Case StudiesCentral and North West London NHS Foundation Trust is the highest performing healthcare organisation in theHealthcare Equality Index 2014. The Trust provides mental health, sexual health, community physical health, addictions, eatingdisorder and learning disability services.For a number of years the Trust has run a Gay Men's Therapy Group. The group was set up in response to national researchidentifying the high levels of alcohol consumption in the gay and bisexual male population. The group meets weekly and is designedfor gay and bisexual men. It provides support to attendees and a confidential space to discuss issues in relation to their alcohol anddrug use, as well as other topics in an accepting and non-judgemental environment. Common themes that are discussed by thegroup include how to socialise and meet other people without the use of alcohol or drugs and issues of self-esteem. Frequentlymen join the group at a time when they are chaotic alcohol and drug users. With support from the group many have achievedabstinence and often a return to employment.Sussex Partnership NHS Foundation Trust is well established in promoting sexual orientation equality within its services.The Trust understands that a key way to provide the best services for lesbian, gay and bisexual people is to have data about theirhealth needs and how they are accessing services. Subsequently the Trust has worked hard to improve practices regardingmonitoring patient’s sexual orientation.The Trust wanted to improve their sexual orientation data. The Trust worked with Stonewall to host a series of focus groups withstaff from teams with high rates of valid data and those with low rates. These focus groups were designed to identify the barriersand benefits of monitoring patient’s sexual orientation from a front-line staff perspective. As a result of this work the Trust hasamended its monitoring systems to enable staff members to feel competent and comfortable to collect this data without intrudingon the rest of their work. This has helped develop a climate where patients feel happy to disclose their sexual orientation.The Trust have developed an innovative tool to present and collate equality and diversity data, called the Equality Performance Hub.The Hub provides data on a whole range of areas including staff training, service user experience, recruitment, incidents andcausation as well as membership data. The Hub is one of a range of ways Sussex Partnership analyse how they are tacklinginequalities and promoting equality.St Andrew’s Healthcare is a charity providing specialist services including mental health, learning disability, autism and braininjury at sites across the UK.The charity has a Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) and Straight People's Alliance for patients. Given thechallenges of being situated in complex secure units and multi-site environments as well as working with vulnerable adults andyoung people the Alliance focuses around activities which bring smaller groups together, such as learning and celebration events,the Equalities Allies and Alliances newsletter, or sharing personal stories for displays in spaces used by patients, visitors and staff.In 2013 over 150 equality ally certificates were given out to patients, and staff too, for projects and activities they’d been part of topromote sexual orientation equality at St Andrew’s Healthcare. These opportunities to experience success are therapeutically importantand valued by patients at St Andrew’s Healthcare.Equality Allies discussed the wishes of lesbian, gay and bisexual patients within the low secure units to have Pride activities. As aresult the patients worked with staff to hold a carnival-themed event which was inclusive of people of all backgrounds and sexualorientations and which included a ‘Stamp out Hate Crime’ pledge.Leeds Community Healthcare NHS Trust provides a range of community services for adults and children and has consistentlyworked to communicate with the local lesbian, gay and bisexual communities.Communications have included Stonewall posters and briefings in patient waiting areas including in all health centres; materials onhomophobic hate crime displayed across the Trust; articles in the Trust’s magazine and in the local press; and updates regularly onthe Trust’s social media.The Trust has also developed a patient leaflet that highlights key health issues for lesbian, gay and bisexual people including alcoholuse, smoking, emotional wellbeing, eating disorders and body image, and sexual health. The leaflet includes information on relevantservices within the Trust or from local and national partners. The Trust worked with the learning disability charity CHANGE to makesure the information is accessible. The Trust has sent this leaflet to local community groups including lesbian, gay and bisexualgroups and learning disability groups. Copies have also been placed in patient waiting areas. The aim is to improve awarenessamongst lesbian, gay and bisexual people in Leeds about their health and clearly communicate the Trust is gay-friendly.
Recommendations Improvements to healthcare12345Put policies in place Healthcare organisations should make sure that theirpolicies make clear to lesbian, gay and bisexual patients that they can expectthe same level of service, regardless of their sexual orientation and regardlesswho treats them. Health and social care staff should be supported in tacklinghomophobia whether from staff or other patients.Provide training to staff Healthcare organisations should provide trainingto staff that goes beyond legislation and policies and addresses caring forlesbian, gay and bisexual patients and their families. Training should be targetedto relevant teams such as palliative care, paediatrics, mental health andcommunity health teams.Communicate what you are doing Many lesbian, gay and bisexual peoplestill expect to be treated worse than heterosexual people when accessingtreatment at a hospital, from a GP, from care home staff or a paid carer in theirhome. This might prevent them from being open with health and social care staffmeaning they might not get the best personalised care. Health organisations canbreak down these expectations by communicating that they are gay-friendly.Tackle health inequalities Compared to the general population, lesbian, gayand bisexual people have higher rates of mental ill health as well as alcohol anddrug consumption. Lesbians are also more likely to have never had a cervicalsmear test, while gay and bisexual men are more likely to experience domesticviolence. As well as being the right thing to do, there are legal and financialreasons why health organisations should be seeking to reduce these inequalities.Improve monitoring Unless health organisations know who their patientsare they cannot know if they are addressing health inequalities or combatingpoor patient experience. This should be the case for sexual orientation in thesame way as gender and ethnicity. Organisations should take steps to includesexual orientation on monitoring forms and communicate why they are askingpatients these questions.Findings are taken from Stonewall’s health research Prescription for Change (2008),Gay and Bisexual Men’s Health Survey (2012) and Gay in Britain (2013).Missed out on entering the Healthcare EqualityIndex this year?For more information on how your organisation can take part in the Healthcare EqualityIndex 2015 next year visit www.stonewall.org.uk/HEI
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