Barts Health Equality and Human Rights Impact Assessment Report

Barts Health Equality and Human Rights Impact Assessment Report4.2 Improving patient experience and human rights protectionAll three Trusts have acknowledged they face challenges in improving patient experience.This project has identified a number of challenges for the new organisation in relation toequality and human rights. Particular groups of people (younger people, ethnic minorities,and women) are more likely to say they are not treated with dignity and respect. Thebaseline review recounts stories from a minority of people who feel they had their humanrights infringed and people who were genuinely fearful of returning to receive care due topoor experiences and significant threats to their health and safety.It would be tempting to follow this up by consulting specifically with people only from each ofthese protected characteristics to understand why they feel they are not being treated withdignity and respect. There are significant benefits to doing this. Yet the rapid baseline reviewin this report has shown how there can be a number of common themes that, if addressedacross all frontline staff behaviour, would have an impact on patient experience andprotection of human rights for a wide range of traditionally excluded groups. For example, acommon theme that came out across a broad range of (specifically ethnic group)consultation sessions on End of Life Care conducted by Newham LINkS was the need for‘patient choice’ and autonomy. Patients felt that they did not always have a say in theirtreatment and that services could be improved by making choices explicit to people.As care pathways are further developed, there will be opportunities for CAGs to work withlocal people to identify relevant aspects of staff behaviour that could be improved in order todeliver more compassionate and responsive care. We would encourage CAGs to thinkcarefully about how ‘difference’ and ‘diversity’ is responded to. Whilst specific communitygroups may have specific requests, it will be important for CAGs to make proportionate andreasonable decisions about how the majority of people’s rights are protected across the carepathway. It may be proportionate to respond to particular inequalities in a targeted way (forexample, the provision of specific language support or adjustments for disabilities), butsometimes mainstream change across the whole system will be a more effective andproportionate use of resource, and will benefit a wider range of people.One way to approach this would be to trial a similar approach to the one taken by MacmillanCancer Support in their Human Rights Standard for Cancer Care. The standard wasdeveloped by brap following consultation with over 400 patients, carers, and staff to identifythe eight key ‘moments that matter’ in a particular care pathway. Staff behaviours wereidentified that, if followed, would help to ensure patient rights are protected in thosemoments that matter (examples include: making sure that important conversations are heldin a private space; ensuring food is not out of patients’ reach; and making sure that patientshave an opportunity to discuss and influence their care in a way they understand). Therewas a high degree of convergence and agreement around what those ‘moments’ should looklike across people from a range of protected characteristics and across professionals. Byensuring staff are equipped to deliver against a standard that responds to issues like this,211