NHS Lothian Disability Equality Scheme 2009-12

NHS Lothian Disability Equality Scheme 2009-12

NHS LOTHIAN

Disability Equality Scheme 2009-12

Contents

Glossary of words and phrases………………………………………….3

Executive summary……………………………………………………….5

Introductory statements…………………………………………………..6

The social model of disability…………………………………………….8

Equality and Human Rights – an introduction………………………….9

How much progress has been made?...... 11

How we involved disabled people………………………………………14

How we assess the impact of what we do on disability equality…….16

How we collect information about disability……………………………19

Employing disabled people in NHS Lothian…………………………...22

Monitoring and developing this Disability Equality Scheme………….26

Contacts and finding out more…………………………………………..28

Appendix 1 – How we involved disabled people in the development of our Disability Equality Scheme

Appendix 2 – NHS Lothian’s Impact Assessment Guidance and Toolkit

Appendix 3 – Equality Impact Assessment report for the Disability Equality Scheme’s impact on NHS Lothian staff

Appendix 4 – Equality Impact Assessment report for the Disability Equality Scheme’s impact on patients and communities across Lothian

Appendix 5 – Disability equality action plan 2009-12

Glossary of words and phrases used in this document

Anticipatory care: this is when a person receives health services to reduce the risk of them developing a health problem, or to make it less severe if it happens.

Attitudinal: this means to do with people’s attitudes.

Baseline: this means the starting point for a measurement.

Disabled person: this includes people who are covered by the Disability Discrimination Act. It also includes disabled children and young people, as well as other people who are disabled due to society’s barriers.

Framework: this is like a strategy or a plan.

Impact assessment: this is a way of working out what impact a policy or a plan will have on different people so that any adverse effects can be dealt with before they happen. Adverse means something that is not good.

Indicators: these are ways of measuring how well something is working.

ITS: City of Edinburgh Council’s Interpreting & Translation Service, jointly funded by NHS Lothian. It is used to arrange British Sign Language Interpreters and Braille or large print documents.

Mentoring scheme: this is a way of supporting people so that they gain confidence and skills.

Optometry: this is a health service for people’s eyes, for example giving sight tests and providing glasses.

Outcomes: these are end results.

Participation: this means taking part. For disabled people it can mean being more visible in public or having your voice heard.

Peer support network: this is a group of people supporting each other.

Primary care: these are the health services you receive in your community, such as your family doctor or GP, or a District Nurse.

Public sector: this is the Government, the National Health Service, councils, the police, schools, universities and other organisations that deliver public services.

Staff side organisations: for example, trade unions.

Workforce: people employed by an organisation.

This Disability Equality Scheme was prepared by:

James Glover, Head of Equality & Diversity

Lesley Boyd, Health Inequalities Manager

Jim Robinson, Health Inclusion Facilitator

Rona Laskowski, Strategic Programme Manager

Sarah Sinclair, Head of Patient Focus and Public Involvement
Executive Summary

This is NHS Lothian’s Disability Equality Scheme for the period 2009-2012. The law says we must publish a Disability Equality Scheme. It sets out the steps we will take to make our services more accessible for disabled people. It also sets out how we will promote disability equality, stop disability harassment and be a better employer of disabled people.

This Disability Equality Scheme follows on from our last one. In the last 3 years, we have made some progress towards the things we said we would do. But we still have a long way to go.

The law says we must involve people in developing this Disability Equality Scheme. We did this during the summer and autumn of 2009. The priorities that disabled people said we should deal with are:

1. All staff have positive attitudes to disability, through effectiveleadership and training in disability equality.
2. All barriers to access have been tackled, including communication.
3. NHS Lothian has become an employer where disabled people are treated equally.

4. NHS Lothian is able to work with service users and partner organisations to support independent living and anticipatory care for disabled people.

We have published a separate action plan that shows what we will do to meet these priorities.

The law says we must show how we gather information about disability. This is important because we need to know how many disabled people use our services and are employed by us. Then we can make improvements. This is included in the Disability Equality Scheme.

We are also required to show how we work out the impact of what we do on disabled people. This is called impact assessment. Our Disability Equality Scheme says how we do this.

This Disability Equality Scheme will be replaced by a Single Equality & Human Rights Scheme in 2010.
Introductory statements

Statement from members ofthe NHS Lothian Disability Equality Steering Group

“From the start of the process, we all recognised the huge challenge that the Disability Equality Steering Group faced in trying to change and influence the culture of a large public institution like NHS Lothian. It became evident early on from our discussions within the steering group that the experience of disabled people as NHS patients has been at times poor.

“As the group continued to meet together over several months to discuss and provide input into the NHS Lothian Disability Equality Scheme, we began to see how by setting specific standards and measurable outcomes we could begin to build a scheme that would encourage NHS Lothian to promote disability equality in all of its work practices and service delivery.

“Institutional disability discrimination still exists in many public bodies and the government has introduced the Disability Equality Duty specifically to tackle disability discrimination in the public sector. By involving disabled people in the development of disability schemes, there is a new opportunity for us to work in partnership with public authorities to remove the attitudinal, physical, social and political barriers that remain within society. The NHS Lothian Disability Equality Scheme seeks to introduce new priorities for NHS Lothian to tackle institutional discrimination in a fundamental and meaningful way.”

Statement from Professor James Barbour, Chief Executive of NHS Lothian

“NHS Lothian is a large, complex organisation with tremendous ability to do good. With such a wide range of health services, and such a large number of staff, NHS Lothian inevitably touches upon the lives of very many people, within Lothian and beyond. This includes disabled people as patients, carers, family members and as employees.

“While we are absolutely committed to tackling inequality, we do not always get it right. This Disability Equality Scheme aims to help us address this, and achieve the highest possible level of disability equality. I am delighted that we have been able to benefit from the commitment and knowledge of disabled people themselves in developing the Scheme. The document will, I hope, reflect the time and effort they have given so freely.

“The Board is determined that NHS Lothian will be the best-performing NHS Board in Scotland, and among the top 25 healthcare providers in the world. To achieve this, we must reach and surpass the highest standards in equality and diversity. This Disability Equality Scheme is a confident step in that direction.”

The social model of disability

“People are disabled by society’s reaction to impairment which prevents their participation as equal citizens” (Inclusion Scotland, 2004).

A model is a way of understanding a situation. The social model of disability says that people with impairments are disabled by the fact that barriers exist in mainstream society. These barriers can be physical, environmental or attitudinal, and prevent people from gaining access to education, employment, health, information, housing, transport and so on.

The social model of disability is generally accepted as being in opposition to the medical model of disability. The medical model says that the difficulties that people with impairments face are caused by the ways that their bodies are shaped or experienced.[1]

This Disability Equality Scheme is built on the social model of disability. It aims to address the barriers that disable people and prevent them from accessing effective health care and information about their health, and from gaining fulfilling employment with NHS Lothian.
Equality and Human Rights – an introduction

Disability equality

The Disability Equality Duty (2006) is a law requiring the public sector to take pro-active steps to make disability equality happen in public services, functions and in the way people are employed and trained.

The Duty requires organisations such as NHS Lothian to publish a Disability Equality Scheme. This is a plan setting out how NHS Lothian will meet the different responsibilities set out in the Duty. The document has to have certain parts, such as an action plan and a description of how disabled people were involved in developing the Scheme.

The legal definition of disability is a broad one. It has changed through amendments to the law and through action in the courts. It includes long term health conditions, and about one person in five in Scotland is disabled. This includes disabled children.

For more information about disability, as well as about the Disability Equality Duty and what organisations must do to meet it, contact the Equality & Human Rights Commission:

Scotland helpline: 0845 604 5510

Website:

You can also read about the Disability Equality Duty in our previous Disability Equality Scheme.

Human Rights

Human Rights are the basic rights and freedoms that belong to every person in the world[2]. The Human Rights Act 1998 made some of these rights[3]more easy to enforce in the UK. NHS Lothian must respect these rights for all people who use its services, people who it employs, and people who otherwise come into contact with NHS Lothian.

For more information about Human Rights in Scotland, contact the Scottish Commissioner for Human Rights:

Telephone: 0141 243 2721

Website:

A Scheme based on results

This is NHS Lothian’s Disability Equality Scheme for the period from 2009 to 2012. It has been written with the help of disabled people, and we have tried to make it as clear and helpful as possible, while making sure that it meets the requirements of the law. We have also linked the Scheme to Human Rights as much as we can.

We have used the UK Equalities Measurement Framework to set out our Scheme and the actions we intend to take. The Framework is a way of setting out what we intend to do in a way that makes it easier to see what difference our actions have made. This is called focusing on outcomes.

To be able to show that we are making progress towards disability equality, we have to know how to measure our work. For many actions we want to carry out there are currently no measures. Much of the first year will be spent working out what these measures are.

For more information about the UK Equalities Measurement Framework, contact the Equality & Human Rights Commission as above.

How much progress has been made?

NHS Lothian’s first Disability Equality Scheme was published in December 2006. Since then much progress has been made. For example:

• Services specifically for disabled people have been developed, like the Lothian Deaf Community Mental Health Service set up in 2008 and a community optometry service for people with a vision impairment.
• NHS Lothian is recruiting more people with a learning disability through its Human Resources strategy.
• NHS Lothian is involving disabled people more in new developments, such as the primary care centre in East Lothian and the Maternity Strategy.
• NHS Lothian has developed an effective way of assessing the impact of what it does on disability equality, and uses this to address potential negative impact in plans and policies across the board.
• Over 3000 staff have been trained in disability awareness.
• A number of comments were received during the involvement events, saying that GP surgeries were more helpful and courteous to disabled people.
• Access to NHS Lothian buildings has improved, after £1million was spent during the 3 years covered by the last Disability Equality Scheme.Disabled people also felt that the accessibility of services generally had improved.
• The HealthcareAcademy and work placement training and skills programmes have targeted disabled people throughout the period covered by the last Scheme. Both have been expanded and there are specific commitments towards people with a learning disability from 2009 onwards.
• Disabled people reported that NHS Lothian seemed to be involving people more in decisions and planning.
• NHS Lothian is working with a voluntary organisation called Minority Ethnic Carers of Older People Project, to identify Black & Minority Ethnic people who need help to access health services if a family member is disabled.
• NHS Lothian works with Deaf Blind Scotland, providing guide communicators to support deafblind people in accessing healthcare appointments and services.

In terms of the priorities listed in the previous Disability Equality Scheme, there has been positive progress. These are the priorities listed in the most recent annual report for the last Disability Equality Scheme:

What we said we would do:

1. Develop our existing involvement arrangements including:

(a)the new joint Edinburgh Equality Network, ensuring that it includes appropriate representation from disabled people.This is now established and includes disabled representatives.

(b)ensuring that the new arrangements for Patient Focus Public Involvement and the Patient’s Bill of Rights incorporate ways of involving disabled people across NHS Lothian.These are still being developed but will be subject to impact assessment to make sure that they take disability equality into account. They form part of actions in this Scheme (see Outcomes 3.5, 4.1 and 8.1).

(c)improving the involvement of disabled people in impact assessments on policies and strategies.We involve disabled people in impact assessments, such as for the Carer’s Assessment Tool, but it is not yet routine and will be developed during the period of this Scheme (see Outcome 3.6).

1. Roll out impact assessment training across the organisation and improving the quality and consistency of impact assessments, so that there is more effective consideration of disability when services, policies and strategies are taken forward.

We analysed the take-up of impact assessment training to find out the parts of NHS Lothian that weren’t applying for the training. We are targeting those areas to make sure that they supply more people to do the training and become better at carrying out impact assessments. You can get a copy of the plan from one of the equality leads.

1. Make progress with the action plans of both the Joint Lothian Learning Disability Strategy and the Joint Lothian Physical and Complex Disability Strategy in partnership with our colleagues across the four Lothian Local Authorities.These major strategies are well under way. Contact NHS Lothian for more information about how they are progressing.

1. Improve the ways in which we collect information about disability by:

(a)Contributing to national NHS Scotland programmes to make evidence gathering more detailed.NHS Lothian staff sit on steering groups of key national projects (such as Better Together) to ensure that they are set up to gather the right information (see Outcomes 3.5 and 4.1).

(b)Piloting work in primary care with two GP practices to improve data collection across equality strands including disability. These pilots are now underway (see Outcome 3.5).

(c)Improving current levels of workforce data gathering on disability (and race), working in partnership with trade unions.This is included in the action plan for this Scheme (see Outcome 6.2).

However significant challenges remain. These include raising awareness about disability equality, staff attitudes to disabled people, and access to services.

These issues were identified by disabled people who we have involved in developing this Scheme. You can see these priorities on page 14.

Challenges that we know about ourselves include making impact assessment more consistent across the organisation, and improving monitoring of disability.

This Scheme attempts to address these so that NHS Lothian can continue to work towards disability equality in its services and as an employer.

How we involved disabled people

What we had to do

The Disability Equality Duty requires organisations to involve disabled people in the development of the Scheme. This involvement must be more than just consultation, and it must have a significant influence on the contents of the Scheme[4]. Involvement must be with disabled people rather than organisations, and should include a range of impairments.

What we did

NHS Lothian carried out a range of involvement activities to develop the Disability Equality Scheme. A summary of these can be found in appendix 1. The activities included: