Laying the groundwork is the key to successful monitoring. If your organisation already monitors sexual orientation, then it would be worthwhile to review and amend existing policies and practices. Creating or building on an existing culture of monitoring, and ensuring an environment of openness and tolerance is essential, but will take time. Organisational drive must be present and monitoring needs to be supported and implemented across the whole organisation.
If you are going to use IT systems, make sure they facilitate sexual orientation monitoring; some practitioners have been held back by computerised systems which generate default answers to fill in missing data, or systems which don’t offer anywhere to record sexual orientation. Make sure that security and data protection measures are in place.
Understand why you’re monitoring
Make sure that you and your staff understand what you are trying to achieve through sexual orientation monitoring and build your systems and processes around that. Monitoring works best when seen as part of a wider intelligence strategy; you can use whatever data is available, including ‘grey literature’ 4, to compare with your datasets and further understand the needs of LGB people.
Staff and service users have to understand why sexual orientation information is being collected, how it will be analysed, what the information will be used for and how it will be safeguarded; you may need to provide training to ensure understanding. Where staff are concerned, remember that they may be answering the question for themselves and asking it of service users; confidence needs to be built into both aspects. When promoting sexual orientation monitoring, focus on how it will benefit the individual:
- How will sexual orientation monitoring improve outcomes for service users?
- How does it relate to outcomes for staff?
- How will it improve organisational culture for employees?
It can help to have a model answer, or an at-a-glance summary of your organisation’s policy on monitoring, ready to hand to explain why you are monitoring sexual orientation and to help staff answer any difficult questions they might have.
Your organisation’s confidentiality policy needs to be easily accessible and well understood by everyone involved in the process. Confidence in confidentiality will ensure confidence in your organisation, and increase disclosure rates among both staff and service users.
Identify training needs in your organisation, both for staff who will be working with service users, and general training to approach the process of monitoring if necessary. Training can be provided before you start monitoring, or if you seem to have low response rates or disclosure. Remember that monitoring is a process, and that your first monitoring exercise may identify many more areas to develop; learning through doing is invaluable.
Establish which individuals or teams in your organisation are responsible for data collection and make sure you have systems to monitor their collection. If you need to, provide training so that staff know why they are monitoring and are able to respond to challenges they might face.
Preparation leads to success
Taking the time to plan and prepare for sexual orientation monitoring will improve the results you get and ensure that monitoring is part of a drive to achieve equality, rather than mere compliance. Monitoring is a process, and any barriers that you meet can be overcome by targeted preparation.4 Grey literature refers to reports produced by voluntary and community sector organisations, government agencies and other groups that have not been distributed commercially. An example would be the Lesbian & Gay Foundation’s Proud to be Safer evaluation of its condom and lube distribution scheme.
Explaining the usefulness of sexual orientation monitoring in the context of individual staff roles and its potential impact on quality of care and service user outcomes can have a positive effect. This worked well with inpatient staff at Pennine Care NHS Foundation Trust where there was an immediate and dramatic improvement in the quality of service user sexual orientation monitoring post-training sessions.Jackie Bailey
Pennine Care NHS Foundation Trust