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31 August 2022

Evidence-based guidance developed to support LGBT+ inclusivity in health and social care

Researchers from King’s College London, funded by the NIHR, have developed practical guidance to aid health and social care professionals to make their interactions inclusive of LGBT+ people.

rainbow flag

The paper, published today in the BMJ Quality & Safety, presents the results of interviews with 74 LGBT+ patients with serious illnesses, caregivers and clinicians.

Participants said creating positive first impressions, by using inclusive language and avoiding negative non-verbal signs, can help to build a positive relationship.

It was also recommended that clinicians should make questions about sexual orientation and gender relevant to care, for example to make sure they are receiving required screening invitations.

Another recommendation to improve care is to provide visible and consistent LGBT+ inclusiveness in care systems. Examples of this include standardising how LGBT+ related questions are asked and using systems that offer the choice to record sexual orientation and gender identity in clinical records to avoid repetition.

The researchers aimed to develop freely accessible guidance on improving communication around sexual orientation and gender-related matters by clinicians and educators. This is available on the King's College London website.

I am delighted that LGBT+ communities, patients, their significant others, and clinicians have come together to deliver this clear, evidence-based guidance. It is clear from the data that sensitive, person-centred communication is wanted and is possible. This guidance will help health and social care staff to overcome some of their concerns in how to conduct such conversations.

Professor Richard Harding, ACCESSCare-C Project Lead, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care

Earlier King’s research funded by Marie Curie led to this study. Dr Sabine Best, Associate Director of Research, at the charity, Marie Curie, said: “Resources like this are vital to improving the support LGBT+ people get from health and social care professionals. We’re proud that research from Marie Curie led to a study that informed this guidance to help professionals be more aware, confident and inclusive, which will lead to a better experience of care for LGBT+ people. At Marie Curie, we took the evidence-based recommendations from the first study in this programme to improve our own services. Having access to robust research to drive positive changes in practice is essential.”

A spokesperson from Stonewall said: “Stonewall welcomes these guidelines, and hopes they will be shared widely throughout the sector – they have the potential to make a huge, concrete difference to many LGBT+ people’s lives.”

Dr Michael Brady, NHS England National Advisor for LGBT Health and Consultant in HIV and Sexual Health, said: “There are very simple things that every health and social care professional can do to ensure they deliver inclusive care and meet the individual needs of LGBT+ patients and service users. This guide should be a ‘must read’ for everyone working in health and social care. I would encourage everyone to use them so, together, we can improve the quality of care we deliver and address LGBT+ health inequalities.”

Paul Roberts OBE, Chief Executive Officer of Consortium, said: “This guide is important for multiple reasons. Of course, it is going to be vital to ensure LGBT+ people get the right care from healthcare professionals, but so importantly it is rooted in evidence. This has been carefully researched and curated, making it all the more powerful. I hope everyone takes a moment to read it, digest it and act on the really helpful tips”

Paul Martin OBE, Chief Executive of LGBT Foundation, said: “Using open and inclusive language is significant when meeting the needs of LGBT+ people. Incorrect assumptions about someone’s identities, pronouns, relationships and families can create barriers and force people to correct assumption or leave them unaddressed. Using open and inclusive language is important for making LGBTQ+ people feel understood and accepted. The LGBT+ inclusive communication guidance will be a valuable tool for Health and Social Care professionals in ensuring that patients feel heard, acknowledged and that the support they’re receiving is person-centred”

Alex Matheson, NHS Rainbow Badge Programme Manager, said: “In our experience of supporting and assessing NHS Trusts around LGBT+ inclusion, we are consistently asked for guidance around inclusive language for healthcare professionals. Predominantly this is driven by a desire to provide inclusive care which is being tempered by a lack of confidence, fear of incidentally causing offence and insufficient training. This guide helps combat that by providing clear information, which centres the voice and wishes of the communities it is designed to support. We will be actively encouraging the use of this guide within all NHS Trusts engaging in the NHS Rainbow Badge Assessment Process.”

The ACCESSCare-C project team have shared findings at several conferences and will continue doing so with healthcare professionals and educators.

About NIHR funding

ACCESSCare-C was funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0816-20001), and supported by the NIHR Applied Research Collaboration South London at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care

The mission of the NIHR is to improve the health and wealth of the nation through research. We do this by:

  • Funding high-quality, timely research that benefits the NHS, public health and social care;
  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle-income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle-income countries is principally funded through UK Aid from the UK government.