Equality & diversity 2013/14

Equality Diversity & Human Rights Annual Report 2013-14

July 2014

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Contents

Executive Summary The Legal & Compliance Framework Moving Beyond Legal Compliance By listening to you we have set our Equality Objectives Getting it right for our patients Getting it right for our staff Strengthening Equality & Diversity Emerging Issues and priorities for 2014 Knowing our communities-Reflecting our diverse communities Lasting Change

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Executive Summary

In January 2014 Wirral Community NHS Trust published its Equality Diversity & Human Rights Strategy 2013-17, the strategy sets out the ways in which the Trust will continue to promote equality of opportunity amongst different groups of people and ensure that potentially vulnerable groups and individuals are supported and their needs are addressed in ways that is best suited to them.

The purpose of this Equality Report is to show the progress the Trust has made during 2013/14 in meeting its equality duties under: Section 149 of the Equality Act 2010 (the Public Sector Equality Duty- PSED) and The Equality Act 2010 (Specific Duties) Regulations 2011 This report provides assurance to the Trust Board, our patients, staff, stakeholders and the communities we serve, of how the Trust is meeting the requirements of the Public Sector Equality Duty. This report complies with the specific duties outlined within the Act, which are legal requirements designed to help the Trust meet the General Equality Duty. The report is structured around the following key themes: The Legal & Compliance Framework Moving Beyond Legal Compliance By listening to you we have set our Equality Objectives Getting it right for our patients Getting it right for our staff Strengthening Equality & Diversity Emerging Issues and priorities for 2014 Knowing our communities- Reflecting our diverse communities Lasting Change In December 2013, following Board approval, the Trust adopted six priority equality objectives which became the focus for our work on equality for the period 2014-17. Whilst much progress has been made against those objectives, and is covered in the ‘Making Things Happen’ section of this report, it is important to note that these objectives do not cover all the work that is being carried by the Trust with the aim of improving equality.

The Trust strives to provide the highest quality of service to all of its patients and a positive employment experience for staff. Equality and diversity considerations are part of the Trust’s work to improve the experience and health outcomes for everyone in its care. This report highlights our approach and work to address any additional needs of those patients and staff who may identify with a range of protected characteristics.

Simon Gilby Chief Executive Jo Harvey Director of Human Resources and Organisational Development

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What we are required to do - The Legal and Compliance Framework

Equality Act 2010 The Equality Act came into force from October 2010 providing a modern, single legal framework with clear, streamlined law to more effectively tackle disadvantage and discrimination. On 5 April 2011, the public sector equality duty came into force. The equality duty was created under the Equality Act 2010. The equality duty consists of a general equality duty, with three main aims (set out in section 149 of the Equality Act 2010) and specific duties for public sector organisations. The Equality Act requires public bodies like Wirral Community NHS Trust to publish relevant information to demonstrate their compliance with the duty.

The Act applies to service users and Trust employees who identify with the following protected characteristics:        

Sex Age * Disability * Race Sexual orientation Gender reassignment Marriage or civil partnership Pregnancy or maternity Religion or belief

The duty has two parts – the general duty and the specific duties. The general equality duty means that the Trust must have due regard to the need to: Eliminate unfair discrimination, harassment and victimisation Advance equality of opportunity between different groups Foster good relationships between different groups It must do this by removing or minimising disadvantages suffered by people due to their protected characteristics; taking steps to meet the needs of people from protected groups where these are different from the needs of other people; and encouraging people from protected groups to participate in public life or in other activities where their participation is disproportionately low.

The specific duties are legal requirements designed to help the Trust meet the general equality duty.

These require the publication of: Annual information to demonstrate our compliance with the Equality Duty published on our website by 31st January each year. Equality Objectives (which are specific and measurable) published for the first time by April 5th 2014, reviewed annually and re-published at least every four years. *Age has been broken down to focus on the different needs of older and younger people and disability has been broken down to address the different needs of those with visual, hearing, physical, learning and mental health impairment

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Moving Beyond Legal Compliance

Wirral Community NHS Trust like all public sector bodies has legal responsibilities under the Equality Act of 2010. As part of achieving legal compliance we are required to undertake a number of key actions. However, both in regards to both our patients and our workforce we want to go beyond meeting our equality duties, we want to develop, share and recognise areas of good practice.

The actions we have so far identified have been developed after consultation with our workforce and patients and stakeholders. By listening to their needs and understanding barriers they might be facing we have begun to recognise how by identifying some key equality action across the Trust we can support need and raise quality in both our service provision and employment.

Launch of our Equality Diversity & Human Rights Strategy

Wirral Community NHS Trust published its Equality Diversity & Human Rights Strategy in January 2014 and the strategy launch was held on the 7th March at St Catherine’s Health Centre Birkenhead.

A brand for the launch of the strategy has been developed to assist in raising the profile of Equality & Diversity issues and helping staff to identify key E&D activities and resources; with a message logo of ‘Getting it right for everyone’ being chosen to signify the Trust’s intent.

“As a gay man with a transgender history I was delighted to attend the equality strategy launch and talk about some of the key challenges that face LGBT people in Wirral, there are many barriers facing LGBT people especially when they encounter health services… Too often our needs are over-looked especially younger LGB and in particular transgender people and people make assumptions about who we are, what need.. I spoke to staff after the event who told said that they hadn’t understood about what the difficulties can be that face LGBT people. For that opportunity I am grateful and I am so pleased that Wirral Community Trust are trying to understand the needs we have and the difficulties we face” Sam Carr Chair of LIVFast Community Network

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By listening to you we have set our Equality Objectives

Wirral Community NHS Trust has a legal duty to publish equality objectives by 2012 and at least every four years after that. We are also required to publish details of the engagement work we have done to develop our objectives and set out how we will measure our progress against them. The purpose of the equality objectives are to help us make a real difference to some of the most pressing issues facing the protected groups that we provide services for and any staff we employ. They will also help us demonstrate how we are meeting our statutory duties. The following 6 objectives have been created from the information gathered from members of the public as well as staff. In order to identify any gaps in services from the service users and staff members, an internal grading criteria in accordance to EDS guidelines, was formed and used across Wirral Community NHS Trust.

By listening to what you told us and based upon our own equalities review we decided that the following 6 Equality Objectives would serve as being the starting point for addressing need for both patients and workforce.

1: review and improve patient feedback from the 9 protected groups 2: improve access to services for people with a learning disability 3: improve patient experience by all protected groups 4: improve the experiences of staff who might be discriminated against 5: review the appraisal system to make sure it supports staff from the 9 protected groups 6: To include equality and diversity in appraisals to ensure objectives are being met * *Revised to reflect changes in EDS2

Next Steps - How we will make progress in getting it right for everyone

Equality Strategy: Key Actions There are a number of key actions contained within the strategy which are being actioned to ensure progress.

Staff Support Networks- Lesbian Gay Bisexual Transgender (LGBT), Black Minority Ethnic (BME), Disability They will help to empower staff, offer peer support, help to raise awareness of any issues they face, and advise the trust on equality and diversity.

“I am really pleased that the Trust has recognised the need for staff support networks, I don’t yet feel confident enough to attend the LGBT meetings but maybe in the future I can feel it won’t matter if people know I’m gay” Trust employee who wishes to remain anonymous

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Training Equality Champions In 2013 the Trust reviewed the role of our Equality & Diversity Champions, the role of the Champions has been refreshed and there is less focus on attending meetings and more about changing culture through raising awareness of equality issues. The Trust has been able to identify a number of staff who have volunteered to become Equality Champions who will help share knowledge and good practice and provide feedback. The champions will be able to act as change agents: changing the culture and attitude within the organisation and challenging practice in a positive way.

Our Equality Champions currently are: Jane Harris Hannah Dreelan Helen Young Martin Hackett Helen Lundy Rachael Dunn Ewen Sim Nicola Kettley Phillipa Compson Paula Jones Carl Royston Julie Griffin Ros Lowther

Falls Team Quality and Governance Heart Failure Service Named Nurse Safeguarding - Children Community Nurse Co-Ordinator- Bank HR Business Partner Medical Director HR Business Partner Centre Manager, ADHC District Nursing, Liscard Podiatry Team Livewell Team Clinic Coordinator Team Leader, Eastham WIC

When I first got involved I wanted to be part of something that concentrated on how to improve the experiences of staff and patients, understanding need, seeing the relevance to how understanding the barriers people face affects the experience they have.

I have had the opportunity to undertake the training of others in an awareness of equality which was a great opportunity for me to meet staff working in different areas of the Trust; to hear their views on promoting equality in their areas and to provide an understanding of the Equality Act 2010. Those that attended the training felt that it gave them the chance to think about equality for patients and staff and how to make improvements for the future.

I hope that I can continue to be a champion for equality within our Trust, to continue to improve my understanding in this area and to ensure that the services we provide are accessible to all within our community.

Helen Lundy Community Nurse Bank Coordinator

Establishing a Community Equality Panel The members of our Community Panel are from a variety of community backgrounds with specific understanding of the needs of people from the nine protected groups, to help shape our equality and diversity plans. They will help us to understand barriers and identify any gaps.

In 2014 we recruited the following individuals to the Community Panel.

Carmel Calvert Garrick Prayogg

Healthwatch Wirral Project Coordinator Wirral Cultural Diversity Group Wirral BRM Voice, 7

Henry Poultney Emma Richards Chloe Harvey Jamie Anderson Libby Heath Angela Murphy Helen Fitzpatrick Sally Jardine Manisha Sharma Kevin Donavan Anne Gay Maggi Hammond

Wirral LGBT Network Terrance Higgins Trust (Wirral) Wirral Mencap Learning Disability Wirral Age Concern Older Peoples Rep Young People’s Representative Healthwatch Wirral Tomorrow’s Women Wirral Trust member Trust member Trust member Trust member Trust member Trust Member

Wirral Mencap is an organisation that represents the needs and views of local people with a learning disability and their carers. We are pleased to be involved in the Equality and Diversity Agenda for Wirral Community NHS Trust as it provides an opportunity to raise awareness of common health needs amongst people with a learning disability, and the issues relating to their experiences of, and access to, community health services. We hope that through working together we can improve understanding of the needs of this group, support the improvement of services and achieve better health outcomes.

Chloe Harvey Manager Wirral Mencap

Getting it right for our patient

Learning from Experience The Trust recognises that by listening to both staff and patients that the values and principles that underpin our work will be enhanced and will begin to address health inequalities for the communities we serve. The Trust has developed a number of approaches to gathering information from patient’s, staff, stakeholders and the wider communities we serve. Alongside these initiatives it is the Trust’s intention to use Community Panel members to gain further understanding of patient experience.

The role of the community panel will give us invaluable support in understanding and identifying barriers that certain groups face when accessing health services.

Making Things Happen It is important that the Trust has real understanding of how patients are experiencing and accessing the services that the Trust delivers across the communities it serves. A key component to increase this level of awareness and understanding is for each part of the Trust’s services to review and identify any barriers across the nine protected characteristics groups. To enable the Trust to gather information across the services the development of an Equality KPI template in 2013-14 has been 8

produced to enable gaps to be identified and actions to be developed. This template serves a dual purpose of not only identifying gaps but also to allow for monitoring of performance against the general duties. Each service is required to use the Equality KPI template which is based upon EDS2 and examine how it currently meets need across the nine protected characteristics groups.

“Black and racial minorities communities have some very specific health needs beyond its host general white communities, services must also be balanced against any equality agenda and delivery; stroke, heart disease, cancer are high among black groups, the key is understanding black health issues.

Understanding black health is the key area of concerns within inequalities, culture, tradition customs, communication; understanding the patient’s needs, effective communication on both side.

Among many cultures medical services may not be the first point of call, some may prefer traditional methods, even treating themselves or rely on spiritual means, hence the need for cultural understanding”.

Garrick Prayogg Project Coordinator Wirral Cultural Diversity Group Wirral BRM Voice, formerly African Caribbean Community Voice}

Getting it right for our workforce

Employer of Choice: By creating a working environment where all employees feel included, valued and rewarded on the basis of their talent and skills, the Trust will increase staff morale. This will lead to improvements in the quality and motivation of the workforce, which in turn leads to improved Trust performance and becoming an Employer of Choice.

Attract the Best Talent: It is essential to recruit and retain people, not only with the right skills, but also the flexibility to change and improve as the needs of the Trust change. The Trust has forged strong links with key local stakeholders such as voluntary and statutory organisations, schools and colleges and community groups to promote opportunities in the Trust.

In February 2014 we ran a successful Careers Evening at St Catherine’s Health Centre The aims of the event were to provide an opportunity to build on the already established links with local schools and colleges, to further enhance the profile of the Trust within the community, to raise awareness amongst young people of the diversity of careers available within the NHS, to support the development of a future recruitment pipeline and to promote partnership working with other NHS, 9

health and educational organisations. In addition to twenty Wirral CT services there was participation from WUTH, CWP, University of Liverpool, NHS Graduate Scheme and Skills for Health Academy.

The target audience for the event were students in years 10 and 11 (aged 14, 15 or 16) and to young members of the Trust of a similar age, as they would be preparing to make their ‘A’ level choices. 27 secondary schools across Wirral were invited, 193 people attended. Nursing proved to be the most popular stand, closely followed by Diagnostics (WUTH), Speech and Language, Health Visiting, Primary Care, Dentistry and the University of Liverpool, School of Medicine. The questions that were most asked were: ‘What does the job entail?’, ‘What grades do you need in which subjects to be able to apply for courses?’ and ‘Are there work experience opportunities?’

Feedback from the stand holders about the event was also extremely positive. They felt that the event looked very impressive, was professional, well organised, and that there was a wide diversity of stands.

Eliminate Bullying and Harassment: The Trust recognises that all employees have a right to work in an environment in which the dignity of individuals is respected and which is free from harassment and bullying behaviour. The existence of such behaviour creates a threatening or intimidating work environment which adversely affects job performance, health and well-being. We manage bullying and harassment through our Dignity at Work policy and procedure. It follows best employment practice and guidance from both NHS Employers and the Chartered Institute of Personnel and Development (CIPD) How we advance equality of opportunity The Trust acknowledges that the health and wellbeing of our workforce is vital, and our objective is to promote and ensure that we provide support and opportunities for staff to keep themselves healthy and safe. We recognise that a strategic approach is required to help our staff build and improve their mental and physical wellbeing. Working in partnership ensures that integrated prevention and promotion strategies are developed that are responsive to staff concerns and will enable staff to meet their duty under the NHS Constitution.

Reasonable Adjustments: The Trust is responsive to individual’s needs, both with the application of adjustments and good management of staff in supporting them appropriately and effectively. We recognise that some disabilities are not easily or openly discussed and must be treated with respect and dignity at all times.

The Trust has an Equality Champions Network and Staff Support Networks that provides support and guidance on promoting equality of opportunity in employment and its services.

A number of years ago, I was asked to go to Occupational Health by a previous manager regarding issues /situations raised in relation to my fear of heights, etc which limited my access to places both at work (& home) . When they first suggested this I was quite negative & indignant and suggested my capability was being inferred to. When I met the Dr in OH his reaction to my 30 year plus problem 10

was so supportive- I felt liberated as he recognised my problem as a substantial disability who said I should have had help 30 years ago. Following my OH appointment as I said- I felt liberated that I could actually tell people how I was feeling in certain situations/conditions and had been given “permission” to not put myself in situations/environments that would cause me distress/anxiety attacks. Our organisation and my colleagues throughout have supported me by recognising some of my limitations and have supported/ made the necessary reasonable adjustments to enable to continue undertake my role without barriers or discrimination.

Member of the Disability Staff Support Network How we eliminate unlawful discrimination As a Trust, we have a diverse range of engagement strategies to ensure that staff and patients have an opportunity be involved in the decisions that affect them. Equality and Diversity must be seen in all sectors of the Trust as an opportunity for creativity and innovation, this will require ongoing efforts to ensure clear and consistent messages are communicated and expert advice and support are afforded at all levels across the Trust.

How we foster good relations In establishing our Equality Delivery System (EDS) we recognised the value and importance of engaging all key stakeholders as part of our involvement process: WCT already has a number of mechanisms to involve people including consulting with staff, local communities, the patients involvement, patient and staff surveys and trade union discussions. We also recognise that the equality duties requires a much more in-depth approach and needs to reach out to people who are not actively engaged in such processes and who are least likely to complain

Strengthening Equality & Diversity

Governance Arrangements Creating a culture that supports and understands equality and diversity is the responsibility of everyone at the Trust. Our aim is to ensure that everyone can use our services and that we have a workplace that is free from discrimination and harassment. We take our legal responsibility seriously and want staff and patients to be treated fairly and with dignity and respect at all times. Equality and Diversity in the Trust is led by the Director of Human Resources & Organisational Development. A Non-Executive Director with a special interest in this area is closely involved in Trust monitoring and progress.

Equality issues have been reported to the Trust Board and Senior Management Team on a regular basis. In 2013 the Trust established an ‘Equality & Diversity Task Group’, commissioned by and accountable to the Trust’s Board. This Group is chaired by the Director of Organisational Development and includes representation from across the Trust services.

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In 2013-14 the Trust has also allocated resources to create a post of Equality Manager to further support staff in meeting their duties. By allocating resources to this dedicated post the Trust has recognised the need for staff to have clear and transparent systems in place to allow them to identify potential gaps and barriers for individuals who may share one or more of the protected characteristics.

Emerging Issues and priorities for 2014

Care Quality Commission Requirements The Care Quality Commission (CQC) expects to find evidence that the Trust is actively promoting equality and human rights across all its services and functions. Performance in relation to equality, diversity and human rights is embedded into each of the core outcomes, requiring the Trust to mainstream effective equality management into our core business activities to successfully achieve compliance against this regulatory framework.

The Trust has made good progress from 2013 on the delivery of the Trust’s equality commitment and key actions and mechanisms have been developed to bring that public commitment into an emerging reality for both patients and workforce. However, we recognise that this is a continuing journey and the review of progress has identified emerging issues and priorities going forward.

These are outlined below

Knowing our communities- Reflecting our diverse communities

Improving data collection This will assist the Trust in development of data analysis required to ensure reporting analysis is linked to protected groups for workforce and patient data. This will assist us to know that our patients and our workforce are representative of the local population. *Our existing equalities data on both workforce and patients for 2012/13

can be found in our Equality Diversity & Human Rights Strategy

and on the Trust website

Expanding our equality and diversity training programme An equalities training matrix has been presented to extended SMT which highlights the additional types of equalities training needed by staff. In 2013-14 we identified four key areas of equalities training in addition to our on-line Equality & Diversity e-learning.

1.

2.

3.

4.

Equality Analysis Equalities & Procurement Equalities Monitoring Bespoke equalities training e.g. understanding needs of people with a learning disability, barriers faced by LGBT people

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Understanding barriers and identifying equality actions In order to further mainstream equality work within the Trust, equality outcomes need to be considered at a divisional, as well as an organisational level. For this to be effective, further enhancements in data collection and utilisation are required. The use of the Equality KPI template will support this mainstream approach. A divisional equality dashboard will be developed for use from 2014-15 onwards.

Revising our approach to equality analysis Whilst there is no longer an explicit legal requirement to carry out equality impact assessments, we do need to be able to demonstrate that we have paid due regard to the general equality duty when making decisions and setting policies. Policies are set at an organisational level, but many of the major decisions relating to service provision are made divisionally A new toolkit has been developed and is now being used across the Trust to ensure a consistent approach and clear evidence of Due Regard against the General Duties EA10 is demonstrable.

The use of the NHS Equality Delivery System The framework has been recently reviewed and updated (EDS2) and the Trust is actively utilising this tool to enable more meaningful benchmarking against other NHS Trusts. The expertise and local knowledge of our Community Panel, Staff Support Networks and Healthwatch will ensure that the equality actions we are building upon are meeting need and supporting us to provide inclusive services.

Benchmarking & Partnership working The use of EDS2 will also facilitate a partnership approach to public and patient engagement and consultation activity with other local NHS trusts, widening engagement opportunities whilst ensuring that protected groups are not inundated with requests for consultation by a myriad of individual public sector organisations. The Trust is a member of the Cheshire, Wirral, Warrington, NHS Providers & Healthwatch Equality Forum/Network.

Lasting Change

Improving patient care is the over-riding concern for the Trust and the focus of our evidence based approach to meeting our equality duties; which will assist us in achieving improvements for all our patients. This approach will also assist in ensuring that we are meeting the needs of staff and are supporting them to have a positive employment experience.

We believe that our actions will support the single definition of quality established by Lord Darzi in his 2008 review High Quality Care for All. A definition which is now enshrined in law through the Health and Social Care Act 2012, it embraces three dimensions of quality, all of which are required for a high-quality service: clinical effectiveness; patient safety; and patient experience.

This commitment to embracing the three dimensions of quality is embedded in our Quality Strategy and the Quality & Cost Improvement Programme and Quality Account.

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The Trust acknowledges that, the quality of care we provide directly impacts on health outcomes, the way patients experience care, the safety of care and the cost of care. It will also impact on the reputation of the organisation and the wider NHS. The Trust acknowledges the invaluable support of staff, patients, stakeholders and the wider communities for the contribution to moving the Trust’s equalities agenda forward. We believe that this evidence based approach will support the Trust in making progress and provides a foundation to achieve positive impact and therefore improvements in how patients experience our services and support staff to have a positive employment experience. This will assist us in learning how too and therefore make sure that we are indeed, ‘Getting it right for everyone’

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