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Home » Training & Assessment » Curriculum » Clinical Chapters » Equity Diversity and Inclusion Health

Equity Diversity and Inclusion Health

Equity Diversity and Inclusion Health (SH)

  • General Practice is at the forefront of delivering accessible, person-centred care to diverse communities. As such, a strong understanding and active application of Equality, Diversity, and Inclusion principles is essential for all GPs. This is fundamental to delivering high-quality healthcare that meets the needs of every patient, regardless of their background, identity, or circumstances.

    This chapter aims to help future GPs recognise and address the complex ways in which health inequalities arise and are perpetuated. GPs must be equipped to respond with cultural competence, inclusive communication, and clinical awareness of how discrimination, bias, and structural inequities impact patients' access to and experience of care.

    Through understanding the social determinants of health and the lived experiences of marginalised groups, GPs can contribute meaningfully to reducing health disparities. This includes being aware of their own biases, advocating for equity within their practice, and working collaboratively to create an inclusive and respectful environment for both patients and colleagues.

    • SH1 Provide culturally sensitive and inclusive care, fostering trusting relationships with patients from diverse backgrounds and addressing the impact of stigma, stereotyping, prejudice, and discrimination on patient-doctor interactions.
    • SH2 Recognise the importance of culturally appropriate communication when providing care to marginalised groups, including:
      • People experiencing homelessness
      • People who use drugs
      • Members of the Travelling Community
      • New communities
      • LGBTQIA+ communities
      • People with mental health issues
      • Children at risk
      • Survivors of domestic violence
      • People with alcohol dependence
      • Individuals requiring interpreters
      • International Protection Applicants, refugees, and migrants
      • People that have been through the care system
      • People with a lived experience of incarceration
    • SH3 Understand health inequities, including the evidence base, methodologies, and their impact on common health conditions.
    • SH4 Recognise the prevalence of multimorbidity in disadvantaged communities and implement effective management strategies.
    • SH5 Address the social determinants of health, the impact of deprivation, and the role of primary care in promoting equitable access to healthcare. 
    • SH6 Tailor health information to meet the needs of individuals with low health literacy.
    • SH7 Demonstrate competence in managing challenging patient behaviours while maintaining a positive and therapeutic doctor-patient relationship.
    • SH8 Demonstrate a commitment and ability to deliver trauma informed care. This requires knowledge of the impact of trauma in childhood on future health, development and behaviour and understanding of the principles of trauma informed care.
    • SH9 Understand the impact of disempowerment on patient-doctor relationships and provide culturally sensitive and inclusive care.
    • SH10 Take a comprehensive social history, identifying relevant social factors that may impact patient health and documenting these factors over time.
    • SH11 Understand and support the principles of independent living, including the role of personal assistants in enhancing the quality of life for individuals with disabilities.
    • SH12 Demonstrate awareness of different accommodation options for individuals in poor housing or using homeless or asylum-seeking services.
    • SH13 Collaborate with community and social services and other healthcare professionals to improve health outcomes for marginalised populations.
    • SH14 Coordinate care for marginalised groups by accessing relevant resources and working with multidisciplinary teams.
    • SH15 Consider the complex needs of vulnerable populations, including those experiencing homelessness, addiction, and those involved in crime, and collaborate with key workers and community services to improve health outcomes.
    • SH16 Advocate for marginalised populations, addressing health inequities and promoting access to healthcare and social services.
    • SH17 Address personal biases, develop self-awareness, and prioritise self-care to maintain resilience and effectiveness when working with marginalised populations.
    • SH18 Promote cultural awareness among practice staff and address discrimination within healthcare settings.
    • SH19 Demonstrate an understanding of the importance of respectful and inclusive language when communicating with marginalised populations, including people with disabilities and those with diverse gender identities, recognising the impact of language on patient experience and care.
    • SH20 Demonstrate the knowledge and skills required to provide safe, appropriate, and person-centred healthcare to trans and gender-diverse individuals, including awareness of specific health needs and barriers to access.
    • SH21 Provide respectful, person-centred care to transgender individuals, recognising that they may require healthcare interventions consistent with both their affirmed gender and their sex assigned at birth, and applying clinical judgement to address these needs sensitively and in line with current best practice and guidelines.

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed 

    Blended Learning Resources (Education Platform)

    Equality, Diversity and Inclusion

    Workplace Based Learning

    The workplace offers a rich and practical environment for GP trainees to develop their understanding of Equality, Diversity, and Inclusion (EDI) in everyday clinical practice. Through direct patient care, trainees encounter individuals from a wide range of backgrounds, allowing them to observe how factors such as ethnicity, disability, gender identity, socio-economic status, and cultural beliefs can influence health behaviours, access to care, and outcomes. Trainees are encouraged to engage in reflective practice, considering how their own attitudes, communication styles, and unconscious biases may impact patient interactions. Additionally, feedback from clinical supervisors and peers provides valuable perspectives on delivering inclusive and equitable care. By integrating EDI awareness into clinical reasoning and patient management, workplace-based learning helps trainees build the practical skills and cultural competence essential for safe, respectful, and effective general practice.

    Day Release

    Day release teaching sessions provide a valuable opportunity for GP trainees to deepen their understanding of Equality, Diversity, and Inclusion (EDI) in a structured and supportive educational setting. These sessions often include tutorials, workshops and case-based learning that focus on key EDI themes such as health inequalities, cultural competence, unconscious bias, and inclusive communication. They allow trainees to step back from the demands of clinical work and critically reflect on how broader societal issues affect healthcare delivery and outcomes. Group discussions with peers from different training practices also enable sharing of diverse experiences and perspectives, enriching the learning process. By integrating theory with practice, day release sessions complement workplace-based learning and equip trainees with the knowledge, skills, and confidence to apply EDI principles effectively in their everyday clinical work.

    Registrar Tutorials

    Registrar tutorials offer a focused and personalised setting for exploring Equality, Diversity, and Inclusion (EDI) within the context of general practice. These one-to-one sessions with a trainer provide a safe space for reflective discussion about real patient cases, ethical dilemmas, and the challenges of delivering equitable care. Trainees can use these tutorials to examine how social determinants of health, and systemic inequalities influence clinical decisions and patient outcomes. Trainers can facilitate deeper learning by encouraging critical thinking, signposting relevant resources, and exploring unconscious bias or communication barriers that may arise in consultations. Tutorials also allow for tailored feedback on the trainee’s approach to inclusive care and can be used to set specific learning goals around EDI. By linking personal experiences with broader principles, registrar tutorials play a key role in developing the cultural competence, empathy, and professionalism essential to high-quality, inclusive general practice.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 13: Patient Advocacy

    A patient from a migrant background presenting with chronic pain and low mood provides an opportunity to demonstrate EPA 13. If the GP Trainer observes the consultation, a PIP-C can be used to assess culturally sensitive history-taking, use of an interpreter, and advocacy to access appropriate supports. A succinct case entry could be: “assessment of chronic pain and low mood in refugee patient.” Reflection should explore the impact of trauma and disempowerment, strategies for addressing social determinants of health, and maintaining a therapeutic relationship in the context of complex needs.

    Core Knowledge Test (CKT)

    • Disease patterns in different populations

    • Management of a consultation with a patient with limited English

    • Managing health risks in marginalised groups

    Clinical Competency Test (CCT)

    • A patient presenting requesting advice and guidance relating to gender dysphoria.
    • A refugee presenting with symptoms of low mood.
    • A patient with low literacy requests help interpreting communication from the hospital.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.