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Jamie Wilson

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The equality act in 2010 made it so people weren

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Influence of Equality Act on Care Settings 

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Influence of Equality Act on Care Settings 

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Kirsty Dix

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4 ways the Equality Act influences care settings

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How does the equality act influence care settings

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The equality act was introduced in 2010 with the main intention to make I become law that every organisation whether private

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How does the equality act influence care settings

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Racial discrimination and bullying in the NHS has been exposed for the first time by a new report, published by NHS England, which highlights how the issue has been "bubbling away in the background".

The NHS Workforce Race Equality Standard (WRES), providing the first comprehensive data for all trusts in the UK, found that at 75% of all acute trusts black and minority ethnic (BME) staff reported higher rates of bullying, harassment and abuse from colleagues than white staff.

There were similar complaints at 50% of ambulance trusts, 78% of mental health and learning disability trusts, and 65% of community trusts.

Tracie Joliff, head of inclusion and systems leadership at the NHS Leadership Academy, said: "This is something which has always been bubbling away in the background but it really needs to be brought to the forefront with purposeful leadership actions to change the culture of the NHS so that all staff are appreciated and valued.

"How do we then expect people who may feel undervalued to deliver care when in fact; they are not being cared for themselves?"

At 81% of acute trusts, a higher proportion of BME staff than white staff said they had personally experienced discrimination from their supervisor or colleagues, and there were similar results at 80% of ambulance trusts, 87% of community trusts and 73% of mental health and learning disability trusts.

The WRES also found a higher proportion of BME staff experiencing harassment, bullying and abuse from patients and the public at 44% of acute trusts, 60% of ambulance trusts, 65% of community trusts and 80% of mental health and learning disability trusts.

The majority of BME staff also said that they did not believe their organisation offered equal career progressions for BME and white staff at 86% of acute trusts, 50% of ambulance trusts, 80% of mental health and learning disability trusts and a shocking 100% of community trusts.

Joliff added: "The NHS must now take swift action to develop leaders who can understand these problems and are able to act to address them as a matter of urgency.

"Leaders may need development support to ensure that they are equipped to make the necessary changes. What is clear is, capable effective leadership is critical to help make the transformation which is so badly needed."

NHS England is investing £2m in 2015-17 in the WRES programme to identify and share best practice building on improving recruitment and board membership of BME staff and reducing bullying and harassment. This includes training and developing 75 champions to help spread best practice and improve patient care within their trusts.

Simon Stevens, chief executive of NHS England and co-chair of the NHS equality and diversity council, said: "This report provides unvarnished feedback to every hospital and trust across the NHS about the experiences of their BME staff. It confirms that while some employers have got it right, for many others these staff survey results are both deeply concerning and a clear call to action.

"As this is the first year of the WRES, it provides a transparent baseline from which each employer will now be seeking to improve."

A 2014 report, 'The 'Snowy white peaks' of the NHS' found that just 5.8% of NHS trust members are from BME backgrounds, prompting NHS leader Simon Stevens to call for greater diversity.

A recent Royal College of Midwives investigation also raised discrimination concerns after it found that BME midwives in London are disproportionately more likely to face disciplinary action than their white colleagues.

The 2015 NHS staff survey highlighted wider concerns about bullying in the NHS, with 13% of staff reporting harassment or bullying from their manager and 18% experiencing it from colleagues.

(Image c. Royal College of Midwives)

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Racism in the NHS 'bubbling away in the background'

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Racial discrimination and bullying in the NHS has been exposed for the first time by a new report, published by NHS England, which highlights how the issue has been "bubbling away in the background".

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The age of a patient should not decide whether they are eligible for surgery or not, according to a report by the Royal College of Surgeons (RCS) and Age UK.

It states that older patients may miss out on vital treatments due to age discrimination. The report also outlines that older people may not get the access to surgery that they need as budgets tighten.

The report called for patients to be considered for surgery on the basis of their health, as opposed to age. It acknowledged that there are some valid reasons for older people to be denied operations, such as health issues or their desire to not have surgery. However, it highlighted "outdated perceptions" that older people should not receive certain treatments.

For example, it pointed out that the majority of those suffering from breast cancer are over the age of 85. However, those most likely to be considered for breast surgery are around 65 years old.

The report said: "Decisions may not always be made on the basis of a comprehensive and objective assessment, but on a series of assumptions about fitness in older age."

Michelle Mitchell, from Age UK, said: "When it comes to people's health, their date of birth actually tells you very little. A healthy living 80-year-old could literally run rings round someone many years younger who does not share the same good health.

"Yet in the past too many medical decisions, we believe, have been made on age alone with informal 'cut-offs' imposed so that people over a certain age were denied treatment."

Chief executive of the NHS Confederation, Mike Farrar, said: "Age discrimination is not only illegal but goes against all the principles and values of the NHS. Access to NHS services should always be based first and foremost on clinical need, not on age.

"This report presents some worrying figures. We need to look at them carefully to examine whether they are the result of arbitrary decisions taken solely on the basis of age, or because some non-surgical treatments could offer greater benefit, or a patient chooses not to undergo surgery."

Tell us what you think - have your say below, or email us directly at opinion@nationalhealthexecutive.com

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Age discrimination deemed 'unacceptable' in the NHS

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The age of a patient should not decide whether they are eligible for surgery or not, according to a report by the Royal College of Surgeons (RCS) and Age UK. It states that older patients may miss out on vital treatments due to age discrimination.

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Almost one-fifth of people (18%) diagnosed with cancer face discrimination from employers or colleagues on return to work, research by the charity Macmillan suggests.

The survey of 1,009 patients, all in work when diagnosed, indicated that 15% returned to work before feeling ready.

Others said they felt guilty for taking time off work for medical appointments.

Liz Egan, from the charity, said: "It's appalling... so many employers are not offering the right support."

Sacked for having cancer

Macmillan Cancer Support warned that it was vital - with one in three people living with cancer in the UK being of working age - that employers offer better support, including providing managers with the right skills.

Its survey indicates that 14% of those diagnosed with cancer give up work or are made redundant as a result.

Terry Foster, 58, from Southport, told the BBC's Victoria Derbyshire programme he was "treated appallingly" by his employer.

He was diagnosed with lymphoma in 2010 and spent 19 days in intensive care - at one stage being given hours to live.

He took doctors by surprise, began to recover and, with a newborn child, hoped he could return to work as a refrigeration engineer.

He drove two-and-a-half-hours to meet his manager, but on arrival was told he "was going to be sacked", he said.

"There was no bit of grace, there was nothing, it was as though I'd done something wrong."

'Increased stress'

Mr Foster said his manager "told me clearly [I was sacked] because I had cancer - because they felt I wouldn't be able to handle the stress of the job.

"That was completely illogical, because it was actually increasing the stress on me because I wouldn't be able to pay the mortgage."

The firm sent Mr Foster a letter further explaining the reason for his dismissal. He feared telling his wife, and worried they would be unable to cope financially.

The Equality Act 2010 - and the Disability Discrimination Act 1995 in Northern Ireland - protect employees from being treated unfairly because of their cancer diagnosis.

They require the employer to make "reasonable adjustments" to any elements of the job that place the employee at a substantial disadvantage, such as accommodating flexible working to cope with fatigue or allowing employees to make a staggered return to work.

Mr Foster took the company to an employment tribunal, representing himself, and was awarded more than £62,000 for unfair dismissal.

But Ms Egan, who leads the Working Through Cancer programme at Macmillan Cancer Support, said many other people with cancer "are not aware they have rights under the Equalities Act.

"If people are unaware of these rights, they are unable to ask their employers to make adjustments for them. Sometimes they don't even tell their employers that they have cancer," she added.
The Victoria Derbyshire programme is broadcast on weekdays between 09:00 and 11:00 on BBC Two and the BBC News Channel.

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'One-fifth of cancer patients face work discrimination' - BBC News

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Almost one-fifth of people (18%) diagnosed with cancer face discrimination from employers or colleagues on return to work, research by the charity Macmillan suggests. The survey of 1,009 patients, all in work when diagnosed, indicated that 15% returned to work before feeling ready. Others said they felt guilty for taking time off work for medical appointments.

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Transgender people in the UK face "high levels of transphobia" on a daily basis and they have "a long way to go" to achieve equality in the UK, MPs say.

The Commons Women and Equalities Committee urged ministers to draw up a new strategy to tackle discrimination.

The NHS and prison service need urgent reform, its MPs said, and there should be more training for police officers and teachers in handling trans issues.

Minister Nicky Morgan said further progress on equality was a priority.

The minister for women and equalities said she was determined to tackle discrimination wherever it existed.
The report is the first by a UK parliamentary committee to tackle transgender issues.
It estimates that as many as 650,000 people in the UK are "gender incongruent to some degree" and the transphobia they experience undermines their careers, incomes, living standards and mental and physical health.

About a third of transgender adults and half of "gender-variant" young people attempt suicide, it says.

Among more than 30 recommendations, the report calls for:

A "root-and-branch review" of the NHS's treatment of transgender people.

Urgent clarification on the position of transgender prisoners, given the "clear risk of harm" if trans people are held in prisons according to their birth genders. It cites the cases of two transgender women who died in 2015 while serving time in male jails.

Official recognition of gender should be based on "self-declaration", rather than a "medicalised" assessment.

Mandatory training for police officers on transphobic hate crimes, and the extension of hate crime laws to cover gender identity.

The lowering from 18 to 16 of the age limit for obtaining official recognition of a new gender without parental consent.

The option to record gender as 'X' in a passport, and an end to the need to show a doctor's letter to alter the gender shown.

More training for school staff to better support "gender-variant" young people.

Guidance for sports bodies to make clear that exclusion of transgender players on grounds of safety or fair competition is rarely justified.

A guide to transgender terms Transgender prisoners: system failure? Do we need more than two genders?
'We have to prove our identity'

"We have a gender-based care system which pathologises trans people," says Tara Stone, chair of Be: Trans Support and Development North, based in Newcastle.

"Currently, if a trans person goes to their GP for help, the procedure is to eliminate every other possible thing that could be wrong and what you're left with is, 'OK, we believe you.' We need to move away from that and just start with, 'Right, we believe you.'

"We have to prove our identity - nobody else in society has to do that - and it leaves people with a feeling of shame, like there's something wrong with them.

'Distrust'

"Recently a girl I've worked with went to her GP for a referral, but the response was, 'I think you need to go away and think about it. Come back in a fortnight's time.' She's entitled to gender identity services, but she was denied that.

"At the point of seeking help from a clinician, a lot of trans people are very vulnerable and, even with the best of intentions, that kind of response risks having a massive impact on their developmental path as a person.

"The trans community in general has a lot of distrust of institutions, because they feel they have been institutionally abused - by the NHS, the police, the government. They then resist engaging with those institutions, meaning they become even more isolated."

The report singles out the NHS, in particular, for criticism, warning of "significant problems... due to the attitude of some clinicians and other staff", driven by "lack of knowledge and understanding and even in some cases, out-and-out prejudice".

There is "overwhelming" evidence of "serious deficiencies in the quality and capacity of NHS gender identity services", it says, and "completely unacceptable" waiting times for first appointments and surgery.

Puberty blockers

Puberty-blocking drugs, which delay the development of adult sexual characteristics, and cross-sex hormone treatments should be provided more readily to young people, given the danger of self-harm and suicide if treatment is withheld, the MPs add.

However, the committee stops short of backing calls for official recognition of changed gender for children aged under 16.
Tara Stone works with All About Trans, a not-for-profit project that promotes trans voices in the media, encourages better understanding of trans people and improves media coverage of the issues trans people may face.

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UK a long way from transgender equality, MPs say - BBC News

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Transgender people in the UK face "high levels of transphobia" on a daily basis and they have "a long way to go" to achieve equality in the UK, MPs say. The Commons Women and Equalities Committee urged ministers to draw up a new strategy to tackle discrimination.

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Two-thirds of NHS staff would recommend the care on offer at their local trust to their own friends and family, an annual poll shows.

Of 203,000 staff questioned for the 2013 NHS survey, 65% said care was fit for relatives, 24% were unsure, while 11% would not recommend the service.

The survey included GPs, ambulance staff, nurses, midwives and dentists as well as other health professionals.

There were improvements on the previous year in 21 of the 28 poll categories.

It is good to see that more staff would recommend the NHS as a place to work and would want friends and relatives to be treated where they work
Health Secretary Jeremy Hunt

Some 90% of staff believed their job makes a difference to patients, 78% are satisfied with the quality of work and patient care they are able to deliver, and 68% say in their role they are able to contribute improvements to the organisation.

Compared with 2012, more said there was good communication between staff and management, and more were being appraised and getting appropriate health and safety training.

'Could do better'

But work-related stress was up slightly, with more than a third saying they had experienced it in the last 12 months.

And a third said they had witnessed or reported potentially harmful errors or near-misses at work in the last month.

Only 56% of staff said hand-washing materials - such as soap - are always available, with the figure being 59% in acute hospital trusts.

Some 15% said they had been the victim of violence in the last year from visitors, patients or relatives, 28% had been bullied or abused by the same group, and 11% suffered workplace discrimination.

Sue Covill of NHS Employers said abuse and harassment of workers from patients and the public was a concern and more needed to be done to protect staff.

But she said many of the survey's other findings were encouraging.

"Staff feeling valued and being valued is absolutely vital to the effective delivery of patient care and we believe it is an important factor behind many of the positive results."

Peter Carter of the Royal College of Nursing was more critical, saying: "Only 30% of staff feel that there are enough staff to enable them to do their jobs properly and high numbers of nurses in particular continue to work extra hours. (82% compared with 81% the previous year.)

"Some 68% of staff have attended work while not being well enough to perform their duties in the last three months alone. It is hardly surprising that there has been an increase in work-related stress.

"Clearly, nurses and other staff are working hard to ensure that patient care is delivered. However, it is simply not sustainable to have staff stretched too thinly and working beyond breaking point."

Health Secretary Jeremy Hunt said: "NHS staff have some of the hardest and most respected jobs in our country. It is good to see that more staff would recommend the NHS as a place to work and would want friends and relatives to be treated where they work.

"But we know we need to do even more and our response to the Francis report set out how the NHS can promote openness and support staff to raise concerns in order to protect patients and give high quality care."

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Most NHS staff deem care 'fit for their own family' - BBC News

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Two-thirds of NHS staff would recommend the care on offer at their local trust to their own friends and family, an annual poll shows. Of 203,000 staff questioned for the 2013 NHS survey, 65% said care was fit for relatives, 24% were unsure, while 11% would not recommend the service.

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The number of racist verbal and physical attacks in the NHS has risen 65% in the past five years, Freedom of Information data suggests.

The total number of incidents rose from 420 in 2008-09 to 694 in 2012-13, figures seen by BBC Radio 5 live show.

The largest numbers of incidents were reported in NHS Greater Glasgow and Clyde, and Leeds Teaching Hospitals.

The NHS said it was "shocking" that abuse takes place and any signs of discrimination are taken seriously.

Some NHS trusts said that higher numbers might be partially explained by improved data reporting systems.

Under a Freedom of Information (FoI) request, BBC Radio 5 live's Victoria Derbyshire programme found that NHS staff are reporting more racist abuse from patients than ever.

However, the reported incidents are very low when set against the 1.7m staff who work in the NHS in the UK.

At those hospitals which offered a breakdown of incidents, there were 567 involving patients or visitors and 33 involving NHS employees in 2012-13.

Of the 152 NHS trusts and boards, 133 responded to the FoI request, but a further 19 refused.

'Punched by patient'

They said they did not collect information on racist incidents, or that they had data protection concerns.

This does not mean there has been an increase in the number of incidents but rather that staff are now reporting them
Rona King, NHS Fife

Among those affected was a nurse from Zimbabwe, who now works at a hospital in the Midlands, who told 5 live that he had been racially abused and sworn at while trying to treat patients.

He also described an incident when a nurse from Nigeria was punched by a patient as she was trying to treat him and security staff had to be called to help her.

Staff at NHS Greater Glasgow and Clyde reported the highest number of racist incidents, with 76 in 2012-13. Leeds Teaching Hospitals NHS Trust reported 32.

A spokesman for NHS Fife, which reported an increase to 26 racist incidents in 2012-13 - the fourth highest NHS trust - said that this was down to staff being encouraged to report any racist incident.

Rona King, of NHS Fife, said: "NHS Fife is committed to addressing all racial incidents in a robust manner.

"By ensuring that all incidents are reported we can support our staff and we have specifically been encouraging staff over the last couple of years to do so.

"This does not mean there has been an increase in the number of incidents but rather that staff are now reporting them. We are closely monitoring this and would hope to see a decrease in these figures in the future."

Responding to the FoI findings, Dean Royles, chief executive of NHS Employers, said: "With rising levels of violence against staff in the NHS, it's shocking that staff can also be subject to racial abuse. It's an issue the NHS takes seriously and, if staff do commit racial abuse, it is considered as gross misconduct.

"We should be proud of the contribution that staff from black and minority ethnic backgrounds make to the NHS. We know from research that diversity is important for patient care and that a diverse workforce is a more productive workforce.

"Therefore, it is right that any signs of inequality or discrimination - factors which can significantly affect motivation - are taken seriously."

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Sharp increase in NHS racist attacks - BBC News

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The number of racist verbal and physical attacks in the NHS has risen 65% in the past five years, Freedom of Information data suggests. The total number of incidents rose from 420 in 2008-09 to 694 in 2012-13, figures seen by BBC Radio 5 live show.