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Tackling Inequalities and Discrimination Experiences in health Services (TIDES)

The Tackling Inequalities and Discrimination Experiences in health services (TIDES) study aims to understand how discrimination witnessed and experienced by healthcare practitioners is related to work and health outcomes, and how this may contribute to inequalities in health service use. TIDES is funded by the Wellcome Trust.

TIDES involves four interrelated projects:

  • Project 1 uses survey data and electronic health records to investigate inequalities in health service use.
  • Project 2 uses the findings from Project 1 to inform a quantitative survey and facilitate qualitative interviews with healthcare practitioners about both experiencing and witnessing discrimination to see what impact these experiences have on inequalities in health service use.
  • Project 3 builds on the findings from the first two projects to look at how healthcare practitioners interact with patients in virtual reality environments.
  • Project 4 involves talking to a range of stakeholders including carers, service users, healthcare practitioners, community members and policy makers about the findings from Projects 1-3. Stakeholders will review evidence, set priorities and develop guidance for an intervention framework to tackle discrimination experiences and inequalities in health service use.


Wellcome Trust Investigators Award

ESRC London Interdisciplinary Social Science Doctoral Training Programme (LISS DTP) CASE Studentship with NHS England. This project aims to understand the nature and impact of workplace violence on the mental and physical health of hospital-based and community nurses across ethnic groups, and the barriers to reporting these incidents, with implications for improving the recruitment of nursing students, work performance, and retention of qualified nurses. The project partners with NHS England Workforce Race Equality Standard (WRES) and builds on the Wellcome Trust funded Tackling Inequalities and Discrimination Experiences in health Services (TIDES) study, which investigates how discrimination experienced by both patients and healthcare practitioners may generate and perpetuate inequalities in health service use. Using a mixed-methods design to analyse TIDES data and follow up those who consented to be re-contacted, this project aims to:

  1. Explore witnessing or experiencing violence across ethnic groups both in and outside the workplace in terms of context, type, frequency, severity and perpetrator (Study 1).
  2. Examine the impact of workplace violence on mental and physical health, job satisfaction, work performance, and intention to stay in the profession and how it varies across ethnic groups (Study 2).
  3. Explore what procedures are in place for reporting violent incidents and what are the barriers and facilitators to reporting (Study 3).


2019 - Invited speaker, Racism in Healthcare, Swedish Forum for Human Rights, Linköping,  Sweden

2019 - Tackling Inequalities and Discrimination Experiences in Health Services: the TIDES study Division of Psychiatry, University College London

2019 - Discrimination, work and health among healthcare practitioners in London NHS trusts NHS England Workforce Race Equality Standard conference, Race and Health: The Evidence Base, Warwick University UK

2019 - International Migration & Mental Health, Migration, Mental Health, and the Mega-City (M3) conference, Geneva


Gazard, B., Chui, Z., Harber-Aschan, L., MacCrimmon, S., Bakolis, I., Rimes, K., Hotopf, M. & Hatch, S. L. (2018). Barrier or stressor? The role of discrimination experiences in health service use. BMC public health, 18(1), 1354.

Rhead, R., Chui, Z., Bakolis, I., Connor, L., Gazard, B., Harwood, H., MacCrimmon, S., Woodhead, C. & Hatch, S. L. (2020). The impact of workplace discrimination and harassment among NHS staff working in London trusts: Results from the TIDES study. Under review

Harwood, H., Gazard, B., MacCrimmon, S., Chui, Z., Rimes, K., Bakolis, I., Hall, J., Rhead, R., Hatch, S. L. (2020). Variations by ethnicity and migration status in referral and treatment pathways for IAPT service users in South London. Manuscript in preparation.

Chui, Z., Gazard, B., MacCrimmon, S., Harwood, H., Downs, J., Bakolis, I., Polling, C., Rhead, R. & Hatch, S. L. (2020). Inequalities in referral pathways for young people accessing secondary mental health services in south east London. Manuscript in preparation.

Rhead R, Woodhead C, Chui Z, Connor L, Harwood H, MacCrimmon S, Hatch SL. Intersectionality, discrimination and mental health service use in England. Manuscript in preparation.


Professor Stephani Hatch

Principal Investigator

Stephani is a Professor of Sociology and Epidemiology in the Department of Psychological Medicine, King’s College London and is the Principal Investigator of the TIDES study.  Stephani is also the founder of the Health Inequalities Research Network, which promotes integrated approaches to participatory research and public engagement in the community.

Dr Rebecca Rhead

Research Associate and Project Coordinator

Rebecca is a Research Associate in the Department of Psychological Medicine, Kings College London and has a PhD in Social Statistics. In her previous work she has used quantitative research methods to study HIV (particularly barriers to care and treatment adherence) as well as military mental health and treatment needs. Rebecca’s current work with TIDES focuses on harassment and discrimination in the NHS and taking an intersectional approach to patient healthcare inequalities.

Zoe Chui

Research Assistant

Zoe is a Research Assistant in the Department of Psychological Medicine, Kings College London and coordinates data collection for the TIDES survey. She has a BSc in Psychology and a MSc in War & Psychiatry. As part of the Health Inequalities Research Network, she runs public engagement activities with the local community to facilitate a dialogue on health inequalities.

Hannah Harwood

Research Assistant

Hannah is a Research Assistant in the Department of Psychological Medicine, King’s College London and coordinates the TIDES interview study. She has an MSc in Health Psychology and  BSc in Psychology, and prior to joining TIDES worked for three years on a variety of military mental health projects at King’s College. She is the lead coordinator for the South East London Photography group (SELPh), part of the Health Inequalities Research Network.

Luke Connor

Research Assistant

Luke is a Research Assistant in the Department of Psychological Medicine, Kings College London. He has a BSc in Psychology and a MRes in Research Methods. His main responsibility is the management and organisation of the Virtual Reality (VR) study.

Shirlee MacCrimmon

Database Administrator

Shirlee is a Database Administrator in the Department of Psychological Medicine, Kings College London. She has a BA in Psychology and a MLIS (Master of Library and Information Science).  She has worked at King’s College for six years; other studies she has been involved in include South East London community health, military mental health, and integrating mental and physical health.

Ioannis Bakolis


Ioannis is a Lecturer in Biostatistics at the Department of Biostatistics and Department of Health Services and Population Research. His research interests are focused on quasi experimental designs, causal inference, hierarchical models, multivariate and variable selection techniques and their applications in policy evaluation, life-course, environmental and mental health epidemiology.

Lucy Ensum

Research Facilitator

Lucy is the Research Facilitator for the TIDES study, and the Programme Co-ordinator for the HERON Network, in the Department of Psychological Medicine at the IoPPN, King’s College London. Lucy is an experienced administrator and project co-ordinator, working for leading London universities since 2010. She brings over 15 years of event management skills to help with the smooth running of the HERON Network engagement activities.

Key Collaborators

Dr Charlotte Woodhead (King’s College London, ESRC Centre for Society and Mental Health)

Yvonne Coghill OBE (NHS England, Director of Workforce Race Equality Standard implementation and Nurse by training)

Professor David R Williams (Harvard University, Sociology & Public Health)

Professor Nick Manning (King’s College London, Social Science, Health, & Medicine)

Dr Katharine Rimes (King’s College London, Psychology)

Dr Lucia Valmaggia (King’s College London, Psychology and Head of the Virtual Reality KCL Lab, King’s College Hospital)

Femi Otitoju (Director of Challenge Consultancy)

Professor Matthew Hotopf (Vice Dean of Research at the Institute of Psychiatry Psychology and Neuroscience; King’s College London, Director of the Maudsley Biomedical Research Centre; BRC)

Dr Mark Ashworth (King’s College London, Health & Social Care Research)

Professor Graham Thornicroft (King’s College London, Health Services & Population Research)

Dr Ioannis Bakolis (King’s College London, Biostatistics)

Professor Ruth Harris (King’s College London, Health Care for Older Adults)

Dr Geraldine Lee (King’s College London) Adult Nursing