Safeguarding Children & Young People While Working Online – September 17th

Workshop with Sally Evans and Andrew Reeves

This workshop is the first in a series which is focusing on working with Children & Young People online and is a collaboration between ONLINEVENTS and ACTO.

About this event

In this 2 hour workshop, there will be input from Sally and Andrew as they share their learnings and experience of safeguarding while working online.

There will also be time for Q&A to meet the learning needs of the group and small group work so that the wisdom that is accumulating in the community of Children & Young People practitioners can also be shared.

ACTO is building a division focussing on the online work of CYP therapists. This event is part of our commitment to growing a network of CYP online practitioners who work to share experience and develop best practice working with Children and Young People online.

This workshop will be recorded and you can use the ticket function to pre-purchase the recording before the event. This will be useful for colleagues who are not able to attend the event live and also for those who attend the event live and want to watch again. It will be available for ACTO members in the ACTO members’ area.

This workshop will be hosted on the Zoom meeting platform where we will use our camera and microphones to interact with each other as a group.

To support practitioners in this time of extraordinary circumstances we are offering access to this group for a self-select fee.

The self-select fee is a radical inclusion policy to open learning for all colleagues. The guide price for this event is £20.00, however, we appreciate that income varies greatly in different locations and circumstances. Please contribute what you can to help us maintain inclusive professional training.

All the colleagues at ONLINEVENTS and the presenters we collaborate with are committed to working in a manner consistent with the BACP Ethical Framework, which can be accessed on the link below. When registering for this event you are agreeing to be present and interact in a manner that is consistent with this Framework.

Workshop facilitators

Andrew Reeves

Dr Andrew Reeves is a Professor in the Counselling Professions and Mental Health, a BACP Senior Accredited Counsellor/Psychotherapist and a Registered Social Worker.

His practice experience spans over 35 years, when he first trained as a Samaritans volunteer at 18, before moving into social and work therapy. His research focus in working with risk in therapy, having experienced the suicide of a client during his training. Since then, he was published extensively in this area. He is previous Editor-in-Chief of Counselling and Psychotherapy Research journal, past-Chair of BACP and is Chair of the York St John Advisory Board Counselling and Mental Health Research Clinic. He supervises mostly doctoral research in counselling, psychotherapy and psychological trauma.

Sally Evans

Sally Evans is a Certified Transactional Analyst psychotherapist with an MSc in Psychotherapy and UKCP registered. Graduate of OTI – Cyber Therapist and Supervisor and ACTO member on both the Therapist and Supervisor registers.

Sally has over 25 years’ experience of working with CYP, both in person and remotely at where she was employed as the Clinical Lead. She has presented at UKCP, BACP, & OCTIA conferences on the topic of counselling CYP online and is the author of several articles on the subjects of CYP in Cyberspace and Suicide Ideation in Cyberspace. She was a member of the original BACP Expert Reference Group, which drew up the counselling competencies for “Working at a Distance.” She is an independent therapist, supervisor/consultant, and trainer, and can be contacted on

Blog CYP

Thinking of using video games therapeutically?

Qualified Counsellor Ellie Finch explores the benefits & key considerations when using video games for working with younger clients.

Perhaps, like me, you’ve experienced the children and young people you work with talk with enthusiasm about games like Minecraft or Fortnite – and could see how much using a video game therapeutically could engage them in counselling?

I’ve been using video games in my private practice with children and young people for the past 2 years and have found it to be a great way to engage children and young people. Sometimes I simply talk about a child’s favourite video game with them; I might ask them what character they like to play, and this can lead to an exploration of their identity. Sometimes I watch a child play and might reflect back to them what I observe. For example, a child with low self-esteem might do something kind for another character in a game and I reflect back to them what I’ve seen of them in the game. Often, I will play the game with the child and together we might play hide and seek, battle monsters, build a castle among many other things.

© Ellie Finch

Games I’ve played with clients include Roblox, Fortnite, Among Us and Animal Crossing. But the game I’ve found most safe, accessible and useful therapeutically is Minecraft.

Before starting to use video games in your practice, there’s a number of important points to consider. I shall map these considerations to the ACTO CYP competences:

ACTO CYP Competency: Psychological Processes relevant to Online Therapy

Ever since I started using Minecraft in my practice I’ve been bombarded with enquiries from parents who can instantly see how it would engage their child in counselling. Often the parents have children who would otherwise not have engaged in counselling if it hadn’t been for Minecraft. However, it’s important to recognise that using a particular video game in sessions might not be suitable for all children. For example, if the child has been struggling with coming off a game to take part in other activities at home, they may struggle with the end of counselling sessions. This can actually be a great opportunity to explore the reasons why they find it hard to come off the game but you may also need to work on setting boundaries around use of games in sessions. In addition, if a client is struggling with not feeling contained in their life, then you will want to consider the landscape of the game you play. For example, Minecraft worlds are enormous and in order to create a more contained space, almost like a sandtray, I provide a physical boundary such as an island or a wall around the space we work in.

© Ellie Finch

I always ask my clients to create a safe place in the game in their first session. This is a place they can come back to at any time if they need to. A safe place can be anything, a cave, a house, a castle…

It also helps to understand the culture of video games and the video game you chose to play itself. For example, terms like ‘griefing’ are useful to know; griefing is a type of online bullying. In Minecraft griefers are players that destroy other players creations. When using Minecraft therapeutically however you can create a private world just for your clients so this can’t happen. In addition, the social side to gaming can be really important to players and the relationships they have through the game are just as significant as their in-person relationships.

ACTO CYP Competency: Assessment of clients for online therapy

Factors to consider when working online using a video game are:

  • Does the place where the child will be having their counselling have good enough internet connection to run the game as well as a video platform such as Zoom?
  • Is the child already playing the game online with other people? If not, you need to work with the parent/carer and child to educate them on online gaming safety, playing on servers with strangers etc. Minecraft Education has an in-built game called ‘Cybersafe: Home Sweet Hmm’ that takes the player through some internet safety challenges and helps the player to come up with strategies to keep safe online: (This game is available on Minecraft Education and Bedrock editions)

ACTO CYP Competency: Contracting and Boundaries

Having an agreement with the client around the use of a video game (or any digital therapy tool or resource) is essential.

My contract, for example, contains the following:

  • Information about the potential benefits of using Minecraft therapeutically as well as the potential challenges.
  • What they can expect a session using Minecraft to be like.
  • Boundaries such as the way we will communicate, how I will ‘unfriend’ them after each session and that I won’t be inviting anyone else into their private Minecraft world.
  • What we will do if we can’t connect in the game or lose connection.
  • I’m also clear about my level of competency in the game (please don’t feel you need to be an expert player – you need to be familiar with game controls, but most important is that you know how to keep your clients safe in the game).

ACTO CYP Competency: Data Protection

It’s essential to clearly explain any potential data protection risks of each game you play to a client.

I provide a clear, age-appropriate explanation of what ‘data protection’ and ‘GDPR’ mean, along with information about security standards (i.e. does the game have an ISO27001 certificate), where the location data is stored (i.e. outside of the UK, outside of EU, or in the US, for example, where they have different data protection laws).

It’s also important to clearly state how you will take steps to protect your client’s data in relation to the game and the limitations of this.

For example, I save a copy of the world after each session which is saved locally on my computer (and backed up to an external, encrypted hard-drive). My computer is password protected and I have installed anti-virus and firewall. I run updates on my computer regularly to ensure the security measures are up to date.

ACTO CYP Competency: Communication in online therapy

I do not advise using the communication channels within a video game. Instead, I use my usual video platform or the telephone (you may find using the telephone helps with internet connection issues).

I ask my clients not to use the chat function in the game. I also ask my clients to not write anything on signs or boards etc in the game that discloses personal information such as names, locations etc.

You will also need to get used to the idea that if you are embodying a character in a game alongside your client then your movements and body language as that character will be forming part of your communication with your client – much in the same way as our body language in real life forms part of our communication.

ACTO CYP Competency: Creativity in Online Therapy 

Video games provide a great online resource for adapting in-person therapeutic resources.

For example, I use Minecraft much like a sandtray by asking clients to create scenes using items and characters in the game which they can select from a vast inventory (a bit like having rows of miniatures on shelves in your therapy room).

© Ellie Finch

I also have a family tree activity where I ask clients to select different coloured and textured blocks to represent themselves and their family and place them in a tree.

Here are some links to resources and publications about my work:

I have a section in Jessica Stone’s book ‘Digital Play Therapy: A Clinician’s Guide to Comfort and Competence’ on using Minecraft as a sandtray:

BACP’s Children, Young People and Families Journal featured an article about my work which includes a case study:

I have made a 10-minute video for parents introducing them to how I use Minecraft therapeutically by taking them on a journey around my Minecraft island that can be viewed on my website here:

I have a free webinar also available on my website where I introduce how I use Minecraft therapeutically:

ACTO CYP Competency: Managing Risk and Safeguarding Issues

Top tip: There are three main editions of Minecraft: Java Edition (available on Mac and Windows), Bedrock/Windows Edition (available of PC, iPhone and iPad, Android, and a range of games consoles including Switch, PlayStation and Xbox) and Education Edition (available on Windows, Mac, iPad, and Chromebook)

Just like working online creates more issues around safeguarding and risk; video games can add a few more to consider. You want to be sure that you are familiar with the video game’s security and privacy settings and have them enabled for yourself and have also advised the client and their parent about how to enable these settings. For example, many video games, including Minecraft (excluding Minecraft Education Edition) are part of social media networks like the Xbox Network. This means that unless you have enabled certain privacy settings your clients may be able to see your friends list, see when you are online, what games you are playing and with who etc. I have written two extensive blog posts for parents about keeping their child safe in Minecraft which is also useful for practitioners using Minecraft Bedrock and Java editions:

Last year Minecraft Education Edition became more widely available to purchase and this is exciting news for therapists as, due to it being designed for use in school settings, it is a lot safer to use with clients than Java and Bedrock Editions. I’ve also written a blog post about the pros and cons of using Minecraft Education Edition:

Playing video games with clients, can provide a great opportunity to talk about online safety and check in with them about their online life. It is essential you do some training in online safety if you haven’t done so already.

ACTO CYP Competency: Endings and Supervision

Endings in video games can be incredibly poignant and meaningful – whether it be taking a screenshot of your characters together one last time or planting a tree together in the client’s world. I ask permission to take screenshots of the client’s work in the game, you can create a document together and use it to review the work at any time, including in the final sessions. It’s also something they can keep.

I’d advise practitioners looking to start using video games therapeutically to seek consultancy and training before starting to work using video games and connect with professional peers already working in this area.

It’s also important that you have a supervisor that either uses video games in their own practice or is open to learning about using video games alongside you.

Next steps

© Ellie Finch

As you can see, there’s a lot to consider when incorporating video games into your practice. There’s also additional factors to consider that sit outside the ACTO CYP competences such as making sure you are working within the terms and conditions of the video game license terms and conditions.

I’ve been inundated with enquiries from parents telling me their children are actually excited about the idea of counselling using Minecraft. And, seeing the huge amount of interest there is amongst counsellors and other professionals in using video games like Minecraft therapeutically, I have been training other professionals and organisations in how to use video games therapeutically and safely with their clients.

You don’t need to be a gamer to use video games therapeutically, but you do need to have some confidence using technology so that you can troubleshoot any technical issues that arise. My Getting Tech-Savvy in Minecraft webinar can help you get to grips with the technical side of using Minecraft therapeutically:

I also provide 1-to-1 and small group consultations, bespoke training to organisations as well as an upcoming training course on using Minecraft therapeutically.

Ellie is also part of the team of ACTO CYP therapists who have just updated the ACTO competences for CYP online therapists which were used throughout this blog post

For further information please email Ellie:

Ellie Finch

All images used are taken by the author. Ellie Finch’s services are NOT AN OFFICIAL MINECRAFT PRODUCT. NOT APPROVED BY OR ASSOCIATED WITH MOJANG OR MICROSOFT.


Play to your strengths

Two autistic members of ACTO challenge all of us to think differently

This blog post is written by two autistic members of ACTO, with over thirty years of experience between us. We both became therapists before we knew we were autistic, and discovering something so essential about the selves we truly are has proved enlightening in understanding the way we work as therapists. But this post is not about Vauna and Max. On Autism Awareness Day it’s about autistic people in general and autistic counsellors and psychotherapists in particular. 

The watchword of Chris Bonnello, an autistic educator, advocate and author, is “play to your strengths”.

That applies to everyone. Beisser’s Paradoxical Theory of Change says that therapeutic change occurs when one becomes what one is, not when one tries to become what one is not. (1) The more we play to the strengths we actually have, rather than chasing those we haven’t, the more we will thrive and grow.

So it also applies to us as autistic, and to us as autistic therapists.

The traditional view of autism

Autism has traditionally been seen / defined as a collection of deficiencies. The traditional view is this:

“Autism spectrum disorder (ASD) is an early onset neurodevelopmental condition that is associated with diverse social, occupational and educational challenges. ASD is characterised by impairment in qualitative social communication and interaction, alongside rigid, repetitive, routine, ritualistic behaviours and adverse sensory responses to certain stimuli.” (2)

An alternative view of autism

However, there are other ways of seeing it.

For example: autism is a way of being, a way of experiencing the world: not in itself a disorder, simply a difference. Many autistic people regard it as not unlike a culture: we have trouble understanding the non-autistic world because it is not our culture, just as the bloggers, born in England, might have trouble understanding the culture of Japan. And non-autistic people have equal trouble understanding our culture. This has been demonstrated very nicely by Crompton et al in their “diffusion chain” experiment (3), is at the heart of Damian Milton’s Double Empathy theory (4), and underpins the neurodiversity model (5): just as the world is biodiverse – and the more biodiverse the better – so humans are neurodiverse. Autistic people are not in any sense inferior, simply neurodivergent – they diverge from the majority, just as a jumping spider that lives on vegetables might be described as bio divergent. It may be unusual, but it’s the one that will survive in a time of food shortage.

The graphic above is Chris Bonnello’s list of autistic strengths (6). Of course, we do not all have all these strengths to the same degree, and people who are not autistic may also have many of them. But it is a useful corrective to the deficiency model.  

For anyone used to the traditional view of autism it may seem counterintuitive that an autistic person should choose to become a counsellor, and unlikely that we should be effective in that field. However, looking at the list of strengths above, it may seem a little less unlikely.

Autism awareness: a perspective

Many autistic people feel uncomfortable about autism “awareness”. Surely, they say, we deserve better than mere awareness? Acceptance at least, if not appreciation? We certainly appreciate our autistic minds and our autistic senses, even if at times they disable us in a society – a world – that is designed by and for people who are not like us.

However, as therapists we know that awareness is not something superficial. When we talk about something being in awareness we mean a full experiencing of that thing, not just a cognitive understanding of it. So maybe on this World Autism Day, rather than reading a theoretical piece on autism as a disorder, read or listen to an actually autistic person talking about our life, our perception and processing of our world.

Why not start with Naoki Higashida’s “The Reason I Jump”? (7) In the words of that so-called low-functioning Japanese thirteen-year-old you will find one of the clearest depictions of the autistic world. That is his world, and that is our world. Come and meet us.

To finish, just to throw some doubt on the stereotype that autistic people are not creative and have no empathy, here’s a wee poem written by one of us about the inner world of a client. The English is a loose translation of the Gaelic.

Cho trom an t-saoghal.

Tha’ n cù a’ teum le muirn

Tha mi’ n dùil, mi’ n dùil.

So heavy the world.

The dog nips in ecstasy

Oh, I wish, I wish.

Authors: Max Marnau and Vauna Beauvais 

Max is an autistic therapist and clinical supervisor, artist and poet living in the Scottish Borders and working with neurodivergent and neurotypical adults.

Vauna Beauvais is an autistic psychotherapist and clinical supervisor, and a coach for adults with ADHD.

Further information:


1. A. Beisser (1970) The Paradoxical Theory of Change. In: Fagan, J. and Shepherd, I.L., Eds., Gestalt Therapy Now, Harper & Row, New York, 77-80.

2. E. Nicholson, ‘How do you know if your client has autism?’ Healthcare Counselling and Psychotherapy Journal, April 2020

3. C.J Crompton et al, ‘Autistic peer-to-peer information transfer is highly effective’, Autism vol 24 (7), 2020, pp. 1704-1712

4. D. Milton, ‘On the ontological status of autism: the ‘double empathy problem’’, Disability & Society, 27 (6), 2012, pp. 883-887

5. Term probably coined by Judy Singer in her thesis, later published as “Why Can’t You be Normal for Once in Your Life?”in Disability Discourse, Mairian Corker Ed., Open University Press, 1999. A discussion can be found in N. Walker ‘Towards a neuroqueer future, an interview with Nick Walker’, Autism in Adulthood, vol 3 no 1, 2021. See also J. Singer, ‘NeuroDIversity – the Birth of an Idea’ Amazon, 2017

6. See website Autistic Not Weird:

7. N. Higashida, ‘The Reason I Jump’ tr K. A. Yoshida and D. Mitchell, Hodder & Stoughton 2014


ACTO is supporting Neurodiversity Celebration Week

ACTO’s CYP team wish to bring awareness to Neurodiversity Celebration Week, which supports changes in attitude and understanding. Sienna Castellon, the founder of Neurodiversity Celebration week and a real innovator, has worked hard since 2018 to change minds and narratives from her own experiences, to ensure that we all move forward in a more enlightened and educated way. ACTO support this.

Here are some links about experiences from different celebrities who challenge stereotypes and help us to create an open forum for support, learning and of course, celebration.

Steve McQueen (3min 47sec):

Michael Phelps (2min 53sec):

Dr Maggie Aderin-Pocock (3min 55sec):

Chris Packham (4min 25sec):

Keira Knightley (4min 04sec):


How to access the members area

Find out more about a new feature on the website. The area that is only accessible to ACTO members.


Workshop Directory Photo

We have noticed that a lot of professional and senior professional members have not uploaded a photo to their directory entry yet.

Feedback shows that a lot of people like to see a photo before they engage with a therapist. So it is a pity to miss out on an opportunity to show your face.

In this workshop we are going to show you how to reduce the size of your photo and then upload it to your profile. You can follow along the steps from behind your own laptop screen. We do encourage you use a laptop and not a mobile phone to follow along with this workshop.

About Mieke

Mieke is on the board of directors and also manages the website. She likes to stay up to date on social media and WordPress websites.

She will guide you through the steps of uploading your photo’s and along the way she will also give some tips on what makes a good profile photo.

When and where?

Tuesday March 29th at 12:00 UK time. This event will take place through zoom. Please reserve your place here.

What do I need?

A nice profile picture of yourself

A laptop computer

Your log in details for the ACTO website


The challenges of working across borders – and how to address them

Join us for a FREE webinar with insurance expert Steve Johnson

March 2022 sees the start of ACTO’s monthly webinars series. The webinars will be free for members – and this first one is free for anyone to join.

For the first webinar, ACTO are delighted that Steve Johnson has agreed to share with us his experience as an insurance broker.

About Steve

Steve has been an insurance broker all his working life. For the last 34 years he has specialised in professional liability insurance for the psychological professions including counsellors and psychotherapists – and has been involved with online therapy from its very beginnings. Steve ran Oxygen Insurance from its launch in 2010 until he left last year to join Partners& Insurance where he has been working on a new insurance facility which will be ready for launch next month. The brand name will be… &Breathe.

About the Webinar

The questions we are asked most often at ACTO revolve around insurance issues. The session will cover the challenges of working across borders including data protection laws, financial sanctions, regulation, insurance and local infrastructure.

Steve is very happy to answer any questions you may have; however it is helpful if you could send them in to us beforehand. You can do so by leaving a comment on this post.

Steve Jonso

When and where?

March 25th 2:30 PM on Zoom. Please register through eventbrite and you will be sent the Zoom link.


Mankind Group Facilitator

Role: Group Facilitator

Application deadline: 9am Mon 28 Mar 22

Interviews: Tues 12 Apr 22

Contract: 1 year fixed term – to be extended subject to funding

Hours: 11 hrs a week – Mondays 09:30-15:30 and Tuesdays 13:30-19:30
£40,057 FTE – AfC band 7 (actual £11,750 pa)

Pension: Employer contribution 3% 

Holiday entitlement: 240 hours per year (actual 71 hours pa)

Line Manager: Clinical Services Manager

Since 2000 Mankind UK ( has offered therapeutic services to support men 18+ in Sussex who have experienced sexual assault or abuse including:

  • online self help resources via
  • 24 weeks of 121 counselling
  • 10 week Psycho-educational Group Course
  • 20 weeks Group Therapy.

Main Duties

  • Deliver 1 psycho-educational course session a week with a co-facilitator (courses run with up to 10 participants for 10 weeks)
  • Deliver 1 face to face therapeutic group session a week with a co-facilitator (groups run with up to 8 participants for 20 weeks)
  • Deliver sessions via online platforms and/or in person as needed.
  • Prepare and update course materials as needed and assist in the development of complimentary online resources.
  • Deliver training to new facilitators on the delivery of the course and groups as needed.
  • Deliver training to counsellors to aid referral into the course and groups, and effective use of complimentary online resources.
  • Manage administration of new referrals into courses or therapy groups and hold waiting lists.
  • Maintain regular contact with clients on the waiting list to retain engagement and motivation.
  • Undertake clinical assessments of potential participants identifying and acting on any risk or safeguarding matters.
  • Attend bi-monthly clinical supervision group and weekly team meeting.
  • Gather and input outcome assessment data into spreadsheets and CORENet.
  • Use outcome information with clients as part of the working relationship.
  • Collect and record client donations and client attendance
  • Maintain digital database of client information and paper files.
  • Participate in research and contribute to service development as required.
  • Pursue continuous professional development (some internal training is provided).
  • Comply with the policies, procedures and service standards of the charity.
  • Use G Suite, Trello, Miro, COREnet, BrightHR, Zoom and other digital systems as needed.
  • Undertake other reasonable duties which uphold and maintain standards of service delivery.

Person Specification (E = Essential, D = desirable)

  1. Qualification in Counselling or Psychotherapy at Diploma level or above through a recognised BACP training (E)
  2. Minimum of 5 years’ post-qualifying counselling practice (E)
  3. Experience running therapeutic or process groups (E)
  4. Experience of delivering psycho-educational training to groups (E)
  5. Experience of delivering group work online (D)
  6. Experience of managing clinical risk (E)
  7. Experience of delivering therapy within the sexual violence sector and using the 3 stage trauma model (Herman, 1992) (E)
  8. Training specific to working with sexual abuse trauma (E)
  9. Experience of adhering to GDPR guidelines (E)
  10. Ability to remotely manage own caseload (E)
  11. Experience of using G Suite, databases and client management applications (E)
  12. Experience of learning to use new digital technologies (E)
  13. Experience of monitoring and evaluation. Working with CORE (Clinical Outcomes in Routine Evaluation) alongside the Impact of Events Scale – Revised (IES-R) or in-house feedback evaluation forms (E)
  14. Understanding of and commitment to equality, diversity and anti-discriminatory practice (E)
  15. Knowledge of issues specific to male survivors, including those who identify as transgender or transsexual (D)

Please address all aspects of the person specification in your application form.

If you would like to know more about the role please email the co-CEO

Job Documents are available at:

Application deadline: 9am Mon 28 Mar 11

Interviews: Tues 12 Apr 22


Talking to children and young people about the invasion of Ukraine

The following links may help CYP, parents and practitioners. We acknowledge that for families who had have to flee other war torn areas, these events may be triggering for them and their children.  We also want to acknowledge that this may feel like another disaster after the last two years of isolation and loss with Covid-19.  

It is important though that if children and young people are asking questions, we answer them as openly and honestly as we can – with a response appropriate to their age. We also recognise the sense of not knowing may impact the overriding feelings of anxiety for both adults and young people.

We therefore feel that finding ways to ground children, young people and ourselves will help to process the emerging information about the invasion of Ukraine.

We hope that you find these resources useful.

Anxiety reduction and calming/grounding strategies

Talking to Teenagers about the invasion in the Ukraine

  • Anna Freud also complied some useful suggestions with BBC Bitesize for parents and carers.

The UK Trauma Council, founded by the Anna Freud Centre has a range of information for families and professionals.  A resource page on how to support refugee and asylum-seeking children from all parts of the world who have experienced trauma. Reports are emerging on lone children crossing borders from Ukraine, this information may be of particularly beneficial for professionals. Here is a list of their support resources to help professionals get started. They also have training available.


NHS goals to improve equality within the NHS

ACTO Inclusion & Diversity director Olivia Djouadi gives her views on the NHS’ equality objectives

NHS England and NHS Improvement has six objectives (see in the table below) which seek to improve equality and specifically to ensure that there is a better overall experience for patients and staff alike within the NHS.

In this article, I will explain what each of the goals are – and why they are relevant.

The equality objectives for NHS England and NHS Improvement for 2020/21 addressed our role as an NHS system leader, commissioner and our own role as an employer. The seven overall objectives are:

1. To improve the capability of NHS England’s commissioners, policy staff and others to understand and address the legal obligations under the PSED and duties to reduce health inequalities set out in the Health and Social Care Act 2012.
2. To improve disabled staff representation, treatment and experience in the NHS and their employment opportunities within the NHS.
3. To improve the experience of Lesbian, Gay, Bisexual and Transgender People (LGBT+) patients and improve LGBT+ staff representation.
4. To reduce language barriers experienced by individuals and specific groups of people who engage with the NHS, with specific reference to identifying how to address issues in relation to health inequalities and patient safety.
5. To improve the mapping, quality and extent of equality information in order to better facilitate compliance with the PSED in relation to patients, service-users and service delivery.
6. To improve the recruitment, retention, progression, development and experience of the people employed by NHS England to enable the organisation to become an inclusive employer of choice.
7. To ensure that the equality and health inequality impacts of COVID-19 are fully considered and that clear strategies are developed and implemented for the NHS workforce and patients. To ensure that the proposed NHS People Plan and patient focused strategies reflect this and make an effective contribution to advancing equality for all protected characteristics and to reducing associated health inequalities.

The Public Sector Equality Duty (PSED)

The PSED requires all public authorities including the NHS to consider whether they should take action to meet these needs or reduce the inequalities.

In its assessment, the PSED observed that there were inequalities evident – especially during the pandemic. During this time, most staff in the NHS were overwhelmed by the impact of the health crisis and therefore were focused on trying to provide the best care that they could in the circumstances. Patient care had also shifted in unexpected ways with waiting lists growing exponentially. So, objectives and goals were agreed to attempt to ease some of the discrimination that had been identified.

Review of the Objectives

Objective 1: This aims to help the NHS to gain a better view of the current situation and areas that need improvement. This would enable staff to reduce inequalities and understand their legal duties.

Objective 2: The second goal concerns staff with disabilities and how advancements were possible.  This would mean better treatment and not being passed over when those with disabilities get an equal opportunity to other staff.

Objective 3: This aims to help staff feel more supported at work and improve the LGBTQI+ patient experience. This can also assist to lower the additional barriers that may cause some to shy away from healthcare in the UK and go abroad.

Objective 4: The fourth objective relates to the language barriers that impact on patient safety and health inequality. Interpreters are not always immediately available and family members may not always be able to translate medical or psychological information.

Objective 5: This goal explains the importance of making information about the legal duty for inequality available for everyone. It also needs to be understandable to staff and patients alike, with copies available for those that do not have internet access.

Objective 6: This final objective seeks to improve staff morale and reduce the numbers of people leaving the NHS. Many staff members have left due to exhaustion. Despite the pandemic, the NHS continues through to provide a full schedule of appointments, arguably helped by the high numbers of people vaccinated against COVID-19.

To help to understand what it has been like for staff during the pandemic I recommend reading Life, Death and Biscuits by Anthea Allen published 17 February 2022. Please feel free to get in touch with me with your views on this crucial area.

Olivia Djouadi

Inclusion & Diversity director, ACTO.