Why human rights and healthcare?

Human rights are about the basics we should all have to live dignified lives; they are part and parcel of what it means to deliver and receive healthcare. These universal minimum standards for how human beings should be treated are expressed in laws such as our Human Rights Act. This sets down legal rules for the behaviour and practice of government and public authorities, such as NHS healthcare organisations and their staff. In this way human rights provide a vital safety-net for us all, patients, families and staff alike.

The way healthcare is delivered can determine whether our right to be free from inhuman or degrading treatment is met, whether our right to respect for privacy is fulfilled and whether our right to liberty is restricted only when necessary. Ultimately, the delivery of healthcare can determine whether our fundamental right to life is respected and protected.

There have been too many recent reminders of the tragic human cost of losing sight of our humanity when delivering healthcare (never mind the financial, legal and reputational risks). All too often, tragic failures of care hit the headlines, from Staffordshire Hospital to Winterbourne View, raising issues around the right to life and the right not to be treated in inhuman and degrading ways. The challenge now is to eliminate poor practice and ensure healthcare services are designed and delivered with the person and their rights at the core. Our work shows that empowering nurses to make human rights part of their everyday work, helps to make this happen. See BIHR’s The Difference it Makes for real life stories of healthcare staff and patient advocates, showing why putting human rights at the heart of health and care is the right thing to do.

Why human rights and nursing?

Ensuring human rights are respected in healthcare is a shared responsibility across the service, from the Chief Executive of a hospital to the frontline doctors, nurses and healthcare assistants. As with all staff in the NHS, nurses have a key role in helping to deliver rights-respecting services. This is something to be embraced, in fact the nurses we work with tell us how useful the Human Rights Act can be once it is properly understood. Nurses tell us that using the framework of the Human Rights Act helps to see things from a different perspective, focusing on the person and their rights first. Putting human rights into practice provides the reference-point for making every day (often difficult) decisions about healthcare based on universal standards, rather than individual moral compasses. Nurses tell us this is one of the key benefits – a common language for decision-making, whether they are talking to patients, families or colleagues. As Paul Vaughan, Royal College of Nursing, says:

 “A human rights approach has changed my thinking on responding to poor care and advising our members, getting a balance between the context of what’s going on and the impact that has on a patient. I am now more confident and willing to say – that’s not good enough and to challenge the directors of nursing. It has really helped me to articulate and challenge poor practice.”

BIHR’s work with nurses

BIHR’s partnership work with nurses empowers them to put human rights at the heart of health and social care, placing the human person and their legally protected rights at the centre of policy and day-to-day practice (we often call this a human rights based approach). Our work shows that human rights when properly understood, can help deliver the dignified, accountable and respectful healthcare services we all value. Just a few examples from the many wonderful nurses we work with include:

  • The Royal College of Nursing through long-term partnership working with BIHR’s Human Rights in Healthcare programmes aligned their Principles of Nursing Practice to human rights, published as Human Rights and Nursing: RCN position paper, it now says: “The RCN is committed to supporting and advocating human rights for the positive and practical difference they make to people, patients and nursing… The RCN believes that a human rights-based approach is essential, both in developing health policies and services and in individual practice, and that nurses have a particular obligation to safeguard and actively promote people’s health rights at all times and in all places.”  We have also seen mainstreaming of human rights RCN processes that reach the membership, such as Congress resolutions and fringe meetings.

  •  Betsi Cadwaladr University Health Board (BCUHB), Wales were one of the partners on our Human Rights in Healthcare programmes with the public sector, and together we used human rights to develop a nutrition and hydration toolkit for ward sisters and charge nurses. The toolkit, which focuses on six key areas; safety, environment, audit, meal times, choice, and empowerment, makes explicit links between nutrition and hydration and the legal duties of staff to respect and protect patient’s human rights.  Anne-Marie Rowlands, Assistant Director of Nursing at BCUHB says: “The importance of good nutrition and hydration in supporting patients’ recovery is well recognised.  This innovative project gives us the opportunity to put human rights principles right at the heart of this work.  And we hope that by following this approach we will improve the outcomes of treatment for our patients.”   

BCUHB Nutrition and Hydration Team and BIHR

  • Mental Health Nurses working in an acute unit in the North of England were a key part of a recent programme BIHR led to empower staff and service users. Part of the project included capacity-building sessions with the nurses to support them to view nursing practice through a human rights lens. This helped re-focus on key issues such as the use of least restrictive practices so that human rights to liberty, privacy and possessions were only limited when lawful and proportionate. Importantly, another key outcome was empowering nurses with the confidence to challenge other staff on the unit. So much so that a nurse had a light-bulb moment in one session, saw the consultant walk past and ran out to speak to him to make a small but key change to way information on patient wishes was recorded.

For the last few months BIHR has been leading some very exciting work with a range of nurses, funded by the EHRC. Working with The Royal College of Midwives (RCM), BirthrightsThe Royal College of Nursing (RCN) and Sue Ryder and a group of passionate nurses and midwives to co-produce a set of innovative new guides The guides and have been carefully put together to respond to key human rights challenges for each professional group in a way that make it as easy to use as possible. These will be launched in the summer, so watch this space

Update: Our practical guide, 'Nursing & Human Rights: a practitioner's guide' is now available to download from our website. 

The future

We are about to start the second year of ‘Connecting Human Rights to the Frontline’ our exciting project, supporting seven mental health service providers to address the human rights issues they encounter every day in a way that harnesses their legal duties under the Human Rights Act to do the best for patients and staff. Over the coming year we’ll be working with nurses and other frontline practitioners on some exciting initiatives, including regional training sessions and new human rights tools for practitioners. For more information and updates on our projects visit our site.       

Update: As 'Connecting Human Rights to the Frontline' has now come to an end, we have launched a suite of resources on human rights for practitioners working in mental health and mental capacity. All our practical guides are available to download online

 Our Human Rights Act

Sadly, the future of the very law which makes all this work possible – the Human Rights Act – is uncertain. The new Government has made promises to “scrap” the Human Rights Act (for more info check out our blog here). We know from the thousands of nurses we work with that this would be really bad news. The Human Rights Act is a vital tool for nurses and their healthcare colleagues, providing a practical framework for action, and one which places our human dignity right at the centre of services. The Human Rights Act helps ensure we have an NHS that delivers on the NHS Constitution and the basic promise of human rights to treat people with equal dignity and respect, not only in spirit but in substance.

BIHR will make sure that the work we do with nurses is highlighted in the coming discussions about why the Human Rights Act matters. If you would like to get involved with this work and stand Together for Human Rights then please sign-up hereby