Annual Equalities Report

Annual Equalities Report Equality and Diversity Steering Group 2013-2014 March 2014 1

Contents Page No Introduction 3 NHS Lanarkshire s Equality and Diversity Reporting Structure Equality and Diversity Steering Group Over-Arching Equality and Diversity Activities 1. Equality and Diversity Strategy 2013-14 2. Equality and Diversity Impact Assessment (EDIA) 3. NHS Lanarkshire Board Activity 4. NHS Lanarkshire Values 5. Equality and Diversity Training 6. Interpreting and Translating 7. Community Engagement 8. Partnership Working 9. Gender Based Violence 10. Workforce and Workforce Development 11. Religious and Belief Specific Care 12. Facilities 13. NHS Lanarkshire Webpages 14. Complaints 15. Areas of Future Work for the Equality and Diversity Steering Group 4 4 5 5 6 7 9 10 13 15 16 16 17 17 18 19 19 20 Conclusion 21 2

INTRODUCTION The Equalities agenda continues to be a significant area of on-going improvement and development for NHS Lanarkshire, post publication of a range of documentation last year, which set out our commitment and direction of work for the next four years. 2013 was spent supporting the embedding of the work into our core business as well as progressing some bespoke areas of work. Last year, NHS Lanarkshire published not only its annual equalities report, but a number of Equality Outcomes and also significant workforce data and information. A number of external assessors who have reviewed the work for the EHRC, Scottish Government and independently have cited Lanarkshire s work, especially on Equality Outcomes and Workforce Data as models of good practice, in a number of national reports. In believing that creating a culture of equality and diversity is the responsibility of everyone in our organisation and we are striving to make this a reality. We want to be an organisation which recognises the contribution of all staff, and which is supportive, fair and free from discrimination. In this annual report we hope to show how we continue to demonstrate our commitment to embed equality and diversity throughout our services, highlight areas where progress is being made, identify areas of new work and indicate where further and on-going development is required. 3

NHS LANARKSHIRE S EQUALITY AND DIVERSITY REPORTING STRUCTURE NHS Lanarkshire s commitment to Equality and Diversity stems right from the top of the organisation. The current reporting structure is through the Staff Governance Committee and the Clinical Governance Committee who in turn report to the NHS Lanarkshire Board. NHS Lanarkshire Board Clinical Governance committee Staff Governance Committee Equality and Diversity Steering Group EQUALITY AND DIVERSITY STEERING GROUP The Equality and Diversity Steering Group continues to have a cross section of representation from across the organisation and is an officer based group. The purpose of the group is to provide a facilitative forum for the implementation of NHS Lanarkshire s Equality and Diversity agenda. The focus of the group is to provide a steer for the implementation of the 2013-2017 Equality Strategy and its action plans, but also to feed into new strategies and policies which include ensuring that our equality priorities are achieved. 4

Steering Group members were key in identifying and supporting the development and publication of NHS Lanarkshire s Equality Outcomes 2013-14 and the Mainstreaming Report and Workforce Data as required by the Equality Act 2012. The group continues to monitor progress and have contributed to and supported the development and publication of NHS Lanarkshire s current Equality Strategy 2013-2017. The group regularly showcases models of good practice within the organisation as well as inviting external speakers when appropriate to help inform members about national issues and topics. OVER-ARCHING EQUALITY AND DIVERSITY ACTIVITIES The following is an annual report of the work that has been overseen and supported by the group and identifies where progress has been made and where there needs to be continued work or further development. 1. NHS Lanarkshire Equality Strategy 2013-14 NHS Lanarkshire Equality Strategy aims to provide a clear picture and direction to illustrate what we aim to achieve in relation to embedding equality over the next four years and demonstrates our commitment to delivering an effective and inclusive service. The Equality Strategy for 2013-2017, replaces NHS Lanarkshire s Single Equality Scheme 2010. This Strategy shows how we intend to continue the promotion of equality in our dual role as both a large local employer and as a provider of health services. The Equality Strategy fully reflects the requirements of the Equality Act 2010 in meeting both the General and Specific Duties and other local and national policy drivers. The Strategy builds on the work committed to and achieved through our Single Equality Scheme (published in April 2010), and carries forward a number of strands that will remain pertinent from an equalities perspective over the next few years. 5

It is anticipated that much of the work will be ongoing and, for this reason, the strategy incorporates an action plan which will remain subject to regular review and amendment to ensure it continues to reflect changing priorities based on legislative developments as well as feedback from our stakeholders. The Board is committed to monitoring progress against the action plan and taking whatever steps are necessary to realise our aims.. 2. Equality and Diversity Impact Assessment (EDIA) As an organisation we recognise the on-going importance of embedding equality and diversity within all our structures and processes and continue to strengthen the integration of equality and diversity within our services. In doing so, EDIA is core to any work that is being commissioned, reviewed or revised. To support the mainstreaming of EDIA, it is embedded within NHS Lanarkshire s guidance on policy writing. In last year s annual report an area of concern that was identified was the completion and submission of completed EDIAs. This has been addressed by ensuring that all policies, before being published on NHSL internal and external websites have to submit a completed EDIA. This is monitored and implemented through the Knowledge and Library Services and the Equalities team, with on-going support and advice as and when requested. All completed EDIAs submitted to the Equalities manager are now available to view NHSL internal website Firstport see link: http://firstport2/staffsupport/equality-and-diversity/default.aspx The following areas have been identified as areas for development in 2014/15: Continuous promotion of the importance of embedding EDIA within the organisation s decision making process 6

Review current EDIAs and work with partners to develop a multi-agency EDIA to support the Integration work currently being developed in partnership with local authorities. Continue to ensure that all Board papers submitted to NHS Lanarkshire s Board have a completed EDIA Continue to work with project leads to support them to ensure EDIAs are embedded and completed on any areas of work. 3. NHS Lanarkshire Board Activity NHS Lanarkshire Board Members training On the 19 th August NHS Lanarkshire held an Equality and Diversity seminar for its Executive and Non-Executive Board members. The seminar was part of the commitment NHS Lanarkshire made in its Single Equality Scheme 2010-2013. The aim of the learning session was to ensure that Board Members: Understand the main requirements of the Equality Act 2010 Reflect on their roles and responsibilities in ensuring compliance Identify the actions that need to be taken for improvement. A number of areas were identified by Board members as requiring further information or evidence of further development: 1. Health Needs Assessments there is a need for better evidence to be able identify which groups are actively engaging and participating and which groups are not. 2. Policies show little evidence of how hard to reach groups are being targeted. This has to be more transparent in the submission of work. 3. Continue to work on identifying and supporting participation of service users and carers. This should be evidenced in policies and service design with better evidence of this demonstrated in policy and Equality and Diversity Impact Assessment (EDIA) 7

4. More evidence and feedback on how equality based policies are being used by staff and service users. Are they being accessed and are they having a positive impact? The overall feedback from the day was that the members found the day to be informative and relevant to their role as Board Members. A number of actions have been identified which the Steering Group should support: The Director of Public Health to identify a Public Health representative for the Equality and Diversity Steering Group to ensure linkage in regard to Health Needs Assessment. The need for better evidence in EDIA on how we target hard to reach groups. Demonstrate what has been done within the EIA when deferential impact is identified. Consider a review of the documentation. Consider if training refreshment is required for General Managers. Consider if the Equalities Champions could be developed to support Impact Assessment. NHS Lanarkshire Board member recruitment NHS Lanarkshire and the Scottish Government in September to November 2013 in a joint exercise carried out a recruitment campaign for two new Board members. A new approach was taken in its recruitment and assessment process, to ensure a diverse range of applicants. Equality groups and general members of the public were positively targeted in the recruitment campaign, with a number of general and bespoke outreach community information events held, to give people the opportunity to find out more about the non-executive positions as well as other ways of getting involved with your local NHS. 8

The new-look recruitment exercise also included a redesigned information pack with frequently asked questions to explain simply what the role involved. The format of the interview and selection process was also revised. This exercise has been assessed as being a success, as the number of candidates that applied and shortlisted increased considerably and this model of board member recruitment has been recognised as one of good practice. 4. NHS Values Through a process of collaboration with staff, our NHS Lanarkshire values have been developed as a set of team, individual and organisational responsibilities. Whilst the NHS Scotland values provide an overarching set of consistent values for all NHS Staff, our local values bring the national values to life in our local day to day activities and actions. With the values now in a format that can be used in a variety of ways, a number ideas about how the values can be used by the organisation and its managers to support communication and staff recognition are being taken forward through the following: Teams implementing the Values in Action Framework; Values embedded into recruitment and corporate induction Using the Values in Action Framework as part of the implementation of change programmes, in development days and Organisational Development work with teams seeking support To support teams with identified needs e.g. in response to staff survey or feedback from the anticipated national staff experience tool to be introduced in 2014-2015 (i-matter). The values through their focus on respect and fairness fundamentally support the Equalities Agenda by making explicit the behaviours that contribute to a quality experience for staff and service users. 9

5. Equality and Diversity Training NHS Lanarkshire continues to provide a robust programme of learning and development opportunities for staff through a range of on-going programmes and development including corporate induction and class room based equality and diversity training. We currently deliver a number of training programmes on equality and diversity including: 1 day Equality and Diversity Training Course for all staff 3 courses a month were delivered and between Jan 2013 Dec 2013, 378 participants completed the course. This is highly evaluated with a number of staff showing an interest increasing their knowledge by doing the Equality Champions programme. The course contents will be reviewed in 2014, in line with the current changes expected from the national updating of the Knowledge & Skills Framework and to ensure that NHS Lanarkshire Values are embedded into the training. A LearnPro Equality and Diversity module has been designed as an update for staff from previous courses, the LearnPro module is expected to go live by August 2014. Half day Equality and Diversity Training Course for consultants and junior medics Two sessions a year are run in partnership for medical education and is a well received course. 3 day Equality and Diversity Champions Programme This 3 day training programmed continues to be delivered in partnership with North Lanarkshire Council and is being delivered bi-annually. 10

Due to the high number of existing champions and difficulty in releasing staff for a 3 day course, NHSL & North Lanarkshire Council recruitment and training of Champions numbers for 2013/14 have been low, and a joint decision was made to reduce the training to twice a year. A LearnPro Equality and Diversity module has been designed and is expected to go live by August 2014, which will support existing champions to update their knowledge and skills on recent legislative changes and other equality issues pertaining to their role. Equality and Diversity Impact Assessment Half day sessions on EDIA are regularly requested by project leads/teams and departments for support and advice on EDIA and bespoke programmes are delivered on request. This has improved understanding of how to complete an EDIA and the completion rates of EDIAs have increased. Departments which have requested the training have a higher rate of ongoing completion. The training increases not only skills but confidence and presents evidence for areas of change. Corporate Induction Programme Equalities have been an ongoing underlying principle in the delivery of Corporate Induction for new staff joining NHS Lanarkshire. From April 2014 a redesign of this programme will commence with content focused on NHS Lanarkshire s values, with equalities featuring more prominently by means of a dedicated section being delivered by our Learning and Development team. This will take the form of an overview of some of the equalities language and legislation, using an NHS based set of scenarios designed to highlight discrimination in action and help staff understand how to challenge and report discrimination. 24 programmes (two per month) are delivered annually which will provide us with a opportunity to introduce the fairness, respect and 11

equalities agenda to a potential audience of 1,000 staff during the coming year (based on figures from a similar period in the previous year). Discussions on content are underway with a variety of groups which add value to this area of work, and which demonstrates partnership working Partnership Representatives, Voluntary Services Manager, Public Partnership Forums, etc. Discussions are also underway to include doctors and senior managers in attending future Corporate Induction programmes. Gender Based Violence Training Courses Including a new Learnpro module on Human Trafficking and a range of specific inputs to support a variety of programmes and staff training needs, such as, routine enquiry of abuse or training GP s and practice staff in the delivery of the national IRIS pilot programme (Identification and Referral to Improve Safety of women experiencing domestic abuse). Gender-based violence has adopted the training requirements for staff in relation to child protection and adult support and protection, utilising a shared public protection framework of wider, specific and specialist staff workforce. 1 day Child Protection The Child protection course is for all registered health professional working in NHS Lanarkshire 1 day Multi-agency Adult Protection NHSL continues to deliver this multi-agency adult protection course in partnership with North Lanarkshire council 12 week Basic Introduction to Sign Language NHSL continues to support and arrange delivery of this accredited BSL course delivered by Coatbridge College and is open to all staff, the course is run twice a year, giving front-line staff basic BSL skills to communicate with BSL users within their services. 12

Literacy and Dyslexia Awareness Training The ½ day sessions are for all staff; however are particularly advantageous to staff in a supervisory role looking to support workers with literacy needs or for staff looking for literacy support Mental Health First Aid Mental Health First Aid is a new course that is being offered, it is a nationally accredited 12-hour training course designed to give participants the knowledge and skills to recognise the signs of mental ill-health and support someone to seek the right help. This is being delivered in-house as well as being offered to community based projects and groups to support NHSL mental health strategy. We regularly review our training based on assessments or feedback to allow us know that the training is meeting need, to adjust content or to re-focus. 6. Interpreting and Translating Following a review NHS Lanarkshire introduced two new policies one on accessing and using Interpreting services and another on the process and procedure in getting information translated. Interpreting In January 2013 NHS Lanarkshire introduced a new way of accessing faceface interpreting services. All face to face and British Sign Language (BSL) interpreters are now being provided by NHS Greater Glasgow and Clyde (NHSGGC) in-house interpreting service. By introducing a new service provider, we were able to making booking an interpreter easier for staff. All bookings are now made through central administration teams. Access to the service is now available to all health professionals providing services for NHS Lanarkshire, which includes GPs, and dentists. For community based pharmacies, access to telephone interpreting has been made available. 13

Although the centralised booking resource has made the booking of interpreters easier for all staff and less complex, we are unfortunately unable to compare the usage figures pre and post changes, mainly due to the different pre-existing booking systems for different parts of the organisation. So, we have been unable to confirm if use of the service has increased. The general consensus is that communities who historically were not always offered the support of an interpreter are now actively being offered the service, especially in areas like British Sign Language(BSL) which has shown a considerable increase. With a more centralised service that records the usage, we will be able to compare and contrast with 2014/15 figures to the 2013/14 figures. Breakdown of the languages requested between Jan 2013-Dec 2013. Language No Language No Language No Language No Arabic 8 Greek 1 Mandarin 107 Slovak 32 Bengali 5 Guajarati 1 Polish 1508 Somali 1 Bulgarian 3 Hindi 15 Portuguese 3 Spanish 19 Cantonese 3 Hungarian 53 Punjabi 100 Swahili 6 Czech 76 Italian 2 Pushto 1 Thai 1 Estonian 23 Kurdish 6 Romanian 85 Turkish 7 Farsi 4 Lithuanian 4 Russian 247 Ukrainian 1 French 6 Malayalam 1 Sign Language 650 Urdu Vietnamese 72 10 NHSL Lanarkshire is undertaking a 1 year on review of the service and will be submitting a paper with key recommendations to NHS Lanarkshire s Corporate Management Team. 14

Telephone Interpreting For telephone interpreting NHS Lanarkshire is using Language Line interpreting services. This service is available to all health professionals providing services for NHS Lanarkshire and has also been extended to community based pharmacists. The service is not being used as often as initially envisaged, in 2014/15 NHS Lanarkshire will be actively promoting the use of telephone interpreting as an a first point of call for certain interpreting requests. Translation Policy All requests for translation continue to be submitted to the Patient Information Manager. This enables provision of resources in alternative formats and avoids possible duplication and unnecessary costs. 7. Community Engagement NHS Lanarkshire continues to support and fund a number of community based groups that represent and articulate the needs of some of the groups who share protected characteristics. NHS Lanarkshire is also working with a number of newly established community based groups to set up outreach health promotional work, for example, a series of health awareness sessions ranging from diabetes to cancer awareness sessions will be run in community based setting. NHS Lanarkshire in partnership with the Princess Royal Trust and MECCOP Carers Centre have commissioned an audit of the current support needs for Chinese Carers in Lanarkshire, the audit involved discussion and engagement with the Chinese community and service providers in identifying short and long term caring and health needs of the community. A final report with the key recommendations will be presented to the working group in April 2014. 15

NHS Lanarkshire will continue to support and promote partnership work between community based groups, the third sector and the North and South Lanarkshire Public Partnership Forums (PPFs). The PPFs have sought the active engagement of a number of equality groups, with varying degrees of success. A number of new members have been recruited recently including 2 as a result of recent Board recruitment. Work continues to ensure engagement with a diverse group of people. 8. Partnership Working NHS Lanarkshire continues to work in partnership with a range of local and national statutory partners on joint and single equalities agendas. In 2013 NHS Lanarkshire as part of its equality strategy supported the setting up of a multi-agency partnership group, with our local statutory partners, which will be looking at identifying and developing key areas of work across the spectrum from an equalities perspective, especially in the area of joined up services and key areas of equalities i.e. Hate Crime reporting. At national level NHS Lanarkshire continues to contribute and work with national bodies, like NHS Education Scotland (NES) and Health Scotland, in shaping and supporting the equalities agenda. 9. Gender Based Violence The Tackling Violence against Women as Gender-Based Violence Strategy was revised for 2013-2018 with a focus on increasing work with partners on primary prevention, as well as acknowledging the new public protection arrangements within NHS Lanarkshire to consolidate child protection, adult support, and protection, gender-based violence and multi-agency public protection arrangements (MAPPA). 16

To mark the international 16 days of action for the elimination of violence against women, NHS Lanarkshire hosted an event with partners on trafficking and prostitution to raise awareness of these issues as matters of human rights and public protection. The event included a challenging exhibition named the Invisible Man and a presentation by Gunilla Ekberg, a Swedish-Canadian lawyer and international expert on the human rights of women and girls. New national inter-collegiate guidance on Female Genital Mutilation (FGM) has been utilised by NHSL to benchmark our services against and ongoing work will take place in 2014 to ensure that services incorporate these recommendations. 10. Workforce and Workforce Development Workforce information is key to delivering positive improvements in equality and diversity of our employees. We are committed to the continued development of robust systems that enhance the quality of data on our employees from all protected characteristics. It is planned to implement the national HR system (Electronic Employee Support System) during 2014/2015 to support and focus positive equality improvements. In addition we will continue to analysis the 2013 national staff survey results to direct and focus equality improvements that will reduce discrimination experienced by staff, considering age and ethnic origin as a priority. 11. Religious and Belief Specific Care The facilitation and delivery of religious or belief specific care to patients, carers, staff, and volunteers is the responsibility of the Spiritual and Religious Care Department of NHS Lanarkshire. This department is placed within the Nursing, Midwifery, and Allied Health Professions Directorate, with the Head of the Department reporting to the Director of Allied Health Professionals. This reflects the remit of the department to provide spiritual care to people of all faiths and no faith as an integral part of holistic, person centred care. Religious care is a 17

smaller but important aspect of care and is a strand of the equality and diversity agenda. To ensure equity of care and appropriate care the Spiritual and Religious Care Department provides multi faith resources for staff, meets regularly with community faith and belief group representatives through the Spiritual Care Advisory Committee, maintains contact information for faith and belief groups and has developed protocols for staff to help them access faith and belief groups if support is requested by patients or carers. Work has recently been undertaken to ensure that the sanctuary space in the three acute care hospitals is suitable for use by people of all faiths and none, in accordance with government guidelines and the Equality Act. The Spiritual Care Policy is currently under revision and will include guidelines for faith and belief group representatives when visiting their members in hospital. 12. Facilities By understanding the needs of the local population, NHS Lanarkshire can understand how to influence behaviours in relation to health and sustainable development. This is achieved by listening to, understanding, and involving the local community in decision-making and scrutiny processes as follows: NHS Lanarkshire is continuing to work with the local community and encourage involvement in the development of public arts at the 3 new HC sites (Wishaw HC, Kilsyth HC and Hunter HC). For the last 4 years NHS Lanarkshire has achieved and maintained the Healthy Living Award Plus, which is recognition of our efforts to encourage staff and patients to make healthy and sustainable food and nutrition choices. In NHS Lanarkshire non patient facilities tea and coffee are Fair Trade products. 18

Within NHS Lanarkshire the Fruits and Roots initiative which operate across a number of sites offers staff, patients and visitors the opportunity to purchase fresh fruit and vegetables from a local supplier. 13. NHS Lanarkshire WebPages External: NHS Lanarkshire has an equality and diversity external webpage, which was populated with the publications of the recent work completed in meeting our specific duties. In 2014 further work will be done to populate the site with increased information for the public and staff. The webpage is now available and is compliant with current legislation. Service users are also able to choose the text size on the screen to suit their need. See link: www.nhslanarkshire.org.uk Firstport: On Firstport, NHS Lanarkshire internal webpage there are a number of WebPages with information and support documents for staff to access, these range from accessing an interpreter to information on the spiritual care services. In 2013 the equality and diversity page was created and is seen as a central source of information for internal and external links, thus creating an equalities one-stop shop of information for staff. This page is regularly updated and populated with new links by the equalities team. The page also hosts current and past completed EDIAs and the EDIA documentation - see link: http://firstport2/staff-support/equality-anddiversity/default.aspx 14. Complaints NHS Lanarkshire continues to be committed to managing all forms of feedback in accordance with the Patient Rights (Scotland) Act 2011 and the related guidance from the Scottish Government called Can I Help You? This includes feedback, comments, concerns, and complaints. The latest version of the booklet and fact sheet information is available electronically on the staff intranet. 19

http://firstport/c16/complaints%20handling/policies%20procedures%20%20guidelines/ Can%20I%20Help%20You%20Guidance.pdf In September 2013 various complaints management protocols were updated and subsequently approved by NHS Lanarkshire s Care Assurance Board. These included a protocol setting out the responsibilities of all staff involved in managing the complaints process, including the Associate Medical and Nurse Directors, Clinical Directors and Senior Nurses. Following the introduction of these updated protocols the Executive Director of NMAHPs signaled her intention to carry out a review of complaints management; this has been amalgamated with the work to take forward the recommendation made in the HIS report. 15. Areas of Future Work for the Equality and Diversity Steering Group 2014/15 In the upcoming year the group will: Update the Equality Strategy Action Plan for 2014/15 Continue to ensure that EDIA is embedded more robustly within NHS Lanarkshire decision making processes Continue to support and develop community engagement structures to attract engagement from a diverse range of the population. Delivery of more outreach health awareness sessions on key priority areas i.e. MH Continue promotion of the interpreting services to service users Complete 1 year review of interpreting service for NHS Lanarkshire s CMT. And in terms of workforce will: Continue to develop a robust system to capture data of service users and our employees from all protected characteristics to enable effective monitoring of equality through the Electronic Employee Support System (eess) 20

Analyse the results of the Staff Survey 2013 and reduce any discrimination experienced considering age and ethnic origin as a priority. CONCLUSION In this report we have given an update on our progress across the year and this demonstrates that Equality is not an add-on, but an integral part of NHS Lanarkshire; we have evidenced the on-going commitment by the leadership and staff as advocates for change. We will continue to make systematic and targeted changes that make a real difference. The report indentifies that there still needs to be more work done which will continue to inform our on-going work programme for 2014 2015. Hina.sheikh@lanarkshire.scot.nhs.uk Susan.dunne@lanarkshire.scot.nhs.uk March 2014 21