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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

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.

Last updated on 14th April, 2020

Can I make a claim under my cancellations/abandonment insurance?

Cancellation insurance usually covers certain expenses and loss of profit, as long as the reason for cancellation is not excluded. These exclusion clauses are often quite wide and exclude avian, swine flu, quarantine, and restrictions of movement as a result of communicable disease. This means that you may not be entitled to compensation under this cover.

Last updated on 27th April, 2021

Will I need to make an application to the court for a remote hearing?

Despite remote hearings being the default position at present, formal permission will still be required by the court and a template order was circulated with the guidance. This template sets out the relevant directions and recitals to include in your order. An application to the COP for a remote hearing will not be required.

Last updated on 29th May, 2020

What happens if someone is asked to restrict their duties but, despite acknowledging the risks to their health involved, they say that they want to continue to work on the front line?

As their employer, you have an overriding duty to provide a safe system of work. The Trust would not be able to run a defence to say that an employee “waived their rights” and chose to continue to work. Provided the decision around restricting duties has been carefully thought out, a full risk assessment undertaken and the employee has been truly consulted about the impact on them, then the decision taken will be a reasonable management instruction. Failing to follow that reasonable management instruction could amount to a disciplinary offence.

Last updated on 19th May, 2020

Can a Tier 2 sponsored worker start working before their visa has been granted?

Ordinarily, no but during the pandemic, yes.

You can start employing a Tier 2 or 5 worker who is in the UK before their visa application has been decided if the following conditions have been met.

  • You have assigned the worker a Certificate of Sponsorship
  • They have made an in time visa application (i.e. they made their new visa application before their current leave expired) and they have provided you with evidence of this
  • The job you employ them in is the same as the one stated on their Certificate of Sponsorship.

Sponsors should be aware that they should carry out right to work checks before the individual starts undertaking work for them and if their visa application is eventually rejected, they must stop employing them.

Although sponsors will not be able to record migrant activity on the SMS about these workers, the Home Office has confirmed that any necessary reports should still be made on the sponsor’s internal systems.

If the worker is outside the UK, they may be able to start work for you remotely subject to the relevant employment, tax and immigration requirements in that country.

Last updated on 15th May, 2020