Equality and Diversity in the NHS Demonstrating Best Practice for BME Staff and Patients

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Equality and Diversity in the NHS Demonstrating
Best Practice for BME Staff and Patients

• Surinder Sharma - National Director for Equality
  and Human Rights
• Department of Health NHS

NHS Southwest 15th May 2007
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The Department of Health - Vision

• The NHS of the 21st Century must be responsive
  to
• the needs of different groups and individuals
  within
• society and challenge discrimination on the
  grounds
• of race, gender, age, ethnicity, religion,
  disability and
• sexuality. The NHS will treat patients as
  individuals, with
• respect for their dignity. Patients and citizens
  will have a
• greater say in the NHS, and the provision of
  services will
• be centred on patients needs
• NHS Plan Core Principles

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A vision enshrined in legislation

• General duty
• The Race Relations (Amendment) Act 2000 places a
  general statutory duty on the DH and NHS bodies
  to promote race equality. DH and NHS bodies must
  have due regard to the need to
• Eliminate unlawful discrimination
• Promote equality of opportunity
• Promote good relations between people of
  different racial groups
• Specific duty
• Specific duties have been placed on listed
  authorities (including DH, NHS Trusts, Primary
  Care Trusts, Special Health Authorities and
  Strategic Health Authorities) to assist them in
  meeting the general duty, including the need to
  publish a Race Equality Scheme. The duties
  include a requirement to collect and publish a
  specific set of information and to set out
  information on a number of actions that will help
  meet the general duty to promote race equality.

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A vision made real

• NHS Plan
• NHS Improvement Plan
• Agenda for Change
• Patient Choice
• Improving Working Lives
• Patient-led NHS
• Better Regulation

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The Equality and Human Rights Group in DH - what
we are trying to achieve

• Ensuring that all individuals, from whatever
  background, can access the NHS
• Delivering services that are responsive to the
  needs of all our communities
• Giving patients choice and reducing health
  inequalities
• Targeting recruitment development opportunities
  at people from different groups
• Recruiting more staff, diversifying our skills
  base better reflecting the communities we serve
• Working to become a good Corporate Citizen by
  developing good practice in procurement,
  employment, capital developments etc - this will
  include development work with our suppliers

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We work within DH National Standards/Targets Prior
ities/Policy Planning Frameworks

• NHS SOCIAL CARE
• Pilot Projects with 6 SHAs
• Blueprint and models of best
• practice
• Each SHA
• Board champion
• Executive champion
• Equality Advisor
• Plus engage
• Trade Unions

OGDs Plus Equality
Commissions Equality Campaigns
CRE EOC DRC Opportunity Now
EHRG Centre of Excellence

• WIDER COMMUNITY
• patients/public/service users
• voluntary sector
• suppliers

Role of EHR Director ?National Champion
(internal external) ?Top Team DH
Board ?External10 point plan wider equality
agenda ?Bridge between DH and NHS on
equality ?Work inclusively...in partnership
Issues for EHRG ?Resources staff and
budget ?Refocusing and reprioritisation ?Communica
tions ?Consistent corporate vision ?Overarching
equality diversity policy ?Strategy and action
plan
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Delivering for Patient and Staff through the Race
Equality Schemes

• To assess effect on race equality of
  organisations policies and functions
• To look for
• Where/ how race equality promoted
• Where/ how inequality being addressed
• Negative impacts on race equality
• To promote good practice and change poor practice
  
• But, over all
• To produce better services through thinking about
  who can potentially benefit.

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As employers, we must attract, develop retain
the right staff
The NHS is the largest employer in the UK and the
third largest in Europe. The NHS is the single
employer of black and minority ethnic staff in
England 14 of the overall NHS workforce 5 -
7 in Ambulance Services (compared to 1.6 in
2000) 75 of the NHS workforce are women 30 of
todays medical students are from BME groups
60 of todays medical students are
female 16.4 of qualified nursing, midwifery and
health-visiting staff are from BME groups. 7.5
of the social care workforce are from BME groups
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Race Equality Initiatives

• Leadership Race Equality Action Plan
• Race for Health
• Working closely with a number of SHAs
• Delivering Race Equality
• Helping the NHS review their Race Equality
  Schemes (as required by the RR(A)Act)
• Help the NHS comply with other legal requirements
  e.g. Disability Discrimination Act and
  forthcoming legislation eg Single Equality Act
  and Age legislation.
• Gypsies and Travellers
• Pacesetters

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To Deliver We Need Support from All Levels -
Leadership Race Equality Action Plan
First launched by Sir Nigel Crisp in 2004, it
challenges NHS leaders to address race equality
and the needs of minority ethnic communities
effectively. It applies to both service delivery
and workforce and complements and supports a
wider range of initiatives in the Department to
promote equality in healthcare. It aims to
develop those who deliver services, through
mentoring, leadership action, training and
development, systematic tracking and celebrating
achievements. Progress on implementation of the
Plan is overseen by an Independent Panel chaired
by Trevor Phillips, Chair, CRE.
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Leadership and Race Equality Action Plan
Developing People

• MENTORING Senior leaders to show their
  commitment by offering personal mentorship.
• LEADERSHIP ACTION Leaders to include personal
  'stretch' targets on race equality in their
  objectives.
• EXPAND TRAINING, DEVELOPMENT AND CAREER
  OPPORTUNITIES Enhance training for all staff in
  race equality issues. Develop more entry points
  for people from ethnic minorities to join the
  NHS.
• SYSTEMATIC TRACKING Build processes for tracking
  the career progression of staff from ethnic
  minorities..
• CELEBRATE ACHIEVEMENTS Acknowledge the
  contributions of all staff in tackling race
  inequalities.

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Pacesetters

• The aim of Pacesetters, to be launched in
  September is to
• Tackle health inequalities for patients and
  public
• Free the workplace from discrimination
• Through innovation, 5 SHAs and 15 Trusts will
  address core and local issues. The core issues,
  in part determined by DH, focus on
• Dignity and respect in the workplace, including
  bullying and new ways of working
• The health status of Gypsies and Travellers
• Data measurement across the six strands of
  equality
• Local issues cover high-impact patient-focused
  changes across all equality strands
• Local communities and local providers will be
  fully engaged
• Innovations will be evaluated and disseminated
  throughout the NHS

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We need thorough accurate data

• Data are essential to highlight inequalities,
  make the case for equality and to monitor
  progress
• The quality of ethnic group data on in-patients
  needs to be improved
• The Healthcare Commission take account of data
  quality in their assessments of Trusts
• QOF rewards GP practices for ethnic recording
• Plans for amended GP registration form to
  include ethnicity of patients
• Equality data on patients staff needs to go
  beyond age, gender and ethnic group
• NHS should refer to DH's guidance on ethnic
  monitoring of July 2005.

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And lest we forget why -
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Vital Statistics

• Heart Disease South Asian people are 50 more
  likely to die prematurely from CHD than the
  general population
• Stroke Amongst African-Caribbean and South Asian
  men, the prevalence of is between 40 - 70
  higher than that of the general population
  respectively after adjusting for age
• Diabetes Men and women of Pakistani and
  Bangladeshi origin are more than 6 times as
  likely as the general population to have
  diabetes, and Indian men and women three times as
  likely. Rates are also significantly higher
  amongst Black Caribbeans.
• Dental Health Around 90 of children in the
  general population have visited a dentist. This
  can be contrasted with approximately 40 of
  Bangladeshi and 60 of Pakistani children.

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