What is Affinity Bias in Health and Social Care?

Affinity bias in health and social care refers to the tendency for people to favour others who they feel are similar to themselves. This similarity can be in background, appearance, values, beliefs, education, social status, or other personal traits. In a care setting, this bias can affect how staff interact with patients, colleagues, and families. It can be unconscious — meaning the person showing the bias may not be aware they are doing it.

In simple terms, affinity bias means giving more positive attention or opportunities to those who are like us, consciously or otherwise. In health and social care, where professionals work with people from diverse backgrounds, unchecked affinity bias can influence treatment decisions, communication, and workplace relationships.

The bias can cause professionals to relate more easily to certain service users and less easily to others, which risks unequal care. It can also occur in recruitment, training, promotions, and team dynamics within care organisations.

How Affinity Bias Can Appear in Practice

In health and social care, situations where affinity bias may appear include:

• A nurse feeling more comfortable talking to a patient who shares the same cultural background, and spending longer with them than with others.
• A care worker giving preferred shifts to colleagues they have more in common with socially.
• A manager choosing candidates for training opportunities who attended the same school or grew up in the same town.
• Health visitors connecting more naturally with parents whose parenting style mirrors their own, and giving more informal advice or encouragement to them.

These examples highlight how affinity bias can influence behaviours without the person consciously intending harm. Small differences in attention, support, or encouragement can add up to bigger inequalities over time.

Effects on Service Users

Affinity bias can impact service users in several ways. If a care provider spends more time, energy, and empathy on certain individuals and less on others, the quality of care can become uneven. Service users who do not share similarities with the staff may feel less welcome, less listened to, or less understood. Over time, this can lead to:

• Reduced trust in care providers.
• Lower engagement with health and social care services.
• Missed diagnoses or delayed treatments if communication is uneven.
• Increased feelings of isolation or discrimination.

In a diverse society, many people may find themselves outside a caregiver’s ‘circle of similarity’. This is why awareness of affinity bias matters for fairness and quality care.

Effects on Colleagues and Teams

Affinity bias does not only affect patients and service users. It can influence relationships within care teams too. If a manager tends to favour staff members they see as more alike to themselves, opportunities may be given unevenly. This risks:

• Unequal access to training and promotion.
• Lower morale among unfavoured staff.
• Team divisions and reduced collaboration.
• Loss of valuable skills when good staff leave due to feeling overlooked.

For health and social care organisations, this can directly affect service quality, staff retention, and workplace culture.

Links to Equality Law in the UK

The Equality Act 2010 protects people from discrimination on grounds known as protected characteristics. These include age, race, sex, disability, religion or belief, sexual orientation, gender reassignment, marriage and civil partnership, and pregnancy or maternity.

Affinity bias is not always direct discrimination under the law — unless it results in unfavourable treatment linked to one of those protected characteristics. But even when it does not break the law, it can break organisational policies and professional standards, such as the Nursing and Midwifery Council (NMC) Code or General Social Care Council requirements.

Professional bodies expect staff and managers to treat people fairly. This includes being aware of unconscious bias and working to reduce its effects.

Why Affinity Bias Happens

Humans naturally seek connection. In settings where stress or workload is high, people may lean more towards familiarity for comfort. This unconscious preference is part of human behaviour, but that does not make it harmless in health and social care.

This bias can develop from:

• Shared cultural or social backgrounds.
• Common life experiences, such as parenting or living in a certain area.
• Similar hobbies or interests.
• Similar appearance or mannerisms.
• Shared values or political views.

In other workplaces, affinity bias might be less harmful. In health and social care, however, all users deserve equal treatment regardless of similarity to staff.

Recognising Affinity Bias

Recognising affinity bias starts with reflection. Staff and managers can ask themselves:

• Do I spend more time with certain service users than others?
• Do I feel more relaxed or open with some people compared to others?
• Does similarity influence my decisions about training, recruitment, or support?
• Have I ever connected more with colleagues who share my background?

Workplace training can help staff see where bias might appear. Without awareness, a person cannot change their behaviour or challenge bias in others.

Reducing Affinity Bias in Health and Social Care

Steps to reduce affinity bias include:

• Training on unconscious bias — Understanding what bias is and how it works.
• Reflective practice — Thinking about interactions and how they could be more inclusive.
• Structured decision-making — Using clear, objective criteria for tasks like recruitment or patient prioritisation.
• Peer review — Discussing cases or decisions with colleagues to check for fairness.
• Monitoring outcomes — Checking data for signs that some groups receive more favourable treatment than others.

Organisations can use these steps to limit bias in both service provision and workplace decisions.

The Role of Leadership

Leaders in health and social care have a role in setting culture. If managers model fair treatment across all staff and service users, bias is less likely to take root. Leaders can:

• Openly discuss unconscious bias with teams.
• Provide tools and training for fair decision-making.
• Encourage staff to challenge bias in themselves and others without fear of blame.
• Make equality part of regular performance reviews and quality checks.

When leaders address affinity bias directly, staff are more likely to be aware of it and take steps to minimise it.

Affinity Bias versus Friendliness

Affinity bias is not simply being friendly. Friendliness can be offered equally to everyone. Affinity bias occurs when friendliness, warmth, time, or opportunities are given more to people with similarities to ourselves.

In care work, friendliness should be consistent so every service user feels valued. If similarities affect treatment quality or staff decisions, that is when it becomes bias.

Why Addressing Affinity Bias Improves Care

Health and social care aim to provide person-centred services — this means treating each person as an individual with equal respect and dignity. Tackling affinity bias helps to:

• Make sure all service users receive the same level of attention and care.
• Build trust between professionals and diverse communities.
• Support fairness in staff treatment and career progression.
• Strengthen team cooperation, as fairness reduces tension and divisions.

Removing or reducing affinity bias supports equality and protects organisations against complaints, legal risks, and poor service quality.

Monitoring for Affinity Bias

Organisations can look out for patterns that suggest affinity bias, such as:

• Certain groups of patients receiving more home visits than others without clear medical reasons.
• Staff from similar backgrounds getting more opportunities for training or promotion.
• Unequal distribution of positive feedback or informal opportunities.

Data monitoring combined with staff feedback can help identify these trends.

How Service Users Benefit from Awareness of Affinity Bias

When affinity bias is recognised and addressed, service users benefit from more consistent care. They get the same time, respect, and effort regardless of similarities to staff. This leads to:

• Better communication between staff and service users from all backgrounds.
• More accurate diagnosis and treatment.
• Higher satisfaction with services.
• Greater willingness to access care when needed.

Final Thoughts

Affinity bias in health and social care is an unconscious preference for people we perceive as similar to ourselves. While it is a natural human behaviour, in care settings it risks unfair treatment, reduced trust, and uneven opportunities.

Left unchecked, it can affect both service users and colleagues. Recognising and addressing it through training, reflective practice, and fair decision-making can bring real improvements to equality, trust, and overall service quality.

In health and social care, fairness is central. Tackling affinity bias helps make sure every person — whether patient, resident, or staff member — feels valued and receives treatment or opportunities based on need and merit, not familiarity.