This page provides a step-by-step guide aimed specifically at GPs and Primary Care Networks which have signed up to the EMBRACE Covenant.

Our practice populations are getting older and we need to ensure that we are supporting all groups in our local areas. The needs of the LGBT+ population are important irrespective of age, but older and old LGBT+ people are all too often hidden, their lives and experiences invisible and their health and care needs not considered.

In 2024, Shrewsbury Primary Care Network (PCN) signed up to the Covenant to EMBRACE A Culture of Inclusion. Their action plan resulted from conversations with SAND, inspiration from local events and discussion across Practices. Their learning and the actions the Primary Care Network has identified are relevant to other PCNs.

This webpage provides FIVE STEPS for GP Practices and PCNs to gain more information, raise awareness, plan, take action and recognise change.

Fiona Hay, GP speaking at the 2023 Small Steps Big Difference Conference

STEP ONE – Watch the 4 minute trailer to the film Gen Silent
This American documentary film, which kick-started all of this work in our County succinctly flags up some of the major themes and it is well worth taking a look at the 4 minute trailer on the right.

In addition to general fears of ageing experienced by us all, such as concerns about health, housing, finance etc many older and old LGBT+ are ageing without children, are estranged from families, have no-one to advocate for them, have a dependency on alcohol or drugs, experience poor mental health etc.

STEP TWO – Watch the 14 minute video on SAND’s journey to understand more about the Covenant.
It illustrates how these issues and concerns have been reinforced by SAND’s work over the past 12 years, leading to the development of a Covenant as a way of gaining commitment to change.

There is evidence that health disparities exist amongst older and old LGBT+ people and so by ensuring that we remove barriers to accessing health care we will help to improve the overall health and wellbeing of this population.

If a population is largely hidden, their experiences and needs are unlikely to be properly catered for and so there is a need for visibility and an understanding of the impact of past criminalisation, prejudice and discrimination on those from the older and old LGBT+ population.

STEP THREE – Review Shrewsbury PCN’s commitments

Shrewsbury PCN has adopted the five key commitments required by the EMBRACE Covenant and made them relevant for their GP Practices.

Shrewsbury PCN EMBRACE Action Plan

Commitment 1: to provide the best possible quality services for older and old LGBT+ people

  • Provide services with no prejudice so that all patients feel safe and confident when using them
  • Provide a culture of openness and honesty that is trusted by our older and old LGBT+ population

Commitment 2: to learn what life can be – and has been – like for different LGBT+ people.

  • Ensure that all staff are up to date with equality and diversity training and understand the issues there may be for the older and old LGBT+ population
  • Encourage staff to listen, consider the issues and suggest changes that will benefit our population
  • Enable everyone working in or with our service to have open and honest conversations about the issues that matter to our population

Commitment 3: to vocally and visually support groups working with and for older and old LGBT+ people

  • Patient participation groups often have more retired members – work with them to enhance understanding of our older and old LGBT+ population and improve their representation in the PPGs.
  • Member practices will actively share sign up to the covenant and ensure that this is visible within their buildings, on their websites and social media

Commitment 4: to create meaningful opportunities for LGBT+ people and groups to ‘influence’ what you do

  • Use our websites and social media to speak up on issues affecting older and old LGBT+ people
  • Work with our PPGs to improve the services we provide for our population.

Commitment 5: to assess and evidence work carried out to engage LGBT+ people

  • Work within our ICS to share the work that we do to support older and old LGBT+ people
  • Identify goals that evidence how we are working with older and old LGBT+ people

Download Example Commitments

Use this as a starting point for thinking about your own commitments Shrewsbury PCN Example 5 Commitments

STEP FOUR – Make your own plan
We suggest that each Practice now develops it’s own implementation plan, linked to organisational aims and priorities. Take a look at the example below.

Action:
Review mission statements (Relating to commitments: 1,2,3,4)

What will this achieve?

  • What we have laid out in our commitments.
  • Outline what we need to do to meet our commitments e.g. We will be able to identify what training needs practices may have and work out a plan to implement this.

Practicalities (Who will do/lead on it? Include here When will they do it & review it?)

Practice Managers / DATE / DATE

Action:
Discuss the covenant in PPG meetings (1,2,3,4,5)

What will this achieve?

Monitor progress on meeting our commitments

Practicalities

Practice Managers / DATE / DATE

Action:
Present the covenant to the PCN board (1,2,3,4,5)

What will this achieve?

Improve understanding and raise awareness of the purpose of the covenant. Discuss what staff training will be needed in practices.

Practicalities

PCN clinical director and COO / DATE / DATE

Action:
Ensure that support for EMBRACE is visible on practice and PCN websites and waiting room screens (1,2,3,4,5)

What will this achieve?

This will raise the visibility and ensure that the whole of our patient population is aware of our support for EMBRACE.

Practicalities

PCN DT lead / DATE / DATE

Action:
Check websites for visibility, ask practice managers in PM meetings what they have done in their practices to improve visibility (3,4,5)

What will this achieve?

This will raise the visibility and ensure that the whole of our patient population is aware of our support for EMBRACE.

Help us to monitor progress and evidence change

Practicalities

Practice Manager/PCN DT lead / DATE / DATE

Action:
Undertake a short survey to send to staff in practices to get feedback on the training. Ask what response they have had from our patient population.(5)

What will this achieve?

Help us to monitor progress and evidence change

Maintain commitment and illustrate change

Motivate and feedback to colleagues

Practicalities

PCN Team / DATE / DATE

Action:
Undertake a short survey for PPG members to canvas their views on the presentation of the EMBRACE covenant and what changes they may have decided to make in their PPG (5)

What will this achieve?

Help us to monitor progress and evidence change

Maintain commitment and illustrate change

Motivate and feedback to colleagues

Practicalities

PCN Team / DATE / DATE

Download Example Action Plan

Use this as a starting point for your own action plan Shrewsbury PCN Example Action Plan

STEP FIVE – Discover more
Browse this website. There are many resources for you to find out more, add to training sessions, provoke discussions, share with colleagues, suggest to the older and old LGBT+ people you meet. These include:

EMBRACE RESOURCES – to help you to continue learning, share learning and to take ongoing practical actions within and across your sector to EMBRACE A Culture of Inclusion.

LIBRARY – of materials mainly produced by others beyond Shropshire, Telford & Wrekin collected and indexed using key words from the Subject headings of the Skills for Care Learning Framework,

WE CAN – focuses on what LGBT+ people over the age of 50 who live, work and/or play in Shropshire, Telford & Wrekin can do to make ageing experiences as good as possible