EQUALITY INFORMATION. January 2015

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1 EQUALITY INFORMATION January 2015 For further information please or phone our Equality and Diversity Team on NHS Newham CCG Equality Information 2015-Final Page 1

2 Contents 1. Introduction 3 2. Compliance with the Public Sector Equality Duty 4 OUR VISION The vision of NHS Newham Clinical Commissioning Group (CCG) is to improve the quality of care for patients, ensuring that services offer value for money, are informed by good partnership working, building confidence and cohesion. 3. Commissioning 7 4. The people we serve Engagement of patients and stakeholders Implementing our Equality Objectives Monitoring Conclusion 20 Appendix 1: 21 Equality information of staff and Governing Body Members Appendix 2: 28 Equality Delivery System (EDS2) Grades NHS Newham CCG Equality Information 2015-Final Page 2

3 1 Introduction This is NHS Newham Clinical Commissioning Group s (CCG) second annual Equality Information. The information will set out how the CCG has been demonstrating due regard to the Public Sector Equality Duty s three aims (page 4) and will provide evidence for meeting the specific equality duty, which requires all public sector organisations to publish their equality information annually. The Equality Information should be published once a year by 31 January. However, it should be noted that we have already published our 2013/14 Annual Report which includes equality and diversity information. There are also other CCG reports that are published on the website that show how the CCG is meeting its Public Sector Equality Duty. This report will provide an update to what was published in the Annual Report. We recognise the diverse needs of our population and we are committed to reducing health inequalities and improving health outcomes for people in Newham. We aim to ensure the provision of high quality and accessible healthcare, and to develop a diverse and well-supported workforce which is representative of the population we serve. NHS Newham CCG Equality Information 2015-Final Page 3

4 2 Compliance with the Public Sector Equality Duty Public Sector Equality Duty (PSED) The CCG has worked to show due regard to the three aims of the public sector equality general duty as set out in the Equality Act 2010: Aim 1- Eliminate unlawful discrimination, harassment and victimisation Aim 2 -Advance equality of opportunity between different groups Aim 3- Foster good relations between different groups The specific duties require public bodies to publish relevant, proportionate information showing how they meet the General Equality Duty by 31 January each year, and to set specific measurable equality objectives by 6 April every four years starting in Both general and specific duties are known as the Public Sector Equality Duties (PSED). As a statutory public body, the CCG must ensure it meets these legal obligations and intends to do so by publishing information demonstrating how the organisation has used the Equality Duty as part of the process of decision making in the following areas: Service delivery - evidence of equality impact analysis that has been undertaken Information - details of information taken into account when assessing impact Communication and engagement - details of engagement activity that has taken place With the introduction of the Equality Act 2010, Equality Impact Assessments have been abolished. A new tool has been developed and adopted to assess the impact of documents and services known as Equality Analysis, which helps the CCG to demonstrate due regard to the PSED. This means that the CCG must work to prevent discrimination, harassment and victimisation from happening in the first place, take steps to meet the health needs of people with certain protected characteristics as set out in the Equality Act 2010 e.g. age, disability, gender reassignment, religion and belief, sexual orientation, sex, race, pregnancy and maternity, marriage and civil partnership, where these differ from the needs of the wider population and encourage people with certain protected characteristics to participate in public life or decisions making where their participation is disproportionately low. NHS Newham CCG Equality Information 2015-Final Page 4

5 CCG s compliance with the PSED EDS2 We have adopted the Equality Delivery System (EDS2) as a best practice tool to manage its equality and diversity performance. We are revising our current EDS2 grades through self-assessment. Our NHS provider Trusts are also implementing EDS2 Equality Analysis We have embedded equality analysis in the Governing Body reports We have provided training for managers and staff We have revised tools and guidance We have completed equality analysis of services/policies Equality Information We have published equality information in our Annual Report 2013/14 We have used equality information to grade our equality and diversity performance We have monitored our providers' compliance with the PSED by publishing Equality Information Equality Objectives We have published Equality Objectives We have implemented Equality Objectives in 2013 and have monitored progress NHS Newham CCG Equality Information 2015-Final Page 5

6 Our providers We believe that our compliance with the PSED is very much dependent on how we commission services; and how our providers comply with their equality duty. We commission services from a variety of organisations and agencies, most of which are public sector organisations; and they therefore also comply with the PSED. Below is a summary of how our main providers comply with the PSED. Our main providers Adopted EDS2 Published Equality Objectives Barking, Havering and Redbridge University Hospitals NHS Trust Published Annual Equality Information Homerton University Hospital NHS Foundation Trust London Ambulance Service Barts Health NHS Trust East London NHS Foundation Trust University College Hospital NHS Foundation Trust NHS Newham CCG Equality Information 2015-Final Page 6

7 3 Commissioning Key achievements 2013/14 Our commissioning activity in the financial year 2013/14 reflected the priorities set out in the Joint Strategic Needs Assessment (JSNA), patient experience and GP cluster feedback and evidence provided to NHS Newham CCG through the NHS England Outcomes Benchmarking assessment. This year, the areas of focus have been: GP cluster model Integrated care Urgent care Mental Health Sir Ludwig Guttmann Health and Wellbeing Centre (SLG) Learning disabilities community services Health advocacy service During the financial year 2013/14, NHS Newham CCG has explored new ways to promote innovation, research, education and training in our commissioning activities. Working in partnership with London Borough of Newham Public Health, we have developed a joint health promotion strategy and multi-media campaign for Newham Talking Therapies, a local NHS therapy service based in community venues. A stand-alone website has been developed for online marketing of the service to meet the national target in access to talking therapies from 13.5% to 15% by March Our service provider East London Foundation Trust (ELFT) has also been working to develop the GP referrals system and the care pathway to IAPT. A named therapist has been aligned to GP clusters to drive ongoing development through peer review, support and challenge. An automated referral system from GP to IAPT has also been implemented to remove barriers to referral. NHS Newham CCG Equality Information 2015-Final Page 7

8 Commissioning intentions for and beyond We developed our commissioning intentions for 2014/15 to address priorities in Newham and these were set out in the CCG prospectus and operating plan for 2014/15. A brief summary of these areas are provided below: Weight management services for obese patients Timely diagnosis and identification of people with pre-diabetes Improving management of diabetes through additional GP and diabetologist capacity Diabetes management for patients with a serious mental illness Improving services for patients with asthma and COPD Increasing anticoagulation therapy for patients in community settings (care closer to home) Provision of IV antibiotics in community settings (care closer to home) Improving Cardiovascular Disease diagnosis and management Integrated care and provision of care co-ordination for patients identified as having a high risk of hospitalisation Increase early diagnosis and management for patients with TB Improve urgent and unplanned care services Enhance the provision of mental health services Between July and August 2014, following a robust discussions with various committees, senior managers and GP Clusters, 115 ideas for commissioning intentions for 2015/16 were presented, 54 were agreed to be taken forward; and of these 36 were agreed to be scoped as a potential projects; and 20 were agreed to go forward as full business cases. Planning for projects commence from April The business cesses will go through equality analysis before they can be agreed for implementation. Transforming Services Together In February 2014, Newham, Tower Hamlets and Waltham Forest Clinical Commissioning Groups agreed to work in partnership with providers and neighbouring commissioners to establish Transforming Services, Changing Lives. The aim of this programme has been to jointly assess east London s health economy in relation to hospital care and how specialties work with primary and community care services. NHS Newham CCG Equality Information 2015-Final Page 8

9 We are positively planning for change to address the challenges we all face thereby improving the health of the local community and preventing ill health. We are now taking forward this work as part of a programme called Transforming Services Together which is about how we transform the whole health care system in east London. NHS Newham CCG Equality Information 2015-Final Page 9

10 4 The people we serve Diversity Ethnicity The 2011 census data shows our population is 308,000 but our registered population is 374,163. Newham has the youngest overall population and one of the lowest White British populations in the country according to the 2011 Census. The borough has a larger than average proportion of residents aged under 10 years, and aged 20 and 39 years, with a correspondingly smaller than average proportion aged 40 and above. People aged 65 and over make up a relatively small proportion of the Newham population in comparison to London and England as a whole. Statistics from the 2011 census showed that 29.0% of the population was White (16.7% White British, 0.7% White Irish, 0.2% Gypsy or Irish Traveller, 11.4% Other White), 4.6% of mixed race (1.3% White and Black Caribbean, 1.1% White and Black African, 0.9% White and Asian, 1.3% Other Mixed), 43.5% Asian (13.8% Indian, Bangladeshi, 9.8% Pakistani, 1.3% Chinese, 6.5% Other Asian), 19.6% Black (12.3% African, 4.9% Caribbean, 2.4% Other Black), 1.1% Arab and 2.3% of other ethnic heritage. Newham has the lowest percentage of White British residents of all of London's boroughs. The White British proportion of the population fell from 54.2% in 2001 to 16.7% in 2011; this decrease of 37.5 percentage points is the largest of any local authority in England and Wales between the two censuses. The joint-lowest wards with White British population are Green Street East and Green Street West, both having 4.8% - the third lowest behind Southall Broadway and Southall Green in Ealing. East Ham North is closely followed, at 4.9%. People of White British ancestry nevertheless remain the largest single ethnic group in the borough. The largest non-white British ethnic groups are Indian (14%), African (12%), Bangladeshi (12%) and Pakistani (10%). Newham has had for many decades a large Indian community. The ethnic group to increase the most in number since 1991 is the Bangladeshi community. Gender /sex The 2011 Census shows that in Newham there is a slightly larger male population at 52.1% compared to 47.9% for females. Religion/belief NHS Newham CCG Equality Information 2015-Final Page 10

11 2011 census data shows that Christianity is the most common religion in Newham at 40%, but this is considerably lower than the England figure of almost 60%. The Muslim community in Newham at 32% is more than 2.5 times that of London, and more than 6 times that of England. The proportion of Hindus in Newham s population is almost 6 times that of England. Newham hosts the second largest Muslim community in England and Wales the largest being Tower Hamlets. It also has the seventh highest Hindu population. The Newham Household Panel Survey (NHPS) details that residents are more likely than the London average to identify with a religion (83% compared to 64%). This figure is particularly high among Asian (96%) and Black residents (89%) Sexual orientation There are no clear figures indicating how many gay, lesbian, bisexual and transgendered residents there are in Newham. National estimates indicate that between 5 to 7% of the population is gay, lesbian bisexual or transgender and that the proportion may be higher in London than elsewhere in the UK. If applied to the Newham population, this would suggest at least between 15,400 and 21,560 people identifying them as gay, lesbian, bisexual or transgender in the borough. Disability Local data suggests that of the working age population, 19.49% of females and 15.99% of males in Newham have a disability, compared with 18.57% and 12.90%, respectively, in London. The proportion of the population who are disability living allowance claimants or incapacity benefit claimants is, for most age groups, slightly higher than, but broadly similar to, the London average. There are around 12,000 adults (aged years) with moderate physical disabilities in Newham, and a further 3,138 with severe physical disabilities. Approximately 2,050 adults (mainly people aged 65 and over) are thought to have moderate or severe visual impairments and over 12,300 moderate, severe or profound hearing impairments. There are approximately 4,245 adults with learning disabilities, a small percentage of whom are known to health and social care services. Health profile-key facts Newham is the third most deprived local authority area in England. Overall smoking rates in Newham are close to the national average, but smoking rates for certain groups are far higher including white British and east European men and women and Bangladeshi men. NHS Newham CCG Equality Information 2015-Final Page 11

12 Around three quarters of adult residents report very low levels of physical activity. 40% of residents report that they eat the recommended minimum level of 5 pieces of fruit or vegetables every day. Life expectancy remains lower than the national average: Male life expectancy 76.2 compared to 78.2 nationally; Female life expectancy lowest in London 80.5 compared to 82.3 nationally; Life expectancy gap between least and most deprived is 4.5 years in males and 4.7 in females. Life expectancy in Newham is on an upward trend for both men and women, but remains lower than the averages for London and England. For women the gap between Newham and England/ London is narrowing, but for men the gap has widened. There are marked differences in life expectancy between different wards in Newham. The patterns for men and women are slightly different, but overall people living in Royal Docks and Green Street West can expect to live 10 years longer than people living in Canning Town North or East Ham North. These inequalities are reflected in death rates from key diseases circulatory, cancer and respiratory. There are significant differences in premature mortality rates between different wards for each of the most common causes of death - circulatory disease, cancer and respiratory disease. Newham has the highest birth rate in England. In 2010 over 6200 babies were born to Newham residents. Over three quarters of these children were born to mothers who were themselves born outside the UK. Child immunisation rates are below the averages for London and England, and below the national standard level required to achieve herd immunity. Newham children have the second highest rates of dental decay in London at age 5. Rates of child obesity are the 5th worst in England for Reception Class children and 10th worst for children in Year 6. Newham has one of the highest rates of Type 2 Diabetes in England; third highest number of diabetics in the UK. The overall rate of Sexually Transmitted Infection is above the average for London and more than twice the average for England. Newham has high HIV prevalence. There was a 3% increase in the number of Newham residents diagnosed with HIV between 2009 and The main group affected in Newham is Black African heterosexuals. Heterosexual people are more often diagnosed late (43%) than men who have sex with men (15%). Newham has the highest Tuberculosis (TB) rate in England. There was a 25% increase in TB notifications in Newham in 2011 compared to NHS Newham CCG Equality Information 2015-Final Page 12

13 5 Engagement of patients and stakeholders Our patient and public engagement programmes are designed to give everyone in Newham the chance to help us make the best choices about the health services we commission and the health care provided locally. We have developed our new Engagement Strategy- Getting involved in your local NHS which includes a specific objective on equality and diversity, Actively promote equality and eliminate discrimination by engaging with a wider audience as mandated by the Equality Act We have promoted the involvement of patients, their carers and representatives in decisions that relate to the prevention or diagnosis of illness in the patient, their care and treatment. During the financial year 2013/14, a particular focus was placed on involving patients, carers and local residents in the development of: - Community nursing which has resulted in the reconfiguration of the service - Health advocacy and language services - Improving access to psychological therapies (IAPT) - Community learning disabilities We worked closely with our Community Reference Group (CRG). The CRG provides an opportunity for local people, patients and community groups to have their say about priorities at a strategic level. Working with the Community Commissioning Team (CCT), these groups are able to influence the re-design of community services and develop their understanding of the commissioning process. NHS Newham CCG also co-hosted a patient engagement event The Big Health and Social Care Day with London Borough of Newham (LBN) as part of the learning difficulties (LD) self- assessment framework (SAF). This identified ways to improve access to primary care services and to ensure that people with LD receive an equitable service across the borough. A joint action plan was developed for the financial year 2014/15 to deliver these outcomes. Service user feedback is a key driver in the development of the IAPT service. Two initiatives that resulted as a direct result of this feedback include: NHS Newham CCG Equality Information 2015-Final Page 13

14 - Improvements in referral handling capacity to ensure referrals are loaded within three days to keep waiting times for first appointments to a minimum - Therapists ensuring that patients are aware at their assessment and that they can call them back if they have any questions before or during treatment All of our commissioning intentions are only entered into once stakeholder engagement and support is demonstrated, as well as patient engagement and the appropriate level of consultation for the intention. This information, coupled with robust finance and activity assessments, support NHS Newham CCG s planning and decision making. We have consulted widely when devising our commissioning plans. We understand that it is only by building effective partnerships with patients and the community that we will be able to improve health services and reduce the high levels of chronic ill health, disability and premature death among local people. Newham is the only CCG in the country to have commissioned local community organisations, rather than NHS professionals, to help us undertake meaningful engagement. In just one year, we have established a range of structures to enable local people to engage with and influence NHS Newham CCG. We have also developed a Community Reference Group (CRG) to play a key role in scrutinising our commissioning plans. In relation to the commissioning intentions for 2014/15, the CRG focussed on a number of key issues that particularly impacted on the local community. These views were taken into account when developing the business cases for those commissioning intentions. Case Study Designing a Self-Management Resilience Plan with patients living with a Long Term Condition, clinicians and commissioners Background In 2014 the Integrated Care Programme s Self-Management Workstream embarked on a meaningful patient engagement exercise to put patients living with a long term condition at the heart of decision making. NHS Newham CCG Equality Information 2015-Final Page 14

15 The steering group which includes clinicians, commissioners and representatives from the local authority recruited two patient representatives living with diabetes to its membership. Having the patient voice at the centre of decision making has enabled the steering group to work in partnership with patients and the community to coproduce a patient centred self-management model for Newham by involving people across the whole commissioning cycle: analyse and plan design pathways specify and procure deliver and improve This case study will explain how patients living with a long term condition have coproduced a health maintenance plan to enable patients such as those over 65 years old living with a long term condition such as diabetes, coronary heart disease, chronic heart failure, chronic obstructive pulmonary disease, stroke, atrial fibrillation or hypertension to improve their health and wellbeing. Coproducing the Self-Management Resilience Plan In March 2014 a workshop was held with patients living with a long term condition and carers to understand patient perception of self-management and to then explore from the patient perspective what support they need to enable them to self-manage. At the workshop participants told us, self-management should be properly resourced and its aim should be to empower people, some of the key feedback included: Properly funded and resourced services Helping patients with will power, discipline and being determined to make the right choices and do the right things motivational support Support needs to be structured and relevant Need for emotional and peer support as well as lifestyle change support Quality Information about services (avoid medicalising / jargon) Communication between services e.g. GPs and pharmacists As a result of what patients and carers told us and based on current best practice, we have used the feedback to develop a new self-management tool to support patients to self-manage as part of the Integrated Care Programme. The tool we ve developed is a Self-Management Resilience Plan (SMRP). Following the workshop in May 2014 we ran an additional workshop with our patient communications review group to help us design the template, the valuable feedback enabled us to develop a patient friendly and meaningful self-management tool that works for patients. NHS Newham CCG Equality Information 2015-Final Page 15

16 This plan will stay with the patient, with copies to relevant agencies who are currently supporting the individual patient, including the patient s GP. The SMRP will be defined and produced by the patient and supported by the self-management support programme. The SMRP is a patient driven care plan that describes in a structured way, the activities and lifestyle and behaviour changes that the patient wishes to engage in as a way of better managing their long term conditions and focuses on the patient s own assessment of: their understanding of their conditions their understanding of their medication their physical well-being their psychological and emotional well being the nature and extent of their engagement and inclusion, socially what impact this all has on their condition whether any changes are required or desired to make any positive change to these areas - what changes, how can they be made, what is a realistic goal, what support would be needed and what support can be accessed Why this approach? Newham has a higher level of mortality from all circulatory disease before the age of 75 years than both the London and England averages which reflects the health and health care challenges within the borough and is one of the highest boroughs for diabetes prevalence in the country, with heart disease, cancer and circulatory disease being the biggest causes of death in Newham. In response, there has been a strategic drive towards developing existing self-care support within the context of integrated care and a key strategic aim as described in the NCCG 13/14 Operating plan is to provide Self-care Specialist input in the community. The following principles of self-management have been adopted in the development of both our model of care and our delivery model: Self-management is not only about exercise and eating healthy, it requires the patient to understand their condition and to have the motivation, capacity and opportunity to undertake the activities and changes in behaviour and lifestyle that constitutes selfmanagement for them. We need to provide skills, education and learning opportunities and facilitate people to self-manage their LTCs - give them the skills, knowledge and access to appropriate provision. Some patients will require more learning and support than others. NHS Newham CCG Equality Information 2015-Final Page 16

17 We need to assess motivation and to support the patients motivation change behaviour and make lifestyle changes by providing: structure and focus; support and guidance to smart goal setting; referral and signposting to competent, relevant and effective support provision Research and best practice evidence (refs) suggests that self-management has to be supported with structure, education and access to a range of local (often community based) provision, including: support/peer groups; physical activities; healthy eating classes education, information and advice; social networking (gatherings); cookery classes In an area like Newham it is essential that all education, information, advice and support initiatives are planned and delivered in a professional manner culturally relevant and appropriate way NHS Newham CCG Equality Information 2015-Final Page 17

18 6 Implementing our Equality Objectives We developed our Equality Objectives when the CCG was operating in shadow form. We have revised these objectives in 2013 and developed additional objectives to ensure they reflect our priorities and commissioning. Progress on the 2012/16 Objectives Objectives Reduce mental health inequalities amongst BME communities in east London. We will implement the Learning Disabilities (LD) Self Assessment Action Plan Progress update We have developed joint mental health strategy with the London Borough of Newham. We are improving IAPT services, CAMHS services and in patient services for BME patients. Our providers are providing services that respect patients human rights; ensure dignity and respect. Patients are discharged into the community and are being care for at home or closer to home through intermediate care; and personal health budget through NHS funded continuing health care. Providers have implemented the passport service for LD patients. We have developed and commissioned services for learning disabilities patients jointly with Newham Council. We will improve access to cancer screening and diagnosis for men and women from BME communities Through the rigorous monitoring of patient complaints and patient feedback with our peer CCGs locally, we have enabled the introduction of additional clinics in Brest Cancer Screening clinics. Cancer waits of 62 days was exceeded - 90% vs 85% target Integrated cancer service, including delivering care closer to home (commissioning intention ) We will implement the Equality Delivery System We have adopted the Equality Delivery System (EDS2) The 2012 grades have been reviewed by using EDS2, the revised version of the EDS. (please see Appendix 2) We will use EDS2 to implement our Equality Objectives and the Strategy Established CCG governance of equality and diversity work Provided equality and diversity training to staff NHS Newham CCG Equality Information 2015-Final Page 18

19 7 Monitoring We monitor information to improve service quality, ensure compliance with the equality duty; and to improve our equality and diversity performance. We have included detailed information about our workforce and Governing Body members in Appendix 1 but below are some examples of how we, and our providers, monitor equality and diversity. Workforce and governance equality data All workforce data Recruited and selection data Leavers data Governing Body Members data Complaints equality data Complaints are monitored by the CCG and providers. Regular updates given to the Quality Comittee and the Governing Body Providers publish complaints data in their annual equality report. However, this is not consistent across all providers. Access to information, consultation & engagement We can monitor the number of hits on the CCG's website e.g. various web pages. We record our engagement and consultation activities in a central log. We also monitor targetted consulation with community groups to analyse inclusiveness and cohesion. NHS Newham CCG Equality Information 2015-Final Page 19

20 8 Conclusion Our Equality Information provides an overview of how we meet our public sector equality duty, both through commissioning and employment. We recognise that making progress in all equality areas is a slow process and we endeavour to work with our community interest and internal groups to prioritise our work which will produce better outcomes. Our top priority next year will be to effectively use EDS2 to revise our Equality Objectives and monitor and report progress. This information is not exhaustive, and there are other key CCG documents which provide further information about our policies, objectives and actions. They include: CCG s Annual Report CCG Constitution CCG Prospectus Organisational Development Plan Joint Strategic Needs Assessment (JSNA) CCG s Operating Plan and Commissioning Intentions CCG s Equality Objectives CCG s Engagement Strategy CCG s Governing Body reports The above documents are published on the CCG s website NHS Newham CCG Equality Information 2015-Final Page 20

21 Appendix 1 Equality information of staff and Governing Body Members CCG Workforce NHS Newham CCG employs 39 permanent staff from diverse backgrounds. This has increased from 29 in Although we have no legal duty to publish our workforce data as we employ less than 150 staff, we have decided to do so as good practice. We believe it will help us to monitor our workforce diversity and to set specific goals and objectives for the future. Chart 1 - Ethnicity White - British White - Any other White background 1 12 The charts are based on the current workforce of the CCG as of October Key highlights: The gender gap in the workforce has narrowed from 41% men and 59% women in 2013 to 44% men and 56% women in Amongst our workforce, 31% of our represent White-British, 18% Asian-Indian, 15% Black-African, 5% Pakistani and 5% Bangladeshi. There is a significant number staff that either have not declared their disability, religion/belief and sexual orientation, or decided not to disclose. This is an area we are looking to improve in the current year. Undefined Not Stated Mixed - Other/Unspecified Black or Black British - Caribbean Black or Black British - African Black British Asian or Asian British - Pakistani Asian or Asian British - Indian Asian or Asian British - Bangladeshi Asian or Asian British - Any other Asian background NHS Newham CCG Equality Information 2015-Final Page 21

22 Chart 2 - Gender Chart 3 - Age Chart 4 - Disability 44% 56% Female Male 31% 18% 3% 15% 33% and above 64% 31% 5% No Not Declared Undefined Chart 5 - Religious Belief Chart 6 - Sexual Orientation Undefined 20 Sikhism 5 Undefined 22 Other 1 Islam Do not wish to disclose 1 2 Do not wish to disclose 2 Christianity 5 Buddhism 2 Heterosexual 15 Atheism NHS Newham CCG Equality Information 2015-Final Page 22

23 Governing Body Member All of the GPs and healthcare professionals who lead the Clinical Commissioning Group work in healthcare in Newham and they reflect our local community. Besides GPs and other healthcare professionals, the CCG Governing Body also has Lay Members and Executive Directors, as well as senior members from Public Health and Newham Council, to provide additional knowledge and experience to support the work of the CCG. We have included information about our Governing Body members who are elected and have the voting rights. Key highlights: Chart 7 - GB Members Gender Nearly 70% Governing Body Members have not defined their ethnicity. This has slightly improved from last year (82%). 75% Governing Body members are male. 25% Female Male 75% Chart 8 - GB Members Disability Chart 9 - GB Members Ethnicity 6% 13% No White - British Undefined 81% Not Declared Undefined Asian or Asian British - Pakistani Asian or Asian British - Any other Asian background NHS Newham CCG Equality Information 2015-Final Page 23

24 Recruitment We monitor equality data of all applicants who apply for jobs, short listed and appointed. However, we do not monitor equality information of temporary or agency staff. The below charts provide information about the recruitment activities based on protected groups from April 2013-March Key highlights: Chart 1 - Recruitment by Ethnicity This data cover the period April 2013-March 2014, and they are not significantly different to the recruitment data we published in January 2014 which covered April-November As the majority of the posts have been recruited since April 2014, the data will be included in our next year s equality information including a trend analysis During the CCG recruited only one permanent staff. The reason we wanted to include the recruitment information is to show how the CCG monitors the equality information of all applicants; and secondly, what lesson can be learned to improve future recruitment activities i.e. attracting more suitable applicants from diverse backgrounds. Any other ethnic group Black or Black British - African Black or Black British - Caribbean Any other Asian background Asian or Asian British Bangladeshi Asian or Asian British Indian Any other white background White Irish White British Appointed Shortlisted Applied NHS Newham CCG Equality Information 2015-Final Page 24

25 30 Chart 2- Recruitment by Gender 12 Chart 3 - Recruitment by Age Applied Shortlisted Appointed Applied Shortlisted Appointed Male Female Chart 4 - Recruitment by Marital Status Chart 5 - Recruitment by Sexual Orientation Applied Shortlisted Appointed Not stated Heterosexual Homosexual I do not wish to describe my sexual orientation. Applied Shortlisted Appointed NHS Newham CCG Equality Information 2015-Final Page 25

26 Chart 6 - Recruitment by Religion Chart 7 - Recruitment by Disability Applied Shortlisted Appointed No Yes Applied Shortlisted Appointed NHS Newham CCG Equality Information 2015-Final Page 26

27 Leavers Key highlights: More female staff left the CCG in This is slightly inconsistent with the total ratio of staff. Majority of the leavers were from Black and Minority Ethnic Communities. The CCG is developing measures to address this issue e.g. Organisational Development Plan. % of Leavers 2013/14 Equality Profile (Total number of leavers = 6) Gender Female 66.7% Male 33.3% Ethnic Origin Asian or Asian British - Indian 16.7% Black or Black British - Caribbean 33.3% Undefined 16.7% White - British 16.7% White - Irish 16.7% Age Band % % 61 and above 33.3% Disability Undefined 100.0% Religious Belief Does not wish to disclose 16.7% Undefined 83.3% Sexual Orientation Does not wish to disclose 16.7% Undefined 83.3% NHS Newham CCG Equality Information 2015-Final Page 27

28 Appendix 2 Equality Delivery System (EDS2) Grades Introduction NHS Newham CCG is carrying out a self-assessment of its equality and diversity performance by using the Equality Delivery System (EDS2). The aim is to review the grading which was carried out by East London and the City (ELC) Cluster in 2012 when the CCG was operating in shadow form. This self-assessment will help the CCG to analyse a range of evidence against the 18 outcomes of EDS2 and develop necessary actions to improve future equality and diversity performance; and to set equality objectives. The grading work is led by a small internal Task and Finish Group which is chaired by the Lay Member of the Governing Body; and the CCG will share the grading externally with Newham Council and Healthwatch. What s Equality Delivery System? EDS2 is a generic tool designed for both NHS commissioners and NHS providers. As different NHS organisations apply EDS2 outcomes to their performance, they should do so with regard to their specific roles and responsibilities. They may have to adjust the generic language of the outcomes to suit what they do. The equality and Diversity Council at the Department of Health is consulting on EDS2 The first NHS wide equality performance framework was launched by Sir David Nicholson in November 2011 to all commissioner and provider organisations. It provides a framework to annually measure evidence for 18 required equality outcomes, across four key goals (two for service delivery and two for workforce issues). It should also provide robust evidence of how an organisation is meeting its Public Sector Equality Duties (PSED). Grading: Essentially, there is just one factor for NHS organisations to focus on within the grading process. For most outcomes the key question is: how well do people from protected groups fare compared with people overall? There are four grades - underdeveloped, developing, achieving and excelling. Undeveloped Developing Achieving Excelling NHS Newham CCG Equality Information 2015-Final Page 28

29 People from all protected groups fare poorly compared with people overall OR evidence is not available OR if evidence shows that the majority of people in only two or less protected groups fare well People from only some protected groups fare as well as people overall (3-5 groups) People from most protected groups fare as well as people overall (6-8 groups) People from all protected groups fare as well as people overall (9 groups plus other disadvantaged groups) (2 or less groups) People covered by EDS2 EDS2 should be applied to people whose characteristics are protected by the Equality Act In summary, there are nine characteristics as follows: Age Disability Gender re-assignment Marriage and civil partnership Pregnancy and maternity Race including nationality and ethnic origin Religion or belief Sex Sexual orientation EDS2 grading can also consider evidence about other disadvantaged groups e.g. homeless people, migrants, refugees etc. who are not protected by the Equality Act Engagement Without engagement with local stakeholders, EDS2 will not work. Engagement refers to the process of getting people e.g. patients, carers, community members and other members of the public involved in decisions about them in a sustained way. This includes NHS Newham CCG Equality Information 2015-Final Page 29

30 planning, developing and managing services, as well as activities that aim to improve health or reduce health inequalities. For staff, engagement also means helping to plan, develop and manage working environments and activities that aim to improve working lives. How the Self-assessment has been done and what will happen next We have analysed relevant evidence in our key strategic policies and reports which include commissioning strategies, providers information and our workforce policies and reports. This will form the basis of our discussion with the community interests. We have set a reasonable baseline which can be sustained and built upon over next five years. We will engage staff and community interests in the grading process We will develop a dashboard to manage the EDS2 progression over next 5 years. Our Equality Objectives will be revised in 2015/16 based on the outcomes of EDS2 grading. Summary of the draft grades Our self-assessment has identified that the CCG has progressed in 1 outcome (1.4) from developing to achieving, and has sustained 16 (6 achieving and 10 developing). The goals and outcomes of EDS2 (Summary) Goal Number Description of outcome Current Grade 2012 Better health outcomes 1.1 Services are commissioned, procured, designed and delivered to meet the health needs of local communities 1.2 Individual peoples health needs are assessed and met in appropriate and effective ways 1.3 Transitions from one service to another, for people on care pathways, are made smoothly with everyone well-informed 1.4 When people use NHS services their safety is prioritised and they are free from mistreatment and abuse and mistakes are minimised 1.5 Screening, vaccination and other health promotion services reach and benefit all local communities Proposed Grade (2014) Target Grade (2019) NHS Newham CCG Equality Information 2015-Final Page 30

31 The goals and outcomes of EDS2 (Summary) Goal Number Description of outcome Current Grade 2012 Improved patient access and experience 2.1 People, carers and communities can readily access hospital, community health or primary care services and should not be denied access on unreasonable grounds 2.2 People are informed and supported to be involved in decisions about them 2.3 People have positive experiences of the NHS and are able to report it. Proposed Grade (2014) Target Grade (2019) A representative and supported workforce Inclusive governance 2.4 People s complaints about services are handled respectfully and efficiently 3.1 Fair NHS recruitment and selection processes lead to a more representative workforce 3.2 The NHS is committed to equal pay for work of equal value and expects employers to use equal pay audits to help fulfil their legal obligations 3.3 Training and development opportunities are taken up and positively evaluated by all staff 3.4 When at work, staff are free from abuse, harassment, bullying and violence from any source 3.5 Flexible working options are available to all staff consistent with the needs of the service and the way people lead their lives 3.6 Staff report positive experiences of their membership of the workforce 4.1 Boards and senior leaders routinely demonstrate their commitment to promoting equality within and beyond their organisations 4.2 Papers that come before the Board and other major Committees identify equality-related impacts including risks, and say how these risks are to be managed 4.3 All managers and other line managers support their staff to work in culturally competent ways within a work environment free from discrimination NHS Newham CCG Equality Information 2015-Final Page 31

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