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LGBT people ‘let down’ in health and social care

Changes needed for LGBT-inclusive care

Jo Carlowe

Tuesday, 22 October 2019

Health and social care providers are not doing enough to ensure services are lesbian, gay, bisexual, and transgender (LGBT) inclusive, MPs warn today. 

In a report* published today, the Women and Equalities Committee finds that LGBT people do not always receive the same level of service as non-LGBT patients. 

The select committee MPs highlight the fact that deep inequalities exist in health outcomes for LGBT communities and that treating these patients ‘the same’ as non-LGBT people will not address these poor outcomes. 

Moreover, the report notes that health providers do not always think inclusively when planning and commissioning services. 

“We have found that too few health and social care providers are actively thinking about LGBT people when they plan their services and that senior leaders are not doing enough to ensure that LGBT-inclusion is hardwired into commissioning strategies,” states the report.

Maria Miller MP, chair of the Committee, said: “We found a lot of good will in health and social care services to make them LGBT-inclusive, and examples of good practice that must be shared and embedded in our services. But unfortunately, the best will in the world won’t change the systemic failings in areas such as data-collection and training that are leading to poorer experience when accessing services, and to poorer health outcomes for LGBT people.

“This can never be acceptable. LGBT-specific services play an essential role in the health and social care services for the moment and must be maintained as long as that’s necessary, but mainstream services must move now ensure that they are inclusive and are effectively identifying and taking into account the needs of the LGBT communities. We must eliminate the unacceptable inequalities in health outcomes that glare out wherever you look.”

The Committee also finds that the NHS Long Term Plan is too generic to work effectively for LGBT people, who should be considered explicitly as part of health commissioning. The Committee says the Equalities Office and the Department for Health and Social Care (DHSC) should formulate and publish a list of the key inequalities in LGBT health that the NHS needs to be accountable for. This should then be included in the LGBT Action Plan, and both authorities should report back to the Committee annually on progress they are making in eliminating the identified inequalities. 

Deficiencies in training are also highlighted. The report states: “This problem filters all the way down to training, where medics of the future are not taught how to provide LGBT-inclusive treatment. While few people set out to discriminate, training currently sends the message that sexual orientation and gender identity are not relevant to providing ‘person-centred care’. We have heard that for many witnesses that it is, in fact, essential. At the moment, there seems to be neither the leadership necessary to ensure services are designed to be LGBT-inclusive nor swift enough improvements among staff on the ground.”

NHS guidelines have recommended that GPs and nurses ask a patient’s sexual orientation when they are seen face to face. However, the Committee notes that this rarely happens. It recommends that hospitals and care homes should be fined if they fail to collect this data.

The report also recommends the role of the national LGBT health advisor should be prioritised and confirmed for the next three years.

Other recommendations include calling on medical schools to ensure LGBT content is in every curriculum, and that Public Health England should work with the National LGB&T Partnership on a five-year plan of health campaigns directed at LGBT people. 

In addition, the report recommends that the Care Quality Commission ensures inspections look for evidence of LGBT- inclusive practice. 


*Health and Social Care and LGBT Communities. A report prepared by Women and Equalities Committee, 22 October 2019

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