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Equality Information Report 2017-18

For further information please contact:

Emdad HaqueSenior Equality, Diversity and Inclusion [email protected] 3688 1121

Final

Our vision: to work together with the Barnet

population to improve health and wellbeing

mailto:[email protected]

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Contents

Introduction S3

About Barnet S4

Our equality and health inequality duties S5-6

NHS mandatory standards S7

Equality Delivery System (EDS2) S8-10

Mandatory Standards S10

CCG Equality Objectives S11

Advancing equality through commissioning S12-14

Our workforce S15

Governance and leadership S16

Inclusive engagement S17

Our providers S18

Forward strategy S19

Appendix 1: Workforce and Governing Body Members Equality

Information including the WRES

S20-34

Appendix 2: WRES Indicators S35

Appendix 3: WRES Action Plan (2017-19) Progress Report S36

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Introduction

We produce our annual Equality Information Report to demonstrate to our stakeholders how Barnet Clinical Commissioning Group

(CCG) is meeting its duty under the Equality Act 2010. The report also shows the improvements we have made through the delivery of

our objectives against the mandatory standards set out by NHS England including the Workforce Race Equality Standard (WRES),

Equality Delivery System (EDS2) and the Accessible Information Standard. In 2017/18, we refreshed our Equality and Diversity

Strategy for 2018-20 by using EDS2 and we now have an action plan in place for 2018/19 which aims to deliver our equality objectives.

We are committed to commissioning services that achieve the best clinical outcomes for patients and a positive patient experience. The

way we achieve this is by engaging patients, community groups, staff and clinicians in the design and procurement of our services and

by applying innovative ideas. We use every opportunity to listen to our patients, whether through local Patients Participation Groups

(PPGs) or voluntary sector engagement events, or planned engagement throughout the business planning process and ensure their

views reflect in our commissioning decisions.

We aim to improve our equality and diversity performance by delivering on our priorities to meet our statutory duties. Some of these

priorities have been addressed through our North Central London Sustainability and Transformation Plan and going forward, we will

work collaboratively with our partners and providers to address health inequalities.

In July 2017, the Governing Bodies of NHS Barnet CCG, NHS Camden CCG, NHS Enfield CCG, NHS Haringey CCG and NHS

Islington CCG established the NCL Joint Commissioning Committee (‘Committee’). The Committee’s role is to jointly commission the

following services as these are most effectively commissioned collaboratively across the five CCGs:

• All acute services including core contracts and other out of sector acute commissioning;

• All learning disability contracting associated with the Transforming Care programme;

• All integrated urgent care (including 111/GP Out-of-Hours services)

• Any specialised services not commissioned by NHS England.

The new arrangements will help to ensure commissioning and future health services across the NCL system are more joined up,

equitable and co-ordinated for local patients.

This report provides a summary of our activities and there is more information in our CCG Annual Report 2017-18 which can be found

on our website www.barnetccg.nhs.uk

http://www.camdenccg.nhs.uk/publications/annual-report-and-account-201617/33135

http://www.barnetccg.nhs.uk/

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About Barnet

Barnet is home to 369,887 residents, based on

a 2016 estimate. The Borough has a higher

proportion of its total population who are aged

over 65 when compared to London. The

number of people aged 65 and over is

projected to increase by 34.5% by 2030, over

three times greater than other age groups.

Barnet’s rising population will place pressure

on all health and social care services, with a

number of implications for health and

wellbeing. Key issues include:

• Obesity and the related conditions for adults,

children and young people;

• Mental health and learning disability;

• Long-term conditions;

• Integrated care;

• Primary care development;

• Diabetes mellitus; and

• Conditions attributable to cold weather

Population and diversity

The population of Barnet is projected to become increasingly diverse, with

the Black, Asian and Minority Ethnic (BAME) population projected to increase

from 38.7 to 43.6% of the total Barnet population. One of the key challenges

will be meeting the diverse needs of these different and growing

communities. Colindale, Burnt Oak and West Hendon have populations that

are more than 50% Black, Asian and Minority Ethnic backgrounds. Over 50%

of all 0-4 year olds in Barnet were from a Black, Asian and Minority

background in 2015 and this is forecast to continue to increase.

There are more children from all Black and Minority Ethnic groups in the 0 – 9

age group, than there are White children. Children and young people in the

10 – 19 age groups are predominantly White. This demonstrates a more

diverse population shift in terms of ethnicity.

Health inequalities

There are inequalities in life expectancy in Barnet by gender, locality/ward and the level of deprivation. Life expectancy at birth in

females (85.0 years) is higher than in males (81.9 years) and overall life expectancy for both the male and female population in Barnet

is higher than the average for England (male =79.4 years, female =83.1 years).

The Garden Suburb ward has the highest life expectancy for both males (84.1 years) and females (88.5 years) while the Burnt Oak

ward has the lowest life expectancy for both males (75.8 years) and females (81.6 years). In addition, the life expectancy gap is wider

and mortality is higher in the most deprived areas compared to the least deprived areas in Barnet. It is clear from international studies

and evidence that people from more deprived groups tend to:

• have higher incidence of cancer;

• be diagnosed later;

• have less treatment; and

• have poorer outcomes

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Our equality and health inequality duties

Barnet CCG came into being in 2013 through an authorisation process by NHS England which included making it

a duty for the CCG to show ‘due regard’ to the Public Sector Equality Duty (PSED) under the Equality Act 2010

and not delegate it to another organisation. Later on, NHS England introduced more guidance for CCGs on how

to demonstrate compliance and continue making continuous improvement in their equality and diversity

performance (see the diagram below).

Statutory duty

Mandatory Standards

CCG Response

Equality Act 2010

Health and Social Care Act 2012

Human Rights Act 1998

Equality Delivery System (EDS2)

Workforce Race Equality Standard (WRES)

Accessible Information Standard (AIS)

• Equality and Diversity Strategy & Annual

Action Plan

• Equality Information

• Equality and Diversity Working Group

• Assurance from providers through Clinical

Quality Review Groups

• Equality Impact Analysis

Enga

gem

ent

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General Duty under the Equality Act 2010

The general equality duty, under the Equality Act 2010, requires Barnet

CCG, in the exercise of our functions, to have due regard to the need

to:

• Eliminate discrimination, harassment and victimisation and any other

conduct that is prohibited by or under the Act.

• Advance equality of opportunity between people who share a

relevant protected characteristic and people who do not share it.

• Foster good relations between people who share a relevant

protected characteristic and those who do not share it.

These are sometimes referred to as the three aims, or arms of the

general equality duty. The Act explains that having due regard for

advancing equality involves:

• Removing or minimising disadvantages suffered by people due to

their protected characteristics.

• Taking steps to meet the needs of people from protected groups

where these are different from the needs of other people.

• Encouraging people from protected groups to participate in public

life or in other activities where their participation is disproportionately

low.

Protected characteristics are defined as:

Age, Sex, Disability, Gender Reassignment (Transgender)

Race, Religion or Belief, Sexual Orientation, Pregnancy and maternity

Marriage and civil partnership.

We additionally pay due regard to the needs of carers, seldom heard

groups and vulnerable groups when making commissioning decisions.

Specific Duty

The specific duty requires Barnet CCG to publish equality

objectives at least once every four years and to publish

equality information once a year, demonstrating that it has

consciously thought about the three aims of the Equality

Duty as part of its decision-making process.

The Act also requires that employers with a workforce of

over 150 employees publish information relating to

employees who share protected characteristics. Although

Barnet CCG does not have 150 employees, adopting good

practice, we have included our employee and governing

Body profile as part of this report.

Under the Health and Social Care Act 2012, CCGs have a

duty to:

• Have regard to the need to reduce inequalities between

patients in access to health services and the outcomes

achieved (s.14T);

• Exercise their functions with a view to securing that health

services are provided in an integrated way, and are

integrated with health-related and social care services,

where they consider that this would improve quality,

reduce inequalities in access to those services or reduce

inequalities in the outcomes achieved (s.14Z1);

• Include in an annual commissioning plan an explanation of

how they propose to discharge their duty to have regard to

the need to reduce inequalities (s. 14Z11);

• Include in an annual report an assessment of how

effectively they discharged their duty to have regard to the

need to reduce inequalities (s. 14Z15).

Our equality and health inequality duties (cont’d)

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NHS mandatory standards

NHS Workforce Race Equality Standard (WRES)

The NHS Workforce Race Equality Standard was developed and

introduced in 2015. Organisations are required to review and report

against nine indicators. The indicators are a mix of NHS staff survey

data and workforce data comparing the experience of BAME and

white staff. It also compares the Governing Body data with the

workforce data and local demography to identify how representative

the Governing Body is compared with the CCG workforce and the

local population. Our first WRES report was published in July 2015,

followed by a progress report that was published in July 2016 with an

action plan. This year we have incorporated the WRES into our

workforce and Governing Body Members report (See our Workforce

and Governing Body Equality Information Report 2017-18).

The Accessible Information Standard means that organisations

providing health or social care need to:

1. Ask people if they have any information or communication

support needs and identify how to meet them.

2. Record those needs in a set way on the patients’ records.

3. Highlight or flag in the person’s file or notes, so it is clear that

they have information or communication support needs and

details of how to meet those needs.

4. Share information about a person’s needs with other NHS

and adult social care providers when they have consent to do

so.

5. Make sure that people get information in an accessible way

and communication support if they need it.

CCGs are exempt from meeting the standard. However, we are

committed to the AIS, and we ensure that whenever we

communicate with the public that we consider the requirements

of the standard. In addition, we will work closely with our

member GP Practices to provide the necessary support to

enable them to meet the requirements of the standard and we

will continue to seek assurance from provider organisations

about their compliance with the standard, including evidence of

how they are planning to meet the standard.

Accessible Information Standard (AIS)

The Accessible Information Standard required all organisations that

provide NHS (including GP Practices) or adult social care to meet

the standard by 31 July 2016.

The aim of the standard is to make sure people who have a

disability, impairment or sensory loss receive information in a way

that they can access and understand, and provide any

communication support they might need. This includes making sure

people receive information in different formats, for example, large

print, Braille, easy read and support such as a British Sign

Language interpreter, deafblind manual interpreter or an advocate.

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The NHS Equality Delivery System was developed as an equality performance

framework to assist NHS organisations to evidence their compliance with the

Public Sector Equality Duty and embed equality and diversity within the

organisation.

At the heart of the EDS2 is a set of eighteen outcomes grouped into four goals:

1. Better health outcomes for all

2. Improved patient access and experience

3. Representative and supported workforce

4. Inclusive leadership

Organisations are required to grade their performance by using a grading system

as follows:

Red- Undeveloped

People from all protected groups fare poorly compared with the demography of

the borough OR evidence is not available, or if evidence shows that the majority

of people in only two or less protected groups fare well

Amber-Developing- People from only some protected groups fare as well as the

people of the borough.

Green-Progressing- People from most protected groups fare as well as the

people of the borough

Purple-Excelling- People from all protected groups fare as well as all people of

the borough.

EDS2 can help CCGs improve the services they provide for

their local communities; improve the experiences of people

using the services; consider reducing health inequalities in

their locality; and provide better working environments, free of

discrimination, for those who work in the NHS.

NHS Equality Delivery System (EDS2) overview

Meeting the Public Sector Equality Duty through NHS Mandatory Standards

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Equality Delivery System (EDS2)-grading processes

The CCG uses EDS2 for its equality and diversity planning and implementation and service improvement to advance

equality, as mandated by NHS England. As described in slide 8 the CCG has worked with community interest groups

and carried out an EDS2 grading in 2017-18 which will help determine the priorities for 2018-19 (see the slide on

forward strategy for more information).

Our current performance is based on the grading in 2017-18 and the recent analysis of the CCG’s evidence across

the 4 EDS2 goals and 18 outcomes.

Publishing grades

Grading and action planning

Evidence gathering

Project planning

and engaging

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Equality Delivery System (EDS2) performance update

Outcome Grade Outcome Grade

1.1 Services are commissioned, procured, designed and delivered to

meet the health needs of local communities

Developing 3.1 Fair NHS recruitment and selection processes

lead to a more representative workforce.

Achieving

1.2 Individual peoples’ health needs are assessed and met in

appropriate and effective ways.

Developing 3.2 The NHS is committed to equal pay for work of

equal value and expects employers to use

equal pay audits to help fulfil their legal

obligations.

Developing

1.3 Transitions from one service to another, for people on care

pathways, are made smoothly with everyone well-informed.

Developing 3.3 Training and development opportunities are

taken up and positively evaluated by all staff.

Achieving

1.4 When people use NHS services their safety is prioritised and they

are free from mistreatment and abuse and mistakes are minimised.

Achieving 3.4 When at work, staff are free from abuse,

harassment, bullying and violence from any

source.

Developing

1.5 Screening, vaccination and other health promotion services reach

and benefit all local communities.

Developing 3.5 Flexible working options are available to all

staff consistent with the needs of the service

and the way people lead their lives.

Achieving

2.1 People, carers and communities can readily access hospital,

community health or primary care services and should not be

denied access on unreasonable grounds

Developing 3.6 Staff report positive experiences of their

membership of the workforce.

Developing

2.2 People are informed and supported to be involved in decisions

about them.

Developing 4.1 Boards and senior leaders routinely

demonstrate their commitment to promoting

equality within and beyond their organisations

Developing

2.3 People report positive experiences of the NHS Developing 4.2 Papers that come before the Board and other

major Committees identify equality-related

impacts including risks, and say how these

risks are to be managed.

Achieving

2.4 People’s complaints about services are handled respectfully and

efficiently.

Developing 4.3 All managers and staff support their staff to

work in culturally competent ways within a

work environment free from discrimination

Developing

Our current performance is based on the grading from 2016-17. This helped us shape our equality objectives in the Equality and Diversity

Strategy 2018-20. In 2017/18 we have sustained our grades and a new grading is planned with the local interest groups and the Council

Public Health for 2018/19, starting with Goals 3 and 4 in June 2018, followed by Goals 1 & 2 in October 2018. This will help us inform our

action plan for 2019/20.

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Our Equality Objectives in the CCG’s Equality and Diversity Strategy 2018-20 have undergone a series of internal engagement events with staff and

Governing Body members. These objectives are aligned with the national best practice tool EDS2. We have ensured the objectives are based on

Barnet priorities and fully aligned with our CCG and NCL strategic plans. An annual action plan for 2018/19 is being developed and is based around

EDS2 outcomes and local intelligence to deliver these objectives.

CCG Equality Objectives

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Advancing equality through commissioning

As a commissioning organisation, our aim is to discharge our equality and health

inequality duties through our commissioning functions. There are a number of

ways we currently meet these duties.

Our approach to equality analysis uses a ‘three lenses’ approach to ensure robust

compliance with the equality duty and make the process more meaningful and

effective.

In the next few slides, we have highlighted some of the achievements in 2017/18.

These achievements demonstrate how Barnet CCG delivered its equality

objectives 1 and 2. More information about the achievements can be read in

Barnet CCG’s annual report 2017-18.

In 2017/18, Barnet CCG’s equality focus was primarily around commissioning

services, based on local evidence, and improving access to services for protected

and vulnerable people in the community. This included access to existing services

and any service that was redesigned or newly commissioned.

Our Governing Body, and relevant Committees, have played an important role in

ensuring compliance with our statutory duties by scrutinising business cases and

equality analysis completed by the commissioners.

As sector leader and lead commissioner, Barnet CCG seeks assurance from

Providers on a number of equality policies as mandated by NHS England. This

includes gaining assurance that providers are compliant with the equality duty and

also all NHS mandatory standards (See page 18).

Equality

duty

EngagementHealth

inequality

EqualityAnalysis

Commissioning decisions

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Advancing equality through commissioning

Equality Objective 1: Commissioning services based on evidence to reduce health inequalities amongst protected and

vulnerable groups.

Barnet CCG aims to work effectively to maximise the local NHS’s contribution to local health and wellbeing. We are here to improve

people’s health, reduce health inequalities and promote prevention and early intervention to support local people to maximise their

personal health and wellbeing. In order to deliver this objective, we engage with, and strive to understand, the needs and wants of local

people and communities.

Key achievements 2017-18

• Across NCL, we have developed our Sustainability and Transformation Plan (STP) to deliver the triple aims of improved health and

wellbeing, transformed quality of care delivery, and sustainable finances as set out in the national Five Year Forward View. Locally as

partners, we have a shared vision, a collective agenda and the commitment to work together in new ways to transform the health

and care services of North London.

• The commissioning and launch of the Dementia Hub in May, in partnership with the Alzheimer’s Society, was a real highlight. The

Hub provides accessible, and much-needed support, in the community for our local residents living with dementia and acts as a focal point to support services across the Borough.

• End of life care: Continuing Healthcare commission high quality care provision for eligible service users at the end of their life. We

continue to work closely with local Hospice teams and District Nursing services to ensure that individuals can receive care in their

preferred place. In 2017/2018, 76% of CHC eligible patients were supported in their preferred place of care at the end of their life.

• A “Red Bag” (important information about a care resident’s health) scheme in care homes was successfully introduced.

• Reconfigured adult community services.

• Streaming of appropriate patients from the Emergency Department to GP surgeries.

• Extended Access service – for 2017/2018 the CCG commissioned an extra 38,000 appointments.

• Building on a suite of locally commissioned services in primary care, Barnet CCG commissioned several new local services to help

meet the changing healthcare needs of the local population.

• Investment was committed to continue commissioning the extended access service to local primary care services.

• Barnet CCG has commissioned CommUNITY Barnet to support its patient and community engagement.

• Through targeted resourcing, and a waiting times reduction programme, Barnet CCG reduced the number of young people waiting

for treatment for over 12 weeks from 119 to 65 and average waiting times from 131 days to 90 days (between 30th September 2016

and 30th September 2017).

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Advancing equality through commissioning (cont’d)

Equality Objectives 2: Improve access to all services by protected and vulnerable groups

In 2017, we have worked with our partners to engage with the public and begin to implement shared plans to deliver improvements to

health and care and spend money wisely. Some highlights of this include:

Key achievements in 2017-18

• Making it possible for residents to access GP services 8am-8pm through extended access in April 2017.

• Following capital investment of £1million by Camden & Islington Foundation NHS Trust, we opened the Women’s Psychiatric Intensive

Care Unit on 13th November 2017. This will ensure that women that require intensive care in NCL are not placed out of area as a first

response to their crisis and need for intensive care.

• One of the first areas nationally to launch the new integrated urgent care model. This includes:

o Mental Health patients can now ring 111, and be transferred directly transfer to crisis team for advice and support.

o Enables clinical staff to get through to a clinical expert for urgent advice and support by dialling the appropriate number.

• Successful bid for enhanced mental health liaison services in A&E at University College Hospital in 2017/2018, and North Middlesex

University Hospital in 2018/2019.

• Launched a specialist Perinatal mental health service for mums across North Central London, following a successful first wave bid for

national funding.

• Made it quicker and safer for patients to get home from hospital by working at agree standard ways of working and working more

effectively with social care.

• We have worked with CommUnity Barnet and others to ensure these are accessible to everyone who has an interest in the issues being

discussed.

• Involving parents/carers of people with learning disabilities, and other conditions, by collaboratively working with the local authority and

the involvement Board.

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Workforce

Equality Objective 3: Recruit, support and retain staff from protected groups

WRES

EDS2

Recruitment

Training

Support

Retention

Barnet CCG employs 85 staff from diverse backgrounds (as at 31st March

2018). Our workforce report provides a detailed breakdown of our

workforce activities. Our commitment to advancing workforce equality has

been strengthened by our work with other NCL CCGs, providers and NEL

CSU. In 2017/18 we have:

• Continued attracting applicants from diverse backgrounds.

• Ensured our selection process followed the NHS recruitment

and selection policy and good practice (e.g. ACAS code of

practice)

• Ensured our process of supporting staff with non-mandatory

and CPD courses was fair and have monitored the uptake by

ethnicity.

• Followed the NHS change management policy in our team

restructuring and completed equality analyses, where required,

to ensure ‘due regard’ to the equality duty.

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Governance and leadership

Equality Objective 4: Strengthen the role of

governance and leadership beyond compliance

CCG Assurance

Equality duty

Mandatory standards

Barnet CCG Governing Body is ultimately responsible for

assuring NHS England that the CCG is compliant with the Public

Sector Equality Duty and is meeting the requirements of the

mandatory standards.

• Barnet CCG Governing Body seeks regular assurance that its duties

are being met and that providers, from whom it commissions services,

are complying with this duty.

• The Equality and Diversity Working Group supports and oversees the

implementation of Barnet CCG’s Equality and Diversity Strategy and is

Chaired by a member of the Governing Body. Membership of the

Group includes Human Resource & Organisational Development,

Engagement, Project Management Office, Equality and Diversity and

Commissioning. The Group is a sub-committee of the Patient and

Public Engagement (PPE) Committee.

• The Group also invites Healthwatch and Public health to discuss

EDS2 grading.

• The CQRC provides the necessary scrutiny on all reports before they

go to the Governing Body.

Clinical Quality and Risk Committee (CQRC)

Senior Management Team

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Inclusive engagement

Our engagement activities are designed to deliver inclusive engagement outcomes that enable Barnet CCG

to deliver our equality objectives 1 and 2

• Barnet CCG works hard to embed engagement across the organisation and to

work closely with our partners and key stakeholders such as Barnet Council,

Healthwatch Barnet, CommUnity Barnet, the other CCGs in NCL and the Health

and Wellbeing Board. Barnet CCG’s Governing Body Lay Member is responsible

for ensuring effective patient and public engagement.

• When we have targeted audiences for public engagement events, we have worked

with CommUnity Barnet and others to ensure these are accessible to everyone

who has an interest in the issues being discussed.

• The aim of our engagement work is, not only to consult people about the services

they need, but to involve them in co-creating them for the future. A good example

of this is the procurement exercise for Children’s Integrated Therapies

(occupational therapy, physiotherapy and speech and language services)

undertaken in January and February 2018. Young people were trained and

supported to be a part of the panels that scored the bids and interviewed the

shortlisted providers to make a final recommendation.

• Throughout the year, the Learning Disabilities Team made regular visits to the

specialist learning disabilities service to speak to patients as part of contract

monitoring activities. Feedback was used to inform the commissioning approach

and provide assurance.

Case study

In June 2017, we hosted an engagement event attended by 85 delegates, including 29 members of the public and 33 representatives from community and

voluntary sector stakeholders. The event was focused on Care Closer to Home, particularly GP extended access, integrated working and digital services.

The views obtained at this event, along with those we heard at the previous Care closer to Home event in February 2017, were used to develop the CCG’s

Personal Medical Services (PMS) contract Commissioning Intentions for GP services. This included improved access, specifically relating to increasing

the number of bookable online appointments and how more integrated services will be delivered in Care Closer to Home Integrated Networks (CHINs).

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Our providers

We have a duty to ensure that all our providers are complying with their public sector equality duty and that they are

implementing the mandatory standards e.g. the WRES, EDS2 and Accessible Information Standard.

Below we have listed our main providers and have included an overview of their current performance.

• Barnet CCG seeks regular assurance from its providers through contract monitoring and at the Clinical Quality Review Group (CQRG).

• Based on providers information, Barnet CCG seeks assurance on the progress on their implementation of the WRES, EDS2 and Accessible

Information Standard.

Our main providers

Adopted

WRES

Adopted

EDS2

Published

Equality

Objectives

Published Annual

Equality

Information

Accessible

Information

Standard

Barnet, Enfield and Haringey Mental Health

NHS Trust

www.beh-mht.nhs.uk/equal-opportunities-

and-diversity.htm

Royal Free London NHS Foundation Trust

www.royalfree.nhs.uk/about-us/equality-and-

diversity

Central London Community Healthcare NHS

Trust www.clch.nhs.uk/about-us/equality-and-

diversity.aspx

http://www.beh-mht.nhs.uk/equal-opportunities-and-diversity.htm

http://www.royalfree.nhs.uk/about-us/equality-and-diversity

http://www.clch.nhs.uk/about-us/equality-and-diversity.aspx

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Forward strategy for 2018-19

We have a shared vision and a collective commitment to work together in new ways to change and improve health and care services in North London for

the benefit of our residents. Our main focus in 2018/19 is complying with our equality and health inequality duty. We recognise the challenges facing

Barnet CCG, both in terms of demand for services and diminishing funding, which make it challenging for us to advance equality for all groups in the

community, therefore, some prioritising may be necessary. However, we remain strongly committed to meeting our legal duties by working with our staff,

Governing Body members, the voluntary sector, and all our partners and providers.

•Enhance the ways we undertake equality analysis and how we use the outcomes to inform our commissioning decisions

•Train managers and Governing Body Members

• Implement the WRES Action Plan

•Targeted engagement with local protected groups

•Collaborative working with Public Health and the Health and Wellbeing Board

CCG level

•Work with providers around EDS2 and the WRES and hold them to account

•Work towards harmonising strategic equality objectives across NCL

•Develop systems and process to benchmark work and share good practice

•Prepare for the implementation of the Workforce Disability Equality Standard (WDES)

NCL Level

Priorities

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Workforce and Governing Body Members

Equality Information including the WRES

Equality Information Report 2017-18

Appendix 1

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Summary

Under the Equality Act 2010, we are required to publish our equality information to show how we are meeting the public sector equality duty

as a commissioning organisation and an employer. This appendix is part of the equality information report and shows how Barnet CCG has

performed in terms of implementing the Workforce Race Equality Standard (WRES) and Equality Delivery System (EDS2) to meet its public

sector equality duty.

Barnet CCG employs 85 staff (as of 31st March 2017) including 15 office holders who are not employees of the CCG but are on the payroll.

We have included them for WRES purpose only. This is not a large number when divided into different protected groups.

Please note, the race equality data in some indicators is too small to draw any meaningful conclusion as a small change in the

number can change the percentage significantly and, therefore, the percentages need to be treated with caution.

• Barnet CCG has made an improvement in the appointment of BAME staff compared to White staff. For example, BAME staff were three

times less likely to be appointed compared with White staff in 2015/16. This has improved to 1.75 times less likely in 2017/18.

• In 2017/18, there were two staff among the new recruits who declared a disability.

• White staff were twice more likely to access non-mandatory training and Continuing Professional Development (CPD) courses than

BAME staff and the ratio was the same as 2015/16

• There has been an increase in the percentage of BAME staff in Barnet CCG since 2016/17

• There were less than five disciplinary cases over the last two years (2016-18).

• The 2017 Staff Survey outcomes show that BAME staff reported more bulling and harassment from staff, and more discrimination from

colleagues/managers than White staff.

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Introduction Workforce and GB members Recruitment Staff experience

Background

As part of the Equality Information Report, Barnet CCG publishes its workforce information every year. This is to show how

the CCG is meeting its duty under the Equality Act 2010 in relation to workforce. In addition, Barnet CCG has been publishing

the Workforce Race Equality Standard (WRES) report since 2015. This year we have combined the WRES report with the

workforce diversity report so that we can show how Barnet CCG is performing across all protected characteristics. This will

also help us in our readiness to adopt the Workforce Disability Equality Standard (WDES).

As at 31st March 2018, Barnet CCG employed 85 staff, including Office Holders. This report includes information about our

current workforce and Governing Body Members, recruitment, training and staff survey by protected groups. We have not

included information about gender re-assignment as there is no available data to report and currently the Electronic Staff

Records (ESR) system does not have a category for gender-reassignment.

How we have prepared the report

This report shows how Barnet CCG has progressed against the nine indicators for the period 2017/2018 and includes (where

applicable) a comparison to the 2016/2017 WRES data. The report also contains recommended actions for Barnet CCG to

implement in 2018/19 to improve the CCG’s position about race equality.

To demonstrate how Barnet CCG meets each indicator, data has been collated from several sources, including workforce

data from ESR and TRAC; local demographic data from the 2011 Census as recommended in the WRES guidelines. The

data on recruitment and non-mandatory training and CPD has been gathered from the April 2017 – March 2018 records.

The Staff Survey 2017 WRES questions outcomes have been used for the WRES indicators (5-8)

23

The roles of CCGs in implementing the WRES

Clinical Commissioning Groups (CCGs) have two roles in relation to the WRES; as commissioners of NHS

services and as employers. In both roles, their work is shaped by key statutory requirements and policy drivers

including those arising from:

The NHS Constitution

The Equality Act 2010 and the public sector Equality Duty

The NHS standard contract and associated documents

The CCG Improvement and Assessment Framework

In addition to the NHS standard contract, the CCG Improvement and Assessment Framework also requires

CCGs to give assurance to NHS England that their providers are implementing and using the WRES.

Implementing the WRES, and working on its results and subsequent action plans, should be a part of contract

monitoring and negotiation between CCGs and their respective providers. If there is something amiss with the

providers’ implementation, or use of the WRES and what the results of WRES actually show, CCGs should have

meaningful dialogue with those providers. However, the credibility of the CCG’s relationship with its providers

can only be meaningful if the CCG itself is taking serious action to improve its performance against the WRES

indicators.

CCGs should commit to the principles of the WRES and apply as much of it as possible to their workforce. In

this way, CCGs can demonstrate good leadership, identify concerns within their workforce, and set an example

for their providers. Formally, CCGs are not required by the NHS standard contract to fully apply the WRES to

themselves, as some CCG workforces may be too small for the WRES indicators to either work properly or to

comply with the Data Protection Act. However, neighbouring or similar (comparator) CCGs may wish to submit a

jointly co-ordinated WRES report and action plan; this can counter any potential risk of small workforce

numbers.


24

WRES Indicator 1: Percentage of staff in each of the Agenda for Change (AfC) Bands 1-9 or Medical

and Dental subgroups and Very Senior Managers (VSM), including executive Board members,

compared with the percentage of staff in the overall workforce disaggregated by:

• Non-Clinical staff

• Clinical staff - of which

- Non-Medical staff

- Medical and Dental staff

• As mentioned on page five and appendix 2, the WRES indicator has been changed since 2016 and now includes all

clinical and non-clinical staff. Barnet CCG reports its staff data by including permanent staff and those who are on

the payroll but not employed by the CCG (e.g. Office Holders).

• For comparison purposes, Barnet CCG has kept the grouping of the data to Band 1-7, and from 8 to 9 and VSM and

has used a separate category for Office Holders who do not fit under either of the first two categories and are not

staff of the CCG (e.g. Governing Body members who are clinical leads and are on payroll).

• Numbers have been included next to the percentages to show statistical significance.

Race


25

2015/16 2016/17 2017/18Performance

compared

with 2016/17

Population(2011 Census)

White58% 59% 56% 3% 64%

BAME29% 32% 27% 5% 36%

Not

disclosed 13% 10% 16% 6% n/a

Workforce by ethnicity compared with local population

The table includes staff and office holders to show the overall commissioning workforce.

16% of the total staff have not disclosed their ethnicity and this is percentage is made up of Office Holders’ number of

non-disclosures (67%). Barnet CCG needs to update this data to ensure greater transparency and clarity.

There has been a small change in the make up of White staff since 2016/17 (-3%), and they appear to be slightly

underrepresented compared with the local white population (64%). The percentage of BAME staff has also decreased

marginally (5%), and appear to be underrepresented compared with the local BAME population (36%).

The disclosure of ethnicity has decreased by 6% since 2016/17 but is greater than the NCL average of 22%.7.


WRES Indicator 1: cont’d

Note: Change less than 2% is not shown

26

WRES Indicator 1: cont’d

Bands 1-7Change in %

representationBands 8a -VSM

Change in %

representationOffice Holders

Change in %

representation

Number % Number % Number %

White 13 57% = 30 64% = 5 33% -22%

BAME 9 39% 2% 14 30% = 0% -18%

Not disclosed 1 4% -3% 3 6% = 10 67% 40%

Staff as at 31 March 2018 and percentage changes from 2016/17

The above table shows the percentage changes in

staffing in Barnet CCG and includes Office Holders. The

changes in percentage need to treated with caution as

they may indicate a small, or no, change in the numbers

of staff. Also, it should be noted that a large number of

Office Holders have not disclosed their ethnicity.

Progress summary

White staff in Bands 1-7 – no significant change

White staff in Bands 8a- VSM - no significant change

BAME staff in Bands 1-7 - increased by 2%

BAME staff in Bands 8a-VSM - no significant change.

The number of Office Holders that do not disclose their

ethnicity has increased by 40%. Currently the data is

showing that there are no BAME Office Holders, however,

we know this is not the case.



27


Breakdown of workforce by protected group as at 31st March 2018 and comparison with NCL CCGs average

Age group BCCG NCL CCGs

Under 31 4% 10%

31 - 40 23% 31%

41 - 50 25% 30%

51 and above 47% 29%

Sexual Orientation BCCG NCL CCGs

Gay 1% 4%

Lesbian 0% 1%

Bi-sexual 0% 0%

Heterosexual 74% 72%

Do not wish to disclose 24% 23%

Marital Status BCCG NCL CCGs

Divorced 1% 5%

Married 66% 46%

Single 29% 41%

Legally Separated 0% 1%

Civil Partnership 0% 1%

Widowed 0% <1%

Unknown 4% 7%


Disability BCCG NCL CCGs

Yes 6% 3%

No 66% 72%


Gender BCCG NCL CCGs

Female 80% 70%

Male 20% 30%

Religion/Belief BCCG NCL CCGs

Atheism 11% 15%

Buddism 0% <1%

Christianity 33% 37%

Hinduism 11% 7%Do not wish to disclose my

religion/belief 27% 26%

Islam 6% 5%

Jainism 1% 1%

Judaism 6% 2%

Sikhism 0% <1%

Other 4% 7%

Key highlights• The CCG employs more disabled staff (6%) compared with the NCL average.• Nearly 50% of all staff are over the age of 50 years old.• Female staff represent 80% of the total workforce, compared to 70% across NCL• LGBT staff represent only 1%, compared to 5% in NCL.

28


WRES Indicator 9: Percentage difference between the organisations’ Board membership and its overall workforce

2016-17 2017-18 DemographyComparison with local

demography

Comparison with

CCG workforce

GB

Members

CCG

Staff

GB

Members

CCG

Staff

White 55% 60% 67% 61% 64% 3% 6%

BAME 18% 34% 7% 33% 36% -29% -26%

Not

disclosed 27% 6% 27% 6% N/A N/A

Key highlights

• The above information is based on Barnet CCG’s voting

members and staff that are employed by Barnet CCG (excluding

office holders).

• There is an underrepresentation of BAME members on the

Governing Body reported compared with the local BAME

population and the CCG workforce and the NCL CCGs’

average.


Governing Body Members ethnicity data as at 31 March 2018 compared with the local population and the CCG

workforce

29


Training WRES Indicator 4: Compare the data for White and BAME staff: Relative likelihood of staff accessing

non-mandatory training and CPD


63%

35%

2%

Non-mandatory training and CPD in NCL CCGs by ethnicity

White BME Do not wish to disclose

Both White and BAME staff have accessed non-mandatory training and CPD in 2017/18. However, as the number of staff accessing non-mandatory training and CPD is very small in Barnet CCG we have aggregated the figures of all NCL CCGs which look more meaningful.

BAME staff in NCL CCGs are almost half as likely to access non-mandatory training and CPD compared with White staff


Barnet CCG monitored the diversity information of all new recruits in 2017/18 and the following are some key findings:

Disability: 6% of our total new recruits had a disability

Age: 35% of all new recruits were aged 50 and above

Gender: Female new recruits represent 67% of the total staff recruited in the year.

Sexual orientation: Heterosexual new recruits represent 82% and gay 6%.

Marital status: 47% are married and 35% single

Religion/belief: Most staff were recruited from Christian (26%), Atheist (26%) and Hindu backgrounds (12%)

Race: See the next slide

Barnet CCG follows the NHS Recruitment and Selection Policy and the terms and conditions set out in Agenda for Change. We monitor

diversity data of all applicants who apply for jobs and those who are shortlisted and appointed. However, we do not monitor equality

information of temporary or agency staff. The following data, therefore, is not necessarily indicative of any trend in recruitment but

merely reflects the data of protected groups from 1 April 2017 to 31 March 2018. When recruiting staff we ensure:

• We monitor the diversity data of all applicants

• Our panels are fully trained and are aware of our equality commitments

• We follow the best practice e.g. Two Ticks symbol (positive about disabled people)

31

Recruitment from 1 April 2017 - 31 March 2018 by ethnicity

Ethnicity Applicants Shortlists Appointments NCL CCGs

average

White 354 36% 77 22% 21 27% 19%

BAME 570 57% 86 15% 10 12% 14%

Not disclosed 72 7% 9 13% 3 33%


As shown in the above table, we have analysed the

recruitment data on White and BAME staff and

those who did not declare their ethnicity by

comparing the with the BAME applicant data and

the BAME appointment data with the BAME

shortlist data. The same has been applied to

applicant, shortlisting and appointments information

for White staff.

WRES Indicator 2: Compare the data for White and BAME staff: Relative likelihood of staff being appointed from

shortlisting across all posts

In 2017/18 Barnet

CCG employed 44

staff BAME staff were

2.25 times less likely

to be appointed

compared with White

staff. This has

improved from 3

times less likely in

2016/17.

In NCL CCGs, White staff were 1.36 times more likely to be appointed compared with BAME staff


Recruitment of staff by protected characteristic (from 1 April 2017 to 31 March 2018

67%

33%

Recruitment by gender

Female Male

6%

82%

12%

Recruitment by sexual orientation

Gay Heterosexual Do not wish to disclose

6%

88%

6%

Recruitment by disability

Yes No Do not wish to disclose

6%

32%

27%

35%

Recruitment by age

Under 31 31 - 40 41 - 50 51 - 60

6%

47%35%

12%

Recruitment by marital status

Divorced

Married

Single

Civil Partnership

Widowed

Do not wish todisclose

26%

26%12%

9%

6%

3%

18%

Recruitment by religion/beliefAtheism

Christianity

Hinduism

Do not wish to disclosemy religion/belief

Islam

Jainism

Other

33


WRES Indicator 3: Compare the data for White and BAME staff: Relative likelihood of staff entering the formal

disciplinary process, as measured by entry into a formal disciplinary investigation (This indicator will be based on

data from the most recent two-year rolling average).

50%

40%

10%

Disciplinary cases in NCL CCGs by ethnicity

White BME Do not wish to disclose

Barnet CCG monitors all disciplinary cases based on protected characteristics. Where the number is less than 5, the CCG will not declare the number in this report to maintain the anonymity of the individual/s concerned.

The number of disciplinary cases across NCL is small and this can make a significant difference in the percentage, therefore, the figures provided need to be treated with caution. The 2017/18 data shows that BAME staff were less likely to enter formal disciplinary investigations than White staff. However, when compared with the percentage of staff across the NCL CCGs it appears disproportionate. For example across NCL CCGs BAME staff represent 27% of the total workforce but they represent 40% of the staff that entered into a formal disciplinary.

34

Staff Survey (WRES Indicators 5-8: Compare the outcomes of the responses for White and BAME staff)


Staff Survey indicator (WRES) Ethnic Group Barnet NCL CCGs average

Indicator 5- KF 25. Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months

White 29% 13%

BME 10% 13%

Indicator 6- KF 26. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months

White 33% 30%

BME 55% 41%

Indicator 7- KF 21. Percentage believing that trust provides equal opportunities for career progression or promotion

White 67% 74%

BME 33% 27%

Indicator 8- Q17- In the last 12 months have you personally experienced discrimination at work from any of the following? Manager, Colleagues

White 10% 11%

BME 32% 23%

Percentage of CCG staff that said ‘YES’ to the WRES questions in the 2017 staff survey

Figures show staff experience of the CCG compared with their counterparts (e.g. White/BAME).

• More White staff reported that they had experienced bulling, harassment and abuse from relatives than BAME staff.

• More BAME staff reported that they had experienced bulling and harassment from staff compared to White staff.

• More BAME staff reported that they had experienced discrimination from colleagues and managers than White staff.

35

Appendix 2: WRES Indicators

2017 updated WRES include:

Indicators: 1-4- Workforce indicators,

5-8: Staff survey indicators, 9: GB

(Board) Members indicator

The aim of the WRES is to help NHS organisations improve their race equality performance.

The standard is mandatory and CCGs are required to implement them in their own organisations and hold their providers to account.

WRES Indicators

36

Appendix 3: WRES Action Plan (2017-19) Progress Report

Indicator Action Outcome Lead Progress so far1. Percentage of staff in each of the AfC Bands 1-9 and

VSM (including executive Board members) compared

with the percentage of staff in the overall workforce.

(clinical and non-clinical)

Attract applicants from the local

community by publicising jobs

locally.

CCG jobs publicised through

local partners and community

organisations.

Workforce

Lead/Communi

cation &

Engagement

Lead

Action to be taken:

Vacancies are publicised through the communication and engagement team to

local community groups such as Patient newsletters, voluntary action groups,

disability group.

2. Relative likelihood of BME staff being appointed from

shortlisting compared to that of White staff being

appointed from shortlisting across all post (internal and

external)

Provide training to Governing Body

Members and staff on unconscious

bias and recruitment and selection

training.

Ensure, where possible, there is a

BME panel member on the selection

panel for positions in Band 8a and

above.

Likelihood of BME staff being

shortlisted and appointed

increased across all Bands to

a comparable level with White

staff.

Workforce

Lead/OD Lead

• Recruiting staff from BAME backgrounds to sit on interview panels for

certain posts in Band 8A+

• Advice, information and training provided to panel members to ensure

quality and equality of recruitment process.

• Monitoring the data annually which we publish in our WRES progress

report

Further action to be taken:

• Planning on delivering further unconscious bias training/Recruitment and

Selection training to all staff including GB members.

3. Relative likelihood of BME staff entering the formal

disciplinary process, compared to that of White staff

entering the formal disciplinary process, as measured by

entry into formal disciplinary investigations.

Continue monitoring all disciplinary

cases.

Disciplinary cases are dealt

with in a fair and consistent

manner.

Workforce

Lead

All policies including the disciplinary policy are Equality Impact assessed. HR

meet on a weekly basis to monitor/review all ER cases across NCL, Case

numbers are shared with key HR data on a monthly basis with EMT boards. In

addition we work in Partnership with our Union colleagues to map against

protected characteristics and provide data for action planning purposes.

4. Relative likelihood of BME staff accessing non-

mandatory training and CPD as compared to White staff.

Publicise non-mandatory training

and CPD programmes.

Encourage and motivate BME staff

through PDP & objective setting

Take up of non-mandatory

training and CPD increased.

OD Lead • Each PDP is being monitored and a Training Needs Analysis will be

created to produce an organisation OD plan. We will be monitoring training

requests for 18/19 and matching this against who can access and parity of

ability to access

Further Action to be taken:

• All training is advertised in Staff Comms, and Newsletters and the Intranet

• Monitor attendance lists against E&D data

5. Percentage of staff experiencing harassment, bullying

or abuse from patients, relatives or the public in last 12

months.

Continue offering equality and

diversity training

Promote dignity at work policy

through Board Development

Sessions and staff meetings

Celebrate diversity in the CCG to

raise awareness

Monitor all external and internal

recruitment activities

Reduced incidents bullying

and harassment in the

organisation.

More staff should feel that the

CCG is a fair employer

OD Lead • Corporate message about equality, diversity and inclusion highlighting the

CCG’s position and commitment to race equality.

• Staff Involvement Group is set up to take forward actions from the staff

survey results.

• Staff away day has taken place.

• OD leads have been appointed to take forward a OD plan, which include

an organisational training plan.

• WAP process to ensure all post are signed off and advertised

appropriately in NCL.

Further action to be taken:

• Training being rolled out across NCL for managers and staff re B&H

6. Percentage of staff experiencing harassment, bullying

or abuse from staff in last 12 months

7. Percentage believing that CCG provides equal

opportunities for career progression or promotion.

8. In the last 12 months have you personally

experienced discrimination at work from any of the

following: Manager, Team Leader, Other Colleagues

9. Percentage difference between the organisation’s

voting membership and executive membership of the

Board

Continuously review the makeup of

Governing Body voting members to

ensure race equality.

Update GB members ethnicity data

GB voting members reflective

of the staff and local

community.

Workforce/CC

G EMT

• The CCG is working to ensure the GB members reflect the community we

serve, and we are updating the ethnicity data across NCL every year to

monitor that.

• We will look to review Board composition and action plan against %

difference

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