Are doctors going to be forced to ask about your sexual orientation?

16 October 2017
What was claimed

All patients over the age of 16 attending a doctor or hospital appointment in England must now be asked about their sexual orientation.

Our verdict

That’s not quite right, these new guidelines aren’t compulsory and it’s up to individual organisations whether they collect it. It’s still predicted to be introduced widely.

“Every patient visiting their family doctor or attending a hospital appointment in England will be asked to declare if they are gay, straight or bisexual under controversial new rules imposed by the NHS.”

Mail Online, 14 October 2017

“NHS doctors and nurses in England will be required to ask every patient from the age of 16 to declare their sexual orientation.”

Times, 15 October 2017

“Patients visiting their GPs or hospitals in England for face to face appointments are to be asked about their sexual orientation in new guidelines being issued by the NHS.”

Telegraph, 15 October 2017

New rules were issued by NHS England earlier this month which recommend that all health services and councils with responsibilities for Adult Social Care in England  record information about their patients’ sexual orientation (if the patient is over 16 years old) in the same way.

A number of media reports suggest that collecting this information is now compulsory.

NHS England told us these new guidelines aren’t compulsory. The guidance suggests that all health services and councils providing adult social care in England should follow a set format and way of collecting the information if they ask patients about their sexual orientation.

The question won’t be mandatory

The information standard issued by NHS England says that “This standard does not mandate implementation and will not monitor conformance.” The guidance does say that NHS England recommends that health services and councils use it. NHS England says it predicts all organisations will be doing so by April 2019.

NHS England told us it wasn’t compulsory for health services and adult social care providers to comply with the new rules and that it was up to individual organisations to collect the information.

What the guidance does say is that “where dataset owners and health and social care organisations decide to record patient/service user sexual orientation, the data should be recorded as per this standard.”

So it seems that if health and social care professionals are going to record information about a patient’s sexual orientation, the guidance sets out the way they have to do it.

A Welsh government spokesperson told us that There are currently no plans to introduce a similar approach in Wales. GPs in Wales would know their patients and will ask about their sexuality if it is relevant to their medical condition.”

A Scottish government spokesperson told us that “There are various reasons why individual boards or services collect information on patients’ sexual orientation. It could help them to improve patients’ experience of care, or to better plan services for future needs. There is national guidance to advise boards, but it is of course entirely up to the individual whether they want to disclose this information.” We’ve asked them for more information on what kind of guidance they provide.

Patients will be asked a multiple choice question

The guidance applies to all health services and council run adult social care services in England. If your health service or the council providing social care follows this new guidance then you may be asked:

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. Person asked and does not know or is not sure
  6. Not stated
  7. Not known

If a patient chooses not to answer then this is recorded. If the patient is unable to answer and the information is not known, then it won’t be recorded.

The information standard came into effect on 5 October and NHS England says it wants all health services and councils providing social care to follow it (if they are going to ask about sexual orientation) by April 2019.

“We recommend that this standard is used to record sexual orientation at every face to face contact with the patient, where no record of this data already exists” according to the guidance. It also says that this information will be updated every so often along with other information collected about a patient – like their home address.

Some services already collect this information

Some services in the NHS already collect information about sexual orientation. Those services using three specific data sets already had guidance on asking patients about sexual orientation. These included two datasets related to mental health and one linked to sexual health services.

NHS England says that “Recording sexual orientation will allow policy makers, commissioners and providers to better identify health risks and will help support targeted preventative and early intervention work to address the health inequalities for people who are Lesbian, Gay or Bisexual.” It also says that collecting the information will allow providers of health and social care to identify health risks and show that LGBT people get equal access to services.

The Health and Social Care Act 2012 describes an information standard as “a document containing standards that relate to the processing of information.”

The NHS has information standards on a wide variety of topics, from how to record a patient’s name, gender and sex to how information about paediatric care or meningitis vaccinations should be recorded.

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