Professor Julie Fish

Job: Chair in Social Work & Health Inequalities

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Address: De Montfort, University, The Gateway, Leicester, LE1 9BH.

T: +44 (0)116 257 7750

E: jfish@dmu.ac.uk

W: www.dmu.ac.uk/hls

 

Personal profile

Professor Julie Fish is Chair in Social Work and Health Inequalities in the Division of Social Work. She Director of the Centre for LGBTQ Research and has published widely in the fields of human rights and lesbian, gay, bisexual and trans health and social care inequalities in disciplines including social work, sociology, psychology, equality and diversity, medicine and nursing.

She has a particular interest in research for public good and of its impact and use in policy and practice.  To this end, she has recently conducting a study funded by Hope Against Cancer entitled Improving the Cancer Journey for LGB people. She has undertaken an ESRC Knoweldge Exchange project (RES-192-22-0111) Developing professional knowledge about breast cancer in conjunction with Macmillan Cancer Support, Breast Cancer Care and LGBT social care NGSs.  She has carried out research for the National Cancer Action team and the NHS Cervical Screening Programme.  During 2012-13, she was a member of the Leicestershire Partnership Trust steering group for an IAPT service for LGBT communities in Leicester and gave a speech at the service launch on 16 September 2013.

She contributed to the Department of Health, Public Health Outcomes Framework for LGBT people, is a member of the DH National Cancer Equalities Initiative and a member of the ESRC Peer Review.

Research group affiliations

  • Director, Centre for LGBTQ Research
  • Deputy Director, Institute of Health, Health Policy & Social Care

Publications and outputs 

  • Coming out in cancer care: Is disclosure of sexual orientation beneficial?
    Coming out in cancer care: Is disclosure of sexual orientation beneficial? Fish, Julie; Brown, Jayne; Williamson, I. Nurses and other health professionals are to ask about sexual orientation at every face-to-face contact across the NHS from 2019. However, there are concerns about the need for, and relevance of, sexual orientation disclosure and of the potential for discomfort and embarrassment. We conducted qualitative interviews with fifteen lesbian, gay and bisexual patients to investigate how experiences of cancer care are mediated by disclosure. Using thematic analysis, three themes emerged: identifying the barriers to disclosure, approaches to, and facilitators of, coming out, and small actions/big impact: nurses’ responses to disclosure. In conclusion, we situate disclosure within a model of holistic care recognising that patients’ individual needs constitute one of the eight principles of quality nursing. Treating the whole person means that patients are more likely to engage in positive health behaviours, have more knowledge, skills and confidence to manage their health and be more satisfied with their care. The file attached to this record is the author's final peer reviewed version.
  • Coming out in cancer care: Is disclosure of sexual orientation beneficial?
    Coming out in cancer care: Is disclosure of sexual orientation beneficial? Fish, Julie; Brown, Jayne; Williamson, I. Nurses and other health professionals are to ask about sexual orientation at every face-to-face contact across the NHS from 2019. However, there are concerns about the need for, and relevance of, sexual orientation disclosure and of the potential for discomfort and embarrassment. We conducted qualitative interviews with fifteen lesbian, gay and bisexual patients to investigate how experiences of cancer care are mediated by disclosure. Using thematic analysis, three themes emerged: identifying the barriers to disclosure, approaches to, and facilitators of, coming out, and small actions/big impact: nurses’ responses to disclosure. In conclusion, we situate disclosure within a model of holistic care recognising that patients’ individual needs constitute one of the eight principles of quality nursing. Treating the whole person means that patients are more likely to engage in positive health behaviours, have more knowledge, skills and confidence to manage their health and be more satisfied with their care. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Social Work with Transgender People
    Social Work with Transgender People Fish, Julie; Donaldson, M.; Hardy, R. This is summary of the podcast recording : Julie Fish •The starting point is inclusive social work education, that case studies include the lives of trans people, that there are inclusive environments in social care settings, that the representation, the approaches, recognise trans people. •When we’re thinking about models of social work practice or models of assessing parenting or children in need, that we use assessment tools that are relevant to trans people’s lives. •That if you are a practitioner and you make a mistake that you acknowledge it and learn from it, and that you critically reflect on some of the discourses that you hear in society and that you interrogate the views of others, especially when they’re transphobic but at other times too, rather than accepting them as true. Matty Donaldson •I think training’s really important, but I think people have to buy into really good quality training. They need to give themselves a full day and then they also need to give themselves space to go away and reflect on what they’re going to do with what they’ve just learnt in that training, and put some of the things they’ve learnt into action. •I often say that if you’re good at working with young people you’re probably pretty good at working with trans young people, because a lot of the skills are transferable in terms of listening to them, respecting them, letting them lead conversations, and giving them space to talk about themselves. That’s really important, not to just forget all that when you’re working with a trans young person, because you feel like it’s a completely different set of skills. So asking them what name they want to use, asking them what pronouns they want to use, and respecting that and giving them the space if they want to explore gender to do that. If they’re not interested, they’re not interested.
  • Towards LGBTQ-affirmative cancer care and support: Barriers and opportunities
    Towards LGBTQ-affirmative cancer care and support: Barriers and opportunities Williamson, I. R.; Fish, Julie; Wildbur, D.; Bell, Katie; Padley, Wendy; Brown, Jayne Background: Survey data suggest that LGBT people report lower levels of satisfaction with healthcare for cancer than heterosexuals. This presentation summarises findings from recent qualitative research to understand the experiences of British LGBT people with cancer and their long-term partners. Methods: Participants were recruited through 5 oncology units at British hospitals, 2 cancer support charities and through media campaigns. In-depth interviews typically lasting between 45 and 75 minutes were carried out with 31 cancer patients who identified as lesbian (N=13), gay (N=14), bisexual (N= 3) and queer (N=1) and 9 long-term partners of cancer patients who identified as lesbian (N= 5), gay (N= 2) and trans* (N=2). Data were analysed through thematic analysis. Findings: Three themes are presented: Understanding the Motives, Meanings and ‘Mechanics’ of Disclosure explores how decisions around whether to ‘come out’ as LGBTQ are influenced by several factors including anticipated stigma, perceived moral or political ‘obligation’ and the manner of healthcare professionals. Creating and Communicating LGBTQ-Affirmative Spaces outlines anxieties faced by LGBTQ patients in interactions with staff and patients in clinical spaces such as waiting-rooms and hospital wards and the desire for more explicit evidencing of an anti-discriminatory culture. Finally Seeking LGBTQ-tailored Information and Support shows how current cancer support typically fails to meet psychosocial and psychosexual needs of LGBTQ patients. Discussion: The findings can be used to influence policy and practice by statutory and voluntary agencies to ensure that effective oncology treatment is accompanied by an holistic understanding of the needs and concerns of LGBTQ patients
  • It’s all right now? Re-thinking queer activism for the 21st century
    It’s all right now? Re-thinking queer activism for the 21st century Fish, Julie; Almack, K.; King, Andrew
  • Promoting good outcomes in Lesbian, Gay and Bisexual cancer care: a qualitative study of patients’experiences in clinical oncology
    Promoting good outcomes in Lesbian, Gay and Bisexual cancer care: a qualitative study of patients’experiences in clinical oncology Fish, Julie; Williamson, I.; Brown, Jayne; Padley, Wendy; Bell, Kathleen; Long, J. EXECUTIVE SUMMARY Cancer inequalities, including differences in cancer outcomes and patient satisfaction, affect a range of groups including lesbian, gay and bisexual (LGB) people. In its strategy to reduce these inequalities, the Department of Health commissioned the Cancer Patient Experience Survey (CPES) providing baseline data in which LGB patients were more likely to say their experiences were less positive than those of heterosexual patients. These differences included accessible information, psychosocial support and the human rights concerns of dignity and respect. The CPES, which was carried out in four successive years (2010-2014), suggesting that these are intractable problems, found that LGB patients were more likely to disagree with statements such as they ‘never felt treated as a set of cancer symptoms rather than as a whole person’ or the ‘doctor never talked about me as if I wasn’t there’. The CPES did not collect qualitative data and consequently the reasons for these differences were not known. This De Montfort University study, funded by Macmillan, illuminates some of the reasons for these survey findings as we were able to gather people’s accounts of their treatment and care. This report identifies key moments in the cancer journey where care provided for LGB cancer patients can contribute to their recovery and well-being. Alongside this evidence of unmet need, NHS England (2017) has recently issued guidance to support the introduction of mechanisms for recording sexual orientation across all health services in England for patients over 16. It recommends that sexual orientation monitoring occurs at every face to face contact with the patient. The collection of this monitoring data has implications; not only for cancer professionals, but also that patients themselves understand why this information is being requested. The report draws on LGB cancer patients’ motivations and methods for disclosing their sexual orientation and the perceived benefits of doing so for their quality of life. The findings will contribute to understanding the health benefits of coming out and how disclosure might be facilitated in hospital settings. This study provides compelling data about some of the factors underpinning inequalities in the experiences and, potentially, cancer outcomes for LGB patients. Managing the worry about whether it is safe to disclose their sexual orientation to professionals and the uncertainty about how this will be received presents an additional burden for LGB people with cancer. Participants in this study were sometimes hesitant to disclose because the opportunity did not arise or they were uncertain about its relevance. The report identifies some moments that matter in the care relationship where professionals could seek to facilitate disclosure thus contributing to Achieving World Class Cancer Outcomes (Department of Health, 2015) for LGB patients. In addition, the findings point to the importance of creating an inclusive care environment; participants noted that even in the Cancer Centres of Excellence, there were few visible signs of inclusion for LGB cancer patients. Steps to promote inclusion may entail a diversity policy statement, imagery on walls or the display of a LGB staff network on a hospital notice-board. participants also shared experiences where they were accepted in an everyday manner by hospital staff. They often talked about a whole hospital approach where they were acknowledged by staff from porters, health care assistants, nurses and consultants. These cancer narratives also highlight the need for LGB cancer support groups and tailored resources. The lack of LGB support groups in the UK mean that some participants were coping with their cancer with few forms of social and emotional support and they found few sources of information which addressed their needs. There was a clear demand for a greater range of LGB support resources that were relevant to the challenges and concerns of specific cancer types and reports of rather patchy provision in this regard, with differences influenced primarily by geographic location and cancer type. Finally, our findings suggest that participants had heterogeneous expectations of cancer care requiring complex .skills from professionals. Yet there is little or no curricula content in university programmes of Medicine or Nursing. This might suggest a lack of recognition of distinctive cancer care needs and may explain why participants reported different patient experiences even within the same hospital. The inclusion of research with LGB patients alongside heterosexual populations and relevant case studies to underpin Learning and Development and Continuous Professional Development to inform understanding of patient experience, psychosocial concerns and cancer risk is urgently needed.
  • Queerying activism through the lens of the sociology of everyday life
    Queerying activism through the lens of the sociology of everyday life Fish, Julie; King, A.; Almack, K. The approaching 30th anniversary of the introduction of the 1988 Local Government Act offers an opportunity to reflect on the nature of lesbian, gay and bisexual (LGB) activism in Britain. The protests against its implementation involved some of the most iconic moments of queer activism. Important though they are, these singular, totemic moments, give rise to, and are sustained by small, almost unobtrusive, acts which form part of LGB people’s everyday lives. In this paper, we aim to contribute to a re-thinking of queer activism where iconic activism is placed in a synergetic relationship with the quieter practices in the quotidian lives of LGB people. We interrogate a series of examples, drawn from three studies, to expand ideas about how activism is constituted in everyday life. We discuss the findings in relation to three themes: the need to forge social bonds often formed a prompt to action; disrupting the binary dualism between making history and making a life; and the transformative potential of everyday actions/activism. The lens of the sociology of everyday life i) encourages a wider constituency of others to engage in politics; ii) problematizes the place of iconic activism. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link
  • An Exploration of Domestic & Sexual Violence Services and Service User Involvement
    An Exploration of Domestic & Sexual Violence Services and Service User Involvement Turgoose, Di; Szabo, A.; Fish, Julie
  • Domestic & Sexual Violence Services and Service User Involvement: An Exploration
    Domestic & Sexual Violence Services and Service User Involvement: An Exploration Fish, Julie; Szabo, A.; Turgoose, Di
  • Exploring approaches to Service User Involvement in Sexual Violence and Domestic Violence Services
    Exploring approaches to Service User Involvement in Sexual Violence and Domestic Violence Services Fish, Julie; Szabo, A.; Turgoose, Di A cross disciplinary (Community & Criminal Justice & Social Work) research project.

 

Click here for a full listing of Julie Fish's publications and outputs.

Key research outputs

Books

Fish, J. and Karban, K. (eds) (2015) Social work and lesbian, gay, bisexual and trans health inequalities: International perspectives. Bristol: The Policy Press.

Fish, J. (2012) Social work and lesbian, gay, bisexual and trans people: Making a difference. Bristol: The Policy Press.

Fish, J. (2006) Heterosexism in Health & Social Care. Basingstoke: Palgrave.

 

Research interests/expertise

  • Loneliness and social support among older LGBTQ people
  • Older Lesbian, gay, bisexual and trans health and social care. 
  • Social work and Health Inequalities
  • Public and Patient Involvement.

Areas of teaching

  • Module leader Research dissertations
  • Personal tutor for academic and professional practice
  • Supervision of undergraduate and MA research dissertations
  • MA tutor
  • Doctoral Training Programme
  • Supervision of PhD students

Qualifications

BA (Hons) English, University of York

PGCE English and Drama, Bretton Hall, University of Leeds

MA Women's Studies, Wolverhampton University

PhD Lesbians' experiences of breast and cervical screening, Loughborough University

Courses taught

[ASCS3120 Research Project] 

Membership of external committees

  • Co-convenor Social Work and Health Inequalities Network
  • Member JUC SWEC Research Committee
  • Member National Cancer Equalities Implementation Group

Forthcoming events

Taking Pride in Our Health: Health, sexual health and well-being in LGBT communities.

Conference attendance

Fish, J (2013) Health research with LGBT people.  Invited plenary presentation on LGBT health and health inequalities for University Hospitals Leicester staff.  3 July 2013

Fish, J (2013) International social work's role in tackling health inequalities: A new agenda for SWE?  Presentation to the 7th International conference on Social Work in Health and Mental Health.  University of Southern California, Los Angeles.  23-28 June 2013

Fish, J (2013) Developing cultural competence for LGBT people with cancer.  Presentation to the 7th International conference on Social Work in Health and Mental Health.  University of Southern California, Los Angeles.  23-28 June 2013.

On behalf of the Social Work and Health Inequalities Network, I joint convened two symposia at the Social Work in Health and Mental Health conference in Los Angeles in 'LGBT health inequalities' and 'SWHI in social work education'.

Fish, J (2013) LGBT Carers: Exploring Queer care.  Presentation to ESRC Carers' seminar: Individual carers: personalized needs.  De Montfort University.  4 June 2013

Fish, J and Lilley, G (2013) Older LGBT people: participation and inclusion in public services.  Invited plenary presentation to Family Outing, the Leicestershire County Council, County Hall, Glenfield, annual LGBT workers' conference.  17 May 2013 (led two workshops) 

Fish, J (2012) Making a difference in the lives of LGBT children and young people.  NSPCC Conference, NSPCC HQ Beaumont Leys, Leicester.  28 November 2012

Fish, J (2012) Taking action on LGBT health and social care inequalities.  Presentation to Social work and Social Development.  Stockholm, Sweden.  Joint World Social work conference.  8-12 July 2012

Fish, J and Karban, K (2012) Health inequalities at the heart of the social work curriculum.  Presentation to Social work and Social Development.  Stockholm, Sweden.  Joint World Social work conference.  8-12 July 2012

Fish, J (2011) Inter-professional working to reduce cancer inequalities in lesbian and bisexual women with breast cancer.  Presentation to 1st European Social Work Research Conference.  Oxford University, UK. March 23-25

Fish, J (2011) Coming out about breast cancer: Involving users and stakeholders. Public and Patient Involvement seminar. Leicester University. 24 May.

Fish, J (2011) Coming out about breast cancer: Involving users and stakeholders. Public and Patient Involvement seminar. University of Northampton 1 June.

Fish, J (2011) Writing for Publication. Presentation to the Researcher Development Initiative in Social Work. University of Bedford. 7 June.

Fish, J (2011) Health and social care inequalities. Presentation to the HLS Health and Wellbeing showcase. 22 June.

Fish, J (2011) Making It Happen: Achieving Lesbian, Gay, Bisexual and Transgender (LGBT) Equality in the NHS South West. Somerset County Cricket Club, Taunton. 28 June.

Willis, P, Fish, J, Pugh, S, Bailey, L, Ward, N (2011) Exploring Queer Care in Social Work: Meeting the needs and interests of LGBT carers. Presentation to the 2011 JSWEC conference. University of Manchester, 14 July.

Karban, K and Fish, J (2011) Health inequalities – at the heart of the social work curriculum. Presentation to the 2011 JSWEC conference. University of Manchester, 14 July.

Fish, J, and Dhami, K (2011) Developing cultural competence in breast cancer services with LB women. Presentation to the 6th LGBT health summit, Cardiff City Hall. 1 September.

Fish, J (2011) Addressing LGBT health inequalities. Presentation to research seminar. University of Bradford. 10 November.

Panel member, National Cancer Equalities Initiative Conference, Hilton London Metropole. 22 March 2010

Fish, J Coming out about breast cancer: shaping the future through research. Joint Social Work Education and Research conference, University of Hertfordshire, 1-2 July.

Fish, J Coming out about breast cancer in lesbians and bisexual women. Paper presented to 4th LGBT health summit. Newcastle. Conference workshop supported by the RCN.

Fish, J Cancer inequality: What have sexual minority women’s experiences of breast cancer to do with it? BSA MedSoc conference Manchester. September 2009.

Beyond a single identity. Leicester University, June 2009. Member of conference organising steering group.

Developing work in social work and health inequalities
Online symposium, Health inequalities and the social work curriculum: Pacific Rim Perspectives. 9 November 2011.

Bywaters, P, Fish, J, Jones, D and Truell, R. Meeting with Professor Michael Marmot: Social work’s contribution to tackling health inequalities. 26 October.

Bywaters, P and Fish, J Meeting with Health Equity Team at UCL in relation to social work and health inequalities. 11 January.

Current research students

  • Carlton Howson (1st supervisor) Telling it like it is: Black and ethnically minoritised students' experiences of HE
  • Claire Gregory (1st supervisor) BME carers' experiences of providing information care
  • Hannah Begum (2nd supervisor) A study of South Asian male survivors of childhood sexual abuse (and engagement with support services)
  • Mandy Gamble (2nd supervisor) The Experience of Nurse Led Case Management in long term conditions
  • Wendy Norton (2nd supervisor) Gay men, fatherhood and surrogacy
  • Rose Parks (2nd supervisor) Yoga in prisons
  • PhD (fees only) scholarship in health and social care (TBC)

Externally funded research grants information

  • 2014 Improving the cancer journey for LGBT people, Hope Against Cancer
  • 2013 ESRC Knowledge exchange programme.  Impact report.  8 May 2013.  RES-192-22-0111
  • 2012 The College of Social Work: led writing of curriculum guide for Physical Health, Dementia and End of Life Care..
  • 2011 ESRC Knowledge exchange programme: Developing professional knowledge about breast cancer in lesbian and bisexual women.
  • Reference: RES-192-22-0111
  • 2010 LGBT Carers seed corn funding from Birmingham university, collaboration with Birmingham and the University of Swansea
  • 2009 National Cancer Action Team: Coming out about breast cancer.
  • 2008 NHS Cervical Screening Programme: Cervical screening in lesbian and bisexual women: A review of the worldwide literature.
  • 2007 Prescription for Change: Lesbian and bisexual women’s health. In collaboration with Stonewall. Funded by Lloyds/TSB Foundation.

 

Professional esteem indicators

  • Joint convenorship of Social Work and Health Inequalities Network (with Kate Karban) June 2010
  • JUC SWEC research committee member
  • Develop Social Work and Health Inequalities webpages for SCIE website
  • Contributing author to the Department of Health, Public Health Outcomes Framework LGBT companion document
  • Membership of ESRC peer review college
  • Contribution to the Leicester, Leicestershire and Rutland Suicide prevention strategy for LGBT people
  • Member of the Leicestershire Partnership Trust steering group for the introduction of a  LGBT IAPT service in Leicester
  • End of life care: the experiences and needs of LGB elders.  Led by Kathryn Almack, Nottingham University funded by Marie Curie Cancer Care
  • Podcast on social work and health inequalities.  Interview by Patricia Fronek, Griffith University, Australia
  • World Social Work Day at Westminster 19 March 2013
  • Development of international teaching resources for World Social Work Day

Case studies

Supporting LGBT People with Cancer: Practice guidance

Lesbian and bisexual women and breast cancer: policy briefing. London: Breast Cancer Care.

Commissioned by the NHS Screening programme to undertake a systematic review which led to a change in the screening guidelines for lesbian and bisexual women

Policy applications of my research

2013 Contributing author to the Department of Health, Public Health Outcomes Framework LGBT companion document

2012 Leicester City Council, Joint Strategic Needs Assessment. March 2012

2011 Her Majesty's Government, Working for Lesbian, Gay, Bisexual and Transgender Equality: Moving Forward. London: HMG

2010 Department of Health, Equality and Excellence: Liberating the NHS. Equality Impact Assessment. London: DH

2010 Memorandum submitted by Stonewall to UK Parliament

Media coverage

Moszynski, P (2010) Lesbians and bisexual women urged to take up cervical cancer screening, British Medical Journal, 2009; 340:b5667

Reviews of my work 

Reviews of Social work and LGBT people Bristol: The Policy Press

"The book ... provide(s) a framework, which underpins the knowledge, skills and values, from which to develop best practice to work with LGBT people ... is (a) high ambition.  That all of these aims are achieved is due, in no small measure, to the systematic and skilful crafting of the content of this work.  The text has a pattern without ever being formulaic."  John Hancox, New Zealand, Journal of Social Work, 2013 vol 13, no 6, 653-655

Julie Fish ... "provides detailed discussions of complex areas of social work practice and integrates a very extensive discussion of relevant research in each chapter.  The arguments about the need for a specific focus on substance misuse, for example, are compelling and avoid a reductive approach to the complex evidence from research."  Dharman Jeyasingham, UK, British Journal of Social Work, vol 42, issue 6, 1217-1219

"Julie Fish provides an accessible and appealing work to practitioners and students who want to deal with lesbian, gay, bisexual and trans (LGBT) service users in an appropriate way.  If anyone, (still) hesitates to see the importance of the LGBT issue in social work, Fish's chain of reasoning is convincing, pragmatic and straightforward."  Andrea Nagy, University of Innsbruck, Austria, International Social Work, 2013, 56:105.

 

Reviews of colleague's work

Fish, J. (2013). The social work dissertation. Carey, M Book review, British Journal of Social Work 43 (8): 1667-1668

JulieFish

LGBT-health-book

social work and lesbian, gay, bisexual and trans people making a difference

ESRC

coming out about breast cancer

Supporting LGBT with cancer

 

Search Who's Who

 

 
News target area image
News

DMU is a dynamic university, read about what we have been up to in our latest news section.

Events target area image
Events

At DMU there is always something to do or see, check out our events for yourself.

Mission and vision target area image
Mission and vision

Read about our mission and vision and how these create a supportive and exciting learning environment.