Equality and Diversity within Healthcare
Human Rights within healthcare.
FREDA is the term used to describe a human rights based approach to clinical practice and provides an understanding of simple human right values.
FREDA stands for:
The ‘F’ in FREDA stands for FAIRNESS which means that all humans have the right to fair trial.
It aims to make sure there is a fair process with dealing for each individuals concerns no matter how high up they are. The
focus is on how an individual
performs and how they act.
For example; each healthcare professional is reprimanded in the
same way if they make an error.
The ‘R’ in FREDA stands for RESPECT which gives the right for an individual to have the respect regardless of their family or private life.
This aspect aims to provide each
individual with the right in having
a diverse situation at home, for
Example; same being in a sex
relationship without being judged for it.
The ‘E’ in FREDA stands for EQUALITY which allows an individual the right to enjoy their human rights without being discriminated against.
The aspect aims to provide each
Individual the same service regardless
of the ethnicity, gender or age.
For example in a healthcare setting
Every healthcare professional would treat each patient the same.
The ‘D’ in FREDA stands for DIGNITY which gives an individual the right to be treated in a humane and proper way.
An individual must not feel degraded in any way.
For example in a healthcare setting; ensuring that there is enough staff to look after
each patient effectively i.e.; ensuring everyone who is
incontinent is changed when needed. Also ensuring privacy is always remained;
Closing the curtains etc.
The ‘A’ in FREDA stands for AUTONOMY which relates to the fact that each individual has the right to a private life. The aim of this aspect is to involve patients in decisions made about how they will be treated or cared for.
For example allowing the Patient a choice in what medication they are having but also ensuring they have full knowledge of their illness and why they need this medication.
Human Rights Interventions Within Health Care
• British Institution of Human Rights (BIHR) in 2012 a programme was developed a range of practical human rights based tools....
• Puts human rights at the heart of health and social care• Provide staff with a framework of common values
• Engage and empower service users• Improve the quality of care for patients
• Supporting existing national health care drivers, e.g. personalisation and dignity in car
Human Rights in Healthcare Evaluation
The guide itself was set up in 2012, it is in particular interest to :
1. The department of Health
2. Commissioners of health and social care
3. NHS Trusts
4. Independent sector providers
5. Professional associations
6. Inspection and regulatory bodies
7. Advocacy organisations
Human Rights Act 1998
• The Human Rights Act gives further effect in UK law to the fundamental rights and freedoms in the European Convention on Human Rights
• Under the Human Rights Act (HRA) 1998, public authorities – including NHS organisations - have a legal obligation to respect and protect human rights.
• Some public authorities have chosen to adopt what is known as a human rights-based approach (HRBA).
This approach views human rights as both:
• a set of legal standards and obligations
• a source of principles and practical methods which determine how those standards and obligations are achieved.
The PANEL Principles
There are five broad principles which are widely recognised as core elements of a HRBA. These are known as the PANEL principles. They provide a useful foundation not only for human-rights based interventions but also for evaluations of such interventions.
• Participation in one’s own development
• Accountability of duty bearers to rights-holders
• Non-discrimination and prioritisation of vulnerable groups • Empowerment of rights holder
• Legality: the express application of a human rights framework
Equality Act 2010
The Act simplifies, strengthens and harmonises the current legislation to provide Britain with a new discrimination law which protects individuals from unfair treatment and promotes a fair and more equal society.
Defines 9 protected groups:
• Gender reassignment
• Pregnancy and maternity
• Religion or belief
• Sexual orientation
• Marriage and civil partnership
This means to give a fair consideration to and give sufficient attention to all of the facts.
NHS Commissioning Board:
The NHS Commissioning Board has a duty to have regard to the need to reduce health inequalities in access to health services and health outcomes achieved as highlighted in the Health and Social Care Act 2012.
The NHS Commissioning Board is committed to ensuring equality of access and non-discrimination of protected equality groups. In carrying out its functions, the NHS Commissioning Board will have due regard to the different needs of protected equality groups, in line with the Equality Act 2010. Any changes affecting equality groups need to be compliant with the NHS Constitution and the Human Rights Act 1998.
Health Education England (HEE)
FREDA principles are very much at the heart of all that HEE does in educating, training and developing NHS staff so that they can treat all patients with compassion and respect.
A good example of this is the work HEE has done to improve awareness of dementia across the NHS – so that patients with dementia can be treated with the appropriate care and understanding. This awareness was raised via online e-learning education portals.
In October 2014, HEE launched the national Values Based Recruitment (VBR) framework. This aims to ensure that all students and staff entering the NHS not only have the right skills, but the right values to care for patients. From autumn 2015, all new recruits of students applying for places on healthcare courses at higher education institutions will undergo an individual, face to face interview to assess their values against those of the NHS Constitution.
Example of the FREDA approach benefitting both people with learning disabilities and healthcare professionals
MERSEY CARE NHS TRUST LEARNING DISABILITY SERVICE
The 'human rights board game' project involved multidisciplinary professionals and service users from the Trusts’ intellectual disability services and brain injury rehabilitation.
FREDA Challenge board game sees players make their way around the board, picking up cards as they go which either give facts about human rights, or give chance elements such as an extra turn. The aim of the game is to collect a full set of FREDA cards. Each card describes a dilemma based scenario whereby a human right has been violated, and asks group members to consider what 'FREDA' might say. Once a player has collected all five FREDA principles, they can progress to the centre of the board; the first person to do so wins the game.
Key learning points from the 'Human rights board game':
1. Learning through personifying FREDA. Service users internalised Freda, making her a person and thinking about what she would say when people were faced with breaches of their human rights or difficult situations:
2. Dilemma based learning means people seem to find using example situations and personal stories to be a helpful way to learn and to help understand the principles of human rights.
3. Learning and solidarity through being part of a group. There was a powerful sense of having a shared experience with other service users, and of feeling less isolated.
‘I thought I was the only one, but finding out there’s others has helped me.’
Co-production as a method of inclusion may help redistribute the power for individuals with intellectual disabilities giving them more control and enabling them to become active agents of change.