Equality and Diversity Report

Transcription

1 Appendix1 Equality and Diversity Report 2012 Delivering on our commitments to fairness and excellence for all

2 Contents Pages Introduction -The chapters related to Goals within the Equality Delivery System Better Health outcomes for all Introduction, EDS goal, equality objectives and progress 2 3 Service user data 5 Involving service users in shaping care services, managing transitions smoothly Assessing individual patients needs and providing appropriate and effective care and support Keeping patients safe 12 Conclusions 14 Improving patient access and experience Introduction, EDS goal, equality objectives and progress 15 Promoting ready access to services, removing barriers 16 Improving Patients experiences of our services 17 Handling complaints and concerns openly and fairly 18 Conclusions 19 Empowered, engaged and well supported staff with inclusive leadership - Introduction, EDS goals, equality objective and progress 20 Our Workforce 21 Recruitment and selection 27 Access to support, training and development 29 Keeping staff safe 29 Staff engagement and empowerment 30 Conclusions 32 [Equality and Diversity Report]

3 Introduction In 2011 Barnet Enfield and Haringey Mental Health NHS Trust adopted the NHS wide Equality Delivery System (EDS) as its framework for the performance management of its compliance with the Public Sector Equality Duty (PSED) under the Equality Act This annual equality and diversity report for 2012 sets out the evidence for the Trust s performance in delivering on its commitment to equal opportunities, celebrating diversity and tailoring care to the individual needs of all its service users. The structure of this report is related to the main sections in the EDS. The EDS is a developmental performance framework which asks those with an interest in the work of the Trust service users, carers, staff and their representatives, to grade the work of the organisation based on the evidence it provides. Much of that evidence is listed in this report. The Trust aims to achieve excellence in the delivery of consistently high quality, value for money, health services. This will include developing more effective partnerships with service users, carers and other organisations, promoting users' recovery and providing the most culturally appropriate services for each individual user. Providing equality of opportunity for service users, their carers and our staff is a central element of our pursuit of excellence in care provision. The Trust is committed to the elimination of unlawful and unfair discrimination and we value the differences that a diverse workforce brings to the organisation. The Trust recognises that discrimination is unacceptable and will work to build a culture of openness, fairness and respect. The Trust Board adopted a set of equality objectives in response to the grades stakeholders gave the Trust for its performance as evidenced through the EDS system. In keeping with the commitment to transparency and openness in the EDS process the Trust has published the grades its stakeholders awarded it last year. The aspiration is that over time our stakeholders will see more and better quality data which demonstrates how we are contributing to improved health and wellbeing for all. Where data is captured by national systems, work is being done to make changes to the appropriate data sets to ensure that data related to the protected characteristics is able to be captured and used to facilitate the analysis of service provision. This is a national challenge and the Trust is working with the NHS locally and nationally to move this agenda forward Equality and Diversity Report

4 Better Health outcomes for all the people we care for The NHS should achieve improvements in patient health, public health and patient safety for all, based on comprehensive evidence of needs and results. Introduction The first two EDS goals have been recognised across the NHS in London as the most challenging. Most Trusts who implemented the EDS in 2011 did so in the understanding that in the first year they would most likely to score as underachieving or developing in these areas, and most NHS trusts were graded at these levels. For a provider of mental and long term physical health care services, this is a particularly difficult area as many of the determinants of outcomes lie outside our control and recovery takes a long time. The Trust felt that over the course of the four years of its equality objectives it would be able to use the EDS to drive measurable improvements and be graded as achieving by the end of the four years. The better health outcomes for all the people we care for, goal, relates to achieving improvements in the health of individual patients, wider public health and patient safety. These are based on comprehensive evidence of needs and results. Last year our stakeholders felt that the Trust could provide little evidence in this area, in part because historically commissioners had not prioritised performance data in these areas. The Trust like many other NHS organisations has identified this as a priority area for development and made it one of its equality objectives. Which is why the Trust can now produce some relevant outcome information for some protected characteristics and the start of a year on year progression to having a full suite of relevant information. The relevant EDS Goal and the corresponding equality objective and the progress being made EDS Goal and grade Better health outcomes for all Trust Equality Objectives, with milestones 1. 1 In order to ensure that services are designed to meet the health needs of local communities, promote their wellbeing, and reduce health inequalities in line with the Trust s clinical strategy, the organisation will. Specifically From the performance of the transitions between parts of our services as well as to other health and social care providers will be monitored to ensure; patients are better informed about their options and the pathways, the transitions are smoother and patients and their carers give increased positive feedback about their experiences by gender, age, ethnicity, compared to the whole population By relevant outcomes reported as part of the Trust Board performance dashboard will include outcome data for a minimum of five protected characteristic groups Progress Once and an agreed suite of pathways to be monitored has been established, the Trust will be better placed to monitor patients transitions. At that point, we will agree with service user groups the best ways to monitor performance in this area. As evidenced in this report, the Trust is now able to report on some Dashboard indicators by three or four protected characteristics. This is the start of a programme to make the analysis and use of such information part on mainstream service management. [Equality and Diversity Report]

5 By April 2015 relevant outcomes reported as part of the Trust Board performance dashboard will include outcome data for all nine protected characteristic groups where relevant. The improvements in meeting the health needs of local communities, promoting their wellbeing, and reducing health inequalities will be measured by the Trust Board as part of its review of the Trust s clinical strategy and other mainstream service quality management. The mechanisms used will include the annual EDS process. 2 In line with the societal system approach of the Trust s clinical strategy, the Trust will work in partnership to reduce health inequalities and promote wellbeing, specifically- By , based on the Joint Strategic Needs Assessment for each borough, the Trust will develop profiles of the communities / protected characteristic/ disadvantaged groups currently suffering the most serve health inequalities and develop effective channels to reach them with information about services, self-help and wellbeing. The Trust will work in partnership with patients and other community groups to ensure there is meaningful engagement and by April 2015 this will include representation from individuals and groups covering all nine protected characteristics and key disadvantaged groups we serve. The level and effectiveness of engagement will be assessed by the amount and breath of involvement in key decision and policy setting fora and the quantity and quality of the input and impact groups have on changes to service and policy developments, training and senior appointments. This will be monitored using evidence to the Patient/Service user strategy group and compliance data for the EDS The principles of the Trust s recovery model and the relevance of local needs assessments have been incorporated into E&D session of mandatory training to link equalities to our approach to care. Partnership and involvement matrices are being actively developed through service user strategy group in preparation for trailing in Head of Equalities &POD Comms is extending involvement engagement through meetings with ethnic and cultural groups with interest in health using speaking engagements, meetings and even a West End film premier Equality and Diversity Report

6 Service User (Patient) Data There are two main sources for data in this section, the 2011 census data which became available at the end of 2012 and data on our patients held on RiO, the electronic patient information system. Staff record demographic details of individual patients, their treatment and progress through this system. However, RiO is a national system and therefore there are certain protected characteristics which currently cannot be readily recorded or retrieved on RiO. One of the key areas for improvement from 2011 was the collection, analysis and review of information on care outcomes and service quality by protected characteristics in order to evidence improved outcome for all. The Board regularly reviews a dashboard of indicators setting out the Trust s performance on a range of healthcare outcomes. This forms the basis of the evidence of our compliance with this aspect of our PSED as a service provider. Analysis of the proportion of patients from different protected characteristic groups compared to the general population is a means of identifying possible areas of concern around equalities. With health however, as socio-economic factors play a significant part in determining health outcomes (Whitehead & Dehlgren, 2006, reprinted 2007) In order to identify any unexpected or unexplainable difference which would indicate possible discrimination it is important to compare the proportion of patients from protected characteristic groups with their proportions in the general population. Genetic and constitutional variations ensure that the health of individuals varies, as it does for any other physical characteristic. The prevalence of ill health also differs between different age groups, with older people tending to be sicker than younger people, because of the natural ageing process. Biologically, women in older industrialized countries exhibit an advantage in survival over men at every stage of life. Beyond this there are social and economic factors which lead to systematic differences in health outcomes for different population groups. Some of these can be addressed by the work of the Trust others require us to work in partnership with other agencies in order to make a difference. Gender Total Gender Clients Female Male 1 Not Specified 3 Unknown Total According to the 2011 census for the three boroughs from which we draw the bulk of our patients 51.3% of the population are female, so our patient population is in line with the population we serve. [Equality and Diversity Report]

7 Ethnicity On a Trust-wide basis, White British, White Irish and White Other, ethnicities are the largest groups amongst our service users. The largest non-white ethnic groups are Black Caribbean and Black African groups. The proportions are generally in line with the general population we serve. The table below shows the main ethnicities in Barnet, Enfield and Haringey (2011 census) White: UK White: Irish White: Other Mixed/: White and Black Caribbean Mixed: White and Black African Mixed: White and Asian Barnet Enfield Haringey Asian/ Indian Asian: Pakistani Asian/ Bangladeshi Asian: Chinese Asian/: Other Black/African/ Black/ Caribbean Barnet Enfield Haringey Black/ Other Equality and Diversity Report

8 Broadly the proportion of patients from the main ethnic groups are in line with the proportion in the general population allowing for known socio-economic and cultural factors and the age profile of our population. Marital Status For the first time we have analysed our patients by marital status, but the proportion of not disclosed and not stated limits the usefulness of this. Religious Belief Another key protected characteristic is religious belief. A patient s religious or spiritual beliefs can have a significant role in their recovery. Further Action This year we have been able to produce patient population figures for four of the nine protected characteristics. The data for some still contains a high proportion of not declared/not disclosed/unknown. A key piece of work for is an information campaign aimed at staff, to get them to seek and record this information and at service users to reassure them and to encourage them to share this with us. [Equality and Diversity Report]

9 Involving service users in shaping care services, managing transitions smoothly The Trust has a Service User and Carer Strategy Group, convened by the Deputy Director of Nursing, Quality and Safety, and jointly chaired with service user representative. The group meets every other month and provides a forum for clinicians, managers, and executive directors to work directly with the community we serve to better understand how we can improve our services. Under the leadership of this group service users have been involved in delivering training to staff on cultural competencies and the patient experience. Service user representatives have been closely involved in discussion about the future development of service provision and the redevelopment of the St Ann s site. Managing service users transitions smoothly The Trust Board already receives regular reports on delayed transfers of care. These are situations where service users are well enough to move back into the community, where they will be supported by a mix of NHS, council and independent sector services. However, sometimes the package of care they need to make this transition is not available. Below are a series of tables setting out the proportion of patients who experienced delayed transfers by gender, ethnicity, religion age and marital status. Men are more likely than women to experience a delayed transfer of care. This is also reflected in the breakdown by age as indicated in the table below Equality and Diversity Report

10 The Board regularly receives and discusses this issue and the underlying causes. Trust managers continue to work with colleagues in local council housing and adult social services to address these issues. This reflects the pressures on social/supported housing. Different ethnicities expereince delays roughly in proprtion to the overall population of patients in the Trust s care, the White British is under represented. And African Caribbean over represented. The proportion of patients with different marital status who experience delayed transfers of care is in line with the proportion in the overall patient population. Just over 60% of patients are known to be single and 63% of the 147 patients who experienced delays were single. Patients experience delays in broad proportion to the percentages in the overall patient population. While delays are to be regretted, there is no indication of discrimination on the basis of marital status. [Equality and Diversity Report]

11 The relative proportions of DToCs by religious belief are comparable to the general population of patients and do not indicate unlawful discrimination Equality and Diversity Report

12 Assessing the clinical needs of all patients The Trust assesses the clinical needs of all of its patients, this process includes collecting data on patients demographic details were possible. It is not yet possible to produce good quality information on the assessments of patients needs by protected characteristics. This will be one of the key pieces of work for The recent acquisition of a new piece of software will greatly assist in pulling out the raw data currently locked in the Trust s patient records management system RiO. Meeting patients cultural and spiritual needs The Trust has a comprehensive Spiritual Healthcare Policy which places spiritual care within our Trust s philosophy and thinking and emphasises its value in promoting the wellbeing of service users who hold a faith. The Trust provides meals which meet the needs of patients requiring Kosher, Halal and vegetarian diets. Patients can chose from menus translated into a range of languages, large print and easy read [Equality and Diversity Report]

13 Keeping patients safe How we deal with incidents In order for staff to learn from incidents and near-misses, we require that all incidents and nearmisses are reported. We now log all incidents on the electronic reporting system DATIX. We also report severe clinical incidents to NHS London and to the National Reporting and Learning Service. When an incident is classed as severe, it will be investigated by either one of our investigating officers or an experienced senior manager. Clinical incidents will be reviewed by a Consultant Psychiatrist. When an incident relates to an untoward death or behaviour involving a service user, a Trust panel will usually be convened, interviewing all concerned professionals and family members. Breaches of the seven day follow-up a measure of safety Following up patients seven days after their discharge is a measure of service quality and patient safely. The Board receives regular reports on breaches of the standard; in there were five breaches of the requirement to follow-up a patient seven days after their discharge. The distribution by age did not indicate any particular bias. Most were men; there were equal numbers of white UK and African with just one white other. There was no pattern for religious belief either. On this measure, there is no evidence that any group s safety is worse than any others. Equality and diversity aspects of incidents data from Datix Top types of incidents reported for Physical abuse, assault or violence 541 Abuse - other 322 Disruptive, aggressive behaviour - other 296 Challenging behaviour / aggressive gesturing 188 Other - please specify in description 173 Fall on level ground 160 Self harm 161 Other incident related to Security 153 Accident of some other type or cause 148 Accidental or malicious use of an Alarm System 117 Total 2259 In 2012 some 2653 patient safety incidents submitted to the National Patient Safety Agency. The tables below show the ethnic, gender and age breakdown Equality and Diversity Report

14 Ethnicity of patients involved in incidents: Gender of patients These figures suggest that men are disproportionatle more likely to be involved in incidents compared to women. Age of patient On the basis of these figures there is an indication that White UK patients are overrepresented, this may be due to the age profile, White UK patients make a larger proportion of the 65+ age groups which has the highest level of incidents. This will be flagged with the service lines for further review. [Equality and Diversity Report]

15 Conclusions The Trust has made progress in producing information on care outcomes by protected characteristics. As this information improves and is reviewed by service line management teams any areas of concern will be addressed. At the moment there is no evidence of discriminatory bias. However, it would be advisable to look at a wider range of service data to be sure. The Head of Equalities and POD Communications will work with the Mental Health Act Office and the management teams of the service lines to look at the grounds under which patients are taken into care and the pathways they take through the service. Across the NHS there is evidence that for example African and African Caribbean patients cost the NHS up to four times more than the average because they come into the service in the most costly ways and are more likely to be treated in the most expensive parts of the service (The Sainsbury Centre for Mental Health, 2006) Equality and Diversity Report

16 Improving patient access and experience The NHS should improve accessibility and information, and deliver the right services that are targeted, useful, useable and used in order to improve patient experience. Improving patient access and experience is the second of the two patient focused EDS goals. For historical reasons the trust had much better developed systems for delivering and measuring the patient experience and access. This is reflected in stakeholders grading the Trust as developing. The Trust delivers services in an area of huge diversity; it is estimated there are over 200 community languages spoken in the three boroughs of Barnet, Enfield and Haringey. This poses significant communications challenges. There are other access issues a provider like the trust needs to consider, such as the physical accessibility of its services, both in terms of people with disabilities which affect their mobility and for people dependent on public transport. Patients also expect and deserve a positive experience when they are in our care. The Trust offers customer care training to staff and there are a number of initiatives like star wards, the productive community team etc. The Trust has made improvements in this area another of its equality objectives focusing on improving the skill capacity and competencies of our staff to work effectively with a very diverse range of clients to better assess and meet their needs. EDS Goal and grade Improved patient access and experience Trust Equality Objectives 3. The Trust will ensure through effective leadership, training and monitoring that staff respect and discuss with all patients their cultural, religious and spiritual needs as part of a holistic clinical assessment. Specifically the Trust will: Ensure that year-on-year the percentage of patients who when surveyed agree that they have been given the opportunity to discuss cultural/spiritual needs increases so that by April 2015 it is at least 90% Ensure that year on year the percentage of patients who when surveyed agree that discussions with staff about their care included their specific cultural/spiritual requirements, increases, so that by April 2015 it is at least 90% Ensure that year on year the percentage of patients who when surveyed agree that they have been given the ability to practice appropriate religious/cultural beliefs in hospital will be at least 90% by April 2015 Ensure that year on year the percentage of patients who when surveyed agree that they have been given information about practicing their religion and access to the chaplaincy service or other faith leaders will be at least 90% by April 2015 Progress Head of Equalities &POD Comms has run a series of pilot workshops for frontline staff on cultural competence, co-delivered by service users and funded by the Strategic Health Authority. Following a review of the effectiveness the modified programme will be offered to teams across the Trust as preparation for staff improving cultural assessment skills and improving the response rate to questions about protected characteristics. [Equality and Diversity Report]

17 Promoting ready access to services, removing barriers The Trust has commissioned a comprehensive interpreting service, which can provide face-toface and telephone interpreting support in over 180 world languages including British Sign Language. For written communications the Trust has a separate translations contract, which allows people to order copies of patient information produced by the Trust in any of the 22 most common languages plus Braille and audio by ringing one number and giving the reference number of the document. The Trust has also published Easy Read versions of key publications. The Trust has active Early Intervention in Psychosis and Improving Access to Psychological Therapy services in each borough. The Trust is reviewing the various means by which patients are referred or self-refer into its services, which should improve the access to our services. Information about all Trust services is available on the website, which can be translated automatically into a range of languages. The Trust site also has Browse aloud and variable point sizes for people with hearing or sight problems respectively. In 2012 the Trust booked over 8,800 face-to-face interpreting sessions with patients. Below is a chart showing the top 10 languages requested by service users or their carers. These figures represent both recent patterns of migration into the area and levels of integration. From discussions with frontline services the very high levels of Turkish interpreting represent both recent arrivals of refugees and migrants and emerging needs within this community. Early intervention in psychosis is a preventative approach for psychosis that has evolved as part of the modern recovery approach to mental health. Because the relatively small numbers and the sensitivities of the service users, the Trust is only publishing data on gender this year. Over time more analysis will be published Equality and Diversity Report

18 Improving Patients experiences of our services A key challenge is to develop qualitative measures of patients experiences of our services which also capture robust data on protected characteristics of the population samples so that results can be related to different groups. The Trust uses a programme of service based surveys to track patients opinions on the quality of care they experience. The surveys use digital hand held devices to ask a number of fixed questions. These surveys typically sample the views of tens of service users in a particular location or service. With such small numbers of respondents any detailed analysis by demographic groups could result in some individual patients being identified with particular responses. This would be a breach of confidentiality and undermine patients participation in the scheme. The Head of Equalities and the Head of Clinical Audit are looking at ways to address this. The first possible solution will be used in the 2013 cultural and spiritual needs survey, where tracking surveys will be used to assess overall quality and an annual snapshot survey which will be given to all inpatients and ask for information on their protected characteristics will used to match general perceptions of quality to patients demographics. If this methodology proves to be robust it will be used more widely. The Trust has access to national surveys. The annual satisfaction survey of people who use community mental health services in Barnet, Enfield and Haringey was released in the autumn of 2012 by the Care Quality Commission. The survey charts the progress that the Trust has made since last year and compares performance with other Trusts. The survey indicates that this Trust is performing about the same as other Trusts in the majority of categories. We scored particularly high (8.3 /10) for the work of the health and social care coordinators. The response rate for this year s survey at 34% is slightly higher than the average for all Trusts. However the Trust does need to get its staff to improve their communications with patients, to listen more and to explain better. It is not possible even in this survey to analyses the responses by protected characteristics. [Equality and Diversity Report]

19 Handling complaints and concerns openly and fairly The Trust actively encourages patients and carers to comment on the quality of its services to them. In response to the comments of stakeholders in 2012 to the lack of information on the protected characteristics of complainants, the Patient Experience Team has actively sought to encourage people to provide this information. The level of non-disclosure is still high however, and as stated earlier there will be a publicity campaign to address this. The Trust has incorporated Principles of Remedy (having good practices to remedy complaints) into our complaints handling procedure. All complaints and claims received by the Trust are handled in an equitable, fair and just manner. The Trust has a dedicated team of staff who handle complains and claims, and we use independent external advisors in our investigations or reviews of complaints and claims where appropriate. There were 226 complaints recorded for The Trust consistently asks complainants about their ethnicity, gender and age. Of the 226 complainants, 217 complainants did not state their ethnicity, so it is not possible to make any inferences about inequalities in the treatment of complaints based on these figures. Only six complainants gave their age, so again it is not possible to draw any inferences the results for gender are below and are broadly in line with the population. Overall it will be important going forward to improve the disclosure of this information. Gender of complainants Equality and Diversity Report

20 Conclusions While there is no evidence which would raise concerns about access or patient experience by protected characteristics, the Trust still needs to continue to develop its information gathering and analysis in order to better evidence this. [Equality and Diversity Report]

21 Empowered, engaged and well supported staff with inclusive leadership The NHS should increase the diversity and quality of the working lives of the paid and non-paid workforce, supporting all staff to better respond to patients and communities needs. And NHS Organisations should ensure equality is everyone s business, and everyone is expected to take an active part, supported by the work of specialist equality leaders and champions. Half of the EDS goals relate to equality and diversity for the workforce. The stakeholders rated the Trust as Achieving for both of these goals, a reflection of the long history of work in this area. The Trust has adopted one equality objective in this area in response to stakeholder feedback. EDS Goals and grades Trust Equality Objectives Progress Empowered, engaged and wellsupported staff Inclusive leadership at all levels 4. The Trust will review and revise its appraisal and performance management system to ensure that corporate values and objectives around staff engagement and motivation to deliver quality care to all are incorporated and measured. It will also incorporate the Competency Framework for Equality and Diversity Leadership framework into the process as applied to the selection, development and appraisal of managers. The staff experience tracker and other survey methods will be used to assess performance as well as the comments of grand-parents on appraisals. In the first year the key performance indicator will be implementation of the revised system and the establishment of a baseline score. o o For and the key performance indicators will be an agreed increase over 2012/13 in the percentage of completed and signed forms returned to POD by the deadline an improvement in staff views as measured in local and national surveys. To reach as close to 100% as is practicable, for staff having an agreed annual performance review and PDP and returning completed forms to POD, by the deadline Through the performance appraisal system ensure leaders at all levels, including the Trust Board; actively incorporate the Trust s values and commitment to mainstreaming equalities in their management activities. The Performance Review and PDP process and forms have been reviewed to include a numerical score, and now incorporate Trust s values as part of the assessment. The target set by the Trust for verified returns of completed performance review forms for 2012 was 85%. The Trust has achieved a verified return rate of over 85% and has therefore exceeded the agreed compliance rate. The Trust has stepped up internal comms and met its 60% response rate for the staff survey 2012 and improved staff perceptions in a range of key areas. Trust will begin the staff opinion tracking surveys by the beginning of March 2013 POD will advise the Trust on the practical incorporation of the essential elements of the Competency Framework for Equality and Diversity in to the recruitment and development of managers. This will particularly helpful in helping the Trust to demonstrate management leadership in relation to inclusivity and equality at all levels Equality and Diversity Report

22 Our Workforce The total number of directly employed staff as at 31 st March 2012, is reflected as a total headcount of 2779 (headcount 2840 in 2010/11) with an FTE of The table below reflects the Full Time Equivalent (FTE) of number of staff in post as at 31 st March 2012 by staff group with comparable data over the previous two years. The increase in FTE in 2010/11 reflects the transfer Enfield Community Services (ECS) staff into the Trust. Staff Group FTE 2009/10 FTE 2010/11 FTE 2011/12 Medical and Dental Nursing Allied Health Professionals Scientific & Technical Additional Clinical Services Estates & Ancillary Administrative and Clerical TOTAL 2, , Staff Groups by FTE 2009/10 to 2011/12 (Data Source: ESR) The table below sets out the distribution of staff by pay grade, this has a bearing on equality and diversity, as for historical reasons women, people from black, Asian and other ethnic minorities are not evenly distributed through the pay scales. Staff directly employed by (AfC) pay bands (Data Source: ESR) [Equality and Diversity Report]

23 Distribution of staff by key protected characteristics This section provides an overview of the directly employed workforce by: Staff group: Gender: Flexible Working Pattern: Age: Ethnicity: Sexual Orientation: Religious Belief and data on Disability. Data indicates the gender breakdown within BEH is >70% female with little change from previous years. Nationally female staff account for >77% of the directly employed NHS workforce. Data in the table opposite reflects the broad staff groups in the Trust broken down by gender and flexible working pattern. Data in table below shows the gender breakdown of Trust staff gender by headcount and % of the workforce. Staff Group Female Male % Full time % Part time % Full time % Part time Scientific & Technical Additional Clinical Services Administrative and Clerical Allied Health Professionals Estates and Ancillary Gender Headcount % Rate Medical and Dental Female % Nursing & Midwifery Registered Total Male % Proportion of staff by Gender and Flexible Working Pattern (Data Source: ESR). Total % Gender Breakdown (Data Source: ESR) Equality and Diversity Report

24 The table below shows the gender balance in BEHMHT compared to like Trusts across London with BEH MHT in the upper quartile for % female staff. While higher than most the proportion of females is not dramatically out of line with other mental health trusts in London. Mental Health Trusts Female NHS Bexley 89% Barnet, Enfield and Haringey Mental Health NHS Trust 70% Camden and Islington NHS Foundation Trust 67% Central and North West London Mental Health NHS Foundation Trust 65% East London NHS Foundation Trust 63% North East London NHS Foundation Trust 66% Oxleas NHS Foundation Trust 69% The South London and Maudsley NHS Foundation Trust 65% South West London and St Georges Mental Health NHS Trust 64% Tavistock and Portman NHS Foundation Trust 71% West London Mental Health NHS Trust 57% Proportion of female staff in BEHMHT compared to similar Trusts across London. (Data Source iview) Workforce Age Profile The graph and table below indicate that the Trust has a higher proportion of staff in the 46 to 55 age group and in the 56 plus group than the average. The table below shows the percentage of BEH staff in age group 50+ compared to like mental health trusts in London. The data indicates BEH has an older workforce than average when compared to like London trusts. This age profile has been modelled into workforce/business plans and associated skills mix across Service Lines and should mitigate against potential future skills shortages. The age profile of our workforce shows approximately 22% of the directly employed workforce is aged over 55, with >33% between the ages of Graph showing the age profile of directly employed Trust staff (Data Source: ESR) [Equality and Diversity Report]

25 Mental Health Trusts Over 50 Over 55 Over 60 Barnet, Enfield and Haringey Mental Health NHS Trust 33% 20% 2% Camden and Islington NHS Foundation Trust 23% 13% 5% Central and North West London Mental Health NHS Foundation Trust 28% 15% 7% East London NHS Foundation Trust 21% 11% 4% North East London NHS Foundation Trust 38% 21% 8% Oxleas NHS Foundation Trust 32% 17% 6% The South London and Maudsley NHS Foundation Trust 29% 16% 7% South West London and St Georges Mental Health NHS Trust 35% 21% 9% Tavistock and Portman NHS Foundation Trust 36% 23% 9% West London Mental Health NHS Trust 29% 16% 7% The percentage of staff in age group 50+ for BEHMHT compared to other Mental Health Trusts in London (Data Source: iview) The age profile reflects historical patterns of recruitment rather than discriminatory practices. Ethnicity The Trust serves an ethnically diverse population across the geographical areas of Barnet, Enfield and Haringey. The recently released 2011 census data shows that about two thirds of the population the Trust serves is white UK, White Irish or white other, with significant numbers of White other. The table below compares the percentage of BEHMHT staff from black, Asian and minority ethnic groups (BAME) against the London and National (England) NHS workforce data. This would indicate that BEHMHT employs a higher percentage of staff from BAME groups than is reflected in the London and the National (England) picture. (Data Source: London SHA ESR data where BAME has been stated). Organisation / Region % BAME BEH MH Trust 51% London Strategic HR 44% All England 17% Proportion of staff from a BAME background within BEH MHT The graph below shows the ethnic background of directly employed staff by broad groups against the ethnic background of the patient population served. This indicates that staff from all white backgrounds are underrepresented in the workforce while staff from both black and Asian backgrounds are relatively overrepresented. This reflects historical patterns of recruitment into the mental health care workforce when posts were hard to fill and the NHS was involved in international recruitment initiatives Equality and Diversity Report

26 Ethnicity Profile Staff in Post / Patient Profile 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% White Black Asian Other (includes Mixed) Not Stated / Not known BEHMHT Patient Profile BEHMHTStaff in Post Profile Broad ethnic background groups of staff against ethnic background of the patient population served. Data in the graph below shows the percentage of BEHMHT staff from a BAME background by pay band in comparison to London figures (Data Source: London data June 2011 where BAME is stated.) Data suggests the Trust is well represented across all pay bands. The positive figures for BEH are indicative of fair and equitable processes. Percentage of staff in BAME groups by AFC Band compared to all London Trusts. (Data Source: NHSL where BAME is stated.) [Equality and Diversity Report]

27 Sexual Orientation, Religious Belief and Disability In recent years as the scope of equalities legislation has expanded data on more and more characteristics has been sought. As with ethnicity monitoring, the trajectory starts with a low rate of disclosure as people do not understand the relevance and worry about the use such information will be put to, but picks up as people better understand the value. Over time people become more comfortable disclosing the information and see the benefits. Information about sexual orientation, belief and disability is gathered electronically on a voluntary basis from all applicants. Data shown is throughout this section is reflected in percentage terms. The disclosure rate generally is going up. Staff voluntary disclosing to the Trust their religious belief has increased to 51%. About 64% belong to one of the many Christian denominations, 8% where Muslim and 7% Hindu. This is broadly in line with both patients and the local population. Our staff by religious belief categories. Staff who have declared their sexual orientation to the Trust has risen to 54% with 46% of employees not wishing to disclose their sexual orientation. Of the 54% declared, 45% declared themselves to be heterosexual. There has been a welcome improvement in the percentage of staff disclosing their disability status to the Trust. Breakdown of Disability status where stated (Data Source: ESR) People with disabilities are underrepresented in most workforces compared to the general population. The Trust actively promotes employment opportunities for disabled people in general though its two ticks positive about disabilities accreditation with job centre plus and initiatives to assist patients back into education, employment or training. Reassuring staff of the security of disclosed information and its usefulness will help maintain this improving trend Equality and Diversity Report

28 Recruitment and selection This section provides an overview of the recruitment activity carried out by the Trust over the 12 month period from 1 st April 2011 to the 31 st March The Trust recruitment processes were deemed to be 100% compliant with NHS Employers 6 Standards (based on an audit by Deloittes during 2011/12). Appointed staff During the 12 month reporting period, 259 staff were recruited. This figure includes external/internal appointments, fixed-term appointments and internal secondments, of which 26.7% of those appointed were male and 73.3% were female. Ethnicity The table below gives a breakdown of the number of applicants and their ethnicity by broad groupings, through each stage of the recruitment process Applicant Shortlisted Appointed White Black Asian Other Undisclosed Table Applicants by broad ethnic group (Data Source: National Electronic Recruitment database) [Equality and Diversity Report]

29 Access to support, training and development Fair access to development opportunities is one of the requirements of equalities legislation. The Trust has monitored access by ethnicity, gender, and working hours for a number of years. The most robust figures are for mandatory training and appraisals as these are reported to external bodies as part of the Trust performance management framework Attendance by Ethnicity, Gender and Working Hours Data in table below indicates that staff in the black and white groups are proportionally slightly less likely to attend at mandatory training compared to Asian and other ethnic groups. Ethnic Group Trust Profile Training attendance Asian 12.4% 13.4% Black 26.5% 24.0% Not Stated 3.3% 5.7% Other including mixed 8.8% 9.7% White 49.0% 47.1% Attendance by broad ethnic group compared to Trust wide ethnicity profile Gender Female Male Trust Profile 70% 30% FT/PT Full Time Part-Time Trust Profile 71.2% 28.8% Training Attendance 75% 25% Training attendance 70% 30% Attendance by gender Attendance by full/part-time (IWL) Female and part-time staff are more likely than their male or full-time colleagues to attend training, this is a positive situation in relation to the expectation that these groups miss-out on development opportunities Equality and Diversity Report

30 Appraisal and PDPs In 2011 the appraisal process was revised with improvements seen in 2011/12 in the percentage of staff with completed appraisals and PDPs. The graph opposite shows the percentage of Trust Staff with Appraisals and PDPs in 2011/12 with the comparable date from 2010/11. Greater emphasis has been placed on specific outputs, individual and team objectives that are clear and relate to specific organisational objectives, and reflect the values of the organisation. The revised forms are simpler and shorter allowing Percentage of Trust Staff with Appraisals and PDPs people to focus on personal performance and accountability. The associated paperwork has been reduced to two pages, with a performance rating system. The Trust s fourth equality objective covers appraisals which are seen as key to ensuring all staff are fairly and positively managed to do their best. The objective is to get as close to 100% as is practicable by April POD will continue to work with frontline managers to support them in improving the response rate. This will involve promotional campaigns and regular updates to service line and directorate management teams highlighting how individual teams are performing. Keeping staff safe The Trust has a zero tolerance stance on the bullying or harassment of its staff by service users, their carers or from other staff. In the 2012 staff survey (which looked at staff opinions in ), 38% of staff said they had experienced bullying or harassment from patients or their families. Surprisingly some 20% said they had experienced instances of harassment from another member of staff. Although 56% said they or a colleague reported such incidents, this is not showing up on official records.. The Business Partnering Team of People and Organisational Development are rolling out an intense programme of coaching and training for frontline teams to help them better manage this issue. [Equality and Diversity Report]

31 Staff engagement and empowerment The Chief Executive and senior leaders across the Trust have put a lot of effort into improving levels of staff engagement. The raw figures from the 2012 national staff survey were released just before the New Year and give an indication of staff perceptions in The Trust does not yet have the full statistical analysis, but the data indicates that we achieved a general improvement in staff perceptions as well as an improved response rate. The survey questions were in five sections. The bullet points below highlight the key issues in each section: - i) Your personal Development 93% of our staff agreed that they had had an appraisal, in the past 12 months, up from 84% in 2011 and above average for MHTs. Our staff were above average in agreeing that it helped improve how they did their jobs and in agreeing clear objectives. ii) Your job Our results for team working improved and are better than the average The responses to questions about how staff feel about their job and the Trust as a place to work indicate an improvement over last year s results with a strong shift to the positive in enthusiasm about coming to work and standard of work. The Trust improved its score for staff feeling the organisation values their work. Staff felt more positive about the quality of care they give and the Trust s results were above average Staff still perceive provision of materials, supplies and equipment as an issue, with only a slight improvement from 2011 and still below average for MHTs. The score for satisfaction with pay actually got worse and is well below the average for MHTs. iii) Your managers The Trust s staff agree more positively that their immediate manager gives clear feedback on their work compared to 2011, and the overall score is slightly above average. Managers are also perceived to be more supportive in a personal crisis compared to last year. Awareness of senior managers has improved and is slightly above the average and the effectiveness of communication between senior managers and staff is felt to have improved, as has perceptions of involvement and commitment to patient care. iv) Your organisation There was an overall slight improvement in positive perceptions, but the Trust s scores are still below average. In particular, the Trust s score in the Friends and family question while better than 2011 was still below the average for all MH trusts Equality and Diversity Report

32 v) Your health, wellbeing and safety at work There were slight improvements in many of the indicators on wellbeing, with the Trust scoring better than average on staff feeling their job is good for their health, not feeling pressured by colleagues or themselves to come in when unwell. But the Trust is still above average for staff feeling work related stress has made them unwell. On patient safety and having an open/reporting culture there has been an improvement in reporting errors and the perception that you will be treated fairly if you report. This is a very positive development. However, the perception that the organisation blames or punishes people who are involved in errors or near misses grew and is slightly above average. The major area for further action is perceptions around violence, bullying and harassment, were even when perceptions have improved we are still below average. Also there is still a significant proportion of staff who still feel that there is discrimination, principally on grounds of ethnicity. Until the Trust gets the results for the full workforce it will not be possible to report on the breakdown of perceptions by protected characteristics. [Equality and Diversity Report]