The NHS rainbow badge is now a familiar sight in UK hospitals (Twitter / @ RainbowNHSBadge)
As for the symbols, there are few more powerful than the pride flag – but the iconic blue and white NHS lettering certainly comes close.
Combine them together on a small enamel badge and the message of inclusion is instantly clear: so unmistakable that it has become ubiquitous in healthcare facilities, on cords and lapels across the country, even on Victim and Town of Holby.
So it’s hard to believe that it all started out as a small “guerrilla project” that didn’t even have official NHS backing.
The children are not well
It was 2018, and Dr Mike Farquhar was noticing a disconnect with some of his straight colleagues.
As a pediatrician, he knew how intimidating hospitals can be for young people; as a homosexual he knew that being homosexual adds a whole new dimension to it.
Her hospital, Evelina London, has long viewed LGBT + inclusion as one of its core values - but in the end, many staff did not fully understand why this was necessary.
“I was very aware of this common perception among heterosexuals that things are much better now,” he said. RoseNews. “People look back to the ’80s and’ 90s and say, ‘Oh, yeah, that was terrible back then. But LGBT + people have it all sorted out now. You have an equal marriage, everything is much better.
“But in fact, when we look at the data, we know that the experiences of LGBT + people are still fraught with pitfalls. And when you look at children and young people in particular, it’s still quite difficult.
Bullying, rejection from family, poor mental health and homelessness often leave young gay men desperate, isolated and alone, resulting in significantly higher rates of suicide, self-harm and substance abuse.
These mental and physical inequalities only increase over time, as stigma and inappropriate training discriminate in healthcare settings, resulting in fewer doctor visits and poorer health outcomes.
Dr. Farquhar knew from experience that these early barriers to healthcare can be devastating.
“I look at my straight coworkers and I’m like, ‘If they’re dealing with LGBT + youth, they probably think it’s okay’ and I was like, ‘Well actually I know it’s not. well, ‘”he recalled.
“The goal of this project was to fill this gap. It cannot just be a small number of LGBT + doctors, nurses and healthcare professionals tackling this problem – we need to make sure that Everybody’s aware. “
A small badge with a big message
The idea came from a conversation with friends: what if there was a way to send a strong but subtle message to LGBT + patients?
“In the beginning, it wasn’t about people being the complete solution to all problems,” Farquhar explained.
“It was about saying, ‘I’m a good person to talk to about your needs, I’m not going to be judgmental, I’m going to take it into account. And if I can’t solve it, I will find out how we can help you solve it.
After a bad day at work, he bit the bullet and ordered a few hundred badges. He only distributed them locally, believing it wouldn’t go any further – but the news quickly spread online.
Although it started with LGBT + youth, it soon became clear that this badge was needed for all ages: the trans man abused by his GP, the HIV positive woman who is afraid of getting tested, the non-binary person. alienated by cervical screenings, the lesbian seeking fertility treatment.
Oh my God, what have we done?
“Very quickly we saw that this was something that people wanted to engage with,” he said. “They understood the concept, they understood why it was important and they wanted to be a part of it.
“He really ran away at the start. We went from 300 badges to a quarter of a million in about a year and a half, I think. And when something takes off that fast, it’s great. You think, “This is amazing! But there’s a little bit of you saying, “Oh my God, what have we done?” “
Which, coincidentally, is what NHS bosses said when they found out.
Hit the brakes
As Dr Farquhar learned late, the NHS logo is a registered trademark owned by the Secretary of State – and by using it without permission it violated copyright law.
At this point, the badge was worn by hundreds of thousands of employees in 75% of NHS trusts. So far he had distributed them under the radar, but was quickly ordered to take a break before it went any further.
Fortunately, the sSenior manager at Evelina Children’s Hospital saw that the idea was “obvious”, and before long they decided to bring the badges back into the fold.
This time, Farquhar had the full support of Guys and St Thomas’ NHS Trust and the NHS communications team – and a big boost from Come dance strictly‘s Dr Ranj, whose TV connections have earned the badge on Victim and Town of Holby.
At the time, it seemed pretty radical.
“At the time, it was pretty radical, which seems ridiculous in hindsight, but I remember [Mike’s] pure passion and determination to make it work. He had my unwavering support from that point on, ”he said.
“I knew it would be something very special, but I had no idea that this little badge that started her life at Evelina London was going to become a symbol of compassion and understanding for so many people.”
An NHS charity funded an even larger deployment, and with it came a commitment that recognized duty of care in wearing the badge.
“One of the dangers is that if someone just wears it lip service, if they make a mistake that goes unrecognized, it makes it even worse,” said Dr Farquhar.
“So we took a few months to really think about the model, to do clear that there had to be that high level of personal responsibility in wearing it. It can’t just be a cute piece of bling that ends up on someone’s bead and means nothing.
By signing the pledge, staff were directed to a range of LGBT + resources; they needed to understand why the badge is needed, the importance of inclusive language and the need to assert care.
I didn’t understand how much I was holding my breath all the time
“The stories that we have received, both from the staff and from the patients, are, I think, a very big part of it,” Farquhar said.
“Very soon after people started wearing the badges, I was getting messages saying, “I suddenly feel like I’m having conversations that I wouldn’t have had before. “
“One of the most striking was that of a lesbian in her 40s who had worked for the NHS all her life. In fact, she had to come to our hospital for surgery.
“She texted me afterwards to say, ‘The nurse had one of these badges, and I knew it all in my head … but until I was actually taken care of by someone with the ‘one of the badges, I didn’t understand how I always held on, how I was holding my breath all the time.’ “
Who owns the rainbow?
However, not all feedback has been positive. The humble badges have since been drawn into debates about the ownership of pride, the meaning of the rainbow and who is “allowed” to claim it.
The issue became particularly hot when the UK went into lockdown last year and children started displaying rainbows in their windows in support of NHS workers.
It didn’t take long for the rainbow to become synonymous with the NHS, appearing on everything from banners and buses to pizzas and tote bags, raising concerns that people would co-opt the images of the pride and erase LGBT + history.
Fury set Farquhar and his colleagues in a difficult position. “I had people contacting me saying, ‘What do you think about rainbows flying?’ He remembers.
“There was a lot of interest in some areas of the media to force things into a binary, one-person battle, and I think that’s corrosive, actually.”
Nonetheless, he realized that there was a “delicate” balance to be struck. On the one hand, rainbows seemed like a harmless way to show solidarity with the NHS – but on the other, blurred lines threatened to undermine badges. Did the carriers support LGBT + people or just the NHS?
Rather than get sucked into toxicity, Farquhar saw a chance for rehab.
“We took the opportunity to do a reminder on the whole principle of the NHS rainbow badge, as well as the history of the pride flag,” he said.
“We said we have to be very careful that in an NHS environment we use the seven color rainbow to say thank you to the NHS. And if we’re talking about things to support LGBT + people, we use the six-color pride flag. “
It wasn’t the first time the badges were tested – in 2019, a transphobic minority of Mumsnet users attempted to label them ‘anti-feminine’ – but it highlighted the need to evolve and to respond to the LGBT + community.
With that in mind, badges will use the Progress Pride flag in the future, and soon they’ll be taken to a whole new level.
This year the initiative was picked up by NHS England, which is building on its success to develop a way to score NHS Trusts on their LGBT + inclusion.
In partnership with Stonewall, the LGBT Foundation and Switchboard, phase two will examine hospitals using a bronze, silver and gold level model to ensure that they are actually implementing the inclusive training that badges represent.
“I’m still a little surprised how far we’ve come,” says Dr Farquhar.
If he had known how quickly the project would come to life, he might have approached it differently – but with an organization as huge as the NHS, unconventional methods are often needed to bring about real change.
“Would I be brave enough to do it all over again?” He asks himself. “I’m not sure… But I think sometimes you just need to do something and then see what happens.