NHS England Equality Information Patient and Public Focus First published January 2014 Updated May 2014 Publication Gateway Reference Number: 01704

NHS England Equality Information Patient and Public Focus First published January 2014 Updated May 2014 Publication Gateway Reference Number: 01704

NHS England INFORMATION READER BOX Directorate Medical Operations Patients and Information Nursing Policy Commissioning Development Finance Human Resources Publications Gateway Reference: 1704 Document Purpose Resources Document Name Equality Information: Patient and Public Focus Author NHS England Publication Date May 2014 (originally published January 2014) Target Audience All NHS England Employees Additional Circulation List #VALUE! Description 0 Cross Reference Previously version published in January 2014 Superseded Docs (if applicable) Action Required Equality Information: Patient and Public Focus (January 2014) n/a Timing / Deadlines (if applicable) Contact Details for further information n/a Habib Naqvi Policy Directorate Skipton House 80 London Road SE1 6LH (0113) 825 3627 Document Status http://www.england.nhs.uk/about/equality/ This is a controlled document. Whilst this document may be printed, the electronic version posted on the intranet is the controlled copy. Any printed copies of this document are not controlled. As a controlled document, this document should not be saved onto local or network drives but should always be accessed from the intranet

Introduction NHS England is committed to high quality care for all, now and for future generations. We know from evidence that we cannot be successful in achieving this vision without advancing equality and tackling health inequalities. Alongside this values-based commitment sit our legal duties to promote equality as required by the Equality Act 2010, and to address health inequalities, as required by the Health and Social Care Act 2012. Since its inception in April 2013, NHS England has undertaken considerable work to meet its moral and legal obligations to promote equality and address health inequalities to improve access to services, patient experience, and health outcomes for the population of England. Further information about our strategic approach to promoting equality and reducing health inequalities can be found here. This document was first published in January 2014; it was refreshed in May 2014. What Evidence Tells Us Available data shows that there are inequalities in access, health outcomes and service experience which have endured over time despite substantial investment in healthcare. Inequalities are in evidence between groups of people with different characteristics and across geographies. For example: GP Patient Survey results in 2012/13 show variation by ethnicity in patient confidence and trust in their GP. British 67%, compared with Chinese 42% and Bangladeshi 52%. This variance by ethnicity was replicated in the same survey in terms of the percentage of patients who would definitely recommend their GP surgery to someone else: British 51%, compared with Chinese 30% and Pakistani 34%. Evidence from the Adult Inpatient Survey shows that the overall patient satisfaction score varies significantly by ethnicity. White British had an overall score of 76.7 whilst six of the black and minority ethnic groups had significantly lower scores. At birth males in the most deprived areas of England can expect to live about 15 more years disability-free than males in the most deprived areas: for females it is almost 13.5 years. People with severe mental illness die on average 20 years younger than the general population, often from preventable physical illness. Lesbian, gay and bisexual people are at higher risk of depression and anxiety disorders and are twice as likely to smoke. Equality and Diversity Council NHS England is committed to a joined up approach to promoting equality and reducing health inequalities, and leads the Equality and Diversity Council (EDC). The EDC works to bring people and organisations together to realise a vision for a personal, fair and diverse health and care system, where everyone counts and the values of the NHS Constitution are brought to life.

The Council s purpose is to shape the future of health and social care from an equality, health inequalities and human rights perspective and to improve the access, experiences and health outcomes and quality of care for all who use and deliver health and care services. The Council is chaired by the Chief Executive of NHS England with a diverse membership made up from across the NHS, social care, partner organisations, as well as from patient, carer and staff groups. On behalf of the wider system, during 2013/14, NHS England has overseen the process of bringing together the leaders from the national health and care organisations, to sign a joint commitment to the advancement of equality and the tackling of health inequalities. Further information about the work of the EDC can be found here. Equality Delivery System The Equality Delivery System (EDS) for the NHS was made available to the NHS in June 2011. Following an evaluation of the implementation of the EDS in 2012, and subsequent consultation with a spread of NHS organisations, NHS England, on behalf of the wider system, refreshed the EDS. Known as EDS2, this facilitative tool was launched in November 2013. The main purpose of the EDS was, and remains, to help local NHS organisations, in discussion with local partners including local people, review and improve their performance for people with characteristics protected by the Equality Act 2010. By using the EDS, NHS organisations can also be helped to deliver on the public sector Equality Duty (PSED). NHS England is committed to implementing the Equality Delivery System (EDS), both as a system leader, and as an organisation in its own right. The four EDS goals are: Better health outcomes; Improved patient access and experience; A representative and supported workforce; Inclusive leadership. How do we engage with people from different protected groups? Over the last 12 months NHS England has held four NHS Values Summits, in Leeds, Bristol, Manchester and London. The NHS Values Summits have brought together a diverse range of people and perspectives, including patients and communities, voluntary and charitable bodies and the NHS workforce. They have encouraged greater understanding of how people s differences, social status and cultural expectations can affect their experiences for health and care. In addition, NHS England held a number of workshops at its AGM in September 2013, bringing together patients, communities, subject experts, experts by experience, clinicians and staff to develop and feedback key messages on priorities for change. We also carried out a broad consultation with over 500 respondents on our strategic approach. We are committed to continued engagement with patients and the public and will continue this approach during 2014-15 and beyond.

The Strategic Partners Programme The Strategic Partner Programme brings together expertise from the voluntary and community sector who work to promote equality for different protected groups, and to reduce health inequalities. Partners work together on key aspects of health and social care, and public health policy with system organisations. Partners work together on key aspects of health, social care, and public health policy with system organisations DH, PHE and NHS England on behalf of patients, service users and the wider public. The Partners reach a broad range of people and communities and provide extensive depth of reach to particularly vulnerable groups. Further information about this programme can be found here. The Strategic Partner Programme membership is detailed below: Programme members Age UK National Voices LGB&T Partnership Young People s Health Partnership NACRO, Action for Prisoners Families and Clinks Disability Partnership Mental Health Providers Forum NAVCA CSV UK Health Forum National Housing Federation FaithAction Men s Health Forum National Children s Bureau Race Equality Foundation Women s Health and Equality Consortium Regional Voices Carers Trust and Carers UK NCPC, Help the Hospices and Marie Curie VODG, NCF and Sue Ryder Disability Rights UK, Shaping Our Lives and CHANGE Gender Identity Services Review NHS England became the commissioner of specialised gender identity services in April 2013. A initial engagement meeting with the trans* community took place in May 2013 prioritised the need to address the significant variations in equity of access currently experienced by patients using gender identity services across England. An interim protocol was launched in November 2013 that has to be used in conjunction with the UK Intercollegiate Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria (published in October 2013). Against this background, NHS England has committed to a programme of work to review current NHS Gender Identity Services across England. The review has grown from collaboration with NHS England s Gender Identity Services Clinical Reference Group, the Equality and Health Inequalities team, NHS Improving Quality (NHSIQ) and the Care Quality Commission. This interim review has focussed on adult services and is the product of many conversations and engagement activities with key partners willing to share their experiences. A number of ways to gather opinion and experiences have been used including face to face meetings, capturing patient stories and social media specifically Twitter over a six month period.

Our Equality Objectives NHS England has set itself four Equality Objectives for the period April 2014 to March 2016: i. We will oversee and support the implementation of the Equality Delivery System (EDS2), so that by 31 March 2016 there is a minimum of 95% implementation across all NHS Trusts, NHS Foundation Trusts, and Clinical Commissioning Groups across England. ii. During 2014/15, we will help support CCGs to plan and commission for equality by embedding equality at the heart of key system levers identified by the Equality and Diversity Council, including the CCG assurance regime and the corporate governance statement. iii. By March 2015, we will have developed an Accessible Information Standard to help disabled patients, service users and carers to receive accessible information and appropriate communication support when in contact with healthcare services, to be implemented by March 2016. iv. NHS England is committed to implementing the Equality, Diversity and Inclusion in the Workplace Strategy 2013 to 2015, to ensure an engaged workforce that is more representative at all levels. The Equality Objectives set out above will help to ensure that our policy-making, decisions and activities are compliant with the public sector Equality Duty, and will provide system leadership to Clinical Commissioning Groups and other parts of the NHS.