Equality in Health and Social Care

What is equality in health and social care?

In simple terms, equality in health and social care means the same access to care and health services for all people irrespective of certain key factors.

These include:

• Age.
• Gender.
• Ethnicity.
• Background or social class.
• Sexual orientation.
• Lifestyle.
• The type of illness or care need.
• Impairment, either physical or mental.
• Religion or belief system.

Why is equality important in health and social care?

Good equality and diversity practices make sure that health and social care services are fair and accessible to all and that everyone is treated in the same way regardless of who or what they are or their lifestyle.

A robust and comprehensive equality and diversity policy is at the core of the provision of health and social care at both an organisational/management level and on a daily basis, with the provision of services by healthcare professionals and social care workers.

People’s differences aren’t necessarily celebrated or highlighted as something out of the ordinary; fair and equal treatment is something to shout about but it should never be viewed as a bonus, something incidental to the core provision of services, but it should be a right.

Equality in the provision of health and social care services is enshrined in several different pieces of equality legislation. We live in an ageing society in the UK. Age UK has produced statistics that reveal there are 12 million people in the UK aged over 65 with greater numbers of the elderly living into their 90s than ever before.

Many of these people have complex health and care needs. There are also approximately 1.5 million people in the UK with learning disabilities who regularly interact with healthcare professionals and social care services. Equality in the provision of health and social care services has never been more important.

How to promote equality in health and social care 

The promotion of equality in health and social care operates on two distinct levels. First, it must be inherent in the structure and policies of the care provider – it is a tangible ethos which can be demonstrated in up-to-date policies and procedures. Second, equality operates on an individual level every day, affecting how each patient is treated by their care worker and healthcare professionals.

No two people are the same and the equality in their care and treatment will be totally bespoke to their situation – as distinctive and individual as their fingerprint.

Inequality is the result of discrimination, and discrimination can be active or passive, so it can be overlooked or accidental. Staff should be educated in how to spot barriers and obstacles to equitable health and social care, and this should also be enshrined in management policies in terms of compliance and ongoing education. Understanding the barriers to equality in health and social care and being able to see them is essential to their removal.

Every health and social care setting should have a written equality and diversity policy. This should be implemented at management/service level and also circulated to all team members with compliance records showing that the policy is regularly seen by all staff at least three or four times a year and when there is an update issued.

There should be regular training offered in equality and diversity, and you can test staff knowledge using online quizzes and challenges, encouraging them to think about different patients and how they would approach their equality needs in your healthcare setting.

It is easy to make pre-judgements or assumptions when trying to make a connection with a new patient within a health or care setting; looking for a point of connection is the hallmark of an empathetic person but can cause unintended bias as it may be based on assumptions which might not be true. Even good intentions can result in accidental bias and lead to inequality.

Equality impacts every aspect of health and social care from the physical structure of the building to how each individual patient is perceived and treated. The focus should be on unique person-centred care; potential areas of discrimination are there to highlight and alert staff. Holistic care will automatically resolve any conflict points and ensure seamless equality for all patients.

Why is promoting equality important?

Promoting equality is very important in all areas of society but particularly in health and social care settings where many people are vulnerable. They may be disadvantaged by age or permanent impairments or on a temporary basis due to illness or disease which is why they are engaging with health and social care services. Equality means health and social care that meets the needs of absolutely everyone and is totally inclusive without discrimination.

It’s easy to pay lip service to promoting equality but discrimination can be subtle, passive or unintentional such as overlooking certain things or simple stereotyping. Discrimination can also be more overt such as direct labelling or unashamed prejudice. Valuing and understanding what makes people different is the first step on the pathway towards inclusion and equality and of being aware of how some differences can impact on health treatment and social care.

What does equal opportunities mean in health and social care?

Equal opportunities in health and social care mean that everyone should have access to the same medical treatment and social care; this is irrespective of any differences about them. Differences fall under the umbrella of diversity.

Understanding diversity is crucial to becoming inclusive and offering equal opportunities to all. Promoting person-centred care should always ensure that each individual’s personal and unique characteristics are at the forefront of the care plan or treatment and that social care and health providers are non-judgemental.

Person-centred care is holistic and looks at all the different aspects of an individual’s care including emotional and physical support and social and cultural influences.

What does equality mean in health and social care?

Equality recognises diversity and seeks to offer the same opportunities and access to health treatment and social care regardless of race, colour, gender, age or mental or physical health, or any other factor which may make somebody different.

Those people working in health and social care may be working with adults described as in need on a regular basis. The protected characteristics listed in the Equality Act 2010 apply to all adults classified as vulnerable; some have a more obvious and direct connection to health and social care than others, but they are still all relevant and applicable.

Understanding the protected characteristics in the statute make issues of equality easier to identify and rectify in a health or social care setting.

Religion and beliefs – Different faiths or religious beliefs may prohibit certain healthcare practices. This characteristic refers to any person following any religion, including atheism which is a form of non-belief. Different beliefs can and should affect how people are treated and will vary depending on the patient’s religion. Taking a one-size-fits-all approach will end up being discriminatory to people practising certain faiths. There is the Multi-Faith Resource for Healthcare Staff which allows healthcare professionals and carers to find out more about different faith groups and how this can impact on medical and social care.

Disability – Meaning a mental or physical impairment which may require a change or alteration to the method of care. Obvious ones include access to clinics and treatment premises, and providing information in a different format such as audio or Braille. Mental capacity can be problematical and complex as some people are neither able to understand the care choices being offered or to decide on an appropriate care pathway. The Deprivation of Liberty Safeguards (DoLS) allow as much control as possible for people who don’t enjoy full mental capacity.

Age – Age affects care needs. It sounds obvious but it is easy to overlook and also easy to make assumptions when presented with a patient of a particular age in a health or social care setting.

Race – Someone’s nationality, colour or ethnicity may require a tailored response which is sensitive to needs and cultural differences. Don’t assume that certain ethnicities may not speak English well or follow other assumptions about different nationalities.

Here are some examples where equality is challenged or not present in a health or social care setting.

• Running a social event for patients in a particular group which is at a venue where there is no access for disabled or physically impaired people who may have difficulty with their mobility or be in a wheelchair.
• Setting kitchen hours in a healthcare setting where there is no provision for people to have access to food at unusual times, such as a Muslim patient who is fasting during the period of Ramadan and who will only eat outside of the hours of sunlight which may be when the catering staff are not available.
• Providing entertainment within a care home setting where there are residents with hearing and visual impairments who are not catered for.

What legislation in health and social care covers equality?

Equality is an issue across society at large, so not all of the relevant legislation is specifically focused on the health and social care sector. Here are the statutes which are applicable to equality in this context.

The Equality Act 2010 – This legislation lists nine specific characteristics based on which discrimination cannot occur in any setting. Discrimination can be present with just one or multiple characteristics.

The characteristics are:

• Disability.
• Age.
• Marriage and civil partnership.
• Pregnancy and maternity.
• Race.
• Religion and belief systems.
• Sex.
• Gender reassignment.
• Sexual orientation.

The Mental Capacity Act 2005 – This Act contains safeguards called the Deprivation of Liberty Safeguards, or DoLS, which are there to protect people who lack mental capacity and who are unable to look after or maintain their own independence, dignity and their right to freedoms. The Mental Capacity Act cares for people who struggle to make their own decisions; it protects them whilst fostering an environment where they can be as independent as possible.

The Human Rights Act 1998 – This is an overview of all the basic human rights and tenets of equality and covers how people should be treated by the state and by public authorities. This statute introduced the concept of ‘FREDA’ which is an acronym for Fairness, Respect, Equality, Dignity and Autonomy.

The Health and Social Care Act 2012 – This gives patients a greater voice in their care.

The Care Act 2014 – The Care Act combines care and support legislation in one statute and aims to put people’s wellbeing at the centre of decisions. The Act provides six principles to support those who work with vulnerable adults. The support must be personal and specific to that adult, chosen by them and with their full consent.

Equality legislation provides a context and framework to promote equality and inclusion in the health and social care sector. The strive for equality is present in all aspects of our daily lives, running through our societal structure like a pattern through marble, but it is never more important than in a health and social care setting.

This is because equality is present to protect the most vulnerable who are disadvantaged either by something permanent like age or a physical or mental impairment or a temporary condition caused by illness or disease.

Because our society in the UK is so diverse, it has never been more important to be inclusive; inclusivity can sometimes be challenging and not obvious, and so discrimination is sometimes therefore unintended or accidental.

So, what is equality in health and social care? The meaning of equality in health and social care is represented by an open door for all and holistic treatment which embraces all diversity.

Equality legislation provides a robust framework for health and social care providers to implement equality protocols and cascade this to staff and workers. But rather than being just a policy or protocol prescribed by management or healthcare seniors, equality in health and social care should be person centred.

It also impacts on other key areas such as health and safety and safeguarding. Equality in health and social care is an attitude of mind and should be present in every aspect of a person’s treatment.