Report of the Joint Director of Equality and Engagement - NHS GM Integrated Care (Manchester locality) and Manchester City Council.

This report explores the inequalities faced by LGBTQ+ communities and the support provided by Council services to improve access, experience, and outcomes.

The committee considered a report of the Joint Director of Equality and Engagement - NHS GM Integrated Care (Manchester locality) and Manchester City Council which explored the inequalities faced by LGBTQ+ communities and the support provided by Council services to improve access, experience, and outcomes.

Key points and themes within the report included:

• The Council’s equality commitments through the Public Sector Equality Duty (PSED);
• The key strategies and plans that aim to make Manchester a more equitable place to live and work;
• An overview of Manchester’s LGBTQ+ population, provided through the 2021 Census;
• The quality of life and feelings of acceptance, comfort, and satisfaction of LGBTQ+ residents;
• The intersectional approach to LGBTQ+ inclusion;
• Education, employment, housing and healthcare;
• Case studies to demonstrate the delivery of the Council’s Equality Objectives; and
• Areas for further work to support the Council’s workforce to lead high-quaity, culturally competent community engagement work.

Key points and queries that arose from the committee’s discussion included:

• Thanking guests for their attendance and their work;
• Noting that the Council had passed a motion to ‘Make HIV History’ but that there remained difficulties for residents in accessing HIV testing kits, and querying why this was;
• How many GPs were yet to register with Pride in Practice;
• If any investigation into a possible causal link between overrepresentation of LGBTQ+ people in the youth homeless population and higher incidences of mental health issues and suicidal ideation in young LGBTQ+ people had been undertaken;
• Whether any up-to-date data was available on the number of Black, Asian and Ethnic Minority (BAME) LGBTQ+ people experiencing racial discrimination from within the LGBTQ+ community, noting that recent figures were from 2018;
• The overall rate of workplace conflicts for LGBTQ+ people, and whether this was improving;
• How the Council was tackling instances of ‘gatekeeping’ in the Gay Village;
• Requesting more extensive data on the number of LGBTQ+ people experiencing homelessness;
• The lack of information on sexual health services within the report and lack of data around patient satisfaction;
• Noting that anti-trans sentiment is higher amongst cisgender men than amongst cisgender women, despite the transphobic narrative being that trans people pose a threat to cisgender women’s safety;
• Noting that the rapid decrease in public support for trans people was the result of a hostile media that platforms transphobic voices;
• How many schools in Manchester had signed up to the Rainbow Flag Award;
• Noting that Neighbourhood Investment Funding had been allocated to support the first-ever Withington Pride, which took place in September 2023 and was attended by a large number of people from across the local community;
• Whether trans inclusion training would be offered to everyone in the Council; and
• What the LGBT organisations would like to see brought forward.

The Deputy Leader stated that this was an important report to identify the inequalities faced by the LGBTQ+ community and expressed that the Council wanted to ensure suitable support was available and that communities felt comfortable, supported and that they could thrive in Manchester.

The Joint Director of Equality and Engagement explained that the report provided an overview of the Council’s work to enhance LGBTQI+ inclusion. She stated that Manchester was a sanctuary for LBGTQI+ people, with the largest community outside of London, but acknowledged the challenges faced by those in the transgender community.  The committee was advised that focus groups had been held during the development of the report and that this dialogue would be continued.

The Lead Member for the City Centre provided an overview of the Council’s LGBTQ+ journey and progress. He highlighted the challenges faced and welcomed the achievements made since the 1980s.

Representatives from African Rainbow Family, The Proud Trust, Manchester Pride, the LGBT Foundation, George House Trust, Manchester Law School and Indigo NHS Greater Manchester Gender Service attended the meeting and shared the work of their organisations and the experiences of their service users in Manchester.

In response to a member’s query regarding what was causing gaps in access to HIV testing kits, Darren Knight of George House Trust stated that whilst Manchester was doing well in take-up of HIV testing, more work needed to be done and there needed to be more investment in sexual healthcare to increase access. He stated that there was a myriad of ways for people to access sexual health treatment and that targeted promotion was valuable. He explained that ‘opt-out’ HIV testing was a gamechanger, but prevention was key and more people needed to be encouraged to use PrEP medicine, which could be taken before sexual intercourse to help reduce the risk of catching HIV. It was noted that there had been a good take-up rate of PrEP amongst gay and bisexual men and there had been a good response to mpox vaccination in 2022.

Paul Martin of the LGBT Foundation conceded with Darren’s comment that access to sexual health services was key. He stated that there was a 1 in 10 chance of calls to a sexual health clinic being answered, which was due to lack of investment and staff shortages. He also explained that organisations in Manchester had reestablished the mpox vaccination programme, following a national decision to only offer this in London, but were unable to publicise this service due to concerns that it may overwhelm capacity. He stated that national investment was needed to enable local services to develop further.

The committee was also advised that 75 out of 84 GP surgeries across the city were currently registered with Pride in Practice. Paul Martin of the LGBT Foundation explained that some surgeries felt they did not need to take part in the Pride in Practice scheme and that some would not engage, particularly since involvement was not mandatory. The Joint Director of Equality and Engagement explained that the Primary Care team worked with GP practices to encourage the take-up of this and linked it with standards. She highlighted that Manchester had a higher take-up of Pride in Practice than other Greater Manchester boroughs.

The Joint Director of Equality and Engagement explained that there were a number of reasons as to why there was a higher percentage of young LGBTQ+ people presenting as homeless but stated that there had not been any specific work undertaken by the Council or Health Service to link homelessness with mental health, but this was something that could be undertaken. The Deputy Leader highlighted that this topic was included in the next report on the meeting’s agenda and that the Council wanted to ensure that services were inclusive and supportive through the new Homelessness Strategy. This was also an area that could be assessed by the Homelessness and Health Taskforce.

The Deputy Leader also recognised the need to address the unique issues facing LGBTQ+ refugees and asylum seekers and the ways that this could be done. She noted the potential impacts of the recent government policy change which would give migrants, refugees and survivors of trafficking a minimum of seven days to find alternative accommodation upon receipt of an eviction notice from Home Office accommodation, and the need to identify ways to support those affected. She also highlighted that the Council was now a Local Authority of Sanctuary.

In response to a member’s query regarding queer and trans people experiencing racism, the Joint Director of Equality and Engagement suggested that the statistics on this from 2018 were unlikely to have changed and recognised the issue. She stated that the Census 2021 data had enabled better collection of information and the Council had revised and published its monitoring standards, which would improve the collection of data once embedded. 

With regards to the overall rate of workplace conflicts for LGBTQ+ people, the committee was informed that this study was undertaken by the CIPD and it was suggested that these figures were unlikely to have changed, given the current climate.

TheJoint Director of Equality and Engagement committed to liaising with the  Licensing team to understand what levers the Council had in place to address ‘gatekeeping’ within the Gay Village. Paul Martin of the LGBT Foundation explained that the Council had commissioned LGBT Foundation to deliver anti-racism training to venues and door staff in the Village and that the study into the future of the Village that was commenced prior to the Covid lockdown would be recommissioned, which he felt would be an opportunity to understand what people wanted in the Village.

Aderonke Apata of the African Rainbow Family highlighted a unique issue facing asylum seekers, which prevented them from entering venues in the Village as they did not hold valid identification.

In response to a member’s comment regarding sexual health services and difficulties in accessing tests, the Chair advised that this would be an issue for Health Scrutiny Committee to consider but suggested making a recommendation to request further detail on provisions. The committee was advised that the Health Scrutiny Committee would consider the Public Health Annual Report, with a focus on sexual health and HIV, at its meeting on 6 March 2024.

TheJoint Director of Equality and Engagement confirmed that trans inclusion training had been rolled out to senior management and would be provided to specific directorates such as Communications and the Housing and Homelessness Service. The Deputy Leader stated that this would be rolled out more widely in future and this would include members.

In closing the item, the Chair asked the representatives from each organisation what they would like to see brought forward to improve the experiences of LGBTQ+ people in Manchester. Lisa Harvey Nebil of The Proud Trust stated that she would like increased LGBTQ+ training and education for schoolteachers, social workers, and youth workers. Farhana Hemani of Manchester Pride suggested it would be useful to adopt the Pioneer Creative Health Strategy and to consider how creativity can help to tackle inequalities as a key part of queer culture. Darren Knight of George House Trust emphasised the need to shift from co-design to co-ownership to ensure that everyone feels involved in plans and changes in the city. Aderonke Apata of the African Rainbow Family championed appropriate accommodation and better access to justice for LGBTQ+ refugees and asylum seekers. Paul Knight of the LGBT Foundation stated the need to continue working collaboratively and to recognise the economic benefits that this would bring. Professor Stephen Whittle of Manchester Law School and Chair of Indigo NHS Greater Manchester Gender Service encouraged the wider rollout of the trans inclusion training to all Council staff.

The Deputy Leader thanked guests for their attendance and committed to continuing to work collaboratively.

Decision:

That the committee

1. thanks the representatives of African Rainbow Family; The Proud Trust; Manchester Pride; George House Trust; LGBT Foundation; and Manchester Law School and Indigo NHS Greater Manchester Gender Service for attending the meeting and commends the work they do for the LGBTQ+ community in Manchester;
2. notes the progress made to date on delivering the Equality Objectives;
3. expresses their support of the approaches to working with communities and areas for further development outlined in the report;
4. recommends that the Council works closely with African Rainbow Family to identify how issues affecting LGBTQ+ refugees and asylum seekers, particularly in accessing housing, can be addressed;
5. requests that officers liaise with the Licensing team to identify what levers the Council had in place to address ‘gatekeeping’ within the Gay Village; and
6. recommends that the trans inclusion training be rolled out across the whole Council at the earliest opportunity.