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Found 183 results
  1. Content Article
    This letter to NHS mental health trusts, Integrated Care Boards and Commissioners outlines NHS England's position on the use of Serenity Integrated Mentoring (SIM) in NHS mental health services. SIM is a model of care that has been used with people with mental health issues who are considered high-intensity users of emergency services. It is a controversial approach as it instructs services providing emergency care not to provide support to these individuals.
  2. News Article
    The government must end “age discrimination” against eating disorder patients that is causing avoidable deaths, experts have warned. A cross-party parliamentary group and the Royal College of Psychiatrists are calling for access targets to make sure adults with eating disorders get treated within a set time. The demands come after the healthcare watchdog said patients were dying while waiting to be seen. Wera Hobhouse, chair of the All Party Parliamentary Group, and Agnes Ayton, chair of the Royal College of Psychiatrists’ eating disorder committee, said the targets must be equal to those for children, which were set in 2016. According to the Health Service Journal, 19 patients under the care of inpatient and community eating disorder services have died since 2017. A senior coroner in Norfolk also highlighted failings in 2019 and sent a warning to both NHS England and the Department for Health and Social Care, over the deaths of five young women. Read full story Source: The Independent, 1 March 2023 To support Eating Disorders Awareness Week, we have pulled together eight useful resources to help healthcare professionals, friends and family support people with eating disorders: Top picks: Eight resources on eating disorders
  3. News Article
    Staff endured a “toxic and difficult working environment” at a maternity unit an employment tribunal has found. The tribunal panel said that the case of a black midwife, Kemi Akinmaji, who partially won her case against East Kent Hospitals University Foundation Trust for racial discrimination showed “there were wider issues beyond the specific allegations before us and which were possibly related to race”. The tribunal judgment said: “The evidence we heard reflected a toxic and difficult working environment generally where the claimant and colleagues were shouted and sworn at over differences of professional opinion. There was some evidence before us that there were wider issues beyond the specific allegations before us and which were possibly related to race… “There is evidence of wider bullying of the claimant in the way the group of colleagues treated the claimant… We’ve also heard that the previous grievance had highlighted risks in respect of unconscious bias and identified recommendations which were not actioned. “The race champion was not appointed and the unconscious bias training not sufficiently followed through. We also heard evidence of staff being wary of further such complaints. These matters were all concerning but we had to limit ourselves to the specific allegations brought by the claimant and which the respondent had been given an opportunity to address.” Read full story (paywalled) Source: HSJ, 1 March 2023
  4. Content Article
    In light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
  5. News Article
    NHS Ambulance service have a “fear of speaking up” amid pervasive “cliquey”, sexist, racist and homophobic cultures, a watchdog has warned. A national guardian has warned of negative cultures in trusts preventing workers from raising concerns as she called for a “cultural review” of ambulance organisations. The review into whistleblower concerns, by the Freedom to Speak Up Guardian’s office, has found widespread cultural issues including clique-like behaviour and bullying and harassment. Dr Jayne Chidgey-Clark, the NHS National Freedom to Speak Up Guardian, has now called on ministers and the NHS to independently review ambulance services, after speaking with ambulance staff across five NHS trusts. The report has called for a cultural review of the ambulance service by NHS England, the Care Quality Commission, the Association of Ambulance Chief Executives and ministers. Read full story Source: The Independent, 24 February 2023
  6. Content Article
    The National Guardian’s Office has published Listening to Workers – the report following its Speak Up review of NHS ambulance trusts in England. The review found the culture in ambulance trusts did not support workers to speak up and that this was having an impact on worker wellbeing and ultimately patient safety.
  7. Content Article
    The 2022 Workforce Race Equality Standard (WRES) report enables organisations to compare their performance with others in their region and those providing similar services, with the aim of encouraging improvement by learning and sharing good practice. It provides a national picture of WRES in practice, to colleagues, organisations and the public on the developments in the workforce race equality agenda The WRES provide detailed analysis to enable employers to understand how their staff experience compares with others in their region and with similar specialism.
  8. News Article
    NHS England has lost an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, and has been criticised for serious flaws in its own investigations. A judgement published today found Michelle Cox, a black woman who was an NHS continuing healthcare manager based in NHSE’s North West regional team, was excluded by her manager “at every opportunity”. The case centres on problems between Ms Cox and her line manager, then regional head of continuing healthcare, which took place from around April 2019 to November 2020. The tribunal ruled Ms Cox's line manager– who is now an associate director of nursing in the West Yorkshire integrated care system – had created an “intimidating and hostile and humiliating environment” for Ms Cox, which had the purpose and effect of unlawful harassment. The tribunal also upheld Ms Cox’s complaint of detriment for whistleblowing, including for raising concerns that members of her team were sitting on continuing healthcare “independent review panels”, which she pointed out was a breach of independence and legal obligations. Read full story Source: HSJ, 22 February 2023
  9. Content Article
    In this opinion piece for the BMJ, Partha Kar, consultant in diabetes and endocrinology, argues that in spite of extensive research and discussion around the need to tackle race inequalities in the medical workforce, little progress has been made at a system level. He highlights the importance of ensuring the Medical Workforce Race Equality Standard (WRES) Action Plan is implemented effectively, with special attention being paid to tracking GMC referrals and competency reviews that appear to be based on ethnicity.
  10. News Article
    Black people have the highest rate of sexually transmitted infections in Britain and officials are not doing enough to address the issue, sexual health experts have warned. Black Britons have “disproportionally high rates” of various STI diagnoses compared to white Britons, with those of Black Caribbean heritage specifically having the highest rates for chlamydia, gonorrhoea, herpes and trichomoniasis. Experts have told The Independent that healthcare providers are failing to address these disparities in STIs. They have called for more research to fully understand the complicated reasons why STIs are higher among people of Black ethnicity. Research conducted through the Health Protection Research Unit (HPRU) found that there were no clinical or behavioural factors explaining the disproportionately high rates of STI diagnoses among Black people. But higher rates of poverty and poor health literacy among marginalised communities are all linked with higher STI rates, according to a 2016 study, which found that behavioural and contextual factors are likely to be contributing. Moreover, experiences of racism among Black people can fuel a reluctance to engage with sexual health services and test frequently, according to HIV activist Susan Cole-Haley. She told The Independent: “I very much believe that it is linked to socioeconomic disadvantage and racism, often in healthcare settings, which can be a significant barrier for people accessing testing, for instance, and feeling comfortable engaging with care.” Read full story Source: The Independent, 19 February 2023
  11. Content Article
    Imagine you have a disease that leaves you in severe pain, and frequently means you need emergency strong opioid pain relief. But your condition is rare, and A&E staff often have very limited knowledge of your condition. And on top of that you’re black, and staff assume you’re drug seeking, and this happens over and over again. This is just one of the ways people with sickle cell disorder face discrimination when trying to access health care. Is it any wonder you’d rather avoid the health and care service than have substandard care and/or face stigmatisation?  
  12. Content Article
    In this blog, US family doctor Lisa Baron highlights the role that social media has played in exposing how patients, particularly women, are dismissed and gaslighted by healthcare professionals, resulting in delayed diagnosis, deterioration and trauma. She talks about her own experience of having her symptoms and concerns dismissed by her GP, which led to a two-year delay in being diagnosed with coeliac disease, rheumatoid arthritis and Sjogren's syndrome. She goes on to talk about her experience of Long Covid and how her symptoms were dismissed and not taken seriously in spite of the life-limiting nature of her condition. She raises concerns that Long Covid patients are turning to unqualified practitioners offering untested, ineffective and expensive treatments as they are not being taken seriously by mainstream healthcare systems.
  13. Content Article
    Last year we published a blog from Dr Chelcie Jewitt on the Surviving in Scrubs campaign. The campaign was created by Dr Becky Cox and Dr Chelcie Jewitt to give a voice to women in healthcare to raise awareness and end sexism, sexual harassment and sexual assault in healthcare. On their Surviving in Scrubs website they share the awful stories from women working in healthcare of sexism, sexual harassment and sexual assault.
  14. Content Article
    In recorded interview, Roger Kline, research fellow at Middlesex University, and Anton Emmanuel, Head of Workforce Race Equality Standard (WRES), discuss 'No more tick boxes', progress on WRES and the need to address race equality as an organisational improvement metric.
  15. Content Article
    “Medical gaslighting” is a controversial term that has emerged to describe a phenomenon some people – women in particular – may recognise. It refers to a patient’s feeling that their symptoms are not taken seriously, or are being misdiagnosed by healthcare professionals. When she was 37, Eleanor presented at a hospital emergency department with severe chest pain. She was diagnosed with slightly high cholesterol and sent home. Three days later, she suffered excruciating pain and was taken to hospital in an ambulance. There, she was asked if she had suffered from panic attacks and was left overnight in a cubicle, before doctors realised she was having a heart attack. She needed eight cardiac stents. “I am sure no man would be asked if they suffer from panic attacks while they’re having a heart attack,” she says. This article in the Irish Times asks why women are more likely to feel their symptoms are not being taken seriously by doctors. Further reading on the hub: ‘Women are being dismissed, disbelieved and shut out’ Gender bias: A threat to women’s health Dangerous exclusions: The risk to patient safety of sex and gender bias
  16. Content Article
    In this blog, Patient Safety Learning’s Chief Executive, Helen Hughes, reflects on a recent discussion about hysteroscopy and patient safety at a conference in January 2023, hosted by the Association of Anaesthetists.
  17. News Article
    A third of Black and ethnic minority health staff have suffered racism or bullying as the NHS fails to address “systemic” levels of discrimination, The Independent can reveal. Levels of bullying and harassment of minority workers have not improved in the past five years with almost 30% saying they have been targeted in the past year, compared to 20%of white staff. Despite being one-quarter of the workforce, minority ethnic staff make up just 10% of the most senior positions, the NHS’s flagship report is set to reveal. One nurse told The Independent she was forced to leave her job following a campaign of bullying, while another, who has left for the private sector, said her mental health was hugely impacted by the discrimination she experienced. Another nurse said she was left “traumatised” by bullying and harassment and she was “gaslighted” by her employer. “This incident is going to affect me for the rest of my life … when I first joined [the NHS trust] I thought I was going to retire there but ... my career [has been cut] short and it’s not fair,” she said. Equality for Black Nurses, a membership organisation founded by Neomi Bennett in 2020, has launched 200 cases of alleged racism against a number of NHS trusts since it was set up. “Racism is driving nurses out of the NHS,” Ms Bennett, told The Independent, warning that this issue had reached “pandemic levels”. Read full story Source: The Independent, 24 January 2023
  18. News Article
    An invitation to a cervical screening test upon your 25th birthday has become a necessary but often unwanted coming-of-age present. Despite years of education and advocacy about the benefits of screening, many women still do not attend. About 16 million women in the UK aged 25-64 are eligible for testing, but only 11.2 million took a test in 2022, the lowest level in a decade. There unfortunately remains a false narrative that there are good reasons to be nervous about cervical screening tests. In reality, the test is not physically painful for the vast majority of women, although it can be a bit uncomfortable. However, the test can be needlessly emotionally painful, and for no good reason. This is in part because some women go through the experience of sitting with legs spread apart and “private parts” out, and then hear the nurse call for “the virgin speculum” to be used. This is the archaic and unnecessarily sexualised term for the extra-small speculum. It should have no place being used in 2023, and it clearly creates feelings of vulnerability. Next week it is Cervical Cancer Awareness week, and campaigners are hoping to shine a light on barriers to cervical screening testing that must be removed. By creating feelings of vulnerability around testing, we are allowing cervical cancer to continue to go undetected. All women should be aware of the importance of attending their cervical screening test and do so with confidence, regardless of their sexual status. This will play a valuable role in reducing the mortality rate. Read full story Source: The Guardian, 19 January 2023 Further hub reading: Doctors’ shocking comments reveal institutional misogyny towards women harmed by pelvic mesh Misogyny is a safety issue: a blog by Saira Sundar Gender bias: A threat to women’s health (August 2020)
  19. Content Article
    In this article for iNews, journalist Sarah Graham talks to Dee Montague-Coast, who has asthma and endometriosis, and who has had very different experiences of care between the two conditions. Dee describes how she has always received excellent care for her asthma, but how she has had to endure disbelief and many investigations, tests for sexually transmitted infections and even surgeries over twenty years, before finally being diagnosed with endometriosis by a private consultant. Sarah highlights the difficulties women face in receiving diagnosis and treatment for endometriosis, in spite of it being the second most common gynaecological condition. She also highlights geographical and race-based disparities in care and treatment and outlines how attitudes towards women's pain means their symptoms are not always listened to and taken seriously.
  20. Content Article
    In December 2022, the All Party Parliamentary (APPG) for Whistleblowing heard evidence on the state of the NHS following the recent report on the avoidable deaths and life changing injuries caused to mothers and babies at the East Kent Trust. The culture at this hospital was described as one where “everyone knew the problems” and where whistleblowers were “thrown to the lions”. A culture attributed to 45 of the 65 baby deaths reviewed.  This blog first appeared on the Whistleblowers UK website in December 2022.
  21. Content Article
    In this blog for the Citizens Commission on Human Rights, Jane London shares her account of how electroconvulsive therapy (ECT) has affected her life since early adulthood, resulting in severe memory loss and heart problems. Jane shares how her physical medical problems including appendicitis and a severe heart attack were put down to depression, and how she was nearly forced to have ECT against her will in England in 1966. When her abusive marriage ended in 1968 and Jane returned to Australia her mother insisted she have ECT, despite her depression being temporary and related to her marriage ending. After 14 treatments, Jane left the treatment facility and received talking therapy to help her recover. Jane talks about the dramatic adverse effect ECT has had on the rest of her adult life.
  22. Content Article
    Racism, xenophobia, and discrimination exist in every modern society causing avoidable disease and premature death among groups who are often already disadvantaged. This Lancet series examines how the historic systems and structures of power and oppression, and discriminatory ideologies have shaped policy and practice today, and are root causes of racial health inequities. Furthermore, by applying a global lens and intersectional framework, overlapping forms of oppression such as age, gender, and socioeconomic status and their impact on discrimination are analysed. Interventions to address the spectrum of drivers of adverse health outcomes with a focus on the structural, societal, legal, human right, institutional and system level are reviewed. Research recommendations and key approaches for moving forward are proposed.
  23. Content Article
    In this article, Kamran Abbasi, editor in chief of the BMJ outlines the need for reform to the General Medical Council (GMC), which is responsible for regulating doctors in the United Kingdom. He talks about how the GMC received a significant backlash from doctors after its handling of the case of Manjula Arora, a GP who was disciplined for a word she used when asking her employer for a laptop. However, he highlights that the GMC's issues started long before this case, with racial bias, discrimination and an adversarial culture present over the last 30 years. Kamran also outlines measures that should be taken to ensure organisational change and accountability for the GMC.
  24. Content Article
    The bold ambitions of integrated care systems (ICSs) to improve population health and tackle health inequalities, coupled with greater integration of health and care services, should definitely be a golden opportunity to do things differently and better. However, if ICSs want to prove that this is indeed a new era, they will need to act quickly to involve groups experiencing marginalisation and discrimination, including disabled people. Fazilet Hadi, Head of Policy at Disability Rights UK, considers how disabled people’s organisations can harness their power and expertise to improve how health and care services work with disabled people.
  25. News Article
    Following the blistering verdict last week of the independent review into the General Medical Council's (GMC) handling of the notorious 'laptop' case, which highlighted the "worrying trend" of ethnic minority doctors facing disproportionate regulatory action, the GMC has launched a new resource 'hub' to support doctors facing racism at work. A new dedicated area on the GMC website offers advice on how to address racism in the workplace, and sits alongside its existing dedicated whistleblowing webpage as the latest of 12 areas in an 'ethical hub' that brings together resources on how to apply GMC guidance in practice, focussing on areas doctors often query or find most challenging, and helping to address important ethical issues. Announcing the launch, the GMC said: "Tackling discrimination and inequality continues to be an urgent priority for health services." It added: "The GMC has committed to working with organisations to drive forward change, setting targets on tackling inequality." Its equality, diversity, and inclusion targets set last year aimed, inter alia, "to eliminate disproportionate complaints from employers about ethnic minority doctors, by 2026, and to eradicate disadvantage and discrimination in medical education and training by 2031". In March this year it published its first progress report, which showed that the gap between employer referral rates for ethnic minority doctors and international medical graduates, compared with white doctors, had "reduced slightly". Read full story Source: Medscape UK, 15 November 2022
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