Wandsworth CCG Public Sector Equality Duty Report 2015

Introduction and background

The Equality Act 2010 brings together all previous equality legislation in England, Scotland and Wales. The Act includes a new public sector equality duty (the equality duty), replacing the separate duties relating to race, disability and gender equality. The equality duty came into force on 5 April 2011.

The public sector equality duty requires public authorities, when carrying out their 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.

The protected characteristics under the Public Sector Equality Duty are:

  • Age
  • Disability
  • Gender reassignment
  • Pregnancy and maternity
  • Race – this includes ethnic or national origins, colour or nationality
  • Religion or belief – this includes lack of belief
  • Sex (male & female)
  • Sexual orientation
  • Marriage and civil partnership, but only in respect of the requirement to have dueregard to the need to eliminate discrimination.

Public bodies must be transparent about how they are responding to the Equality Duty, and are required to publish relevant, proportionate information showing compliance with the Equality Duty.

This report produced by the Patient and Public Involvement and Equalities team at the CCG, outlines how Wandsworth CCG is complying with these requirements. It sets out our achievements in the last year, and the areas identified for improvement and further development.

About Wandsworth CCG

Wandsworth Clinical Commissioning Group (CCG) was formally authorised to be the body responsible for delivering the new healthcare reforms and commissioning functions for health services across Wandsworth on 12th December 2012. It is co- terminus with the London Borough of Wandsworth but also looks after an additional 71,000 patients who are registered with a Wandsworth GP but who live outside the Borough.

Other CCGs in South West London include Croydon, Kingston, Merton, Richmond and Sutton CCGs. Wandsworth’s CCGcomprises 3 locality commissioning groups (LCGs) Battersea, Wandle and West Wandsworth. These locality commissioning groupsare broadly co-terminus with previous local health groups.These commissioning groups work together to help manage local budgets and commission services for patients.

Running alongside CCGs are the Health and Wellbeing Boards which remove divisions between the NHS and local authorities and give communities greater say in the services needed to provide care for local people. The boards also bring together those who buy services across the NHS, public health, social care and children’s services, elected representatives and representatives from HealthWatch to plan the right services for their area. They will look at all health and care needs together, rather than creating artificial divisions between services.

The core business areas within the organisation are:

  • Commissioning healthcare services on behalf of the population of Wandsworth.
  • Improving the health and wellbeing of the population of Wandsworth and reducing inequalities in health.
  • Coordinating and developing health services provided by primary care contractors –e.g. GPs, dentists, pharmacists and optometrists.

Wandsworth’s work with the local authority is working to integrate services, including:

  • combining health and social care support for dementia suffers to reduce hospital readmissions
  • improved communication between health and social care professionals to enhance the support package offered to vulnerable members of the community
  • fast-tracking learning by integrated public health teams in local authorities
  • Joint Strategy Needs Assessment as the driver of clinical priorities
  • Health and Wellbeing Strategy with key themes
  • Integration
  • Resilience
  • Prevention
  • Transformation of out-of-hospital care through our Wandsworth Council integration work-stream “Planning All Care Together” or PACT
  • Improvement and development of primary care
  • Using the voice of patients to influence our commissioning intentions

Our Vision

The vision of the CCG is: “Better care and a healthier future for Wandsworth.”We will achieve this by being Patient focused, Outcomes driven, Principled; Collaborative and Progressive & Professional.

Health of Wandsworth

As a large inner London borough, Wandsworth has some unique challenges in relation to healthcare provision. Some of these key challenges are:

  • There are higher proportions of younger adults (20 – 44) living in the borough than anywhere else in England.
  • The borough is more ethnically diverse than the national population
  • The population is highly transient, more so than the national population with the patient population changing 30% each year
  • Wandsworth varies widely in its level of deprivation - ranging from the very affluent to the very deprived

Further information about our borough and the health of Wandsworth is available here.

Our Staff

Wandsworth CCG is committed to recruiting, developing and retaining the best workforce to make sure we provide high standards of healthcare. We believe in valuing, developing, communicating and consulting with our staff.

Workforce profile

In post headcount
Excluding Governing Body Members / WTE excluding Governing Body Members
99 / 86.90

These figures do not include interim contractors or agency workers.

Please note that Governing Body Members are Office Holders and not employees.

Equalities profile

The following tables are a snapshot profile of the organisation (by percentage), relating to six of the nine protected characteristics as at 30th September 2015. Monitoring will continue to identify any priority areas to address.

Equality and Diversity at Wandsworth CCG

Our equality and diversity activities are closely aligned to our vision, strategic objectives and commissioning intentions. We design, develop and implement our equality actions in close collaboration with patients, users and community organisations, all our actions are outcomes driven and we regularly monitor and assess our performance in close partnership with the different communities we serve. With their support, the CCG is becoming increasingly aware of the impact of commissioning activities on different protected groups, we know where we are making progress and now have a better understanding of the areas we need to improve and develop further.

We deliver on our equality and diversity priorities with support from the Thinking Partners Group (TPG) which is made up of representatives from local community groups, HealthWatch, Expert Patients, the third sector, carer groups, and senior staff from the organisation and from Public Health.

To ensure Wandsworth CCG meets its statutory equality duties under the Equality Act 2010 we use the Equality Delivery System (EDS)[1] to develop a strategic approach. We have been using the EDS since 2011 and is a tool or framework created by the NHS to help local NHS organisations, in discussion with local partners including local populations, review and improve their performance for people with characteristics protected by the Equality Act 2010. There are 4 goals to the EDS (we are now on EDS2 which came out in November 2013 – which is simpler and more user friendly).

–Goal 1 - Better Health Outcomes

–Goal 2 - Improved Patient Experience

–Goal 3 - Representative and supportive workforce

–Goal 4 - Inclusive Leadership

Since 2011

  • We have confidently and firmly established the Thinking Partners Group as partners in driving equality and diversity into the heart of the organisation. It does this through critical friendship, bringing local intelligence to meetings, helping us to shape and implement our equality priorities, and assessing our performance.
  • Each year we organise an EDAY (Equality Action, Delivery YES!) event in partnership with the TPG, bringing community groups, patients, carers and users together with the CCG’s senior leadership team and staff to discuss and assess our equality performance using the Equality Delivery System (EDS) framework. We use this opportunity to share our experiences and learning around equalitiesand to identify priorities for the coming year.
  • Now in its fourth year, we launched the Community and Seldom Heard Groups Grant Scheme to ensure that the needs, views and priorities of hard to reach organisations are considered and fully embraced within NHS services.
  • In 2014, equality and diversity in the CCG was given a higher profile by the Board with the Chief Finance Officer being appointed to oversee the equality and diversity function. Together with the Chief Officer of the CCG, they play an active role in shaping our priorities and encouraging local community organisations to work with the CCG to address health inequalities.
  • More and more GP locality leads and locality groups are also taking an active role in equality and diversity issues in Wandsworth. GPs regularly visit community organisations and patient groups, building their knowledge base and gathering local intelligence to inform and improve service delivery across their practices.
  • There is a good Interpreting and Language Translation Service for Hearing People and People with Sensory Impairment (British Sign Language) running at GP practices, Dental Practices, Pharmacy Contracts and Ophthalmic Practices in Wandsworth, a service valued by patients and service users.
  • An independent audit of the CCG HQ building was done for the CCG by a member (wheel chair user)of the Disability and Social Care Advice Service in October 2015. Following the visit a report was submitted to the CCG for consideration, with a number of recommendations outlined.
  • More and more staff are accessing equality and diversity training both online and at developed sessions focusing on CCG issues and priorities.
  • We have established successful Learning Lunches”, with staff ( and representatives) attending presentations by community partners about their work and projects. This facilitates a conversation between the CCG and the presenting organisation.

The following now captures our performance in 2015 – 2016.

Our Equality Report for 2015 - 2016

At last year’s EDAY event which took place in October 2014, community organisations, patients and users, identified health inequalities as a key area for the CCG and the Council to focus on. Many wanted to be involved in developing a model for co-producing services in close partnership with community groups, patients, users and carers; more community groups to be commissioned to deliver local services – and to keep service deliver local, diabetes, GP services, communication, having a more visible leadership were all identified as areas for further development. A detailed work programme wasdeveloped; see Appendix A and B, now using the EDS2 to report on our position and performance to date.

Wandsworth CCG’s position

Confirm governance arrangements and leadership commitment: The Chief Finance Officer was appointed Equality and Diversity lead and as such Chair of the Thinking Partners Group (TPG), working closely with community, seldom heard groups, volunteers and patient representatives.He also provides leadership on a programme of work including addressing health inequalities and the Health and Wellbeing Strategy.

The TPG continues to be the main vehicle through which the CCG develops and facilitates its equality and diversity priorities. The TPG reports formally to the Board via the patient and public involvement reference group (PPIRG). The PPI Reference Group provides support to ensure the voice of patients and the public are embedded in the work of the CCG. This group monitors the work of the Clinical Reference Groups and Locality Commissioning Groups, challenges in areas where PPI has not been considered and offers expert advice where needed. The PPI Reference Group is chaired by a Lay Member of the Board.

There is an Equality and Diversity Work Plan in progress and the CCG board is committed to improving the systems and framework for embedding equality analysis into the CCG’s planning and decision making processes. In practice this would mean that all Board reports, service improvement plans, policies and projects presented to them for approval or decision will need to include a detailed equality analysis before submissions are approved.

Identify local stakeholders: The Thinking Partner Group, the PPI Reference Group, PPI forums, community and faith based groups actively work with the CCG to embed equalities across all CCG activities. Through the Seldom Heard Grants scheme, the CCG continues to identify and work with a range of community groups. It has identified the need to diversify its reach into other communities, these include disability groups, Polish, Muslim, Somali and new communities in the borough.

Assemble evidence: The evidence is summarised in our equality and diversity work planprogress report, feedback from the annual EDAY events, reports from CCG commissioners and within our equality and diversity engagement activities to reduce health inequalities.

Agree roles with the local authority:There is now a Local Authority Public Health representation on the Thinking Partner Group and involvement in EDAY.

Analyse performance: Our Annual EDAY event helps us monitor, analyse and assess our equalities performance.

Agree grades – The Action Plan is work in progress. Our grades will be finalised at our March 2016 TPG meeting. Our grading will be as follows:

  • under-developed – still have a very long way to go and no evidence available and no protected group fares well
  • developing – only a few protected groups are benefiting, and evidence is limited
  • achieving– most protected groups fare well as others in the community and there is evidence to support
  • excelling – all protected groups fare well, with evidence to support

Prepare equality objectives and more immediate plans:This year, our EDAY event took place in November (2015), where our equality performance was assessed by patients, users, community groups. The action plan has now been reviewed; new priorities have been identified, and will be incorporated into our equality objectives.

We will work with commissioners to mainstream our objectives into future business plans.

The CCG will publish revised plans and include a report in the CCG Annual Report as agreed in the action plan.

  • Appendix A – Sets out our equality and diversity objectives for 2015 – 2018 and our current performance and progress.
  • Appendix B –Sets out potential new priorities to meet our Equality Objectives (to be agreed but based on priorities identified at EDAY 2015).
  • Appendix C – outlinesour engagement activities this year that contributes to reducing health inequalities.
  • Appendix D – provides examples of a range of commissioning activities which support and advance equality and diversity.

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APPENDIX A - Wandworth CCG Equality and Diversity Objectives - January 2015 – January 2018

EDS Goal / Priority Area / Action needed / Associated tasks / By Whom / Date / Progress – EDS Grade
EDS Goal 1
Better Health Outcomes for all / Improve Communication / We need to do more to help different communities understand what the CCG does, including the range of services on offer and how to access them. As part of this the CCG:
a)works with local community to identify actions which help to improve communication with local people, users, patients etc
b)provides support and training to CCG staff so they provide clear, accessible and appropriate information to local people
c) will help understand where the social care functions sit. There is the need for patient awareness and education and for information to be provided better across community, patient groups, hospitals, GP practices etc. To work with Local Council on this. / Further programme of WHIZ roadshows in community settings (Monthly)
Further programme of CCG Market Stalls to take place on monthly basis, this includes setting up a stand in the local supermarkets.
Develop an introduction to communication skills, with focus on NHS branding, and writing skills
Discuss with Comms team the need to develop and awareness campaign and discuss further with joint commissioning leads.
Identify from public what their needs are in terms of understanding the social care function.Develop and roll out programme of awareness as appropriate. / Lead – PPI and Comms Team
The Thinking Partner Group (TPG)
Involve the Locality Authority in raising patient awareness and education in terms of the social care function. / From April 2015, and then ongoing / Achieving.
-Our programmes of WHIZ events ,market stalls and learning lunches are now well established
- Our staff have access to E and D Leads via the TPG to community organisations.
- We continue to develop our communications activities to ensure that patients understand how health and social care are developing and changing.
Co-production of health services with patients, users, carers and local communities. / Dedicate some TPG meetings to help the TPG come up with a co-production model
To encourage CCG staff/commissioners to involve the TPG in shaping, designing and production of services right at the beginning and not simply consult when decisions have been made / Set up co-production workshop for Thinking Partners Group and commissioners.
Encourage Commissioning Leads to attend Thinking Partners Group and get feedback and input from the group.
Encourage recruitment from Thinking Partners group to participate in redesign exercises
Encourage service redesign managers and commissioners to share with TPG any initiative/projects for the TPG to comment on gaps, ensure health inequality is considered
Embed co-production model in the PPI toolkit. This can then be promoted widely across wider health services (example of good practice) / PPI Team / Schedule a discussion at the March 2016 TPG meeting and then ongoing / Achieving
There is now more dialogue between managers and community organisations via the TPG, Learning Lunch’s, Market Stalls and WHIZ events.
Co-production activities are taking place through the Community Seldom Heard Grant Scheme.
Preventative Health – work with communities to help them get better at preventing ill health and improving their well being / To continue to contribute to the development and implementation of the Health and Well Being Strategy
Continue to develop innovative approaches and actions to address Health Inequalities and feed this into the strategy and commissioning process. This will be a long term plan.
To intensify activities to prevent poor health and improve well-being by identifying gaps in workplans. / Identify Tier one activities from CRGs
To continue to contribute to HWB strategy.
Invite CRG leads to use TPG to help address gaps.
In collaboration with the CCG, use the Seldom Heard Grants Scheme to focus on health inequalities / PPI team with CRG leads / This is a long term strategy and work plan
Started February 2015 and then ongoing / Achieving
The Chief Finance Officer represents the CCG on the Health and Wellbeing Board.
All staff including Clinical Reference Group Leads are increasingly using the TPG to help address gaps in services.
The SHG Scheme 2015 focused on Health Inequalities and 12 community schemes established as a result.
EDS Goal 2
Improved Patient Access and Information / Access to Information / Set out a plan and activities for how CCG will communicate and involve diverse community groups, as well as share the changes/improvements it makes.
Set out a plan and activities for how CCG will receive and take action on feedback we receive from diverse community groups and use this to improve services.
Increase diversity of the intelligence we use to improve services. Need to understand what intelligence is available and then work with TPG and other patient groups to collate other information
Empowerment of local patients, users, communities, carers. As part of this to a) take education to churches, leisure, work, office, schools, pre-natal groups
b) take diversity training to community
c) advertise on non-terrestial channels, eg ethnic channels, snapshot stories, telling stories of different experiences / Develop a comms plan
See goal 1, action 1: Enable participation from community groups in WHIZ roadshows.
Ensure TPG members are invited to market Stalls
Develop audit on how we gather information to improve services.
Develop training package or toolkit for Thinking Partners so they can deliver E&D messages in their communities / Comms and PPI team
CCG lead for Market stalls / From April 2016 onwards / Developing (See EDS Goal 1 re: WHIZ and Market Stalls.
EDS Goal 3
A Representative and Supported Workforce / Get more staff out into the community / Commissioners to outline how they will be get closer to local communities, involve them more dynamically in their activities
Create a plan for how different staff across the organization will communicate, meet, involve and engage local communities. TPG can help with the plan / Consider the further roll out of GP Visits
Continue to develop Corporate Social responsibility policy and related activity and develop further work experience initiative(CS to look at again)
Identify and support male staff to participate in the Men’s health forum
Invite commissioners to attend TPG meetings as guest speakers
See market stalls events in Goal 1 / Chief Finance Officer and GP lead in PPI team / Ongoing / Achieving
Community Group visits by GPs are scheduled to take place in March 2016
One new male member for staff has joined the Mens Health forum, other male staff are being encouraged to participate
Commissioners now regularly attending TPG
EDS Goal 4
Inclusive Leadership / More Visible Leadership in the community / Senior team to set out their strategy and actions they will take to improve their visibility in the local community / Ask Board members to identify Equality issue priorities.
Invite Board members to attend Thinking Partners Group meeting and share their priorities with the group (for their input and before the plan is finalized) / Chief Officer and Chief Finance Officer / January 2016, then communication to TPG

APPENDIX B - Priorities identified at EDAY 2015 to inform potential priorities for Wandworth CCG Equality and Diversity Objectives - January 2015 – January 2018