Training in equality and diversity is much better today than it used to be, but I believe that it still has a lot of room for improvement. Over the years I have attended several 'seminars', 'lectures' and other so called 'training events' that have purported to be serious 'training tools' for those working or volunteering in different aspects of social care. To be honest most have been a waste of time.

It surprised me to see how many of these were hosted by able-bodied straight white middle-class men and women who have no real idea of prejudice in any form, they attended a 'course' and obtained a qualification, how ridiculous is that! Or am I being unfair? My personal belief is that only someone who has experienced discrimination can tell others what it is like and explain how hurtful discrimination is.

At some 'events' I've even witnessed homophobic and racist views being expressed by 'professional' attendees which have only been challenged by others attending, those holding the event have ignored this type of behaviour on more than one occasion.

I attended one such event in Manchester city centre some years ago, the company I worked for wanted to assess if it was of any use as part of company staff training. After two hours in the morning and two hours in the afternoon I concluded that it was of no value at all and only a money-spinner for the training company that put it together. 

After the event I invited some of those that I had spoken with to join me for a drink (I don't drink alcohol but I do enjoy going to a good bar), although some were apprehensive they did go with me to Canal Street. Guess what? They all enjoyed themselves and before leaving everyone of them thanked me for the invite and told me that they had learned more by meeting people on Canal Street than had all day in the 'training event'.

Don't get me wrong, a lot of training sessions like this are very good and are improving all of the time. I'd just be careful and check out the organisation behind the training session to see if they have the right people and experience to provide it.

Multicultural Britain means multicultural beliefs and values, and without the support of all the cultures in the UK there would be no NHS. These are inescapable facts.

On 7/15/2022 at 6:12 PM, Mancunian said:

Training in equality and diversity is much better today than it used to be, but I believe that it still has a lot of room for improvement. Over the years I have attended several 'seminars', 'lectures' and other so called 'training events' that have purported to be serious 'training tools' for those working or volunteering in different aspects of social care. To be honest most have been a waste of time.

It surprised me to see how many of these were hosted by able-bodied straight white middle-class men and women who have no real idea of prejudice in any form, they attended a 'course' and obtained a qualification, how ridiculous is that! Or am I being unfair? My personal belief is that only someone who has experienced discrimination can tell others what it is like and explain how hurtful discrimination is.

At some 'events' I've even witnessed homophobic and racist views being expressed by 'professional' attendees which have only been challenged by others attending, those holding the event have ignored this type of behaviour on more than one occasion.

I attended one such event in Manchester city centre some years ago, the company I worked for wanted to assess if it was of any use as part of company staff training. After two hours in the morning and two hours in the afternoon I concluded that it was of no value at all and only a money-spinner for the training company that put it together. 

After the event I invited some of those that I had spoken with to join me for a drink (I don't drink alcohol but I do enjoy going to a good bar), although some were apprehensive they did go with me to Canal Street. Guess what? They all enjoyed themselves and before leaving everyone of them thanked me for the invite and told me that they had learned more by meeting people on Canal Street than had all day in the 'training event'.

Don't get me wrong, a lot of training sessions like this are very good and are improving all of the time. I'd just be careful and check out the organisation behind the training session to see if they have the right people and experience to provide it.

Well, I "outed" myself as a former nurse training, a few days ago, but I never ran any diversity and equality training, and boy I would have had some fun doing them.

I have attended many of them in the past and you're right, so many of them were run by people who had little or no experience of being on the receiving end of prejudice. So many times, it has just been a quick summary of the legislation on equality, and those trainers did get annoyed when I know more about the legislation than they did.

But we should never under estimate the power of actually knowing people from different minorities, seeing them as people and getting to know their experiences. Like taking colleagues to a gay bar for a drink. But we shouldn't ignore the power of drama and literature too, both of them can demonstrate different people's lived experience of life. British soap operas have done so much for equality because have portrayed the lives of many different and diverse characters. Audiences get involved with those characters' lives and it helps open people's minds.

From my experience, I don't feel equality and diversity training has done much for tackling prejudice. People working with and knowing different people from different backgrounds, the raise in out LGBTQ+ people, making us far more visible in other people's lives, has helped far more.

On 7/16/2022 at 10:53 AM, Zombie said:

Multicultural Britain means multicultural beliefs and values, and without the support of all the cultures in the UK there would be no NHS. These are inescapable facts.

I work with Christians, Muslins, Jews and people with no beliefs, and my colleagues are from almost all racial backgrounds. I'm out at work and all my colleagues have met my husband, yet I experience no homophobia at work.

I love multicultural Britain, and the NHS is very multicultural, well at the patient facing side. Unfortunately, in Britain we have people who are using prejudice and discrimination to give themselves power. We had the sight of MPs, running for party leader, trying to be more transphobic than each other in a TV debate, the other day, and they saw their transphobia as a virtue.

1 hour ago, Drew Payne said:

I work with Christians, Muslins, Jews and people with no beliefs, and my colleagues are from almost all racial backgrounds. I'm out at work and all my colleagues have met my husband, yet I experience no homophobia at work.

I love multicultural Britain, and the NHS is very multicultural, well at the patient facing side. Unfortunately, in Britain we have people who are using prejudice and discrimination to give themselves power. We had the sight of MPs, running for party leader, trying to be more transphobic than each other in a TV debate, the other day, and they saw their transphobia as a virtue.

I’m genuinely puzzled

Your blog, which I carefully read, is almost entirely about serious NHS failures identified in a report and also experienced by you.

But now you say that you experience “no homophobia” at work in the NHS, rather there’s a problem with politicians “using prejudice and discrimination to give themselves power”.

So why did you ask “How can we say we focus on person-centred care when LGBT staff’s safety is so bluntly ignored by the NHS?”

3 hours ago, Zombie said:

I’m genuinely puzzled

Your blog, which I carefully read, is almost entirely about serious NHS failures identified in a report and also experienced by you.

But now you say that you experience “no homophobia” at work in the NHS, rather there’s a problem with politicians “using prejudice and discrimination to give themselves power”.

So why did you ask “How can we say we focus on person-centred care when LGBT staff’s safety is so bluntly ignored by the NHS?”

 

I originally wrote this blog as a comment piece for Nursing Standard magazine (as with all the blogs in this short series). I was writing about a report that showed, for so many areas of the NHS, nothing had changed in decades and LGBT staff were still subjected to the most awful prejudice and treatment. I wrote it as an angry response because it felt like, for far too many people, nothing had changed. I wrote it to challenge the magazine's readers. At the time of its original publication, there was a lot of talk of "person-centred care", and a lot of it was just paying lip-service to a very challenging concept, that's why I wrote, “How can we say we focus on person-centred care when LGBT staff’s safety is so bluntly ignored by the NHS?” I wanted to bluntly challenge the magazine's readers.

I work in team of twenty-two nurses, all from very different backgrounds, and have never experienced any homophobia from colleagues at work. My husband works for the same NHS Trust and everyone at work knows him as my husband, but they have also approached him for professional advice because they already know him. I was in this job when I originally wrote this article. I was out at work and having no problems because of it, then I read this report and was deeply shocked. It was detailing prejudice that I had thought,had  hoped, had disappeared ten years ago. I first thought was, I have to write a piece for the Nursing Standard on this. So I did and they published it. It came from a place of anger because I had thought, from my own experience, we had moved away from this sort of disgusting homophobia. I was wrong.

Thanks for the background. The inadequate staff training you received is a serious failure and my view of most online training is it is often a tick box exercise, a waste of time and done to save money. Sure, poorly delivered training by inexperienced / poor trainers is also a waste of time but that’s also an NHS management failure.  And we live in a COVID world - but if COVID is becoming a permanent excuse to avoid returning to proper training by management vetted training companies then problems like this will never be addressed.

So if nothing happened following the YouGov survey/report, that suggests the healthcare workers union failed / didn’t want to get involved, and also a serious failure by NHS management. All material issues in business risk reports (and staff safety is a material risk) should contain action plans and timescales agreed with individual managers (copied up the line-management chain), agreed actions to be followed up and verified, and all failures then reported to senior management for appropriate remedial response (senior management actions/responses are then also audited). This is all basic management stuff, so why doesn’t NHS management manage?

On 7/18/2022 at 2:55 PM, Zombie said:

Thanks for the background. The inadequate staff training you received is a serious failure and my view of most online training is it is often a tick box exercise, a waste of time and done to save money. Sure, poorly delivered training by inexperienced / poor trainers is also a waste of time but that’s also an NHS management failure.  And we live in a COVID world - but if COVID is becoming a permanent excuse to avoid returning to proper training by management vetted training companies then problems like this will never be addressed.

So if nothing happened following the YouGov survey/report, that suggests the healthcare workers union failed / didn’t want to get involved, and also a serious failure by NHS management. All material issues in business risk reports (and staff safety is a material risk) should contain action plans and timescales agreed with individual managers (copied up the line-management chain), agreed actions to be followed up and verified, and all failures then reported to senior management for appropriate remedial response (senior management actions/responses are then also audited). This is all basic management stuff, so why doesn’t NHS management manage?

The move to all online training was long before Covid. I originally wrote this blog in 2015 and back then almost all my work training was online. I left being a Nurse Trainer in 2011 when my employer lost several face-to-face training contracts. Training budgets have been cut since 2010, when NHS funding was cut.

I don't feel this is all a failure of NHS management, I feel it goes up much higher. This is a failure of the Department of Health and the Minister of Health. Neither of them are very concerned about staff training, or even staff retention. Their attitude, for years, has seemed to be "we can always train new staff." They haven't been very interested in retaining staff. Neither have they been very interested in training and developing staff, we've seen that by the severe cuts to staff training budgets across the NHS. When funding is short, staff training is always the first thing to be cut, but the DoH and the Health Minister have not condemned any of this, or even seem bothered by it.

Nothing really came from this YouGov survey because, as a society, we don't really take homophobia seriously. So often its excused as someone's religious beliefs or personal views. We have seen a massive rise in homophobic hate crime since the Brexit referendum and yet there has barely any noise about this, outside of the gay media.

I originally wrote this as a response to my anger, but also because no one was talking about this report. I'd hoped that it would open up debate but it didn't, it didn't seem people were interested in it. I still feel so frustrated by this.

Government doesn’t manage “the NHS” (maybe it did in 1948 when “the NHS” was founded) but the current “NHS management” (the term implies the NHS is a unitary body which of course it isn’t - hence the quotation marks) has responsibility for all the various day to day functions including training and staff safety issues.

Just like Government doesn’t manage for example the day to day running of the military, or education and so on.

What Government does do is provide the budget and put in place various things like the legal / regulatory / oversight / purchasing frameworks (this is not an exhaustive list and includes the general legislative framework such as employment laws etc) for all of these state activities. So if, say, a hospital does not meet the required standards then the appropriate oversight body eg the Care Quality Commission will at that point intervene (“special measures” and so on).

Otherwise all the day to day stuff (recruitment, training, discipline etc) is the responsibility of the appropriate management structure. And that includes the response - or rather lack of response - to the Stonewall report.

Lastly, you say:

“Nothing really came from this YouGov survey because, as a society, we don't really take homophobia seriously. So often its excused as someone's religious beliefs or personal views. We have seen a massive rise in homophobic hate crime since the Brexit referendum and yet there has barely any noise about this, outside of the gay media“

which raises some interesting issues but, again, finding a way to deliver services and meet all these various challenges is the responsibility of “NHS management”.

16 hours ago, Zombie said:

Government doesn’t manage “the NHS” (maybe it did in 1948 when “the NHS” was founded) but the current “NHS management” (the term implies the NHS is a unitary body which of course it isn’t - hence the quotation marks) has responsibility for all the various day to day functions including training and staff safety issues.

Just like Government doesn’t manage for example the day to day running of the military, or education and so on.

What Government does do is provide the budget and put in place various things like the legal / regulatory / oversight / purchasing frameworks (this is not an exhaustive list and includes the general legislative framework such as employment laws etc) for all of these state activities. So if, say, a hospital does not meet the required standards then the appropriate oversight body eg the Care Quality Commission will at that point intervene (“special measures” and so on).

Otherwise all the day to day stuff (recruitment, training, discipline etc) is the responsibility of the appropriate management structure. And that includes the response - or rather lack of response - to the Stonewall report.

Lastly, you say:

“Nothing really came from this YouGov survey because, as a society, we don't really take homophobia seriously. So often its excused as someone's religious beliefs or personal views. We have seen a massive rise in homophobic hate crime since the Brexit referendum and yet there has barely any noise about this, outside of the gay media“

which raises some interesting issues but, again, finding a way to deliver services and meet all these various challenges is the responsibility of “NHS management”.

Certain parts of the NHS are now run by Private firms. My local HIV clinic was run by a private firm, when the Specialist retired, they didn't bother replacing him.

I was lucky I had plenty of Meds and was able to find a new clinic fairly easily.

13 minutes ago, chris191070 said:

Certain parts of the NHS are now run by Private firms. My local HIV clinic was run by a private firm, when the Specialist retired, they didn't bother replacing him.

I was lucky I had plenty of Meds and was able to find a new clinic fairly easily.

yeah, this started in the 90s under the Conservatives, and Labour continued and expanded with the terrible “private finance initiative” (to massage govt debt figures) and then we had the so-called “internal market” (“competitive tendering” to commercial healthcare also took away NHS skills in these areas when they were “privatised”) - all of which just added further expensive layers of admin bureaucracy and paper pushing - cancelling out one of the BIG original benefits of the NHS which was to remove all the expensive costs of individual billing / invoicing / accounting / settlement, underwriting + claims management, policy issue + renewals etc of “individualised” commercial healthcare.

The whole thing’s been disastrous. There was a bill going through around 2017 I believe, which was supposed to unravel much of the “internal market” madness, but I don’t know if that’s gone through.

The blame must be shared by governments of both political parties. They have both used (abused) healthcare as a political football because it is NOT just about the headline “£xxxbn” taxpayer money tipped into the NHS but all the tampering and bad interventions that both sides are guilty of (and, of course, NHS management for day to day stuff)

On 7/19/2022 at 6:46 PM, Zombie said:

Government doesn’t manage “the NHS” (maybe it did in 1948 when “the NHS” was founded) but the current “NHS management” (the term implies the NHS is a unitary body which of course it isn’t - hence the quotation marks) has responsibility for all the various day to day functions including training and staff safety issues.

Just like Government doesn’t manage for example the day to day running of the military, or education and so on.

What Government does do is provide the budget and put in place various things like the legal / regulatory / oversight / purchasing frameworks (this is not an exhaustive list and includes the general legislative framework such as employment laws etc) for all of these state activities. So if, say, a hospital does not meet the required standards then the appropriate oversight body eg the Care Quality Commission will at that point intervene (“special measures” and so on).

Otherwise all the day to day stuff (recruitment, training, discipline etc) is the responsibility of the appropriate management structure. And that includes the response - or rather lack of response - to the Stonewall report.

Lastly, you say:

“Nothing really came from this YouGov survey because, as a society, we don't really take homophobia seriously. So often its excused as someone's religious beliefs or personal views. We have seen a massive rise in homophobic hate crime since the Brexit referendum and yet there has barely any noise about this, outside of the gay media“

which raises some interesting issues but, again, finding a way to deliver services and meet all these various challenges is the responsibility of “NHS management”.

But the Government does manage so much of what the NHS does, but they do this with targets, requirements and policies. They also police so much of this by directly fining NHS Trusts for breaching them. These all dictate what different Trusts can and cannot do and many of they dictate the day-to-day running of a Trust.

Most of these targets, requirements and policies come from the Department of Health and NHS England, who are directly under the influence of the Minister of Health.

One example is an Accident and Emergency departments. If a hospital’s Accident and Emergency has dangerously high demand levels and/or is dangerous under-staffed and it is temporary closed to manage that demand, then that Trust is fined by the Department of Health for doing so. Therefore the pressure on a Trust’s management is not to close it. This is the Government directly managing a hospital. And there are a lot more targets and requirements that impact on the day-to-day running of a Trust, there are targets that impact were a patient can be placed on a hospital ward, and the Trust is fined for breaching. This is on top of the requirement for yearly “savings”.

Hospitals do not even get to chose their own specialist services, this is decided upon centrally.

My yearly mandatory training requirements aren’t set my employer, they were set by the Department of Health and they are not related to my job. They are divided up into clinical and non-clinical training streams and that is about it. I work in the community, actually working in people’s homes. I have to do regular training on how to deal with and prevent fires in hospitals. This training has zero relevance to my job but the Department of Health says I have to do it. The Department of Health sets targets for recruitment and all Trusts use the same disciplinary procedures, as laid down by the Department of Health.

The government has never treated the NHS as an arms-length body, they (whichever party is in charge) have always been very involved in the management of the NHS. Since 2010, the NHS has seen major strategic reforms that have completely changed how the NHS is run and managed, and this was all directly from Government policy.

The Department of Health was very silent about the recent Stonewall reports into the homophobia in the NHS, the government was also very silent and the media was very uninterested. It feels as if no one cares and I am very frustrated by this.

This blog concerned LGBT/homophobia experienced by staff and patients in the NHS. Specifically, the blog is about staff/patient safety/welfare which is a “day to day” NHS issue because it requires continuous daily management which government cannot do and must be done in real time by the NHS itself.

Staff and patient safety and welfare is clearly a day to day responsibility of NHS management because the NHS is obviously the employer of staff (responsible for recruitment, pay, employment conditions etc) and is the welfare/healthcare provider for patients (responsible for admissions, treatment, safety etc, including where clinical treatments are outsourced and/or private hospital facilities are used) - government does not do this since it is neither the employer of NHS staff (confirmed on pay slips etc) nor the healthcare/welfare provider for patients (confirmed in NHS patient discharge papers etc).

…as you yourself confirmed with your question at the end “How can we say we focus on person-centred care when LGBT staff’s safety is so bluntly ignored by the NHS?” How much clearer could it be that the NHS had responsibility for this, and yet did nothing, when you said so yourself in such scathing terms?

I included reference to some of the other management areas for which government is responsible simply in order to draw a distinction between LGBT staff/patient safety, which is definitely a day to day NHS responsibility, and these other areas which are clearly not.

I also included a clear caveat that “this is not an exhaustive list” because I was merely posting a blog reply and not writing the textbook