in News
Just over half of senior ethnic minority leaders have considered leaving the NHS due to experiencing workplace racism a survey suggests. The survey was carried out by the NHS Confederation’s BME Leadership Network and its 123 respondents included chief executives, directors and senior managers. Responses were collected from network members online before three roundtables were held with senior ethnic minority leaders to understand their experiences and the challenges they have faced in relation to discrimination. The survey found: 51% of respondents said they had considered leaving the NHS in the past three years because of their experience of racist treatment while working. More than 20% said they had experienced verbal abuse or abusive behaviour targeting racial, national or cultural heritage five times or more in the last three years. 69% had experienced this behaviour from other leaders or managers within their organisation at least once in the same timeframe. 57% had experienced it from leaders or managers in another organisation at least once over the same period. Joan Saddler, NHS Confederation’s director of equality and partnerships, said the NHS was at risk of losing “committed, highly skilled and motivated talent to institutional racism and discrimination”. Read full story (paywalled) Source: HSJ, 17 June 2022 You may also be interested in reading: BMA: Racism in medicine- Posted
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