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What steps can we take to avoid sub conscious bias being a factor in our decision making?

There has been a significant amount of press coverage talking about institutional racism within the NHS not only in terms of the treatment of patients but also in terms of the low representation of ethnic minority staff in management positions. Whilst tackling that issue is beyond the brief here, it is important to recognise that sub conscious bias can, regrettably, play a part in decision making processes. An Employment Tribunal will explore a alleged discriminator’s conscious and sub conscious decision making and working in an environment which has not set out sufficient controls to avoid such sub conscious stereotyping places someone at a greater risk of being discriminated against.

In the context of the issues we are addressing here, i.e. risk assessments around BAME staff, as we have stated above, it is essential that BAME staff are represented at all levels in the discussion. Trusts need to be mindful that BAME are underrepresented in management positions.

BAME staff need to be included in the dialogue and need to have a safe place where they can challenge decisions that are being made in relation to them. There needs to be accountability in the processes applied. Meaningful conversations need to happen and concerns should not be dismissed.

Related FAQs

Can I progress an application for EIA development?

Where a development is considered to be “EIA development” (being development where an Environmental Impact Assessment or Environmental Statement is required to be submitted) there are additional statutory publicity and notice requirements over and above the requirements for a standard planning application. Regulations usually require that the environmental statement is to be made available for inspection by the public at all reasonable hours at an address in the locality for a period of at least 30 days. Copies of the environmental statement are also to be made available for people to take away from that address. This clearly requires physical copies to be available at a specified location for a prolonged period of time, which may prove problematic during the current health crisis.

New regulations came into effect on 14 May 2020 which will temporarily suspend the above requirements and will instead require the Environmental Statement to be available for inspection online. The applicant must however provide a certificate to the Local Planning Authority stating what steps have been undertaken to bring the application (and the Environmental Statement) to the attention of people who are likely to have an interest and why it considers that such steps were reasonable.

How do I carry out a Right to Work check during the Covid-19 pandemic?

The Home Office has provided useful guidance on how to carry out a compliant Right to Work check using the temporary adjustments in place for Covid-19. In summary:

  • You will need to ask the job applicant to send you digital copies of their original documents, for example by scan, photo or mobile app.
  • Hold a video call with the job applicant and ask them to show their original documents on camera so you can check them against the digital copies you have already received.
  • On the date you made the check, record that you have done this by using the following wording “adjusted check undertaken on [insert date] due to Covid-19”. Evidence of right to work checks still need to be held securely either in paper or electronic format.
  • You can use the online RTW checking service where the job applicant has Biometric Residence Permit or pre-settled or settled status under the EU Settlement Scheme. You should do this whilst on the video call with the applicant/employee, and you must first obtain their permission to view their details on this scheme.
What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

How do you protect MHFAs from the potential stresses of the role?

There should be some data collected as to the type and number of interactions MHFA are having, to ensure no one individual or individuals are overloaded. MHFAs should be encouraged to maintain regular self-care practice, to lean in to all support provisions available in their organisation, to engage in peer support, and to take a break from their role as a  MHFA to prioritise their own wellbeing as needed. It is also important that those who volunteer to be MHFAs have the support of their managers.  So they have the time to do both their core role and their MHFA duties without feeling pressurised to cram work into spare time to make up for time spent on MHFA duties.

What are the key questions to ask ourselves as a business?

Some examples of the key questions to ask include:

  • Is there still a viable underlying business that is likely to continue beyond the current crisis?
  • What does the revised short to medium cash flow look like and will the company continue to be able to pay its liabilities?
  • Does the company have the support of all of its stakeholders – lenders, shareholders, customers, suppliers and banks – even though the business might be in breach of its own obligations?
  • What measures could (and should) the board put in place to protect creditors, including making sure that exposure to creditors (both collectively and individually) is not increased, assets are not sold at less than value and no creditor is treated more favourably than another?
  • Is there still a reasonable prospect of the business avoiding liquidation or administration?

The key question is always whether accepting the money is in the best interests of creditors as a whole bearing in mind that accepting Government support and continuing to trade might increase the company’s overall liabilities. Directors should be mindful that if the business fails, their decisions during this critical time may be scrutinised and it is therefore important that directors have up-to-date financial information and projections to form the basis of any decisions, take stock, get the right advice and document the decisions that are taken.