Improving communication between clinicians and LGBT+ people with serious illness (ACCESSCare-Communication)

The way that health and social care professionals speak with LGBT+ patients, and people who are important to them, affects experiences of healthcare. However, these professionals do not consistently receive training on how to do this sensitively.

Palliative and end of life care researchers who are part of NIHR ARC South London responded to this issue by initiating a project (ACCESSCare-Communication) to identify how LGBT+ people with serious illness want their sexual orientation and gender identity or gender history to be engaged with by health and social care professionals.

The team also aimed to develop freely accessible guidance on improving inclusivity of communication around sexual orientation and gender-related matters, for use by clinicians and educators.

How the research was conducted

The researchers conducted interviews with LGBT+ people with serious illness, informal caregivers, including partners, friends and family, and health and social care professionals. Findings from the interviews were used to develop draft guidance.

In total, the research team interviewed 74 people, including:

• 34 LGBT+ people with serious illness
• 13 informal caregivers including partners, friends, and family members
• 27 health and social care professionals working with people with serious illness.

Analysis of the interview data highlighted three principles to ensure communication with LGBT+ people is more inclusive and improved. Health and care professionals should:

• Approach all interactions using inclusive language
• Be aware of the wider environment and who else is present
• Create inclusive opportunities for people to share aspects of their self in care.

Commenting on the findings, Dr Debbie Braybrook, research associate in palliative care at King’s College London, and a member of the research team, said: “When seriously ill LGBT+ people feel unable to share important aspects of their identity this can be deeply distressing, detrimental to appropriate care, and hinder the involvement of significant others."

The findings from the interviews were used to formulate evidence-based, best practice guidelines for use by healthcare professionals and educators looking to practice and promote appropriate patient-centred care for LGBT+ people.

Further interviews with five clinicians and involvement of patients and the public showed the guidance was well received and was considered useful.

She continued: "We hope that this will improve the experience of care for all patients, and make care more inclusive for LGBT+ people with serious illness.”

The ACCESSCare-C team have shared findings at several conferences, and will continue doing so with health and social care professionals and educators.

Study outputs:

• Free evidence-based LGBT+ Inclusive Communication Guide for health and social care professionals
• 10 posters to be used in conjunction with the evidence-based LGBT+ Inclusive Communication Guidance can be accessed by filling out the form here 
• Open Access journal article in BMJ Quality & Safety: Communication about sexual orientation and gender between clinicians, LGBT+ people facing serious illness and their significant others: a qualitative interview study of experiences, preferences and recommendations

Funding

This study is funded by the NIHR under its Research for Patient Benefit programme (Grant Reference Number PB-PG-0816-20001) and is supported by the NIHR ARC South London. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Acknowledgments 

• This research summary was co-written with the ACCESSCare-C Patient and Public Involvement team.
• The poster illustrations (above) were designed by Arke agency, with alterations such as badges by King's College London ACCESSCare team, with support from the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care and King’s Culture, King’s College London.