Greater Manchester: Improving access to health services in the LGBT community

Health services across Greater Manchester have been encouraged to adopt LGBT-friendly practices through a partnership involving the LGBT Foundation and the local NHS and councils in the region. 

Pride in Practice supports GPs, dental surgeries, optometrists and pharmacists to ensure all lesbian, gay, bisexual and trans people have access to inclusive healthcare that understand and meets their needs.  

‘LGBT community has faced many barriers’

Pride in Practice was launched 10 years ago and has evolved to provide training to all primary care staff. It is funded by the Greater Manchester Health and Social Care Partnership.

The scheme runs a one-hour training programme covering language and terminology, discussing inequalities experience by LGBT communities in healthcare and offering practical advice on how to develop inclusive services.

There is also an accredited assessment which is a discussion with the service on what they are doing already to support LGBT patients within their community and how they can develop this further. The assessment looks at knowledge at the practice as well as sharing recommendation on how to improve policies and documents used by the service.

Pride in Practice Manager Aimee Linfield said: “The LGBT community has faced many barriers over the years - being told they are not welcome, denied fertility treatment and seeing health professionals that do not understand their needs.   

“Some of it is structural. The NHS patient records system, for example, only allows someone to be recorded as male or female which means that non-binary genders cannot be recorded.

“Also, for someone to change their gender marker at the GP a whole new record and NHS number must be created and the patient’s records transferred over. This creates a situation where a trans man - someone whose gender identity is male, but was assigned female at birth - will not be automatically invited for cervical screening. We support practices to include trans status monitoring on patient registration forms as one way of ensuring that the correct information is sent out to patients.”   

Services now more likely to meet LGBT needs

The accreditation award can be displayed along with LGBT posters in the surgery or promoted on the practice’s website. “It may seem a little thing,” said Ms Linfield.

But it makes a big difference. Just seeing a poster gives LGBT people confidence they can be themselves.

Feedback from the LGBT community has shown that when posters are displayed 24 per cent are more likely to disclose their sexual orientation and 21 per cent their trans status. In doing this they said services were much more likely to meet their needs.  

Alongside the training and accreditation award, conferences have been held and a network of champions recruited to promote the work. One of those is Rosie. She said: “The importance of being ourselves is critical when dealing with our health care. If medics don’t know about us how can they treat us appropriately?”  

She said the improvements she has seen since her practice became involved with Pride in Practice have been significant. 

“Patients are involved in the practice and LGBT issues are taken seriously. Staff may ask sensitive questions about marital status or next of kin as heterosexuality is not assumed. My wife is included in all my health care decisions and is recognised as a carer. This is very different than it was.”  

‘Our staff now confident on LGBT issues’

This is an experience that has been repeated across Greater Manchester. Pride in Practice has worked with nearly 400 GP practices and around 200 dental practices, pharmacies and opticians, training more than 7,000 health care professionals in the process.  

It has led to an 11 per cent increase in LGBT people accessing primary care services and a 35 per cent increase in access to community pharmacies since 2016-17.  

Dr Helen Ward, a GP in Bolton, said the experience of being involved in Pride in Practice was invaluable. “I was surprised to learn how many LGBT patients recalled a bad experience.

I genuinely don’t feel any of our staff had negativity towards LGBT patients prior to the Pride in Practice training, but I think quite a few may have felt awkward or embarrassed about addressing the issue.

“I feel our training gave all our staff an opportunity to really feel confident in addressing issues such as not assuming a patient wants a female or male chaperone. When I don’t look shocked or awkward, the relief in the room is often palpable and you can see them visibly relax.” 

The work in Greater Manchester has acted as a springboard for Pride in Practice to be adopted in other areas, including some London boroughs and Buckinghamshire and Grimsby. 

Ms Linfield said: “It is so important to address the barriers the LGBT community face especially now with COVID-19. Like any marginalised group, LGBT are at higher risk of health inequalities and the pandemic will have just exacerbate that. Peer support groups have not been held in person and people have become more isolated – we need to address this.”  

Contact details 

Aimee Linfield, Greater Manchester Pride in Practice Manager, LGBT Foundation: [email protected]