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Achieving positive interactions

3. How are you doing in achieving respectful and positive interactions from public, patients and staff, in relation to older people, people with disabilities, people with mental health problems, people from black and ethnic minority communities and others who are seen as different and how are you addressing disrespect, bullying and abuse?

This question is about how you promote and reinforce a culture of respect for difference and harmonious interaction within the NHS. This is particularly important where there is evidence, or a perception, that patients have little respect for staff and vice versa.

Self assessment questions

  • What policies and strategies do you have in place to ensure compliance with anti-discrimination legislation (single equality and/or race equality schemes etc)?
  • Do your policies and strategies encourage integration and positive contact between people from different backgrounds or do they encourage segregation by treating people from different backgrounds separately?
  • How do you ensure your policies and strategies are implemented and their effectiveness is regularly monitored and evaluated?
  • What training and support do you provide for staff who have direct contact with patients and public to ensure that they adopt behaviours that make people feel welcome and valued by the NHS?
  • What training and support do you provide for staff to ensure that they make people feel welcome and valued by the wider community? 
  • How do you ensure that your staff challenge racism and other forms of unfair discrimination, disrespect, bullying and abuse?

Some examples of good practice

For many people, particularly new migrants and people who have limited contact with others (perhaps because they are house-bound), the NHS represents the face of their local community so it is really important that the face they see is welcoming. East Lancashire PCT have recognised this across many aspects of their work:

  1. They have produced a 'Values and purpose' framework to ensure that staff live the values and are performance managed in relation to those values 
  2. They use their programme of Equality Impact Assessments to check that policies, procedures and service provision fulfil requirements for equal access and treatment 
  3. Their HR policies and procedures are used to create a culture of inclusion and engagement, with support mechanisms to handle issues of disrespect, bullying or abuse 
  4. They have a Mediation service to resolve any issues using a shared responsibility model

The Joseph Rowntree report, 'Community engagement and community cohesion' (2008) describes an approach used in Newham to bring people from different communities together. Newham used community forums to engage people. These worked well for some but less well for others so they shifted focus from engagement structures to engagement events, developing a varied programme to engage diverse groups in different ways. These included reading days in local libraries, community festivals and a popular 4 day programme of summer evening concerts in a park celebrating the music traditions of different communities in the borough. People attending the events were asked to answer questionnaires and a range of other more creative techniques were used to gain feedback from people. The evaluation showed that the events were valued but it was felt that more local people should be involved in organising them (thus building community capacity) and there should be more feedback about the action that is taken in response to the views that were gathered.