How comfortable are NHS staff with asking about sexual identity?

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.

January 2019 – Welcome!

In the month that we launch our new website we’ve been busy. The start of the month saw Liz Hughes publish a joint position paper with other members of Mental Health Nurse Academics UK and people with lived experience: “Seeing Red” raises the issue of period dignity in inpatient mental health settings. Liz engaged in a streamed video chat about this issue with UNITE Mental Health.

In addition, Liz is a co-investigator on a new study Identifying and evaluating mental health early intervention services and self-care support for lesbian, gay, bisexual and transgender young people: a mixed methods study led by Lancaster University and funded by the Health Services and Delivery Research stream of the NIHR. The study will examine and evaluate access to mental health support for young people who identify as lesbian, gay bisexual, or transsexual (LGBT). LGBT young people report significantly higher rates of depression, self-harm, suicidality and poor mental health than heterosexual youth. We are pleased to welcome Dr Emily Pattinson, who will be working with Liz on this three year study, to the Mental Health Research Group. 

John Baker and Kathryn Berzins have been busy blogging for the National Elf Service (@mentalelf on Twitter). Kathryn’s blog examined a review which focused on the role of carers under the Mental Health Act, and John’s discussed a recently published systematic review on Community Treatment Orders.

A journal accepted our first paper to explore some of the work led by Joy Duxbury’s team to reduce the use of restrictive interventions in acute mental health settings informed by the 6 Core Strategies approach (more on this in a future blog).

Nicola Clibbens‘ upcoming World Café will focus on carers’ views about their participation in mental health research featured on the radio (Hallam FM). The World Café event will be held in Doncaster at The Dome in Doncaster on 14th March 1-3.30pm as a partnership between Rotherham, Doncaster and South Humber NHS Trust and The University of Leeds.