Notes from the NHS LGBT Health 2022 Conference
What an inspiring and informative day at the NHS LGBT Health Conference 2022.
I always find it incredibly motivating and reassuring to be surrounded by so many like-minded individuals who all recognise the importance of addressing the health inequalities faced by LGBTQ+ people. A room full of people where no eyebrows are raised when I introduce “my wife”, where I proudly showed a photo of our magical IVF baby (alright, toddler, but always a baby to me), and where I felt surrounded by like-minded colleagues all working towards the same end- achieving positive change for our community. What a team.
We heard from Dr Michael Brady, National Advisor for LGBT Health at NHS England, Dr Kate Nambiar, newly-appointed medical director at the Terrence Higgins Trust, Alex Matheson of the NHS Rainbow Badges Programme which (until very recently- when there became too many plates for me to keep spinning- I was the LGBT Development Officer for) Dame Ruth May, Chief Nursing Officer, and many other leading lights in the LGBTQ+ Healthcare landscape.
As a clinician, an EDI consultant AND a member of the LGBTQ+ community myself, I found myself bombarded in the very best way with information, insights and key learning, leaving my neurons in a spin!
Here are my key takeaway points:
- From a clinical perspective- It is becoming increasingly more common for patients attending sexual health services to be self-medicating without disclosing this to their GP’s (two figures were quoted as 23 and 25% of patients). The LGBTQ+ community are very good at supporting their own through widely established support networks, which creates echoes of the AIDS crisis and sharing of antiretroviral therapies. Whilst the majority of this information on peer support sites is actually well-referenced, it is frequently based on theoretical research or early-stage work that currently lacks the clinical data to back it up. This can mean people are on poorly managed regimens and unable to access the care they need if complications develop. As primary care providers, we need to be aware of this, know where to signpost and know what to do in the event we are presented with a patient in this situation.
- It was fascinating for me to see the results from the UK GP Patient Survey, indicating that younger LGBT+ people are more likely to experience problems with physical mobility in comparison to all patients the same age. I would personally be really interested to explore this further, looking at the data for the low back pain population and how this would impact the care we provide as Chiropractors and primary care providers. Perhaps a research article in the pipeline there…
“Ill health accompanies minoritisation and marginalisation of the transgender community.” – Dr Kate Nambiar.
- It is becoming increasingly difficult for UK academic institutions and healthcare providers to ignore the need for specific LGBTQ+ inclusive education and training. This is also true for practitioners, where it is becoming increasingly more difficult to ignore the need for training. This is despite the standard line of “but I treat all patients the same.” (Honestly, if I had a pound for every time I’ve heard that.) Of course, you provide your patients with the same great care- it’s not a question of deliberately providing poor care to a particular community. But equality in healthcare does not mean treating everyone the ‘same’, it instead requires us to recognise that each patient is an individual with their own needs, support requirements, and intersectional elements that we must also consider.
- It was a truth universally acknowledged that at today’s conference speakers were, in many cases, ‘preaching to the choir’- speaking to a group of individuals who “get it” already. One of the key points raised repeatedly throughout the conference was the barriers posed by a lack of senior leader “buy-in”. There were a huge amount of people who are doing incredible work on the ground and yet can’t take these exciting initiatives forward due to a lack of funding or a lack of executive-level support. (And funding. Of course.) The case for executive coaching grows ever stronger…
- LGBT networks within NHS Trusts need to a) exist- many don’t- and b) recognise and work towards a defined strategic purpose. Some of the networks we are working with through Oakley Coaching will create strategic change through events, training, EDI strategies and more and I am thrilled we’re in a position to support them. We must recognise that inclusion and engagement IS often strategic, and there must be a focus on driving change and improvement within an organisation. We’ll be keeping this at the forefront of our minds in the upcoming projects we have within the NHS.
- Some brilliant examples were given of how LGBTQ+ inclusive training is being embedded at the undergraduate level within a number of healthcare training programmes however… we have yet to establish a relationship between LGBTQ+ education of clinicians and patient outcomes from care simply because… the question is not being asked. As is so often the case. This means it’s easy to ignore the issue, gloss over it and/or use this as a reason to exclude LGBTQ+ inclusive training from undergraduate and postgraduate curricula.
If students are to remain patient-oriented rather than disease-oriented, they must learn to identify in complex, concrete, detailed terms with people they know only as crude stereotypes, and of whom they are usually afraid.
- Many educators are not providing training in the curriculum because they do not believe it is relevant to the students. I’ll just leave that thought with you.
- On the topic of education…. LGBTQ+ training is not a tick box exercise. Nor is EDI. It is an active, ongoing and dynamic process that we should all commit to, no matter what stage of our career. I am reassured that the training we provide through the Confident Clinicians’ Academy can hold its own against the best practice recommendations made today.
- We discuss the numerous ways in which clinicians can create a more inclusive service in their practice, and this was echoed in an insightful talk on LGBTQ+ Inclusivity in Primary Care from Pride in Practice. Patients consistently report that seeing inclusive materials, policies, literature and posters in a clinical space are key factors in choosing a healthcare provider and/or remaining with that healthcare provider. It’s not rocket science, and it’s not difficult to create an inclusive space.
- Finally… A significant cultural shift needs to take place within the NHS and wider healthcare landscape to ensure every clinician and service-user-facing staff member has the knowledge, skills and confidence to engage with LGBT people in the way they need. Given the current political climate, we all expressed concerns over the storm that is coming, and how we can tackle this- addressing the lack of understanding amongst healthcare professionals in relation to LGBT healthcare needs which is such a firm barrier that stands in the way of progression. We must consider the service development, research agenda and training required to tackle these inequalities and ensure we have the resource available to support this.
It was a pleasure to connect with so many colleagues and professionals today, and we’re inspired to continue our aim at Oakley Coaching to bridge the gap between clinical understanding and the delivery of person-centred healthcare.