Equality, Diversity & Inclusion in Healthcare

SJT Textbook: Equality, Diversity & Inclusion in Healthcare

Equality Diversity and Inclusion MSRA

This guide covers the essential framework for Equality Diversity and Inclusion MSRA scenarios. In the Professional Dilemmas paper, you are tested on your ability to apply the Equality Act 2010 not just as a law, but as a daily clinical tool to reduce health inequalities.

🎥 Video Lesson (YouTube)

🎧 Podcast Lesson (Spotify / Apple / Amazon)

🎯 THE CORE PRINCIPLE

Equality, diversity and inclusion (EDI) in healthcare means lawful, respectful care that adapts to individual needs so that outcomes are fair. The Equality Act 2010 protects patients and staff from discrimination based on protected characteristics; the GMC expects you to treat people fairly, tackle discrimination, and communicate clearly.

In practice, that means identifying communication and access needs, following the Accessible Information Standard (AIS), using professional interpreters, and making reasonable adjustments for disability, language, and culture. The SJT rewards options that remove barriers, challenge discriminatory behaviour, and support those affected, with a clear audit trail.

Exam logic: specific, practical adjustments plus supportive, zero-tolerance responses to discrimination score higher than vague reassurance, avoidance, or “just carry on”.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Identify communication and access needs early (e.g. BSL, easy-read, wheelchair access, longer slot).
2. Arrange qualified interpreters and reasonable adjustments rather than relying on family members.
3. Use accessible information and teach-back to ensure understanding and valid consent.
4. Challenge discriminatory behaviour and microaggressions; support the person affected and escalate via policy.
5. Record communication needs (AIS), adjustments made, any incidents, and follow-up plans in the notes.
6. Consider health inequalities and protected characteristics when planning care, without delaying urgent treatment.
7. Signpost to complaints, PALS or staff support if a patient or colleague experiences discrimination.

Avoid answers that minimise concerns, rely on relatives as interpreters, or hide problems instead of using formal processes.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I am documenting your communication needs and flagging them so future teams can meet them consistently.”
* “I’m sorry you experienced this; I’m going to record what happened, support you now, and escalate it under the trust’s anti-discrimination policy.”
* “Let’s look at what adjustments would help you access care safely, and we’ll record these in your notes.”

Identify needs • Necessary adjustments • Clear communication • Lift concerns/escalate • Update plan • Document & Evaluate.

Explain to yourself: INCLUDE = find the barrier, put adjustments in place, talk clearly, escalate problems, record and review.

📋 QUICK FAQ

Can I use family members as interpreters?
Avoid this except in genuine emergencies. Use a qualified interpreter for consent and significant decisions. If a competent adult still prefers a family member, explain risks, obtain informed agreement, and avoid using under-16s; document clearly.

What is the Accessible Information Standard (AIS)?
AIS requires NHS and publicly funded services to identify, record, flag, share and meet people’s information and communication needs (e.g. BSL, easy-read, large print, email, text relay).

What if a patient reports a discriminatory remark from staff?
Take it seriously: listen, apologise for the impact, support the patient, factually document what was said, and escalate under local policies (e.g. incident reporting, HR). Offer follow-up and signpost to PALS or complaints.

Are blanket exclusions ever acceptable?
Rarely. Policies that exclude whole groups (e.g. “no interpreters”, “no visitors from X group”) risk unlawful discrimination. Tailor decisions to clinical need and law; seek senior/expert advice if unsure.

📚 GMC ANCHOR POINTS

* Treat patients and colleagues fairly and do not discriminate; challenge unacceptable behaviour.
* Communicate in ways patients can understand and support them to participate in decisions.
* Promote a respectful, fair working culture and act when patient safety or dignity is at risk.

(From GMC Good medical practice 2024, Decision making and consent, and related guidance.)

💡 MINI PRACTICE SCENARIO

A Deaf patient attends for a non-urgent procedure; no BSL interpreter has been booked. Reception suggests using the patient’s teenage child to interpret so the list is not delayed.

Best action: Rearrange to the earliest safe slot with a qualified BSL interpreter; provide accessible written information and safety-netting today; record AIS needs and what has been agreed.

Why: AIS and GMC standards require you to meet communication needs using appropriate interpreters. Using a child risks consent, confidentiality and safety. A short delay with proper adjustments gives safer, lawful care.

🎯 KEY TAKEAWAYS

✓ Equality law protects against discrimination based on protected characteristics.
✓ Equity in practice means removing barriers with reasonable adjustments.
✓ Use professional interpreters, not family, for important decisions.
✓ Challenge discriminatory behaviour; support and escalate.
✓ Record communication needs, adjustments and incidents clearly.

🔗 RELATED TOPICS

* → Resource Allocation & Fairness
* → Communicating with Non-English Speakers (interpreters)
* → Consent in Adults

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

A 54-year-old Deaf patient attends a diabetes review. No BSL interpreter has been booked. The consultation is non-urgent but important for glycaemic control. Reception suggests using the patient’s teenage child to interpret. The patient looks frustrated but says they have taken time off work to attend.

Options:
A. Proceed using the teenage child as an interpreter so the slot is not wasted.
B. Shout slowly and rely on lip-reading to complete the consultation.
C. Reschedule to the earliest safe slot with a qualified BSL interpreter; provide accessible written information and safety-netting today; document AIS needs.
D. Tell the patient they should have organised their own interpreter and send them home.
E. Ask the child to interpret only for signing the consent form.
F. Arrange a telephone BSL/video relay interpreter urgently if available; if not possible, rebook with face-to-face BSL support and written information.
G. Record the communication problem, add an AIS flag to the record, and inform the clinic manager so systems can be improved.
H. Continue seeing the patient without any interpreter and ask them to sign that they understood.

Example SJT — Rank 5 (best → worst)

A ward patient reports that a staff member made a racist remark during a medication round. They are visibly upset and say they no longer trust the team. The ward is busy, and the nurse in charge looks stressed.

Options:
A. Listen fully, acknowledge and apologise for the impact; document the account; support the patient; escalate via the trust’s anti-discrimination and incident reporting policies; and plan follow-up.
B. Move the patient to another bay to avoid further contact but take no further action.
C. Tell the patient it was probably “just a joke” and encourage them to ignore it.
D. Ask the patient to confront the staff member directly and report back if it happens again.
E. Agree it is concerning but decide not to record anything to avoid “trouble for the team”.