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Found 183 results
  1. Content Article
    This report outlines the results of a survey of 10,000 nursing staff in the UK carried out by the Royal College of Nursing (RCN). The survey highlighted stark differences in career progression and treatment in the workplace between White nurses and those from a mixed ethnic background, and Black and Asian nurses. In the 35-44 age group, 66% of White and 64% of respondents from mixed ethnic backgrounds said they’d been promoted. This dropped to just 38% of Asian and 35% of Black respondents. Black respondents working in both hospital (39%) and community (32%) settings are more likely to report having experienced physical abuse than respondents of other ethnic backgrounds. In response to these findings, the RCN is calling on the UK Government to reform human rights law to help tackle workplace racism, including introducing a legal requirement to eliminate disparities in recruitment, retention and career progression. They also want employers to have greater responsibility to protect minority ethnic groups from racism in all its forms.
  2. Content Article
    Systemic racism in maternity care is an urgent human rights issue. For too long, evidence and narratives about why racial inequities in maternal outcomes persist have focussed on Black and Brown bodies being the problem – ‘defective’, ‘other’, a risk to be managed. Birthrights’ year-long inquiry into racial injustice has heard testimony from women, birthing people, healthcare professionals and lawyers outlining how systemic racism within maternity care – from individual interactions and workforce culture through to curriculums and policies – can have a deep and devastating impact on basic rights in childbirth. This jeopardises Black and Brown women and birthing people’s safety, dignity, choice, autonomy, and equality. The inquiry’s report, Systemic Racism, Not Broken Bodies, uncovers the stories behind the statistics and demonstrates that it is racism, not broken bodies, that is at the root of many inequities in maternity outcomes and experiences.
  3. Content Article
    Despite widespread condemnation of the UK's asylum partnership arrangement with Rwanda, the Home Office appears to be going ahead with its plans to relocate to east Africa people who it deems to have arrived illegally and who are therefore not eligible for asylum in the UK. The policy, formed in response to increasing arrivals of migrants in small boats (28 500 arrived to the UK in 2021), has been hailed by Prime Minister Boris Johnson as the “morally right thing to do”, and is designed to deter refugees from entering the country through “illegal, dangerous or unnecessary methods”. Faith leaders, charities, civil servants, and members of parliament in the UK have denounced the plan as unethical, wrong, racist, and callous—sentiments echoed by the UN Refugee Agency (UNHCR), Human Rights Watch, and Amnesty International. The agreement is unfair and shameful. It might be illegal and is certainly immoral. It is also undoubtedly bad for health.
  4. Content Article
    Racism is a pervasive problem in Western society, leading to mental and physical unwellness in people from racialised groups. Psychology began as a racist discipline and still is. As such, most clinical training and curricula do not operate from an anti-racist framework. Although most therapists have seen clients with stress and trauma due to racialisation, very few were taught how to assess or treat it. Furthermore, clinicians and researchers can cause harm when they rely on White-dominant cultural norms that do not serve people of colour well. This paper from Racism is a pervasive problem in Western society, leading to mental and physical unwellness in people from racialized groups. Psychology began as a racist discipline and still is. As such, most clinical training and curricula do not operate from an anti-racist framework. Although most therapists have seen clients with stress and trauma due to racialisation, very few were taught how to assess or treat it. Furthermore, clinicians and researchers can cause harm when they rely on White-dominant cultural norms that do not serve people of colour well. This paper from Williams et al. discusses how clinicians can recognize and embrace an anti-racism approach in practice, research, and life in general. Included is a discussion of recent research on racial microaggressions, the difference between being a racial justice ally and racial justice saviour, and new research on what racial allyship entails. Ultimately, the anti-racist clinician will achieve a level of competency that promotes safety and prevents harm coming to those they desire to help, and they will be an active force in bringing change to those systems that propagate emotional harm in the form of racism.
  5. Content Article
    Women are 50% more likely to receive a wrong initial diagnosis; when they are having a heart attack, such mistakes can be fatal. People who are initially misdiagnosed have a 70% higher risk of dying. The latest studies have similarly shown that women have worse outcomes for heart operations such as valve replacements and peripheral revascularisation. As well as being misdiagnosed, women are less likely to be treated quickly, less likely to get the best surgical treatment and less likely to be discharged with the optimum set of drugs. None of this is excusable, but is it understandable? What is behind this bias and how can how it be fixed? Sian Harding, emeritus professor of cardiac pharmacology at Imperial College London, looks at the evidence in this Guardian article. Related reading Dangerous exclusions: The risk to patient safety of sex and gender bias Gender bias: A threat to women’s health Medicines, research and female hormones: a dangerous knowledge gap
  6. Content Article
    The Government's Race Disparity Unit has published data relating to NHS staff reports of discrimination at work. The charts, tables and commentary on this page cover survey data from 2019, and the data from 2020 is available to download without commentary. 300 NHS organisations took part in the staff survey in 2019, including 229 NHS trusts.
  7. Content Article
    This statement from Chair Peter Wyman addresses allegations of bullying and racism within NHS Blood and Transplant as reported in The Times on 21 August 2022. In the statement, Peter Wyman says, "I cannot overstate the importance we place in ensuring we have a strong, positive and inclusive culture so we can serve the public and patients who need us.  “Issues of racism and bullying came to light in parts of our organisation two years ago after an in-depth staff listening exercise. We’ve moved on a lot in the past two years. Our actions have included providing a safe way for staff to raise and discuss issues by appointing a Freedom to Speak Up Guardian, improving recruitment processes to be more inclusive, matured how we manage conflict and grievances and refreshing our code of conduct so we all know the behaviours that are expected of us. We continue to measure progress through ongoing staff engagement.   “We are making progress but like every good organisation we should always be challenging ourselves to do even better. In particular, I want to ensure we have a culture that enables each of us to be our best, that encourages everyone to speak up without fear or favour if they see something wrong or something which might be done better. I want a culture where everyone is valued for who they are and what they contribute. "There can be no place for any form of discrimination, bullying or harassment.”
  8. Content Article
    Health inequalities are not inevitable and are unfair. Many people from different backgrounds across our society suffer health inequalities which can negatively impact the whole community, not just those directly affected. Birmingham and Lewisham African Caribbean Health Inequalities Review (BLACHIR) set out to urgently reveal and explore the background to health inequalities experienced by the Black African and Black Caribbean communities. Birmingham is home to 8% of the Black African and Black Caribbean populations in England and 23% of Lewisham’s population is Black African or Black Caribbean (ONS 2011). The main aim of the Review is to improve the health of Black African and Black Caribbean people in the communities by listening to them, recognising their priorities, discussing, and reflecting on the findings and coproducing recommended solutions for the Health and Wellbeing Board and NHS Integrated Care Systems to consider and respond to.
  9. Content Article
    Painful menstruation—dysmenorrhea—interferes with the daily life of around one in five women. This blog looks at why painful periods receive so little research attention and examines the impact this has on women's lives and health. Sharing a personal story of her own painful periods, the author discusses how doctors are quick to prescribe birth control pills and antidepressants to treat painful periods, rather than investigating the problem to find out whether the cause of pain is endometriosis, a condition where endometrial tissue forms outside the uterus. It is thought that around 10% of ovulating women in the US have endometriosis and it takes an average of ten years for accurate diagnosis. The author discusses the need to raise the visibility of dysmenorrhea and endometriosis so that medical research takes it on as a serious issue.
  10. 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.
  11. 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.
  12. Content Article
    Everyone has the right to come to work without fear of racism. This resource from the General Medical Council (GMC) provides advice on how our guidance principles on non-discrimination apply when tackling racism. Where racist behaviour occurs among colleagues and patients, we recognise the fear that many doctors have of reporting these incidents. It signposts a range of support channels and highlights the duties we expect of doctors in senior positions in tackling and rooting out discrimination where it arises. It includes case studies from doctors and others on their experiences, advice and best practice.
  13. Content Article
    It is time to end all forms of stigma and discrimination against people with mental health conditions, for whom there is a double jeopardy: the impact of the primary condition itself and the severe consequences of stigma. Many people describe stigma as ‘worse than the condition itself’. This Lancet Commission report is the result of a collaboration of more than 50 people globally. It brings together evidence and experience on the impact of stigma and discrimination and successful interventions for stigma reduction. The report is co-produced by people who have lived experience of mental health conditions and includes material to bring alive the voices of people with lived experience. The voices whisper or speak or shout in the poems, testimonies and the quotations that are featured.
  14. Content Article
    The investigation and tribunal hearing of Dr Manjula Arora generated significant anger and anxiety among the medical profession. The case raised once again the perception of a regulatory process lacking in fairness; of a system in which the stakes seem much higher if you are a black and minority ethnic doctor. The General Medical Council (GMC) acknowledged that strength of feeling, making clear it would not oppose Dr Arora’s appeal against the sanction and commissioning a review of the case to understand lessons to be learned for future cases.
  15. Content Article
    Racism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is firmly rooted in our professional Code and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence. This document is a resource for individuals at all levels. This resource does not replace existing NHS England policies and procedures for speaking up and managing racism. It is a resource to support best practice in line with organisational policies and procedures.
  16. Content Article
    The Surviving in Scrubs campaign, created by Dr Becky Cox and Dr Chelcie Jewitt, gives a voice to women in healthcare to raise awareness and end sexism, sexual harassment and sexual assault in healthcare. In this blog for the hub, co-founder Dr Chelcie Jewitt tells us more about the campaign.
  17. Content Article
    While many physicians may avoid discussing the subject, a study showed that who gets addressed with the honorific “Dr.” may depend on gender, degree and specialty.
  18. Content Article
    The gap in healthy life expectancy is being driven by the increasing numbers of people managing a long-term condition (LTC) and, increasingly more than one – known as multi-morbidity. This situation affects a higher proportion of the population facing systemic discrimination and marginalisation, and those experiencing higher levels of deprivation. This report from the Chartered Society of Physiotherapy raises awareness of health inequities in rehabilitation and recovery services across the UK
  19. Content Article
    In this perspective for the New England Journal of Medicine, Harderman et al. recommend that healthcare systems engage, at the very least, in five practices to dismantle structural racism and improve the health and well-being of the black community and the country.
  20. Content Article
    In this article for Stylist, Sarah Graham, founder of the Hysterical Women blog, looks at the statistics around gender and heart attacks and gender. She highlights the worrying disparities and argues that sexism plays a dangerous role. The term Yentl Syndrome is used to describe the different ways men and women are treated after heart attacks.
  21. Content Article
    Racial discrimination still exists in NHS organisations but can be eradicated if the attitudes and processes used to improve patient safety are adopted, says Roger Kline.
  22. Content Article
    The aim of the study, published in the Journal of Patient Safety, was to determine whether race differences exist in voluntarily reported harmful patient safety events in a large 10 hospital healthcare system on a high reliability organisation journey. Findings showed that race differences in harmful events exist in voluntary reporting systems by type and by hospital setting. Healthcare organisations, particularly healthcare high reliability organisations, can use these findings to help identify areas of further study and investigation. Further study and investigation should include efforts to understand the root cause of the differences found in this study, including the role of reporting bias.
  23. Content Article
    Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the nature and rate of patient safety events occurring amongst ethnic minority consumers, which is critical for the development of relevant intervention approaches to enhance the safety of their care.The findings of this systematic review, published in the International Journal for Equity in Health, provide substantial evidence to suggest that people from ethnic minorities are vulnerable to a higher rate of patient safety events in the hospital and community setting compared to the mainstream population.
  24. Content Article
    The contents of this book are based on the experiences of: NHS patients who have experienced avoidable harm, and associated cover-ups. NHS staff who have suffered detriment for speaking out on behalf of the above. The author's own experience as an employee of St George's hospital, Tooting, and doing locum work at hospitals in London and the Home Counties. Written from the perspective of an NHS Operating Department Practitioner, and whistleblower, NHS Dirty Secrets describes how the NHS cover-up culture is a risk to patient safety, and how employment and promotion practices are skewed in favour of those most likely to support the NHS cover-up culture. The NHS cover-up culture, itself, is decomposed and analysed, with examples given as to the methods used to support the hiding of issues, such as patient deaths, from public scrutiny.
  25. Content Article
    Six years ago The Snowy White Peaks of the NHS highlighted the scale of race discrimination in the NHS, the UK’s biggest employer of Black and Minority Ethnic (BME) staff. COVID-19 has shown so much more needs to be done. 300 health and social care staff have died so far from COVID-19, a disproportionate number of BME heritage. We know NHS staff infection was overwhelmingly due to occupational exposure whose causes are varied but include the disproportionate BME staff role in patient-facing services, their poorer access to appropriate PPE, the greater reluctance of BME staff to raise concerns, disproportionate deployment into “hotter” roles, and the greater presence of BME colleagues amongst agency staff. BME staff have been largely absent from decision-making. The COVID-19 impact on BME staff, and Black Lives Matter, has prompted promises to tackle racism more resolutely. So what should NHS leaders do to ensure faster progress to tackle workforce race discrimination? Roger Kline, in this BMJ Leader blog, has ten suggestions for Boards and Integrated Care System system leaders.
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