Pennine MSK Annual Equality Report For 2015 1. Executive Summary Pennine MSK s mission statement is, We will keep the patient at the heart of everything that we do by providing outstanding care and support to every patient every time. This mission statement holds all equality and diversity principles at its centre. We are committed to ensuring that our service delivers outstanding patient care to our patients from the community of Oldham. We are required by law to show how we ensure our services and processes consider the nine protected groups stipulated in the Equality Act 2010 and to address health inequalities related to the protected groups. We are committed to ensuring health outcomes improve for all of our patients and therefore addressing those related to protected groups and improving access to our service will help us achieve this. We foster a culture of openness and transparency with our whole workforce and value every member of staff s contribution to deliver high quality care to our patients. We provide equality of opportunity in all aspects of our workforce practices including recruitment, access to training, supervision and support. We monitor who is accessing our service and collect views on patient experience which helps us to highlight what is working well and areas for improvement. We monitor our 1
workforce and our recruitment as we would like to work towards a goal of employing a workforce that represents the community that we serve. We have worked hard this year to improve our Data collection but we recognise that this can be improved further and plan to improve the focus on this in the next year. We have identified that staff would benefit from improved support and guidance to ensure data is collected effectively and we plan to improve this support in the coming 12 months so that we can explain more effectively why we collect the information and what it is used for. The Pennine MSK Partnership intends to embed its equality and diversity values into every day practice, policies and procedures so that equality and diversity becomes the norm for all. There are eight key principles at the heart of the company s plans for the future: 1. Patient Centred Care 2. Whole system approach linking primary, hospital and social care 3. Partnership working 4. Patient and public involvement 5. Priority of investment in primary and community services 6. Equality of health and service provision 7. Valuing staff, people and patients 8. Building and enabling and creative culture across the organisation In developing and implementing this Single Equality Scheme, Pennine MSK Partnership aims to: Be an organisation that harnesses the talents of all, by welcoming diversity and managing it in a truly effective manner. Be an organisation where all forms of harassment and discrimination are not tolerated and are actively eradicated. Demonstrate that equality of access is embedded in everything we do for users of our services. Be an organisation that promotes good relations between people of all groups and communities. 2
2. Equality Act (2010) We are bound by the Equality Act 2010 which sets out when it is unlawful to discriminate or harass a person and gives rights to our service users, carers and employees to raise complaints regarding discrimination. The law protects people on the grounds of protected characteristics : Age Disability Gender re-assignment Marriage and civil partnership Pregnancy and maternity Race and ethnic origin Religion or belief Sex Sexual orientation 3. Equality Objectives for 2015 Our Equality objectives for the year were: 3.1 To increase our monitoring of protected characteristics across the service of both patients and staff to improve the usefulness of the information. We introduced an E&D monitoring form for both patients and staff and rolled this out across the service. All new patients are sent a form to complete and return at their first appointment. These forms are then coded onto our clinical system. All staff complete an E&D form at induction. We monitor E&D details of all applicants at recruitment. 3.2 To aim to improve communication across the service regarding Equality and Diversity with clinicians and patients. We improved our patient information leaflet and updated our website with more information about our commitment to Equality and Diversity. We held team briefs to ensure staff understood the importance of collecting E&D data and what we use the information for. 3.3 To ensure all staff receive training on Equality and Diversity that is appropriate for their role. All staff complete an Equality and Diversity on-line course and assessment every three years. 3
4 Equality Data collection and monitoring of our workforce Staff E&D protected characteristics are held and recorded on a password protected spread sheet and cross referenced with their next of kin record. 4.1 Our Workforce The Annual Workforce Report outlines the equality and diversity data of Pennine MSK Partnership Limited. Data is from April 2014 to March 2015. The report includes equality data of the Board of Directors. Overall staff data. The following charts represent the workforce of Pennine MSK by each of the protected characteristics. 1 Age 1 4 21 20 20's 30's 40's 50's Prefer not to answer 18 4
2 Disability 1 Yes No 63 3 Gender reassignment No gender reassignment Has had gender reassignment 0% 100% 5
4 Marriage & Civil Partnership 3 1 4 2 1 Divorced Widowed 9 Married Seperated 3 Single Common Law 41 Engaged Prefer not to answer 5 Pregnancy/maternity leave Not on maternity leave On Maternity leave 5% 95% 6
6 Race 1 1 1 1 3 2 4 British White/Black Caribbean Pakistani German Irish Bangladeshi 51 Indian Prefer not to answer 7 Religion & Belief 1 2 4 9 Christian None religion Muslim 12 36 Hindu Bhuddist Prefer not to answer 7
8 Sex 15 Male Female 49 9 Sexual Orientation 1 1 7 Heterosexual Bisexual Lesbian Prefer not to answer 55 8
Numbers Numbers 4.2 Recruitment and Selection The following charts represent our recruitment and selection process by protected characteristics that are currently measured. 90 80 70 60 Recruitment by Age 50 40 30 20 10 0 Under 20 21-29 30-39 40-49 50-59 60+ Applications 6 81 50 28 15 2 Shortlisted 0 8 4 1 1 0 Appointed 1 2 0 1 0 Recruitment by Disability 180 160 140 120 100 80 60 40 20 0 Applications Shortlisted Appointed Yes 5 5 0 No 159 14 6 Do Not Wish to disclose 2 1 0 9
Number Number Recruitment by gender reassignment 200 180 160 140 120 100 80 60 40 20 0 1 2 3 Gender Reassigment Yes 0 0 0 No 185 14 4 120 100 80 60 40 20 0 ASI AN or ASI AN BRI TI ASI AN or ASI AN BRI TI Recruitment by Ethnicity ASI AN or ASI AN BRI TI ASI AN or ASI AN BRI TI Ban glad eshi Blac k Briti sh - Afri can BLA CK or Briti BLA sh CK BRI TI Chi nes e Do not wis Indi h to an disc lose Iris h MIX ED- Whi te & Asia n MIX ED- Whi te & Blac k OT HER ETH NIC GR OU P- Paki stan i WH ITE - Any oth er ba Applications 6 9 2 3 1 7 14 6 1 11 2 2 2 2 4 2 5 103 Shortlisted 1 2 1 1 1 14 Appointed 1 4 WH ITE - Briti sh 10
Shortlisted Bangladeshi British Do not wish to disclose Indian Pakistani WHITE - British 11
Number Appointed British WHITE - British Recruitment by Gender 160 140 120 100 80 60 40 20 0 Application Shortlisted Appointed Female 138 12 4 Male 33 7 1 12
4.3 Composition of Pennine MSK Board The following table details the Board of Directors at Pennine MSK by protected characteristic. Age Gender (M/F) Disability Marital Status Sexual Orientation Ethnic Origin Religion or Belief Pregnancy Gender reassignment 57 F No Married Het British Prefer not to say 56 M No Married Het British Christian N/A No 56 M No Married Het British No Religion 57 F No Married Het British Christian No No 47 F No Married Het British Christian No No 46 F No Married Het British Christian No No 55 M No Married Het British No Religion 46 M No Married Het British Christian N/A No No N/A N/A No No No 4.4 Other workforce data Secondments No secondments to report in the period. Leavers One leaver in the reporting period who had a declared disability. Grievances No grievances to report in the period. Disciplinary No formal disciplinary procedures to report in the period. Promotions One promotion in the reporting period. 4.5 Training and Development All members of staff at Pennine MSK have completed the online e-learning Equality and Diversity training which is refreshed every 3 years. 4.6 Employee Communication During this year we collected the base line data for staff and explained via team briefs the importance of the collation of this information. We also commenced collecting data from patients and again via team briefing sessions explained the importance of this information to all staff. 13
5 Service Access and Reasonable Adjustments We take pride in providing reasonable adjustments for any patient who needs to access our service. 5.1 Patients with Learning Disabilities Research shows that people with Learning Disabilities experience poorer health outcomes and can be less likely to access health services compared to the general population based on the 5 determinants of health inequalities set out by Public Health: - Social influences Genetic and Biological factors Behaviour and Lifestyle choices The impact of communication and health literacy Services quality and access issues. This year we raised awareness with all clinical staff on helping patients with learning disabilities to ensure that their health outcomes are not affected by their learning disability. This was by way of on line training and reinforcement at regular Clinical Peer Review meetings. 5.2 Clinic locations We offer our clinics at a range of locations across the borough of Oldham so that patients in many cases do not have to travel far from home. 5.3 Patient Transport We access the Patient Transport Ambulance service for patients who are eligible. Full training is provided to all staff on the booking of transport for patients. 5.4 Interpreter Service We access face to face interpreter and BSL services for all patients who request it. We ensure this service is available through a contracted provider and we provide full guidance to all staff on how to access the service. We regularly review with the contractor to ensure a high quality interpreter service is provided. This year we have provided face to face interpreter services for 1400 appointments. 14
A breakdown of the languages provided is detailed below. Language % Arabic 2.86% Bangla 26.23% BSL 2.63% Bulgarian 0.46% Cantonese 0.69% Czech 1.83% Farsi 1.72% Gujarati 5.61% Hindko 0.11% Hungarian 2.18% Kurdish 1.15% Language 0.00% Latvian 0.11% Lingala 0.23% Lithuanian 1.60% Oromo 0.11% Polish 2.86% Portuguese 1.26% Punjabi 8.82% Pushto 0.34% Romanian 1.15% Russian 0.46% Singala 0.23% Slovak 0.46% Somali 0.11% Swahili 0.34% Tigrinya 0.46% Turkish 0.23% Urdu 35.74% This year we also introduced the use of Language Line a telephone based interpreter service which we have found very helpful if patients have arrived at clinic without booking an interpreter and for telephone consultations. 15
5.5 Accessible Information We format all patient information leaflets and clinic letters to a large print for patients who request it and can provide in different colours and/or fonts if requested. We deal with several patients by email rather than telephone who are hard of hearing as they prefer this method of communication. 5.6 Patients accessing Pennine MSK The service has held 16,525 patient appointments this year. The following tables provide a breakdown by protected characteristic held on our central records. Age Age range Patient Count % of Total -19 216 1.31% 20-29 1045 6.32% 30-39 1807 10.93% 40-49 2852 17.26% 50-59 3593 21.74% 60-69 3415 20.67% 70-79 2448 14.81% 80 + 1149 6.95% Sex Sex Patient Count Female 9931 Male 6594 Marital Status Patient Marital status Count Not stated 14134 Single (& [unmarried]) 1 Divorced 214 Married/Civil Partner 2 Marital state unknown 38 Engaged to be married 3 16
Married 1352 Single person 326 Marital status 1 Married/civil partner 3 Married (& [remarried] or [newly wed]) 1 Separated 43 Cohabiting 6 Common law partnership 132 Widowed 269 Ethnicity Ethnicity Patient Count Afro-Caribbean 1 White - ethnic group 1 Pakistani 1 Other Asian (NMO) 1 Ethnic groups (census) NOS 12 Ethnic group not given - patient refused 3 White British 25 Asian - ethnic group 1 Other Asian ethnic group 1 British or mixed British - ethnic category 2001 census 3033 Irish - ethnic category 2001 census 25 Other White background - ethnic category 2001 census 11 White and Black Caribbean - ethnic category 2001 census 3 White and Black African - ethnic category 2001 census 1 Other Mixed background - ethnic category 2001 census 2 Indian or British Indian - ethnic category 2001 census 34 Pakistani or British Pakistani - ethnic category 2001 census 176 Bangladeshi or British Bangladeshi - ethn categ 2001 census 74 Other Asian background - ethnic category 2001 census 1 Caribbean - ethnic category 2001 census 11 African - ethnic category 2001 census 11 Other Black background - ethnic category 2001 census 1 Chinese - ethnic category 2001 census 2 Other - ethnic category 2001 census 9 Ethnic category not stated - 2001 census 15 English - ethnic category 2001 census 5 Scottish - ethnic category 2001 census 1 Turkish - ethnic category 2001 census 1 Italian - ethnic category 2001 census 1 Kashmiri - ethnic category 2001 census 1 17
Other Asian or Asian unspecified ethnic category 2001 census 1 Polish - ethnic category 2001 census 4 Any other group - ethnic category 2001 census 1 Iranian - ethnic category 2001 census 1 Kurdish - ethnic category 2001 census 1 Latin American - ethnic category 2001 census 1 White British - ethnic category 2001 census 28 Czech 1 Portuguese 1 Race: Not stated 13021 Religion The vast majority of our patients have not disclosed their religion so we are not able to report on this protected characteristic. 5.7 Patient Experience Capturing patient experience is an important aspect of our service. And it represents a very high indication of service quality. We monitor patient experience using a variety of methods: We use the Friends and Family test which is sent by text and/or voice message We send patient satisfaction surveys to a random selection of patients who have had appointments every month. We ask patients for their opinion in clinic. We incorporate an equality monitoring section into all questionnaires to ensure we are actively engaging people with all protected characteristics. From our satisfaction questionnaires we have found that there is no difference in the levels of patient satisfaction no matter which protected characteristic patients have. We had twice as many responses from women than men. The age group most likely to reply were 60-69 year olds. 41% of respondents declared a disability. We were less likely to receive a response from people from an ethnic minority background and this is something we hope to address with our equality objectives for 2016. With our friends and family test we have enhanced our reporting and from November 2015 we are able to analyse our responses by the protected characteristics which we are able to code on our electronic patient record. Again, more women respond than men 65%. In the age categories the Age group of 60-69 gives us the highest response rate. 18
As we only have 2 months data for 2015 and as we have already acknowledged in this report we need to increase the numbers of equality data collected from patients with regard to ethnicity to enable us to report this measure fully. This will form an equality objective for the service in 2016. 5.8 Complaints We monitor the complaints that we receive by the protected characteristics that we can code on our patient record. This information tells us that female patients are more likely to complain than male patients with 66% of complaints received by women. The highest age range is 50-59 year old patients with 28% of complaints raised by this age group. We do not have sufficient codes for ethnicity recorded yet to report this characteristic with any meaning. 5.9 Improvements to consider We need to more fully explain to staff and patients the importance of collecting service user information, particularly the equality data so that we can further enhance our service and ensure we are meeting the needs of the population that we serve. More work on this will continue throughout 2016 led by the Directors. 5.9 Reporting and Monitoring We will encourage more collection of equality data with existing patients via the team of Health Care Assistants running the clinics at the Integrated Care Centre. We will share this report with all staff in the service via a series of team briefings in Quarter 1 of 2016. 19
6 Equality Objectives for 2016 Having considered the data we have set the following objectives for 2016. To improve the amount of equality data we are collecting from the patients who are already in the service, particularly in our inflammatory pathway. To begin to collect data regarding disability from our patient population. To ensure we continue to meet the mandatory requirements for learning and development with all our staff and ensure the training provided meets the needs of our staff. To improve the communication between the service and it s staff, users, GP s and the voluntary and community groups in the local Area. To increase the number of responses to satisfaction surveys from people of differing ethnic origins. 20
Report prepared by Ruth Holden, Director of HR and Operations and approved by the Board of Directors of Pennine MSK Partnership Limited on 10 February 2016. 21