The Rainbow Alliance has created the opportunity for a social movement in which Trust staff, service users, carers and anyone with an interest in LGBT+ health equality collaborate with the shared goal of enhancing the quality of care which we deliver across the organisation to the LGBT+ community. It provides an opportunity for its 'members' to lead on delivering LGBT+ service improvement projects in their areas and accepts accountability to the Trust’s Equality and Inclusion Group The alliance has established effective working partnerships across Leeds with other NHS Trusts, the local authority and third sector support services.
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
The Rainbow Alliance has created the opportunity for a social movement in which Trust staff, service users, carers and anyone with an interest in LGBT+ health equality collaborate with the shared goal of enhancing the quality of care which we deliver across the organisation to the LGBT+ community. It provides an opportunity for its ‘members’ to lead on delivering LGBT+ service improvement projects in their areas and accepts accountability to the Trust’s Equality and Inclusion Group The alliance has established effective working partnerships across Leeds with other NHS Trusts, the local authority and third sector support services. Members ensure the Rainbow Alliance has a visible presence around the Trust as part of promoting inclusivity. The Rainbow Alliance facilitates quarterly meetings in the city centre to give anyone the opportunity for anyone to contribute to developing services to better address LGBT+ health inequality. The alliance promotes, supports and represents the Trust during key events involving the LGBT+ community. Contributions from all Rainbow Alliance members are equally valued and encouraged when collaboratively considering the ongoing work of the alliance and regular updates are provided s via social media, quarterly meetings, emails from alliance leads and Trustwide communications.
What makes your service stand out from others? Please provide an example of this.
It is an LGBT+ network which puts the needs of service users at the top of its priorities. It is not a ‘staff network’ but a co-produced network of which the priority is about improving health equality
How do you ensure an effective, safe, compassionate and sustainable workforce?
We have quarterly open meetings for anyone to attend and discuss the goals of the alliance. Staff training on both LGB and trans health awareness is provided through the alliance to any member of staff. We also open the training up to other agencies who approach us and ask about access to training. The Rainbow Alliance receives queries from trust staff who want to better support someone on their case load who is from the LGBT+ community and they will work with the staff member to enhance knowledge and provide information on appropriate support. The alliance recently formally recruited a Trust volunteer. They are a representative of the Trans community and their role is to further develop inclusive physical environments around the Trust, encourage and book staff onto the training, discuss the importance of sexual orientation monitoring in teams & also represent the Rainbow Alliance and LGBT+ awareness events in the region.
Who is in your team?
Broad representation consisting of clinical and non-clinical staff and people from outside of the organisation
How do you work with the wider system?
Rainbow Alliance leads on a newly established Trans Health Partnership event in the region and facilitates the delivery of an open access Trans health promotion event. This is a multiagency event to address to health inequalities of the trans community. The alliance is also well established within the LGBT+ organisational network within the region and has established and continues to foster good working relationships with voluntary sector, local authority, NHS trusts.
Do you use co-production approaches?
We are mindful of involving members of the LGBT+ community in everything we do and to share in decision making on what our priorities should be. The terms of reference for the network were established in collaboration with members of the community who were invited to attend an open meeting to develop terms of reference. The alliance must be based on the concept of coproduction for it to hold a sense of integrity for what it seeks to achieve as the LGBT+ community itself is what hold the knowledge and skills to be able bring significant change. The alliance is about people (professionals or otherwise) on an even playing field with a shared passion and commitment to the cause
Do you share your work with others? If so, please tell us how.
We share our work via internal communications within the organisations, Twitter, LYPFT website, via voluntary organisations newsletters, health promotion events, LGBT equality events (Pride). The alliance recently had an article published in the mental health nursing journal to mark LGBT History Month
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
We are in the process of evaluating the impact of staff training for LGB and trans health awareness. This involves a pre and post-training questionnaire which each attendee completees. As from 1st April – we much now mandate the collection of data around sexual orientation monitoring (SOM). A lot of work has gone in to preparing staff to approach SOM in a way which is meaningful for the service user and one which contributes to better understand on health inequalites for LGB people. The first report is due to be generate in the next few weeks. The alliance will use this initial report to see which service areas are already making progress with SOM and to offer support to services who are evidently not yet gather this valuable data and establish why this might be
Has your service been evaluated (by peer or academic review)?
How will you ensure that your service continues to deliver good mental health care?
Ongoing support from Trust equality and inclusion group. We are also very much supported by our chief exec and chair. We don´t receive funding directly as we utilise a lot of existing resources in the organisation
What aspects of your service would you share with people who want to learn from you?
It is a difficult journey to address the mental health inequality of LGBT+ people. A lot is known about the health risks of this community but there is little health research which sets out what interventions can improve health outcomes. Encouraging staff to attend non-compulsory training is a challenge as well and can be frustrating. We try to always communicate the health risks of LGBT+ people and use this as a foundation to try and lead staff into wanting to book onto the training and for managers to see the importance of releasing staff to attend. It is difficult to balance time to take on projects above and beyond someones day to day job description – so although we have members signed up, it can be variable what they can commit to in terms of contributing to work streams. Implementing sexual orientation monitoring is an ongoing struggle. We have produced a info leaflet (and an easy read version) for staff and service users but there are some mixed views on whether some professionals think we should be asking people about their sexuality. The lead of the Rainbow Alliance, Kate is currently working with Uni of Leeds and will act as principle investigator for an upcoming study which explores for views of members of staff in relation to asking about sexuality
The following questions are an opportunity for you to provide further details on how you implement positive practice in your service delivery and how you ensure your service is advancing access and equalities. Answers to these questions will not influence how your PPiMH awards application is assessed, however any responses received may contribute to the potential inclusion of your service/team as a positive practice example within published guidance developed by NCCMH and NHS England.
How many people do you see?
It varies a lot. We have just under 100 members.
How do people access the service?
Twitter, the alliance email, contacting the alliance lead. Information is shared on notice boards around the Trust as to how people can get involved with the rainbow alliance
How do you ensure you provide timely access?
The email and twitter account is always monitored by a member of staff or the Rainbow alliance volunteer
What is your service doing to identify mental health inequalities that exist in your local area?
Study with Uni of Leeds regarding staff views of sexual orientation monitoring. Evaluating impact of staff training on knowledge, skills and confidence
What inequalities have you identified regarding access to, and receipt and experience of, mental health care?
Straight assumptions are made about people. Lack of understanding of societal discrimination and oppression and how this correlates with health and wellbeing. If someone is LGBT+ and from a BME community, their risks of developing a mental illness are higher due to increased discrimination and becoming estranged from family. Older LGBT+ people have also lived through some of the most horrific societal attitudes towards LGBT+ people, but are a community who are often ‘put back in the closet’ as services tend not to acknowledge sexual orientation in older people.
What is your service doing to address and advance equality?
We work directly with communities to establish what their priorities of how they want services to improve. We want to better understand who accesses our service who identify as LGBT+ and sexual orientation monitoring will enable us to do this. We want to influence research priorities in looking at interventions for reducing health inequality. We are participating in a study with Uni of Leeds to better understand staff attitudes towards sexual orientation and use its findings to establish future areas for development
What support do you offer families and carers? (where family/carers are not the service users)
We embrace anyone to work with us
Is there anything else you want to share about what makes you an example of positive practice?
We are currently being approached by a couple of other NHS Trusts who want to establish a Rainbow Alliance network in their Trust (in Hull). Rainbow Alliance has also been referenced in a recent publication re trans health by Healthwatch in south Yorkshire
Brief description of population (e.g. urban, age, socioeconomic status): Lesbian, gay, bisexual and trans (LGBT+) communities
Size of population and localities covered:
Yorkshire. No defined population size
Commissioner and providers
Commissioned by (e.g. name of local authority, CCG, NHS England): The alliance is not commissioned in its own right and uses existing resources (financial and human) within the trust
Provided by (e.g. name of NHS trust) or your organisation: Leeds and York Partnership Foundation Trust