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Equality and Inclusion 2016


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Title: Equality and Inclusion 2016

Equality and Inclusion 2016
For all staff
Approx. 30 mins
Using OLM
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Using this interactive training course
To navigate your way through the course please
use the information button and the interactive
  • Information Button.
  • Where this appears, please click on the
    information button to show further information.
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  • This will always appear on the screen allowing
    you to navigate the training course.
  • Forward Button.
  • Click on this button to move forward to the next
    slide (this will only appear once you have
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    and have left to complete.

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Equality and Inclusion 2016
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  • Understand how to act in a way which supports
    equality and inclusion
  • Recognise how team and organisational cultures
    can contribute to the promotion of equality and
  • Gain confidence about when to be proactive and
    challenging in the promotion of equality and
  • Gain or refresh a basic knowledge of equality
    legislation, understand how the Trust manages
    equality and inclusion and know where to obtain
    further information.

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  • This Equality and Inclusion training course aims
    to give you information about working with and
    responding to the needs of colleagues and service
    users. The aim is to show how we can celebrate
    difference, demonstrate inclusion, respect,
    fairness and anti-discriminatory actions that
    is, actions which promote equality and inclusion
    for people who may be disadvantaged, compared to
  • Equality and Inclusion forms one of the core
    elements of the NHS Learning and Skills
    Framework. Therefore we need to evidence, within
    our personal development portfolios, our
    understanding of equality and the ways in which
    we have promoted equality and inclusion through
    our work.

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  • Discrimination is the unfair treatment of a
    person or groupon the basis of prejudice
  • Diversity is about the recognition and valuing of
    difference, in the broadest sense. It recognises
    respect, value and harnesses difference
  • Equality/ Equal is about creating a fairer
    society, so that everyone can fulfil their
  • Equal opportunities ensures that people have an
    equal chance, and are not disadvantaged
  • Prejudice is a pre-conceived opinion of a person
    or a group of people, often with little or no
  • Stereotype is a widely held belief towards a
    group of people. These perceptions can lead
    people to blame or criticise a specific group of
    people unfairly.
  • Inclusion is the act of including or of being
    included with a sense of belonging, respect and
    feeling valued for who you are
  • Barriers are obstacles which prevent
    communication and progress
  • Culture the ideas, customs and social behaviours
    of particular people or society

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The Equality Act and Public Sector Equality Duty
  • The Public Sector Equality Duty (PSED) and the
    Equality Act 2010 came into force on 6 April
    2011. This legislation moved towards promoting
    equality/inclusion and taking steps to annually
    eliminate discrimination.
  • As a public organisation we are required to
    publish information showing how we are comply
    with the Public Sector Equality Duty when taking
    decisions and making policies and this includes
    information about the impact of our policies and
    decisions on our patients, our staff and the
    general public.
  • Our current equality objectives are
  • Objective 1
  • The services we provide for patients and carers
    will be accessible and people will not report
    that they are unable to access them because of
    their protected characteristic/s.
  • Objective 2
  • SEPT will be a safe and inclusive place to work
    for staff with equal opportunities in respect of
    recruitment, staff development and progression.
  • The new legislation covers 9 protected groups

Gender Reassignment or Gender confirmation surgery
Religion Belief
Pregnancy Maternity
Marriage Civil Partnerships
Sex Sexual Orientation
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The recognition and valuing of difference, in
the broadest sense, recognising respect, value
and harnesses difference is the definition of
Equal Opportunities
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  • Why does discrimination happen?
  • People adopt attitudes, perceptions, prejudices
  • stereotypical views during early life that are
    then hard
  • to shift sometimes then compounded in later life.
    A person may become prejudiced by witnessing
    discriminatory behaviour by their peers. This is
    known as unconscious bias. Now please watch this
    2 ½ minute video about unconscious bias.
  • https//www.youtube.com/watch?vlgvovd_DoQE Is
    your brain a racist? Unconscious bias
  • The Equality Act defines seven types of
    discrimination. These are

Associative discrimination - this is direct
discrimination against someone because they are
associated with another person who possesses a
protected characteristic.
Direct discrimination - where someone is treated
less favourably than another person because of a
protected characteristic.
Discrimination by perception - this is direct
discrimination against someone because others
think that they possess a particular protected
characteristic. They do not necessarily have to
possess the characteristic, just be perceived to.
Indirect discrimination - this can occur when you
have a rule or policy that applies to everyone
but disadvantages a person with a particular
protected characteristic.
Harassment by a third party - employers are
potentially liable for the harassment of their
staff or customers by people they don't
themselves employ, i.e. a contractor.
Harassment - this is behaviour that is deemed
offensive by the recipient. People can now
complain of the behaviour they find offensive
even if it is not directed at them.
Victimisation - this occurs when someone is
treated badly or less favourably because they
have made or supported someone else who has made
a complaint or raised a grievance
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Discrimination Actions
Discriminatory actions include bullying,
harassment and victimisation.
Bullying - A misuse of power or position which
criticises, condemns or humiliates people,
undermining their ability and confidence.
Harassment Systematic and continued conduct or
comments which are unreasonable, unwelcome or
offensive and causes the recipient to feel
threatened, humiliated or embarrassed.
Victimisation -Treating an individual less
favourably because they have complained about
discrimination or supported someone else who has.
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Trust Approach to Equality Inclusion
  • The Trust has developed a range of support
    mechanisms for staff
  • A range of Policies Procedures including
  • Grievance/Disability in Employment/Time off for
    Trade Union Duties/Whistle-blowing/
  • Equal Opportunities/Flexible Working
  • Risk Management Security Policies Local
    Security Management Support for staff
  • Workforce Wellbeing Services
  • Bullying Harassment support and guidance
  • Employee Assistance Programme and Counselling
    Service for Staff
  • Equality Champions

These policies are in place to support all
staff. They demonstrate that our Trust is
committed to providing support and will continue
to develop workable and effective solutions. All
can be accessed via the Trust intranet.
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Health Inequalities
Age There is a great deal of anecdotal evidence
of negative attitudes, from healthcare providers,
towards older people, that affect the quality of
service they receive. Older people make up 62 of
social services service users, but only 47 of
the budget is spent on them More people report
experiencing age discrimination than any other
form of discrimination.
Disability The prevalence of disability increases
rapidly with age approximately 75 of men and
women aged 85 and over have a disability 24 of
deaf or hearing-impaired people miss
appointments 19 miss more than five
appointments because of poor communication Disabl
ed people are four times more likely, than the
general population, to find dentists' offices
inaccessible or inadequate. Twice as many find
their Doctor's surgery inaccessible. One study
has estimated that people with learning
disabilities or long-term mental health problems
are 58 more likely to die before the age of 50
than non-disabled people.
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Health Inequalities
  • Race
  • There are significant differences between the
    health of the general population
  • and the health of black and minority ethnic
    groups (BME).
  • For example
  • They have a significantly lower life expectancy
    than the wider population
  • Smoking rates are higher among BME men
  • They are less likely to visit GPs, practice
    nurses, dentists or contact NHS direct
  • The prevalence of stroke is much higher among
    African-Caribbean and South Asian men
  • The incidence of diabetes is five times higher
    among South Asians and three times higher among
    those of Caribbean backgrounds than in the
    general population

Gender Men can be perceived as more likely to
become violent, than woman, and may therefore be
more likely to be detained under a section of the
Mental Health Act, rather than admitted
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Health Inequalities
  • Sexual Orientation
  • Many lesbian, gay, bisexual and transgender
    (LGBT) people face discrimination in todays
  • For example
  • The experience of homophobia can have a serious
    health impact, especially on young people.
  • 60of gay men, lesbians and bisexuals reported
    being physically attacked during their time at
  • 53 of those who had been bullied had
    contemplated self-harm or suicide as a result of
    the violence experienced
  • Older LGBT people are five times less likely to
    access services for older people, than is the
    case in the general older population, because
    they fear discrimination, homophobia and

It is therefore vital that when services are
changed, reviewed or redesigned that equality
issues such as this are considered.
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Legislation - Gender
If arrangements are put in place, which take no
account of gender, women or men may experience
unfair or unequal outcomes. The Equality Act
2010 legally protects people from discrimination
in the workplace and in wider society. It
replaced previous anti-discrimination laws with a
single Act, making the law easier to understand
and strengthening protection in some situations.
It sets out the different ways in which its
unlawful to treat someone. An exception to the
Act is where gender is a genuine occupational
requirement. Employers will be able to recruit
staff, on the basis of a genuine occupational
requirement, if it can be shown that it is
necessary for the post holder to be of a
particular gender, to carry out the requirements
of the post. The Act also makes it illegal to
treat anyone less favourably on thegrounds of
gender or gender re-assignment.
Workforce Issue Women can be put at a
disadvantage by policies that are not family
friendly, whilst men can also be disadvantaged
when family friendly policies are solely aimedat
women, and assume that men have no parenting
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The Equality Delivery System
As an organisation we manage and monitor equality
and diversity through a national scheme known as
the Equality Delivery System. Each year we make
commitments to be more inclusive and take more
steps to eliminate discrimination at work and in
our services. It is strictly monitored by the
Board, Executive Team, and the Equality
Diversity steering group which meets bi-monthly.
Please click on the play button below
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  • The Trust is proud of its work in the area of
    Equality and Inclusion and some of
  • Our recent achievements include
  • Holder of the Two Ticks Disability Charter and
  • Accredited as a Mindful Employer
  • Stonewall member and workplace champion
  • Number of equality Champions across the Trust
  • Lead Trust for Equality and Inclusion regional
  • Close links to NHS Employers
  • More information on all of these achievements and
    how they can
  • support you is available at . LINK here

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Ethnicity / Race
The Equality Act protects people from
discrimination on the grounds of race, skin
colour, nationality and ethnic or national
origins in relation to employment, education,
goods, facilities, services and
premises. Currently our workforce statistics
show that 22 of our workforce are from a BME
Workforce Issue People who have been educated
outside the UK, may not have the same
qualifications as those educated in the UK, but
often will have the same knowledge, experience
and skills for a particular job. It is important
to think about which qualifications are required
in the Job Descriptions and Person Specifications
(e.g. stating 'A' Levels required' would
discriminate against people from outside the UK
whose qualifications are different, but still
provide them with the necessary level of
education for the post).
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Ethnicity / Race
Now please watch this 5 minute video Everyday
Racism The Things I Hear Every Day
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The 2006 census
  • The 2006 census of inpatient services in England
    and Wales, in relation to black and minority
    ethnic communities, found that for African and
    Caribbean people
  • The rates of admission to hospital were three
    times higher than average
  • Referral rates from general practitioners were
    lower than average and rates of referral from the
    criminal justice system were higher than average
  • There was greater involvement of police in
  • Rates of detention under the Mental Health Act
    1983 were between 19 and 38 per cent higher than
  • There were higher rates of detention in medium
    and high secure wards
  • There were higher rates of control and restraint.
  • The report concluded that although many
    explanations have been offered for these
    patterns, the evidence is still inconclusive. It
    urges statutory agencies, in partnership with
    others, to plan and commission services that will
    improve the pathways of care for black and
    minority ethnic groups.
  • There is also now a 2011 Census with more up to
    date Census information this information will be
    incorporated into future lessons.

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The Workforce Race Equality standard
  • NHS providers are now required to analyse
    activity to identify areas where
  • black and minority ethnic groups are treated less
    favourably than their white
  • Counterparts.
  • We published our data on 1st July 2015 and we
    know that in some areas,
  • our BME workforce are having a less positive
    experience than our white staff
  • and we want to take action.
  • Regular progress updates and Board and ET
  • A designated action plan
  • A small group of BME staff supporting the work
  • A designated Trust lean (Jo Debenham)
  • Our action focus around creating a more positive
    experience for BME staff
  • in the areas of recruitment and promotion,
    bullying and harassment, disciplinary
  • activity and access to training Senior managerial
  • For more information about this work go to the
    Equality and Diversity
  • pages on the intranet.

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Minority Languages The Trust has a contract with
Essex Interpreting and MiltonKeynes Community
Language Service to provideinterpreters for
assessments and meetings, with peoplewho cannot
understand English well enough to fully
participate. British Sign Language is also
included. As a principle of good practice it is
not appropriate for a service user's family
member to provide interpretation in professional
meetings. Please see the Trust leaflets on the
Translation and Interpreting Service.
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Disability The Equality Act 2010 aims to end the
discrimination thatmany disabled people face. It
now gives disabled peoplerights in the areas of
employment, education, access togoods,
facilities and services. The Act defines a
disabled person as someone who has aphysical or
mental impairment that has a substantial and
long-term adverse effect on his or her ability
to carry out normal day-to-day activities. A
mental illness no longer has to fulfil the
criterion of 'clinically well-recognised' Long
term means that the effect of the impairment has
lasted or is likely to last for at least 12
months People with HIV, cancer and multiple
sclerosis will be deemed to be covered by the Act
from the point of diagnosis, rather than from the
time when the condition has some adverse effect
on their ability to carry out normal day-to-day
activities. Currently our workforce statistics
show that 4 of our workforce class themselves as
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  • Now please watch this 4 minute video
  • Stupid things to say to a disabled person

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Environment Adjustments
  • Each area should ensure that its procedures do
    not inadvertently discriminate against disabled
    people. Some adjustments to the physical
    environment and procedures may need to be
    undertaken as the need arises, but it is
    reasonable to foresee some of the needs that will
    arise (e.g. accessible washing facilities for
    wheelchair users, fire evacuation procedures for
    deaf people).
  • Remember that long term health problems such as
    Arthritis, heart or chest conditions and diabetes
    are also now classed as disabilities under the
  • Scenario
  • A blind service user with a guide dog, would need
    to have special arrangements made for an
    admission to an in-patient unit, so that the
    guide dog could stay with them. This is legal.

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Reasonable Adjustments
  • The Act places an obligation on employers to make
    'reasonable adjustments' to the physical features
    of premises and arrangements for employing
    disabled people.
  • Your HR advisors can help you with this.
  • These could include
  • physical adjustments to the working environment
  • equipment
  • provision of specialist aids and adaptations
  • additional support
  • adjustments to working arrangements e.g. time to
    recover or adapt
  • adaptation of duties, hours
  • help with personal care.
  • Access requirements include
  • reading material in a form suitable for people
    with a visual impairment or learning disability
  • switches
  • door handles, sinks etc at a suitable height
  • physical access for wheelchair users
  • Text phone or video phone for deaf people.

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  • Mental Health Problems
  • Anyone with a mental health condition has
    protection under the Act and can expect to be
    treated no less favourably than people with
    physical health conditions or people with no
  • Workforce Issue
  • Colleagues may require flexible working hours to
    cope with the side effects of medication or to
    attend appointments. Some people may need a quiet
    place of work others may have strategies they
    find useful for coping with stress, such as
    taking regular short breaks or having a mentor
    for support other than through their manager.
  • People should be allowed to decide for themselves
    which adaptations to the workplace may be
    helpful. You should not assume that a person with
    a mental health problem will not be able to cope
    with the normal pressures involved in undertaking
    work. Indeed some people find that concentrating
    on work tasks is helpful in managing their mental
    health condition.

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Stigma and Discrimination on Mental Health Grounds
The 2007 Attitudes to Mental Illness Report found
that among asample of the general population
37 of people would not want to live next door to
someone who has been mentally ill
52 have known someone close to them having some
kind of mental illness
57 agree that residents have nothing to fear
from people coming into their neighbourhood to
obtain mental health services
58 agree that people with mental illness are far
less of a danger than most people suppose
14 believe that people with mental illness
should not be given any responsibility
72 think that mental illness is an illness just
like any other
22 think that women who were once patients in a
mental hospital can be trusted as baby sitters
17 consider it frightening to think of people
with mental problems living in residential
68 believe that people with mental health
problems should have the same rights to a job as
anyone else
84 agree that we need to adopt a far more
tolerant attitude towards people with mental
illness in our society
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Legislation Sexual Orientation
Equality Act 2010 The Act outlaws discrimination
in employment and vocational training on the
grounds of sexual orientation. Sexual
orientation mans the gender to which a person is
attracted. It applies to discrimination on
grounds of orientation towards persons of the
same sex (lesbians and gay men), the opposite sex
(heterosexual people) and the same and opposite
sex (bisexual people).
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Legislation Sexual Orientation
  • We are very proud of the relationship we have
    with Stonewall and we are not only stonewall
    member but also a workplace champion. Did you
    know that
  • One in five lesbian and bisexual women have
    deliberately harmed themselves in the past year,
    compared to 0.4 of women generally.
  • 3 of gay and bisexual men have attempted to take
    their life in the last year, compared to just
    0.4 of men in general.
  • A third of gay and bisexual men who have accesses
    healthcare services in the last year have had a
    negative experience in relation to their sexual
  • Half of lesbian and bisexual women report
    negative experiences in the healthcare sector in
    the past year.
  • 9 of lesbian and gay people and 10 of bisexuals
    rated their doctor poor or very poor
    at taking problems seriously compared to 5 of

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Religion / Faith
  • Since there are many religions and faiths among
    our staff and service users, it is likely that we
    may not know a great deal about all of them and
    for this reason basic information can be gained
    on particular religions simply by communicating
    with individuals. There is no substitute for
    spending time with people in order to understand
    their individual needs.
  • We also have excellent reference information
    about faiths andtheir characteristics in our
    EACH handbook available on theintranet.
  • In meeting equality and diversity needs related
    to religion, considerationsshould include
  • Gender of care provider
  • Form of address
  • Food
  • Washing facilities
  • Terms and expressions used
  • Personal care
  • How spiritual needs will be met.

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Religion / Faith
Currently our workforce tells us that our
workforce is made up of the following
religions Christianity 41 Islam 2 Judaism
0.5 Buddhism 0 Hinduism 2 Other 5
Legal Duty NHS Trusts have a legal duty to take
steps to protect Human Rights. The Human Rights
Act imposes a direct legal obligation on NHS
Trusts to ensure they respect European Convention
rights in all that they do. This means that
Trusts need to consider the human rights
implications of all of their policies and
practices. Any service user, carer or staff
member, who feels that an NHS Trust has breached
their human rights may be able to take the Trust
to court.
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Human Rights
In October 2000, The Human Rights Act 1998 came
into effect in the UK. This meant that people
could take cases about their human rights to a UK
court. The core human rights principles are
fairness, respect, equality, dignity and
autonomy. The articles of the European Convention
of Human Rights Article 2 - right to
life Article 3 - prohibition of torture, inhuman
or degrading treatment (could cover particularly
serious cases of harassment or bullying)
Article 4 - prohibition of slavery and forced
labour Article 5 - right to liberty and
security Article 6 - right to a fair trial and
fair and public hearing in determining civil
rights as well as criminal charges Article 7 -
no punishment without law Article 8 - right to
respect for private and family life, home and
correspondence (covers broadly the protection of
personal information, personal space and private
communications) Article 9 - freedom of thought,
conscience and religion Article 10 - freedom of
expression (but no right for content and manner
to be abusive) Article 11 - freedom of assembly
and association Article 12 - right to marry
Article 14 - prohibition of discrimination (Note
this does not outlaw discrimination per se but
requires that there is no discrimination in
the enjoyment of other convention rights).
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Human Rights
Legal Duty - Articles 3 5 Prohibition of
Torture (Article 3). This right also prohibits
inhuman or degrading treatment, such as
inadvertently placing people in humiliating
situations through lack of thought or planning.
NHS staff have a duty to intervene to stop abuse
or degrading treatment or punishment, as soon as
they become aware of it, whether it is undertaken
by staff or service users. The Right to Liberty
(Article 5) The right to liberty is the right not
to be restricted or locked in. This can be
lawfully limited in the instance of detention
under a section of the Mental Health Act, but the
Trust should ensure that when restraint is used
it is proportionate in the situation and that
care is taken to protect the rights of people
without capacity to consent to treatment.
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Human Rights
  • Legal Duty - Article 8
  • Article 8, Legal Duty, is the right for respect
    for private and family life, home and
  • In healthcare there are a number of related
    issues such as
  • privacy on wards and in care homes
  • freedom to choose how one looks and dresses
  • family visits
  • sexual and other relationships
  • freedom to participate in social and recreational
  • invading privacy without permission e.g. for
    blood test or body searches.
  • This right is a qualified right and may be
    interfered with in order to take account of the
    rights of other individuals and / or the wider
    community. A public authority may be asked to
    produce reasons for its decision to interfere
    with someone's Article 8 rights

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People with a mental health condition report that
fear of prejudice stigma and discrimination
often prevent them from applying for employment.
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Equality Impact Assessments
  • There is no legal requirement to undertake
    Equality Impact assessments but to maintain
    current good practice the Trust will continue to
    do the required impact assessments in order to
    asses the impact something will have on a
    protected C groups
  • Considering whether a policy, procedure or
    service has the potential to discriminate against
    one or more of the protected characteristics,
    should be part of our everyday work and thinking
    and ensure that equality groups will not be
    subject to negative impacts as a result of the
    proposals. Therefore, the Trust has agreed that
    the senior manager responsible for presenting the
    policy to the Board for approval, should still be
    responsible for carrying out the Equality Impact
  • A form is provided to support this.
  • We are very proud this year that no ET or Board
    Papers can be submitted without evidence that
    equality and inclusion have been considered.
  • Eliminating Negative Impacts
  • A negative impact is an effect that could
    disadvantage one or more of the protected
  • characteristics.
  • A positive impact is an effect that could have a
    positive influence on one or more of the
    protected characteristics, or improve equality of
    opportunity and / or relationships between
    groups. For example, a service provided
    specifically for women would have a positive
    impact but would not necessarily have an adverse
    impact on men.
  • For more information on Equality Impact
    Assessments please see SEPTEquality and
    Diversity on the Intranet and also the SEPT

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Bullying and Harassment
  • Without respect for equality and diversity,
    bullying and harassment can be allowed to take
    place. Examples of bullying and harassment
  • Insults
  • Exclusion or victimisation
  • Misuse of power or position
  • Deliberately undermining people and blocking
    promotion or training opportunities.
  • Malicious rumours
  • Ridiculing or demeaning someone

These can be one off or persistent/repeated
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Complaints Service Users
Service users, carers and family members who see
or experience anything like this, should bring it
to the attention of the manager immediately. They
also have the right, under the NHS Constitution,
to complain about it to any member of Trust staff
or the Complaints Officer directly. There will be
no recriminations against them for doing so and
they will be taken seriously. The Complaints
Officer organises an investigation into the issue
and the investigator agrees with the person how
it will be handled and when the investigation
will be completed. Anyone can contact the
Complaints Officer Freephone - 0800 085 7935
Email - complaints.department_at_sept.nhs.uk
write to The Complaints Officer, The Lodge,
The chase, Wickford SS11 7XX. They can also
write to Sally Morris, Chief Executive, Trust
Head Office, The Lodge, The Chase, Wickford,
Essex, SS11 7XX. More help is available from the
Patient Advice and Liaison Service (PALS)
Freephone 0800 085 7935 or The Independent
Complaints Advocacy Service (ICAS), who can be
contacted on 0845 4546 1083, between 09.00 and
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Complaints - Employees
  • The Trust has a Grievance Policy that sets out
    the types of behaviours which are unacceptable
    and for ensuring that unfair discrimination,
    harassment, bullying and victimisation does not
    occur at work. If you feel that you have been
    unfairly treated please refer to the Grievance
    Policy (HR02).
  • Individuals and their immediate line managers
    should try to resolve matters informally, through
    normal working relationships, before invoking the
    formal stages of the Grievance Procedure.
    Concerns that remain unresolved through informal
    resolution must be raised in writing by the
    employee (or their representative, if
    applicable), using the Grievance Notification
  • The grievance should be raised with the immediate
    line manager. Where the grievance is against the
    line manager, the matter should be raised with
    the next level of line management.

Equality and Diversity means treating everyone
fairly and respectfully for who they are and no
one should receive less favourable treatment than
anyone else
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Remember, if you want to find more information /
evidence about this subject or anything else
which is relevant to your work or study, join
your local healthcare library. For staff in Essex
contact Basildon Healthcare Library.
www.btuheks.nhs.uk library_at_btuh.nhs.uk 01268
524900 EX3594 
It may be that you work in a different area, for
example Luton. Details of all the Health
Libraries in the East of England can be found at
this site You are welcome to join any of
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IT Training IT training is available in Word
Excel PowerPoint
Publisher Outlook
Explorer General skills
For information on locations, dates, times,
availability and for any other questions please
contact Jay Thornton james.thornton_at_sept.nhs.u
k 01268 568068
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Review of Objective(s)
  • Before completing the test, please ensure you
    have acquired the relevant knowledge against the
    modules objective(s) below
  • Understand how to act in a way which supports
    equality and diversity
  • Recognise how team and organisational cultures
    can contribute to the promotion of equality and
  • Gain confidence about when to be proactive and
    challenging in the promotion of equality and
  • Gain or refresh a basic knowledge of equality
    legislation, Trust policies and procedures and
    know where to obtain further information
  • If not, please take this opportunity to revisit
    the presentation content.

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