Focus on pride in practice

19 October 2017

The standards for pharmacy professionals describe how safe and effective care is delivered through person-centred professionalism. In this article, we have teamed up with LGBT Foundation to highlight how pharmacy professionals can demonstrate person-centred professionalism in a variety of situations.

About LGBT Foundation and the LGBT communities

The LGBT Foundation is a charity delivering a wide range of services to lesbian, gay, bisexual and trans (LGBT) communities.

LGBT communities are diverse not only because they include people of different genders and sexual orientations but also because they are made of people from all parts of society.  LGBT people come from all backgrounds in terms of ethnicity, culture, age, socio-economic and professional status and degree of health awareness.

Not only this, but LGBT people are often ‘invisible’; some choose to be open about who they are, while others may have concerns about being too open because of fear or experience of discrimination.  All of these things affect how people in LGBT communities access health care.

The kinds of things that matter to LGBT people when they are seeking health services are that:

  • they are in a safe place where, if they choose, they can disclose information about their trans status, gender history or sexual orientation
  • assumptions will not be made about them simply because they are LGBT
  • information about them will be treated confidentially and they will not lose control over what other people know about them
  • they will be treated with respect, and in particular without discrimination or judgement

Delivering person-centred care                        

Every person is an individual with their own values, needs and concerns.  Person-centred care is delivered when pharmacy professionals understand what is important to the individual and then adapt the care to meet their needs.  This might include addressing the specific needs of people from LGBT communities.

Everyone benefits from care that is person-centred and co-ordinated around their needs.  However, evidence shows that LGBT people experience barriers in accessing health and social services due to a lack of understanding of their specific needs and a lack of targeted service promotion. Furthermore, research has also demonstrated that LGBT people are less likely to engage with health interventions and screening programmes if it is not explicit that they are welcome to access the service.

A lot of work has been done to identify the inequalities previously experienced by people using services. For example, NHS England has developed a clinical commissioning policy to ensure equitable access to mainstream services in England is achieved by assessing whether services are accessible and appropriate for LGBT people.

Pharmacy professionals have an important role to play as they are often the most frequent contact a LGBT person gets with a healthcare professional.  They are also ideally placed to make positive steps to support the health of LGBT people and to improve access to quality, inclusive care.  They could do this by examining their interactions with them, the pharmacy environment, and the policies and staff training on offer.  

Creating an inclusive environment

People receive safe and effective care when pharmacy professionals recognise and value diversity.  Pharmacy professionals should ensure that LGBT people are able to access services within a safe, inclusive environment where they are able to address any issues related to sexual orientation and trans status comfortably. 

A person’s health and wellbeing are dependent on pharmacy professionals working in partnership with them to develop and establish a trusting relationship. This includes respecting the choices they have made.

We know from the limited research into LGBT people's experiences of accessing pharmacy services that many travel away from home to use a pharmacy if they wish to reveal aspects of their LGBT identity.  Fifty per cent of all LGBT respondents had either experienced discrimination first hand or had formed an impression that a pharmacy near their home would not be welcoming to them.

When people receiving care are welcomed in a non-judgmental and inclusive way, they are more likely to remain engaged in the care they are receiving.  Staff training is one way to help to create a welcoming environment. 

Improving knowledge of the concerns LGBT people may experience with their health and the use of the right language may help LGBT people know that you are accepting and inclusive.  Making assumptions about gender identity or sexual orientation based on a person’s name or how they look or sound can isolate people.  The use of gender neutral language especially when asking questions can help prevent that.

In addition to the use of the right language, body language and tone of voice are also important and contribute to communicating effectively.

The importance of confidentiality

Pharmacy professionals must respect and maintain a person’s confidentiality and privacy.  Maintaining confidentiality is a vital part of the relationship between a pharmacy professional and the person seeking care. People may be reluctant to ask for care if they believe their information may not be kept confidential and this may be one reason why LGBT people don’t access the pharmacy services they need.

Through our recent standards consultation we heard from many organisations representing LGBT people.  One example given highlighted that work needs to be done to change the real and perceived barriers around confidentiality. 

Ask yourself:

- Are the people seeking pharmacy services aware of the importance of confidentiality, data protection and information governance within the pharmacy?

- Do they know that they may speak to a pharmacist confidentially, for example in a consultation room or behind a screen?

Supporting LGBT people

There are many ways to support LGBT people in your community.  Pharmacy professionals must respect and safeguard a person’s dignity and support LGBT people to access the services they need.

Signposting and providing information to LGBT people about local support organisations or being able to provide a support helpline number can be one way to help.

LGBT Foundation's Pride in Practice programme is working with community pharmacies to strengthen their relationships with LGBT people in the area, providing training and support packages for primary care services.  A key part of the Pride in Practice service are the views and experiences of LGBT people as these are central to how services are developed in primary care. The service focuses on small but meaningful changes that are easy for primary care outlets to implement while having a big positive impact on patients.

Displaying a LGBT friendly poster or the recognised rainbow sticker may also make LGBT people feel more welcome and accepted.  LGBT Foundation encourages all primary care outlets to put up one of their free, downloadable LGBT Foundation’s helpline posters in their waiting area so that LGBT people can see themselves represented.

Martin’s story

The poster led to a life-changing experience for one older gay man from Rochdale. Martin comes from an orthodox Jewish background.  He was married to a woman who he’d had two children with when he decided that he needed to be open about his sexual orientation and let himself be who he really was.

He first tried to come out to his wife, who responded very negatively and he ended up losing his home and access to his children. He then tried to come out to the local orthodox Jewish community, who he was very involved with, but he found that they rejected him completely.

He was feeling very low, with no family and no social support, and he considered ending his life.  Then he remembered seeing a poster up in his GP practice that said ‘lesbian, gay, bisexual and trans’ and he realised he could talk to his GP.

Martin’s GP was really supportive and referred him to LGBT Foundation’s specialist counselling service. Martin is now one of LGBT Foundation’s most active volunteers. When asked about how important that simple poster was, he said: “I wouldn’t have had the confidence to speak to my GP without the poster being up…”.

Many health professionals have reported that the posters have resulted in increased numbers of people coming out to them and this has improved relationships with those people as a result.

The poster helps people to be open and honest about who they are and what their health needs are.  Health professionals are then able to give them the best and most appropriate advice and treatment, such as encouraging trans people to access the appropriate cancer screening services and supporting same gender couples who are starting a family.

LGBT people are more likely to make a disclosure to their GP or pharmacist about their sexual orientation or gender identity, than they may be to other people.  Revealing their identity to another person is a big step for an LGBT person and listening and acknowledging this disclosure is very important for an LGBT person seeking help.

Find out more

  • The LGBT Foundation provides resources and information for all primary care practitioners  through Pride in Practice, a quality assurance support service that strengthens and develops your relationship with your lesbian, gay, bisexual and trans (LGBT) patients within your local community, including a free, downloadable poster
  • The Royal Pharmaceutical Society’s blog includes an article on London Pride 2017, which highlights research by METRO charity on the mental wellbeing of young LGBT people
  • In Scotland, The Equality Network aims to bring about equality and improve the human rights situation of lesbian, gay, bisexual, transgender and Intersex (LGBTI) people in Scotland, including  Scottish Trans Alliance a project to improve gender identity and gender reassignment equality, rights and inclusion in Scotland
  • In Wales, Stonewall Cymru helps to shape a country where people are free to be themselves, organisations help drive change, public attitudes improve, prejudice is challenged, and laws protect LGBT people.

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