equality & diversity 1

Barbara Hankins MSc (07802 654249) - 20Mar07

1

EQUALITY & DIVERSITY

The Patient’s Perspective


2

Equality & DiversityObjective

Providing a Healthcare Service that recognises, respects and responds to the diversity of the local communities we serve


3

Race Equality Local Population Statistics

White Pakistan Indian Black British

Caribbean

Local Community 641,300 104,000 56,000 48,000 (66%)In Patient ProfileSelly Oak 65% 3% 2% 3%Queen Elizabeth 65% 5% 5% 6%

Workforce 69% 1% 6% 4%


4

Race Equality Scheme Issues from Initial Impact Assessments

• Patient Information• Interpreting Service• Telephone Communications• Communications Barriers• Cultural needs/awareness• Gap with Primary Care


5

Disability Equality Scheme Trust Issues

• Requires for the first time that it takes a pro-active approach

• Needed to involve a range of people with disabilities in the whole process, including employees and the wider community


6

Disability Equality SchemePatient Issues

• 9 million deaf and hard of hearing people in the UK or 1 in 7 of the UK population

• Of these 698,000 are severely or profoundly deaf• Another 450,000 of them are severely or profoundly deaf

and cannot hear well enough to use a voice telephone even with equipment to make it louder

• An estimated 500,000 black and ethnic minority people are deaf or hard of hearing

• Communication difficulties can place them all in danger of misdiagnosis or delay in treatment


7

Disability Equality SchemeKey Concerns

Research conducted by Sign, found that thekey concerns for the needs of deaf people in the NHS were:-• To improve access to all health services• To prioritise and promote disability equality• To improve facilities and services for deaf

people


8

Disability Equality Scheme Experiences of people who are

deaf and their carers

• Lack of knowledge, awareness and consideration by doctors, health professionals and receptionists shown in poor attitudes and lack of deaf awareness in communication

• Information on deafness not being transferred between healthcare services, not being acted upon and lack of a system to do so

• Medical staff with little training in deaf awareness/ communications tactics

• Service providers being unclear on how to deal with deaf patients, particularly A&E.


9

Disability Equality Scheme Some solutions to help improve our

patient’s experience• Allow more time for appointments• Ask patients how they prefer to communicate• Make sure staff are aware of RNID Talktype• Use pictures, Video and DVD. • At least one front-line staff member should have basic

deaf awareness training• Produce a short video of the ward and staff to orientate

patient to the ward environment• Update the website and ensure it is up-to-date and is a

comprehensive source of information


10

GENDER EQUALITY SCHEME Trust Issues

• Needs to be a central plank of service and strategy

• Will require the Trust’s entire service remit to be tailored to men or women and in areas that are not as obviously gender sensitive

• Collecting gender-specific disease data is a crucial first step

• The Health Service is historically starting from a very low base


11

Gender Equality Scheme The impact of sex differences on

health and illness• Men typically develop heart disease ten years

earlier than women• Women’s immune systems make them more

resistant than men to some kinds of infection including tuberculosis

• Women are around 2.7 times more likely than men to develop an auto-immune disease such as diabetes

• Male-to-female infection with HIV is more than twice as efficient as female-to-male infection


12

Gender Equality Scheme Gender differences in health and illness

• Men are more likely than women to commit suicide

• Women are 2-3 times more likely than men to be affected by depression or anxiety

• Men are more likely than women to die of injuries, but women are more likely to die of injuries sustained at home

• The gap between male and female smoking rates is beginning to narrow as young women are taking up the habit more frequently than young men.


13

Gender Equality Scheme Gender differences in health care

• Reporting practical problems in access to services

• Caring responsibilities or transport problems

• Admit weakness or accept that they may be ill


14

Gender Equality Scheme Gender differences in use of

health care services – In-Patients• Women - slightly more likely to be admitted as inpatients• Men from most ethnic minorities – slightly lower rates of

inpatient treatment• Indian and Pakistani men - higher rates of in-patient

treatment• Asian women - more likely to be referred to hospital by

their GP but also were more likely not to attend appointments

• Differences in hospital treatment for mental health problems reveal higher admission rates amongst men in early life and again in old age, while female rates are higher in middle age


15

Gender Equality SchemeGender differences in use of

health care services – Out-Patients• Men are more likely than women to attend A&E• Women have higher rates overall of GP referrals for

out-patient appointments• Higher rates of referral for in-patient treatment for

women in general surgery, general medicine and psychiatry in particular

• Differences vary by ethnic group• Chinese women and men were less likely to have

attended as out-patients compared with general population

• Chinese women and men are less likely to report being affected by a number of key health conditions


16

Gender Equality Scheme Gender Blindness

• The health of women and men is strongly influenced by their biological sex and their social gender

• Targets for reduced waiting times are same for both sexes but results would be of greater value if disaggregated for women and men and for different clinical specialties

• However, targets may be reached at different speeds for different specialties and may also reflect specific difficulties facing women and men in accessing care

• Without a framework in which gender is identified as a relevant factor, the possibility of gender differences cannot be properly explored.


17

Equality & Diversity Conclusions

• A huge agenda to be completed• Collecting gender-specific disease data is a crucial

first step• Working towards a Single Equality Scheme can

help• Patients come from a wide range of ethnic groups,

with different cultural perceptions of health, illness and healthcare.

• Being sensitive to these different perceptions can impact positively on a patient’s progress and vice versa – but first you have to be aware of them!


18

Equality & Diversity

Equality & Diversity in the NHS is allabout changing how we work andmeeting the real needs of the people who use health services

Thank you for your time

equality & diversity 1

Documents