As of April 2019, sexual identity monitoring became mandatory across the NHS. Health disparities – inequalities in the provision of or access to healthcare – are faced by many different minority groups. Collecting monitoring information such as age, race and socioeconomic group makes healthcare providers aware of these disparities and therefore better able to take action to address them. The existence of disparities in accessing health care has been the subject of increased empirical study in recent years, yet without accurate and suitable monitoring data on patients’ sexual orientation it is difficult to know the true extent of these disparities. In 2013 the Lesbian, Gay, Bisexual and Trans (LGBT) Public Health Outcomes Framework Companion Document (Williams et al., 2013) recommended that sexual orientation and gender identity should be routinely monitored in health and social care to allow for a better understanding of disparities facing the LGBT community when accessing health care.

Research in the US suggests staff and patient perceptions of collecting sexual orientation monitoring information differ drastically, with staff greatly over-estimating how much discomfort collecting this information would cause patients. While 80% of healthcare staff thought that asking patients about their sexuality or gender identity would cause offence, only 11% of patients reported they would be offended when asked (Maragh-Bass et al. 2017).

“80% of healthcare staff thought that asking patients about their sexuality or gender identity would cause offence.” (Maragh-Bass et al. 2017)

Kate Ward – in association with The Rainbow Alliance – conducted a service audit at Leeds and York Partnership Foundation Trust. Her findings mirrored those of previous research: a disconnect between UK staff and patients perceptions of recording information about sexual orientation. In the absence of any UK studies on this topic we have devised a survey to try to gain some insight into NHS staff’ views about collecting mandatory sexual orientation monitoring data.

“How comfortable do NHS staff feel about collecting information about patient sexuality?”

We will invite NHS staff who collect sexual orientation data during their day-to-day interactions with patients to share their opinions and behaviours . A 5 minute online survey will be used to collect information about how staff currently collect information about sexual orientation within their trust. As a result of this survey, we hope to gain a better understanding of how staff feel about collecting sexual orientation data from patients and what support staff would like to be put into place. In addition, each trust involved in the study will receive a document showing the how their trust is collecting sexual orientation information and the opinions of their staff, this document will help trusts understand how they are conforming to the sexual orientation monitoring information standard.

“What support would staff like?”

We will send out an online questionnaire to a sample of acute care and mental health NHS Trusts for completion by any employee that collects patient information as part of their role. The questionnaire will ask a series of questions about that individual staff member’s opinions and behaviours surrounding sexual orientation monitoring. We will also ask staff to volunteer information about their own sexual orientation, LGBTQ+ training and job role. All questionnaires will be anonymous. We will use this information to investigate any potential connections between comfort and willingness to collect information about sexual orientation and staff members own sexual orientation, job role and LGBTQ+ awareness.

Do you have to record sexual orientation as part of your role? How do you feel about that? We’d love to hear your thoughts.

For further information please contact us or Emily Pattinson directly Follow Emily (@EmilyPatPsyc) and Liz (@LizHughesDD) on Twitter.


Maragh-Bass, A.C. and colleagues (2017) Risks, benefits, and importance of collecting sexual orientation and gender identity data in healthcare settings: a multi-method analysis of patient and provider perspectives. LGBT Health, 4(2), 141-152.

Williams, H. and colleagues (2013) The lesbian, gay, bisexual and trans public health outcomes framework companion document. The Lesbian and Gay Foundation.

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