Promoting partnership working in the NHS

Promoting Lesbian, Gay, Bisexual, and Transgender Inclusive Workplaces - Business Services Organisation, Northern Ireland

Health and Social Care, Northern Ireland

Health and Social Care in Northern Ireland are provided as an integrated service. There are a number of organisations who work together to plan, deliver and monitor Health and Social Care across Northern Ireland. These include The Public Health Agency, 6 Health and Social Care Trusts and The Business Services Organisation amongst others.


Northern Ireland has the least progressive legislation in the UK in relation to sexual orientation and gender identity. Alongside this, recent research among lesbian, gay, bisexual, and transgender (LGB&T) public sector staff in Northern Ireland indicated that a very high percentage (82 per cent ) had experienced harassment and that LGB&T health and care service users also experienced homophobic attitudes from staff.

In discussions between the province’s Public Health Agency (PHA) and trade unions, it was agreed to explore what could be done in the health and care sector to tackle the problem. A project team was established with dedicated staff and resources, bringing together trade unions, the Business Services Organisation (BSO) HR and Equality Team and PHA health improvement staff.

Partnership working 

Jacqui Kennedy, Assistant HR Director at BSO, said: “We recognised the importance that reducing homophobia in the workplace could have in wider society.  Both employers and trade unions were willing to put resources into supporting a solution and a shared vision was developed". 

Members from UNISON, Northern Ireland Public Service Alliance, Royal College of Midwives, Royal College of Nurses and Chartered Society of Physiotherapists have been actively involved in the project planning and implementation.  British Medical Association and UNITE are on the project email circulation list.   Having trade union support has been key to enabling staff to feel this is a genuine initiative not just an equality tick box exercise.

Trade unions were able to feed back the views of LGB&T members who were not ‘out’ in their workplaces and who therefore didn’t feel able to engage in face-to-face forum meetings.   Trade union logos were used on all promotional posters and, as some of the trade union representatives identified as LGB&T and already connected into the community organisations, it was easier to bring them on board for subsequent particular pieces of work.  Unison hosted the forum meetings.

First steps

  • An anonymous online survey was set up in addition to two focus groups and promoted to all 16 Health and Social Care employers across Northern Ireland. 
  • A letter, inviting people to contribute, was signed by the chief executive of the PHA and each HR director was contacted by a trade union representative and asked to commit to undertaking and promoting the survey to staff, including those who did not have computer access.
  • The survey was also promoted via trade unions and through local LGB&T community organisations. 
  • Focus groups were facilitated by an employer and a trade union representative.
  • 123 staff responded and survey results supported the rationale for the establishment of a LGB&T staff forum and a business case was put forward and accepted. 

Fidelma Carolan a trade union representative on the project team said: “We established a lesbian, gay, bisexual and transgender staff forum across the Health and Social Care service in Northern Ireland. The aim was to promote inclusive workplaces and improve attitudes and provision to LGB&T service users and patients.” 


Key challenges faced by the project team (and how they were overcome) were as follows:

Accessing an invisible workforce particularly staff who are community based – the project team ensured posters were placed in offices where staff such as home care workers picked up resources etc.  Trade unions promoted this to home contacts and via general newsletters/members updates.

Concern that homophobia would increase in workplaces through staff making negative comments about information that was promoted –   an e-learning programme was developed to support staff to better understand LGB&T issues.  Trade union workplace reps were made aware of a possible backlash and encouraged to be pro-active in responding to it.  Where posters were torn down, they were replaced by trade unions and management.

Potential political backlash – the initiative was clearly framed within departmental policy to promote staff health and wellbeing and better meet the needs of service users.

Maintaining continuity as most of the trade union representatives were volunteers - PHA allocated some facility time for co-ordination of the forum to a dedicated member of staff.

Engaging across a geographical spread  with 16 employers throughout Northern Ireland  - forum meetings were in both Belfast and Derry/Londonderry but the team also focused on regular online contact through e-bulletins and a newly-established website.


  • LGB&T staff forum members have participated in roadshows across nine hospital and workplace sites, they have hosted ‘rights’, mental health and accessing support events
  • A new LGB&T poster targeting staff and service users has been developed
  • An e-learning tool has been developed
  • The programme is part of an ongoing equality training package for new and existing staff
  • LGB&T service users feel more confident to come out to health professionals
  • The PHA is becoming the first public sector organisation in Northern Ireland to sign up to new Diversity Champions initiative
  • PHA has committed to supporting the project on an ongoing basis with staff resources and a small budget
  • Some trade unions have also allocated a full-time official to support it  
  • A number of other public sector bodies, such as Belfast City Council, Education and Library Boards and the Department of Justice, have met with the project team with a view to adopting the model in their organisations. 

Fidelma Carolan said: “This initiative has totally depended upon the partnership between the employer and the trade unions. Visibility is a valuable first step to challenging prejudice.”

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