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Found 183 results
  1. Content Article
    Unconscious bias, which is deeply ingrained and often hard to recognise, impacts decisions in ways we may not realise. Implicit bias, shaped by repeated exposure to real-world interactions, also plays a significant role in this phenomenon. As such, in healthcare, intuitive decision-making can be a double-edged sword. It can help during emergencies but can also lead to discrimination and biases, especially in complex situations. In addition, hidden and automatic biases, which are further strengthened by unquestioned repeated practices, have a significant impact on daily healthcare interactions. Historically, gynaecology occupied a marginalised position within the realm of surgical care, often relegated to the status of a ‘Cinderella service’. This perception stemmed from societal attitudes and gender biases, which influenced how gynaecological surgeries were viewed in comparison with other surgical specialties. Gynaecology, being predominantly focused on women's reproductive health, was sometimes considered less prestigious or less prioritised than other surgical fields such as orthopaedic surgery or general surgery.
  2. News Article
    Health experts say more attention should be given to patients’ experiences after research found multiple examples of their insights being undervalued. A study led by the University of Cambridge and King’s College London found clinicians ranked patient self-assessments as the least important when making diagnostic decisions. Ethnicity and gender were felt to influence diagnosis, particularly a perception that women were more likely to be told their symptoms were psychosomatic. Male clinicians were more likely to say that patients overplay symptoms. The findings prompted calls for clinicians to move away from the “doctor knows best attitude” when caring for patients. One patient shared the feeling of being disbelieved as “degrading and dehumanising”, and added: “I’ll tell them my symptoms and they’ll tell me that symptom is wrong, or I can’t feel pain there, or in that way.” Read full story Source: The Guardian, 18 December 2023
  3. Content Article
    This study in The American Journal of Surgery aimed to assess the impact of gender on imposter syndrome among surgical trainees. An online national survey was distributed to surgical subspecialty residents between March and September 2022 which included demographics, validated Clance Imposter Scale and a short questionnaire evaluating depression and anxiety. The study found that Women surgical trainees were found to be more affected by imposter syndrome, particularly frequent and intense imposterism. Risk factors found were being single, having no dependents, working in obstetrics and gynaecology and being a foreign medical graduate. The authors identified a need for residency programs to develop wellness curriculum to address imposter syndrome among all surgical trainees.
  4. Content Article
    National Voices is committed to tackling racial inequalities – in healthcare, health status, within their own organisations and across the charity sector. With unacceptable statistics, like Black women are four times more likely to die around pregnancy than White women, and Black babies are almost three times more likely to die than White babies – still now, in 2023 – the need for effective action could not be stronger.  
  5. News Article
    A health and social care minister privately said there was ‘systemic’ racism within the NHS and called for an investigation into it. Helen Whately told Matt Hancock of her belief in a private message which was today shown to the covid public inquiry. An inquiry hearing with Mr Hancock – who said he agreed with the point – was shown an exchange between Ms Whately, then care minister, and Mr Hancock in June 2020. The Guardian had reported the previous day that an internal report had found systemic racism at NHS Blood and Transplant. Ms Whately, who is now minister of state covering social care and urgent and emergency services, said: “I think the Bame next steps proposed are important but don’t go far enough. There’s systemic racism in some parts of the NHS, as seen in NHSBT.” She added: “Now could be a good moment to kick off a proper piece of work to investigate and tackle it.” Read full story (paywalled) Source: HSJ, 1 December 2023
  6. News Article
    A hospital that unnecessarily delayed a man’s surgery at the last minute because he had HIV failed in their care, according to England’s Health Ombudsman. The 48-year-old from Walsall, who does not want to be named, had been due to have prostate surgery at Walsall Manor Hospital on 10 March 2020. His surgery was scheduled to be the first of the morning. As he was about to enter the operating room, he was told that due to his HIV status his surgery would now be moved to last on the operating list that afternoon. The hospital claimed that this was due to the level of cleaning and infection control that would need to take place following his surgery to reduce the risk to others. However, the Parliamentary and Health Service Ombudsman (PHSO), found that Walsall Healthcare NHS Trust acted inappropriately and failed the man. This is because the universal precautions that apply to all patients having surgery are enough to protect and prevent infections from spreading among patients and staff. Therefore, no additional cleaning should have been necessary. The policy of placing a patient at the end of an operating list usually relates to patients with a high-risk bacterial infection. It should not be applied to a person who has HIV and is receiving treatment. The Ombudsman also found that although the Trust had made some changes since this happened, they had not done enough to make sure the same mistake did not reoccur. PHSO recommended the Trust apologise to the man and create an action plan to stop this happening again. The Trust has complied with these recommendations. Read full story Source: Parliamentary and Health Service Ombudsman, 1 December 2023
  7. Content Article
    A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. Leape et al. identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behaviour in the health care setting: disruptive behaviour; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behaviour; passive disrespect; dismissive treatment of patients; and systemic disrespect. At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognised by health workers as disrespectful. Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfilment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behaviour is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behaviour is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
  8. News Article
    Three in five foreign doctors in the NHS face “racist microaggressions” at work, such as patients refusing to be treated by them or having their abilities doubted because of their skin colour. The widespread “thinly veiled, everyday instances of racism at work” experienced by medics trained overseas has been uncovered by a survey of more than 2,000 UK doctors and dentists. Almost three in five (58%) said they had encountered such behaviour, from colleagues as well as patients, although most did not report it because they thought that no action would be taken. Doctors affected can feel upset, humiliated, marginalised and not taken seriously as a result. The findings have raised fears that international medical graduates may choose not to work in the NHS, which is increasingly reliant on their skills given the service’s shortage of doctors. Dr Naeem Nazem, the head of medical at the medical defence organisation MDDUS, which acts for doctors accused of wrongdoing, said: “These findings show us that a worryingly large number of overseas-trained doctors working in the NHS face racist microaggressions in the course of their work, from both patients and colleagues, and that many do so regularly.” Read full story Source: The Guardian, 8 November 2023
  9. Content Article
    Medical defence organisation MDDUS's latest annual member attitude survey has found that many have experienced or witnessed persistent racist microaggressions at work. Almost two-thirds of International Medical Graduate members report they’ve been subject to racist microaggressions and have little faith in being heard and the issue being taken seriously. MDDU's 'We hear you' campaign aims to be a catalyst for positive change and help rebuild confidence in the way such abuses can be reported.
  10. News Article
    Black and Asian women are being harmed by racial discrimination in maternity care, according to an inquiry. The year-long investigation into "racial injustice" was conducted by the charity Birthrights. Women reported feeling unsafe, being denied pain relief, facing racial stereotyping about their pain tolerance, and microaggressions. The government has set up a taskforce to tackle racial disparities in maternity care. Hiral Varsani says she was traumatised by her treatment during the birth of her first child. The 31-year-old from north London developed sepsis - a potentially life-threatening reaction to an infection - after her labour was induced, which she says was only spotted after a long delay. "I was shivering, my whole body was aching, my heart was beating really fast and I felt terrible. But everyone kept saying everything was normal," she says. "It was almost 24 hours later before a doctor took my bloods for the first time and realised I was seriously ill." She believes her race played a role in her care: "I experienced microaggressions and was stereotyped because of the colour of my skin. "I was repeatedly ignored, they just thought I was a weak little Indian girl, who was unable to take pain." While death in pregnancy or childbirth is very rare in the UK, there are stark racial disparities in maternal mortality rates. Black women are more than four times more likely to die in pregnancy or childbirth than white women in the UK, while women from Asian backgrounds face almost twice the risk. Read full story Source: BBC News, 23 May 2022
  11. News Article
    Injured women are experiencing sex discrimination in the administration of a life-saving drug that cuts the risk of bleeding to death by 30%, researchers have warned. They found that female trauma victims were half as likely to receive tranexamic acid (TXA) as injured men – even though the treatment is equally effective regardless of sex. “These results are very concerning. TXA is the only proven life-saving treatment for traumatic bleeding. Women were treated less frequently than men regardless of their risk of death from bleeding or the severity of their injuries,” said Prof Ian Roberts of the London School of Hygiene and Tropical Medicine (LSHTM), who was involved in the study. “This looks like sex discrimination, and there is an urgent need to reduce this disparity, so all patients who need the drug have the chance to receive it.” “Whatever of the mechanism of injury, and whatever the bleeding risk we looked at, women were statistically less likely to receive tranexamic acid than men, apart from road traffic collisions with a very high risk of bleeding,” said Tim Nutbeam, whose research was published in the British Journal of Anaesthesia. “However, when we looked at mechanisms of injury which we tend to associate less with major trauma, such as falls from standing, women and particularly older women were much less likely to receive it.” As striking as these results are, they are not necessarily surprising, he added: “It is already known that women with chest pain are less likely to receive aspirin, less likely to be resuscitated for out of hospital cardiac arrest, and less likely to be taken to hospital by an ambulance using lights and sirens.” Read full story Source: The Guardian, 18 May 2022
  12. News Article
    A “shocking” number of nurses from overseas are winding up “in trouble” or sanctioned within their first few months of working in the UK partly because of a lack of induction and support, a conference has heard. The issue was raised during a panel session at the Unison health conference in April discussing the importance of ethical recruitment practices in nursing and midwifery. According to Unison, it is supporting “many” overseas nurses who have been “exploited, unfairly treated and subject to racism” since their move. Among the panel was Gamu Nyasoro, a clinical skills and simulation nurse manager in the NHS and an elected member of Unison’s nursing and midwifery occupational group committee. Ms Nyasoro, who is from Zimbabwe and has been working in the NHS for the past two decades, said she herself had been discriminated against and had faced several challenges during her migration. She raised concern that overseas nurses were not given enough information about how to live and work in the UK, including about how to access healthcare services themselves, or about country specific rules and regulations. There was also the issue that UK employers “don’t look at their skills beforehand”, which means nurses were being put in roles or areas they were not confident in. She cited examples of staff who had been specialising in neonatal services before moving, who were then being asked to work with older people, and those who had been practising as a midwife in their home nations and then being required to work in emergency departments in the UK. Read full story Source: Nursing Times, 28 April 2022
  13. News Article
    GPs face “appalling and systemic” racism from patients and colleagues, a leaked NHS report has revealed. The first Health Education England report for London of its kind says racism and discrimination are widespread within primary care across the capital, and GPs in other parts of the country have raised similar concerns. Doctors speaking with The Independent have told stories of being called derogatory and racist names, of staff leaving due to the bigotry they’ve faced, and of patients asking to see a “white” or “English” GP. Senior GPs have warned patients will ultimately suffer as a result, as experienced doctors leave practices to avoid such abuse. Professor Simon Gregory, deputy medical director for Health Education England, said: “There is considerable evidence that the UK is systemically racist, and that the NHS is a systemically racist workplace. “This report is shocking evidence of terrible, indeed appalling, levels of discrimination across protected characteristics and with much intersectionality, but especially shocking levels of racial discrimination.” “The awful and painful narratives of so many colleagues over so many years cannot be ignored but thanks to London’s primary care educational leaders we now have firm evidence. Evidence that cannot be ignored.” Read full story Source: The Independent, 4 May 2022
  14. News Article
    The NHS has been accused of “shocking and systemic” racism during the pandemic as black healthcare workers say they were given poor PPE and pushed into the Covid frontline first. Hundreds of black and brown healthcare staff across the UK have spoken to academics at Sheffield Hallam University about their experiences of racism during the pandemic. The accounts raised issues of racism within the health service which led to black and brown nurses and midwives being put at greater risk than their white colleagues, due to poorer PPE, training, workload and shift patterns. Rosalie Sanni-Ajose, a senior theatre practitioner, who worked across multiple London NHS hospitals through an agency called Yourworld told The Independent: “During the pandemic, we found that most of us (black agency nurses) have been placed in ITU to look after Covid patients are on a Continuous positive airway pressure (CPAP) machine or the ventilator." “Then when I work in A&E, they divided areas into sections - green area, red area, and the normal areas. So some of the ethnic minority staff were then put in the red areas all the time. Further some of us, we have comorbidities like asthma, or diabetes, or have an exemption that has been clearly stated they not allowed to work there.” Through its research, which involved 350 black and brown nurses, midwives and healthcare staff across the UK, Sheffield Hallam University found 77% of respondents said they’d been treated unfairly when they challenged racism. Just over 50% of the respondents said they’d experienced unfair treatment in the pandemic in relation to Covid deployment, PPE or risk assessment. One third have left their job as a result of racism, while more than half have experienced poor mental health due to the racism they experienced. The academic team, lead by Professor Anandi Ramamurthy said the healthcare professionals’ reports reveal “a story of systematic neglect and harassment which predates the pandemic.” Read full story Source: The Independent, 5 March 2022
  15. News Article
    MPs will investigate the sexual harassment and sexual assault of female surgeons taking place within the NHS. BBC News reported women being sexually assaulted even in the operating theatre, while surgery took place. And the first major report into the problem found female trainees being abused by senior male surgeons. The Health and Social Care Committee said it would look into the issue and its chair, Steve Brine, said the revelations were "shocking". "The NHS has a duty to ensure that hospitals are safe spaces for all staff to work in and to hold managers to account to ensure that action is taken against those responsible," Mr Brine said. "We expect to look into this when we consider leadership in the NHS in our future work." Read full story Source: BBC News, 13 September 2023
  16. News Article
    Hundreds of migrants have declined NHS treatment after being presented with upfront charges over the past two years, amid complaints the government’s “hostile environment” on immigration remains firmly in place. Data compiled by the Observer under the Freedom of Information Act shows that, since January 2021, 3,545 patients across 68 hospital trusts in England have been told they must pay upfront charges totalling £7.1m. Of those, 905 patients across 58 trusts did not proceed with treatment. NHS trusts in England have been required to seek advance payment before providing elective care to certain migrants since October 2017. It covers overseas visitors and migrants ruled ineligible for free healthcare, such as failed asylum seekers and those who have overstayed their visa. The policy is not supposed to cover urgent or “immediately necessary” treatment. However, there have been multiple cases of people wrongly denied treatment. Dr Laura-Jane Smith, a consultant respiratory physician and member of the campaign group Medact, said: “I had a patient we diagnosed as an emergency with lung cancer but they were told they would be charged upfront for treatment and then never returned for a follow-up. This was someone who had been in the country for years but who did not have the right official migration status. A cancer diagnosis is devastating. To then be abandoned by the health service is inhumane.” Read full story Source: The Guardian, 20 August 2023
  17. News Article
    Bisexual people experience worse health outcomes than other adults in England, a study has found. Data from lesbian, gay or bisexual (LGB) patients indicates these groups have poorer health outcomes compared to those who identify as heterosexual. The new findings indicate that bisexual people face additional health disparities within an already marginalised community. Experts from the Brighton and Sussex Medical School, and Anglia Ruskin University who led the analysis of more than 835,000 adults in England, suggest the differences could result from unique prejudice and discrimination that can come from both mainstream society and LGBTQ+ communities. Read full story Source: The Independent, 25 July 2023
  18. News Article
    A former breast cancer surgeon has said the NHS needs a MeToo movement because of sexual harassment in hospitals. Dr Liz O'Riordan said she experienced sexual harassment from colleagues on a weekly to monthly basis in some of her jobs as a junior doctor. In her first week as a junior doctor, she recalled a colleague asking if she "got an erection" after removing an 11-year-old boy's appendix. "We need to be able to say this is not good enough," said Dr O'Riordan. "When you are a trainee in a practical field, you are relying on your boss to let you operate to show you how to cut; it is a craft that you learn." "Basically you are naked in scrubs stood from shoulder, to hip, to knee, next to someone all squeezed in; a lot of body contact; you are relying on them to let you cut, and if you call them out they may say 'I don't like you, you are not coming to theatre today'. "It's very, very, very hard to stand up for yourself and say 'that is not on' and the minute you let them get away with it, it is accepted and they can carry on getting away with it." Read full story Source: BBC News, 12 July 2023 Related reading on the hub: Under the knife: Life Lessons from the operating theatre by Liz O’Riordan Calling out the sexist and misogynist culture within healthcare: a blog by Dr Chelcie Jewitt, co-founder of the Surviving in Scrubs campaign
  19. News Article
    Racism is “a stain on the NHS” and tackling it is key to recruiting and retaining staff, the outgoing president of the Royal College of Psychiatrists (RCP) will warn. The health service has a moral, ethical and legal duty to do more to stamp out racism, Dr Adrian James is expected to say at the college’s international congress in Liverpool. He will cite pay gaps, disparities in disciplinary processes and a “glass ceiling” for doctors from minority ethnic backgrounds who want to progress into management positions as problems in the NHS that are linked to racism. Last month, the NHS Race and Health Observatory, which was formed in 2021 to examine disparities in health and social care based on race, said better anti-racism policies could strengthen the NHS workforce. The RCP agreed that “better care, training and anti-racist policies” would increase staff numbers in the NHS, and that this would “improve patient experience and save millions of pounds spent annually on addressing racism claims brought by staff, clinicians and patients”. Read full story Source: The Guardian, 10 July 2023
  20. News Article
    Doctors and nurses often “weight-shame” people who are overweight or obese, leaving them feeling anxious, depressed and wrongly blaming themselves for their condition, research has found. Such behaviour, although usually the result of “unconscious weight bias”, leads to people not attending medical appointments, feeling humiliated and being more likely to put on weight. Dr Anastasia Kalea and colleagues at University College London analysed 25 previous studies about “weight stigma”, undertaken in different countries, involving 3,554 health professionals. They found “extensive evidence [of] strong weight bias” among a wide range of health staff, including doctors, nurses, dieticians, psychologists and even obesity specialists. Their analysis found that a number of health professionals “believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”, said Kalea, an associate professor in UCL’s division of medicine. She added: “Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and we know this acts as a barrier to the services and treatments that can help people manage weight. “An example is a GP that will unconsciously show that they do not believe that the patient complies with their eat less/exercise more regime they were asked to follow as they are not losing weight." “The result is that patients are not coming back or they delay their follow-up appointments, they avoid healthcare prevention services or cancel appointments due to concerns of being stigmatised due to their weight.” Read full story Source: The Guardian, 10 August 2022
  21. News Article
    A quarter of Black, Asian and minority ethnic (BAME) non-executive directors of NHS trusts have seen or experienced discrimination in the course of their work, a report reveals. While almost four out of five (79%) of these BAME non-executives said they challenged such behaviour when they encountered it, only half (50%) said that led to a change of policy or behaviour. The other half felt they had been ‘fobbed off’ or subjected to actively hostile behaviour for having spoken up,” says a report commissioned by the Seacole Group, which represents most of the BAME non-executive board members of NHS trusts in England. It adds: “This level of discrimination is unacceptable anywhere and even more so in the boardrooms of NHS organisations. Too many Black, Asian and other ethnic NEDs (non-executive directors) are being subjected to it and left to deal with it on their own.” Read full story Source: The Guardian, 21 July 2022
  22. News Article
    Women working in healthcare earn on average 24% less than their male peers and face a larger gender pay gap than in other economic sectors, a joint report by the International Labour Organization and the World Health Organization has found. The analysis, which looked at data from 54 countries across all geographic and income regions, found a raw gender pay gap of around 20%, which jumped to 24% when factors such as age, education, and working time were considered. Gender pay gaps also tended to be wider in higher pay categories, where men were over-represented, while women were over-represented in the lower pay categories. The authors said the findings highlighted that women, who accounted for 67% of the global health and care workforce in 2020, were underpaid and undervalued. Read full story (paywalled) Source: BMJ, 13 July 2022
  23. News Article
    Female doctors have launched an online campaign that they say exposes shocking gender-based discrimination, harassment and sexual assault in healthcare. Surviving in Scrubs is an issue for all healthcare workers, say the campaign’s founders, Becky Cox and Chelcie Jewitt, who are encouraging women to share stories of harassment and abuse to “push for change and to reach the people in power”. The campaign has called for the General Medical Council (GMC), which regulates doctors, to explicitly denounce sexist and misogynistic behaviour towards female colleagues and “treat them with respect”. More than 40 stories have been shared on the campaign’s website, ranging from sexual harassment by patients to inappropriate remarks and sexual advances from supervisors. The campaign is bolstered by evidence that shows 91% of female respondents had experienced sexism at work within the past two years. The findings are a result of nearly 2,500 surveyed doctors working in the NHS – the majority of whom were women – published in a 2021 report by the British Medical Association (BMA). Read full story Source: The Guardian, 11 July 2022
  24. News Article
    Women including refugees, asylum seekers, and undocumented migrants are being charged as much as £14,000 to give birth on the NHS in England, a report by Doctors of the World (DOTW) has found. The report, which examined inequalities in maternity care among migrant pregnant women and babies, gathered the experiences of 257 pregnant women accessing DOTW’s services from 2017 to 2021. It found that over a third (38%) who accessed its services had been charged for healthcare, often inappropriately. The women were charged £296 to £14 000, and half of them were billed over £7000. The report said that inequalities in access to antenatal care experienced by migrant women were likely to lead to poorer outcomes for their pregnancy and the health of their children. The evidence highlights the need for urgent action to address the inequalities experienced by migrant pregnant women and their babies. There is a pressing need for immigration status to be considered as part of the ethnic and racial health inequalities agenda and for independent action to be taken to review the impact of NHS charging policy. Read full story (paywalled) Source: BMJ, 20 June 2022
  25. News Article
    People with disabilities must be helped more by health providers to access information, a report has found. Over 300 people in North Yorkshire were asked about communication from GPs, hospitals, and healthcare providers in a survey by watchdog Healthwatch. The report said there is "some good practice" but many patients are not being contacted in their preferred format. This leads to missed appointments which "costs time and money". Since 2016, the Accessible Information Standard means health and care organisations must legally provide a "consistent approach to identifying, recording, flagging, sharing, and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment, or sensory loss," Healthwatch said. But the report said some people receive printed letters which they are unable to read meaning they have to ask for private and confidential information to be relayed. Scarborough respondent Ian said it was "amazing" that in the 21st Century many are still facing such issues. "The [GP booking] system doesn't anticipate that not everyone can use the phone," he said. "The problem is a lot of organisations haven't moved with the times". Read full storyp Source: BBC News, 21 June 2022
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