"Funding from the Charity helped us make the idea more than ‘just a pin badge’."
The idea for the initiative started from a conversation between me (Mike) and friends on holiday about the power that small symbolic signals can have, like many of the badges I wear on my work lanyard. I’ve always worn a rainbow badge, so we discussed creating one with ‘NHS’ written on it.
I forgot all about it until I’d had a bad day and wanted to do something positive to make a difference. I wanted to create something that would actively break down the barriers that lesbian, gay, bisexual and trans (LGBT+) patients face within the NHS. We know that one in four LGBT+ people have witnessed discriminatory or negative remarks against LGBT+ people by healthcare staff.
Before launching the pilot at Evelina London, I funded the first 300 badges myself and used word of mouth and social media to get the buzz going. At this point I saw that there was a lot of interest and support behind it, but I knew it needed to be more than a gimmick.
That’s when Jess and I applied for funding at the Charity. We teamed up to map it out as a campaign; using the £5,000 grant to fund not only the badges but design for materials. We knew if it was going to be meaningful, it needed resources behind it. Jess helped give the lift-off as an initiative born at Evelina London, having the hospital fully behind it gave it the seal of approval. She also encouraged us to think about how we could make it as easy and low cost as possible for other organisations to adopt the initiative by creating a toolkit complete with designed and editable materials.
We’ve worked hard to build a model that emphasises what sits behind the badge. For staff signing up to the scheme, reading information about why the badge is needed and what it symbolises ensures that they’re aware of the responsibility attached to it. Staff must be willing to promote themselves as open, tolerant and inclusive as well as act as a good person to talk to. From the outset we wanted this emphasis on education, responsibility and support to be the focus. We enlisted supportive staff, gaining their feedback and input into materials at various stages.
We set a timeline for roll-out and a target number of staff we hoped would sign up to wear a badge – 25% of staff members to combat the 25% of NHS patient-facing staff that have heard their colleagues make negative remarks about LGBT+ people. One of the reasons the rainbow badges caught so fast is because people understand the need for it.
When the LGBT+ Forum – a dedicated forum to support our LGBT+ colleagues – agreed to roll the scheme out across the rest of Guy’s and St Thomas’ NHS Foundation Trust, we’d tested the model and knew others could now drive it forward. By July 2019, over 4,000 badges were being worn; making up 25% of all staff at the Trust. So far, six in ten acute trusts in England have already or are set to implement the badges and supporting resources, as well as GP surgeries and nation-wide NHS organisations.
From this point, we had to be realistic because we couldn’t be in full control of its roll-out, but we could be in control of the spirit in which it’s given. Before other trusts get on board, we make sure there’s at least one senior professional to lead its expansion and oversee that the model is being adhered to.
For us, it’s about being honest about what the badge can and can’t do. The badges are just one step towards confronting the issues LGBT+ patients face in healthcare and challenging entrenched attitudes. We’re now working alongside NHS England to mobilise and harness the commitment behind the badge to find more comprehensive, long-term solutions.
We’re proud of what the badges have achieved as an awareness-raising tool. They’ve been a way of bringing people together, starting conversations and making people feel positive. They’ve raised questions that needed to be asked.
Dr Mike Farquhar is a consultant in sleep medicine at Evelina London, and Jessica Law is a Senior Communications Manager at Evelina London.
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