What is Bias in Health and Social Care?

Bias is when someone’s personal views, beliefs, or experiences affect the way they treat, think about, or provide care to others. In health and social care, bias can influence decisions, attitudes, and actions towards people who use services. This can have a direct effect on the treatment, care, and support individuals receive.

Bias can be conscious or unconscious. When bias is conscious, it means a person is aware of their prejudices or dislikes. Unconscious bias means the thoughts or actions happen instinctively, often without the person realising.

Bias does not always mean someone intends to treat another person unfairly. Sometimes, people may act in a biased way without knowing. In health and social care, it’s important for workers to be aware of and challenge their own biases. Unchecked bias can lead to inequalities and poorer outcomes for those receiving care.

What are the Different Types of Bias?

Several types of bias exist in health and social care settings. These include:

• Racial and ethnic bias
• Gender bias
• Age bias
• Disability bias
• Socio-economic bias
• Weight and appearance bias
• Sexual orientation and identity bias

Racial and Ethnic Bias

Racial bias involves unfair treatment or assumptions about people because of their race or ethnic background. This can result in people from minority groups receiving poorer care, feeling unwelcome, or being misunderstood. In the UK, there have been situations where some ethnic groups face barriers to accessing services or have their symptoms taken less seriously.

Gender Bias

Gender bias happens when care varies depending on a person’s gender. For instance, women’s health complaints might be dismissed, or men may be less likely to seek help because of stereotypes about masculinity. Bias can affect diagnosis, treatment, and support provided.

Age Bias

This is when someone is judged or treated differently because of their age. Older adults may be seen as less capable or as a lower priority, which can result in their needs being overlooked. Similarly, younger people can be dismissed if seen as ‘too young’ to understand their own health.

Disability Bias

People with physical or learning disabilities can face assumptions that they are less able or have a poorer quality of life. Health needs may be ignored or seen as ‘part of the disability’ rather than a separate issue requiring attention.

Socio-economic Bias

People from less wealthy backgrounds can be viewed as less deserving or responsible for their difficulties. Staff may make harmful assumptions about their lifestyle, choices, or commitment to treatment.

Weight and Appearance Bias

People who are overweight or have certain appearances can face stigma. This can mean health problems are blamed entirely on weight, which leads to missed diagnoses or poor support.

Sexual Orientation and Identity Bias

LGBTQ+ individuals can experience prejudice or lack of understanding. They might feel unable to be open about their identities, which can affect the care they receive.

How Bias Shows Up in Practice

Bias can affect many parts of health and social care, including:

• The language used with people who use services
• Diagnosis and treatment decisions
• Advocacy and support
• Access to services
• Relationships between staff and people receiving care

Language Used

The words care staff use can carry bias. Examples include using patronising language with older adults or different terms for those with mental health issues. Tone of voice or non-verbal behaviour can also reveal biases.

Diagnosis and Treatment

Bias can mean some symptoms or complaints are ignored, misdiagnosed, or not taken seriously. Staff may make assumptions based on stereotypes rather than evidence. For instance, assuming a young person is ‘just anxious’ instead of listening to their full concerns.

Advocacy and Support

Care workers may not put in the same effort for every person. They might help those they relate to or sympathise with, while neglecting others. This leads to unequal levels of support.

Access to Services

Organisations may design services that suit one group more than others. For example, clinics opening at times that are inconvenient for working parents or locations that are hard for people using wheelchairs to reach.

Relationships and Attitudes

Staff may show friendliness to one person and coldness to another, based on unconscious feelings. This affects the level of trust and comfort people feel.

Impact of Bias on People Receiving Care

Bias can have serious effects on individuals and groups. These can include:

• Lack of trust in health and care providers
• Reluctancy to seek help again
• Poorer physical and mental health outcomes
• Feeling excluded, unwelcome, or misunderstood
• Reduced satisfaction with care

People who sense they are treated differently can feel hurt, anxious, or angry. They may avoid services altogether, which puts their health at further risk.

Where Does Bias Come From?

Bias can come from different sources in health and social care.

Personal Experiences and Beliefs

People are shaped by their upbringing, culture, and life experiences. Staff might hold personal beliefs that affect how they see others. These beliefs might not always match professional values.

Stereotypes and Assumptions

Stereotypes are widely held but oversimplified ideas about groups of people. For example, assuming older adults are forgetful, or that single parents are less committed. Such assumptions can influence behaviour and decisions.

Organisational Culture

The way an organisation runs can affect how bias develops. If staff see unfair treatment go unchallenged, or if rules favour certain groups, it can reinforce biased behaviours.

Training and Education

Training can help tackle bias, but sometimes staff are not given enough. Without good training, unconscious biases may remain unchecked.

Media and Society

The media often shapes the way different groups are seen. News, films, and social media can spread stereotypes, which influence public opinion and, in turn, the attitudes of staff in care roles.

Unconscious Bias

Unconscious bias is one of the hardest forms to address. People may truly believe they treat everyone fairly, but deep down, past experiences or beliefs guide their actions. This can show up in:

• Body language or facial expressions
• Quick decisions or ‘gut feelings’ about people
• Who staff choose to spend more time with

Staff may not notice these patterns until they reflect or receive feedback.

Tackling Bias in Health and Social Care

Reducing bias is important for fair, safe, and respectful care.

Reflective Practice

Care workers should think about their own behaviour and decisions often. This means looking back on actions and asking:

• Did I treat everyone the same?
• Did I jump to any conclusions?
• How do I feel about certain groups or individuals?

Reflective practice encourages honesty and self-improvement.

Training and Education

Regular training helps staff learn about bias and how to manage it. Training covers:

• Understanding different cultures and backgrounds
• Challenging stereotypes
• Good communication skills

Training needs to be ongoing, not just a one-off session.

Diverse Teams

Teams that include a variety of backgrounds can help reduce bias. Different perspectives can challenge group assumptions and help staff spot bias in each other’s work.

Listening to People Who Use Services

Listening is a powerful way to tackle bias. Staff need to hear people’s experiences and feedback. This helps identify areas where bias exists and create change.

Supervision and Support

Regular supervision helps staff discuss issues, reflect, and get advice. Managers and leaders should support an open culture where concerns about bias can be raised safely.

Reviewing Policies and Procedures

Organisations must review policies to stop bias creeping in. This involves:

• Checking if some groups are left out
• Adjusting services to suit all needs
• Making reasonable adjustments, like accessible buildings

Policies and Laws Protecting Against Bias

Several laws and policies fight discrimination and bias in the UK. They include:

• The Equality Act 2010 – protects people from unfair treatment on grounds such as race, gender, religion, disability, age, and sexual orientation.
• The Human Rights Act 1998 – defends the basic rights and freedoms of everyone.
• The Care Act 2014 – stresses personalisation and choice in social care.

Regulatory bodies, such as the Care Quality Commission (CQC), have standards to check organisations treat people fairly and respectfully.

The Role of Advocacy

Advocates support individuals to have their voices heard. Where someone feels bias has affected their care, an advocate can:

• Help raise the concern or complaint
• Support the person through appeals or meetings
• Speak up for those who find it hard to express themselves

Advocacy helps to balance out power and make sure everyone is listened to.

The Benefits of Reducing Bias

Challenging bias leads to:

• Healthier, happier people
• Trust between staff and those who use services
• More inclusive and effective care
• Fewer complaints or conflicts
• A positive reputation for organisations

When bias is addressed, everyone benefits.

Everyday Actions to Challenge Bias

Health and social care workers can take small steps every day to avoid bias:

• Treat each person as an individual
• Listen closely, without judgement
• Avoid assumptions based on appearance or background
• Take time to reflect on your actions
• Attend regular training
• Value diversity in your team and the people you meet

The Ongoing Work Needed

Bias will not disappear overnight. It requires constant attention. Staff need support, clear policies, and enough resources to provide fair care. Leaders should set an example and hold people accountable.

People who use services can also be involved. Listening to feedback and creating partnerships with communities helps stop unfairness.

Final Thoughts

Bias is when views, attitudes, or stereotypes affect how care is given or received. It can arise from conscious or unconscious beliefs. Bias can harm individuals and groups, often without staff intending it.

A fair health and social care system requires honesty, reflection, and a willingness to challenge our own thoughts and actions. Protecting everyone’s rights and dignity is at the heart of good care. Awareness, training, supportive leadership, and listening are key tools for making sure bias does not stand in the way of quality care.