New guidelines over the rights of lesbian, gay and bisexual partners over hospital visiting and involvement in treatment decisions

Jun 14 2004

"When my partner was diagnosed with Alzheimers, it was a devastating blow. What made matters even worse was having staff in the home and other health professionals continually querying who I was. I had power of attorney and we took the decision to tell staff about our relationship, but that didn't stop them questioning whether I was the most appropriate person to make decisions about my partner's affairs."

Because Sam's experience is by no means unique, health unions have today launched guidelines aimed at ending the confusion and misunderstandings amongst many healthcare workers, over the rights of lesbian, gay and bisexual partners over hospital visiting and involvement in treatment decisions.

The guidance compiled by UNISON and the Royal College of Nursing provides detailed information on how healthcare workers can give confidence to lesbian, gay and bisexual service users and has been endorsed by the Chartered Society of Physiotherapy, College of Occupational Therapists, Royal College of Midwives and the Society of Radiographers.

Karen Jennings Head of Health for UNISON said:

"This guide is not about giving special treatment, it's designed to make healthcare workers think about changes in our society and family structures and apply an understanding of cultural diversity when delivering health care.

"Publicity around the proposed Civil Partnership register has emphasised denial of hospital visiting rights and access to information to same sex partners as one of the wrongs that must be righted. This guide makes clear that such rights are not dependent on partnership registration or indeed marriage. The term 'next of kin' is widely misunderstood. In the vast majority of cases, the refusal of health care workers to acknowledge a same sex partner has no legal basis. It certainly hinders good health care.

"Research shows that most lesbian, gay and bisexual people don't have the confidence to be open about their sexuality. This can have very serious repercussions on their health and even on the treatment they receive. They fear, and sadly sometimes experience, hostile and judgmental reactions if they do come out. This guide will hopefully help to change that experience."

Beverly Malone, General Secretary, Royal College of Nursing said:

"This joint piece of work will assist healthcare staff in providing the best care possible to lesbian, gay and bisexual service users and their families. It is not about special treatment, but for equal treatment, as research has identified that lesbian, gay and bisexual service users do not always receive the best care that is possible due to lack of awareness and prejudice in society. We hope that this document will go someway to bridging those gaps and improve the healthcare experience for lesbian, gay and bisexual service users."

The guidelines highlight some of the difficulties faced by lesbian, gay and bisexual people using the NHS they include this checklist for health workers:

• Be aware that you have lesbian, gay and bisexual service users, even if you don't know who they are.
• Be sensitive about the way you request information from service users, use language that is inclusive and gender neutral.
• Ask service users who information should be given to and who should be involved in treatment decisions, explaining what this means, rather than using the term 'next of kin'.
• Ask who should be contacted in case of emergency - do not assume this will be the same person.
• Also ask the names of other people who the service user wishes or does not wish to have contact with.
• Ensure all paperwork - such as information leaflets and admission and consent forms - uses language that is inclusive of lesbian, gay and bisexual families.
• Challenge prejudiced attitudes and behaviour in co-workers, other service users and service users.
• Make it safe for same sex partners and family members to be open about their relationships if they want to, so they can be supported during illness or crisis.
• Respect privacy and confidentiality.
• If necessary, provide lesbian, gay and bisexual service users and their families with details of where to get further, specialist support, advice and information.

The leaflet can only give a brief overview of best practice in delivery of healthcare to lesbian, gay and bisexual service users. Training for all staff and monitoring of outcomes will be essential elements of any action plan on achieving good practice.

The guidance is available on http://www.unison.org.uk/acrobat/14029.pdf and www.rcn.org.uk/london/resources