EQUALITY & DIVERSITY STRATEGY 2014/ /17

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1 EQUALITY & DIVERSITY STRATEGY 2014/ /17 Version: 1.0 Approved: December

2 CONTENTS Page 1. Introduction 3 2. The legislative background 4 3. Our population 5 4. What are we trying to achieve? 6 Our strategic aims Hearing a diverse range of Doncaster voices and using equality data to help us to commission effective services that meet identified health needs 4.2. Paying due regard to our Public Sector Equality Duties and equal opportunities within employment How will we achieve this? Internal capacity & capability Partnerships Delivery Reporting Review 11 2

3 1. Introduction Diversity literally means difference. There are many things that make us all different. Some examples are shown below. Age Sexual Orientation Education Race Past experiences Personality Religion / Belief Health status Career Disability Carer responsibilities Single / married / civil partnership / divorced / separated / widowed Language Gender (including transgender) Pregnancy Parenting responsibilities In valuing diversity, we recognise and value the differences between us and the benefits that these differences can bring. Valuing diversity is about creating a working culture and working practices that recognise, respect, and harness differences for the benefit of those for whom we commission services, our staff, our partners and our organisation. Equality does not mean treating everyone the same because some people are disadvantaged to begin with through differences like disabilities. Ensuring that everyone has an equal opportunity may mean making different adaptations for different people like targeting communication campaigns into specific communities in appropriate formats. Equality is therefore not about treating everyone the same, but about treating people according to their needs so that we reduce disadvantage. Equality and Diversity is central to the work of NHS Doncaster Clinical Commissioning Group (CCG) to ensure that we commission equity of access to services and treatment. The promotion of equality, diversity and human rights is central to the NHS Constitution and other national drivers to reduce health inequalities and increase the health and well-being of the population. We are committed to embedding values of equality and diversity into our commissioning processes, policies and procedures that secure health and social care for our population and into our employment practices. 3

4 2. The legislative background The Equality Act 2010 brought with it Public Sector Equality Duties. Public bodies are required to declare their compliance with the duties on an annual basis. Section 149 of the Equality Act outlines the general duties to have due regard to the following in the exercising of our functions: Eliminate unlawful discrimination, harassment, victimisation and any other conduct prohibited by the Act Advance equality of opportunity between people who share a protected characteristic and people who do not Foster good relations between people who share a protected characteristic and people who do not For the specific duty we are required to: Publish information to demonstrate compliance with the general duty, on the make-up of our workforce, and on those affected by our policies and procedures Publish one or more equality objectives covering a four year period In the context of the Public Sector Equality Duty the protected characteristics are defined as: Age Race Disability Religion or belief Gender reassignment Sex (male and female) Marriage and civil partnership Sexual orientation Pregnancy and maternity As a result of the general nature of the clauses, the responsibility of defining due regard has fallen to the Courts. Case law sets out broad principles regarding what public bodies need to do to have due regard to the aims set out in the general Public Sector Equality Duties. These are sometimes referred to as the 'Brown principles' (R. (Brown) v. Secretary of State for Work and Pensions [2008]). KNOWLEDGE CONSCIOUS APPROACH TIMELINESS REAL CONSIDERATION NO DELEGATION RECORD KEEPING Those who have to take decisions must be made aware of their duty to have due regard across the protected characteristics. Due regard involves a conscious approach and state of mind and must be considered up-front. A body subject to the duty cannot satisfy the duty by justifying a decision after it has been taken. The duty must be exercised with real consideration such that it is integrated with the decision making process and can influence the final decision. The duty remains the responsibility of the CCG at all times and is a continuous duty. It is good practice for those exercising public functions to keep an accurate record showing that they had actually considered the general equality duty and pondered relevant questions. 4

5 3. Our population The Census has collected information about the population every 10 years since 1801 (except in 1941). The latest census in England and Wales took place on 27 March We use the statistics collected from the Census to understand the similarities and differences in our populations characteristics locally, and compare regionally and nationally. Doncaster s population is 302,400 (compared with 290,600 mid-year estimate 2010). Doncaster has seen the greatest difference (4.06%) when compared to the 2010 mid-year estimates in the Yorkshire and Humber Region. 36.7% of Doncaster s residents who are classified as economically active are in full time employment, 0.2% up on the 2001 census return. The proportion of people in full time employment is still below both the regional (37%) and national (38.5%) average although the gap is narrowing as regional and national average have seen a fall since 2001 of 1.8% and 2.1% respectively. The number of children and young people (0-19) stands at 72,600 and this is 3.3% higher when compared to the 2010 mid-year estimates and 4.9% higher in the 0-4 year age band. The number of working age people (20-64) stands at 178,600 and this is 5.4% higher when compared to the 2010 mid-year estimates but particularly the and age band which are 12.9% and 14.8% higher respectively. The number of older people stands at 51,200 and this is similar to the 2010 mid-year estimates, however the number of people within this group aged over 85 stands at 6400 and this is 6.7% higher. Census 2011 data, including a specific report on Ethnicity in England 2011 and the local comparators which gives us a breakdown of the population by ethnic group. Whilst Doncaster is still predominately White British, it has, over the last 10 years, become more ethnically diverse with rising numbers of people identifying themselves with minority ethnic groups in Population breakdown: 91.8% White British 3.4% Other White 1.1% Mixed Multiple Ethnic Groups 2.5% Asian / Asian British 0.8% Black / African / Caribbean / Black British 0.4% Other Ethnic Groups. The 6 largest ethnic groups in Doncaster in order of size are a) White British, b) White Polish, c) Pakistani or British Pakistani, d) Indian or British Indian, e) White and Black Caribbean, f) African. Minority ethnic groups tend to be located around the Town Centre and surrounding areas. In particular the hotspot areas include Lakeside, Balby along Balby Road, Hexthorpe, Wheatley Park along Wheatley Hall Road, Intake and Belle Vue. We know that patterns of inequality in health can vary by ethnicity from one health condition to the next. We use national data to highlight inequalities such as Black African and Caribbean men who tend to have higher rates of prostate cancer and women from Black and other minority groups who are more likely to present with more advanced breast cancers and have poorer survival rates from breast cancer than white women. 5

6 4. What are we trying to achieve? NHS Doncaster CCG has two very different roles: Our role as a commissioner of services, reaching out into the community for whom we commissioning services. Our role as a corporate body and an employer. To capture both these roles, we have developed two vision statements, an externally-facing vision for our role as a commissioner of services, and an internallyfocussed vision for our role as a corporate body and an employer. Commissioning role: To hear a diverse range of Doncaster voices and use equality data to help us to commission effective services that meet identified health needs. Corporate Body: To ensure that we pay due regard to our Public Sector Equality Duties and equal opportunities within employment. We monitor progress towards this vision through Delivery Plans which are overseen by the Engagement & Experience Committee Hearing a diverse range of Doncaster voices and using equality data to help us to commission effective services that meet identified health needs Diverse population: Doncaster has a diverse population comprised of many different communities of both place and interest. A community of place is a community of people who are bound together because of where they reside, work, visit or otherwise spend a continuous portion of their time e.g. a neighbourhood. A community of interest is a community of people who share a common interest. Frequently, such communities cannot easily be defined by a particular geographical area. The concept of a community of interest links well to the protected characteristics under the Equality Act 2010 such as religion or belief, sexual orientation, or ethnic origin. In this way we may talk about the Catholic community, the gay community, or the Chinese community. We will endeavour to understand the communities that make up Doncaster in order to support us in our role as a commissioner of services. Advocate for patients: As a commissioner we act on behalf of the public, patients and their carers, investing funds on behalf of our communities. In order to make commissioning decisions that reflect the needs, priorities and aspirations of the local population we need to engage with the public and actively seek the views of patients, carers and the wider community. Effective patient and public engagement is therefore a cornerstone of what we are trying to achieve as an organisation, and so we will strive to hear voices of people from across communities of interest and place in Doncaster and across the protected characteristics. 6

7 Engagement: Good engagement generates insights about the experience of our patients, carers and public to develop foresight for our organisation (commissioning aspirations, market intelligence, provider capabilities). This intelligence is very valuable and can help make us a smarter health investor able to achieve better value for our healthcare resources. We need this insight data to ensure that patient and public experience is embedded into all our decision-making processes, so that user/carer experience across all the protected characteristics is one of the elements that we consider alongside quality, outcomes and overall value for money when making decisions as detailed in User / the diagram opposite. We will Carer aim to employ different Experience engagement methodologies to best suit each area within our commissioning cycle: Consultation on our strategic plans and priorities. Engagement on how we specify outcomes, redesign pathways or services and procure services Validation of the quality and performance of the services we commission Targeting engagement: Our approach to advancing equality and tackling health inequalities is influenced not only by what the data tells us but by listening to, and learning from, patients, carers, and the public. To do this, we need to understand the composition of communities of place and communities of interest within Doncaster, and, where possible, target our communication and engagement activity to reach communities most affected by our commissioning initiatives. This is supported by one of our 4-year equality objectives originally agreed in 2013 to ensure appropriate and accessible targeted communication with local communities to empower patients. Health inequalities: NHS England s strategy for promoting equality and tackling health inequalities confirms that the available data demonstrates there are inequalities in both health outcomes and service experience that have endured over time, despite substantial investment in healthcare. Inequalities are in evidence between groups of people with different protected characteristics, and across geographies. This is very much reflected locally in the Doncaster data available to us in the Community Profiles of the 88 communities that make up Doncaster (which include elements such as population, educational attainment, crime levels and health issues) and in the local Census 2011 data. We aim to consider how we can reduce health inequalities through our commissioning activity. Needs Assessment: A Joint Strategic Needs Assessment (JSNA) helps identify the current and future health and wellbeing needs of a population. Doncaster s Joint Strategic Needs Assessment is part of the work programme of the Doncaster Health and Wellbeing Board. Joint Strategic Needs Assessment reports are used by the Board to identify priorities for action, and to inform the writing of the local Health and 7 Outcomes / activity Value for money Quality

8 Wellbeing Strategy. The Joint Strategic Needs Assessment is also fundamental to NHS Doncaster CCG s commissioning strategy, and features heavily during our planning rounds. To aid prioritisation, the Joint Strategic Needs Assessment covers four areas: a) How is Doncaster currently performing against the national average? b) Is Doncaster improving from past performance? c) Is Doncaster narrowing the gap with the national average? d) Are inequalities improving between communities in Doncaster? The inequalities section is specifically used to track commissioning impact. We will commission specific Needs Assessments as required to identify the key needs of the population in terms of healthcare resource including where the population is currently accessing services and where additional unmet need may exist. Needs assessments will allow us to obtain an in-depth understanding of the needs of a specific population group for which we are responsible for commissioning healthcare. Needs assessments can be undertaken at different levels such as the entire population, by condition e.g. diabetes, or based on communities of interest e.g. hearing impaired. We work with the Public Health Team in Doncaster Council to commission needs assessments. We will use such information available to us to identify and commission for health needs. This is supported by one of our 4-year equality objectives originally agreed in 2013 to make effective use of equality data within the commissioning cycle to prioritise commissioning of services and embed equality within Provider contracts Paying due regard to our Public Sector Equality Duties and equal opportunities within employment The right corporate systems and processes help organisations to embed equality and diversity considerations into the very fabric of the organisation, making it everybody s business to show due regard to our public sector equality duties. The first thing that our team members need is knowledge of the public sector equality duties, which can be achieved through a range of development opportunities. This is particularly critical for our decision-makers; we need to understand how our decisions do or might affect people with different protected characteristics. We also need to ensure that we take account of potential impact consciously and at the right time in the decision-making process. As a commissioner, a great deal of our influence is through the services that we commission. We recognise that the public sector equality duty is non-delegable, but we do seek to enshrine its principles in the service specifications that we develop and in the contracts that we award. We have an Engagement & Experience Committee reporting directly to our Governing Body which oversees the equality agenda within our organisation and we will ensure strategic leadership of the equality and diversity agenda at Governing Body level. Diversity means that everyone is different, and each individual s experience, knowledge and skills bring a unique contribution to an organisation and must be 8

9 valued equally. We have committed to equality of opportunity for all our employees and potential employees through our Equal Opportunities Policy. The promotion of equality and diversity will be actively pursued through our Human Resources policies and procedures and our mandatory training programme which will ensure that employees and potential employees are not subject to direct or indirect discrimination. Through these means, we aim to embed due regard to our public sector equality duties in all our decision-making practices. 5. How will we achieve this? 5.1. Internal capacity & capability The communication, engagement & equality team comprises: Lay Member for Public & Patient Engagement and Equality Clinical Lead for Public & Patient Engagement and Equality Chief of Service with strategic responsibly for communication, engagement, experience & equality Head of Communications Patient Experience Manager Equalities & Engagement Officer Other equality, communication and engagement services are contracted for externally such as: Community infrastructure engagement and support Design and print Website management 5.2. Partnerships Tackling health inequalities in Doncaster is a multi-dimensional challenge reaching beyond the boundaries of health. Wider determinants impact upon health variation and inequalities such as lifestyle, housing, employment, poverty, societal networks, and access to and take-up of healthcare. A health inequality is a cumulative negative effect of these factors. As such, we cannot hope to address health inequalities alone; it will take a wider partnership approach. We are represented at every level of Team Doncaster, the Local Strategic Partnership. To achieve ambitious transformational change, partners must work collectively to focus available organisational resources effectively and efficiently. The Health and Wellbeing Board in Doncaster is responsible for bringing together key partners to ensure organisational plans and priorities are aligned to support transformational change and efficient use of resources. The Health and Wellbeing Board is a key driver for change and NHS Doncaster CCG is an active member. 9

10 Partnerships to tackle inequalities can be effective at many levels. CCG delivery plans have seen initiatives developed such as: A Doncaster Cancer Survivorship Project a partnership between Doncaster health and social services, Macmillan Cancer Support and other voluntary organisations to improve support for cancer survivors and help them return to a normal, healthy life. A Prostate Cancer Awareness Campaign in partnership with Doncaster Rovers Football Club. The CCG, Doncaster Council and the Alzheimer s Society working together along with Dementia patients and their carers on an initiative to make Doncaster a Dementia Friendly Community. Working in partnership with Healthwatch Doncaster. A partnership with community pharmacies on a Choose Well initiative. We aim to take an active part in local partnership strategic structures aiming to work together to address inequalities. We are also commissioning integrated voluntary and community infrastructure engagement and support within Doncaster Delivery We have already used and committed to continue to use the national Equality Delivery System (2) to develop Equality Objectives in line with the public sector equality duty. These are the objectives which we use as success indicators to measure ourselves on our journey to our overall equalities vision contained within this Strategy. These are: Objective 1: Make effective use of equality data within the commissioning cycle to prioritise commissioning of services and embed equality within Provider contracts. Objective 2: Ensure appropriate and accessible targeted communication with local communities to empower patients. The vision described in this strategy forms the basis of operational delivery plans overseen by the Engagement & Experience Committee and its supporting Management Group, with progress reported to the Governing Body through the minutes of the Engagement & Experience Committee Reporting The public will be informed of equality & diversity progress via: Equality information published by 31 st January each year in line with the public sector equality duty. The minutes of the Engagement & Experience Committee published through the CCG Governing Body papers. 10

11 CCG website pages. Routine engagement activity. 6. Review This Strategy will be reviewed as a minimum every 3 years. 11

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