Downloads & Links
- staff disciplinary procedure
- bullying & harassment policy
- Diversity & Equality: www.faculty.londondeanery.ac.uk/e-learning/diversity-equal-opportunities-and-human-rights
- Patient Safety: http://www.gmc-uk.org/Raising_and_acting_on_concerns_about_patient_safety_FINAL.pdf_47223556.pdf
- Doctors: Ramesh Mehay & Ashraf Khan
- Nurses: Zoe Booth
- Admin: Chris Rushton & Pam Brown
6th July 2016
Date of Next Review
Why is this important
Human rights are the basic rights and principles that belong to every person in the world. Human Rights are based on the FREDA principles: Fairness, Respect, Equality, Dignity and Autonomy’ (EHRC). Human rights protect an individual’s freedom to control their day-to-day life, and effectively participate in all aspects of public life in a fair and equal way. We believe that all individuals should be treated in line with the FREDA principles. These are basic fundamental human rights and it is morally unacceptable and damaging to treat people unfairly, without dignity or without respect. Individuals are different in so many ways and this diversity should be celebrated because we can learn and create new and wonderful experiences with one another if we have the right attitude. Promoting equality, dignity and respect results in…
- people being treated fairly
- good morale amongst workers (means higher motivation through being valued)
- this leads to better performance (people work better, they go the extra mile)
- this also leads to a more stable workforce (less resignations or absences)
- a good reputation for the organisation as a whole
We live in an increasingly diverse society (around gender, race and ethnicity, disability, religion, sexuality, class and age) and need to be able to respond appropriately and sensitively to this diversity. Promoting equality, dignity and respect is the key to not only a productive workforce but productive collaborative relationships in general.
Equality is about ‘creating a fairer society, where everyone can participate and has the opportunity to fulfil their potential’ (DoH, 2004). By eliminating prejudice and discrimination, the NHS can deliver services that are personal, fair and diverse and a society that is healthier and happier. An equalities approach understands that who we are, based on social categories such as gender, race, disability, age, social class, sexuality and religion – will impact on our life experiences.
Diversity literally means difference. When it is used as a contrast or addition to equality, it is about recognising individual as well as group differences, treating people as individuals, and placing positive value on diversity in the community and in the workforce. One way in which organisations have responded to the issue of diversity in recent years has been the development of flexibility in working practices and services. For example, an employer may allow an employee to work a flexible working pattern to accommodate child care arrangements, or a GP surgery may offer surgeries at the weekends to accommodate those who work full time during the week. These approaches recognise that in order to provide accessible services and to ensure we promote inclusive working environments organisations may need to respond differently to both individuals and to group
Discrimination is less favourable treatment based on someone’s protected characteristic (see next section below). A protected characteristic is an individual strand of diversity as covered under the Equality Act. The Equality Act covers 9 protected characteristics. Discrimination and exclusion can be multi-layered and occur because of:
- an aspect of individuality, e.g. some aspect of personal appearance, size, personal likes, etc.;
- our social situation, e.g. being an ex-offender, being homelessness, being a lone parent, misuse of drugs or alcohol, citizen status or health.
- our protected characteristic i.e. being refused a job because of our sexual orientation or limited access to health care because we are disabled.
Dignity is a state or quality of being worthy of honour or respect. How do you know when you are being treated with dignity? With dignity you are in control, feel valued, have confidence, are able to make decisions and are comfortable. In general, you are able to prosper. Without dignity, you feel devalued, lack confidence, lose control, feel embarrassed, ashamed, humiliated and as a result you don’t do very well. In general, you start to spiral downwards!
Patient Dignity & Respect
The Practice’s Dignity and Respect Policy is based on the principles of excellent staff management and ethical behaviour which underpins the practice’s values in providing patients with an environment centred upon self-respect, tolerance and support. This policy also helps Ashcroft Surgery to be reactive with regard to situations that could compromise a patient’s dignity. The policy aims to give support to all persons connected with a suspected breach of the practice’s rules (this includes the complainant and the respondent). Complaints will of course will follow the usual practice complaints procedure. All staff members have a personal and legal responsibility to comply with this policy on practice premises or in other locations relating to Ashcroft Surgery.
GENERAL GUIDING PRINCIPLES
- Ensure that patients are treated with dignity and respect at all times;
- Support a working environment based on principles of self respect, tolerance and support for all staff
- Continuously promote good relations to the benefit of all;
- Facilitate a culture whereby patients and staff feel confident to report suspected breaches of this policy, and to believe action will be taken to make things better.
ALL STAFF MUST OBSERVE THESE THINGS…
- Patients’ ‘personal space’ should not be compromised where at all possible.
- The Practice will not under any circumstances, stereotype patients based on pre-formed, perceived opinions.
- Conversations about patients will generally not take place with other staff members outside the practice; in exceptional cases where there is a need for this, both parties will ensure confidentiality
- During work-related conversations, patients will be referred to with respect and the subject matter discussed confidentially, regardless of where the discussion takes place in the practice.
- Conversations about patients between staff members and non-staff members will only take place where consent has been given by the patient and only in a secure confidential environment.
IN THE RECEPTION AREA…
- Patients will be addressed by their preferred title (e.g. Mr, Mrs Ms).
- A notice in reception offering the provision of a private discussion with a receptionist, if required.
- A notice in reception to offer the facility of a private chaperone during consultations, if required.
- A notice in reception stating that guide dogs are permitted in all parts of the building.
- A hearing loop is installed in the reception area and operational at all times, and staff members trained in its use.
- Patients can choose to see a male or female clinician, where available. Where their first choice is not readily available, they may wait until their chosen clinician becomes available. For urgent cases, patients will be encouraged to see a clinician appropriate to ensure that ‘best and prompt care’ is undertaken.
- Patients whose first language is not English may have a family member or friend present to accompany them.
- Clinical staff will be sensitive to patient needs and will ensure patients are comfortable in complying with any requests during the consultation.
- Communication between health professionals and patients will be personalised to each individual patient, taking into account any disability or difficulty they may have.
- Patients will be given adequate time and privacy for the provision of any required samples on the premises without feeling any time pressures or other constraints.
- Patients will be given as much time and privacy as is required to take on-board any ‘bad news’ given by a GP. Where possible, clinical staff will anticipate this need and leave sufficient time between appointments, as necessary.
- Members of staff should not enter a closed consultation room or treatment room without knocking and receiving permission to enter from the health professional conducting the consultation.
- Health professionals conducting a consultation in a patient’s home will be sensitive to the location, surroundings and any other persons present who could potentially overhear matters discussed.
DURING A CLINICAL EXAMINATION…
- A trained chaperone will be offered where an intimate examination is to take place. Where an intimate examination is considered necessary for a patient with difficulty in understanding due to issues such as English not being their first language, consent or cultural issues, a chaperone will be used.
- Patients who have difficulty in undressing will normally be offered the services of a same gender staff member to assist.
- Patients will only be requested to remove the minimum amount of clothing necessary for the examination.
- Patients will be offered to undress behind a screen in order to maintain their privacy and dignity.
- The area used for dressing/undressing will be equipped with clothes hangers or pegs for the patient to use.
- Areas used by patients for dressing/undressing will be secure from interruption or from being overlooked
- If a clinician leaves a room, the patient will be offered something to cover themselves up (e.g. a clean single sheet or their own garment).
- A clean, single-use sheet, will be available and used for each examination on the clinical couch and changed after each patient.
- The curtain will be kept drawn at all times until the patient is fully dressed again.
- Washing facilities will be offered to any patient, if required.
AFTER A CONSULTATION…
- Clinical staff will respect the dignity of patients and will not discuss issues arising from the above procedures unless in a confidential clinical setting appropriate to the care of the patient.
- All staff will continue to be respectful of the patient, even when the patient is not there.
DISCRIMINATION – what are the ‘protected characteristics’?
People are diverse in so many ways and this should be celebrated rather than discriminated against. We can all learn from each other. The ways in which people are diverse is listed below under 9 characteristics.
- Gender reassignment
- Marriage and civil partnership
- Pregnancy and maternity
- Religion and belief
- Sex – man or woman
- Sexual Orientation
It’s important to remember not to confused these protected characteristics with self-identity. A person’s self-identity is their conception and expression of their own indviduality. For example, an elderly man may not see himself as old and not wish to be treated differently to someone younger. A doctor who is gay may wish to be seen as a kind person who is compassionate and thoughtful rather than as a gay person or even as a doctor. So, don’t stereotype, make assumptions, patronise, humiliate and disrespect people by taking them less seriously.
And it is also unacceptable for an individual to use one aspect of their social identity to discriminate against another person because of an aspect of their social identity. For example, a muslim trainee who never has any eye contact with female colleagues or patients when he is talking to them yet he does have direct eye contact with male colleagues; this would be direct discrimination based on gender – which is unacceptable. Another example: a person discloses to a colleague that they are gay; the colleague responds by saying that because they have a strong moral objection to homosexuality, they would appreciate it if they don’t refer to their sexuality ever again and in that way they will get on fine. This is direct discrimination based on gender. Again, one cannot use their own social identity to discriminate against another’s.
To ensure that we value diversity and consider the individual’s identity appropriately, the following principles may be useful:
- we need to treat all people as individuals and respond to them, and their social identity, in an individual manner
- treating people fairly does not mean treating people in the same way – we need to recognise difference and respond appropriately
- respect all people their protected characteristic or social situation
- try to increase our knowledge and understanding of aspects of social identity that may be different from our own
- avoid stereotyping or making assumptions about people based on their social identity
- recognise that certain aspects of the way your organisation works (e.g. evening working, weekend working, surgery times and so on), may impact on some individuals more than others
- recognise that your own social identity may impact on others in different ways
- avoid using inappropriate and disrespectful language relating to social identity or social situations
All staff or those working on behalf of the practice must ensure that all staff, patients and the public are treated equally irrespective of their gender, marital status, age, disability, race, colour, nationality, religion, sexual orientation, ethnic or national origin. They shall not be disadvantaged by any conditions or requirements such as a disability.
All staff must not enter into or by not raising concerns be seen to condone any acts of discrimination. Any staff or practice representative who either direct or by inferred support of discrimination by not making an objection known, decimates against another person may face disciplinary action within the Practice Disciplinary Policy that could lead to staff dismissal. Any alleged incidents of discrimination will be treated as a very serious issue.
All patients asking to register are accepted without any vetting or interview, subject to the list position and identity criteria for all. The practice has a small but significant number of patients from minority ethnic backgrounds including Asia and Eastern Europe. Whilst there are a number of doctors within the practice who can communicate in other languages we cannot cover all languages spoken by our patients. A local interpreting service is available, pre-booked by telephone, for interpreters to attend at the patient appointment time. This is requested through the Eccleshill Hospital reception. Where possible patient information leaflets are obtained in other languages. There is also an interpreting service for deaf patients which can be accessed, contact details noted below.
Equally though, patients must be respectful of our staff. All staff should be treated by patients in a non-discriminatory way and behaviour which violates dignity, equality and respect will not be tolerated.
CHALLENGING DISCRIMINATION – notes for staff
At times you will be required to challenge people over their behaviours if you feel it is potentially discriminatory. Knowing what to challenge, and when to challenge, can be tricky and open to personal interpretation. There are some non-negotiables re inappropriate language/behaviour e.g. swearing, language that is racist/sexist/homophobic, etc. We can often find debate over questions such as ‘what constitutes inappropriate banter?’ or ‘They meant no offence by a comment – do I still need to challenge?’ However, not challenging is not a neutral act – it can be seen as colluding behaviour.
If in doubt about whether you should challenge someone’s behaviour or not, consider the following.
- Is the banter/joke/comment excluding anyone or aimed at anyone in order to ridicule them?
- Could someone be offended by the behaviour?
- Lack of intention is not an excuse for behaviour. You are required to consider and manage the effect of behaviour.
- Is the banter/joke/behaviour open to misinterpretation or misunderstanding?
In terms of how to challenge… there is no definite way to challenge inappropriate behaviour and no doubt you will find your own approach to challenging effectively. The following may be useful to consider.
- Don’t punish or blame – say what is better.
- State your position: ‘That’s disrespectful; we don’t talk about patients like that.’
- Understand the situation…
- Do you challenge there and then, or quietly at a later date?
- What will be most effective for the person involved/for those witnessing the incident?
TYPES OF DISCRIMINATION
- Jonathon wants to make a formal complaint but you decide not to take this seriously because he has schizophrenia and you know he can be prone to delusions. (= direct discrimination based on his disability).
- Other examples – not employing someone because the rest of the team would be uncomfortable with them (e.g. being lesbian or gay, male/female, etc.)
Discrimination by association
- Linda is a receptionist who has a child with disability and therefore needs a bit of flexible time. Other receptionists resent this and treat linda poorly as a result. (= Linda is being discriminated against because of her association with a child with disability).
- Other examples – treating someone poorly simply because they hang out with a gay/black/disabled friend.
Perception based discrimination
- Teasing Jay about being gay, based on the perception he is gay (although he is not gay). This is direct discrimination based on the perception of Jay’s sexual orientation.
- Jayne is 22 weeks pregnant and has to go to the toilet often. Her line manager feels staff are taking too many toilet breaks and starts to come down on those who he feels takes too many (one of whom is Jayne). (=indirect discrimination because he does not take Jayne’s pregnancy into account).
- The surgery decides to hold a meeting every month to discuss practice issues. The meeting is at a nice venue, away from your practice catchment. One of your colleagues is wheel-chair bound and finds it impossible to attend because it is two bus stops away and doesn’t even have a ramp or lift to aid his access. This is discrimination based on disability.
Indirect discrimination (justifiable, and therefore acceptable)
- A surgery advertises for a reception staff member whose main role will be answering the phones. In the job advert they say that they are looking for someone who speaks fluent English. (this could indirectly discriminate against some ethinic groups, but is justifiable given the nature of the job and the emphasis on clear oral communication).
Harrasment always happens because of a breach of one of the 9 protected characteristics. And it is legally enforceable, which means you can take someone to court over it! See our harassment policy. bullying & harassment policy
- Your broadband breaks down and two repair people turn up. Whilst making them a cup of tea, you overhear them making some racist jokes about Polish people. (Did you know that you can bring a harrasment claim against the company on the basis that you found it offensive and degrading?)
- Tracey is a lesbian who is not ‘out’. Her colleagues don’t know and don’t even have any suspicion. However, some of them often make homophobic remarks which she finds offensive and hostile. This is harrasment based on sexual orientation.
- James reports to his line manager that he finds a particular patient difficult because they make offensive remarks about him being gay. The line manager responds by saying ‘let’s watch the situation’ (despite it being contineud behaviour) and suggests that the patient probably didn’t mean what they said. Failure to take reasonable steps and intervene is third party harassment.
- Lucy makes a formal complaint to the her line manager that some of the nurses are not particularly nice to patients. Subsequently, whenever the nurses send an email, they include all reception staff except Lucy. This is victimisation.
- James brings a formal complaint that some of his colleagues are treating him unfairly because of his sexual orientation. The complaint was upheld and resolved through the organistion’s formal grievance procedure. Although the poor behaviour because of his sexual orientation has stopped, he know feels ostracised – they don’t make jokes about him anymore but they don’t include him in things like socials. This is victimisation.
PROVIDING FOR PEOPLE WITH DISABILITY
The practice’s building provides the following to make life easier for the less able bodied.
- Wide access entrances
- A lift
- Specific parking bays near the front door
- A call system which is provides both visual (written display) and sound notification (beeps).
- 2 small loop systems for use with hearing aids
- Disabled toilets
IN TERMS OF RECRUITMENT…
When recruiting new staff the practice follows clear and transparent HR (Human Resources) principles designed to avoid discrimination. The practice uses panel interviews (min 2 but 3 preferred), with pre-set scored questions, being the same for each candidate. It is recognised that positive action provisions within the Race Relations & Sex Discrimination Acts does permit employers to take positive measures to redress under-representation. Though, this measure will only be considered and used when there is an identified specific requirement such as the mix of male and female Doctors because a proportion of the practice patients wish, for example, to access a female doctor for certain items.