February saw the annual celebration of Lesbian, Gay, Bisexual and Transexual (LGBT) history month. Until recently, many LGBT people preferred to avoid attention, for fear of negative stereotypes, discriminations and feeling undervalued or excluded in society. And unfortunately some people still do.

In health and social care, respect for people's dignity and self-reliance, and ensuring fairness and equality, are key principles that underpin the work of all healthcare assistants (HCAs) and assistant practitioners (APs). We know from research that LGBT people want opportunities to 'come out' when and if they choose. Staff need to be positive about sexual orientation, and offer health and social care that is tailored to lives and lifestyles. LGBT people do not want to be discriminated against, and rightly expect services to take seriously any discrimination. Service users can face particular challenges

'Because of the high turnover of staff, you have to come out to new people all the time. The potential of getting a negative reaction is huge. These people are responsible for so many of your everyday tasks' Doug, who lives in residential care (Social Care Institute of Excellence

Some LGBT people face issues and injustices through multiple forms of discrimination like when they have a disability, are from a particular ethnic group or are older. LGBT people with complex needs can also be at risk of isolation and insitutionalization, given the greater likelihood of being single, without children and living alone (Age Concern) .

There are a number of challenges to providing high quality services that are well designed to meet the needs of LGBT people. These include:

• Creating a positive culture to LGBT issues across the service
• Ensuring everyone has fair and equal access to services. This may involve reviewing policies and procedures to ensure that they do not discriminate
• Providing training and support to staff on the issues. This could include showing how staff can take positive action to make LGBT people feel welcome.
• Involving LGBT people in the design and further development of services so that these can be better equipped

Better services should not only meet needs of the LGBT people using them, but must also be good places for all people to work (Health With Pride). This includes creating organisational cultures that embrace and celebrate diversity, are not homophobic, and deal with with harassment or discrimination appropriately.

Stonewall published its sixth Workplace Equality Index last month. The index challenges employers to demonstrate how efforts to support LGBT staff have a lasting impact on the workplace. The top 100 list shows fair representation across health and social services but does indicate that more attention should be afforded to supporting LGBT staff working in both health and social care. Ensuring workplaces are LGBT friendly makes sense. People who are happy in their jobs are more productive., an inclusive workplace can enable employers to attract and retain experienced staff thereby reducing costs such as on training.

Celebrating diversity matters not only because it is about fundamental respect and equality for all, but also because it helps to ensure everyone's human rights.

'It takes no compromising to give people their rights. It takes no money to respect the individual. It takes no survey to remove repressions' (Harvey Milk, the first openly gay man to be elected in California, speaking in 1973).

By Rhidian Hughes, taken from The British Journal of Healthcare Assistants (Vol. 4)