The Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle Community Health Single Equality Scheme Annual Report 2010/2011
Contents Introduction...3 What have we done to promote equality, diversity and human rights within The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health?...4 What outcomes have we achieved?...6 What have we contributed to as part of the Network of Equality and Diversity Leads led by NHS North East?...16 What do staff feel about equality, diversity and human rights in the organisation?...17 Acknowledgement and contact details...18-2 -
Introduction This is a report about what The Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle Community Health undertook within 2010-11 to make the NHS a better and fairer place for patients and staff. It builds on the work started in 2008 and reports ongoing work and new actions. It is called an Equality, Diversity and Human Rights report because it shows the work we have done to: Help all people, whoever they are, to receive high quality health care we call this equality Recognise and celebrate the fact that every person is an individual - we call this diversity Make sure every person is treated with dignity and respect - we call this human rights We have written the report to show some of the things we have done over the last year, why we did them, and what was the outcome of what we did. We also show what we have learnt from doing what we have done. This work was undertaken by the two organisations who came together on the 1 st of April and will continue with the work to meet the needs of the population of Newcastle and the wider population who utilise it s services. Newcastle has a population of 270 500 (www.healthprofiles.info) who live mainly in the area represented by Newcastle City Council. Within the city there are wide variations in the health of local people. This is because of inequalities in health such as poverty, ill health and deprivation. English society is now more diverse than ever before and our openness and tolerance is part of what distinguishes us as a country. This is reflected in our high levels of cohesion, with 82 per cent of people agreeing that people from different backgrounds get along well together in their local area. Dept. of Communities and Local Government (2008) However, the evidence shows clearly that for some groups in some places, the outcomes in areas such as health, education, care and support and employment are less good. How fair is Britain? The first Triennial Review CEHR (2010) One of The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health s major challenges is to tackle these inequalities. The equality, diversity and human rights work that we are undertaking is one way that we are addressing these issues. Because we believe equality, diversity and human rights are really important to the NHS, this report does not just say what we have done within our own organisation, it also shows what we have done as part of a network of Equality and Diversity Leads through the region of NHS organisations (NHS North East). - 3 -
What have we done to promote equality, diversity and human rights within The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health? The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health aims to be a leading organisation for promoting Equality and Diversity in the North East. We believe that any modern organisation has to reflect all the communities and people it serves, in both service delivery and employment, and tackle all forms of discrimination. We need to remove inequality and ensure there are no barriers to health and wellbeing. The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health is committed to promoting equality, diversity and human rights in all we do. Our Vision is: To be the health service for Newcastle and a leading national health care provider Our Aims are: To put patients at the centre of all we do, providing the safest and highest quality health care To be the healthcare provider for Newcastle and a national specialist centre In partnership with Newcastle University Faculty of Medical Sciences and others to be nationally and internationally respected for our successful clinical research and development programme which leads to benefits in healthcare and for patients To maintain financial viability and stability To promote healthy living and lifestyles Our Values are: To place our patients at the heart of everything we do To value and enhance the contribution of staff, volunteers, members, Governors and other partners and stakeholders Zero tolerance of unsatisfactory behaviours Consistently high personal and professional standards in all activities To focus upon continuous improvement in the pursuit of excellence To have pride in public service and all that we do To continually seek best value for money - 4 -
Our work on equality, diversity and human rights helps to deliver this vision by identifying and tackling discrimination in the way we work. We focus on promoting equality whatever a person s race, age, gender reassignment, disability status, marital or civil partnership status, sex, sexual orientation, religion or belief. We call these terms protected characteristics. The vision is that will have a culture of fairness, equality, and respect for diversity that is evident to everyone. The Trust has aimed to implement its Equality and Diversity vision by: becoming a leading organisation for the promotion of Equality and Diversity, for challenging discrimination, and for promoting equalities in service delivery and employment creating an organisation which recognises the contribution of all staff, and which is supportive, fair and free from discrimination ensuring that The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health is regarded as an exemplary employer We believe and expect all staff to promote equality, diversity and human rights. The Involvement and Equalities Steering group is bringing together The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health groups. The following people are members of our internal Equality Diversity and Human Rights Working Group: Frances Blackburn, Head of Nursing, Freeman and Walkergate (Co-Chair), Karen Pearce Senior Human Resources Manager (Co-Chair),, Lucy Hall Equality, Diversity and Human Rights Lead, Caroline McGarry Involvement and Equalities Officer, Julie Anderson Head of Staff Engagement, Reverend M Saunder, Marjorie Shipton Hospital Chaplain, Rhona Stanbury and Katie Dewar Deaflink, Alison Blackburn Newcastle Disability Forum, Ann McNulty and Dipu Ahad Health and Race Equality Forum, Jean Fraser The National Association of Laryngectomee Clubs representative, Sally Baylis Liaison Officer, Action for Blind People, Michael Bell Estates Manager, Chris Bound Staff Nurse Ophthalmology, Mary Burns Adult Safeguarding, Tom Davison Senior Audiologist, Alison Forsyth Learning Disability Liaison Nurse, Karen Giles Head of Education and Development Katie Dodd Carers Centre, Alison McCall Clinical Coding Service Manager, Nicola Taylor and Janette Frank PALS, Julie Waite Matron. The following people will be joining the group in September 2011: Angela Ellins Public Health, Bea Groves representative on Transgender issues, Caroline Dowse Sexual Health, John Reid Links, Debbie Banks Outpatient Services Manager. Our Equality Strategy sets out our a bridging strategy between the previous Single Equality Schemes and an Equality Delivery System that will be published in April 2012.This will help us to maintain the mainstreaming of equality, diversity and human rights in all we do. The following tables describe some of the good practise within service delivery and the things we have done within The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health to promote equality, diversity and human rights. It brings the scheme to a conclusion and looks ahead to the actions that will be need to be continued and reviewed in the production of the Equality Strategy and subsequent Equality Delivery System that will replace it. It does not include every action or example of good practise, but gives a flavour of the work that we have undertaken, and the work that still needs to be done. - 5 -
What outcomes have we achieved within The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health? What we have done (Leadership, Corporate Commitment, and Governance) Developed an Equality Strategy that says what we will do to promote equality, diversity and human rights over the next three years. Agreed that our Equality Strategy is a live document that will change as we develop. New actions have been developed for 2011/12. Started to develop an Equality Delivery System (EDS) for 2010-2016 We have continued to participate in and contribute to a monthly meeting, called the EDHR Leads group across the NHS North East. Why did we do it What was the result Looking ahead The 2010 equality legislation requires public bodies to comply with duties in relation to the new protected characteristics and types of discrimination. We wanted to do more and have a joined up plan for all protected characteristics. To meet the requirement of Equality Legislation. This is the new strategy developed by the Department of Health to address inequalities and meet the requirements of the 2010 equality legislation. We believe that by working together on equality issues we can be more successful and make better use of resources. Our Equality Strategy will be published on our website once approved by the Board. It gives us a clear plan to work to. Our Equality Strategy is regularly updated. For example actions identified in this annual report will become part of our strategy. We can adapt the scheme to meet new requirements. Work with 3 rd sector organisation to consult on the EDS has begun and work to consult with staff side with is at the planning stage. NHS Employers are working with EDHR Leads across the region to support the development of the new scheme The EDHR Leads Group is already a national example of best practice. The EDHR Leads Group has worked together to facilitate events and produce resources and develop the EDS. An Equality Delivery System (EDS) will need to be developed by April 2012. Equality data needs to be published by January 2012 Equality analysis and objectives need to be published by April 2012 The organisation will use the information from the consultations to its equality objectives. NHS North East is not expected to exist after 2013 other mechanisms are being developed to continue joint working. - 6 -
Established an EDHR group at director level across the SHA. To ensure that EDHR is a clear priority for NHS organisations. Representation at director level is important in prioritising EDHR in organisations. EDHR commissioning and contracts training has been developed. NHS North East is not expected to exist after 2013. Other regional mechanisms to ensure EDHR is prioritised within commissioning need to be considered. Developed equality leadership roles within the organisation Service users experience our services at the point of delivery. It is important that we can recognise good practise and make necessary changes at all levels of the organisation. Newcastle s Community Health model of leadership was published as an example of good practise on the NHS employer s website in 2010. Services have clear action plans. They produce evidence about how they are progressing against these actions. A programme of working with Matrons in all directorates is being undertaken to further develop the EDHR agenda in a meaningful way. Reviewed the processes that embed equality, diversity and human rights into aspects of training, and the Knowledge Skills Framework (KSF) process. Equality issues need to be meaningful to staff in their work environments, in order to make changes that will benefit service users and staff. A number of changes have been made to training programmes to ensure equality and diversity issues are embed within the programmes, 92% of our staff have undertaken equality and diversity training as part of their mandatory training requirements. This is an increase of 15% in the last 12 months. Staff will work together to consider whether further changes are needed. Work experience placements have been developed for people with Learning Disabilities The DH says that too often, Year 10 and 11 students who have learning disabilities are not offered quality work experience Some staff have used the KSF examples document in their appraisals These documents are useful and in conjunction with Equality Fact Files are a useful resource to support staff and managers in appraisals. 8 students have received quality placements. Some have extended their placement over 2 school terms rather than 1 Other departments are undertaking training to increase the number of placements - 7 -
What we have done (Equality Impact Assessment) Published the results of Equality Impact Assessments (EqIA) on the Trust web site. Trained Equality Diversity Leads in community services delivery areas to undertake Equality Impact Assessments. Undertaken an audit on the quality of evidence used in Equality Impact Assessments. Developed a data base of evidence to support Equality Impact Assessments. Why did we do it What was the result Looking ahead To comply with legislation and to let people see the results. To help services consider the different needs or requirements of service users, and whether there is any public concern about a way in which services operate to meet needs appropriately and sensitively. To ensure that EqIA is a process on which changes to practise can be based. To address issues identified in the EqIA audit Results of Equality Impact Assessments are available for scrutiny. We need a better system of ensuring publication and follow up of recommendations. Services have EI Assessed service policies, guidelines and systems. Changes have been made to referral processes, assessment processes, service information and training. Commissioning has EIA the Strategic Operating Plan and other strategies. Learning to undertake Equality Impact assessments works best when staff assess policies and functions that they are relevant to their role. Reliable sources of timely and relevant qualitative and quantitative evidence were used. Staff and service user s feedback and evidence were used to make changes to policies and procedures. However evidence was not always referenced and quantitative data not always analysed. We will report on this in 2012 There is no specific duty to carry out EIA in the new Equality Act 2010 public duties. However they may remain a useful mechanism to provide evidence that is required under legislation. The organisation needs to consider this issue. If EIA continues in the form of equality analysis - training of staff needs to be considered. Include this as a training issue if the process continues. Patient journey through To develop a systematic Changes made to processes. We need to consider issues - 8 -
appointment, referral assessment, treatment and discharge are being EIA approach to EIA in service delivery. Some changes can be made at service level; others require a corporate or regional approach. of communication and access in all NHS referral systems. Updated the Equality Impact Assessment framework To comply with the Equalities Act 2010 Marriage and civil partnership, gender reassignment and pregnancy and maternity added as new categories to the EIA. Basic training for EDHR leads has been delivered in relation to the changes. Review of the updated process will need to be considered. What we have done (Partnership Working, Consultation and Involvement) Why did we do it What was the result Looking ahead Consulted with the membership of the Trust Developed training together with the Health and Race Equality Forum and The Disability Forum, Transgender and Twisting Ducks, Deaf Link and LInks. Fact files developed in partnership with community organisations and the Strategic Health Authority. Undertook You re Welcome audits. Representatives of local organisations are part of The It helps the Trust to deliver services that people need Staff in these organisations have expertise that compliments NUTH expertise. Staff wanted short guides that told them what they could do day to day to promote equality and diversity To meet the national recommendations for young people s services To ensure that local people s views are included in our The membership was able to contribute to developments within the Trust. This training evaluated well. Training is more effective when led by people from the equality group the training relates to. It gives the opportunity for questions and understanding for both facilitators and learners. We need to develop more training using this model. Fact files on physical and sensory disability, in relation to older age, race, transgender, learning disability, physical and sensory disability, religion and belief and human rights have been produced. Some staff are using these to inform their practise. 4 services have been accredited by You re Welcome Better understanding of the practical issues that local people wish to be addressed and We need to make sure there is a diverse membership. This is an effective model of training that evaluates well. Developing further fact files on areas such as sexual orientation, young people, mental health and men and women may be useful. Ensure Factfiles are readily available to staff across the organisation Other services will be identified to work towards accreditation. We need to ensure that representatives of people from - 9 -
Equality, Diversity and Human Rights group. Asked 3 rd sector and clinical staff to present information about good practice and gaps to the Equality, Diversity and Human Rights group. Cancer Services are working together with young people 19-24 to develop their services Midwifery Services are working together with 3 rd sector organisations to review their services to black and minority ethnic people. mainstream business. To understand more about what we are doing well and what we should change. This group of young people were recognised to have specific needs that did not fit into either children or adult services. To maintain and improve services that meet the needs of women from BME communities working together to meet them. Partnership work is effective and meaningful. We will report on this in 2012 We will report on this in 2012 We will report on this in 2012 the new protected characteristics are invited to join the group. What we have done (Accessibility and Communications ) An audit of communication support provided in community services Provided English language interpreting and British Sign Language Interpreting. Training to promote understanding of the need for interpreters and other Why did we do it What was the result Looking ahead To address issues learnt from last year. Continue to ensure high quality accessible communication support is available for all those that need it. To ensure that all staff are aware of the need for communication support for Many needs are being met but community staff need more information about access to Easy Read information and BSL interpreters. Communication support was provided. Staff are aware of the need to book interpreters and other communication support. We will consider using this audit within the hospitals - 10 -
communication support has been delivered at induction A LInk report Using interpreters when accessing health and/or adult social care services has been produced. Information is available in different formats on request. Help Cards were piloted within the organisation. Published and communicated general information about services on the Trust website. The information can be accessed in large print and video versions From computers in the Trust staff can access Deafsign to support communication with you. Staff can type in instructions; the on screen translation service will convert to British Sign language Updated the Equality and Diversity Info net page and asked E&D leads to inform community staff of this site within their teams. some patients. To understand service user and staff perspectives on interpreting. To make sure that service users can use the information they receive. The card can be used by anyone who needs help to access NHS services. To make sure that local people can access information. To support better communication with Deaf people. Staff can access information about different aspects of equality and diversity. This will be reported in 2012. Information has been provided in other languages and large print. Information has been added to the extra net regarding access to easy read information and information in other languages. People that used the card found it helpful. More work is required to involve 3 rd sector organisations in the distribution of the card if it is to be continued. The site is more accessible. We will report on this in 2012 Staff have accessed E&D information and appointment cards in other languages. A regional evaluation of the card is being carried out. This will need to be reviewed. This information will be added to the Hospitals Trust Intra Net Community Action on Health assessed the information service users received by following a patient journey To review the formats of information that service users were given. Top tips information developed and disseminated to services. - 11 -
through a service. Directory of Services for people of ethnic minority developed. undertaken up to date DDA audits on all Trust buildings. Community Development Workers working with Ethnic Minorities and Mental Health identified that staff and service users were unaware of support available. To ensure all buildings are accessible to disabled people More information available for staff and service users. Link www.ntw.nhs.uk/pic The results of the audit are being used to make sure our buildings are more accessible for staff and visitors. The Estates Dept are addressing DDA needs. What we have done ( Workforce and Training ) Maintained the 2 tick Disability Award Newcastle Community Health Continued membership of the Mindful Employer Charter. NUTH published a breakdown of our workforce by gender, age, ethnicity, sexual orientation and religion. Why did we do it What was the result Looking ahead To continue to promote the organisation as an equal opportunities employer. We are aware of the impact that psychological issues have on employees and are committed to addressing these issues. To develop a plan that will help us to employ a workforce that reflects our local population. Positive image of the Trust. Bronze award for Better Health at Work achieved. The results are published in the Equality Strategy Human Resources will review equality initiatives within the new organisation. NUTH undertook a staff survey. To review staff experience of working in our Trust. The 2010 survey found that 93% of staff stated that the Trust acts fairly with regard to career progression or promotion regardless of ethnic background, gender, religion, sexual orientation, disability or The results of the staff survey are being reviewed and actions planned to address concerns - 12 -
age. 11% stated that they have experienced discrimination. Equality diversity and human rights training is mandatory and also included in induction. To build a culture which is supportive, fair and free from discrimination for staff and service users The staff survey results show that 76% of staff in have undertaken EDHR training. This compares favourably with staff in similar organisations where on average 41% of staff have received training. Services have completed EDHR e-learning. The next step is to consider further training in relation to particular protected characteristics potentially delivered in this way Developed a new EDHR e- learning package. To update the learning in view of new legislation. The package incorporates information about new protected characteristics and forms of discrimination. Adding clinical case studies to the training may make it more useful to clinical staff. We have worked together with the Strategic Health Authority to develop Staff Network Groups that support staff who feel part of, or have an interest in, one of the equality strands Reports show some gay, disabled and BME staff have a negative experience in the NHS. Staff network groups provide support to staff. Contribution to understanding of issues, events and training. The Religion and Belief Network developed a Diversity Calendar Fact File and delivered an event in the Interfaith Week NHS North East is not expected to exist after 2013 and we will need to consider whether regional networks are viable. What we have done (Procurement ) Ensured contracts contain clauses in relation to E&D Why did we do it What was the result Looking ahead To promote E&D in all areas. This is difficult to measure. - 13 -
What we have done ( Monitoring Data, Reporting and Publishing ) Published a break down of patient access to hospital services by age, gender and ethnic origin A demographic breakdown of population by race, age and gender is included in the Director of Public Health Annual Report. Health Equity Audits include data in relation to gender, age and ethnicity where this data is available. The Joint Strategic Needs Assessments also identifies health needs by sub groups. Started a pilot of equality monitoring of participants in a patient survey. Why did we do it What was the result Looking forward To identify the take up of services by some protected characteristics To understand local demographic needs To work towards ensuring that we have included all people with protected characteristics within patient, public and carer involvement. The results are published in the Equality Strategy. Results included in the joint strategic needs assessment. We will report on this in 2012 The organisation is reviewing the collection and analysis of equality data Although progress has been made, collection of data remains problematic. Published an annual report and results of Equality Impact Assessments on the web site. To let people know about the progress we are making with the key objectives within the Single Equality Scheme. Review of progress and changes to the Single Equality Scheme Action Plan. We have done a lot and there is still much more to do. - 14 -
What we have done (Complaints) Recorded race, disability, age and gender in relation to complaints. How to Complain leaflet developed and translated into top 10 languages. Ongoing work with the Patient Satisfaction form to use with people that have made a complaint. This will include equality monitoring data. Resource pack and guidance developed in relation to complaints. Why did we do it What was the result Looking forward To find out if there are particular groups of people that have complaints and to find ways to address any trends identified. To improve understanding and access to the complaints system. To find out if there are ways that we could improve the system. To develop a standard approach to the complaints procedure. The sample is too small to identify any trends. More accessible information. There are lots of issues to consider in making the patient satisfaction form a useful tool. A standard approach to the complaints procedure is now being carried out. It is difficult to ask the questions related to additional protected characteristics during sensitive discussions, we need to consider sending a questionnaire after the complaint has been dealt with. - 15 -
What have we contributed to, as part of the NHS North East Equality, Diversity and Human Rights Network? The table below describes some of the things we have done across the wider NHS North East What we have done Why did we do it What was the result Looking ahead We have continued to contribute to the EDHR Network of NHS equality leads from across the north east. Developed a strategic SHA EDHR Group. We were part of a steering group that developed a template Single Equality Scheme. We are currently developing and Equality Delivery System that will comply with the 2010 Equality Act and the new Equality Strategy. We have acted as a coordinator for one of the Staff Network Groups and encouraged staff involvement in all networks. Staff Networks support staff who feel part of, or have an interest in, one of the equality strands Developed a regional EDHR Conferences and a religion and belief event. We believe that by working together on equality issues we can be more successful and make better use of resources. In response to the review its governance structures. To ensure EDHR is mainstreamed at the higher levels. We believe that Single Equality Schemes help promote equality, and we felt a template would reduce the workload for others. Local equality leads asked us to use our resources to do this as reports show some gay, disabled and BME staff have been bullied. Staff network groups provide support to staff. To share good practice and energise staff about this agenda. The EDHR Network has grown to include representatives from trade unions and NHS employers. It has helped carry out many of the things in this grid The group has supported regional and national developments in equality and diversity All NHS organisations in the North East have adopted Single Equality Schemes this year. We can make difficult but important tasks easier by working together with other organisations Staff network groups are helpful ways of promoting diversity and supporting staff. Groups need support and resources. Some staff wish to be involved without attending meetings. The conferences evaluated well. This is a useful way to take the EDHR agenda forward. We need to review the target audiences for 2011. In relation to all the actions in this section NHS North East is not expected to exist after 2013 and we will need to find other mechanisms to continue joint working. This group will now be hosted by the Leadership Academy - 16 -
What do staff feel about equality, diversity and human rights in the organisation? In 2010 NUTH staff survey staff were asked about their experiences of equality, diversity and human rights. Relevant results of this survey are presented below. Equal opportunities 93% of staff said the Trust acts fairly with regard to career progression /promotion, regardless of ethnic background, gender, religion, sexual orientation, disability or age. This compares favourably with acute trust national average of 90% Experience of discrimination 11% of staff said they had experienced discrimination in 2010. The trust's score is favourable when compared with the average a score of 13% in trusts of a similar type. Percentage of staff feeling valued by their work colleagues 75% of staff in the trust agreed with at least three of the following four statements: that their colleagues treat them with respect; that their colleagues seek their opinions; that they are trusted to do their job; and that they feel part of a team. The trust's score is slightly less favourable when compared with an average score of 76% trusts of a similar type. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months 18% of staff at the trust said that they had experienced harassment, bullying or abuse from colleagues or managers in the previous 12 months. The trust's score is slightly less favourable when compared with an average score of 15% trusts of a similar type. The Trust is aiming to participate in research with other NHS bodies to examine bullying and harassment. Perceptions of effective action from employer towards violence and harassment Staff were asked questions about the extent to which they think their trust takes effective action if staff are physically attacked, bullied, harassed or abused. The trust's score of 3.6 was above (better than) average when compared with trusts of a similar type. On-going the Trust will consider demographic information regarding the experiences of staff with protected characteristics to determine if their experiences vary from the averages reported above. - 17 -
Acknowledgements The Newcastle upon Tyne Hospitals NHS Foundation Trust and Community Health would like to thank all the individuals, groups and organisations who gave their time and expertise to support the organisation in meeting the objectives within our Single Equality Scheme. Contact details Lucy Hall Equality and Diversity Lead Newcastle Hospitals Community Health Benfield Road Newcastle upon Tyne NE6 4PF 0191 275 5114 Fax 0191 275511 This document is available in different formats on request by telephoning 0191 2755114 Or faxing 0191 2131968-18 -