EQUALITY & DIVERSITY STRATEGY

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1 EQUALITY & DIVERSITY STRATEGY

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3 APPLICATION FOR AUTHORISATION Equality and Diversity Strategy Key evidence demonstrated: Evidence for authorisation CCG can demonstrate compliance with the public sector Equality Duty and is using EDS or equivalent to help attain compliance and ensure good quality performance. Signpost Section 4.1 on Page 12 sets out that the CCG has adopted the EDS system as a framework for delivering continuous annual improvement in outcomes for patients and meeting the CCG s Public Sector Equality Duties The attached Equality Impact Assessment of our E&D Strategy evidences that we are giving consideration to the impacts (both negative or positive) of our strategies and plans and how they impact on equality issues.

4 Equality and Diversity Strategy If you require this document in another format or language please contact: Telephone: Write: NHS Bath & North East Somerset Clinical Commissioning Group Headquarters, St. Martins Hospital, Clara Cross Lane, BATH, BA2 5RP. Website: www.

5 Foreword We are pleased to launch our first Equality and Diversity Strategy for Bath and North East Somerset Clinical Commissioning Group. The strategy sets out our commitment to taking equality, diversity and Human Rights into account in everything we do whether it involves commissioning services, employing people, developing policies, communicating with or engaging our local communities in our work. We believe that this strategy and action plan will help the Clinical Commissioning Group to tackle current health inequalities, promote equality and fairness and establish a culture of inclusiveness that will enable health services in Bath and North East Somerset to meet the needs of all its population. Our Governing Body commits to monitoring our progress and reporting regularly and openly on the developments set out in this plan. As leaders we acknowledge and accept our roles in supporting the strategy and will play our full part in making its aims a reality. Dr Simon Douglass GP Accountable Officer (Designate) NHS Bath and North East Somerset Clinical Commissioning Group

6 Equality and Diversity Strategy Introduction Bath and North East Somerset Clinical Commissioning Group (B&NES CCG) is committed to eliminating all forms of discrimination and providing equality of opportunity for everyone. We recognise and value the diversity of our communities and believe that equality is pivotal to the commissioning of modern, high quality health services. This strategy outlines our overall approach to equality, diversity and human rights in our capacity as an employer and a health commissioner. This includes how the CCG will: Develop a governance structure for equality and diversity; Ensure all staff have the necessary skills to commission services in line with the Equality Act 2010 and Public Sector Equality Duty under this act. Complete Equality Analyses/Equality Impact Assessments (EAs/EIAs) to identify potential impacts on and outcomes for patients Use the results of EA/EIA as an integral part of our decision making and commissioning processes Ensure that our communications and engagement activities are inclusive, that is to say that they are reaching effectively to people from all protected groups, including carers and seldom heard or marginalised communities Work with our statutory and voluntary sector partners on equality issues and to tackle health inequalities Ensure that our Human Resources policies are fair and transparent, and work in partnership with our staff and potential employees to improve working lives Monitor complaints, comments and compliments by protected characteristic Develop assurance mechanisms to satisfy ourselves that providers who are delivering services on our behalf including the Commissioning Support Service (CSS) are complying with the Equality Act this will include for example completion of access audits to ensure services are accessible The approaches outlined above apply to all of the protected characteristics as defined by the Equality Act 2010 (see Appendix 1).They include: age, disability, gender reassignment (transgender), marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex (gender), and sexual orientation.

7 The practical result of the Act is that the CCG is legally required to consider how its policies, plans, procedures, projects, services and decisions will affect people (such as patients, carers, service users, communities and employees) with one or more of the protected characteristics. 2. B&NES CCG s Vision, Mission, Values and Key priorities Our overall vision is: Healthier, Stronger, Together Our mission is: To commission high quality, affordable, integrated patient centred care which respects and responds to the needs of our local population. In doing so we will harness the strength of clinician led commissioning and empower our patients to improve their health status. Our values We will: Focus on continually improving the quality of services Be credible, creative and ambitious on behalf of our local population Work collaboratively and be respectful of others Be focused, committed and hard working Be alert to the needs of all our population, particularly those who are most vulnerable Operate with integrity and trust Our priorities Key service priorities for the CCG include: Improving the management of patients with Long-term conditions & supporting the frail elderly and improving skills for managing End of Life Re-designing the Urgent care system in B&NES to create a more responsive system, with improved same day access to diagnostic and treatment Supporting patients with Dementia and mental health needs, aimed at improving post diagnostic support and intervention in primary care For further information Insert access to link (when strategic plan is finalised) In the conduct of this work the CCG will be mindful of delivering on the main B&NES local priorities which include a reduction in health inequalities and promotion of equality.

8 3. Meeting our duties The publication of this strategy and action plan is a clear expression of our commitment to valuing diversity and embedding equality and Human Rights consideration in the way we deliver our business and make commissioning decisions. We aim to reduce health inequalities by actively identifying and removing barriers or unfair bias to the health and wellbeing of our communities. We recognise: Our legal duties relating to equality and human rights we understand that compliance is not enough and we need to go beyond to promote cultural changes which help to make equality and human rights an integral and real part of our business That our responsibility for discharging the duty cannot be delegated or subcontracted and that ultimate responsibility for discharging the duty remains with us as commissioners. This means that we must have mechanisms in place to make sure that organisations providing services on our behalf are also meeting the duty, this includes the CSS That moral case for equality and diversity is fully justified - health inequalities are unacceptable and must be minimised That the Marmot Review 1 estimated that additional annual cost to the NHS of not addressing health inequalities to be 5.5 billion this we believe is a strong business case for identifying and addressing barriers to health equality. 3.1 Equality Act The Equality Act 2010 brought together all the previous and separate pieces of antidiscrimination legislation into one Act of Parliament. The Act covers the following protected characteristics": age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex and sexual orientation. There are a number of notable exemptions to the Act e.g. transgender. There is an exception to the general prohibition of gender reassignment discrimination in relation to the provision of separate- and single-sex services. Such treatment by a provider has to be objectively justified and must be a proportionate means of achieving a legitimate aim. 3.2 Public Sector Equality Duty The Equality Act contains special provisions for public sector bodies known as the Public Sector Equality Duties (PSED). It is made up of a general duty which is the overarching requirement and specific duties which are intended to help performance of the general duty. 1 The Marmot Review, Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England post HMSO, The Equality Act 2010

9 The general duty has three aims and it applies to most public authorities, including the NHS Commissioning Board and the CCGs (and bodies exercising public functions such as private healthcare providers), who must, in the exercise of their functions, pay due regard to them. These are: Aim 1: Aim 2: Aim 3: 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 share it; and foster good relations between people who share a protected characteristic and people who do not share it. Under the Specific Duties 3 of the Public Sector Equality Duty public authorities are required to publish in a manner that is accessible to the public the following information: Publish information to demonstrate its compliance with the public sector Equality Duty at least annually and no later than the 30 th of January. This information must include, in particular, information relating to people who share a protected characteristic who are its employees (public authorities with fewer than 150 employees are exempt) people affected by its policies and practices. This includes information on: community profile by protected characteristics; results of consultations/engagement with people possessing one or more protected characteristics; patient profile; patient satisfaction; results of Equality Analyses/Equality Impact Assessments and how they have influenced decisions Equality objectives at least every four years. All such objectives must be specific, measurable, achievable, resourced and time-bound. 3.3 Human Rights Act 4 Public sector organisations also need to have due regard to the Human Right Act 1998 (HRA). There are five principles of human rights which are: fairness, respect, equality, dignity and autonomy called the FREDA principles which also form part of the NHS Constitution. In commissioning and delivering services which are compatible with the HRA, the CCG commits to undertaking Human Rights based approach in line with PANEL principles: Participation, Accountability, Non-discrimination, Empowerment and Legality. 3.4 The NHS Constitution 5 3 HMSO, Equality Act 2010 (Specific Duties) Regulations HMSO, The Human Rights Act Department of Health, The NHS Constitution for England: The NHS Belongs to us All (2012)

10 The NHS constitution revised in March 2012 contains seven principles that guide the NHS as well as a number of pledges for patients and the public. A number of these demonstrate commitment by the NHS to the requirements of the Equality Act and the Human Rights Act. The first of the seven principles requires that the NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief. There are also a number of rights contained in the constitution which demonstrate the NHS s commitment to equality and human rights and which include: The right not to be unlawfully discriminated against in the provision of NHS services including on grounds of gender, race, religion or belief, sexual orientation, disability (including learning disability or mental illness) or age The right to be treated with dignity and respect, in accordance with your Human Rights The right to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this The right to accept or refuse treatment that is offered to you, and not to be given any physical examination or treatment unless you have given valid consent The right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services 3.5 The NHS Equality Delivery System 6 The NHS has a developed a framework for assessing equality performance called the Equality Delivery System (EDS). The EDS can help NHS Organisations to: demonstrate their compliance with the general and specific equality duties and human rights obligations; deliver on the NHS Outcomes Framework and the NHS Constitution; help NHS organisations improve the services they provide for their local communities, consider health inequalities in their locality and provide better; working environments, free of discrimination, for those who work in the NHS and; help NHS organisations to identify and shape their equality objectives. The EDS is based on four key goals and 18 associated outcomes. Evidence against each of these outcomes is used to determine the organisation s equality performance against one of four grades. These four goals and grades are shown below: 6 The Department of Health, The Equality Delivery System for the NHS (2011)

11 The EDS is to be shared and agreed with our stakeholders on annual basis. The CCG has decided to adopt the EDS as a framework because it will allow us to: meet the requirements of the Equality Act 2010 and Public Sector Equality Duties and embed equality and Human Rights into our day to day business Develop the work undertaken by our predecessor NHS B&NES PCT Strengthen our engagement with patients, cares and communities from all protected groups Enhance our evidence for domain 2 relating to the CCG authorisation Work in line with the NHS Constitution and Human Rights principles. 4. Leadership and Governance The CCG has developed its constitution, governance and accountability mechanisms to enable it to meet all its duties and responsibilities including the delivery of statutory functions such as Equality, Diversity and Human rights. 4.1 What we have already done: Identified a Chief Operating Officer (on behalf of the Clinical Leader/Accountable Officer) and the Governing Body Lead for equality and diversity as set out in our CCG s constitution Identified an Executive Director as the Equality Champion Delivered, in June 2012, a written brief to the CCG s Governing Body on their responsibility under the Equality Act 2010 and associated Public Sector Equality Duties. Included an Equality and Diversity workshop in the CCG s development plan, members of the Governing Body will be required to attend this workshop so that they develop a better understanding of the implications of the Equality Act 2010 and associated Public Sector Equality Duty Secured, jointly with NHS Wiltshire, interim specialist resource to advise the CCG on matters of equality, diversity and Human Rights Adopted the Equality Delivery System as a framework for delivering continuous annual improvement in outcomes for patients and meeting our Public Sector Duties Supported and consulted on the development of draft equality objectives for B&NES (For further information insert access link to equality objectives)

12 4.2 What we plan to do: Identify a lay (Patient champion) and a GP member (GP champion) on our Governing Body to lead on matters of equality, diversity and Human Rights Provide training to equality leads of the Governing Body on how to perform their role most effectively Make equality, diversity and Human Rights a standing item on the CCG Governing Body agenda every 6 months Report on CCG s performance against our equality objectives and EDS goals and outcomes at least once a year Publish annual equality data and information to meet the requirements of the specific Public Sector Equality Duty Monitor and conduct an annual review of progress against our equality objectives set in 2012 Ensure that exception reports on CCG, CSS, and other providers performance around equalities are on the Clinical Commissioning Committee (or relevant sub-committee) agenda at least twice a year Put in place a robust Equality analysis and Equality Impact Assessment (EA/EIA) process which is completed as part of the decision making process from the beginning and enables the CCG to have a full understanding of the equality risks to patients of any decisions they make. 5. Equality Analysis/Equality Impact Assessment (EAs/EIAs) EAs/EIAs allows public authorities such as the CCGs to identify the impact or effect (either negative or positive) of their policies, procedures, projects, services, and functions on different sections of the population, paying particular regard to the needs of protected groups and other disadvantaged groups. Where negative impacts are identified the organisation needs to take steps to deal with this. The Equality Act 2010 requires statutory authorities to carry out EAs/EIAs and show how they have reflected the result of EAs/EIAs to make their decision. To a great degree all functions or activities of the CCG are subject to general or specific equality duties - this means that all strategies, policies, action plans and projects we undertake must be assessed for equality impact including our Human Resources policies and procedures. 5.1 What have we already done: We have made a commitment to increasing the quality and number of EAs/EIAs that we complete and making sure that EA/EIA is part of the policy formulation/service design from the very outset so that we can use the results more effectively in our commissioning and other decisions We have developed and disseminated a guide and template for managers and commissioners We have completed an EA/EIA for our Strategic Plan 2012/ /2016

13 5.2 What we plan to do Arrange training for CCG managers responsible for completing EAs/EIAs Ensure that providers and CSS complete EA/EIA training for their staff as this will assure the CCG of further compliance with equalities legislation in undertaking the work commissioned by the CCG Work with our partners including CSS to improve data and information resources to better inform and facilitate the completion of EAs/EIAs 6. Communication and engagement We recognise the importance of working with all our local communities, statutory partners, staff and the voluntary sector so that they have a voice which will inform the planning and commissioning of our local NHS services. We are committed to making our communication and engagement work inclusive ensuring that we make opportunities for minority groups and seldom heard groups to have their say. We understand that high quality accessible communication is a key domain for authorisation 7. Consequently we have made a commitment to listen to and work in partnership with the people we serve as described in our Communication and Engagement Strategy we will make sure that this strategy is inclusive. 6.1 What we have already done We will by 1 st October 2012 complete an EA/EIA on our communication strategy to identify barriers to effective communication with our minority communities Made a commitment to removing barriers to effective communication and where necessary by making reasonable adjustment and creating opportunities for minority communities to have a voice Introduced regular healthy conversation sessions with our communities to get feedback on the work we are doing these conversations are held with grass-root networks via their membership of the Health and Wellbeing network. This is a list of range of provider organisations covering secondary care, community care and the voluntary sector Developed our approach to communicating with the general public through holding targeted events 6.2 What we plan to do Ensure that our communication is accessible to all our service users and communities e.g. when requested we have the capacity to provide information in large print or Braille or in different languages Implement the actions identified in the outcome of our EA/EIA of our Communications and Engagement Strategy and review progress to ensure that we are compliant with the requirements of the equalities legislation 7 NHS Commissioning Board, Clinical Commissioning Group Authorisation: Draft Applicant s Guide (2012)

14 Engage with protected groups at least once a year as an integral part of reviewing our performance against the EDS goals and outcomes Make linkages with HealthWatch, the voluntary sector, as well as making good use of patient feedback groups in helping us to reach protected groups Work with the Public Health team on the equalities agenda in supporting around protected groups 7. Workforce Training We are committed to working in line with the current employment legislation including meeting the provisions of the Equality Act The CCG will aim to provide a working environment which is free from discrimination, victimisation and harassment on individual and/or institutional basis on the ground of any of the nine protected characteristics specified in the Equality Act We will also make sure that our employment policies and procedures are working in line with the Human Rights Act We also aim to recruit, retain and develop a workforce which is representative of all sections of our communities. We believe this will enable us to embed equality, diversity and Human Rights into our business and help us to respond more effectively to the needs of our service users and communities. Our responsibilities as an employer are set out in our suite of Human Resources policies and procedures. 7.1 What we have already done: Developed and published our Human Resources policies and procedures which are compliant with the Equality Act 2010 Adopted EDS framework to help us to deliver year on year improvements in working lives of our employees, and to comply with the workforce element of the Public Sector Equality Duty Assessed the impact of our employment policies and procedure in relation race, and disability and gender Placed a requirement on our employees to undertake statutory and mandatory training including equality and diversity (ideally annually but every three years as a minimum) made a commitment to collect and analyse data and information to inform us about the impact of our employment policies and decisions on our employees and potential employees Adopted the elements of NHS Competency Framework for E&D Leadership by sponsoring our E&D Lead to undertake and attain an award of Institute of Leadership and Management Level 4 qualification Managing Equality and Diversity in an Organisation 7.2 What we plan to do: Arrange EA/EIA training for CCG staff responsible for undertaking EAs/EIAs this will help us to deliver our commitment to increase the quality and numbers of EAs/EIAs completed. We plan to use the results of EA/EIA to

15 improve our decision-making and deliver better health outcomes for protected groups Complete EAs/EIAs on all our existing Human Resource policies and procedures to assess impact on different groups on the grounds of different protected characteristics when they next come up for review Work in partnership with the Local Authority and CSS to engage staff with one or more protected characteristics and staff side bodies at least once a year as part of the review of our performance against the EDS goals and outcomes. Periodically review and revise our statutory and mandatory training to ensure that it remains relevant 8. Commissioning and Procurement We recognise that we are ultimately accountable for ensuring that services we commission are delivered in line with the equality and Human Rights legislation and that both we and our providers comply with the Public Sector Equality Duty. So we will aim to ensure that all our contracts and Service Level Agreements include clauses and performance measures around our equality and Human Rights duties and responsibilities e.g. access to services and information in appropriate formats or treating everyone with dignity and respect. We understand that we need to work with our partners and providers to improve collection of qualitative and quantitative data to enhance our ability to commission high quality services. Whenever possible we will aim to disaggregate performance data by the nine protected characteristics so that we can monitor the impact of our commissioned services on different groups and take action to rectify any shortcomings in our performance. 8.1 What we have already done: Adopted the NHS EDS as the framework to help us to gather and analyse equality information against EDS goals and outcomes Introduced specific equality clauses (relating to services and Human Resources) in our 2012 contracts to providers and incorporated equality performance into quarterly performance reports Have developed some capacity to disaggregate performance data by age, sex, race, some disabilities, and pregnancy and maternity 8.2 What we plan to do: We will by 1 st October 2012 complete an EA/EIA of our Commissioning Plan to make sure that it takes account of the needs of all our services users and communities Review that specific equality clauses in contracts are working as intended Incorporate specific equality clauses in all our Service Level Agreements Improve the use of existing disaggregated performance data to influence our decisions Explore the scope to extend our capacity to disaggregate performance data by all nine protected characteristics

16 9. Complaints, concerns and compliments We recognise that complaints, concerns and compliments are an important indicator of people s satisfaction with our services. The feedback from service users and our communities also helps us to deliver continuous improvements to our services. We aim to respond to any complaints and concerns effectively, as fairly as possible and in a timely manner. Analysis of complaints information by protected characteristics can be a good indicator of potential inequalities likely to arise from our policies and procedures and the way we apply them in practice. In order to capture service experiences of our people we are committed to providing information on how to complain, raise concerns and give compliments. We aim to provide and disseminate this information in accessible formats, via variety of means, across all groups of people protected under the equalities legislation as and when opportunities arise. 9.1 What have we already done: Secured future arrangements for the delivery of a complaints and concerns service via Central Southern Commissioning Support Service 9.2 What we plan to do: The CCG s Governing Body will receive a report on complaints, concerns and compliments at least twice a year. Report will include equality monitoring of access to services and analysis of any equalities trends that have arisen from complaints received or the way they have been handled. The aim is to learn these incidents and improve our service in the future. Appendix 1: Action Plan Appendix 2: Description of Public Sector Equality Duty protected characteristics Appendix 3: Equality Act 2010 general and specific duties Appendix 4: Human Rights Act 1998 Appendix 5: NHS Equality Delivery System: Goals and outcomes Date reviewed/ approved: 26 July 2012, Clinical Commissioning Committee Final version: 9 th September 2012 Review Date: September 2014 Records Management: Chief Operating Officer

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19 APPENDIX 1 ACTION PLAN Category Action Target date 1. Leadership, governance & accountability 2. Equality Analysis/Equa lity Impact Assessment 3. Communicati on & Engagement 4. Workforce & training 5. Commissioni ng and procurement 6. Complaints, concerns & compliments Identify a lay and a GP member as equality champions on our Governing Body as E&D Leads October 2012 Provide training to Governing Body and E&D Leads on how to perform their role most effectively October 2012 Report on CCG s performance against our equality objectives and EDS goals and outcomes at least once a year Summer 2013 Publish annual equality data and information to meet the requirements of the specific Public Sector Equality Duty January 2014 Monitor and conduct annual review of progress against equality objectives set in 2012 (refer to equality objectives) Summer 2013 Ensure that exception reports on CCG, CSS, and other provider performance around equalities are on the Clinical Ongoing Commissioning Committee (or relevant sub-committee) agenda at least twice a year Ensure EA/EIA process is an integral part of the decision making process and not an after-thought Ongoing Arrange training for CCG managers responsible for completing EA/EIA Spring 2013 Ensure that providers and CSS complete EA/EIA training for their manager as this will assure the CCG that providers Ongoing are complying with equalities legislation in undertaking the work commissioned by the CCG Work with our partners including CSS to improve data and information resource to better inform and facilitate Ongoing completion of EAs/EIAs Ensure that our communication is accessible to all our service users and communities March 2013 Implement actions identified in the outcome of our EA/EIA of our Communications and Engagement Strategy and Refer to review progress to ensure that we are compliant with the requirements of the equalities legislation strategy Engage with protected groups at least once a year to as part of the review of our performance against the EDS goals March 2013 and outcomes Complete EA/EIAs on all our existing Human Resource policies and procedures as they come up for review Ongoing Work with the B&NES Council and CSS to engage staff with one or more protected characteristics and staff side Spring 2013 bodies at least once a year to as part of the review of our performance against the EDS goals and outcomes Periodically review and revise our statutory and mandatory training to ensure that it remains relevant Ongoing Improve the use of existing disaggregated performance data to influence our decisions & explore the scope for extending disaggregation of this data by all nine protected characteristics Review that specific equality clauses in contracts are working as intended & incorporate specific equality clauses in all our Service Level Agreement The CCG s Governing Body will receive a report on complaints, concerns and compliments at least twice a year. March 2014 Ongoing TBA

20 The Public Sector Equality Duty 2010 (protected characteristics) 1. Age Being of a particular age/ within a range of ages. Appendix 2 2. Disability A physical or mental impairment which has a substantial and long-term adverse effect on day to day activities. This includes people with mental health problems, learning disabilities and long-term or serious illnesses such as heart disease, cancer or HIV/ AIDS. 3. Gender (Sex) Being a woman or a man. 4. Gender reassignment (transgender) 5. Pregnancy and Maternity A person has the protected characteristic of gender reassignment if the person is proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning their sex by changing physiological or other attributes of sex. If a woman is treated unfavourably because of her pregnancy, pregnancy related illness or related to maternity leave. 6. Race People who have or share characteristics of colour, nationality, or ethnic or national origin can be described as belonging to a particular racial group. 7. Religion or belief or lack of belief The full diversity of religious and belief affiliations in the United Kingdom. 8. Sexual orientation A person s sexual preference towards people of the same sex, opposite sex or both. 9. Marriage and Civil Partnership This is relevant in relation to employment and vocational training; the CCG will need to ensure that it considers this protected group in relation to employment.

21 Appendix 3 Equality Act 2010 Section 149 General Duty General Equality Duty 1. Eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it Due Regard Conduct prohibited by the Act. To comply with the general duty, a public authority needs to have due regard to all three of the aims (see below). The Equality Act explains that the aim of advancing equality of opportunity involves, in particular, having due regard (means thinking consciously about) to the need to: Remove or minimise disadvantages suffered by people due to their protected characteristics. Take steps to meet the needs of people with certain Protected characteristics where these are different from the needs of other people. Encourage people with certain protected characteristics to participate in public life or in other activities where their participation is disproportionately low 3. Foster good relations between persons who share a relevant protected characteristic and persons who do not share it Meeting different needs includes (among other things) taking steps to take account of disabled people s disabilities for example making reasonable adjustments. Fostering good relations is described as tackling prejudice and promoting understanding between people from different groups. Note: Organisations that are not public authorities are also required to have due regard to the needs listed above whenever they carry out public functions. This could include, for example, a private company or voluntary organisation with a contract to provide certain public services. This means that as commissioner the CCG will need to assure that an organisation they intend to commission can comply with the general equality duty. Specific Equality Duties Created by secondary legislation The Equality Act 2010 (Specific Duties) Regulations 2011 Publication of equalities information Each public authority is required to publish equalities information to demonstrate its compliance with the general equality duty. This needs to be no later than 31 January 2012, and at least annually after that, from the first date of publication. This information must include, in particular, information relating to people who share a protected characteristic who are: Its employees People affected by its policies and practices. Public authorities with fewer than 150 employees are exempt from the requirement to publish information on their employees. This is likely to be the case for local CCGs.

22 Publication of equality objectives Each listed public authority must prepare and publish one or more equality objectives that it thinks it needs to achieve to further any of the aims of the general equality duty. This must be done no later than 6 April 2012 and at least every four years after that. The objectives must be specific, measurable, achievable, resourced and time-bound.

23 Appendix 4 The Human Rights Act 1998 The Human Rights Act came fully into force on 2 October It gives further effect in the UK to rights contained in the European Convention of Human Rights. The Act: Makes it unlawful for a public authority to breach Convention rights, unless an Act of Parliament meant it could not have acted differently Means that cases can be dealt with in a UK court or tribunal, and Says that, where possible, all UK legislation must be given a meaning that fits with the Convention rights The 15 rights contained in the Human Rights Act are: The right to life* The right not to be tortured or treated in an inhuman or degrading way* The right to be free from slavery or forced labour The right to liberty and security* The right to a fair trial* The right to no punishment without law The right to respect for private and family life, home and correspondence* The right to freedom of thought, conscience and religion The right to freedom of expression The right to freedom of assembly and association The right to marry and found a family The right not to be discriminated against in relation to the enjoyment of any of the rights contained in the European Convention* The right to peaceful enjoyment of possessions The right to education The right to free elections *Particularly relevant to work of NHS organisations

24 Appendix 5 Equality Delivery System - Goals and Outcomes Goal Narrative Outcome 1. Better health outcomes for all 2. Improved patient access and experience 3. Empowered, engaged and wellsupported staff The NHS should achieve improvements in patient health, public health and patient safety for all, based on comprehensive evidence of needs and results The NHS should improve accessibility and information, and deliver the right services that are targeted, useful, useable and used in order to improve patient experience The NHS should Increase the diversity and quality of the working lives of the paid and non-paid workforce, supporting all staff to better respond to patients and communities needs 1.1 Services are commissioned, designed and procured to meet the health needs of local communities, promote well-being, and reduce health inequalities 1.2 Individual patients health needs are assessed, and resulting services provided, in appropriate and effective ways 1.3 Changes across services for individual patients are discussed with them, and transitions are made smoothly 1.4 The safety of patients is prioritised and assured. In particular, patients are free from abuse, harassment, bullying, violence from other patients and staff, with redress being open and fair to all 1.5 Public health, vaccination and screening programmes reach and benefit all local communities and groups 2.1 Patients, carers and communities can readily access services, and should not be denied access on unreasonable grounds 2.2 Patients are informed and supported to be as involved as they wish to be in their diagnoses and decisions about their care, and to exercise choice about treatments and places of treatment 2.3 Patients and carers report positive experiences of their treatment and care outcomes and of being listened to and respected and of how their privacy and dignity is prioritized 2.4 Patients and carers complaints about services, and subsequent claims for redress, should be handled respectfully and efficiently 3.1 Recruitment and selection processes are fair, inclusive and transparent so that the workforce becomes as diverse as it can be within all occupations and grades 3.2 Levels of pay and related terms and conditions are fairly determined for all posts, with staff doing equal work and work rated as of equal value being entitled to equal pay 3.3 Through support, training, personal development and performance appraisal, staff are confident and competent to do their work, so that services are commissioned or provided appropriately 3.4 Staff are free from abuse, harassment, bullying, violence from both patients and their relatives and colleagues, with redress being open and fair to all

25 Goal Narrative Outcome 3.5 Flexible working options are made available to all staff, consistent with the needs of the service, and the way that people lead their lives. (Flexible working may be a reasonable adjustment for disabled members of staff or carers.) 3.6 The workforce is supported to remain healthy, with a focus on addressing major health and lifestyle issues that affect individual staff and the wider population 4. Inclusive leadership at all levels NHS organisations should ensure that equality is everyone s business, and everyone is expected to take an active part, supported by the work of specialist equality leaders and champions 4.1 Boards and senior leaders conduct and plan their business so that equality is advanced, and good relations fostered, within their organisations and beyond 4.2 Middle managers and other line managers support and motivate their staff to work in culturally competent ways within a work environment free from discrimination 4.3 The organisation uses the Competency Framework for Equality and Diversity Leadership to recruit, develop and support strategic leaders to advance equality outcomes