The NHS England Fundamental Information Standard for Monitoring Sexual Orientation.

Abstract

In October 2017 NHS England launched the Fundamental Information Standard for Monitoring the Sexual Orientation of patients/service users (aged ≥16 years) in all health services and local authorities with responsibilities for adult social care. This acts as a pilot for a unified information standard and is being shared with other UK home nations.1 This announcement has been misreported in the media and prompted objections from the Family Doctor Association, but extensive research has shown that negative reactions are typically based on uncontextualised assumptions about the process and feasibility of monitoring patient sexual orientation (Box 1).2–4 Box 1. ### Standardised monitoring question, response items, and coding1 Which of the following options best describes how you think of yourself? 1. Heterosexual or straight 2. Gay or lesbian 3. Bisexual 4. Other sexual orientation not listed 5. Not known (not recorded) This article contextualises the introduction of the information standard and reports unpublished data from a survey exploring the attitudes of general practice staff in England towards monitoring sexual orientation. News coverage has reported challenges to the value and purpose of such monitoring, but it has been consistently shown that significant and unaddressed health inequities exist among lesbian, gay, and bisexual (LGB) people compared with the general population, including: self-harm and suicide, smoking, alcohol and drug use, eating disorders, domestic abuse, some cancers, and increased isolation/vulnerability in old age, as well as men’s sexual health.5–7 UK research has also shown lower rates of LGB access to health services, avoidance of screening …