Recommendation for Equalities Objectives 2014-15

  1. Introduction

We want to ensure that we have a healthcare system in Islington which is equal for all people to use, whatever their background or social situation in life. As part of this process, Islington Clinical Commissioning Group is setting its Equality Objectives for the year ahead, and reviewing those of 2013-14.

We have used a tool called the Equality Delivery System (EDS) to help us develop our equalities objectives. This is a national tool developed by the Department of Health. This year the EDS was updated to be made more user friendly, flexible and to look at outcomes centred on current patient care and needs. Its methodology includes the use of ‘inclusion health groups’, rather than those covered by the nine protected characteristics. Inclusion health groups refer to groups identified as having to face significant health inequalities.

  1. Proposed equality objectives 2014-15

Our programme of engagement over the course of the year has furnished us with views and insights from a broad cross-section of patient groups in Islington. Based on the evidence from working with these groups, and analysis using EDS, we are recommending two equality objectives for the coming year. These are detailed in the table below:

Table 1. Proposed equality objectives 2014-15

Objective / Action / Timescale and Expected Outcome / Directorate/Team and Lead Individual
Understanding the current situation for Islington community who need to use interpreting and translating services within primary care services. / Qualitative research to understand better the needs for language translation and interpretive services, advocacy, undertaken in partnership with community groups to ensure their needs inform this work.
Qualitative and quantitative analysis of Language line (a face to face and telephone service) to review the rate of uptake, and gain insight into the effectiveness of the service within GP practices. / One year
With a view that the topic this objective is based on will span longer than one year.
The next steps will be to assess the research gathered and come up with a series of actions. / Primary Care
Engagement
Improving the collection of demographic data on the nine protected characteristics across Islington health services. / We are going to work with our acute providers to improve the collating, monitoring and evaluation of demographic data.
Work with public health to continue to encourage ethnicity audits in GP practices, community, and acute sector / One year
As with the above objective, this is the first stage in a more long term area.
Better data collection and analysis will lead to improved insights about our local population.
We will then use this information to think about how we can improve services, such as providing community support to targeted GP practices or specific local populations. / Quality and Performance
Primary care
  1. Evidence for the proposed equality objectives

These equality objectives have been developed through our work with our partners at the Council as part of the annual Joint Strategic Needs Assessment, which provides us with an evidence base and framework for commissioning health and social care services. As part of our commissioning work, we also looked beyond the JSNA, to include views groups who are well known to experience significant health inequalities.

We have a close working relationship with HealthWatch Islington, and the Islington’s Refugee and Migrant forum. Through our work with these groups, we have heard from a wide cross section of Islington’s community, including representatives from mental health, BME communities, vulnerable and homeless communities, people living with disabilities, faith groups and those with long term conditions such as COPD.

This listening and engagement work has given us important insights into barriers that these groups are experiencing. We spoke with these groups specifically because, in line with the EDS tool, we wanted to gain insight from inclusion health groups and from those who have the nine characteristics.

Through this feedback we have identified five key areas where the community has told us there is significant need for improvement. These are:

  • improved access to mental health services within the BME community – specifically to lower level or community support such as talking therapies and iCOPE
  • better understanding of interpreting and advocacy needs for refugee and migrant groups in the borough when accessing services in order to provide support for this group to access as many services as possible that they need
  • better understanding of the needs of patients within primary care, specifically:
  • minimum standards and menu of options so patients can know what to expect
  • flexibility within practice
  • better at information reading and sharing for a patients’ appointment
  • better monitoring and capturing of data within health services to support patients’ care; and
  • the importance of patient centred care, looking at a person holistically and delivering care as such.

Tackling these challenges requires accurate, current insight into the needs of these groups, and detailed evidence about those using our local services.

This is why we are recommending that our equalities objectives for 2014-15 focus on two research exercises, as this will provide us with the evidence and insight necessary to address these challenges.

  1. Further information:

Please see the briefing included as an Annex for more detailed information on feedback from Islington’s patient groups.