Equality and Diversity Steering Group. Annual Report 2013/14

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1 Item 12 Equality and Diversity Steering Group Annual Report 2013/14 Produced by: Equality, Diversity & Inclusion Steering Group Board of Directors Meeting 27 th May 2014 Action for Board: For information For consideration For decision 1

2 Equality, Diversity & Inclusion (EDI) Committee Annual Report 2013/14 Introduction The Equality, Diversity and Inclusion (EDI) Committee s annual report to the Trust Board on its Equality Duty 1 for the year ending 31 March In January 2014, the Board received and considered information relating to our patients and workforce over the period. This report provides two issues for board consideration and decision ie: Compliance with statute - an objective opinion as to the Trust s compliance with the Equality duty as reported in the annual Report and progress of the specific, measurable Objectives set out by management. an assessment of the assurances as to how effective the actions of Trust have been to embed equality, diversity and inclusion in support of the achievement of Corporate Strategy, specifically around: Background 1. Organisation and workforce development - to continually enhance our delivery of activities in research, education and quality clinical services 2. Quality patient-centred care - in response to the National Reviews and our internal strategies to make Moorfields fit for the future. 1...The Equality Duty is supported by specific duties, set out in regulations which came into force on 10 September The specific duties require public bodies to publish relevant, proportionate information demonstrating their compliance with the Equality Duty; and to set themselves specific, measurable equality objectives......public bodies subject to the specific duties must publish information to show their compliance with the Equality Duty. This means that the information they publish must show that they had due regard to the need to: 1. Eliminate unlawful discrimination, harassment and victimisation and any other conduct prohibited by the Act; 2. Advance equality of opportunity between people who share a protected characteristic and people who do not share it; and 3. Foster good relations between people who share a protected characteristic and people who do not share it. These are described as the three aims of the Equality Duty. Source: EQUALITY ACT 2010: Specific Duties to Support the Equality Duty - What Do I Need to Know? A Quick Start Guide for Public Sector Organisations Government Equalities Office, Oct

3 The Equality & Diversity Steering Group (part of the initial governance structure of the Foundation Trust in 2004), has existed to note and promote good practice across the Trust as a service provider and an employer. The Group has also aimed to raise awareness about matters relating to equality and diversity. The role of the Equality and Diversity Steering Group has migrated since its initial inception. The six-monthly meetings are now a source of information, support and review for the Trust executive as they develop, promote and embed good practice in equality, diversity and inclusion. Information is offered through access to presentations from other NHS organisations and other industry sectors. Support is offered through discussing both the objectives and other areas of activity Review is provided through discussion of executive briefings on activity reported during the year. Meetings are chaired by a non-executive Director of the Trust Board. From 2013, membership includes patient representation. In light of the changes to the Act, the Membership Council will have an invitation for members although governors will not be members. This is reflected in the recommended Terms of Reference provided with this report for board approval. Statutory and Regulatory issues Public sector organisations are required to publish, on or before 31 January, information that demonstrates our compliance with the general duty and, where gaps are found, how the Trust is going about making improvements. We last published on 31 January Following publication of the Trust s specific and measurable Objectives (completed by 6 April 2012), the Trust must also publish subsequent objectives at intervals, the next publication deadline being no later than 6 April Guidance and Statutory Updates No new guidance or statutory updates were received during the year. Management of Human Rights The Director of Corporate Governance has executive lead for Equality & Diversity and Human Rights. The policies and procedures governing operational and corporate processes and arrangements throughout the Trust have regard to the high level principles of the Human Rights Act The 3

4 requirements are enshrined in the NHS constitution and are reflected both in the tone and focus of the Trust s Corporate Strategy (July 2010). Trust Policies No updates to Equality, Diversity or Inclusion policies were made during the year. The Issues and Activities Considered by the Committee: 2013/14 This section of the report focuses on the work to promote awareness in relation to equality, diversity and inclusion note where areas of good practice have been developed. The impact is noted for the two general areas of patient care / clinical services, and human resources / workforce. Patient Care/ Clinical services - The recent NHS commitments embrace putting the patient at the heart of what we do. To embed this, two-way communication that is both flexible and consistent will enable the Trust to truly listen and hear what this particular stakeholder group is saying. A best in class approach also teases out issues from harder to reach patients and those challenged by health inequalities. This feedback is just as valuable, but may be harder to obtain from patients less familiar (or confident) with finding their way through the system. It may also be a greater challenge articulating concerns. Workforce - The approach to embed Moorfields Way a programme of exemplar culture and leadership is one of the practical activities being progressed by the Trust. 4

5 2013/14 Activity of the committee is noted below: 1. Annual Review the Groups Terms of Reference 2. Technical updates on Statute, Regulations, Guidance, Internal Policies 3. Review Template of the Annual report to Board (incl patient feedback) 4. Compliance with Equality duty report: - Focus on Inclusion January 2014 Other Activity: 2013/14 5. Reports Received: Protected Quality Care Workforce Characteristics Impact: Impact: Privacy & Dignity Report (Nov 2013) All X X Review of Trust Objectives progress All X X Statistical review of Workforce programmes - no statistical information received X Qualitative review of Workforce programmes - Report on EDI Staff Day (Sept 2013) Disproportionate representation of ethnic minority staff in disciplinary proceedings (Mar 2013) Received updated Equality, Diversity & Inclusion Policy (Mar 2013) All Race, ethnicity X X 6. Presentations and Briefings: Business in the Community (equalities CSR) (Nov-13) Gender Race X EDI good practice Forum (Aug 13) All X X Patient Experience (Nov-13) All X Patient Experience - Interpreting Services Provision (Nov-13) Race, ethnicity X Patients and Clinical Services The Dignity Focus Group, organised by one of the Trust s matrons with multidisciplinary membership of clinical staff, non-clinical staff and patient representatives, continues to deliver on its activities and provides a written report to the Group. Patient Experience: The reviews of Quality: Patient Experience through separate strands of activity at both board committee and executive working group level. 5

6 Clinicians Perspectives: An update to provide perspective and context kindly supplied by Consultant, Miss Parul Desai 2, Professional practice: The application of the equality and diversity agenda in routine clinical practice, service delivery and outcomes can be demonstrated through clinical audit, particularly in the domains of age, gender and ethnicity. It can identify unexpected variations, and can be used as another criterion for assuring quality of care provided, but without imposing any additional burden on data collection, as these data are routinely collected. The Committee received a presentation of a clinical audit on thresholds for cataract surgery across all Moorfields sites over a 3 year period ( ) and involving 9233 patients. The findings indicated that for the population of patients served by Moorfields in London, there were no variations by ethnicity for surgical intervention, given by the indicators visual acuity on admission for surgery, and access to second eye surgery. Given that the clinical pathway from referral to treatment is relatively short, this suggests that there was also little variation in referral by ethnicity for these patients. Workforce Considerations The Trust is aware, supports and is actively working to incorporate systems that address other protected characteristics as part of its Objectives. Activity relating to national reviews or local initiatives were noted, namely: Culture and Behaviour definition? View? Clinical and Corporate leadership The Trust sponsorship and development of clinicians within the senior clinical management structure: Learning and Development Mandatory training for staff on Equality, Diversity & Inclusion is delivered inhouse. Moorfields was one of six Trusts that supported a local NHS Black & Ethnic Minority Leadership (BEL) programme. It closed in 2011/12 after being offered from and then from The impact and outcomes for Trust staff was requested from HR in 2012/13 but is still awaited; it is hoped to include the learning from supporting these pro in a future report. 2 Miss Parul Desai is a Moorfields Consultant in Ophthalmology and Public Health and also the Director of Population Health, Health and Social Care Information Centre, Leeds. 6

7 Employee Relations (Data for workforce and employee relations supplied in other board performance reports so is not reported in detail in this report.) Last year the committee considered issues around the disproportionate representation of ethnic minorities in disciplinary action and referral to professional bodies for sanction. To assess and gain assurance for the Trust s activity for this issue a review of the Trust s record (2008/09 to date) was requested and is expected from management. Records of Complaints and Compliments In addition, the HR department confirm the following information from a review of complaints and complements in light of specific request to review by gender. Finally, HR considered issues of bullying and harassment raised by staff. The committee considered total number of complaints/ compliments received and reported in 2012/13 and 2013/14 that cited attitude and behaviour by staff type ie corporate ie non-clinical/ non patient-facing roles, clinical support and admin/ clerks/ porters etc, finance - this may typically be our staff in the cashiers office, nursing and AHP staff, medical staff, any other staff specifically looking at complaints about consultant attitude and behaviour: Consultants Population by Age Range Male Total as at 31 Female March 2013/14 < TOTALS Complaints received related to consultants

8 Number Number of consultants as at 31 March by age range Male Female Consultant Related Complaints received Male Female Consultants by Age Complaint < Total 9 8

9 2013/14 Assessment Performance Consideration Evidence to support conclusion as at March 2014 Trust has system and a planned process The Trust has now published its third annual in place to understand and translate the mandatory report Focus on Inclusion (January issues into Trust operations, workforce 2014) in compliance with the duty imposed by development, culture of leadership and section 149(1) of the Equality Act 2010 board governance. Grasped the key issues and has basic compliance embedded in the Trusts workforce activity and clinical service delivery. Agreed - for some aspects of the already established protected characteristics of race, age and gender. A five year report on the Trust s employee relations performance for ethnic minority nursing staff and allied health professions (2008/ /13) has been requested. Evidenced values and vision around supporting board level diversity in recruitment process. Trust is not only compliant with the September 24 th staff engagement activities statute but looks to additional guidance to implement best practice; has grasped the key issues and is implementing compliance into Trust operations, workforce development, culture of leadership and board governance. Grasped the key issues, has basic compliance in place, embedded and operating effectively and is working on stretch programmes to move beyond basic compliance to best practice/ exemplar performance In light of its clinical specialty, the Trust commitment to supporting employment and intern opportunities for people with visual impairment has resulted in partnership activities with local charities to ensure this can be embedded in the recruitment practice for the Trust. Suggested methodology for assessing progress in 2014/15 1. No compliance: No system or process in place to comply with minimum statutory requirements; Not yet grasped the key issues of Equality, Diversity and Inclusion Trust at increased risk of breach of statute. 2. Minimum compliance Process to comply with minimum statutory requirements is in place but not embedded into standard management activity; Basis issues of Equality, Diversity and Inclusion noted. 3. Good Practice - Regulatory and other public sector Compliance plus NHS good practice, embedded in most management activity 4. Best practice Best practice in NHS and other public sector No programme of activity to deliver best in class 5. Exemplar - Best in class Implementing best in class 9

10 Recommendations The Equality and Diversity Steering Group has made recommendations to update its own Terms of Reference to reflect the implications in light of the changes to the NHS Act. The board is asked to approve these updates (shown as document updates) to reflect the required membership and development of committee activity. The committee is aware that this issue cuts across the corporate and clinical activity of the Trust. Management may wish to ensure the detailed co-ordination is delegated and discharged by a single function. With an existing staff member with expertise in the issues of equality, diversity, inclusion and human rights in place, this resource should draw together the statistical information across clinical services/ patients, medical, clinical and corporate workforce activity. This will ensure that the board continues to receive the annual report on a timely basis as information is collated throughout the year by management. Conclusion Areas of good practice were highlighted in the Trust s annual Focus on Inclusion report. The executive group continues to work to embed the issues for equality, diversity and inclusion into the culture and leadership for the organization. Overall, the board can take assurance that activities conducted this year are following a co-ordinated approach and objectives are being progressed. Deborah Harris, Non-Executive Director Chairman - Equality, Diversity & Inclusion Steering Group May

11 Moorfields Eye Hospital NHS Foundation Trust Equality, Diversity & Inclusion Steering Group Terms of Reference Role The role of this committee will be to support the Trust Board in the assessment of its development and promotion of good practice in equality, diversity and inclusion awareness as employers and service providers, and by working towards the elimination of discrimination of any protected characteristic. The Trust has established the Equality, Diversity & Human Rights Executive Group, responsible for the operational delivery of the Trust objectives and the vision and values of the Trusts report, Focus on Inclusion. Appropriate external expert advisors are commissioned as needed to support the work of this group. As such, this committee s role is now one of information, support and review. Chaired by a non-executive Director of the Trust Board, the membership of this group reflects Moorfields different staff and stakeholders. The proposed membership from 2013 is to ensure the group includes a patient and two governors. This is reflected in the recommended Terms of Reference provided in this report for board approval. The group meets twice during each year to consider aspects of activity and governance, review and reporting that demonstrate how equality, diversity and inclusion are reflected across the Trust, be it through: Clinical Activity: 1. Clinical Services - accessibility and appropriateness of clinical service for needs of new patients and, management of current and future patients to promote and support diversity and equality in its administration; how the Trust demonstrates it understands and uses the most effective tools and systems to provide performance information and board assurance. Leadership and oversight levels: 2. Board of Governors/ Membership Council - advertising, recruitment and appointment of Non-Executive directors; promotion and recruitment of Trust membership; current and future processes that enable a diversity in governor and membership mix to reflect the population served by the Trust. 3. Board of Directors - advertising, recruitment, development and retention processes to enable continued diversity in the talent pool of both its Non- Executive and Executive Directors 4. Senior Management - advertising and recruitment of service/ function leads; current and future processes to enable diversity in the talent pool from which the executive team is drawn. 11

12 Workforce: Recruitment, Development and Talent Management: 5. Workforce Development - advertising and recruitment of new employees, management of current and future processes to promote and support diversity / management of disciplinary and grievance procedures to evidence equality in its administration 6. Talent management and Employee Relations 7. Workforce Development - exit processes for and end of employment of employees, management of current and future processes to promote and support diversity, representation, management of disciplinary and grievance procedures to evidence equality in its administration Membership The group is chaired by a non-executive director of the Trust Board; executive lead is provided by the Director of Corporate Governance. In addition to the executive working group, membership includes representatives from across the Trust s stakeholders and is: Staff and Patient Governors Patient representative/s A patient with expert knowledge and experience in EDI issues Non-Executive Director Director of Corporate Governance Medical/ Clinicians/ Clinical Services: Medical - Public Health Director of Nursing & Allied Health Professions Service and business unit manager/s - withdrawn Eye Care Liaison Officer (ECLO) Representative from the Patient Experience Committee 3 Workforce: Disability Focus Group - withdrawn, no longer active Ethnic Network Group/s - withdrawn, no longer active Director of HR HR Manager with specific lead on EDI and/or Learning & Development Performance and information Manager Communications & PR - withdrawn Invited Representatives Representation will also be offered (as appropriate) to union representatives and : 3 can be provided by the Dir of Nursing & Alllied Health Professions. This role encompasses representation and briefings for PALS, complaints or whistleblowing issues 12

13 Scope of Activity 1. To support the workplans of the Equality, Diversity & Human Rights Executive Management Group 2. To assess and monitor the delivery of the Trust s equality, diversity and inclusion strategy and policies. 3. To gain assurances that the Trust is compliant with all related statutory requirements and is operating in line with guidance and best practice. 4. To assess how the executive promotes a culture throughout the Trust to ensure equality, diversity and inclusion awareness are embedded into service improvement and delivery. 5. To assess how equality, diversity and inclusion are incorporated into training and talent management throughout the Trust. 6. To note targets and performance indicators as set by management in order to benchmark and evidence progress and accountability. 7. To assess progress of management plans to promote and monitor equitable access to services for all. 8. To identify and signpost resources that highlight areas of good practice for the executive working group. 9. To support the development of networks, partnerships and collaborations with local, regional and national organisations (whether in the private, public or third sector) to better understand the varied needs of both the Trust s workforce and the communities served by the Trust, to identify unmet need, and to enhance the services provided. 10. To provide an annual report evidencing activity of the committee and making any recommendations for the Trust Board to consider. 11. The committee will meet at least twice during the year and will consider any proposed updates to its Terms of Reference at one of these meetings. Final: May

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