Annual Equality Report for Our Staff for 2014

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Contents

1. Executive Summary 3 2. Introduction 4 3. Equality Delivery System 2 5 4. Our Aspirations for Equality and Diversity 6 5. The Profile of our Workforce 11 6. The impact of our Practices and Processes on Our Staff 13 7. Conclusion 15 Appendix 1: Workforce and local demographics as at 31 December 2014 16

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1. Executive Summary

This report sets out our approach to Equality, Diversity and Inclusion here at UCLH and meets our public sector legal duties outlined in the Equality Act (2010) and in meeting the nine protected characteristics:

Age

Disability

Ethnicity

Gender

Gender Reassignment

Marriage and Civil Partnership

Pregnancy and Maternity

Religion or Belief

Sexual Orientation We recognise that delivering our vision “UCLH is committed to delivering top-quality patient care, excellent education and world class research” requires a workforce performing at its very best and able to be themselves whilst at work. In order to achieve this, and meet both the spirit and letter of legislation and best practice, it is important that we work closely with our staff, engaging with them in creating an accessible and inclusive organisation and working environment.

1.1 Summary of key findings

The characteristics of our workforce are broadly consistent with local populations in terms of religion and ethnicity. We have stronger representation of females in general than the local population.

The learning and development accessed by staff is broadly consistent with the demographics of the workforce as a whole, i.e. broadly speaking staff with all protected characteristics have similar or better levels of access to learning and development. It is vital that senior leadership and management at UCLH is representative of the wider workforce and the local community. There is work to do to encourage, support and develop women and individuals from Black and Minority Ethnic communities so that they put themselves forward for these senior roles. Employees managed through formal Employee Relations processes are broadly consistent with the demographics of the wider staff group, with some notable exceptions in relation to staff from BME backgrounds, those with disability, and those over 50. The policy has been reviewed, however further work will be carried out to ensure that processes and systems are transparent and robust. We have identified a recording/reporting issue between the data captured from applicants for posts with the trust which will be the focus of improvement that is impacting on our ability to accurately understand the make up of our workforce. In addition, we have identified the need to capture data relating to and actions to support transgender individuals which are currently inadequate.

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There are a number of actions in the report for future action. These are as follows.

Actions:

Improve data quality of employee demographics throughout the recruitment process and on appointment

Identify recording mechanisms for recording demographics for staff on all protected characteristics

Ensure consistent capturing of data for age across the Trust in line with census data capture.

Continue to monitor trends and take appropriate actions where appropriate (demographics of leavers)

Run a campaign to encourage people to report their characteristics within Employee Relations (where this data is not captured elsewhere)

Develop links with partner agencies and produce an action plan to address our duty to transgender employees

Introduce routine and random sampling of formal disciplinary processes to ensure no bias in the use of these processes

Work with the NHS Leadership Academy to encourage greater take up of leadership courses by females and BME individuals

Develop a mentoring programme to improve accessibility of senior and leadership positions for women and BME staff.

2. Introduction

UCLH recognises that it is extremely fortunate to have a mix of employees from a diverse range of communities, religions or beliefs and sexual orientation. The demographics of the workforce is broadly consistent with that of our local and the general communities (refer to Appendix 1). We also recognise that the proportions of female staff and individuals from Black and Minority Ethnic communities are greater than the local and general populations. This is in part due to the nature of the work that we undertake and recruitment campaigns we have undertaken to recruit overseas nurses. The rich mix of our staffing make up helps us to better identify the needs of our staff (helping us achieve greater retention) and our patients. Indeed we are “enriched by our diversity”. In June 2012, UCLH launched its ‘values’, which emphasised that ‘safety’, ‘kindness’, ‘teamwork’ and ‘improving’ should be at the heart of all that the Trust and its staff undertake. A raft of evidence shows a positive link between staff experience and that of patients (and the outcome of their care). This includes the work of Professor Michael West.

Michael West in his publication “NHS Staff Management and Health Service Quality: Results from the NHS Staff Survey and Related Data (August 2011”) says:

“There is a spiral of positivity in the best performing NHS Trusts. The extent to which staff are committed to their organisations and to which they recommend their trust as a place to receive treatment and to work is strongly related to patient outcomes and

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patient satisfaction. Climates of trust and respect characterises these top performing trusts.

This is best evidenced by the link between ethnic discrimination against staff and patient satisfaction. The greater the proportion of staff from a black or minority ethnic (BME) background who report experiencing discrimination at work in the previous 12 months, the lower the levels of patient satisfaction. Where there is less discrimination, patients are more likely to say that when they had important questions to ask a nurse, they got answers they could understand and that they had confidence and trust in the nurses. Where there was discrimination against staff, patients felt that doctors and nurses talked in front of them as if they weren’t there; that they were not as involved as they wanted to be in decisions about their care and treatment”.

It is within this context that we embarked upon an engagement action plan between 2012 and 2013 designed to inform and encourage dialogue between individuals about protected characteristics and what they mean to each of us as individuals and collectively. The aim of this engagement action plan was that staff operating within this framework, would display and live the values that will help to make our hospitals the best places to work and be treated. These values were developed collaboratively with staff and patients with over 1000 people contributing to their development. In addition to this, the NHS Constitution (2013) pledges that staff “have the right to have healthy and safe working conditions and an environment free from harassment, bullying or violence”. It further sets out that staff “are treated fairly, equally and free from discrimination”.

3. Equality Delivery System 2

The Equality Delivery System (EDS) is NHS England’s tool to ensure that the legal obligations of the NHS are met under the Equality Act. The EDS was reviewed nationally and re-launched as EDS2 in November 2013. UCLH, like most NHS trusts, has adopted the NHS Equality Delivery System (EDS2) tool. The EDS tool was initiated by the NHS Equality and Diversity Council and developed to help NHS organisations to remove inequalities through providing a fair, diverse and personal service to its patients and staff. It helps organisations understand how equality can drive improvements and strengthen accountability to those using them. The EDS2 implementation is based on achieving 18 outcomes grouped within four goals:

- Better health outcomes - Improved patient access and experience - A representative and supported workforce - Inclusive leadership

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“by recognising that every patient has different needs and circumstances, we can best meet those needs and improve outcomes by delivering a personal form of care, using and supporting the diverse talents and experiences of our workforce. The EDS is a toolkit to help all staff and NHS organisations understand how equality can drive improvements, strengthen the accountability of services to those using them, and bring about workplaces free from discrimination.” These goals can only be achieved through effective and genuine engagement with local stakeholders* and getting them involved in important decisions about the planning, development, commissioning, management and delivery of health services in a sustained way. For staff, engagement also means helping to plan, develop and manage working environments and activities that aim to improve working lives. The outcomes from EDS2 will be one of the strands that will inform our action plan for the year ahead.

4. Our Aspirations for Equality and Diversity

The creation of three strands of diversity activity into Compliance, Engagement and Living our Values allows us to focus on specific activities in order to fulfil our general and specific duties and assess the impact of our practices on our employees. In 2014 we addressed our specific duties through the following action plans:

a) The Living our Values project is designed to eliminate

discrimination, harassment and victimisation b) The Compliance Action Plan is intended to demonstrate how we

advance equality of opportunity between persons who share a relevant protected characteristic and those who do not and how we further the organisation’s Equality Objectives

c) Our Engagement Action Plan is designed to advance equality of opportunity between persons and those who do not share a relevant protected characteristic

d) This Annual Report is intended to comply with the fourth duty to publish equality information annually.

There Annual Equality Report for our Patients for 2014 outlines the provision of care to patients.

In response to the issues identified in our 2012 and earlier staff surveys we launched a Living Our Values campaign, designed to further embed the values into the culture of UCLH. Using the values, and the behaviours that underpin these, we intend to reduce incidents where staff experience negative behaviour from their colleagues, managers, patients or their relatives. These behaviours include violence, bullying, harassment and unfair treatment. This work will continue throughout 2015.

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4.1 Key events / highlights in 2014

The Trust was given NHS Employers Equality Partner status in

2014.

We came 167th within the Stonewall Top 100 Employers for 2014,

performing better than 230 other UK organisations as opposed to

last year where we only performed better than 205 other UK

organisations. We are now working with our partners to enter the

top 100 listing for the year ahead.

The Trust became the first organisation in the UK to be awarded

the International Disability Management Standards Council’s

certificate for our absence and disability management, following an

audit and inspection

The Employee Relations team and the Occupational Health team

won Team of the Year in the ENEI Diversity Award (Employers

Network for Equality and Inclusion). These teams were also a

finalist in the HPMA award for HR Team of the Year

The Deputy Head of Workforce for the Specialist Hospitals Board

was awarded the NHS Employers “Personal Fair Diverse Champion

of the Year” and was shortlisted for the ENEI Diversity Champion of

the year

Sue Beatson, Deputy Head of Nursing was shortlisted for the

National Diversity Awards and was awarded Diversity Leader for

the Trust

Work has been done with the National Apprenticeship scheme to

develop supported internships for individuals with learning

disabilities to enable them to secure employment on an ongoing

basis

In the last 12 months we have delivered a range of Trust-wide events as part of our engagement plan. Some of these are listed below.

Deaf Awareness Week 2014: 19th – 23rd May To mark this week, road shows were held across the sites.

Mental Health Awareness Week 2014: 12th – 18th May The Staff Psychological & Welfare Service marked Mental Health Awareness Week by talking to staff around UCLH about the services that they offer as well offering top tips related to this year’s theme which is anxiety.

Dementia Awareness Week 2014: 18th May On 18th May it was the start of ‘Dementia Awareness Week which focused on recruiting 1 million dementia friends by 15th March 2015. Its aim was to give more people an understanding of dementia and small differences people can make living in the community. Face to face

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sessions were held and a short video accessed via link was shared on how to become a ‘dementia friend’.

NHS Employers Equality, Diversity & Human Rights week 2014 : 12th – 16th May The Click & Connect Building Meaning Engagement Workshop on 15th May highlighted the power of networks : staff networks, BME networks, any group of like minded group with common concepts of truth telling, empathy and trust. Based on the Connect and Click theme from NHS Employers to demonstrate how we communicate with groups across the Trust, a display was set up in the main trust which highlighted the events of the Diversity and Equality Agenda over the past 12 months.

Taste of Faith event: 13th February 2014 A lunchtime multi-faith networking event took place on 13 February 2014. Its aim was to break the myths and preconceptions of the top five religious/beliefs identified across the Trust (Buddhism, Christianity, Hinduism, Judaism and Islam) and to help staff to gain a better understanding and awareness of different religions and beliefs. A representative from each belief met with staff for a face-to-face conversation about their belief. International Women’s Day: 13th March 2014 To celebrate International Women’s Day a networking event featuring a presentation by Pinky Lilani took place on 13 March 2014. Pinky is the Founder and Chair of the Asian Women of Achievement Awards and is also listed in the ‘BBC’s 2013 power list 100 – most influential Women in the UK’. She can be credited with creating the Asian Women of Achievement Awards, Women of the Future and the First Women awards, working tirelessly to connect women and help them get ahead. In 2007, she was honoured with an OBE for her efforts to celebrate women's achievements and she kindly agreed to share her experience and journey with our staff. Age UK Ran a stand within the Trust to signpost services to staff such as counselling, befriending, benefit support and nail care. Age UK are also the lead agency for Opening Doors London. This is a new project providing information and support services to and with older lesbian, gay, bisexual and / or transgender (OLGBT) people in the UK. Black History Month, October Cecilia Anim, Deputy President of the Royal College of Nursing (RCN) delivered an inspirational presentation to UCLH staff on the 21st October entitled ‘What black history month means to me’. Cecilia is an influential leader in the field of nursing and is dedicated to promoting and championing the work of the profession. This was reflected in the NHS: 50th anniversary celebrations where Cecilia was recognised as a Black Minority Ethnic (BME) trailblazer in the NHS. The Black History Month event was oversubscribed and received a lot of positive feedback from staff. Cecilia was introduced by Mike Foster, Deputy

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Chief Executive, on the day. Additionally, all Trust sites introduced African and Caribbean food to their menus during October and adopted T-Shirts and promotional material to endorse the event. Sikh prayers, November The third annual celebration of a Keertan Deebar on 11th November was a great success. The local Sikh community and students prayed for the hospital. The Trust is always seeking to extend its engagement with both local and London-wide world faith communities. New Chaplain The Trust has recently appointed a new whole-time woman chaplain for the first time. Rev. Dr. Julia Candy is already proving to be a most valuable member of the chaplaincy team. UCLH Annual Festive Open Event In December 2014, we held our annual Festive Open Event to showcase our latest service developments, treatments and technology and to engage with our patients and wider public who had the opportunity to talk to our staff and get information ranging from how to provide first aid, become a UCLH member, and join the NHS to learn more about our diversity and equality work and progress within the Trust.

For the year ahead, the various action plans have been coalesced into one plan that reflects the findings from the data identified through equality monitoring detailed in Section 4, including demographics, national staff survey, Workforce Race Equality Standard (WRES) and a locally modified model to reflect all the protected characteristics. The events planned for 2015 will pay additional regard to females and BME individuals with leadership roles. We will also undertake activities to improve the life outcomes for young people with additional needs (in line with the government’s Green Paper ‘Support and Aspirations’ 2011). This places an emphasis on the need to raise employment aspirations and expectations of children and young people, families and everyone who supports them. Age UK

4.2 Diversity Champions Recognising that we are enriched by our diversity and that an organisation’s approach to Diversity and Equality is most effective when activities are developed and implemented by the widest group of individuals with different interests, we have appointed eleven diversity champions from across our workforce. Each focuses on a different protected characteristic; these individuals are working alongside the Diversity and Equality Steering Group to influence and inform the activities we undertake across the Trust, whilst also taking feedback on the effectiveness of those activities. This programme of work is being refreshed and re-launched in 2015.

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4.3 Living our Values

The purpose of the Living our Values project is to further embed the UCLH values into the culture of UCLH by using them to make significant improvements to reduce the incidents of staff experience of negative behaviour from their colleagues. These behaviours include violence, bullying, harassment and unfair treatment. Over time, the annual staff survey has, unfortunately, consistently shown that some staff experience bullying and harassment behaviours more frequently that others. The expected outcome of this project is to reduce the percentage of staff that report experiences of negative behaviour. The actions taken include:

An alteration to the Employee Led Complaints policy has been drafted to include After Action Review as an informal option to resolve complaints where applicable.

All DATIX forms related to this area have been recorded and monitored by the project team centrally for content since November 2013. This enables the identification of trends in complaints and where possible the departments where these are generated which allows for targeted action and interventions where necessary.

A local staff survey has been developed and piloted in the Workforce Directorate, nursing staff within the Emergency Services Division and the Specialist Hospitals Board Management Team. This has allowed further detail around the issues staff are reporting in this area to be obtained and has involved them in the action planning to address the issues raised, facilitating local resolution of the issues in place.

A confidential staff bullying and harassment help line has been set up within the Staff Psychology and Welfare Services department which staff can make contact with should they be experiencing any problems in this area. A psychologist manages these contacts and provides advice and information, signposts staff to relevant departments or individuals or can provide a face to face intervention from Staff Psychology and Welfare Services if appropriate.

Agreement in principle has been reached with the Royal College of Nursing (RCN) to work in partnership on their ‘Is this Discrimination?’ project. The goal of the project is to explore cultural change and deliver workplace equity. The RCN undertook a detailed piece of work across London during 2012/2013 on the protected characteristic of race and ethnicity which highlighted the disproportionately high numbers of black and minority ethnic nurses who were currently undergoing disciplinary hearings and /or being referred to the Nursing and Midwifery Council. Following on from this research, the RCN Diversity Unit have developed a three-year project that is designed to map the experiences of the nursing family across all of the protected characteristics defined by the

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Equality Act 2010. The RCN will pilot this work with UCLH in the autumn of 2015.

A video is being developed to address concerns about bullying and harassment and promoting values and good behaviours. A draft plan/script is now being worked up to utilise the staff awards and promote the values and good behaviours positively rather than focus on the negative aspects and consequences of bullying and harassment. This will also strengthen the link between the Living our Values Project, the Staff Awards process, the Making a Difference programme and the UCLH values. This material will be completed by the autumn of 2015.

5. The Profile of Our Workforce

Under the Equality Act (2010), there is a specific duty to monitor and publish the equality profile of our workforce. The purpose is to analyse data and employment practices, to identify gaps and to promote positive activity that encourage diversity. The workforce equality data is analysed by a number of the protected characteristics identified in the Equality Act 2010 with a view to review our performance and identify gaps for further action and improvement. For a full breakdown of all of the equality monitoring data, and details of where the information is collected from please see the complete equality monitoring report at Appendix 1 of this report. This section will look at key themes and trends from the data, and any objectives identified. For consistency all the data is cross referenced to the Census 2011 results information for the London Boroughs of Camden, Islington, Haringey and Westminster where UCLH provides a range of services. This year UCLH has also sought to use the guidance released by NHS Employers for the Workforce Race Equality Standard (WRES). A preliminary review of the standard found that it triangulated multiple strands of data, including the National NHS Staff Survey, facilitating analysis and identification of hot-spots. Within all areas there are high non disclosure rates and unknown/ blanks recorded within the Trust data. This has the effect of distorting the characteristics of the workforce reported and impacts on any reasonable inferences being drawn from the data. This issue will form part of the objectives for the coming year and will enable the creation of informed action plans. Age The age profile of our workforce differs from the age profile of adults within local communities. 73% of our workforce is aged between 30 and 59 compared to 57% within the local population. Our workforce has lower than representative demographics for staff aged between 18 to 24, which make up 23% of our workforce (compared to 31% of local communities). Though 56% of the applications received in the year

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were from applicants in the age group 30-59, the likelihood of applicants in this age group being appointed was lower than that of applicants in the under 30 category. Staff in the age category 30-59, and particularly those over 50 were significantly more likely to enter formal disciplinary processes. Further investigation will need to be done to establish why this might be the case and improve transparency in and the quality of related processes. Disability The staff profile in relation to disability does not represent the population within the local communities. 1% of the workforce stated that they have a disability compared to 15% of the population. 1% of staff who faced a disciplinary process were disabled and the likelihood of disabled staff entering the formal disciplinary process was greater. In addition, the likelihood of non disabled staff being appointed from shortlisting is slightly higher. Though drawing inferences from these findings is not easy in light of the low levels of reporting (57% of staff choose not to declare any information in this regard), it will be necessary to review processes, particularly in relation to employee relations to prevent any adverse impact. The disability profile of staff who complete the annual NHS staff survey is representative of the population (15% of staff completing the survey indicated that they had a long standing illness, health problem or disability), and suggests that staff may not want to disclose a disability directly to the Trust. Improving the confidence of staff in reporting disability will be an area of focus in the coming year. Ethnicity The ethnic demographic mix of our workforce broadly mirrors that of the local communities. 32% of the workforce stated that they belonged to a Black Minority Ethnic (BME) background and 41% white. By comparison, the ethnicity of communities that we serve ranges from 36% BME to 64% white. However, 27% of the workforce has chosen not to disclose this information. It is encouraging to note that a greater proportion of staff who access non-mandatory training (including CPD) are from BME backgrounds (49% as compared to 44% white). However, it is of concern that a markedly greater proportion (64%) of staff who progress through disciplinary processes are BME. The likelihood of white staff being appointed from shortlisting is also higher than that of BME staff. The latter two findings requires further investigation and possible re-training and will be an area of focus in the year ahead. The ethnicity of The Board and senior staff (band 8 and above) is disproportionately white. Actions to address this are outlined in Section 6 “Access to Learning“.

Gender As a trust, the proportion of the workforce that is female (71%) exceeds that of the local population (50%). This is not surprising as the proportion of female applications for roles in the Trust far exceeds male

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applicants. Indeed where almost all general populations have a broadly 50 / 50 female to male ratio our employee demographic is 71% female to 29% male representation. This compares favourably with the average gender split for acute trusts in England which is 80% female and 20% male.

However, the main exception to this is employee relations where males are more involved in formal disciplinary processes than females. In addition, of senior positions within the organisation, only 60% of these positions are held by women, with the male representation in this category increasing to 40%. Male candidates are also slightly more likely to get appointed from shortlisting. Activities to address this are again outlined in Section 6 “Access to Learning”. Gender Reassignment UCLH data on individuals who have undergone or are undergoing gender transition is poor. Furthermore we lack consistent processes to support individuals who may be transitioning. We are in the process of developing links with partner organisations and formulating an action plan to begin to address this. Religion or Belief Nearly half the workforce (49%) chose not to declare their religion. The profile of staff reporting religion or belief is lower than those stated in the 2011 census. Those individuals that have disclosed their religion / belief is more closely aligned to the population. 26% of those who have declared a religion in the Trust are non-Christian (including atheists) compared to 23% of the population. Sexual Orientation 50% of staff in the Trust report being hetero-sexual and 2% indicate that they are Lesbian, Gay, Bisexual or Transgender. 48% of staff elected not to declare this information. As there is no census data available to compare our representation, it is hard to judge whether this is a fair representation. However, it is encouraging that the recruitment process did not present any adverse impact on the likelihood of LGBT candidates being appointed. The same was true of disciplinary processes. The proportion of LGBT staff accessing non-mandatory courses was directly proportionate to the Trust demographics.

6. The impact of our practices and processes on our staff 6.1 Recruitment and Selection

The Trust implemented a values-based recruitment process for all posts advertised within the Trust. This stage requires applicants to demonstrate they share the UCLH values through scenario-based questions. This process has been extended into our consultant recruitment process, where individuals undertake psychometric assessments and answer questions based specifically on the UCLH values.

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Over the past year, however, we have been able to demonstrate a good level of compliance and commitment to ensure that individuals are not adversely affected during our recruitment processes because of their protected characteristics. In order to preserve anonymity at the shortlisting stage of recruitment, demographic data is not available to managers. This is maintained throughout the recruitment process - however the visibility of some protected characteristics means that this is not always possible at all stages of the process. The data indicates areas of priority for further improvement / review. The reasons for the reduced success of candidates from particular groups at the appointment stage will be explored as an action and a plan will be developed by the Recruitment team with the Trust Diversity & Equality lead to address these.

Other developments in Diversity and Equality monitoring during the recruitment process (launched in 2013) include collection via the Trust’s e-recruitment system of data on gender reassignment and more detailed reporting of disability description. Implementation of the Trust’s new e-recruitment system now also enables a reporting distinction between applicants who declare that they do not wish to disclose their sexual orientation and/or religion or beliefs from applicants who do not respond to these monitoring questions. We will continue to work to improve the quality of protected characteristics information available for applicants in the recruitment process and formulate activities in line with the UCLH Workforce Compliance plan

6.2 Access to Learning There is significant under-representation of female and BME individuals in senior leadership roles within UCLH. As outlined above, the representation of the senior management roles reverses the representation at lower levels within the organisation. In order to address this, UCLH will work with the NHS Leadership Academy to encourage greater take up of leadership courses by females and BME individuals to help them secure appointments at senior level within UCLH. Mentoring programmes are also being considered to address this disparity within the workforce, and improve accessibility of senior leadership positions for female and BME staff.

6.3 Use of Employee Relations (ER) Processes Within the Workforce

The analysis using the modified WRES identified adverse impact through the disciplinary processes on BME and disabled staff and those over the age of 50. Employee relations processes will be reviewed to ensure they are robust and transparent.

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6.4 Equality Analysis and Equality Impact Assessment of Policies and Service Changes

We firmly believe that the best way to consider the effect on different groups protected from discrimination by the Equality Act 2010 is by regularly reviewing the equality impact of service changes and policies. This helps us to recognise any potentially negative consequences and to assess the effectiveness of our policies, practices, activities and decisions.

In the past year, a number of policies have been reviewed and the use of Equality Impact Assessments (EIAs) is now a standard element of the Trust’s policy approval process. We also have an internal governance system in place in order to quality check any EA carried out. This is currently done through our Diversity and Equality Steering Group (DESG) forum with representation from different departments of the Trust and our staff partners.

7.0 Conclusion

UCLH will refresh the learnings from the work undertaken over the year to finalise action plans for the year ahead. Our involvement as an NHS Equality Partner provided fresh insight and ideas for our Diversity and Equality strategy. With full and ongoing senior leader and executive commitment, it is expected that UCLH will continue to make advancements, as evidenced last year through the improvement within the Stonewall index and the International Disability Standards Council accreditation. The organisation is already a keen advocate of the Personal, Fair and Diverse Campaign. Over the year ahead, UCLH will seek to reinforce its links and networks with partner organisations to ensure wider discussions on current issues and the sharing of best practice.

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Appendix 1

Our Workforce Demographics as at December 2014 in comparison with the demographics in Census 2011 for our local communities (Camden, Islington, Haringey and Westminster). Note: There is no comparative information on pregnancy, gender re-assignment and sexual orientation.

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UCLH Workforce Director ate 250 Euston Road London NW1 2PG Tel No 0203 447 9727 Email address Karin.roberts@uclh.nhs.uk Web address WWW.UCLH.nhs.uk