The Difference It Makes: Putting Human Rights at the Heart of Health and Social Care BIHR were very excited to introduce in December our new guide to human rights in health care. The Difference it Makes had a high level launch, where it was welcomed by key note speaker, Jon Rouse, the Director General for Social Care at the Department of Health. The guide has been flying off the shelves ever since. The introduction explains why human rights matter in healthcare. The link between the two is not new; in 1948 the UK was championing international human rights at the same time as creating the NHS at home. We can sometimes lose sight of the fact that the person, the human being is at the heart of the healthcare system, but the first principle of the NHS constitution is: “The NHS provides a comprehensive service, available to all… It has a duty to each and every individual that it serves and must respect their human rights”. This report is the outcome of over 10 years work with our partners in the health and social care field. This raises the question: how did you fit 10 years of work into a guide less than 30 pages long? The answer to this is that over these 10 years, it has been our mission to show that human rights are not a complicated legal issue to be dealt with by judges and lawyers. They can be simple tools that can be used to make everyday decisions. This guide focuses particularly on how healthcare practitioners can use human rights, but can also be used by anyone using services or those seeking to use a human rights approach in their own area of work. Our guide, then, seeks to show how a human rights approach can be used in health care settings and we have illustrated it with loads of examples of good practice from our partnership work with both public sector bodies and voluntary and community groups in health and social care. To quote ourselves, “put simply, a human rights approach is the explicit use of human rights values and standards in policy, planning and delivery”. We’ve laid out a simple approach to using human rights in everyday decision making: it’s called the PANEL approach… Participation This is about the involvement of key people in decision making, both the individual and their family/carers. It’s also about making sure these people understand the situation and can have their say. At a human rights level, it about the right to respect for private and family life. Participation can make a huge difference to people’s experience of healthcare. One of our partners worked with Paul, a young person caught in a legal battle to be rehoused due to traumatic experiences in his borough. He took part in a project teaching young people about human rights, and he was able to contact the court and explain how he felt his human rights had been interfered with. Paul was rehoused, but most importantly, he said he felt as though he had a voice in his own case and a right to be heard. Accountability Accountability is about ensuring everybody knows who is responsible for ensuring human rights decisions are made. If a public body has duties under the Human Rights Act, it’s about knowing who is accountable for those duties being met. Health service users should be able to clearly identify who is accountable for human rights decisions that concern them. Balbir, a 48 year old woman one of our partner organisations worked with, suffered a stroke leaving her severely physically disabled and as a result she could not use the stairs to get to her bedroom or bathroom in the house she shared with her two teenage sons. The local authority refused to build a downstairs bathroom and Balbir was left sleeping and using a commode in her living room. After her advocate wrote to the local authority explaining that her circumstances were humiliating and degrading, referring to her right to be free from inhuman and degrading treatment under the Human Rights Act, and the authority agreed to install an accessible downstairs bathroom. Non-Discrimination Equality is a key human rights principle, and a human rights approach aims to see discrimination eliminated with particular attention paid to groups who have been made vulnerable. Our partner organisations have run human rights skills and information sessions for service users living with HIV, young people in the Roma community and carers of older people. Mersey Care NHS Trust developed a human rights based quality of life assessment to tackle discriminatory attitudes in dementia care, with support from BIHR. Empowerment Empowerment is the purpose of the guide! It’s about making sure that staff and service users have both knowledge of human rights and the skills and confidence to use human rights in practice. Many organisations we worked with produced their own guides, teaching their staff to use human rights in their own areas of work such as the human rights board game developed by a group of staff and service users from Mersey Care NHS Trust. Law A defining feature of a human rights approach is the explicit reference to human rights law. The main law protecting our human rights in the UK is the Human Rights Act (HRA). Four pages of the guide lay out simply how the Human Rights Act works and the main rights relevant in health and social care settings. Using a human rights approach can improve the outcomes for both healthcare professionals and service users; putting people at the centre of healthcare, improving services and in the long term reducing complaints. That’s why it is important that the PANEL approach isn’t simply treated as a checklist but used as a way to think about the totality of your approach. Over the last 10 years we’ve worked with some fantastic organisations, both charities and NHS Trusts, and we’ve tried to share a little bit of what they do in this report, so if you’re interested in finding out more about the great work being done in this area, please download a copy from our website here.