YOUR SERVICES YOUR SAY

YOUR SERVICES YOUR SAY LGBT PEOPLE S EXPERIENCES OF PUBLIC SERVICES IN SCOTLAND PUBLIC SECTOR CONSULTATION REPORT AND RECOMMENDATIONS

FOREWORD In 2014 for the first time in Scotland, we published a detailed examination of LGBT people's experiences of accessing public services, including health and social care, policing and local authority services. Colin Macfarlane, Director, Stonewall Scotland This report laid bare the significant barriers LGBT people face accessing vital services and their dayto-day experiences of discrimination and poor treatment within Scotland's public sector. To build on our report's recommendations, we engaged directly with public service providers to discuss the challenges they face in supporting the LGBT community in their area, and to identify best practice strategies to overcome these issues going forward. LGBT equality is written into both our laws and the duties placed on our public bodies, and public support for LGBT equality has never been higher. Unfortunately the lived experience of LGBT people does not always reflect this. This report serves as a benchmark for Scotland's public sector, and we look forward to continuing to work in partnership to ensure that everyone in Scotland can access the services they need confident that they will be treated with fairness, dignity and respect. 3

BACKGROUND Under the specific duties of the public sector equality duty, Scottish public authorities are required to report on the progress made towards achieving their Equality Outcomes by 30 April 2015. In order to support public authorities to better understand the experiences of their LGBT service users, in February 2014, Stonewall Scotland published new research into the experiences of lesbian, gay, bisexual and trans people accessing public services in Scotland. The research revealed that despite changes in the law to prevent discrimination on the basis of sexual orientation and gender identity; LGBT people in Scotland still experience discrimination and expect to be treated poorly when accessing public services such as Health and Social Care, Education, Policing and Housing. One in six (16 per cent) LGBT people say they have experienced poor treatment because of their sexual orientation or gender identity when accessing public services in the last three years. The research also looks in more detail at where specific problem areas exist and who is experiencing these issues, as well as highlighting examples of good practice that have been implemented to improve the lives of LGBT people in Scotland. Stonewall Scotland invited representatives from public sector organisations across Scotland to participate in roundtable discussions, looking at the research findings, key areas for concern, and ways of improving services for LGBT people. This included considering ways of raising LGBT people's confidence in accessing public services without fear of discrimination. Four roundtables were held in Inverness, Aberdeen, Glasgow and Edinburgh with a total of 30 organisations represented, covering health and social care services, housing, policing, higher and further education, and local authority services. Through these roundtables key barriers to LGBT engagement in public life were identified and explored. Issues identified by Your Services Your Say were used to frame discussions on the challenges to improving confidence and quality of experience among LGBT service users. Through these roundtables we aimed to work with service providers to set the research in context, reflecting on how it impacts their service and their local area, raise awareness and understanding of the data available on the barriers to LGBT people accessing public services, whilst also giving the opportunity to highlight where more detailed service user research would be valuable. A seminar at Stonewall Scotland's annual Workplace Conference provided a forum for the issues identified at the roundtables to be considered in further detail, and supported participants to come up with individual action plans to tackle key areas identified at the roundtables. This report aims to pull together the findings from this far reaching consultation, and provide a point of reference on LGBT experiences of Scotland's public services, ahead of the next stage of the Public Sector Equality Duty's Equality Outcome and Mainstreaming reporting cycle. It will additionally inform further consultation which will be carried out on key themes in 2015. One in six (16 per cent) LGBT people say they have experienced poor treatment because of their sexual orientation or gender identity when accessing public services in the last three years. 4

RESEARCH FINDINGS: AN OVERVIEW One in six LGBT people experienced poor treatment because of their sexual orientation or gender identity when accessing a public service in the last three years. The report also provided a detailed picture of LGBT people's experiences and expectations across different service areas: health and social care, housing, policing, family life, post-16 education and training, and in the local community. Analysis of some service areas is framed around LGBT people's expectations of these services, rather than lived experiences. This was for two reasons: firstly, the sample size for some key services would not be adequate once excluding those who have not used the service. In order to achieve that kind of data, more detailed service user research or monitoring would be required. Asking people's perceptions of a service additionally enabled analysis of the barriers which may prevent LGBT people from using that service at all. Key themes identified across the report focussed on: false assumptions being made about service users' sexual orientation or gender identity expectations and fears about 'coming out trans respondents' experiences and expectations were consistently worse across all service areas. The impact of this on the community is evidenced both in this report and Stonewall Scotland's Hate Crime (2014) research, which highlights issues around feeling safe in the community, lack of trust and failure to access key services, and lack of consultation from service providers. 5

LOCAL AND NATIONAL DATA Your Services Your Say provided the most detailed analysis of LGBT people's experiences of public services in Scotland to date, and the high response rate allowed data to be broken down to compare experiences across Scotland's electoral regions. Consultation participants highlighted, however, that it would be valuable to have more detailed data at local authority or NHS board level. It was also emphasised that within local authority areas, there can be significant differences in an individual's experience depending on their local community or environment. Improving national and local data availability therefore will rely on building better local engagement and communication networks. It would additionally be beneficial to encourage major polling agencies to increase the representation of LGBT participants on their panels, and ensure that questions relating to participants sexual orientation and gender identity are asked in an appropriate way. Monitoring both staff and service users is also a vital source of information, but despite the Government priority to improve local and national data, many public authorities continue to find this challenging. Measuring Up, the EHRC's report on the performance of the public sector in meeting the demands of the PSED, identified that only 47 per cent of public authorities published employee information relating to sexual orientation, and only 22 per cent reported on 1 gender reassignment. The roundtable discussions highlighted key challenges and shared good practice. There was an acknowledgement of a general lack of understanding of the value of monitoring across service users and staff. Ensuring that the purpose of any monitoring exercise is clearly explained, as well as making it clear and explicit how the data will be used and stored, is an important first step. Organisations should also follow up on any monitoring or consultation with information about how this has impacted on the service. Consultations should also be aware of the diversity of opinions and needs that will exist within one community, and be sensitive to this. The consultation delegates also suggested that the research findings painted quite a negative picture of LGBT people's experiences and expectations. Positive case studies and sharing good practice would be valuable in supporting organisations to take positive steps towards improving services for LGBT people, whilst positive messaging also may impact on LGBT people having increased confidence in accessing these services. Only 47 per cent of public authorities published employee information relating to sexual orientation, and only 22 per cent reported on gender reassignment. 1 EHRC Scotland (2013), Measuring Up: Report 2, Monitoring Public Authorities Performance of the Employment Duties. 6

MAINSTREAMING The Scottish Minister's proposal's to support the better performance of the PSED 2013-17 states that: Across public services, there is a critical need to more fully connect and align equality outcomes with the pursuit of wider strategic outcomes. We must foster leadership and cultures which promote equality as a fundamental part of the way that organisations and partnerships work to achieve outcomes, rather than a bolt on. A key topic of discussion was around where responsibility for equality agendas should sit within organisational structures. Whilst the value of individual equality officers or leads was strongly emphasised as a means of ensuring that the equality agenda is given due regard, a move from seeing equalities work as the role of that single equalities lead, to part of a wider improvement strategy is at the heart of effective mainstreaming. Achieving this cross organisational buy-in, however, was seen as a major challenge to successful mainstreaming. Good practice identified included: Prioritising key areas of work: identifying key areas for improvement and tangible actions rather than trying to do everything at once. These priorities should be in line with overarching organisational targets and should be clearly communicated to staff. Senior buy-in: ensuring that work is evidenced based and evaluated, and ensuring consistency of messaging. Highlighting the relevance of work or tools to improve services for one protected characteristic to improving others was also seen as a valuable way of responding to accusations of prioritising the needs of one characteristic over others. Effective mainstreaming within existing training and capacity building projects: building relevant equalities issues into existing training packages will support staff to understand the relevance of those issues to their job role, for example person centred care training should make reference to the importance of involving same-sex partners in care decisions when appropriate. Similarly training on new or updated policies and procedures could refer to any issues highlighted with an Equality Impact Assessment, and the relevant evidence used. For example a Gender Based Violence strategy should take into account the specific experiences of LGBT people and domestic abuse. Training and policy changes should be followed up with staff including in personal development plans and appraisals. An additional challenge to ensuring consistency across services, however, is the impact of relatively autonomous organisations falling under local authority or NHS responsibility. Schools and GP surgeries (amongst others) often have a level of autonomy over policies, decision making and training. Equalities work can therefore depend on an individual's priorities rather than wider policy. 7

IMPROVING CONFIDENCE IN THE PUBLIC SECTOR A key question raised at the roundtables is challenging expectations and fears around 'coming out'. How can organisations facilitate someone being able to come out and be comfortable being out without being intrusive? Discussions related this to the values of person centred care and who and what is important to the service user. For example a patient's partner is important to their recovery and therefore feeling comfortable with them being part of consultations or able to visit is incredibly important. It is also important to consider the impact that early experiences of discrimination and bullying can have on an individual's confidence going into further or higher education, and other public services. Consultation participants highlighted the impact that negative stereotypes of LGBT people can have on their ability and confidence to access public services, and in particular education and training. A particular barrier exists, for example, for gay men in youth work settings, where the 'predatory' stereotype can damage their confidence to go into that area of work, or damage career prospects. Positive role models were seen as a valuable way of breaking down stereotypes and negative attitudes towards LGBT people. Reverse mentoring can also support a deeper organisational understanding of the issues impacting on LGBT people within their organisation, and improve senior buy-in. Discussions looked at the wider role that third party crime reporting sites can play in the community as trusted offices and how Police Scotland can work to ensure that appropriate sites are available. Your Services Your Say suggests that a quarter of LGBT people would not feel confident reporting a hate crime through a third party reporting site or website. Stonewall's Hate Crime Research also showed that only four per cent of hate crimes or incidents were reported through a third party reporting site. Consultation participants also emphasised that ideally crimes should be reported directly to the police, and promoting Third Party Reporting sites should not detracted from that aim. Ensuring that communication strategies are inclusive and meet the needs of the diversity of Scotland's communities has become an increasingly high priority in meeting the Public Sector Equality Duty. This trend provides an excellent opportunity for organisations to reflect on the impact of their communications on LGBT people, and whether they are representative of different families and relationships. There are some simple steps to achieve an inclusive communications style for LGBT staff, including using gender-neutral language; however it is important that communication strategies are nuanced to the communities they target. This is particularly important when communicating with dispersed workforces and communities, where support should be offered in different areas to tackle issues around isolation and small community dynamics, particularly where 'coming out' to a professional may not provide the anonymity of a larger service. Your Services Your Say highlighted that one of the biggest barriers to LGBT people accessing public services is the expectation of discrimination before they even come into contact with it. Consultation participants suggest that profiling the positive cases and demonstrating how negative experiences have been resolved can be helpful in building trust and breaking down assumptions. When a complaint does highlight a policy or procedural issue, using this as a means of reviewing policies has also proved effective in some organisations, and communicating this is equally important. Finally, profiling positive stories about patient experiences or issues being dealt with effectively was seen as an effective strategy in building trust. See Stonewall Scotland's Ten Steps to LGBT inclusive Communications for further information. 8

RECOMMENDATIONS Public authorities should show visible leadership in relation to tackling discrimination across Scotland schools, workplaces and communities, by signing up to Stonewall's NoBystanders campaign. See NoBystanders.org.uk for more details. Support should be available to facilitate effective engagement with LGBT communities at a local level, including considering the challenges of dispersed populations. Public authorities should engage with equalities organisations to identify and share good practice examples of employee monitoring in order to effectively meet their legal duties in relation to publishing employment information. They should ensure that this information is used to inform policy change and progress equality within their organisation. Organisations should consider external benchmarking tools to measure their progress in developing inclusive workplace cultures, and enhance their understanding of internal monitoring data, including participation in Stonewall's Workplace Equality Index. Public authorities should support staff to attend Stonewall Scotland's LGBT Role Models, and Allies programmes as a means of building capacity within their organisations and LGBT communities across Scotland. Relevant LGBT equalities issues should be built into existing training packages to support staff to understand the relevance of those issues to their job role To improve local and national data, public bodies should introduce service user monitoring in sensitive and discreet areas, using the guidance available in Stonewall Scotland's Monitoring Guide. This could include, for example, colleges and universities introducing monitoring in specific subject areas as a means of identifying barriers to certain curriculum areas. 9

NEXT STEPS This consultation provided valuable insight into the barriers to LGBT people accessing public services in Scotland, and, significantly, highlights existing good practice in ensuring services meet the needs of LGBT people in Scotland's diverse communities. In March 2015 public authorities will be required to report on their progress to date in meeting the demands of the Public Sector Equality Duty. Stonewall Scotland hopes that this report will support organisations to frame the work they are doing to support LGBT staff and service users and to identify key issues where further attention is required. Further consultations scheduled for summer 2015 aim to take this work to the next stage and develop tangible actions which authorities can take to tackle the issues raised in this report. For more information about these events, please contact: catherine.somerville@stonewallscotland.org.uk 10

YOUR SERVICES YOUR SAY LGBT PEOPLE S EXPERIENCES OF PUBLIC SERVICES IN SCOTLAND PUBLIC SECTOR CONSULTATION REPORT AND RECOMMENDATIONS Officers and staff across the organisation have embraced the ethos of 'No Bystanders' and have joined me in signing the pledge. We are all committed to achieving a wholly inclusive and representative workforce which in turn assists us in keeping people safe across all the communities that we serve. Chief Constable Sir Stephen House We firmly believe in providing the highest standard of care and service for everyone. We are committed to creating an environment that is inclusive and welcomes individuals of all backgrounds, whilst promoting and celebrating the rich talents and experiences from our unique mix of people. Jeane Freeman, Board Chair, NHS National Waiting Times Centre Board www.stonewallscotland.org.uk @stonewallscot