Annual Equalities Report Equality and Diversity Steering Group 2015-2016 March 2016 1
INTRODUCTION The Equalities agenda continues to be a significant area of on-going improvement and development for NHS Lanarkshire. 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. 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 Healthcare Quality Assurance and Improvement (HQAI) Committee who in turn report to NHS Lanarkshire Board. NHS Lanarkshire Board HQAI Staff Governance Committee Equality and Diversity Steering Group 2
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. 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: 1. NHS Lanarkshire Leadership,Corporate Commitment and Governance 2. NHS Lanarkshire s i-matters 3. Equality and Diversity Impact Assessment 4. Equality and Diversity Training 5. Interpreting and Translating 6. Community Engagement 7. Gender Based Violence 8. Health Improvement 9. Religious and Belief Specific Care 3
10. Workforce and Workforce Development 11. Communication 12. Feedback, Comments, Concerns and Complaints 13. NHS Lanarkshire Equality Outcomes update 14. Conclusion 1. Leadership, Corporate Commitment and Governance Mainstreaming the Equality Duty is an organisational responsibility to which NHS Lanarkshire s Board is committed. Its significance, as part of our core business is demonstrated by the existence of regular reporting to the Board through our governance structures and the nomination of an Executive Lead for equalities on the Board and within the Corporate Management Team. The Board also ensures that clear and consistent messages are given to senior managers about the importance of meeting the equality needs of service users and employees. To ensure NHS Lanarkshire s continued commitment to the equalities agenda through Leadership and Governance. During the course of the year some Board members took the opportunity to attend a Human Rights seminar as an introduction to human rights requirements including an opportunity to explore their relevance and application to NHS Lanarkshire. In addition Board members participated in a range of topic based seminars in which the impact on the equalities agenda was considered where appropriate e.g. financial planning. In 2015/16 NHS Lanarkshire Board Members have been able to: Explore the relevance of human rights requirements to NHS Lanarkshire Consider the equality and diversity impact of Board developments and decisions Consider and discuss progress and challenges in progressing Board action plans 4
For members of the Healthcare Quality Assurance and Improvement Committee and the Staff Governance Committee there was opportunity for consideration and discussion of regular reports exploring the progress, challenges and learning in taking forward our Equality and Diversity action plans. 2. NHS Lanarkshire i-matters The bespoke Staff Experience Tool for NHS Scotland, imatter, was introduced within NHS Lanarkshire in January 2015 and is being implemented on a phased approach. The board has been tasked to be fully rolled out by September 2017. This followed approval for use of the Tool across all Health Boards during 2014/15, reflected in the healthy organisational culture strand of the 2020 Workforce Vision Implementation Plan published in November 2013. The imatter Tool provides the opportunity for more focussed and responsive reporting at a team and line manager level around issues that the NHS Scotland Staff Survey which continues to be operational is only able to report on at local level, by professional group or by pay-band. So far 3220 staff (253 teams) across 6 directorates including the Corporate Management Team have taken part and have agreed or are in the process of agreeing a team action plan around staff engagement. Their action plans are based around areas that the team feel they can work on together to influence improvement. 3. Equality and Diversity Impact Assessment 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, Equality and Diversity Impact Assessment (EDIA) is core to any work that is being commissioned, reviewed or revised. 5
To support the mainstreaming of EDIA, it is embedded within NHS Lanarkshire s guidance on policy writing. 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. In 2015/16 NHS Lanarkshire has been working with its partners in North and South Lanarkshire Councils in developing and embedding a multi-agency approach to EDIA. 4. 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 see attached document for details. http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/4-equality-and-diversity-training.pdf 5. Interpreting and Translating Interpreting NHS Greater Glasgow and Clyde (NHSGGC) continues to be NHS Lanarkshires primary provider in interpreting services for spoken and British Sign Language (BSL) languages. Deafblind Scotland provides services for deafblind service users. Demand for a wide range of languages continues to increase with the changing populations within Lanarkshire, NHSGGC continues to provide a good service which at times can be stretched to capacity and work with NHS Lanarkshire to address any concerns and complaints in regards to the service delivery issues. Most requested lanaguges from April 2015 to February 2016 were; Polish, British Sign Language, Russian and Mandarin. 6
Telephone Interpreting NHS Lanarkshire continues to actively use 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, dentist and opticians. The main languages accessed between March 2015 Feburary 2016 via this service were: Polish, Romanian and Russain, whilst historically most popular languages requested Urdu and Mandarin are in single figures. Translation Policy NHS Lanarkshire routinely provides resources in alternative formats for staff to access for patients. Resources can also be developed and produced as required to meet the needs of individuals. The following NHS Lanarkshire Policies provide guidance for staff: Accessible Information Translation Written Information Leaflets Translation of information and the development of resources in alternative formats is coordinated by the Patient Affairs Department. High volume resources such as our Inpatient information booklet, Outpatient Information Sheet, Healthcare Associated Infection information, Health Rights information (provided by NHS 24) are available for staff to access and print from the Firstport intranet site; with Easy Read information available from the NHS Lanarkshire Learning Disability website. Information for these resources (not Easy Read) is available in Polish, Urdu and Simplified Chinese based on North & South Lanarkshire Councils census information. Other languages are produced as required. During 2015/2016 we have also translated resources to Swahili, Punjabi and Arabic. 7
6. 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. A number of engagement exercises were carried out in 2015/16 in regards to service users experiences or change in service delivery and design that have been supported by the equalities agenda. - NHS Lanarkshire has consulted and created Deaf and deaf blind patient passport cards for services users. These cards have been designed to highlight the need for BSL interpreters or other services when attending appointments. Cards provide guidance to staff on how to access the appropriate process and resources. Cards will be distributed through local deaf clubs and forums in spring 2016. see attached document for details - A multi-agency engagement event was held with the Deaf and deafblind communities In October 2015. The event aimed to discuss and explore the experiences and barriers encountered in accessing and using services. The event report is available on NHS Lanarkshires public website highlighting key recommendations. see attached document or link for details http://www.nhslanarkshire.org.uk/about/equality-anddiversity/pages/equality-diversity http://www.nhslanarkshire.org.uk/about/equality-anddiversity/documents/2015-16/6-patient-communication-passport.pdf - In response to some of the finding of the engagement event, NHS Lanarkshire in partnership a local Deaf club ran a Health Fair on 11 th March 2016. A number of practitioners from identified areas of need were invited to the event and information was shared and signposted. The 8
event did Keep Well checks with attendees and the event was attended by between 50-60 member of the Deaf and deafblind communities. - In March NHS Lanarkshire will be launching Patient Access Cards for people who require assistance to get to appointments. The card was designed after feedback from patients who said that due to a number of different factors they sometimes struggled, or found it difficult, to get to their appointments after checking in. The cards will provide staff with information to help enhance the patient experience the card will have NHS Lanarkshire, North & South Lanarkshire Councils logos allowing it to be used pan-lanarkshire across all services. - NHS Lanarkshire carried out an extensive review of its Out-Of-Hours Service culminating in a three-month formal public consultation. As part of the consultation process, NHS Lanarkshire representatives held a number of public consultation events across Lanarkshire. An event was also held at Deaf Services Lanarkshire Coatbridge offices attended by 19 deaf service users. The valuable feedback from the event was captured as part of the overall review. 7. Gender Based Violence NHS Lanarkshire 1. The Big Lottery funded Lanarkshire Domestic Abuse Response (LDAR) established all four operating elements within its first year and submitted a very positive end of year report in December. 9
2. EVA Services in conjunction with partners developed and launched a national trauma animation which Police Scotland were extremely impressed with the DVD and now utilize in their training of officers. The animation can be accessed on the link below http://www.nhslanarkshire.co.uk/services/eva%20services/pages/trauma -and-the-brain.aspx 3. EVA services have had an exceptionally busy year in advocacy, therapy and training. Referrals were up by 15% on last year. 4. Routine enquiry of abuse training was delivered to mental health practitioners to complete implementation of the routine enquiry programme in 5 service settings. 5. Multi-Agency Risk Assessment Conferences for very high risk cases of domestic abuse operated across Lanarkshire, with regular health input from health visiting, addictions, EVA Services, maternity and Emergency Care. 6. Mentors in Violence Prevention programmes have been established in schools in both North and South Lanarkshire and Health Improvement staff are supporting the multi-agency delivery. see attached document for details http://www.nhslanarkshire.org.uk/about/equality-and- diversity/documents/2015-16/7-gender-based-violence-lanarkshire- Domestic-Abuse-Response.pdf 8. Health Improvement : NHS Lanarkshire is delivering a range of actions to reduce health inequality and improve health NHS Lanarkshire (NHSL) has developed a comprehensive Health Inequalities Action Plan that was approved by the Healthcare Quality Assurance and Improvement Committee on 16 December 2015. areas: The plan covers eight key 10
Early years and young people; Employment as an asset for health: maximising NHSL s role as an employer to address inequalities; Tackling poverty and minimising the impact of welfare reform; Place Standard: To work with both local authorities to achieve the Place Standard in one area in each local authority area; Reshaping NHSL s services to address inequalities; Preventative services that support the most deprived populations in Lanarkshire; Utilising the Assets based approach to improve health and wellbeing within our most deprived communities; Identifying and developing person-centered approaches to those who are vulnerable. See attached document for details http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/8a-health-inequalities-workplan.pdf http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/8b-health-improvement-workplan.pdf 9. Spiritual and Religious Care NHS Lanarkshire continues to recognize that offering support for Religious or Belief Group activity is an important aspect of Spiritual Care, enhancing wellbeing which can have an important knock on effect both on recovery times and on staff experience which has a direct impact on patient experience and safety. see attached document for details http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/9-spiritual-and-religous-care.pdf 11
10. Workforce and Workforce Development Actions relating to employment policies that support people to gain employment or ensure fair terms and conditions for all staff NHS Lanarkshire is committed to working with other government partners, to help develop the workforce by training and employing individuals who are often overlooked by traditional recruitment methods and have considerable talent that could be utilised within the organisation. There are a wide range of other partners who participate and support routes to employment and targeted employment support. These include DWP, North Lanarkshire Council, South Lanarkshire Council, SERCO, ISS, New College Lanarkshire, NLC Regeneration Services and Routes to Work. See attached document for details http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/10-workforce.pdf 11. Communications The NHS Lanarkshire s Year Three Communications Action Plan 2015-16 includes a wide range of actions to improve how we are keeping members of the public and staff well informed. Actions include work to review and redesign the NHS Lanarkshire website (See below), a Plain English initiative and the launch of an online version to make The Pulse staff magazine more accessible. NHS Lanarkshire Website NHS Lanarkshire is reviewing its public website with a view to developing a new site that is more user-friendly and provides easily assessable and relevant health information. As part of this process the web team has sought feedback and input to inform a future Equality and Diversity Impact Assessment (EDIA) of the planned development. 12
A Survey Monkey questionnaire about the NHS Lanarkshire website was actively promoted to attendees at the Deaf and Deafblind Communities event in October 2015. A workshop was held in February 2016 to involve NHS Lanarkshire service users and staff in the early development work for the new website. Members of a number of third sector, volunatray and NHS equality groups were attended the workshop which focused on user needs. Following Government Digital Service best practice, user personas were created based on the SurveyMonkey responses with equality and diversity factored in when designing these personas. The personas were used as the basis for a discussion on what different users would ideally look for from an NHS Lanarkshire public website. The valuable feedback on the day will help shape the direction of the web development. 12. Feedback, Comments, Concerns and Complaints NHS Lanarkshires Mid-year Report on Feedback, Comments, Concerns and Complaints report provides an update on the feedback, comments, concerns and complaints that we received between April and September 2015 and on some of the improvements we have made as a result. We have continued to use, review and update the ways in which we gather people s feedback. We regularly asked service users and carers what they thought and welcomed their comments at any time. Listed below are some of the changes informed by the feedback. http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/12-feedback-comments-and-complaints.pdf 13
NHS Lanarkshire Equality Outcome March 2016: 1. Equality Outcome 1: Black and minority ethnic, older and disabled people will have a positive experience of health check services and the uptake of these services will increase within these groups. Status for 2015: This equality outcome is on-going and will continue to report on progress in 2015-16. 2. Equality Outcome2: Women in vulnerable groups and their babies will get the best start in life through improved engagement and uptake of antenatal care. In addition the provision of vital pregnancy screening programmes and early healthcare interventions will be targeted to those who may be at more risk of conditions due to ethnicity, age, disability or social disadvantage. Status for 2016: This outcome is complete 3. Equality Outcome 3: Looked after and accommodated children in the community will experience an increased sense of wellbeing and associated positive health outcomes. Status for 2014/15: This outcome has now been completed and mainstreamed. The LAAC service is currently being developed which will monitor performance against Chief Executives Letter 16 4. Equality Outcome 4: People from Lesbian, Gay, Bisexual &Transgender (LGBT) communities within Lanarkshire will have an increased awareness of mental health service provision and experience informed and sensitive healthcare responses. Status for 2016: Parts of this equality outcome have been completed mainly the production and publication of the It Get better film. Other aspects will be on-going and will continue to report on progress in 2016. 5. Equality Outcome 5: Young people who are disabled and socially disadvantaged experience equality of opportunity in relation to training and employment within NHS Lanarkshire. Status for 2016: This outcome has now been completed and mainstreamed http://www.nhslanarkshire.org.uk/about/equality-and-diversity/documents/2015-16/13-equality-outcomes-2015.pdf 14
13. Conclusion NHS Lanarkshire continues to address and work on areas of equalities with considerable challenges and successes. As evidenced in this report NHS Lanarkshire is working with a wide range of service users, carers, agencies within the public and third sector, with degrees of success. Work is continuing to be done to support staff through enhancing their knoweldfge and skills to ensure services are sensitive and person centred. - 15