Abstract
Discrimination in delivery of care to patients with inflammatory bowel disease has been reported in the UK with regards to the South Asian population. This paper explores whether it is also true for Afro-Caribbean and Eastern European migrant workers. Treatment was investigated in NHS trusts, which served substantial migrant and minority communities, through Freedom of Information requests for data on use of biologics or hospital admissions over a five year period. In Bristol, Nottingham, Derby and Burton, Princess Alexandra Hospital Trust in Harlow, Essex and Kings College Hospital NHS Foundation Trust in South London Afro-Caribbean patients were treated significantly less often than White British patients. Eastern European migrant workers, were admitted significantly less often in Croydon, and the Princess Alexandra Hospital NHS Trust in Essex. However, there was no evidence of barriers to access for these communities in Wye Valley Trust, University Hospitals of Bristol NHS Foundation Trust or Queen Elizabeth Hospital Kings Lynn. In North West Anglia both South Asian and Eastern European patients were significantly less likely to be admitted to hospital than members of the White British community. It is incumbent on all gastroenterologists to consider their own clinical practice and encourage their hospital units to adopt effective policies which remove discriminatory barriers to good quality care.
Highlights
Discrimination in the delivery of care and clinical management of patients with inflammatory bowel disease has been reported in the USA, Canada and the UK [1,2,3,4,5,6]
The hypothesis was that patients with inflammatory bowel disease should have similar hospital admission rates and biologic therapy rates regardless of ethnic origin
In Northwest Anglia National Health Service (NHS) Foundation Trust patients of South Asian origin, who were largely Pakistani, were four times less likely to be admitted to hospital than members of the White British community, with an admission rate of 26% of the expected value. (p < 0.00001, Table 1)
Summary
Discrimination in the delivery of care and clinical management of patients with inflammatory bowel disease has been reported in the USA, Canada and the UK [1,2,3,4,5,6]. In a national study of emergency admissions for ulcerative colitis and outcomes, King et al (2019) found that Asian patients had a significant delay to surgery [8] It was as long ago as 1988 that Bhopal first recognized the existence of racism and discrimination in clinical practice within the National Health Service (NHS) [9]. [10] During the 21st century Black and Pakistani women have received poorer care in the NHS than White women with breast cancer [11] and ethnic minority patients with renal disease are less likely to receive a donor organ [12] This issue of discrimination is seen across the clinical spectrum in the NHS with patients from Black and ethnic minority communities receiving less labor-intensive therapies for treatment of psychotic disorders. Most of the selected Trusts served areas where such communities exceeded 10% of the population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
