Award criteria

Any practice that engages with Pride in Practice should be highly celebrated!

It domonstrates that they are commited to providing an inclusive service to all the communities that they serve and that they recognise the specific needs of lesbian, gay and bisexual patients.

Practices pay an annual subscription to Pride in Practice to have access to the wide selection of services offered by Pride in Practice to support and celebrate each practice. 

All Pride in Practice awarded surgeries will now complete the self assessment and submit supporting documentation before being awarded. Below is the self assessmnt questions and the reasons behind each question asked. Each 'yes' equals one point and the grades are:


Bronze: 19-21 *An award can only be issued if marked questions are answered ‘yes’.

Silver: 22-24 **A silver award can only be issued if marked questions are answered ‘yes’.

Gold: 25-26 ***A gold award can only be issued if marked questions are answered ‘yes’.

We welcome feedback so please do contact to share your feedback with us so we can contiue to develope the service we provide.  

Pride in Practice Self-Assessment

Staff = All staff with direct patient contact (unless otherwise specified)

Policies / legal rights

1. Does your practice have a ‘zero tolerance’ policy regarding abusive behaviour or offensive language, which with specific reference homophobia and biphobia (aimed at or conducted by either patients or staff)?

This is a very clear way of communicating that your practice is a welcoming and safe environment for lesbian, gay and bisexual (LGB) people.

Reception environment / legal rights

2.  Do all staff feel confident in enforcing the zero tolerance policy and challenging any homophobic or biphobic language or actions observed in the practice? 

(NB if the practice answers ‘no’ to Q1, they cannot answer ‘yes’ to Q2)

Having a policy is one thing but the policy needs enforcing consistently by all staff. Often it is assumed that all staff know what counts as ‘homophobia’ or ‘biphobia’ but that is often not the case.

For example: in the event of teenagers using the term ‘gay’ as a negative term / instead of the word ‘bad’, do all staff count that as homophobic? Then you must consider the training staff receive on best practice when challenging homophobia or biphobia.

You should also consider how you measure peoples' confidence in enforcing your zero tolerance policy. Is it via peer assessment, self-assessment etc? Is that method a valid reflection of an individual’s confidence?

3. Do your registration forms have a confidentiality statement included?

It is important that a patient feels confident that the information they share with practice staff is kept confidential.  Reducing this concern and reassuring patients will build their trust and in turn make them more open with your practice staff.

Having a statement on registration forms (which is often the first occasion when you ask patients to divulge private and personal information) can be reassuring and therefore increase your chances of collecting more accurate information from your patients.

4. Are all patients that wish to be accompanied by another person (friend/partner/family member) during a consultation empowered to do so and have their companion made to feel welcome?

It is important that all patients are made to feel safe and confident during consultation. For some patients this means they may like to be accompanied by someone else.

To ensure fair and equal treatment of patients, if someone’s same sex partner accompanies them, that individual should be included and acknowledged in the same way as heterosexual partners would be.

It is important to not assume that if an LGB patient is accompanied by someone of the same sex, it necessarily means that they are in a relationship with that person. 

Does your practice publicly display:

5. A statement of how often all staff receive equality and diversity training?

This is a very clear way of communicating that your practice is a welcoming and safe environment for LGB people. This is a key message, both for your LGB patients and for all your other patients. 

6. A statement of how often your equality and diversity policies are reviewed and updated?

This demonstrates your practice’s ongoing commitment to ensuring that all staff are equipped with the skills, knowledge and understanding to meet the current needs of patients and staff. 

7. A confidentiality statement in the waiting area?

It is important that a patient feels confident that the information they share with practice staff is kept confidential.  Reducing this concern and reassuring patients will build their trust and in turn make them more open with your practice staff.

8. LGBT Foundation’s helpline number? 

LGB people have told us that they often scan service venues for clues to identify if the service will be inclusive for them.

Displaying leaflets, posters and magazines targeted at the LGB community is a very simple way of helping create ma welcoming environment for LGB patients.

The resource pack Pride in Practice  sends out to your practice will include information you can display. To receive more resources please contact your dedicated account manager or email 

9. Do all staff understand that not all patients will feel confident to correct an incorrect assumption of sexual orientation?*

For some patients correct an assumption of heterosexuality will feel very easy and not affect the patient-clinician relationship. For other patients however, correcting an incorrect assumption of heterosexuality would raise their anxiety levels and have a negative affect on their ability to trust and be open in future consultations. 

Medical consultations/ legal rights

10. Do all clinicians receive training on the prevalence and impact of conditions and issues that particularly affect lesbian, gay and bisexual communities, such as suicide idealisation and self-harming (in addition to HIV and sexual health)?

Frequently, the prevalence and impact of various conditions differs in the LGB community compared to the rest of the general population. Often people are aware of the difference in HIV or STI rates but there are great differences across many aspects of health and wellbeing. Many of the difference are covered in the Pride in Practice compendium. For example:

13% of GB men have had a problem with their weight or eating in the last year compared to 4% of men in general.[1]

11.. Do all staff have knowledge of evidence relating to the health of minority groups within the lesbian, gay and bisexual community?

It is important to recognise that people often fall into more than one protected characteristic. There is a lack of research and evidence into the minority groups within the LGB community, however some research is detailed in the compendium provide by Pride in Practice. For example:

7% of women over 25 years old have never had a cervical screen.[2]

15% of LB women over 25 years old have never had a cervical screen. [3]

19% of BME LB women of over 25 years old have never had a cervical screen. [4]

12. Are all clinicians promoting cervical screening to all eligible women who are or have been sexually active (including those who have female partners) and to trans men who have cervixes?*   

Becasue of changes in medical knowledge and best practice, many women who have sex with women believe that they do not need to have cervical screenings. For information and resources to encourage lesbian and bisexual women to take up cervical screenings, contact pip@lgbt.fouindation or your dedicated account manager.

Trans people are regularly left out of routine screenings programmes, such as cervical and breast screenings, so it is important that they are encouraged to take up screening by their health professionals. For advice on how to make routine screenings more comfortable for trans patients, contact or your dedicated account manager.

13. When in consultation with women of child bearing age and discussing sexual activity, do all medical staff in your practice ask questions identifying the gender of sexual partner/s?*

One of the most frequent frustrations Pride in Practice hears about from LGB patients is that very often health professional presume heterosexuality until told otherwise. This leaves the LGB patient unsure of whether to correct the mistake (and be unsure of the response they will receive) or receive information or advice that may not be relevant to them.

The most frequent reports of presumed heterosexuality are from lesbian and bisexual women, who are exclusively sexual active with women, being asked about contraception (not safer sex practices).

Too frequently we hear reports of from LB women who are immediately asked about the methods of contraception after answering that they are sexually active, but not before being asked about the gender of their sexual partner or partners. 

14. When providing safer sex advice or STI testing to patients, is the gender of their sexual partner or partners asked for?*

Using gender neutral language is important to ensure patients do not feel as though they are in a heterosexist environment. For example, the use of ‘partner’ instead of ‘boyfriend/ girlfriend’ or ‘husband/wife’.

However there will be frequent times, especially when discussing sexual health, when the gender of sexual partners is required. Medical staff must ensure that the patient is offered the opportunity to disclose their partner’s gender rather than having to correct an assumption.

For example:

Medical staff member: ‘Are you sexually active?’
Patient: ‘Yes’
Medical staff member: ‘Are your partner or partners men, women, both or other?’

The inclusion of 'other' gives the patient the option to disclose if they have a trans and/or non-binary partner or partners so that you can give them the most relevant information. If challenged, the staff member can simply answer:

‘These are standard questions we ask everyone that do not presume sexual orientation because I want to ensure I can give you the most relevant medical information and advice’.

Information gathered via this type of questioning could indicate:

  • That a male patient should be offered an STI screen that includes rectal and pharyngeal sites.
  • That female patients who are having sex women should be made aware of safer sex practices.


Remember! When promoting the use of dental dams for women who have oral sex with women, dental dam use should also be encouraged with heterosexual patients too. This is to ensure that no patient is receiving less favourable service and the message of safer oral sex is consistent.

15. During consultation, are sexually active men who have sex with men, of whom their partner/s HIV status is unknown/positive, encouraged to have a HIV test at least once year?*

British Society for Sexual Health and HIV (BASHH) suggests that men who have sex with men should be tested annually or more frequently if clinical symptoms are suggestive of seroconversion or ongoing high risk exposure.

You can encourage testing during consultations. If a patient consents to have their contact details shared with Pride in Practice we can email them a reminder in 12 months’ time, with details of general STI testing centres, that include HIV tests. If you do not have the referral form for patients to access this service please contact your dedicated account manager or email

16. Do all clinicians know the latest prevalence rate of HIV in your area; rate per thousand as published by Health Prevention Agency and the recommended best practice if the rate is above 2 per 1000 people?*

The Health Protection Agency advises that local authorities and NHS bodies with a diagnosed HIV prevalence greater than 2 per 1,000 population of 15-59 years should implement routine HIV testing for all general medical admissions. If you do not know the prevalence rate your practice could be falling short of the Health Prevention England guidelines.

To find out the HIV prevalence in your geographical area please use the link below:

17. Does your practice offer HIV testing? If not, do you know where to refer people for HIV testing?

It is best practice to offer an HIV test to anyone who believes that they may have been at risk. However it is also important to be able to signpost people to nearby STI testing centres if appropriate. Some people prefer to use STI testing centres to undergo routine sexual health screenings and others prefer to use their GP. The best case scenario is one where a patient feels able to make choices that enable them to take responsibility for their sexual health.

Legislation / legal rights

18. Do all clinicians understand current legislation that gives same-sex couples with registered civil partnership status equivalent rights to married couples, including entitlement to decision-making regarding health and social care?

The first same sex marriage took place in Summer 2014, however many same sex couples still have or prefer to have registered civil partnerships. Therefore it is still important that medical staff are aware of the current legislation that states that a civil partner is always acceptable as next of kin.

19. When people in same-sex relationships want information on parenting options, do all clinicians in your practice feel confident in discussing the legal frameworks and choices available to them?

For many people the first port of call for family planning advice is their GP practice, and therefore all medical staff need to be aware of the options that are available for same sex couples wanting family planning advice, and are able to sign post for further information.

New Family Social is a good contact for couples looking into adoption and fostering. They are a growing national charity that provides support and information for prospective and existing LGBT adopters and foster carers.

‘A guide for gay dads’

‘Pregnant Pause: A guide for lesbians on how to get pregnant’

20. Are all clinicians aware of the legal rights that same-sex couples have when deciding on their or their partner’s child’s health care?

It is important when dealing with the children of same sex couples that medical staff are aware of the extent decision making that that couples can have for their child.

Citizens Advice Bureau uses the following definitions:

Same-sex partners living together
A same-sex partner has no automatic parental responsibilities and rights for their partner's children that they live with. However if a child is conceived by donor insemination or fertility treatment on or after 6 April 2009 a same-sex partner can be the second legal parent.

Civil partners
A civil partner does not have automatic parental rights over their partner’s children but has a general duty to safeguard the health and welfare of children under 16 who live in the household. If a child is conceived by donor insemination or fertility treatment on or after 6 April 2009 a civil partner can be the second legal parent and have automatic parental responsibilities and rights towards the child. 

Information provided under Questions 17, 18 and 19 are taken from the Citizens Advice Bureau.

Signposting and referrals

21. Do all staff have the knowledge, ability and confidence to signpost to potential sources of support and advice specific to the patients' sexual orientation, if appropriate or requested?

There is a continuing change of LGB specific services, especially in this climate when the difficulty in securing funding means local voluntary/community groups are ceasing. If you signpost to LGBT Foundation we can signpost patients to the services in their area.

If a patient is happy to have their contact details shared with LGBT Foundation, we encourages you do so. Then we can call the patient to discuss the services they are looking for, rather than relying on the patient to make the first step.  

22. Do medical staff have an awareness of whether or not there are referral pathways to local or relevant agencies that can provide specialist services and support to lesbian, gay and bisexual patients, and do they have the ability and confidence to refer?

LGBT Foundation can signpost patients to services however some organisations have specific referral pathways that if used can mean patients’ needs can be met quicker, rather than going via LGBT Foundation.

If your practice is based in Greater Manchester that are a number of services delivered by LGBT Foundation that require specific referral forms. If you are not aware of these please contact your dedicated account manager. 

23. Do medical staff offer a choice between a mainstream service and an LGB-specific service (if available) when referring a patient for a service such as counselling?

Patient choice is crucial as part of meeting a patient’s needs. Not every LGB patient will want to access LGB specific services but offering such services alongside mainstream services gives patients more options over their health and wellbeing.

Patient voice

24. Does your practice consult with lesbian, gay and bisexual patients/staff/advocates in the development of health promotion activities?

Engaging with the LGB community on any health promotion topics means that one is able to gauge if the message is reaching the community, and consultation is recommended for all major health promotion (not only those promotions focusing on sexual health).

It is important to remember that not everyone who identifies as LGB would want to be considered an ‘expert’ or consulted on LGB health promotion activities.

Sexual orientation monitoring

25. Does your practice monitor sexual orientation of new patient registrations?**

Monitoring for all protected characteristics including sexual orientation is essential as it will help build an evidence base, and enable you to better understand staff and service users and provide for their different needs.

Furthermore by conducting monitoring LGB patients and staff can be consulted in health promotion activities.

26. When current patients are updating their contact details are they encouraged to update all demographic information including sexual orientation?***

Identification sexual orientation can be fluid as are many all of the other protected characteristics (disability, religion, maternity etc.), therefore is it recommended that when updating a patient’s contact details that one should ask a patient to check their demographic information too and update it if necessary.   

27. Does your practice have evidence of how data collected on sexual orientation of patients has been utilised?***

It is important that data collected regarding sexual orientation is used in order to improve patient outcomes, ensure equal access to services.

Case study: How can data on sexual orientation be used?
The situation:
Many lesbian women have been told previously by either a health professional or a member of the community that they do not need to attend cervical screens.
They were not told this because people are homophobic, but people were working with the research that was currently available regarding prevalence rates and the transmission of HPV. Now we have research that highlights that any woman who has had any type of sexual intercourse with either a man or a woman, should be advised to have a cervical screen. However many lesbian women still believe they do not need a cervical screen.

Using sexual orientation data:
When using your computer systems to produce letters to remind women about cervical screens, you can cross reference with sexual orientation, so that the letter your write to lesbian or bisexual patients have an added sentence about the need for lesbians to have screens, or include a targeted resource of further information.

[1] Guasp A. (2012) ‘Gay and Bisexual Men’s Health Survey’ Stonewall

[2] Hunt R & Fish J, Prescription for Change, Stonewall, 2008

[3] Hunt R & Fish J, Prescription for Change, Stonewall, 2008

[4] Guasp A. and Taylor J. (2012) Ethnicity – Stonewall Health Survey