The Equality Act 2010 provides us all with protection from discrimination connected to one or more protected characteristics. It states that we must reduce discrimination or disadvantage, advance equality of opportunity and foster good relations.
There are many good examples of how this is happening in the NHS and we have tried to collect as many examples as we can in these pages. We hope the examples will help you reflect on your own behaviour, the culture in your team and find ways to create safe and inclusive policies, practices, and systems that we create at work.
Bias and the danger of a single story
We all have biases – opinions or beliefs about people or groups of people that influence our judgment and behaviour. We often seek out information that reaffirms these biases and ignore information that contradicts them.
Examples of bias might be believing that all Neurodiverse people are good at maths, Black people are athletic, Women are emotional or Old people are forgetful.
We are often not aware of our biases and it’s important to challenge our assumptions and stereotypes as they can affect how we react to people, how friendly we are towards them, how much attention we give them and if we take action.
Resources for reflection
- Chimamanda Adichie describes how the stories we hear about a person or group of people can alter how we view them. If the stories we repeatedly hear only offer a ‘single story’ it affects our perception. Seek out a range of stories to challenge stereotypes and beliefs.
- Danish TV channel TV2 created an advert to help people look at the whole person and not fall into simple stereotypes.
- Disability Sensitivity Training Video helps you ‘Focus on the person, not on the disability’
- Paralympian Dylan Alcott talks about Mainstreaming Disability and the importance of not presenting one view of disability.
- National Autism Implementation Team video to raise awareness of intersectionality and the importance of listening to someone’s whole story.
- Helen Turnbull’s TEDx talk on Inclusion, Exclusion, Illusion and Collusion
- Melanie Funchess’s TEDx Talk on Implicit Bias – how it effects us and how we push through
- Jay Smooth’s TEDx Talk How I learned to stop worrying and love discussing race
Examples of good practice
- NHS Lothian Staff Networks run Lunch & Learn sessions for all staff to learn more about a range of topics.
- ‘Flip it to test it’ – Are you biased? I am – Ted Talk by Kristen Pressner
- Project Implicit is an international project studying attitudes, stereotypes and biases that influence perception, judgement and behaviour. You can test your own reactions to learn more about your own biases.
- Impact Assessments – help you make data driven decisions about the impacts of any changes to your service.
- NHS Lothian commissioned research to uncover their historical connection to slavery and ensure stories from a wide range of people were told.
- There are a number of toolkits that help with ‘framing’ – how you describe your service and patients – for example:
Microaggressions
Microaggressions are everyday actions that communicate hostile, derogatory or negative messages towards a person or a group, based on an aspect of their identity. Repetitive instances of microaggressions (whether intentional or not – it’s the impact that matters, not the intent) can amount to unlawful harassment in breach of the Equality Act 2010.
Resources for reflection
- Fusion Comedy created a film that uses the analogy of mosquito bites to explain the impact of microaggressions.
- Little Black Book Film club created a film ‘All the little things’ to show daily microaggressions in the workplace.
- Juliet Hall describes microaggressions in every day life.
- John Amaechi talks about the difference between being Not-racist and being Anti-Racist
Examples of good practice
- The Allyship Hub helps people ‘actively supporting and advocating for marginalised groups. Allies recognise where power is held within a system and work in solidarity and partnership with marginalised groups to amplify, empower and help drive change’.
- Loretta J. Ross explains ‘call in culture’ in her TED talk ‘Don’t call people out — call them in’ and shares strategies for having challenging conversations
- Barack Obama takes on ‘woke’ call-out culture ‘That’s not activism’ by explaining ‘If all you’re doing is casting stones, you are probably not going to get that far’
- Melinda Epler shares a TED talk on 3 ways to be a better ally in the workplace.
- NES Equality, Diversity and Human Rights Team, introduces an anti-racist approach
Reasonable adjustments
The Equality and Human Rights Commission states that “Equality law recognises that bringing about equality for disabled people may mean changing the way in which employment is structured, the removal of physical barriers and/or providing extra support for a disabled worker.
This is the duty to make reasonable adjustments.
The duty to make reasonable adjustments aims to make sure that, as far as is reasonable, a disabled worker has the same access to everything that is involved in doing and keeping a job as a non-disabled person.
When the duty arises, you are under a positive and proactive duty to take steps to remove or reduce or prevent the obstacles a disabled worker or job applicant faces.
You only have to make adjustments where you are aware – or should reasonably be aware – that a worker has a disability.”
Many of the adjustments will not be expensive, and you are not required to do more than what is reasonable for you to do. Different people will need different changes, even if they appear to have similar impairments.’
Resources for reflection
Examples of good practice
- The Cultural Awareness Hub created a series of films about good practice in maternity wards – It’s OK to ask.
- The screening team and Healthy respect teams have created inclusive websites to share information – Inclusive information for screening, Inclusive information for sexual health
- NHS Lothian provides Translation, Interpretation and Communication Support for people who need information in a range of formats and languages. The NHS website can be translated using the option at the top of the screen.
- NES has an Equality and Diversity zone with a range of information including support address some of the spiritual and religious needs of people, improving communication and being aware of bias in interviews.
- NHS Lothian has a Local Access Policy – if a patient of carer informs us of an Additional Support Need that may prevent them from accepting an appointment there is information on the intranet on how to support them.
- National Autism Implementation team create a guide for professionals Beyond Accommodations: Supporting Autistic Health Professionals
- Different Minds created an ebook, made by autistic people with information and advice for health professionals.
Working culture
Resources for reflection
- Improving wellbeing and working cultures is a policy from the Scottish Government that sets out their vision to enhance working cultures across our health, social care and social work workforce, through focusing on wellbeing, leadership and equality.
- Amy Edmonson talks about the importance of psychological safety at work – the idea that the workplace is safe for speaking up – for ideas, concerns and even mistakes.
