This information is for the attention of all NHSGGC staff involved in the treatment and care of Black and Minority Ethnic patients (BME). Following these guidelines will help ensure that our BME patients access the services and treatments that meet their needs.
Around 5% of our BME patients do not speak English. This group of patients have additional barriers to accessing our services that must be addressed.
Getting It Right for BME patients – Core Elements
Expectations for all NHSGGC staff
Treat people fairly – treat BME people fairly and without prejudice or stereotyping. NHSGGC has a zero tolerance policy on discrimination.
Know your community – have knowledge of the local community who may use their service, including an ethnicity and language breakdown.
Collect ethnicity data – always collect the ethnicity of patients using your service. This is mandatory in Scotland for Acute services. TrakCare care and EMIS enable you to record the ethnicity of people who use our services in the demographics pages. People can say ‘prefer not to say’ but we need to ask all people who use our services. Anyone who comes into contact with a patient and has responsibility for checking their demographics to confirm identification and should update their details including ethnicity. Patient demographics which includes ethnicity should be checked on every visit for every patient to a hospital to ensure it is fully updated. If available on paperwork prior to visit e.g. through a GP Referral, then whomever is logging this on the system should update demographics. The patient does not always need to be present for the first update. All patient must have their ethnicity recorded.
Prepare translated resources – have resources about your service ready, including consent to treatment forms, for your BME patients who may not speak English. Have a stock available in the languages you use most and know how to access others when required. For more information go to Clear to All.
Know how to access interpreting support – It is our responsibility to provide interpreting support for any patients using our services. Support is available either via telephone or face to face interpreters. For more information go to Interpreting Services
Ensure patients know how to access interpreting support – patients who don’t speak English can use our telephone interpreting service to call your or any other NHSGGC service. Patient leaflets are available for immediate download in 40 languages. See Direct Patient Access information. Other languages can be provided for your patient.
Get feedback from BME patients – ensure that any patient engagement is inclusive of BME communities, including non-English speakers
Know how to access staff training that covers race equality – you can log in to LearnPro for the statutory and mandatory equality training
Source: Joseph Rowntree Foundation
Know your population
NHSGGC’s BME population
The 2011 Census provided evidence of the changing ethnic composition of NHSGGC.
In 2011, the BME population in NHSGGC was 7.5% (an increase for 3.6% in 2001). This ranged from 14.2% in Glasgow South area to 1.4% in Inverclyde.
In Scotland as a whole, 4% of the Scottish population were from a BME group.
The largest BME group in Greater Glasgow and Clyde was Asian (Asian, Asian Scottish or Asian British) which made up 5.3% of the total NHSGGC population.
The largest sub-group within the Asian population were Pakistani, which made up 2.4% of the total BME population in NHSGGC.
The 2022 census ethnicity data is due to be released in summer 2004 and will be available here when published. This is likely to show an increase in our BME population.
Community Languages
About 5 in every 100 people admitted to our hospitals as inpatients do not speak English.
NHSGGC has over 100 language groups that use our services. The top 10 languages are currently:
Arabic
Urdu
Polish
Mandarin
Romanian
Farsi
Punjabi
Kurdish Sorani
Cantonese
Slovakian
Your service’s patient population may not reflect these main language groups so it is important to monitor this. For example, a patient population which is mainly drawn from refugees and asylum seekers will have a different language profile.
Engagement
Services need to establish an understanding of needs by engaging with BME patients and staff to identify issues for BME patients in our services. This can include data collection around ethnicity. It is important to note that all of us have an ethnicity and therefore all patients should be asked their ethnicity in our services.
Services should regularly engage with patients to understand what they think about the services we provide. It is important to include BME patient specifically in patient engagement to ensure their voice is heard in how to improve services. Speak to the Board’s Patient Experience and Public Involvement Team (PEPI) for advice.
Taking an anti-racist approach
Taking an anti-racist approach means ensuring that how we behave or design and operate our services does not discriminate against BME people.
Discrimination means treating people less favourably due to their colour, nationality (including citizenship), ethnicity or national origin (Equality Act (2010)). We all have an ethnicity.
As NHSGGC staff we need to recognise that racism – or any form of discrimination – is a fundamental cause of poor health in affected populations.
We need to create an environment free from racism and stereotyping. We have a responsibility to deliver Person and Family Centred Care to all our patients, based on their individual needs and best practice. Do not make assumptions about a patient’s needs – ask them.
It’s important to recognise that being in the majority group brings with it a sense of power and belonging that BME people may not feel. Pointing out perceived differences in appearance, describing BME patients as ‘not our patients,’ ‘not belonging here,’ or as ‘foreign’ when they were born here, all contribute to ‘othering.’
This ‘othering’ can often take the form of using offensive language. Sometimes people will describe certain language as ‘banter’ or ‘having a laugh,’ which can make it difficult for someone to challenge. It is important to always speak up and address the use of offensive language that may be heard in our services.
Racism is classed as a Hate Incident or Hate Crime and should be reported through the NHSGGC Datix Incident reporting system
Inclusive Care
Patient Information
Provision of patient information is a key aspect of health services whether this is written, verbal or in other formats.
Services should assess all patient facing written information to ensure it is accessible.
Identify the core information patients will need and have this available in plain English before requesting translations through the Clear to All service. Clinical letters, diagnostic instructions and compliance-related written information specific to an individual patient can also be translated through this service.
Some patients will wish to take home information about their condition in English, as well as the language they read. This is so family members who read only English are aware of the details.
If your service has high numbers of service users who do not speak English, identify the language profile over a few months and decide on an appropriate stock of your core service information in community languages. For example, in the NHSGGC area there are over 100 languages in use. Maternity Services reviewed their language profile and identified that their service information should be translated and made readily available in at least 10 community languages. Any language out with this list could then be requested via Clear to All as required.
Please be aware if your leaflet is providing additional information through links to English language websites. If the information is integral to the content, it should be translated and provided separately. Otherwise, the leaflet should include a statement to say, ‘If you are unable to access the information on this site, please speak to your clinician’.
All patient leaflets should include the NHSGGC statement regarding availability in accessible formats. For more information go to Alternative Format/Language text section at Interpreting & Language Resources.
When you have completed your review of your service leaflets and implemented this approach, ensure that all staff are aware of how and when to use patient information.
Consider, when making new resources, how this will be translated. This particularly relates to audio and video resources. Liaising with Clear to All is essential to establish the most suitable format. Videos can be voiced over (not subtitled) in community languages but ensure the images used in videos represent our diverse population.
Provision of Interpreting Support
It is our responsibility to provide interpreting support for any patients using our services. All staff should therefore have good awareness of and confidence in using the NHSGGC Interpreting Services.
Support is available either via telephone or face to face interpreters. For more information on how and when to use the service, and resources such as, How to Access Interpreting posters, go to Interpreting Services
Patients who don’t speak English can use our telephone interpreting service to call your or any other NHSGGC service. Please ensure that your patients are given an information leaflet explaining this service in the appropriate language. Leaflets are available for immediate download in 40 languages and can be requested if not currently available. See Direct Patient Access information.
If you or your service would like to attend training on how to use interpreting services, go to our training webpage.
Barriers to Accessing Services
Adopting a flexible appointments system will help ensure that non-English speaking patients have the time they need to communicate and understand any exchange. This also applies to anyone who needs additional time to speak or who uses communication support e.g. patients who have a learning disability, speech difference or British Sign Language user.
Cultural and social issues may be an additional barrier to accessing certain services for some BME communities. For example, there is not a specific word that means ‘depression’ in certain languages, including Punjabi, Urdu and Hindi. The stigma or lack of understanding of mental health problems may be a prohibiting factor for some individuals accessing any NHSGGC services. Also, if patients experience negative or racist attitudes from staff, this will prohibit them from engaging effectively with health services.
If there is a NHSGGC registered healthcare chaplain available on site, they can assist in supporting staff and BME patients and if appropriate, can access specific faith leaders that may provide reassurance for some BME patients. Visit our website for more information.
Community isolation may be a barrier for individuals from smaller BME groups or people who have sought asylum. These individuals may have little or no understanding of the availability of services or how they are provided. This can result in isolation from many statutory services, including the wider health services. Issues relating to migration status can exacerbate such problems.
Your service may work with particular voluntary organisations who could help with considering how best to reach and engage with BME communities. Organisations who can support staff include the Integration Networks e.g. Maryhill Integration Networks, Amma Birth Partners, Red Cross for asylum seekers and refugees.
Acute Patient Pathway – Issues to consider
Pre-admission/Admission
Where possible, ensure staff are aware of your patient’s additional support needs and condition history before they attend. SCI gateway referral letters should highlight if an interpreter is required and any other additional needs.
At times, however, this may not be listed on the referral letter.
It is good practice for staff to routinely ask, “Is there anything I need to be aware of when planning your care?” This may include barriers to accessing appointment times, preferred communication methods/support or issues with travel costs.
Ensure that the patient’s interpreter needs are recorded in the ‘demographics’ on TrakCare and not only on an alert. Update TrakCare if you have a patient who does not speak English and you were unaware of this before they attended their appointment.
Use telephone interpreting if a face to face interpreter was not secured, even to just re-appointment and explain what is happening. Telephone interpreting can be used for the majority of NHSGGC appointments.
Patients who require any kind of communication support will need flexibility within their appointment. Please provide this time to ensure that patients using an interpreter fully understand the information being conveyed and have the opportunity to ask any questions. Make sure that what you have said has been understood.
For face to face interpreting support, check if the patient has stated a preference for the interpreter’s sex.
Do not use family members or bilingual staff as interpreters. Do not use Google translate.
More information on NHSGGC’s policy regarding interpreting support can be found in the policy document.
During Stay
BME patients and carers should be supported and empowered to have their say regarding co-produced care and treatment plans.
Understanding the parameters of our services is important to all our patients. Staff should ensure that the patient understands the service or treatment and why they are receiving it to ensure compliance and consent. Checking that this information is fully understood will maximise benefits to the patient.
Do not exclude non-English speaking patients from group work – they should be offered every part of the patient pathway in line with English speaking patients. The Interpreting Service can offer interpreters who are particularly skilled at working in group settings and can advise staff accordingly.
Discharge
Check that your patient fully understands their discharge plan in terms of clinical follow-up, self-care and supports in the community. If interpreting support is required for this, note that this intervention will take a longer time to complete.
It is vital to use interpreting support at the point of dispensing medication to ensure your patient understands the purpose of their medications and when and how to take it.
Information prescriptions have been used to support this in some services, with translations made as required. Ensure your non-English speaking patient knows how to call back to the pharmacy if they have any questions about their medication, using the direct access telephone interpreting service.
BME communities in NHSGGC have high rates of poverty, and many patients can find themselves going home to difficult circumstances. Please use the Money Worries web page to access simple NHSGGC referral pathways to money advice services and interventions such as the Home Energy Crisis Response Service.
Supporting Information
Clear to All – accessible information guidance and support
This information is for all staff involved in the treatment and care of Autistic patients in NHSGGC.
Using these guidelines will help ensure that Autistic people are enabled to access services and undergo treatments in a manner which fully addresses their needs.
What is Autism?
“Autism is a lifelong developmental disability which affects how people communicate and interact with the world”.
“Autism is not a disorder… it is a neurological difference: one with a unique way of thinking and experiencing the world.”
These quotes indicate the range of opinion which exists when seeking to define Autism or being Autistic. One firmly describes Autism as a deficit based disability whilst the other considers Autism as part of the broad range of neuro types (Neurodiversity) which exist in the world.
You may often hear the term “Autism Spectrum” which reflects the range of ways someone can experience being Autistic. It is different for everyone. Some people will require very little or no support with their day to day life whilst others may live in a supported environment. Many people will have levels of support somewhere in between and these needs may vary over time.
Identifying Needs – the Autistic SPACE Framework
The variability in the experiences of Autistic people can make it difficult to create a standardised approach to patient care. The Autistic SPACE framework has been developed by Autistic Doctors International to encompass the breadth of autistic experience and healthcare access needs.
Sensory needs – Sensory sensitivities are common to almost all Autistic people but the type of and degree to which people experience these varies. Hypo or hyper-reactivity to any sensory stimuli is possible and can vary contextually.
Predictability – Access to healthcare is best maximised for Autistic people when the environment and context is made as known and predictable as possible. Sudden or unplanned change is particularly difficult.
Acceptance – It is important to have a holistic approach, in which Autistic characteristics are understood and accepted.
Communication – Autistic people communicate differently. Many use fluent speech, but may experience challenges with verbal communication at times of stress or sensory overload. Others may be non/minimally speaking and use augmentative and alternative communication methods, including visual cards, writing or electronic devices.
Empathy – Autistic people do not lack empathy but it may be experienced or expressed differently from people who are not Autistic.
Physical, Emotional and Processing Space
Autistic people may need more physical space. Proximity to others, particularly within touching distance, is often difficult to tolerate.
Identifying, processing and managing emotions can be challenging, particularly when Autistic ways of expressing emotions are not understood. Sensory overload or overwhelming emotions may lead to Autistic meltdown or shutdown. Considering this will minimise risks, but if it occurs, the best approach is often to allow space to recover.
Understanding that Autistic people may need additional time to process new information or unexpected changes when compared to non-Autistic people is invaluable in improving the accessibility of healthcare.
Autistic Meltdowns/Shutdowns
A meltdown is an intense response to an overwhelming situation. It happens when someone becomes completely overwhelmed by their situation and can lead to a temporarily loss of control of their behaviour.
Whether in terms of outward expression (meltdown) or inward expression (shutdown), this is often brought about by lack of consideration of the Autistic SPACE principles outlined here.
Neither of these things should be viewed as challenging behaviour but if they do occur the best approach is often to allow space for the person to recover.
Experiencing persistent meltdowns/shutdowns can lead to Autistic burnout, characterised by pervasive, long-term exhaustion, loss of function, and reduced tolerance to stimulus. Application of the Autistic SPACE principles can help go some way to reducing this. For further information and advice on Autistic meltdowns, see the National Autistic Society website.
Acute Patient Pathway – Issues to consider
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Pre-admission
Give as clear a picture as possible of what the person can expect to happen.
Information (in appropriate formats) should include an explanation of processes and medical terminology. It should also, where possible, include routes to buildings/clinics from point of arrival at the hospital.
If there is sufficient advance notice of the admission, offer the opportunity for a pre visit or additional information to reduce anxiety levels about the experience. This will also aid staff understanding of what is required to improve a patient’s journey.
If it is an outpatient appointment, try to give an Autistic person appointments at less busy times of day. This may help reduce stress levels caused by busy environments.
Admission
Is the reception desk in a noisy or brightly lit area? Is there a lot of information for the Autistic person to process? Consider using a quieter, less brightly lit space for admission and allow time for the person to ask questions and process what they are being told.
If there has been no opportunity to chat or answer questions prior to admission, staff should take extra time to ensure the Autistic person (and where relevant their family/carer/partner) has understood what is happening. Speak clearly, giving the Autistic person time to process the information. If someone is non-verbal do not assume that they do not understand what is being said.
During Stay
If the waiting area is brightly lit or noisy consider the use of a quieter, less brightly lit space. Also take into account any smells; is it possible to minimise this?
Explain any examinations or processes to be undertaken during the stay. If an Autistic Person has a carer, enlist their support but do not talk over the Autistic Person.
Any changes which need to be made should be clearly explained to the person as soon as possible. This will give time to enable an Autistic person to process the changes and feel more comfortable.
Consider where the Autistic person will be during their stay in terms of lights, sounds and smells. If necessary try to allocate a quieter less brightly lit space away from strong smells.
If it is not possible to find an alternative space, consider what can be done to lessen the environment and sensory influences. A single room can be easier in terms of lessening light, sound and smell. Encourage use of noise cancelling earphones or ear buds. – Many Autistic people will have these but may not be sure of using them in the environment; consider providing such equipment. Some Autistic people also wear dark glasses to lessen the impact of bright light.
Ensure that the Autistic Person is aware of the position of other relevant facilities such as toilets (Accessible toilets if necessary).
Over-stimulation of an Autistic Person’s senses may lead to “stimming”. Stimming is a self-regulatory behaviour intended to soothe or steady an Autistic Person. This can take many forms including humming, rocking and hand-wringing or flapping but will vary from Autistic person to Autistic person. It may also involve the use of stimming tools (sometimes called stim toys) such as fidget spinners or rings and squishy toys or just something the person finds comforting. Not all Autistic people visibly stim and it may go unnoticed by others if it takes a less visible form.
Be aware that a previously vocal person can also shut down when under stress, becoming less able to communicate.
Discharge
When the appointment or hospital stay is over, be clear about what will happen next, including any timescales and the need for follow up.
Take time to go through any information that an Autistic person may need and ensure that it is in a format which is suitable for them. Go through the information with the person if necessary, ensuring you check their understanding. Take special care to ensure any medical terminology is explained.
Good Practice example – RAH Day Surgery
Autistic patients can enter the unit via an alternative entrance which enables a less stressful start to their appointment/stay.
Within their six bedded wards, staff at can pull their dark curtains around individual beds to create more privacy and lessen sensory input. They can also reduce lighting in the individual areas.
All staff in NHSGGC should feel safe, respected and valued.
Our workplace should be a place where discrimination is unacceptable and where everyone has the chance to thrive, regardless of their background or identity.
Our anti-racism campaign is based on the words of our own staff from their experiences at work. NHSGGC is an inclusive employer and there is no place for racism in our services.
Racism takes many forms, from stereotyping to blatant harassment, physical harm and direct discrimination.
‘Everyday racism’, such as thoughtless, demeaning or offensive comments, can be subtle and difficult to challenge. For example, constantly being asked “Where are you from?” when generations of the family have been born in Scotland. Or hearing a mimicked accent in workplace banter.
It’s up to all of us to stand against racism. Here are some ways we can make a difference.
Speak Up!
If you witness racism, don’t stay silent – challenge it.
If you’re able to – and feel it’s appropriate and safe to, speak up in the moment and address the colleague or patient that is demonstrating racist behaviour.
If the moment has passed, you can still speak up. Don’t let casual racist comments or asides go by. Focus on how it’s made you feel rather than labelling the behaviour – this increases the likelihood that the person will listen and learn. For example – “I felt really uncomfortable when I heard the comment you made during that meeting. What did you mean by that?”
If racism is directed at your colleague by a patient, offer support to your colleague.
If you don’t feel you can intervene in the moment, record the incident by writing it down as soon as possible. Follow it up later by checking in with the colleague the behaviour was directed at to see if they’re ok and if they would appreciate support.
It’s really important to report any incidents. Speak to a senior member of staff or contact the HR Helpline directly. See Report It section below.
Get confident about speaking up! Attend our Active Bystander Training and learn how to effectively intervene in situations of racism and discrimination.
Support Colleagues
It’s not enough to simply not be racist. NHSGGC staff must be actively anti-racist. This means being an ally to those who experience racism by listening, acting and working together to address injustices.
Educate Yourself
Increase your confidence in taking action by getting to know the issues.
Listen to the experience of black and minority ethnic people
Understand the sensitivities of language and get people’s names right
Find the similarities and the things we have in common; respect the differences
Make space for those who are often not heard
Confront your own biases and stereotypes
Be an Active Bystander
If you witness racism of any kind it is your responsibility as an NHSGGC staff member to take action.
Commit to taking positive action when witnessing unacceptable behaviour.
Gain confidence on how to intervene by attending Bystander Training and ensure any incidents are reported.
Listen to and Support Colleagues Directly Affected by Racism
When someone shares their experience of racism –
Listen – Remember that this moment is not about you and your feelings.
Don’t compare – Making comparisons to your own experiences can feel invalidating to the person who is sharing.
Don’t dismiss – A response like, ‘I’m sure they didn’t mean it’ can feel to the person sharing like you’re minimising or brushing off their experience.
Acknowledge – Statements like, ‘I’m sorry you experienced that’ or, ‘No one should have to go through that’ help the person sharing feel heard and validated.
Support – It can mean a lot for someone to hear a simple statement like, ‘I’m here for you.’
Adapted from Amnesty International
Raise Awareness of the Issues
Listen to people with lived experience of racism and amplify their voices.
Share your actions with colleagues, friends and family and encourage them to join you.
Report It
Anyone can and should report a racist incident.
If you believe you or one of your colleagues has experienced racism, call our HR Helpline on 0141 201 8545. Mon – Fri 9am to 4pm (Thurs 12pm to 4pm)
Any member of staff who experiences racism from a patient in their professional role or witnesses it, should report it to their line managers and document it on Datix.
Where a perceived criminal offence has taken place Police Scotland should be contacted and the incident number included in the Datix report. If it’s not an emergency (if there is no immediate risk to the wellbeing of the individual) you can call 101 and make a verbal report to the police. Call 999 in an emergency situation.
Get Involved
Make sure your team makes a statement by displaying your own, personalised Stand Against Racism poster
Speak to your colleagues and manager and get agreement to sign up your ward / service.
Contact us at ggc.standagainstracism@ggc.scot.nhs.uk for a copy of your personalised poster, write your team name in the space provided and display it where everyone can see.
Please also send us a photo for our ‘See Who Has Signed Up’ gallery!
Join the BME Staff Network
Join the BME Staff Network to connect with colleagues, share experiences and support each other. You can join as a BME member of staff or as an ally.
Follow and Support Anti-Racism Activities
Ask the Equality and Human Rights Team at equality@ggc.scot.nhs.uk for guidelines on how to ensure your ward or service doesn’t discriminate against BME patients.
Keep informed through social media campaigns and commentators.
Support drives for change and demand action by signing up to campaigns and petitions.
What is a Hate Crime?
Hate crimes are crimes that are motivated by prejudice of some kind. These are crimes where the victim is targeted because they are a member of a particular social group or have a particular characteristic, which the perpetrator has negative views or beliefs about. The legal definition is:
“Any crime which is understood by the victim or any other person as being motivated (wholly or partly) by malice or ill will towards a social group.”
With the introduction of the Hate Crime and Public Order Act (2021) in April 2024, the law recognises crimes motivated by prejudice based on someone’s:
Age
Disability, including physical disability, learning disability and mental health difficulty
Race (including nationality, ethnicity and skin colour)
Religion
Sexual Orientation
Transgender Identity
Variations in Sex Characteristics
These groups suffer disproportionately as victims of harassment and crime and much of this is motivated by prejudice. In addition to the effect on the individuals experiencing the hostility, these incidents create mistrust and suspicion between communities. This makes hate crime an issue for every service and every community.
Everyone has a role to play in stopping hate crime. If an incident is perceived by the victim – or any other person – as being motivated by prejudice or hate then it should be reported as a hate crime.
Watch the following video for more information.
Reporting Hate Crime – everyone’s business
Help & Support for Victims
Many hate crimes go unreported for a number of reasons.
For many people, exposure to abuse is a life-long experience and not perceived as crime.
Some people may know the perpetrators and be frightened of the consequences of reporting. They may even be suffering at the hands of people claiming to be their friends.
Some people may have a fear or mistrust of the police. Others may have previously reporting a hate crime but feel it wasn’t taken seriously.
If you are in a position to talk to people who may be at risk of hate crime then ask the question. Many people will want to be asked but are never given the opportunity to disclose.
If someone discloses a hate crime to you there are steps you can take to support that person to make a formal report even if they don’t want to be identified.
If you witness a hate crime you can contact the police and report it. This can also be done anonymously
How to Report a Hate Crime
If it’s not an emergency (if there is no immediate risk to the wellbeing of the individual) you can call 101 and make a verbal report to the police.
Hate Crimes can be reported anonymously. If you are working with a patient or client who does not want to give name but wants you to support them to report it you can assure them of their anonymity.
This may mean Police are restricted in the action they can take, but just reporting a perceived offense will allow Police to target resources to a particular area so you may see things like an increased police presence.
A Hate Incident field should be selected and completed under the category ‘violence and aggression’. Incidents are regularly reviewed by NHSGGC’s Violence and Aggression Team and any developing trends or ‘hotspots’ can be identified and appropriate interventions made. Local managers with reviewing and approval responsibilities will interrogate the Datix reports and ensure appropriate outcomes are achieved.
FAQs about Hate Crime
What is a Hate Crime?
Hate crimes are crimes that are motivated by prejudice of some kind. These are crimes where the victim is targeted because they are a member of a particular social group or have a particular characteristic, which the perpetrator has negative views or beliefs about.
In Scotland the law recognises crimes motivated by prejudice based on
Race (including nationality, ethnicity and skin colour)
Religion
Sexual Orientation
Disability, including physical disability, learning disability and mental health difficulty
Transgender Identity
Do I have to give my name to make a report?
No you don’t. Hate Crimes can be reported anonymously. This may mean Police are restricted in the action they can take, but just reporting a perceived offense will allow Police to target resources to a particular area so you may see things like an increased police presence. If you are working with a patient or client who does not want to give name but wants you to support them to report it you can assure them of their anonymity.
The incident happened weeks ago…can I still report it?
Yes you can. If an incident is happening there and then, you need to call 999 and report it immediately to the police, but if it happened in the past you can still call 101 – the police non-emergency number and report it or go online and complete the hate crime reporting form.
What if I’m not sure if it is a Hate Crime?
It is not your responsibility to prove that a hate crime has occurred. It is the job of the police to gather evidence from a range of sources during their investigation of an incident. This includes CCTV footage, witness statements and forensic evidence.
The Lord Advocate has told the police that an incident must be investigated as a hate crime if it is perceived, by the victim or any other person, to be aggravated by prejudice.
This means that your perceptions are important. When you report a hate crime, tell the police that you believe it was motivated by prejudice and why you think that is the case. This could be about the language used at the time, things you have heard the suspects say in the past or that certain groups are being singled out in your street / building, etc.
Why do we need Hate Crime laws?
The Scottish Government Working Group on Hate Crime gives 3 reasons for having hate crime legislation.
Research consistently shows that some social groups are proportionately more often victims of harassment and crime and that much of this is motivated by prejudice against those groups
Hate crimes can cause more psychological damage to a victim than crimes that are not motivated by hatred, because the victim’s core identity is being attacked. This personalises the crime and can cause the victim a greater amount of distress.
Hate crime is socially divisive. Such crimes need to be particularly condemned in order to avoid a situation in which the relevant group feels victimised as a group, with members in constant fear of attack. Prejudice against groups can lead to a number of consequences, ranging from fear of crime and inability to participate in normal social activities to paranoia and vigilantism
Staff Resources & Training
We Stand Against Hate – A3 posters and A5 leaflets encouraging hate crime reporting. Contain QR code link to the Hate Crime web page. For copies contact equality@ggc.scot.nhs.uk
Responding to Hate Incidents – An Employee Guide A guide for NHSGGC employees on the organisational position in relation to hate crime, what to do if you are a victim of or witness to a hate incident or if a hate incident is disclosed to you in the course of your work.
Hate Crime Reporting – E learning module The module covers topics such as types of hate crime, why hate crimes go unreported, why hate crime laws are needed and support for victims. Go to the Learn Pro home page and search for GGC 056 Hate Crime.
Hate Crime Awareness Session on MS Teams This short session gives participants an understanding of what hate crime is and how to report if witnessed in the workplace. It is an important safeguarding learning opportunity for all members of staff working in frontline roles. To view dates and to register, please visit our Staff Training page.
We have to challenge prejudice and its consequences when we see them. Hate crime is not within our responsibility to dismiss. We must listen to victims. Too often I hear that experiences are minimised, and I will not accept that. It is not “part of the job” to be abused, or stand by when others are victimised. We are a diverse and amazing organisation, with such potential to arise and use that diversity for good.
We must challenge hate and overcome our own discomfort about “making a fuss”. Standing up for the vulnerable and the marginalised is not making a fuss, it is the foundation of a better place for us all.
Amanda Law, Chair of the LGBTQ+ Forum
Hate crime continues to exist and it has no place in our organisation. Within NHSGGC we strive to treat people with care, compassion and kindness. It’s our responsibility to stand up, call it out when we see or hear it. By doing this, we halt the haters and protect and empower others. Let’s all do our part in creating a culture with diversity and equity at its core.
Sajid Farid, Chair of the BME Staff Network
Hate crimes are a blot on the beauty of diversity that should be cherished. We must stand together against the forces of intolerance and bigotry, for only by showing kindness and empathy can we weaken the roots of hate. Together, we can create a future where every race is welcomed, every culture is honoured, and every heart is filled with love.
Ann Cameron-Burns, Employee Director
Nobody comes to work to face abuse because of who they are, what religion they follow, who they choose to love. I’m proud that we all stand together to stop hate. That’s the only way to eliminate it – give it no place to hide and grow.
Anne MacPherson, Director of Human Resources and Organisational Development
We all need to stand up to Hate Crime when we see or hear it. If left unchallenged it can take hold and undermine the great community we’re all part of. Our NHSGGC family is 40,000 strong. We can use that strength to make sure hate has no place in our workplace.
Alastair Low, Hate Crime Lead, Equality & Human Rights Team
It’s really important that people understand what a hate crime is so that when they see or hear it they can call it out and challenge it. We have the systems in place in NHSGGC to deal quickly with the perpetrators of hate crime so we can all step up and make a difference.
Jane Grant, Chief Executive
Many hate crimes go unreported due to fear, mistrust or not recognising that a crime has been committed. If we witness or experience an incident that we believe is motivated by prejudice then it is vital that we report it as a hate crime. This will ultimately help create a safer workplace and build stronger communities for us all.
The Scottish Women’s Health Plan
The Women’s Health Plan (2021-2024) reinforces the actions to be taken to improve women’s health and address inequalities. These include raising awareness around women’s health, improving access to health care and reducing inequalities in health for girls and women, both for sex-specific conditions and in general health.
The Plan is part of wider work being undertaken across the Scottish Government to improve women’s health, particularly with regards to mesh, maternal health, and screening services.
Women’s health is not just a women’s issue. When women and girls are supported to lead healthy lives and fulfil their potential, the whole of society benefits.
An Interim Progress Update 2023 has been published which provides some key highlights that have taken place since the publication of the Scottish Women’s Health Plan.
Why do we need a Women’s Health Plan?
Women face particular health inequalities and disadvantages because they are women.
Women are 51% of the population but are under-represented in medical research and have poorer outcomes for a range of health issues, not just reproductive health.
Women’s health is also affected by social factors. For example, women are more likely to experience poverty and be affected by gender-based violence.
The Women’s Health Plan has identified 6 priority areas requiring action across a women’s life course:
Menstrual health
Menopause
Endometriosis
Contraception and Abortion
Cardiac disease
Reduction in inequalities in health outcomes
What’s happening in NHS Greater Glasgow & Clyde?
Dr Emilia Crighton, Acting Director of Public Health is the strategic lead for the Women’s Health Plan in NHSGGC. Louise Carroll, based in the Equality and Human Rights Team, is leading the co-ordination and implementation of the Plan.
A huge amount of work is taking place across NHSGGC which links to the vision and actions of the Women’s Health Plan.
Activities associated with the implementation of the Plan in NHSGGC, including a staff engagement event, are planned for early 2023.
If you would like further information on the Plan or wish to highlight women’s health programmes or projects, please contact:
To support the Women’s Health Plan, NHS Inform have a dedicated Women’s Health Platform containing a wide a range of information on health topics affecting women. These include resources on menstrual health and the menopause.
Thank you for visiting our Pride Pledge page.
Over 5,600 of our staff have already made the pledge and we hope there will be many more!
Make the Pledge and Wear the Badge with Pride!
The NHS Scotland Pride Badge promotes inclusion for LGBTQ+ people and makes a statement that there’s no place for discrimination in NHS Scotland.
As an NHS staff member who wears the badge, you are pledging to –
be aware of and responsive to issues faced by LGBTQ+ people accessing care
be a friendly, listening ally who staff and service users can safely approach
use inclusive language and respect identity
To make the pledge and receive your badge please click on the Webropol link (below) and complete the form. Please make sure you include a complete NHSGGC work site postal address so we can get your badge to you as quickly as possible.
* Please don’t worry if you do not receive your badge right away – it just means we’re dealing with a lot of requests. If you have already contacted us, please don’t send a follow up query about delivery as we won’t be able to respond. We will issue your badge as soon as possible. *
The Pride Badge Toolkit should provide you with all you need to know about wearing the NHS Scotland Pride Badge. It also gives you some useful tips about managing things like social media responses and signposting people to national organisations.
If you are unable to complete an online application for your Pride Badge, please print and complete the word version of the form and return to:
Equality and Human Rights Team
Public Health Department
NHS Greater Glasgow and Clyde
Westhouse
Gartnavel Royal Hospital
1055 Great Western Road
Glasgow G12 0ZH
or save as an electronic document and e-mail to: equality@ggc.scot.nhs.uk
Some people may be having a particularly tough time and may disclose to you that they have experienced hate crime on the grounds of their LGBTQ+ identity. It’s important that you know there are supports in place for people to report this type of crime and that it can be reported easily. More information on reporting a hate crime is available from the Police Scotland website.
You may be approached by colleagues who discloses they are experiencing discrimination in the workplace from colleagues or service users and would like support to deal with it. Our HR Department is on stand-by to support any employee who feels they are being victimised or bullied because of their identity. More information is available on the HR Support and Advice Unit page.
NHSGGC has supported the development of Staff Forums representing the voice of our BME, Disabled and LGBTQ+ staff. Please support the Forum membership by signposting anyone interested in joining. More information is available on our Staff Forums page.
NHSGGC Sign Up for Pledge to be Seen Campaign
1 in 5 people in the UK identify as having a visible difference – a mark, scar or condition that affects their appearance. Yet more than half feel they are ignored by organisations. It’s time for people with a visible difference to be seen and heard. That’s why we are proud to have signed up to Changing Faces’ #PledgeToBeSeen campaign, committing to represent more people with a visible difference in our publications and campaign.
“I’m proud that an organisation as significant as NHS Greater Glasgow and Clyde has agreed to back Changing Faces’ Pledge To Be Seen campaign. When you stop and think about it, you hardly ever see someone with a visible difference in adverts or marketing campaigns, and all too often, if visible differences are represented in popular culture, it isn’t in a positive way, with the “disfigured villain” trope still very common.” Kaylin McLaughlin, local campaigner for Changing Faces
What is ‘Visible Difference’?
Changing Faces describe visible difference as a scar, mark or condition on your face or body that makes you look different.
This can be something you are born with or it could happen later. Anyone can be affected by a visible difference, at any point in their life.
Examples include –
A condition that changes the shape, size, feel or look of the face or body, or how it functions, such as vitiligo, psoriasis or alopecia.
A part of the face or body that is different, such as a birthmark, cleft lip or having fewer fingers on one hand.
Scars, burns or changes to the face or body from an accident, an act of violence or self-harm. These can also occur because of an illness, treatment or operation.
The impact of a visible difference varies from person to person. Some people are proud of their visible difference and live fulfilling lives. Others find it emotionally challenging and feel that it limits what they can do.
Staff Learning & Resources
Online learning sessions offer a great opportunity to increase our understanding of the issues around visible difference and better support our patients and colleagues.
Representatives of Changing Faces can share what it’s like to live with a visible difference, talk about language, when and how to ask about difference, and how we can increase positive representation of visible difference.
If you would like more information on learning sessions for your team or staff group, please contact martin.patterson@ggc.scot.nhs.uk
Changing Faces also offers information specifically for health staff working with patients who have a visible difference.
“Providing fair and equitable healthcare for all is at the heart of NHS Greater Glasgow & Clyde and we are acutely aware of how important it is to accurately represent our diverse community in all our materials and campaigns.
Our ongoing commitment to building a fairer workplace for everyone means creating an environment where diversity is valued – better equipping us to appropriately support our patient community.
This pledge reinforces our resolve to ensure that anyone with a visible difference feels both seen and heard by our organisation.” Dr Emilia Crighton, Interim Director of Public Health, NHSGGC
Support
Many people with a visible difference have social anxiety, depression and low confidence.
Changing Faces offer a range of free, specialist wellbeing services, including:
Support is also available for any staff member experiencing issues in the workplace. Contact the HR Support & Advice Unit on 0141 278 2700
Get Involved
If you have experience of the issues highlighted in the campaign and would like to get involved, please contact the Equality & Human Rights Team at equality@ggc.scot.nhs.uk
“Having NHS Greater Glasgow and Clyde commit to being a Pledge To Be Seen organisation is a huge step forward for our mission in Scotland. Being partnered with the UK’s largest NHS health provider will ensure many more people learn about what life is like with a visible difference, and how they can make the world a more accepting place.” Heather Blake, Chief Executive, Changing Faces
“I have worked with many service users who have visible differences and am only too aware of the negative response that people may have to deal with in various aspects of their life. More and better representation across society is crucial to creating acceptance. It is also important that every one of us can be reassured by seeing ourselves represented by organisations we rely on for our health and wellbeing, such as NHSGGC.” Dr Rebecca Crawford, Consultant Clinical Psychologist, NHSGGC
NHSGGC policy states that we must provide formal interpreting support for all out-patient appointments and at least once a day for an in-patient stay.
This support can be provided via our British Sign Language (BSL) Online interpreting Service – using NHSGGC’s communication support iPads – or by booking a Face to Face interpreter.
The BSL Online interpreting service is available 24 hours a day, 7 days a week. This means that in an unplanned or emergency situation, staff can quickly link up to an interpreter at any time and communicate with their Deaf patient. It can also be used during hospital stays, or to enable Deaf patients to communicate with staff if waiting for a face to face interpreter to arrive.
The BSL Online service can be accessed at a wide range of sites across NHSGGC – full list available below. Staff should contact the relevant departments to access the communication support iPad, which comes ready to use with easy access instructions.
A short instruction video on how to access a BSL online interpreter using the iPads can be viewed here.
For more information on using BSL Online or Face to Face interpreting support – see the NHSGGC Interpreting Policy or contact Paul.hull@ggc.scot.nhs.uk
Asking and responding to patients’ money worries is part of Inequalities Sensitive Practice, which is about taking into account each patient’s social circumstances and how they are affecting their health. It also relates to person centred care.
Advice On Money Worries – Who is it for?
Money advice support is for patients, parents/carers or staff of all ages, regardless of their working status.
Why is it important?
With the recession and changes to the benefits system, many of our patients are experiencing money difficulties and mounting debts. The COVID-19 pandemic has also created additional financial worries for many people.
This is important to health services as in addition to being a cause of poor health, money worries can also be a barrier to engaging fully with our services.
“I observe this again and again – that I cannot address medical issues as I have to deal with the patients’ agenda first, which is getting money to feed and heat.” GP
By asking a simple question and providing assistance on where to get help, we can do a lot to prevent unnecessary worry and anxiety.
Click here to view Money Worries: In Sickness & In Health – a short film aimed at healthcare professionals outlining the link between poor health and money worries.
What Kind of Advice is Available?
If your patients are facing financial difficulties, they should not pay for advice. You can help your patients to use the free, high quality services available across NHSGGC which offer help with:
Maximising Income
Debt Advice
Benefits
Savings
Banking
Budgeting
Evidence shows that referring patients to these services can result in improved mental health, increased income, debt reduction, increased financial planning and reduced stress.
How Do I Ask About Money Worries?
If done sensitively, patients value being asked about money problems and referred to Money Advice Services. It only takes a few minutes to do and can be incorporated easily into patient assessment as part of a person centred approach. Most NHSGGC assessment forms cover money worries.
“Do you have any money or debt worries?
“Would you like to speak with an advisor to discuss money worries or help you to claim any benefits that you may be entitled to?”
“Is having a baby adding financial pressure?”
These type of standard questions for introducing the topic of money worries are used in the community setting. Similar questions are used in hospitals, where staff need to establish whether the patients has any immediate work/money related concerns as a result of their health condition.
If you are working with groups of people it is good practice to discuss people’s health in the context of their life circumstances. Money and debt worries are a major issue for many people and should always be covered in these discussions.
How Do I Make a Referral?
Where patients have issues relating to money worries and debt, the role of staff is to:
The Money Advice Service website offers information and advice on budget planning and improving your finances, including tools and calculators to help you plan ahead.
Home Energy Crisis Response Service
NHSGGC has launched a Home Energy Crisis Response Service for patients in Acute and mental health care.
The dramatic increase in home energy costs means that many more people’s health is at risk due to fuel poverty. Patients may be struggling to heat their homes or have had their power disconnected, resulting in damp, cold housing and all the associated health impacts. It can also mean that patients cannot return safely to their homes after a hospital stay.
The new service targets patients who need help with home energy in order to return home safely from a hospital stay without the worry of the additional health consequences of living in a cold, damp home.
Delivered via hospital engagement and remote assistance, the service will tackle energy emergencies, advocate on behalf of patients with energy providers and help with access to external home energy emergency funds.
Who is Eligible?
A person is eligible if they – • are a patient or carer accessing or receiving care from an NHSGCC Hospital • have any immediate or emergency need relating to meeting home energy costs • are experiencing poverty/financial difficulties.
To access this service there is no requirement to be receiving any additional benefits.
SIS staff will also discuss any wider needs with the patient or carer and ensure onward referral to the appropriate support services.
For Mental Health Acute, referrals can be made directly to the service: Email: energycrisis@moneymattersweb.co.uk Telephone: 0141 445 7614
Home Energy Advisors
As part of this service, a Home Energy adviser is now based at various hospital sites throughout the week. The service is available Monday–Friday across all NHSGGC hospitals.
Impact on health
The recent Marmot Review ‘Fuel Poverty, Cold Homes and Health Inequalities’ highlighted the dangerous consequences of living in a cold home to a child’s health and future life expectancy.
It predicts increases in asthma and other respiratory illness; circulatory problems; mental health problems and a worsening of other existing medical conditions such as diabetes, musculoskeletal and rheumatological conditions, dementia and Alzheimer’s.
The Marmot Review characterises fuel poverty as a ‘significant humanitarian crisis with thousands of lives lost and millions of children’s development blighted’.
We hope this project will help to save lives in Greater Glasgow and Clyde as well as mitigate against adverse health consequences.
Gender-Based Violence (National Guidelines)
What Health Workers Need to Know
This guidance is intended for use by service managers and staff members who, in the course of their work, are involved in identifying and responding to gender-based violence.
Gender-based Violence National Guidelines – What health workers need to know
If you require this or any other NHS information in another format, such as large print or braille, or in another language, please use the contact details on your patient leaflet or letter or contact us.
