Equality and Diversity Strategy and Plan
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www.portsmouthccg.nhs.uk
Contents
Foreword ................................................................................................................................................... 1 1. Introduction ........................................................................................................................................ 2 2. Our Achievements .............................................................................................................................. 3 3. Equality Actions .................................................................................................................................. 7 Appendix One: Action Plan ....................................................................................................................... 8 Appendix Two: Equality Act 2010 – Protected Characteristics .................................................................. 9 Appendix Three: Equality Act 2010 General and Specific Duties ............................................................. 10 Appendix Four: Human Rights Act 1998 – Outline ................................................................................. 11 Appendix Five: NHS Equality Delivery System 2 – Goals and Outcomes ............................................... 12
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Foreword
We are pleased to launch our second Equality and Diversity Strategy and Action Plan for
Portsmouth Clinical Commissioning Group. This document sets out our commitment to taking
equality, diversity and Human Rights into account in everything we do whether commissioning
services, employing people, developing policies, communicating with or engaging local people in
our work.
This strategy and action plan will help the Clinical Commissioning Group to tackle current health
inequalities, promote equality and fairness and establish a culture of inclusiveness that will
enable health services in Portsmouth to meet the needs of all.
Our Governing Body commits to monitoring our progress and reporting regularly and openly on
the developments in this plan. We acknowledge and accept our roles in supporting the strategy
and will play our full part in making its aims a reality.
Dr Jim Hogan
Clinical Leader/Chief Clinical Officer
Portsmouth Clinical Commissioning Group
2 1 Department of Health (2013) The NHS Constitution: the NHS belongs to us all. March. HMSO London.
2 HMSO (2010) Equality Act 2010. London.
3 HMSO (1998) Human Rights Act 1998. London.
4 HMSO (2012) Health and Social Care Act 2012. London.
1. Introduction
1.1 NHS Portsmouth Clinical Commissioning Group (CCG) is committed to equality of
opportunity for all people and to eliminating unlawful discrimination. We recognise and value the diversity of the local community and believe that equality is central to the commissioning of modern, high quality health services, particularly in relation to the protected characteristics as set out by the Equality Act 2010.
1.2 This means that:
We will take account of the diversity of the population we serve, and the potential barriers some people face when accessing health services and how we can work to reduce these.
We will tackle health inequalities and ensure there are no barriers to health and wellbeing.
We will ensure our health providers also meet the legal requirements around equality and human rights.
Members of the public have the right to expect the care and treatment they receive to be provided in an environment that is free from unlawful discrimination.
CCG staff have the right to work in an environment that is free from discrimination, victimisation and harassment.
1.3 The CCG’s equality and diversity work is based on:
The principles of the NHS Constitution1
The Equality Act 2010 and the requirements of the Public Sector Equality Duty under that Act2
Human Rights Act 19983
Health and Social Care Act 2012 requirements, including the duties placed on the CCG to reduce health inequalities, promote patient involvement and involve and consult the public4
1.4 This paper describes NHS Portsmouth CCG’s achievements since we published our first
Equality and Diversity Strategy in 2012. It also sets out our action plan for the next year in line with the CCG’s priorities within its Operating Plan 2014 to 2015.
3 5 Department of Health (2011) EDS2, Making Sure Everyone Counts. A refreshed Equality Delivery System for the NHS.
London. November.
2. Our Achievements
2.1 The CCG’s first Equality and Diversity Strategy was published in September 2012. It set out
the organisation’s commitment to taking equality, diversity and human rights into account in everything we do, whether commissioning services, employing people, developing policies, communicating with or engaging local people in our work.
2.2 As a result of our Equality and Diversity Plan 2012, the CCG has achieved the following:
2.2.1 Complied with the Public Sector Equality Duty
The CCG has used the NHS Equality Delivery System5 (EDS2) to help achieve compliance with the requirements of the Equality Act 2010 including the Public Sector Equality Duty. Using EDS2, the CCG identified its strengths and weaknesses to produce baseline evidence in order to prioritise actions. From this assessment and the EDS2 goal of “empowered, engaged and well-supported staff”, the CCG developed an equality objective. That is, to improve staff awareness and responsiveness to needs of protected groups. The CCG has published this equality objective. Improvement on the baseline will be sought through a survey of CCG employed staff and CCG facing staff in commissioning support partner organisations. This survey will seek to measure the number of staff responding positively to a range of questions evaluating their awareness of the needs of different protected groups, and their ability to respond to those needs.
2.2.2 Built equality and diversity into our governance structures:
Incorporated equality and diversity into the CCG’s Constitution.
Developed and published a Human Resource Framework that refers to compliance with the Equality Act 2010.
Assessed our impact of our employment policies and procedures in relation to race, disability and gender.
Incorporated equality and diversity into the CCG’s Commissioning Plan 2013-2016.
Incorporated equality and diversity into the CCG’s Organisational Development Plan.
Provided reports on the CCG’s compliance with equality duties to the Governing Board.
Published performance against EDS2 on the CCG’s website at: http://www.portsmouthccg.nhs.uk/
Adopted a tool to be used jointly across health and social care for undertaking Equality Impact Assessments on all our functions and commissioning plans. By undertaking equality impact assessments we will assess the effect of our policies, plans, procedures, projects and decisions on the different communities that comprise the population we serve and also our employees.
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2.2.3 Equality and Diversity Training
Equality and Diversity training for all our staff is mandatory and managers are encouraged to promote a culture where equality and diversity is part of the everyday business of the CCG.
2.2.4 Tackling Health Inequalities Advancing equality and tackling health inequalities is a key driver for the CCG. We are a key partner on the Portsmouth Health and Wellbeing Board where leaders from the health and care system work together to improve the health and wellbeing of the local population and reduce health inequalities. Portsmouth’s Joint Strategic Needs Assessment (JSNA) is produced by the CCG and Portsmouth City Council in partnership with the voluntary and community sector, Portsmouth Hospitals and Solent NHS Trusts, the University of Portsmouth, JobCentre Plus and Hampshire Fire and Rescue to assess jointly the health and wellbeing of the people of Portsmouth. The JSNA Steering Group has links to other partnership boards, particularly to the Children’s Trust and the Safer Portsmouth Partnership. The JSNA directly informs the Joint Health and Wellbeing Strategy. This Strategy is the mechanism for the CCG and the local authority to address the needs identified in the JSNA by setting out agreed priorities for collective action by the key commissioners. These commissioners are the CCG, local authority and NHS Commissioning Board. It also provides the opportunity to identify how commissioning of wider health related services could be more closely integrated with commissioning of health and social care services. Portsmouth Health and Wellbeing Strategy may be found at: https://www.portsmouth.gov.uk/ext/documents-external/hlth-jhwellbeingstrategy201213and201314.pdf Our agreed priorities have been translated into actions in our Five-Year Strategic Plan (2014-2019). In addition to Portsmouth Health and Wellbeing Board, these priorities are being developed in partnership with Fareham & Gosport and South Eastern Hampshire CCGs and Hampshire County Council. This enables us to move away from commissioning isolated care to commissioning pathways of service so that they are planned and delivered to meet the wider needs of the individual. For example, pathways of care for those with long term conditions and the elderly To underpin our work in tackling inequalities and facilitate the completion of equality analysis, we have developed a data resource, drawing on 2011 national census data.
2.2.5 Communications and Engagement To achieve our vision for Portsmouth residents to live longer and healthier lives we involve patients and the public in the design of services, consult when there may be changes to services which will affect them, listen to the feedback they give us about their experiences of healthcare services and, most importantly, act on that feedback to improve the quality of services. Our Communications and Engagement Strategy sets out our principles and actions for engaging with our patients, public and stakeholders and CCG member general practices.
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Our annual public engagement report for 2013/14 “Listening to Patients” details the consultation and engagement activities the CCG has undertaken in its first full year of operation. A copy may be found on our website at: http://www.portsmouthccg.nhs.uk A variety of mechanisms are utilised for engaging with the communities we serve to include paper and online feedback and survey forms, social media, face-to-face interviews, forums, open and public meetings. Engagement is undertaken on all aspects of our work, from our 5-year strategic plan to specific service provision. Engagement events for specific services have been attended by special interest groups and recent service users, the voluntary and community sector and local healthcare monitoring bodies. They have included: • Reducing the impact of men’s health inequalities in Portsmouth. • Review of Crisis, Resolution and Home Treatment Team • End of Life Group in partnership with Fareham and Gosport and South Eastern
CCGs. The majority of our surgeries in Portsmouth have a Patient Participation Group (PPG) where patients discuss health and health care issues. Patient representatives from the individual practice PPGs are invited to attend regular, city-wide forums to discuss services of interest and importance to them. For example, older people’s mental health, the walk-in centre and minor injuries unit were discussed in September 2013. Our Governing Board meets in public bi-monthly and invites questions from the public. Questions to the Governing Board have included those on wheelchair services, dementia care and osteoporosis services. At its July 2014 Governing Board a patient story relating to a frail elderly couple was used to discuss and debate access and support in the community, following which comments were invited from the public. The City’s Integrated (CCG and City Council) Commissioning Unit has dedicated Service User Involvement officers to lead engagement work with service users and the public. The team also has established links with local groups and good mechanisms for involving service users in service reviews. The services this Unit commissions include those for people who have protected characteristics under the Equality Act. These are:
Adult Mental Health, including services based in hospital settings
Older People’s Mental Health, including Dementia
Access to Psychological Therapies
Substance Misuse
Learning and Physical Disabilities
Autism services
Re-ablement services
NHS Continuing Healthcare services
Neurological rehabilitation services As part of our equality and diversity assessment under the NHS Equality Delivery System (EDS2), we received feedback on accessibility of healthcare services from PUSH, substance misuse service users’ group and Central Point Day Centre for the homeless. A staff survey conducted under our EDS2 assessment was largely positive with staff
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indicating they feel the CCG values the importance of staff wellbeing and views and values their opinions.
2.2.6 Patient Experience
The City Council Customer Services Team handles complaints, concerns and comments on our behalf. A report is submitted quarterly to our Quality and Safeguarding Executive Group. The number of complaints received by the CCG is low, being 14 in total from April 2013 to end of March 2014. The majority of complaints are made directly to providers of services. The CCG is committed to learning from patient experience, and communicating action taken at, for instance, through Board Meetings and our annual report. We now need to ensure all sections of our population are able to raise concerns with us. We also need to expand on our scrutiny of patient experience by drawing out issues of discrimination and harassment, and take opportunities, as appropriate, to record protected characteristics of patients and members of the public using this service.
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3. Equality Actions
In determining the equality actions for the next year, we have considered:
Our equality and diversity achievements since we published our first strategy in May 2012.
Our assessment of the CCG’s performance against goals of the Equality Delivery System.
Our work with patients and the public and community representatives to identify actions that are important from the patient’s point of view.
Equality and diversity within our commissioning and procurement plans.
The equality actions for 2014/15 are set out in the table below are for the year.
Appendix One: Action Plan Appendix Two: Public Sector Equality Duty protected characteristics Appendix Three: Equality Act 2010 general and specific duties Appendix Four: Human Rights Act 1988 Appendix Five: NHS Equality Delivery System: Goals and outcomes Date approved: 29/10/14 Review Date: October 2017 Records Management: Chief Operating Officer
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Appendix One: Action Plan
Category
Action Target date
1. Leadership and governance
Publish relevant and proportionate annual equality data and information to showing compliance with the general and specific equality duties.
January 2015
Review the CCG’s assessment against the EDS2. March 2015
Review the CCG’s equality objective in line with annual review of EDS2.
Make sure exception reports on CCG provider performance around equalities are standing items on the Quality and Safeguarding Executive at least twice a year.
Ongoing
2. Equality analysis
Increase the number and quality of equality impact assessments undertaken each year. Ongoing
Arrange training for CCG managers with responsibility for completion of equality impact assessments. Autumn 2014
3. Communication and engagement
Put in place mechanisms to provide information in foreign languages or alternative formats (Braille, large print, ‘easy read’) on request, and publicise this service.
March 2015
Implement actions identified in the Communications and Engagement Strategy Equality Impact Assessment. March 2015
Work with partner organisations to identify and engage with protected groups and key stakeholders in review of the
CCG’s grading EDS2 goals and outcomes.
March 2015
4. Workforce and training
Complete an Equality Impact Assessments on all new Human Resources policies and procedures, and assess the impact on all nine protected characteristics as existing employment policies come up for review
April 2015
Engage staff from protected groups and staff side organisations in the process of reviewing our assessment against EDS2.
Annually
5. Commissioning and procurement
Ensure quality and contract monitoring of equality and diversity clauses in provider contracts Ongoing
Work to improve the use of existing performance data disaggregated by protected characteristic. March 2015
Explore potential for disaggregation of performance data by protected characteristic. March 2015
6. Complaints, concerns, comments and compliments
At least once a year, receive a patient experience report on poor. Reporting will draw out issues of discrimination and harassment, and opportunely record protected characteristics of patients and members of the public using this service.
Ongoing
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Appendix Two: Equality Act 2010 – Protected Characteristics
The Public Sector Equality Duty 2010 (protected characteristics)
1 Age
By being of a particular age/ within a range of ages.
2 Disability A physical or mental impairment which has a substantial and long-term adverse effect on day to day activities. This includes people with mental health problems, learning disabilities and long-term or serious illnesses such as heart disease, cancer or HIV/ AIDS.
3 Gender (sex)
Being a woman or a man.
4 Gender reassignment (transgender)
A person has the protected characteristic of gender reassignment if the person is proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning their sex by changing physiological or other attributes of sex.
5 Pregnancy and maternity If a woman is treated unfavourably because of her pregnancy, pregnancy related illness or related to maternity leave.
6 Race People who have or share characteristics of colour, nationality, or ethnic or national origin can be described as belonging to a particular racial group.
7 Religion or belief or lack of belief
The full diversity of religious and belief affiliations in the United Kingdom.
8 Sexual orientation A person’s sexual preference towards people of the same sex, opposite sex or both.
9 Marriage and Civil Partnership
This is relevant in relation to employment and vocational training; the CCG will need to ensure that it considers this protected group in relation to employment.
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Appendix Three: Equality Act 2010 General and Specific Duties
Equality Act 2010 Section 149 General Duty
General Equality Duty Due Regard
1 Eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010
Conduct prohibited by the Act. To comply with the general duty, a public authority needs to have due regard to all three of the aims.
2 Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it
The Equality Act explains that the aim of advancing equality of opportunity involves, in particular, having due regard to the need to:
Remove or minimise disadvantages suffered by people due to their protected characteristics.
Take steps to meet the needs of people with certain protected characteristics where these are different from the needs of other people.
Encourage people with certain protected characteristics to participate in public life or in other activities where their participation is disproportionately low
Meeting different needs includes (among other things) taking steps to take account of disabled people’s disabilities – for example making reasonable adjustments.
3 Foster good relations between persons who share a relevant protected characteristic and persons who do not share it
Fostering good relations is described as tackling prejudice and promoting understanding between people from different groups.
Note: Organisations that are not public authorities are also required to have due regard to the needs listed above whenever they carry out public functions. This could include, for example, a private company or voluntary organisation with a contract to provide certain public services. This means that as commissioner the CCG will need to assure that an organisation they intend to commission can comply with the general equality duty.
Specific Equality Duties
Created by secondary legislation – The Equality Act 2010 (Specific Duties) Regulations 2011
Publication of equalities information Each public authority is required to publish equalities information to demonstrate its compliance with the general equality duty. This needs to be no later than 31 January 2012, and at least annually after that, from the first date of publication. This information must include, in particular, information relating to people who share a protected characteristic who are:
Its employees
People affected by its policies and practices. Public authorities with fewer than 150 employees are exempt from the requirement to publish information on their employees. This is the case for local CCGs.
Publication of equality objectives Each listed public authority must prepare and publish one or more equality objectives that it thinks it needs to achieve to further any of the aims of the general equality duty. This must be done no later than 6 April 2012 and at least every four years after that. The objectives must be specific and measurable. Both the equality information and the equality objectives must be published in a manner that is accessible to the public. They can be published as a separate document, or within another document such as an annual report or a business plan.
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Appendix Four: Human Rights Act 1998 – Outline
The Human Rights Act 1998
The Human Rights Act came fully into force on 2 October 2000.
It gives further effect in the UK to rights contained in the European Convention of Human Rights.
The Act:
Makes it unlawful for a public authority to breach Convention rights, unless an Act of Parliament
meant it could not have acted differently
Means that cases can be dealt with in a UK court or tribunal, and
Says that all UK legislation must be given a meaning that fits with the Convention rights, if that is
possible.
The 15 rights contained in the Human Rights Act are:
The right to life*
The right not to be tortured or treated in an inhuman or degrading way*
The right to be free from slavery or forced labour
The right to liberty and security*
The right to a fair trial*
The right to no punishment without law
The right to respect for private and family life, home and correspondence*
The right to freedom of thought, conscience and religion
The right to freedom of expression
The right to freedom of assembly and association
The right to marry and found a family
The right not to be discriminated against in relation to the enjoyment of any of the rights contained in
the European Convention*
The right to peaceful enjoyment of possessions
The right to education
The right to free elections
*Particularly relevant to work of NHS organisations
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Appendix Five: NHS Equality Delivery System 2 – Goals and Outcomes
Goal Narrative Outcome
1. Better health outcomes for all
The NHS should achieve improvements in patient health, public health and patient safety for all, based on comprehensive evidence of needs and results
1.1 Services are commissioned, designed and procured to meet the health needs of local communities, promote well-being, and reduce health inequalities
1.2 Individual patients’ health needs are assessed, and resulting services provided, in appropriate and effective ways
1.3 Changes across services for individual patients are discussed with them, and transitions are made smoothly
1.4 The safety of patients is prioritised and assured. In particular, patients are free from abuse, harassment, bullying, violence from other patients and staff, with redress being open and fair to all
1.5 Public health, vaccination and screening programmes reach and benefit all local communities and groups
2. Improved patient access and experience
The NHS should improve accessibility and information, and deliver the right services that are targeted, useful, useable and used in order to improve patient experience
2.1 Patients, carers and communities can readily access services, and should not be denied access on unreasonable grounds
2.2 Patients are informed and supported to be as involved as they wish to be in their diagnoses and decisions about their care, and to exercise choice about treatments and places of treatment
2.3 Patients and carers report positive experiences of their treatment and care outcomes and of being listened to and respected and of how their privacy and dignity is prioritised
2.4 Patients’ & carers’ complaints about services, and subsequent claims for redress, should be handled respectfully and efficiently
3. Empowered, engaged and well-supported staff
The NHS should Increase the diversity and quality of the working lives of the paid and non-paid workforce, supporting all staff to better respond to patients’ and communities’ needs
3.1 Recruitment and selection processes are fair, inclusive and transparent so that the workforce becomes as diverse as it can be within all occupations and grades
3.2 Levels of pay and related terms and conditions are fairly determined for all posts, with staff doing equal work and work rated as of equal value being entitled to equal pay
3.3 Through support, training, personal development & performance appraisal, staff are confident and competent to do their work, so that services are commissioned or provided appropriately
3.4 Staff are free from abuse, harassment, bullying, violence from both patients and their relatives and colleagues, with redress being open and fair to all
3.5 Flexible working options are made available to all staff, consistent with the needs of the service, and the way that people lead their lives. (Flexible working may be a reasonable adjustment for disabled members of staff or carers.)
3.6 The workforce is supported to remain healthy, with a focus on addressing major health and lifestyle issues that affect individual staff and the wider population
4. Inclusive leadership at all levels
NHS organisations should ensure that equality is everyone’s business, & everyone is expected to take an active part, supported by the work of specialist equality leaders & champions
4.1 Boards and senior leaders conduct and plan their business so that equality is advanced, and good relations fostered, within their organisations and beyond
4.2 Middle managers and other line managers support and motivate their staff to work in culturally competent ways within a work environment free from discrimination
4.3 The organisation uses the “Competency Framework for Equality and Diversity Leadership” to recruit, develop and support strategic leaders to advance equality outcomes
