NHS Highland Race Equality Scheme 2008 - 2011
Appendices
Appendix 1 / NHS Highland Action Plan 2008 – 2011 / Page 2Appendix 2 / Background information: The
Population of the NHS area / Page 29
Appendix 3 / Race Equality in the Highlands: Survey Results / Page 41
Appendix 4 / NHS Highland’s Progress against previous action plan / Page 50
Appendix 5 / NHS Highland EQIAs / Page 74
Appendix 6 / Workforce Monitoring Statistics / Page 77
1
Appendix 1
2008 – 2011 action plan
For all new actions an EQIA will be carried out to ensure that the specific pieces of work are free from any negative impact upon BME individuals or any other group in the community who may experience discrimination, and do all they can to promote good relations and equality.
Action 1 - Responding to the needs of our community
Every action in this RES can only be successfully achieved if there is an understanding that the views of patients, their families, carers, staff and any other person in the community are heard and responded to. This requires us to have an understanding of our community and have effective channels of communication and consultation that reach BME individuals in our community. To support this, it is imperative that we work in partnership with other public agencies and organisations across Highlands to share key information and best practice, avoid over consultation with community groups and share work load. This is the foundation of making sure the work contained within this RES is delivered appropriately, fairly and sensitively.Linked to previous action: 2 and 21 (appendix 4)
Supports:
Duties:
Eliminate unlawful discrimination
Promote equality of opportunity
Promote good relations between people of different racial groups
Policy and Service Delivery / Our roles:
Improving health
Planning and providing health care
Employer role
Public sector organisation and partner
Involve patients and carers and the design and delivery of services.
Action / Status / Expected outcome / Responsibility / Achieved by
1.1 Collect the views and opinions of service users and staff and react to the feedback received. There are 4 levels at which this will be sought:
1.1a Staff and patients will be encouraged to give ongoing feedback at any point in the service.
1.1b Patient satisfaction audits and surveys developed in house are implemented with cultural competence to make sure that the opinion and feedback of the diverse population is heard
1.1c National patient surveys are used and implemented with cultural competence in NHSH - to make sure that the opinion and feedback of the diverse population is heard / Ongoing / BME populations feel able to report any issues with health care in the highlands.
The organisation can provide evidence to show that services have changed and developed as a result of feedback from BME individuals and groups
Monitoring data shows that the
BME individuals have been involved (or invited to be involved) in any consultation process.
The Patient Experience questionnaire and Staff surveys show that individuals feel that opinions and views are valued and reacted to. / Gill Keel
All staff
Gill Keel / Ongoing
Action / Status / Expected outcome / Responsibility / Achieved by
1.1d Effective communication channels are maintained with BME individuals and groups to ensure that the delivery of health care is appropriate and that BME individuals are provided with accessible information about the services we provide. / NHSH services respond to feedback from BME individuals and communities and can evidence change in practice as a result. / Gill Keel
Esther Dickinson / Ongoing
1.2 Continue to work in partnership with voluntary and public agencies across Highland / Ongoing / Work is co-ordinated between partners to achieve efficiencies, avoid duplication and reduce work load. Evidenced by a yearly list of outputs driven by community need and delivered in partnership with Highland organisations. / Moira Paton / Ongoing
Action 2: Increasing access and removing barriers to all NHSH services
This action concentrates upon 5 key areas that staff from all service areas can develop in order to remove any barriers to services experienced by any individual. These areas include: developing systems for monitoring patient ethnicity, carrying out EQIAs, providing an interpreting service, providing a translation service and training our staff.Linked to previous Action 2,3 ,7,20 ( appendix 4)
Supports:
Duties:
Eliminate unlawful discrimination
Promote equality of opportunity
Promote good relations between people of different racial groups
Policy and Service Delivery / Our roles:
Improving health
Planning and providing health care
Action / Status / Expected outcome / Responsibility / Achieved by
2.1 Patient monitoring
- Equality Profiling of all service users is carried out at point of entry into service and analysed by NHSH
New action / Targeted work can be undertaken where it is identified that our patient profile does not fit what we know of our population
- We can provide examples of positive action based on equalities profiling undertaken by NHSH
Data Information and Implementation network / 2010
2009
Action / Status / Expected outcome / Responsibility / Achieved by
2.2 EQIA
EQIA training is delivered across Highland to develop staff skills in carrying out assessments
- 40 staff a year receive training in EQIA delivery
- 35 new EQIAs are signed off and published each year
- All EQIAs are quality assured and published online
2.3 Interpreting
A partnership contract for the provision of an interpreting service is signed and agreed.
All services across Highland receive information in how to effectively work with interpreters via a revised guidance document, supporting materials and training. / Ongoing
Ongoing / Any patient that needs an interpreter is offered one for every appointment evidenced by:
- An increase in usage following the launch of the new guidelines and information.
- Positive feedback from the Polish and Chinese association members and other BME groups
- A decrease in problems fed to the team arising as a result of interpreting booking and usage.
- An evaluation of the service shows positive feedback from both staff and patients.
2009
(Ongoing monitoring)
Action / Status / Expected outcome / Responsibility / Achieved by
A system is put in place to track any patient with accessibility needs (including interpreting) through the whole service / Any patient who requires an interpreter is recognised within the system and an interpreter is provided along with any appointment. / Esther Dickinson and Natalie Morel / 2010
BME individuals have access to ‘interpreting cards’ that they can hand to any member of staff to inform them of the need to book an interpreter and the language required. / Patients are supported to request an interpreter whenever one is needed.
- Feedback from staff members that the cards are being used by their patients
- Feedback from the Polish and Chinese association members and other BME groups that they have found them useful
- A decrease in problems fed to the team taking forward the E&D agenda, arising as a result of interpreting booking and usage.
Action / Status / Expected outcome / Responsibility / Achieved by
2.4 Translation
A partnership contract for the provision of translated information across NHSH is signed and agreed – this ensures NHS staff have one company to approach when they are producing translated information. / New action / Staff are able to supply existing translated materials or produce new materials for any patient who needs it. Evidenced by:
- The number of new translated materials held in the data base.
- Community feedback shows that information is being offered in appropriate formats.
Translation organisation / July 2009
The company awarded the contract manages one central data base of materials translated over the period of the contract - accessible by partnership agencies in Highland /
- The number of ‘hits’ on the webpage holding translated information increases.
Translation organisation
An online resource is developed within NHSH holding both old and new translated information – accessible to both staff and patients.
(Other mechanisms to access this information will also be developed for anyone not in the intranet) /
- Community feedback shows that information is being offered in appropriate formats.
- Staff feedback indicates that translated information is easy to find and relevant to their work
Shirley Noble Esther Dickinson / Dec 2009
Action / Status / Expected outcome / Responsibility / Achieved by
2.5 Training
A comprehensive timetable of training is offered and evaluated throughout the year in NHS Highland. This will be delivered at a variety of times and in different formats to suit staff need. Training will cover:
- Core Principles of E&D
- Accessibility
- Interpreting best practice
- EQIA training
- E&D for Trainers
- E&D for HR
- Inequalities in health and its relationship to Equality and Diversity
- Staff choose to access training and development opportunities in creative ways across NHS Highland.
- Staff feed their work back to the community and Health Improvement planning team for upload to the staff Equality and Diversity page to share good practice.
- CHP and Raigmore managers can report areas of good practice within their services
Raigmore
Andrew Ward
North CHP
Sheena Craig
Mid CHP
Gill McVicar
SE CHP
Nigel Small
A&B CHP
Caroline Champion
Pan Highland Staff
Esther Dickinson / Ongoing
Action / Status / Expected outcome / Responsibility / Achieved by
A framework to support staff to take ownership of their own development around the E&D agenda is developed. Guiding staff towards training, resources and best practice to encourage change in work place practice.
An E&D checklist for all staff delivering any training across NHSH is developed and agreed organisation wide.
Work with the Learning and Development team to develop a system to evaluate the effectiveness of training delivery Highland wide / All training is designed and delivered in a culturally sensitive and supportive way
Staff will receive training which is culturally sensitive and supportive.
Feedback/evaluation at all levels showing how learning has been applied in the workplace to improve experiences for patients and staff from BME communities and is integrated throughout all training opportunities. / Esther Dickinson
Judith Mackelvie
Paul Maber
Michelle Williams / June 2009
Jan 2009
Sept 2009
Action / Status / Expected outcome / Responsibility / Achieved by
2.6 Focused pilot
One service (the Chemotherapy Unit at Raigmore Hospital) has been chosen to focus upon all activities covered above (2.1 – 2.5).
The chemotherapy unit has been identified due to staff commitment and the discrete nature of the unit
Within the unit staff will be supported to identify how Equality and Diversity can be embedded into their practice in relation to:
Monitoring, EQIAs, Interpreting
Translation and training / Lessons will be learned from this piece of work. From this we will identify strategies to introduce sound E&D practice to all services
Improvements to the service and best practice will be identified. This will be shared with the management team in Raigmore Hospital to encourage other units to see the benefit of this work.
Learning points will be shared; online, via word of mouth, at presentations and in articles.
Best practice will be drawn up and a second area will be identified to take on this work. / Andrew Ward
Nichola Summers / Dec 2009
Action 3: Achieving our duties as an employer
Delivering fair and sensitive services is not only about supporting patients but also about supporting employees. For this action we have promised to address any inequalities as they arise from analysis of our staff monitoring data. This includes data for potential employees and employees leaving NHS Highland, in addition to data relating to significant events that can happen while at work, such as grievances or training. We also need to ensure that all of our policies and processes are written and applied in such a way as to support employees in all ethnic groups. This action is designed to assure ourselves that the way in which we advertise jobs, select, recruit and support our staff to fulfill their potential is fair and sensitive.Linked to previous actions 18,19 (Appendix 4)
Supporting data for these actions are attached in appendix 5.
Supports:
Duties:
Eliminate unlawful discrimination
Promote equality of opportunity
Promote good relations between people of different racial groups
Employment / Our roles:
Employer role
Action / Status / Expected outcome / Responsibility / Achieved by
3.1 Equality and diversity employment action plan:
Data –staff in post
The data is used to inform investigation into specific job families and work units. To increase the return rate, promotional materials are being prepared in advance of the next mail out.
3.2 Applications for employment and promotion
Applications are analysed and entered on to a local database.
3.3 Applications for and participation in learning and development
AT Learning system (AT-L) allows adequate monitoring of applications. Before AT-L is fully functional attendance sheets are being used for monitoring. (This links to the training section in action 2) / Ongoing / 100% of staff will have returned their SWISS monitoring data
There will be a better understanding of the distribution and levels of staff from different ethnic groups. NHSH will be able to ensure that there is a diversity of staff, reflective of the local community in different job families and units.
A complete dataset will allow NHSH to better use different and varied channels of advertisement, ensuring that under represented groups can access vacancies.
Analysis at present shows that study leave forms broadly fall in line with what is shown on SWISS returns. The response rate for SWISS is actually much lower so achieving better SWISS response rates and standardizing returns will support future analysis. / For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum) / Next Mail out Dec 2009
Ongoing thereafter
Action / Status / Expected outcome / Responsibility / Achieved by
3.4 Performance assessment procedures
Senior manager staff groups and executive cohort data has been analysed and incomplete returns will now be targeted
3.5 PIN policies: Grievance and discipline
Annual analysis of the grievance and discipline ethnicity data. Most recent data shows that staff subject to disciplinary procedures are far more likely not to have their ethnic background data held.
3.6 Staff who leave NHS Highland employment
Monitoring data is in place and is published annually, which informs positive action to increase retention rates. / Ongoing / A full dataset will allow some analysis of this small staff group to inform understanding about access to these roles from equality groups.
From targeting low return areas, we can better analyse and address grievance issues.
The exit interview process also provides qualitative data to improve retention and identify and problem areas in the organisation. / For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum) / Ongoing
Ongoing
Ongoing
Action / Status / Expected outcome / Responsibility / Achieved by
3.7 PIN policies: Equal opportunities policy
The Equal opportunities policy was to be re-launched with a different heading, but this outcome will now follow on from the national review and impact assessment.
3.8 Promoting equality and diversity in our role as an employer
Ensuring all employees can access and provide pertinent information through appropriate use of interpretation and translation
3.9 Reporting and monitoring arrangements
Data is analysed and published on a quarterly basis and positive action publicized / Ongoing / All employees are aware of NHS Highland’s commitment to Equality and Diversity and know how this affects them as employees.
Employment rights and responsibilities are embedded in our Equality and Diversity work.
Employees are aware of the importance of gathering data and can see how positive change can impact on them as a result of data analysis. / For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum) / TBC – awaiting national guidance
Ongoing
Ongoing
Action / Status / Expected outcome / Responsibility / Achieved by
3.10 Governance arrangements
Clear governance arrangements are already in place for reporting through the Highland Partnership Forum network. These will be maintained and improved to ensure adequate publicity for action / Ongoing / All employees are well informed and involved in decisions affecting them / For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum) / Ongoing
3.11 Recruitment and selection
To achieve this targeted advertising will be explored, following the example set by Diversity Champions model with support from Stonewall.
To achieve an inclusive interview process, managers will be trained in interview skills and equality and diversity / Diversity of the workforce reflects the ethnic diversity of our community
Action / Status / Expected outcome / Responsibility / Achieved by
3.12 PIN policies
PIN policies are being reviewed and impact assessed nationally. Locally NHS Highland will follow up this process to ensure that they meet the requirements of local impact assessment procedures and thus can deliver our employment duties adequately. / Ongoing / PIN policies will support all staff adequately and awareness of PIN policies will be raised for all staff. / Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum) / TBC – awaiting national guidance
3.13 Other HR policies
All new policies and policies for review that reach the HR sub group are being impact assessed. All existing employment policies and practices have been impact assessed and are race sensitive. Monitoring is in place to ensure all policies are applied equitably. / All of our employee policies are equipped to support all members of staff. Monitoring shows that there is equitable uptake of HR policies. / Ongoing
Action 4: Procure goods and services equitably