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Single equality scheme 2010-2013


If you would like the scheme in another format, or another language then please contact the communications team on: Call: 01484 464074 Text: “KPALS” to 64446 Email: communications@kirklees.nhs.uk Communications team NHS Kirklees Broad Lea House Bradley Business Park Dyson Wood Way Bradley Huddersfield HD2 1GZ We would welcome your comments and feedback about our scheme, if you have any views please get in touch.

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Single equality scheme 2010–2013


Contents Foreword. .................................................................................................................................4 Section 1 — Background 1.1 1.2 1.3 1.4 1.5 1.6 1.7

Introduction and our commitment.....................................................................................5 About NHS Kirklees............................................................................................................7 Why have we produced a single equality scheme?...........................................................10 How we developed the scheme........................................................................................10 Legislative and policy framework......................................................................................11 Aims of our equality scheme............................................................................................15 What have we achieved so far?........................................................................................15

Section 2 — Kirklees context 2.1 2.2 2.3 2.4

Kirklees population profile................................................................................................17 Health inequalities............................................................................................................18 NHS Kirklees workforce....................................................................................................29 Diversity driver.................................................................................................................43

Section 3 — Meeting our duties 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13

Responsibility...................................................................................................................44 Consultation and involvement..........................................................................................44 Working in partnership....................................................................................................47 Assessing relevance of functions and policies...................................................................47 Equality impact assessments.............................................................................................48 Collecting data, sharing information................................................................................48 Commissioning and procurement.....................................................................................50 Easy access to information for all......................................................................................51 Training............................................................................................................................52 Monitoring and reviewing our scheme.............................................................................52 Publishing our scheme.....................................................................................................53 Comments and feedback.................................................................................................53 Complaints......................................................................................................................54

Appendix 1: Single equality scheme action plans 2010 - 2013....................55 Appendix 2: Existing legislation.................................................................................63

Single equality scheme 2010–2013

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Foreword NHS Kirklees is pleased to present our second single equality scheme, which builds on the achievements of our first equality scheme and sets out our commitment to delivering our equality duties.

Rob Napier Chair

The Department of Health’s White Paper, Equity and excellence: Liberating the NHS, sets out the government’s long-term vision for the NHS. Primary care trusts, including NHS Kirklees, are due to be abolished by 2013. If this goes ahead, the commissioning of healthcare in Kirklees will transfer from NHS Kirklees to two GP led consortia. NHS Kirklees is working closely with local GPs to ensure a smooth transition into the new commissioning arrangements. Whilst this is a time of significant change for NHS Kirklees, we must continue to meet our statutory equality duties at the same time as supporting the new organisations to embed equality and diversity into their business activities.

Our commitment to equality and diversity is embodied in our vision as a PCT:

Working together to achieve the best health and well-being for all the people of Kirklees. Mike Potts Chief Executive

Please address any comments you have about this scheme to: The Equality and Diversity Manager Broad Lea House Bradley Business Park Dyson Wood Way Bradley Huddersfield HD2 1GZ

We can only achieve this by identifying and addressing inequality in health experiences and outcomes together with access to our services. Therefore, one of our core values as an organisation is to value diversity and challenge discrimination. This equality scheme is important in enabling us to achieve this vision and demonstrate our values, particularly at a time of change and significant financial challenge. However it is also a ‘living’ document and will need to be developed and updated to take account of changing needs, circumstances, and evolving legislative and regulatory requirements. Broad ownership of the scheme and commitment to the actions contained in it are vital to its success and we therefore welcome any comments or feedback you might have.

Tel: 01484 464039 Email: ppi@kirklees.nhs.uk

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Rob Napier Chair

Single equality scheme 2010–2013

Mike Potts Chief Executive


Background

SECTION 1: Background

1.1 Introduction “The NHS of the 21st century must be responsive to the needs of different groups and individuals within society, and challenge discrimination on the grounds of age, gender, ethnicity, religion, disability and sexuality. The NHS will treat patients as individuals, with respect for their dignity. Patients and citizens will have a greater say in the NHS, and the provision of services will be centred on patients’ needs.” Source: Abstract from Department of Health, NHS Plan, 2000 This new single equality scheme for NHS Kirklees is a public commitment of how we plan to meet the needs and aspirations of local people and staff, the challenge of the NHS Constitution and our statutory duties as set out in the equality legislation. Although we have a range of legal responsibilities, we view this as a minimum requirement and want to move beyond this. To help make this a reality, we are determined to promote equality of access to services and eliminate discrimination for everyone. We are also committed to treating our workforce fairly and providing a working environment that promotes equality of opportunity and helps them to develop to their full potential.

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We see equality, diversity and human rights as part of our core business. This scheme helps us to build on the progress we have already made but also makes sure that we get the basics right so that we are able to measure our performance and outcomes. This is shown in our equality scheme action plan, which is an integral part of the scheme. It sets out a practical work programme, which identifies areas for improvement and specific actions to help us embed equality and diversity in everything that we do. The key priorities for the 2010–2013 single equality scheme are: • Better health outcomes for all • Improved patient access and experience • Empowered, engaged and well supported staff • Governance and inclusive leadership at all levels

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SECTION 1: Background

Whilst our existing equality scheme has made some progress, there are areas in which progress was slower or more limited than expected and some objectives that were not met. A progress update identifying some of our key achievements is described below in section 1.7. We intend to use this single equality scheme as an opportunity to build on our achievements and learn from less successful areas. We are committed to building an infrastructure with our partners, our staff and the communities we serve, that supports equality and helps us deliver a world class service that addresses health inequalities, improves health outcomes and achieves the best health and well-being for all the people of Kirklees. It is important to note that most of this document was formulated and written before the release of the Department of Health’s White Paper, Equity and excellence: Liberating the NHS. The authors of the document could not anticipate the scale of the changes the White Paper would bring to the architecture of the NHS. Therefore, the reader should bear in mind that some of the points made in the following document may seem a bit out of place given the changes which are likely to be taking place. However, it is intended that this scheme be published as a baseline from which we can start working towards the government’s goals. As the transitional arrangements with shadow GP consortia progress, we will be able to generate more detailed information and action plans outlining our commitments for the coming years.

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Single equality scheme 2010–2013


SECTION 1: Background

1.2 About NHS Kirklees NHS Kirklees was established in 2006 from three former primary care trusts in Huddersfield and North Kirklees. We have the same boundaries as Kirklees Council and organise our work across the same six localities, which are shown on the map. Until 31 March 2013, we are the custodians of the National Health Service in Kirklees and this is reflected in our name - ‘NHS Kirklees’. From April 2013, two GP consortia will lead the commissioning of healthcare across Kirklees – North Kirklees Health Alliance (which will bring together 32 practices currently within the North Kirklees and Dewsbury Commissioning Consortia and stand alone practices) and the Greater Huddersfield Commissioning Consortium (which will consist of 41 practices currently within the Huddersfield Commissioning Consortium, Three Valleys Commissioning Consortium and stand alone practices). Working on a geographical basis we are, together with our partners, using the context of place to tackle the particular issues of that area, where needs are identified for that locality from the joint strategic needs assessment and local intelligence as well as for other communities of interest e.g. those with certain health conditions, disability or at risk of significant ill health. Directors and senior NHS Kirklees staff are members of the leadership groups within these areas. In common with other primary care trusts, we have three main functions: 1. Engaging with our local population to improve health and well-being; 2. Commissioning a comprehensive and equitable range of high quality, responsive and efficient services within allocated resources, across all service sectors; and 3. Directly providing high quality, responsive and efficient services where this gives best value.

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SECTION 1: Background

As a primary care trust, we are currently responsible for making sure that NHS services are in place to meet the needs of local people. NHS Kirklees is accountable for making sure that these services are safe, accessible, high quality and provide value for money. In line with national developments, NHS Kirklees has internally separated its commissioning function from its community health services. Kirklees Community Healthcare Services is the provider arm of NHS Kirklees and remains accountable to the board of NHS Kirklees. On 15 December 2010, the NHS Kirklees board approved a detailed plan for Kirklees Community Healthcare Services to progress to become a social enterprise in Spring 2011. If the plans are formally approved by the Strategic Health Authority and the Department of Health, Kirklees Community Healthcare Services will operate in shadow form from April 2011 and will be independent of NHS Kirklees by October 2011.

Our vision and values NHS Kirklees’ vision and values were originally developed in collaboration with staff and our partners through a series of workshops and communication events and signed off by the board in 2007. In 2009, we reviewed our vision, values and goals in light of world class commissioning, the Healthy Ambitions report published by the Strategic Health Authority and our own strategic priorities. The vision and values underpin all key organisational development activity within NHS Kirklees. All initiatives are considered in light of the vision and values to assess how they help us to meet them.

Our vision and values are: Working together to achieve the best health and well-being for all the people of Kirklees. • To recognise that people are at the heart of everything we do. • To support people in taking responsibility for their own health and well-being. • To show understanding, dignity and respect for all our clients, partners and staff. • To encourage open, clear and honest communication. • To value diversity and challenge discrimination. • To encourage innovation and continuous improvement and celebrate the contribution made by our staff • To be accountable for the decisions we make, the work we do, the resources we use and the impact on the environment.

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SECTION 1: Background

Strategic goals The strategic goals for NHS Kirklees are: GOAL 1 Raise male and female life expectancy at birth so that it is not significantly below the national average in any part of Kirklees. GOAL 2 Improve health outcomes for children and young people, working in partnership to improve life chances and safeguard children. GOAL 3 Target individuals and populations to tackle health and well-being inequalities, focusing on the priority issues identified locally. Provide advice, support and care to these individuals, families and communities, in the form of high quality targeted interventions known to work, to increase the control they have over their own health and well-being. GOAL 4 Empower those people in Kirklees with a long term condition to exercise control over their own lives and be central to the decision making about their own care, so preventing problems arising or worsening and enabling them to independently manage their own health and well-being.

Medium to long-term changes In 2010 we published a five year strategic plan, which from 2013 will be owned by the new consortia. Over the five year period described by that plan, working with our GP consortia colleagues, we aim to achieve changes which further our goals. We are committed to progressing these objectives in partnership with GP consortia through the shadow period until 2013. We described a shared ambition with Kirklees Council and other partners that by 2020 Kirklees will: • be recognised in West Yorkshire and beyond as an area of major success; • have a strong economy supported by an attractive, high quality environment, offering the best of rural and urban living; • place a high value on creativity and learning; • comprise communities who are proud of their past, but enjoy diversity, are outward looking and face the future with optimism; • be a safe, healthy and supportive place to live and work for both young and old people, with a clear commitment that all should share in this success. Building on this, the two newly established GP consortia will develop the vision and establish their own goals and values to enable progression of our original strategic plan programmes across the whole of Kirklees.

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SECTION 1: Background

1.3 Why have we produced a single equality scheme? As a public authority, we have a legal duty to advance equality, eliminate unlawful discrimination and foster good relations between people who share a protected characteristic and those who do not share it. The specific requirements of the new integrated public sector equality duty, are set out below. This scheme helps us meet our legal duties, promote equality and focus on what is important to our workforce and the community we serve. It explains why equality is important and how we can fulfil our objectives in a way that will be meaningful to our stakeholders and promote equality for all our staff and the population of Kirklees. The development of a single equality scheme provides a framework to integrate equality and diversity into all that we do so that it becomes an integral part of how we carry out our day to day work. Our first ever single equality scheme was published in 2007. Since then we have continuously strived to meet and understand the changing needs of our staff and the people living in Kirklees. The single equality scheme will build on the good work we have already done and will help us to harmonise and coordinate our approach to meeting our equality duties. Our single equality scheme is a ‘living’ document that will develop and evolve in line with legislative and policy changes, feedback from stakeholders and changing priorities.

1.4 How we developed the scheme Our draft single equality scheme is informed by the findings from an initial information gathering exercise which reviewed national and local data from the following sources: • Kirklees joint strategic needs assessment

• Outcomes of equality impact assessments carried out by NHS Kirklees

• Current Living in Kirklees Survey (CLIK) 20081

• Equality and diversity scheme 2007 – 2009

• NHS Kirklees Strategic Plan 2010 – 2015

• NHS Kirklees organisational development plan

• Patient feedback received between 2008 and 2010 • Equality and Human Rights Commission and Department of Health 1

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• Staff survey 2009 • Workforce monitoring information • Diversity driver report

See section 2.2 below for an explanation of the CLIK Survey 2008

Single equality scheme 2010–2013


SECTION 1: Background

To build on these initial findings and get a clearer picture of the needs and aspirations of staff and local people, we carried out a number of consultation and involvement exercises. These are explained in more detail below in section 3.2 Consultation and involvement.

1.5 Legislative and policy framework National context For the first time in the history of the NHS, the recently developed NHS Constitution brings together in one place what staff, patients and the public can expect from the NHS. It reaffirms the core values of the NHS and explicitly states patient and staff rights and responsibilities. It confirms equality as one of the guiding principles; ‘The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population’ (NHS Constitution, 2009) The NHS Constitution also outlines the specific rights of patients not to be ‘unlawfully discriminated against in the provision of NHS services including on the grounds of gender, race, religion or belief, sexual orientation, disability (including learning disability or mental illness) or age’ and the right to be treated with ‘dignity and respect, in accordance with your human rights’. For staff there is also a set of rights, to: • have a good working environment with flexible working opportunities; • be involved and represented in the workplace; • have healthy and safe working conditions and an environment free from harassment, bullying or violence; • be treated fairly, equally and free from discrimination; • prevent discrimination against patients or staff and to adhere to equal opportunities and equality and human rights legislation.

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SECTION 1: Background

Legal context The new Equality Act 2010 received royal assent in April 2010. Most of the provisions of the Act came into force in October 2010. It is the most significant piece of equality legislation for a generation and distills current discrimination law into a single Act. It replaces all current legislation relating to the different strands of equality and simplifies, streamlines and strengthens the law. In April 2011, the current public sector duties that cover race, disability and gender will be replaced by a single equality duty, which will extend our obligations to include age, sexual orientation, religion and belief, gender reassignment and pregnancy and maternity. It also applies to marriage and civil partnership, but only in respect of the requirement to have due regard to the need to eliminate discrimination. From 5 April 2011, we will no longer have a legal duty to publish equality schemes. However, as a public sector organisation, we will still have a legal duty to demonstrate that promoting equality and tackling unlawful discrimination are central to our policy making, the commissioning and delivery of our services and our employment practices. This scheme will therefore provide us with a strong foundation for making the transition from the previous legislation to the new requirements of the Equality Act 2010.

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Single equality scheme 2010–2013


SECTION 1: Background

The following boxed text summarises the new legislative framework in which our equality and diversity work will take place from 5 April 2011. Prior to this date, the public sector equality duties covering race, gender and disability still apply. These are set out in Appendix 2.

EQUALITY ACT 2010 General duty (due to be implemented 5 April 2011) The general equality duty is set out in the Equality Act 2010. In summary, those subject to the equality duty must, in the exercise of their functions, have due regard to the need to: • Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act. • Advance equality of opportunity between people who share a protected characteristic and those who do not. • Foster good relations between people who share a protected characteristic and those who do not.

Specific duties (in draft and subject to change) In summary, a public authority covered by the specific duties is required to:

Publish information • Publish information to demonstrate its compliance with the general equality duty across its functions. This must be done by 31 December 2011, and at least annually after that, from the first date of publication. This information must include, in particular: • Information on the effect that its policies and practices have had on people who share a relevant protected characteristic, to demonstrate the extent to which it furthered the aims of the general equality duty for its employees and for others with an interest in the way it performs its functions. Public authorities with less than 150 employees are exempt from the requirement to publish data on their effects on their employees.

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SECTION 1: Background

Prepare and publish equality objectives By 6 April 2012, prepare and publish: • One or more objectives that it reasonably thinks it should achieve to meet one or more aims of the general equality duty. It must also: • Make sure the objectives are specific and measurable.

Publication The information on equality objectives must be published at least every four years. The above information and equality objectives must be published in a manner that is reasonably accessible to the public. It can be published within another document.

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SECTION 1: Background

1.6 Aims of our equality scheme The aims of our equality scheme are to: • Provide a framework which helps deliver NHS Kirklees’ vision, values and objectives • Meet and move beyond our legal responsibilities • Challenge existing practices leading to better access and outcomes for the community we serve • Be seen as a leader in good employment practice locally and nationally • Deliver the equality scheme through the development and implementation of an action plan

1.7 What have we achieved so far? NHS Kirklees has been working hard in many areas over several years to promote equality for our service users and employees. Listed below are examples of progress made by NHS Kirklees: 1. In 2007, we established an equality and diversity steering group chaired by a nonexecutive director of NHS Kirklees, which reports to the communications and public relations committee. The steering group meets on a bi-monthly basis and includes senior representation from all directorates. 2. In October 2009, we appointed a permanent part-time equality and diversity manager who is our strategic lead for equality and human rights. 3. Equality and diversity training is compulsory for all staff and we include general equality and diversity awareness as part of the mandatory training programme for all new starters. Board members have received bespoke equality and diversity training and human resources provides an annual employment update for managers. The equality and diversity managers at NHS Kirklees and NHS Calderdale jointly delivered a series of lunchtime briefing sessions for staff on the new Equality Act 2010 in February 2011. 4. Diversity driver assessment workshop delivered in January 2009. 5. There are regular reports on the workforce, which includes a range of monitoring data that show the profile of staff by race, gender, disability, religion, age and sexual orientation. We also monitor the progression of staff through the recruitment and selection process, sickness absence and staff undergoing the performance process.

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SECTION 1: Background

6. NHS Kirklees publishes an annual report, which includes the range of workforce monitoring data as well as details of key work carried out and a summary of findings from the annual staff survey. 7. In 2009, all the NHS Kirklees’ buildings were audited for Disability Discrimination Act compliance. As a result issues identified at Holme Valley Memorial Hospital were addressed as part of the Hawthorne Ward scheme and an induction loop was included in the reception design for the new headquarters along with braille signage. Other issues identified have been prioritised within the NHS Kirklees’ overall estate plans. 8. In 2010, the Patient and Public Involvement team added an equality monitoring section to the Pharmaceutical Needs Assessment questionnaire used for public consultation, so that feedback could be disaggregated by equality group. 9. The Patient and Public Involvement team is currently developing a stakeholders database in partnership with Voluntary Action Kirklees. The database will include details of seldom heard groups. 10. As part of the public health women of childbearing age project, a new drop-in centre called Auntie Pam’s has been set up in Dewsbury. The project has been designed for local women by local women and is staffed by volunteers with personal experience of pregnancy and parenthood. It is targeted at pregnant women, aged 15 – 25, who are not engaged with services. 11. A free stop smoking club for women, ‘Time for Me’, has recently been launched in Batley.

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Single equality scheme 2010–2013


Kirklees context

SECTION 2: Kirklees context

2.1 Kirklees population profile Table 1: Populations by age group, 2009 and 2025 projections Age group

2009 Total

%

2025 Total

%

Under 19 (2009) or under 20 (2025)

101,500

23.7

116,800

19-64 yrs (2009) or 20–64 yrs (2025)

163,500

61.6

65 – 84 yrs

54,700

Over 85 yrs Total All aged 65 and over

Population difference 2009 to 2025

% change in population in age group 2009 and 2025

25.7

15,300

15.1

254,000

55.8

-9,500

-3.6

12.8

71,500

15.7

16,800

30.7

8,000

1.9

12,700

2.8

4,700

58.8

427,700

100

454,900

100

27,200

6.4

62,700

14.7

84,200

18.5

21,500

34.3

2

Source: FHS July 2009, ONS 2006-based sub-national population projections The total population living in Kirklees in 2009 was approximately 427,700. By 2025 the population is predicted to increase by 6.4% to nearly 455,000. Currently, nearly one in four of the population is aged under 19 years. Over half the population are of working age and just under one in seven are aged over 65 years. By 2025 the proportion in the working age group will have reduced and those aged over 65 will have increased to nearly one in five as people live longer than before. The increase in those aged over 65 includes a large increase in the proportion living over 85 years. Overall the numbers of births are slightly increasing, particularly among families of South Asian origin. More than one in four young people under 19 are now of South Asian origin. There is a small African Caribbean population mainly located in Huddersfield.

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SECTION 2: Kirklees context

Ethnicity profile Kirklees has a diverse ethnic mix, with a higher proportion of the population from ethnic minorities than for England as a whole (see table 2 below). The largest ethnic minority groups in Kirklees are Pakistani (7%) and Indian (4%).

Table 2: Estimated residential population by ethnicity mid-2007 for Kirklees (experimental statistics) No. White Mixed White and Black Caribbean

336000

KIRKLEES

ENGLAND

%

%

84

88

32000

1

1

500

0

0

Mixed: White and Asian

2100

1

1

Mixed: Other Mixed

1000

0

0

Asian or Asian British: Indian

17100

4

3

Asian or Asian British: Pakistani

28600

7

2

800

0

1

Mixed: White and Black African

Asian or Asian British: Bangladeshi Asian or Asian British: Other Asian

2100

1

1

Black or Black British: Caribbean

4100

1

1

Black or Black British: African

2200

1

0

600

0

1

1300

0

1

Black or Black British: Other Black Chinese or other ethnic group :Chinese

Source: ONS There are also significant variations by ethnic group between the six localities within Kirklees, with a higher proportion of Black and minority ethnic groups living in Dewsbury and Mirfield, Batley, Birstall and Birkenshaw and Huddersfield North and South.

2.2 Health inequalities Health inequalities are health differences between people which can be changed. There is a growing body of evidence that shows significant variations in both health experience and outcome by different parts of the community. This section looks at the position in Kirklees for different groups, using local data drawn from the Current Living in Kirklees survey 2008 and other sources where available and noting national findings where appropriate.

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SECTION 2: Kirklees context

The health of people in Kirklees is generally worse than the England average. Over the last ten years, early deaths from heart disease and stroke have fallen but still remain worse than the England average. Long term condition management has been a focus and remains so given the increasing proportion of those living with these conditions. Infant mortality remains high, particularly in the north of Kirklees. This has led to a focus on women of child bearing age and their personal behaviours, as they have more influence on family behaviours, such as eating a healthy diet and being physically active. Smoking levels in Kirklees remain too high and obesity is an area of increasing concern for both children and adults.

Ethnic origin There is a growing body of research that suggests that many minority ethnic communities experience poorer health in comparison to the national population. Research indicates that there is a disparity in how minority ethnic communities access and experience health services. The Race for Health publication called Driving Forward Race Equality in the NHS identifies some of the health differences and other issues faced by minority ethnic communities. These are listed below: • Some 35% of African Caribbean men smoke, compared with 39% of White Irish men, and 27% of the general population. • Infant mortality in England and Wales for children born to mothers from Pakistan is double the average. • Young Asian women are more than twice as likely to commit suicide as young White women. • In 2004, people from Black and minority ethnic groups comprised 39.1% of hospital medical staff but only 22.1% of consultants. • Young Black men are six times more likely than young White men to be sectioned for compulsory treatment under the Mental Health Act. • South Asian people are 50% more likely to die prematurely from coronary heart disease than the general population. • Asian women aged 65 and over have the highest rate of limiting, long-term illness (64.5% compared to 53% for all women aged 65 and over). • The prevalence of stroke among African Caribbean and South Asian men is 40% to 70% higher than for the general population • Men and women of Pakistani origin are more than six times as likely as the general population to have diabetes. Rates for Indian men and women are three times higher and are significantly higher for African Caribbeans. • 90% of children in the UK have visited a dentist. This compares with approximately 60% of Pakistani children.

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SECTION 2: Kirklees context

• In terms of access to, and experience of, NHS services, people from minority ethnic groups give less positive responses than the wider population, particularly for primary care and hospital outpatient departments. (Source: www.raceforhealth.org/storage/files/introduction_to_rfh_programme.pdf

Summary of Current Living in Kirklees survey findings by ethnicity • Asian and mixed respondents were more likely to be younger than white and Black respondents. Asian respondents were the most likely ethnic groups to be male. • Asian and Black respondents were less likely than white and mixed respondents to have rated their overall health as excellent or good. Asian respondents had worse physical health functioning than White respondents. Black respondents were the most likely ethnic group to have reported suffering from any health conditions in the previous 12 months, particularly high blood pressure. Asian and Black respondents were the most likely ethnic groups to have reported suffering from diabetes. • All Black and Minority Ethnic (BME) groups had worse mental health functioning than White respondents. Black and mixed race respondents were the most likely ethnic groups to have reported suffering from depression, anxiety and other nervous illness over the previous 12 months. • Black and mixed race respondents were the most likely ethnic groups to be smokers and to be obese. Asian respondents were the least likely ethnic group to have reported eating five or more portions of fruit and vegetables per day and to be undertaking physical activity. White and mixed race respondents were the most likely ethnic groups to have reported hazardous levels of alcohol consumption and binge drinking. • Asian and Black respondents were more likely than other ethnic groups to have a low household income. Asian respondents were the most likely ethnic group to have children living in their household and to be living in overcrowded housing. • Mixed race and Black respondents were most likely to feel lonely or isolated where they live. Mixed race respondents were the most likely ethnic group to expect to be living outside of Kirklees in five years time.

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Disability There is no comprehensive data on the number of disabled people at either a local or national level. However, the 2001 census does indicate that 18% of the Kirklees population has a limiting long-term illness, which is defined as ‘any long-term illness, health problem or disability which limits your daily activities or the work you can do’. Nationally, the report of a formal investigation by the Disability Rights Commission (2006) called Equal Treatment – Closing the Gap, found that people with learning disabilities and people with mental health problems are much more likely than other citizens to have significant health risks and major health problems: • For people with learning disabilities, these particularly include obesity and respiratory disease; • For people with mental health problems, these include obesity, smoking, heart disease, high blood pressure, respiratory disease, diabetes and stroke. • People with schizophrenia are almost twice as likely to have bowel cancer as other citizens • Both groups are likely to die younger than other people. • People with serious mental health problems are also more likely than others to experience conditions like strokes and coronary heart disease (CHD) before the age of 55. Once they have these conditions they are less likely to survive for more than five years. It is known that disability rates increase with age and that the vast majority of disabled people are not born with a disability, but acquire it as they grow older. The needs of disabled people with progressive conditions usually increase over time as their impairments become more severe, and many disabled people need more support as they get older.

Summary of Current Living in Kirklees survey findings for disabled respondents The Current Living in Kirklees survey asked respondents if they had a long-term illness, health problem or disability which limits their daily activities or work they can do. • Disabled respondents are more likely than non-disabled respondents to be males and to be older. • Disabled respondents were less likely than non-disabled respondents to have rated their overall health as excellent or good. Disabled respondents had much worse physical health functioning than non-disabled respondents and were more likely to have reported suffering from a range of health conditions over the previous 12 months, including pain problems and high blood pressure.

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• Disabled respondents were less likely to report positive emotional well-being. Disabled respondents had worse mental health functioning than non-disabled respondents and were more likely than non-disabled respondents to have reported suffering from depression, anxiety and other nervous illness over the previous 12 months. • Disabled respondents were less likely than non-disabled respondents to have reported positive health behaviours such as consumption of five or more portions of fruit and vegetables per day and undertaking physical activity. Disabled respondents were more likely to be obese. • Disabled respondents were more likely than non-disabled respondents to have a low household income, to have children living in their household, to be retired or to be permanently sick and unable to work. • Disabled respondents were more likely than non-disabled respondents to feel lonely or isolated all or most of the time.

Gender NHS Kirklees is committed to tackling gender inequalities by recognising the specific health needs of women, men and transgender people. There is a growing awareness of the correlation between gender and health and the differences between men and women in both health status and use of services. Some examples of these differences include: • Women are two to three times more likely than men to be affected by depression • Men are three times more likely than women to commit suicide • Smoking rates in young women are rising • Men are more likely than women to die prematurely from heart disease • Heart disease in women is more likely to remain undetected for longer • Women are 2.7 times more likely than men to develop auto-immune diseases such as diabetes but are more resistant to some kinds of infection, including tuberculosis • Women are more likely than men to report practical problems in access to services • Men are less likely to seek medical advice. In Kirklees, life expectancy at birth is significantly below the national average for women. Male life expectancy is now 77.4 years and female 80.8 years. There are also variations across the localities with life expectancy in Dewsbury significantly below the national rate for both men and women.

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Summary of Current Living in Kirklees findings by gender • Female respondents are more likely to be younger than male respondents. Male respondents are more likely to be disabled. • Female respondents were more likely than male respondents to have rated their overall health as excellent or good. Male respondents were more likely than female respondents to have reported suffering from health conditions in the previous 12 months, particularly pain problems and high blood pressure. Physical functioning was better in women overall than in men. • Female respondents were more likely than male respondents to have reported suffering from depression, anxiety or other nervous illness in the previous 12 months. Mental health status was better in men overall than in women. • Male respondents were more likely than female respondents to have reported hazardous or harmful levels of alcohol consumption. Female respondents were less likely to be sedentary and more likely than male respondents to want to increase their levels of physical activity in the future. • Female and male respondents had similar household incomes and tenure. Male respondents were more likely than female respondents to be working full-time. Female respondents were more likely than male respondents to be working part-time and to have children living in their household. The survey did not monitor for gender identity. Whilst there has been considerable work on estimating the number of transgender and transsexual people within the UK population, there is still no publicly available statistical data on which to make firm estimates. A survey of the local transgender population in Calderdale in 2009 identified 38 transgender people including five transgender people aged 19 or younger. A significant concern for a third of the respondents (half of post-gender reassignment surgery (GRS) respondents) was a perceived lack of post-operative (GRS) hormone monitoring and the potential implications for their physical health. Research has shown that almost 20% of transgender people surveyed for the equalities review reported that healthcare was either affected or refused altogether by GPs who knew they were transgender. Whilst there are notable examples of excellent care and good practice, 60% of transgender people who thought their GPs and other medical professionals would like to be more helpful and supportive reported that the practitioners felt unable to do so through lack of training and information. As a consequence of the attitudes and reactions of health professionals, transgender individuals are vulnerable to discrimination and inappropriate routine healthcare.

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SECTION 2: Kirklees context

Sexual orientation There are no accurate statistics available regarding the profile of the lesbian, gay and bisexual population. Sexual orientation is not incorporated in the census or most other official statistics. Central government estimates that 5-7 % of the total population identifies as lesbian, gay or bisexual. If applied to Kirklees, this would account for 20,000-28,000 of the Kirklees population. Lesbian, gay and bisexual people can have very specific health concerns that are not necessarily met by mainstream service providers and they can also experience social and health inequalities. In addition, discrimination and homophobia can have a significant impact on how they experience health services. This can mean that lesbian, gay and bisexual people may be reluctant to disclose their sexual orientation, because they anticipate discrimination, which can result in a failure to receive appropriate healthcare. A briefing by the Department of Health in 2007 on young lesbian, gay and bisexual people highlighted the following: • young lesbian, gay or bisexual people are four times more likely than their heterosexual counterparts to suffer major depression • young gay and bisexual men are seven times more likely to attempt suicide • young lesbian and bisexual girls are almost ten times more likely to smoke and report higher weekly alcohol consumption • young lesbian, gay and bisexual people are more likely to use recreational drugs

A survey into lesbian, gay and bisexual health needs in Bradford in 2007 found: • 21% of respondents smoked. • 42% regularly or occasionally exceeded recommended levels of alcohol and 33% regularly or occasionally binge drink with women twice as likely as men to exceed limits or binge drink. • More than 25% of women are not accessing regular cervical cancer screening. Of those, 14% were advised that as lesbians, cervical cancer screening is unnecessary. • 60% of respondents have experienced mental health issues over the last five years.

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Summary of Current Living in Kirklees findings by sexual orientation It should be noted that owing to the relatively low numbers of lesbian, gay and bisexual people responding to the survey, the findings below need to be interpreted with caution. • Lesbian, gay and bisexual respondents were as likely as heterosexual respondents to have reported good overall health. The prevalence of health conditions was similar among lesbian, gay and bisexual and heterosexual respondents. • Lesbian, gay and bisexual respondents (particularly bisexual women) had worse mental health functioning than heterosexual respondents and were less likely than heterosexual respondents to have reported positive mental health and emotional well-being. Lesbian, gay and bisexual respondents were more likely to have reported suffering from depression, anxiety and other nervous illness in the previous 12 months and more likely to have reported accomplishing less in the previous months because of emotional problems. • Lesbian, gay and bisexual respondents were more likely than heterosexual respondents to be smokers and more likely than heterosexual respondents to have reported wanting to increase their levels of physical activity in the future. • Lesbian, gay and bisexual respondents were more likely than heterosexual respondents to have reported feeling lonely or isolated where they live for all or most of the time. Lesbian, gay and bisexual respondents (particularly 18-24 year olds) were more likely than heterosexual respondents to expect to be living outside of Kirklees in five years time. • Lesbian, gay and bisexual respondents were more likely than heterosexual respondents to live alone and to be receiving a household income of under £10k per annum.

Age It is widely recognised that younger and older people experience particular barriers in relation to access, attitudes and treatment. Age has implications for all people. Age equality is not only about eliminating discrimination, but delivering equitable outcomes for people with different needs at different stages in life. A one size fits all service is not sufficient. Older people are the main users of many health services but they might not be designed with older peoples’ needs in mind. A traditional service designed around isolated episodes of care within well defined specialties and agencies cannot fully meet the needs of the increasing numbers of older patients. Some significant health related age issues include: • Cancer, heart disease and stroke, respiratory disease and injuries account for more than 80% of all deaths in people aged 65 years and over.

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SECTION 2: Kirklees context

• Coronary heart disease remains the leading cause of death in the United Kingdom. One in four people die from coronary heart disease, 50% of whom are over 65 years old. More than 40% of older people have some degree of disability or impaired functioning as a result of coronary heart disease. • One in seven of those 65 years and over live with ‘major’ depression which disrupts day-to-day functioning and more than 700,000 have dementia at any one time. • For young men (15-34), one of the leading causes of death is suicide. This is seven times higher for young gay and bisexual men. • At any one time about 10% of young people under 19 years old will have mental health problems severe enough to interfere with their daily lives. • 11,000 children are looked after and accommodated by local authorities. Within this already disadvantaged group more than 40% have emotional or mental health problems.

Summary of Current Living in Kirklees findings by age • Older respondents were less likely than younger respondents to rate their overall health as excellent or good, and were more likely to have suffered from health conditions over the previous 12 months, especially pain problems such as arthritis and high blood pressure. Physical functioning was poorer in older people than younger people. • Younger respondents were less likely than older respondents to have reported positive mental health. Respondents aged 18-24 were the most likely age group to have reported suffering from depression, anxiety and other nervous illness over the previous 12 months. Mental health status was worse in 18-24 year olds than in every other age group. • Younger respondents aged under 44 were the most likely age group to be smokers. Respondents aged 75+ were the least likely age group to have reported eating five or more portions of fruit and vegetables per day. Older respondents were less likely than younger respondents to carry out moderate physical activity, but were more likely than younger respondents to want to increase their levels of physical activity in the future. • Respondents aged 18-24 and 25-34 were the most likely age groups to have reported hazardous levels of alcohol consumption. Respondents aged 18-24 were the most likely age group to have reported binge drinking (just over half of this age group were binge drinkers). • Respondents aged 18-24 were the most likely age group to report feeling lonely or isolated for all or most of the time and to expect to be living outside of Kirklees in five years time.

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Religion and belief The Current Living In Kirklees survey did not monitor for religion and belief, hence we have little local data available beyond the 2001 census information. Kirklees is a multi-cultural, multi-faith community and we are committed to meeting the needs of patients and staff of diverse religious groups, as well as people with no religious belief, and to respond sensitively and appropriately to their different needs. Issues around religion and belief are more likely to be about inequalities in access and treatment than about specific health inequalities relating to a person’s religion. Specific issues to be considered include gender issues (same-sex wards and treatment by members of the opposite sex), sexuality and reproduction, spiritual practices such as prayer and ablution facilities, dietary requirements, the impact of fasting on those with long-term conditions or breastfeeding, clothes as a religious sign of modesty, death and dying and respect for the deity or place of worship.

Carers In the UK, there are approximately six million carers, excluding health professionals and care workers, and a further 6,000 people become carers every day. Many people do not see themselves as carers, but simply as someone who is helping to look after a friend or relative who is elderly, ill or disabled. Around three in five people will be a carer at some point in their lives. The results of the 2008 Carers Week survey of 1,997 carers throughout the UK highlight just what effect caring can have. Key findings include: • More than three-quarters of those questioned (77%) feel that their health is worse as a result of the strain of caring. • A large majority of carers admitted to feeling ill, anxious or exhausted, with 95% saying they regularly cover up or disguise the fact that their health is suffering in order to continue with their caring responsibilities. • Almost one in four (24%) of carers say they frequently feel unable to cope with their day-to-day duties due to the physical and emotional stresses of their caring role, and a further 64% say they are occasionally unable to cope. • More than two in three of those questioned (67%) said there had been a number of instances when they had been unable to find an opportunity to visit their GP about their own health concerns, due to time constraints and a general lack of flexibility to leave the house to attend appointments. • Almost two-thirds (65%) admitted that, to some extent, health problems had affected their ability to care, with 96% saying they were very concerned about who would take over their role should they fall ill.

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SECTION 2: Kirklees context

Summary of Current Living In Kirklees findings for carers The survey asked a set of questions about caring for other people. Firstly, respondents were provided with a definition of caring: ‘This question is about people who provide unpaid care for family, partners or friends in need of help because they are ill, frail or have a disability. This includes a person who looks after someone who misuses alcohol or substances’. Respondents were then asked if they care for someone who has a long-term illness, health problem or disability that limits their daily activities or the work they do. • Carers are more likely than non-carers to be aged 45-64. Carers are more likely than non-carers to be disabled. • Carers were less likely than non-carers to rate their overall health as excellent or good, and were more likely to have suffered from health conditions in the previous 12 months, particularly pain problems such as arthritis. Carers have poorer physical health functioning than non-carers. • Carers were less likely than non-carers to have reported positive mental health. Carers were more likely than non-carers to report suffering from depression, anxiety and other nervous illness over the previous 12 months. Carers have poorer mental health functioning than non-carers. • Carers were more likely to be obese than non-carers and more likely to be sedentary. Carers and non-carers also reported similar incomes and household tenure. Carers were less likely than non-carers to be employed. Carers were more likely than noncarers to have people of pension age living in their household.

Deprivation There is a strong correlation between health and socio-economic status. Kirklees is the 82nd most deprived local authority area out of 354 in England. More than 70,000 people locally are now classed as income deprived. There is a significant concentration of deprivation within the urban areas of Huddersfield and Dewsbury with a few other pockets of deprivation within the north of Kirklees. Since 2004, there have been some changes in deprivation. The most significant improvements were in parts of Batley and Thornhill in Dewsbury. There were also some small areas that have worsened, which were split between the central areas of Dewsbury and Huddersfield. There were variations between the localities for the proportion of the population living in the most deprived areas. Overall, Kirklees had 27% of its population living in the 20% most deprived areas. Dewsbury & Mirfield (46%) had the highest level of its population living within these areas, closely followed by Huddersfield South (37%) and Batley, Birstall & Birkenshaw (38%). Denby Dale and Kirkburton and the Valleys had the lowest proportion of their population living in deprived areas.

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2.3 NHS Kirklees workforce As a public sector body, NHS Kirklees has a duty to monitor its workforce on key employment indicators by ethnicity, disability, and gender to make sure that there is no discrimination against any of these groups. NHS Kirklees has decided to extend this to include data on age, sexual orientation and religion or belief. We are making efforts to increase our workforce so that it reflects the local population served. However, because of the economic conditions during 2009/10 and the anticipated abolition of primary care trusts by April 2013, there has been limited staff recruitment, hence the profile of staff employed remains similar to 2008/9. The equality data for employed staff as at 31 March 2010 is outlined below.

Ethnicity The charts below outline the ethnicity profile for NHS Kirklees and Kirklees Community Healthcare Services, as well as ethnicity by staff group. The ethnicity profiles are generally representative of the local population. However, it should be noted that the percentage of Asian/ Asian British employees in Kirklees Community Healthcare Services is under representative of the population of Kirklees. Ethnicity Profile - Commissioning PCT Ethnicity Profile - Commissioning PCT

Ethnicity profile – Commissioning PCT 0.27% 0.27% 0.27% 0.27% 1.07% 9.92% 1.07% 9.92% 1.07% 1.07%

Ethnicity Profile - KCHS

Ethnicity profile – KCHS 0.33% 1.83%

0.33%

4.83% 0.92% White

White White Mixed Mixed Asian/Asian British Asian/Asian British Black/Black British Black/Black British Chinese/Other Ethnic Group Chinese/Other Ethnic Group Not Stated Not Stated

87.40% 87.40%

Mixed

Asian/Asi

Black/Bla

Chinese/O Group

Not State

91.76%

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SECTION 2: Kirklees context

Ethnicity by staff group – Commissioning PCT Commissioning PCT - Ethnicity by staff group

100%

3

1

90%

3

6

4

80% 70% Percentage

1

1

26

1

60% 50%

1

1

32

56

215

40% 14

30%

7

Not Stated Chinese or Other Black/Black British Asian/Asian British Mixed White

20% 10%

A

dd

Pr o an f S A d T cien dd e iti ch tific on ni al c cl s i A dm erv nica ic l i an ni es s Es ta d C trat le iv te s a ric e nd al an ci lla ry N ur an Me sin d D d g en ical & m tal re idw Se gist ifer er y ni ed or M an ag er

0%

Staff group

Ethnicity by staff group – KCHS

KCHS - Ethnicity by staff group

100%

21

90%

17

1 3 28

1 2

2

2

3

80%

4 13 2 8 5

1

13

Percentage

70% 60% 50% 40%

227

97

14

523

21

11

178

30%

31

20% 10%

Cl

in A ic dd a A l Se itio dm r n vi al an inis ces t d ra c A ler tive l Pr lie ica of d l es He s a Es ion lth ta al t s an es ci an lla d N r ur a sin nd Me y d g & Den ica m t l re idw al gi if st e er ry e M S d an en ag io r St er ud en ts

0%

Staff Group

30

Single equality scheme 2010–2013

Not Stated Chinese or Other Black/Black British Asian/Asian British Mixed White


SECTION 2: Kirklees context

Age The age profile shows that a high percentage of staff across both organisations are between 4059 years of age. This is higher than the Kirklees workplace population. The percentage of staff over 50 for NHS Kirklees (commissioning) is 25.2% and 29.3% for KCHS. It is evident that both organisations employ fewer staff under the age of 20 than the local population. It could be argued that as a healthcare provider a large proportion of staff require professional qualifications, i.e. nursing which could account for the lower numbers of staff below the age of 20.

Age profile

Age Profile

40% 35%

Percentage

30% 25% Commissioning PCT KCHS Kirklees Workforce Population

20%

Percentage 15% 10% 5% 0% <20

20-29

30-39

40-49

50-59

60+

Age

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SECTION 2: Kirklees context

Gender The graph below shows the total number of male and female staff for NHS Kirklees at 31 March 2010, which is broken down into commissioning and provider organisations. The table below shows the percentage of male and female staff across the organisation in comparison with the Kirklees population. It should be noted that the data is for the whole population of Kirklees and therefore does not reflect the workplace population. Nonetheless, the data shows that NHS Kirklees has a predominantly female workforce. From the NHS Staff Survey 2009 results, NHS Kirklees has a slightly higher percentage of female staff (91%) overall in comparison with the average for primary care trusts (88%).

Gender Female Male Totals

Commissioning PCT Count 305 68 373

% 82% 18%

Gender profile

Kirklees population

KCHS Count 1131 70 1201

% 94% 6%

51.4% 48.6%

Gender Profile

1200

1131

1000

Head count

800 Females Males

600

Headcount 400

305

200 68

70

0 Commissioning PCT

32

Single equality scheme 2010â&#x20AC;&#x201C;2013

Kirklees Community Healthcare Services


SECTION 2: Kirklees context

Disability This information can also be viewed alongside the results from the NHS Staff Survey 2009 which were: • Do you have a long-standing illness, health problem or disability? Yes = 14% No = 86% • (If answered YES to the above) Has your employer made adjustments to enable you to carry out your work? Yes = 72% No = 28%

Disability Profile - Commissioning PCT Disability profile – Disability Profile - KCHS Commissioning PCT Disability profile – KCHS

4.0%

Disability Profile - KCHS

0.3% 13.9%

3.1%

No 14.7% Not Declared Undefined Yes

3.1% 0.2% 14.7%

0.2%

No Not Decl Undefine Yes

No Not Declared Undefined Yes

82.1%

81.8%

82.1%

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SECTION 2: Kirklees context

Sexual orientation Bisexual Gay Heterosexual I do not wish to disclose my sexual orientation Lesbian Undefined

Commissioning PCT 1 2 251 116 3 0

KCHS 0 0 776 422 2 1

The data shows that 1.6% of staff in the commissioning arm of NHS Kirklees identify as gay, lesbian or bisexual. This percentage is 0.1% for Kirklees Community Healthcare Services. However, it should be noted that a high proportion of staff have stated that they do not wish to disclose this information, so the actual percentages might be higher. Stonewall estimate that approximately 6% of the UK population are gay, lesbian or bisexual. The census of 2001 does not record the sexual orientation of people; however, it recorded that 512 people in Kirklees stated they live in a same-sex couple. This equates to 0.17% of people over 16 years of age in Kirklees. (ONS, 2001). ‘Undefined’ refers to those who have not responded to the sexual orientation part of the data validation questionnaire. It is evident that there has been a significant improvement in data quality since 08/09, where 34% of staff were ‘undefined’ (across both commissioning and provider organisations).

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Religion/belief Religion / beliefReligion/Belief – Commissioning PCT PCT - Commissioning

200 180 160 140 120 100 80 60 40 20 0 Atheism 31

Buddhism Christianity 1

Hinduism

I do not wish to disclose

Islam

Judaism

Other

Sikhism

1

111

22

0

14

3

190

Religion/ Belief - KCHS Religion / belief – KCHS

700

600

500

400

300

200

100

0 Atheism Buddhism Christianity Hinduism KCHS

77

1

641

9

I do not wish to disclose

Islam

Judaism

Other

Sikhism

Undefined

387

35

1

44

5

1

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SECTION 2: Kirklees context

Flexible working With the move to a new headquarters at Bradley, we will be reviewing our flexible working arrangements for staff during 2010. Kirklees Community Healthcare Services staff can apply on an annual basis to work flexibly. Approvals are granted for one year only and staff must reapply at the beginning of the next year. This makes sure that all staff have the opportunity to work flexibly. A summary of staff who received approval to work flexibly at Kirklees Community Healthcare Services in 2009/10 is given below: Buy additional leave

White

Male Female No details given Total approved

36

Number Compressed hours Number approved approved

14

12 2 16 30

Single equality scheme 2010â&#x20AC;&#x201C;2013

White Mixed Black/Black British

Male Female No details given Total approved

84 1 2

11 75 59 146

Annualised hours

White

Any other ethnic background Male Female No details given Total approved

Number approved

v17

1 1 17 20 38


SECTION 2: Kirklees context

Our gender pay gap We have researched our payroll/electronic staff record using the mean spinal salary point to determine our gender pay gap at 37.7%. This calculation is based on the formula provided by the Government’s Equalities Office. Within Kirklees Community Healthcare Services, the gender pay gap is 43.4% while the gender pay gap for the commissioning arm of the PCT currently stands at 24.2%. We believe that the following factors could be contributing to our gender pay gap: • The low number of men working in clinical and administrative and support roles. • The higher proportion of men who work in the medical and dental professions. • There are significantly lower numbers of men working in the organisation. However, almost half of thebymen concentrated in senior Gender Pay are Band - Commissioning PCT level positions (grade 8a and above). Due to the economic conditions mentioned earlier and the future changes to the commissioning arrangements in Kirklees, it is unlikely that we will be able to reduce this figure as recruitment 15 and turnover across the organisation will remain 12 low until closure in April 2013. 90%

100%

57 80%

Gender by pay band – Commissioning PCT

Gender by Pay Band - Commissioning PCT

Percentage

70%

27

60% 50%

Percentage 40%

100%

148

15 12

90%

Not on AfC Band 8+ Band 5-7 Band 1-4

57 80%

30% 24

70%

Percentage

20% 60%

27

95

10%

148 50%

0% Percentage 40%

6 Female

Not on AfC Band 8+ Band 5-7 Band 1-4

Male

Gender

30%

24 20% 95 10% 6 0% Female

Male

Gender

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Gender by Pay Band - Commissioning PCT

SECTION 2: Kirklees context 100%

15

12

90% 57 80%

Gender by pay band â&#x20AC;&#x201C; KCHS

Gender by Pay Band - KCHS

Percentage

70%

27

60%

100%

Not on AfC Band 8+ Band 5-7 Band 1-4

29

148

50%

60

90% Percentage 40%

20

80%

30%

24

70%

20%

Percentage

60%

95

647

12

10%

6

50%

0%

Percentage 40%

Female

Male

24

Not on AfC Band 8+ Band 5-7 Band 1-4

Gender 30% 20%

433 17

10% 0% Female

Male

Gender

Table 1 shows the average salaries and gender pay gap for staff in posts at Agenda for Change (AfC) band 8a and above, as well as director, medical and dental staff. There is a larger pay gap in table 1 which is due to the higher proportion of men who are in the medical/dental category (45% of men in table 1 are in the medical and dental or director group, this compares with 25% of women).

Average salaries for staff on AfC band 8 and above (including director and medical and dental staff) Average spinal salary for AfC 8+, director and medical and dental staff Female Male Grand Total Pay gap

38

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NHS Kirklees Commissioning Provider Whole organisation Head Average Head Average Head Average count salary count salary count salary 68 54211.71 89 52561.67 157 53276.338 35 56793.26 31 77952.42 66 66731.652 103 55088.93 120 59120.95 223 57258.628 4.5% 32.6% 20.2%


SECTION 2: Kirklees context

Average salaries for staff on AfC band 8 and above (excluding director and medical and dental staff) Average spinal salary for AfC 8+

Female Male Grand Total Pay gap

NHS Kirklees Commissioning Provider Whole organisation Head Average Head Average Head Average count salary count salary count salary 57 50218.74 60 44914.5 117 47498.615 27 52111.63 12 50603.75 39 51647.667 84 50827.17 72 45862.71 156 48535.878 3.6%

11.2%

8%

Analysis of the gender pay gap within the director and medical/dental pay band (non AfC) shows that the gender pay gap within Kirklees Community Healthcare Services is 28.2%. The figure in commissioning is -3.2%. This negative figure shows that within commissioning the average salary for those in the highest pay band is greater for women than men.

Gender by professional staff group Commissioning Additional prof scientific and technical Additional clinical services Administrative and clerical Estates and ancillary Medical and dental Nursing and midwifery registered Senior manager

Female 13 1 215 1 7 32 36

Male 8 0 34 0 4 1 21

Kirklees Community Healthcare Services Additional clinical services Administrative and clerical Allied health professionals Estates and ancillary Medical and dental Nursing and midwifery registered Senior manager Students

Female 236 206 89 4 28 541 16 11

Male 2 7 13 10 18 14 6 0

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SECTION 2: Kirklees context

Formal employee relations cases The chart below shows the number of employee relations cases which are either completed or ongoing as at 31 March 2010. The gender of staff is also recorded, however this has not been reported on due to the possibility that the employees could be potentially identifiable.

Ethnicity BME White

Disciplinary

Grievance

Capability

1 1

0 4

0 3

Bullying/ harassment 1 1

NHS Staff Survey 2009 The levels of staff satisfaction and experience of working for NHS Kirklees are monitored via the annual staff survey. The 2009 staff survey generated a response rate of 69% (505 staff). NHS Kirklees recognises that not all staff identified themselves as belonging to equality groups; this could be for a number of reasons. The equality data related to the respondents is as follows: 44 male 72 disabled 449 white

453 female 420 not disabled 48 black and minority ethnic

8 did not specify 13 did not specify 8 did not specify

NHS Kirklees was in the top 20% of primary care trusts offering flexible working options (see reference to Kirklees Community Healthcare Services above). 84% of staff who took part in the survey said they had been given this option. The NHS Staff Survey 2009 included three key areas around equality and diversity. The results for NHS Kirklees are as follows: • 97% of staff believe that the trust provides equal opportunities for career progression or promotion, which is higher than the trust score in 2008 (93%) and higher than the national average for primary care trusts. • A new key finding for 2009 measures the percentage of staff experiencing discrimination at work in the last 12 months; this places NHS Kirklees in the best 20% of primary care trusts. • 48% of staff reported that they have had equality and diversity training within the last 12 months. This is an average score across similar organisations, and has increased from 38% in 2008. The trust is looking at ways to improve this figure.

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• Harassment, bullying or abuse from patients/relatives in the last 12 months has decreased from 16% in the 2008 survey to 11% in 2009. This now places us in the best 20% of primary care trusts. • 13% of staff experienced harassment, bullying or abuse from other staff, this has not changed from the 2008 staff survey, and we maintain a rating of better than average for primary care trusts.

Employment NHS Kirklees commits: • To recruit, develop and retain a workforce that is able to deliver high quality services that are accessible, responsible and appropriate to meet the diverse needs of different groups and individuals. • To make sure we are a fair employer achieving equality of opportunity and outcomes in the workforce. • To make sure staff are able to understand and promote equality, diversity and human rights through appropriate training and awareness, skills and competencies and evaluation of performance. • To make sure appropriate support policies and systems are in place for staff to ensure a positive work life balance. • To set up appropriate mechanisms to monitor and publish workforce statistics for gender, ethnic origin, age and disability and to use this data to plan targeted activity where necessary. • To provide opportunities for staff to support its aim to become a local employer of choice, such as establishing staff networks and effectively engaging with the workforce as a stakeholder in the organisation.

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Positive about disabled people - Two Ticks NHS Kirklees is an accredited ‘Two Ticks Symbol’ user. The symbol is a mark given by the Employment Service to employers who have agreed to take action to meet five commitments regarding the employment, retention, training and career development of disabled employees. Employers who use the symbol have agreed that they will take action on these five commitments: • to interview all applicants with a disability who meet the minimum criteria for a job vacancy; • to make sure there is a mechanism in place to discuss with disabled employees what can be done to make sure the employee can develop and use their abilities; • to make every effort when employees become disabled to make sure they stay in employment; • to take action to make sure that all employees develop the appropriate level of disability awareness needed to fulfil these commitments, and • each year, to review the five commitments and what has been achieved, to plan ways to improve on them.

Conclusions This report sets out the workforce information for the period 1 April 2009 to 31 March 2010. During this time a validation exercise of all staff has been carried out on the information held about them. One of the key aims of this exercise was to improve the monitoring information of staff. The data validation exercise has resulted in additional data and information about the majority of staff, including religion and belief and sexual orientation. However, we acknowledge that whilst there has been a significant improvement in data quality since 2008/09, some staff are still reluctant to disclose personal information. When comparing the ethnicity profile of the workforce to the general population, it is evident that the ethnicity profiles of staff are generally representative of the local population. However, it should be noted that the percentage of Asian/Asian British employees in Kirklees Community Health Services is under representative of the population of Kirklees. The data highlights that a high proportion of staff across both organisations are over 40 years of age and that we employ few staff under the age of 30 compared to the local workforce population. NHS Kirklees has a predominantly female workforce and a gender pay gap that currently stands at 37.7% across both organisations. The gender pay gap for provider services is 43.4% while the figure for commissioning services is 24.2%. Further analysis in the highest pay band (non AfC director, medical and dental staff) identifies that women are paid slightly more on average than men in commissioning services but the gender pay gap in the provider arm remains high at 28.2%.

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The organisation continues to make efforts to encourage under-represented groups to work in NHS Kirklees by regular attendance at local career events. The human resources and organisational development team routinely circulate all vacancies to a variety of local community groups and agencies in the Kirklees area. However, given the current economic climate and the anticipated abolition of NHS Kirklees by April 2013, staff turnover across the commissioning arm is likely to remain very low. Subject to formal approval by the Department of Health and the Strategic Health Authority, provider services will be operating as a social enterprise in shadow form from April 2011 and will be a separate legal entity by October 2011.

2.4 Diversity driver The diversity driver is a structured self-assessment tool for organisations to benchmark where they are in terms of diversity management. It provides a baseline on which to build plans and check progress regarding diversity management. It has a customer focus as well as a focus on the internal workforce. The diversity driver enables organisations to identify their strengths and weaknesses in the field of diversity and to prioritise areas for action. A strategic meeting was held in January 2009 for NHS Kirklees as part of the diversity champions project. Staff representing a cross-section of the organisation attended this workshop. The workshop delivered a list of strengths and areas for improvement relating to how the participants felt that the organisation was performing regarding diversity. Individuals were asked to vote on which of the areas for improvement they thought were the most important to be addressed in order to progress the organisations diversity agenda. The top three priority areas were identified as follows: • The service leaders need to demonstrate that they believe in equality and diversity and that they would challenge non-inclusive behaviour - 360 degree leadership appraisal • We need ways of joining up action plans and sharing good practice across the organisation – a learning organisation. • We do not have a systematic way of collecting and analysing equality data on staff, service users and contractors. A full copy of the diversity driver report for NHS Kirklees can be found at www.kirklees.nhs. uk/fileadmin/documents/publications/equality_and_diversity_scheme/diver_report_final_ version_14.1.09_01.pdf

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3

Meeting our duties 3.1 Responsibility The Chief Executive and board of NHS Kirklees are legally accountable for compliance with the equality legislation. We have strong board level leadership of the equality and human rights agenda, and leadership and commitment at all levels of the organisation will be central to the success of the scheme to make sure we eliminate discrimination and seek to promote equality and diversity wherever we can. We believe that each individual employed within NHS Kirklees should take responsibility for, and ownership of this agenda. We all need to contribute to policy development and ensure implementation, promote good practice and encourage change.

3.2 Consultation and involvement We have built on the feedback we received from our first equality scheme and have made sure that we listened to the views of a range of different individuals, organisations and members of our staff in developing our three year scheme. Between August 2010 and November 2010, we carried out a programme of consultation and engagement activity seeking feedback to shape this scheme. This included sending a draft summary of this document to individuals, community groups, and other interested parties for comment. We also attended meetings with staff and stakeholders and the consultation document and questionnaire were both available online. We analysed all the responses we received and used these to inform the equality scheme and action plan. All comments and submissions to the consultation are available in the single equality scheme engagement and consultation report, which is available through our website at www.kirklees.nhs.uk/public-information/equality-and-diversity/nhskirklees-single-equality-schemes/

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If you would like a hard copy of the report or a copy in another language or format (such as braille, audio CD, data CD, easy read or large print), please contact us using the details on page two of this document. The disability equality duty requires us to do more than just consult stakeholders and staff. It gives us a duty to actively involve disabled people in the development of the scheme. With this in mind, we worked in partnership with the Kirklees Disability Rights Network from the early stages of development to make sure that the views and experiences of disabled stakeholders were heard and properly integrated into our action plans. This scheme has also been informed by a range of sources (see section four above) with particular reference to the results of the Current Living in Kirklees survey 2008. The survey is a result of a joint project between NHS Kirklees and Kirklees Council. The purpose of the survey is to provide real information about health and social inequalities, which can be used to shape planning and investment decisions. A postal questionnaire was sent to a random sample of 70,000 addresses in Kirklees. The 2008 survey had a 31% response rate and for the first time the data was disaggregated by equality group, with the exception of religion and belief. Following analysis of the survey results, public health carried out a qualitative analysis of the health and lifestyle needs of 18 to 24 year olds, in partnership with Kirklees Council. The results of this in-depth analysis are now available and will inform the new joint strategic needs assessment.

Key messages from our stakeholders • Public documents should be accessible and written in a simple format that can be easily understood by all sections of the community. • Make sure that important information is available in a range of formats, including community languages, large print, braille, audio and easy read. • Distribute information in a wide range of community settings including doctors’ surgeries, libraries and community settings. • Use local media, community radio and local community groups to get key messages out to the public. One group mentioned that word of mouth is the best way to communicate with the Pakistani community and another group suggested getting information included in their community newsletter. • Work in partnership with specific sections of the community to raise awareness of health issues and lifestyle choices. • Commission targeted health screening for specific communities in local venues. • Take action to tackle the specific health inequalities experienced by some disadvantaged groups including the South Asian communities. • Reference the health needs of lesbian, gay, bisexual and transgender people in the joint strategic needs assessment

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• Where the health needs of particular equality groups are not fully understood at a local level, commission research to plug the information gap. • There should be more community involvement and genuine partnership working between NHS Kirklees, Kirklees Community Healthcare Services and local communities. • GPs and practice based staff should receive awareness raising and training around equality and diversity issues. • Make sure that the new GP consortia fully understand their statutory duties in relation to equality and diversity. • Improve the monitoring of services by equality group and use the information to challenge poor performance and enhance health experiences and outcomes for disadvantaged groups. • Make sure that robust and effective equality impact assessments are carried out across the organisation.

Key messages from our staff • Provide a simple summary of the single equality scheme. • Commission and deliver healthcare that meets the needs of the whole population. • Target information at community groups and link in with neighbourhood newsletters. • Develop opportunities for involvement by minority groups in the workplace. Staff network groups were mentioned as being a good idea. • Celebrate our diversity and create a working environment where people are proud to be themselves and not scared to be open about who they are. • Provide assurances to staff about the confidentiality of equality monitoring data. • Deliver equality and diversity training at staff meetings and promote equality as a useful project management tool. • Include a section on religious holidays in the special leave policy • Carry out equality impact assessments on all decommissioning decisions. • Strengthen our equality and diversity training for staff and deliver equality impact assessment training to lead officers. • Work with GP consortia to make sure that they understand their equality duties. • Include an equality and diversity section on GP Link. • Incorporate a standard clause regarding equality and diversity into all our contracts.

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3.3 Working in partnership NHS Kirklees has a long standing track record of working with partners to tackle poor health and health inequalities. We recognise that we can meet peoplesâ&#x20AC;&#x2122; needs more effectively if we work closely with key partners to assess local needs, agree strategic priorities and deliver services together. We are part of the Kirklees Partnership, which brings together partner agencies from across the public, private, voluntary and community sectors, to improve service delivery and quality of life locally. Our wider work with the Kirklees Partnership has enabled the delivery of a joint Sustainable Community Strategy which covers the period 2009 â&#x20AC;&#x201C; 2012. This sets out the strategic direction and long term vision for Kirklees. Kirklees Council is one of our key partners in the provision of health and social care. We have a joint communicating for health board and the joint strategic needs assessment, which describes the future health and wellbeing needs of the local population, is developed in partnership with Kirklees Council. We are also working closely with Voluntary Action Kirklees to support the involvement of voluntary and community organisations in the planning of health and social care provision and specifically, the development of this scheme. These partnerships are valued very highly by the trust, both in terms of the support provided and as an important link to the communities we serve.

3.4 Assessing relevance of functions and policies We need to make sure that we have given proper consideration to equality for all of our policies and functions, both current and proposed. Most policies, functions or business activities that involve and affect people will have the potential to affect different groups of people in different ways, and will therefore be relevant to the equality duty. We are in the process of assessing the relevance of all of our policies and functions in line with the new equality duty.

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3.5 Equality impact assessments Equality impact assessment is a tool aimed at improving the quality of local health services by making sure that individuals and teams think carefully about the likely impact of their work on different communities or groups. They help us to consider any potential risks on different groups but also provide us with an opportunity to consider how a policy, service or decision can help to develop equality, thereby making sure the best possible outcome is achieved. And where a negative or adverse impact is identified, it allows us to take steps to reduce or remove any disadvantage that might be experienced by a particular group or community. As part of our single equality scheme, each directorate will identify new and existing relevant functions and processes, which they intend to analyse over the next two years. This programme of assessments will be produced and published on our website. Some equality impact assessment training has already been provided to relevant staff across NHS Kirklees. In light of the new equality duty, we are currently in the process of reviewing the current equality impact assessment toolkit with our partners in Calderdale and Wakefield. Once the new toolkit has been agreed, we will develop new training and guidance for managers undertaking these assessments. The current NHS Kirklees toolkit for carrying out equality impact assessments, can be found at www.kirklees.nhs.uk/public-information/equality-and-diversity/equality-impact-assessments/. All completed equality impact assessments are published on the NHS Kirklees website.

3.6 Collecting data, sharing information The ability to collate data and share information across the main equality groups is central to our ability to deliver and commission world class health services. In relation to the NHS Kirklees workforce, we routinely collect equality data (age, disability, ethnicity, gender, religion or belief and sexual orientation). A full workforce diversity report 2009/10 providing figures for staff in post, recruitment activity, employment cases and leavers is available on the PCTâ&#x20AC;&#x2122;s website: www.kirklees.nhs.uk/public-information/equality-and-diversity/workforce-information/ All hospital trusts have a responsibility to share information with the primary care trust. This information is predefined nationally and is known as a minimum data-set. The three main minimum data-sets cover in-patient, out-patient and accident and emergency activity and include information on ethnicity, gender and age. The minimum data-sets are received and analysed on a monthly basis. There is currently no national minimum data set in place for community services or primary care providers (this includes GP practices).

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There is a national performance indicator to support improved coding of ethnicity data for mental health and hospital trusts. As part of the annual contract negotiations between commissioners (primary care trusts) and providers (hospitals), NHS Kirklees has also developed a local data quality improvement plan which includes an indicator to improve ethnicity coding. Having both a national and local performance indicator for recording ethnicity has helped to improve the completeness of ethnicity data and will support NHS Kirklees to assess how services are used by different ethnic groups. There is currently no national or local performance indicator for measuring the completeness of disability, religion or sexual orientation information. NHS Kirklees has introduced a similar data quality improvement plan with Kirklees Community Healthcare Services Although there is no national minimum data-set for community services, Kirklees Community Healthcare Services is working in partnership with NHS Kirklees to develop local data flows. The initial priority is to develop a child health minimum data-set to support delivery of the vaccination and immunisation programme targets. There is potential to expand these data flows to other areas to include improved collection and monitoring of equality data. At national level, negotiations are underway to develop a minimum data-set for GP practices. The original timescales were to introduce a minimum data-set from April 2011, although it is expected that there will be some slippage with these timeframes. The GP minimum data-set will provide NHS Kirklees with significantly more health data than it has at present and is expected to include information to support the equality and diversity work programmes. During 2008/09, NHS Kirklees supported its GP practices to participate in five new clinical directed enhanced services). A directed enhanced service is an additional service GPs provide over and above their baseline contract. One of these directed enhanced servicesâ&#x20AC;&#x2122; relates to ethnicity. The ethnicity directed enhanced service requires practices taking part to record the ethnicity and first language of each patient registered in the practice. This makes it possible to report disaggregated information on the numbers of patients in each category to NHS Kirklees. The aim of the ethnicity directed enhanced service is to support practices to assess the needs of their population and address inequalities. In summary, although NHS Kirklees receives some equality information on its services, this is not consistent across all provider organisations. Furthermore, NHS Kirklees has not yet fully assessed the usefulness of the data it holds for developing baselines and improvement plans linked to equality and diversity programmes. The lack of available data and consistent systems for analysing and reporting information in a way which helps practitioners and managers to improve their services, presents a serious risk to our ability to achieve our aspirations around equality. Improved data collection and reporting is a priority for NHS Kirklees, as outlined in our Information and Health Intelligence Strategy. The specific actions identified to address the equality and diversity information requirements are identified in the equality scheme action plan.

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3.7 Commissioning and procurement Our main function is as a commissioner of local health services. Commissioning in the NHS is the process of making sure that the health services provided effectively meet the needs of the population. It is a complex process with responsibilities including: • Assessing population needs, including effective engagement and communication • Prioritising health outcomes • Contracting with hospitals and other healthcare providers to supply health services to our local population • Performance managing service providers Effective commissioning of local health services is critical to promoting equality, improving health and well-being outcomes, reducing health inequalities and achieving an NHS that is fair to all and responsive to the needs of local people. NHS Kirklees commits to commissioning services, which are accessible to the diverse needs and abilities of all our service users. Wherever possible, we will: • Make sure that local health inequalities are taken into account, identified and addressed when we commission services. • Monitor service providers in relation to equality to make sure that contracted services have appropriate measures in place. • Make sure service planning and consultation takes account of the population served.

Procurement and contracting The idea of fairness for all is at the heart of the NHS, and is reflected in the NHS Constitution. We make every effort to guarantee that the organisations from whom we commission health services offer equitable access to all diverse groups within Kirklees, irrespective of gender, race, disability, age, sexual orientation, religion or belief. As a commissioner, we are required to make sure that those we contract with meet the requirements of equality legislation, such as the collection of data in order to monitor access and outcomes by ethnicity, disability and gender. Equality duties relevant to the provider are explicitly and clearly stated within NHS Kirklees contracts. NHS Kirklees recognises that procurement can be used as a powerful lever to drive equality.

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At NHS Kirklees, we are committed to using our considerable purchasing power to make sure that all our procurement activity is conducted in a fair and equitable way and to promote equality wherever possible. We are also committed to making sure that our service providers and suppliers are aware of their responsibilities and will aim to embed equality considerations throughout the procurement process, from the initial stages of identifying service needs through to contract monitoring.

3.8 Easy access to information for all NHS Kirklees publishes a significant amount of information each year. We are committed to making sure that all the information we publish uses language that is appropriate to the intended audience, and to making sure that it is available in accessible formats and via accessible methods. In practice this means: • Writing all information in plain English • Making sure any illustrations have a good colour contrast • Making it clear on all standard information leaflets where people can get information in alternative formats • Supporting a readers panel, who check that the information we produce is easy to understand and is accessible. The panel includes people with a disability. • Producing key publications in a number of different languages and formats where appropriate, including braille. NHS Kirklees published a communications and engagement strategy for 2009 - 2011. This aims to make sure that communications and engagement activities support our key objectives of improving the health of Kirklees residents and health service users, reducing health inequalities, and improving patient knowledge of and confidence in health services in Kirklees. A copy of this can be found at www.kirklees.nhs.uk/public-information/publications/strategies-and-declarations/

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3.9 Training NHS Kirklees is striving to create an environment where staff feel supported and encouraged to fulfil their potential in the workplace. We have a strong commitment to education, training and development through learning and development programmes. The trustâ&#x20AC;&#x2122;s mandatory training programme includes an embracing diversity half-day module, which is delivered to all new staff across NHS Kirklees. Up to the end of 2009/10, 72% of new staff had attended this one-off session. Staff are required to attend a refresher course every three years. In addition, the NHS Kirklees board received mandatory equality and diversity training in 2009 and two half-day equality impact assessment workshops were commissioned for managers in the same year. In February 2011, the board received training on the importance of carrying out equality impact assessments. We also provide human resources training programmes for managers, which includes an annual employment update. In 2011, the equality and diversity managers in Kirklees and Calderdale jointly delivered Equality Act 2010 briefing sessions for staff across both primary care trusts. However, in spite of our best efforts, we recognise that there are some gaps in our equality and diversity training programme. Therefore, our arrangements for training staff in connection with our equality duties is currently under review and we are considering new ways of developing staff awareness and competence in this key area.

3.10 Monitoring and reviewing our scheme In order to ensure effective implementation of the statutory duties the trust has established an equality and diversity steering group. The steering group is chaired by a non-executive director and operates at a strategic level with representatives feeding back into their respective directorates. The steering group reports to the communications and public relations committee. It will hold responsibility for monitoring and reviewing the activities within our equality scheme and action plan. Progress against the action plan will be assessed each year and a report produced, which will be submitted to the board through the communications and public relations committee. The annual review of the scheme including the progress report will be circulated to stakeholders and made available through our website. Our equality scheme will be reviewed and updated annually, and a full review will be carried out every three years in accordance with the guidelines set by the Equality and Human Rights Commission.

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3.11 Publishing our scheme Our equality scheme and action plan will be published on the NHS Kirklees internet and intranet site. We will also publish information about relevant involvement exercises and the results of equality impact assessments and action plans on an ongoing basis. NHS Kirklees will raise awareness of our equality scheme by providing it in a variety of accessible formats where appropriate, for our workforce, patients, service users and the public. It will also be included in our staff induction programme, our staff newsletter and the NHS Kirklees annual report.

3.12 Comments and feedback We welcome comments and feedback on this equality scheme and the way it operates. We view this scheme as a ‘live’ document, which has the potential to develop and evolve as a result of your feedback and any legislative and policy changes. We are interested to know of any possible or actual adverse impact that this scheme might have on any groups in respect of age, disability, gender, race, religion or belief, sexual orientation or other characteristics. We would also like to know how effective this scheme is in promoting and delivering equality and human rights. Comments and feedback can be sent to: NHS Kirklees FREEPOST RSHB-GRJU-ALSL Patient and Public Involvement Broad Lea House Bradley Business Park Dyson Wood Way Bradley Huddersfield, HD2 1GN Email: ppi@kirklees.nhs.uk or tel: 01484 464024/5

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3.13 Complaints NHS Kirklees sees complaints as an important vehicle for service development, improvement and for monitoring the impact on equality and diversity. We aim to have a transparent and responsive complaints service that is accessible to all members of the community. Our complaints policy sets out the way in which complaints are dealt with from members of the public. We are also committed to dealing with concerns from staff through the appropriate internal policies and procedures. NHS Kirklees has an established Customer Liaison Service which can provide information and advice on NHS services and help to find quick solutions to some problems with services. If you wish to contact the Customer Liaison Service or make a formal complaint regarding the scheme, please write to the above address or contact:

Customer Liaison Service/Complaints Tel: 01484 464464 Text: â&#x20AC;&#x153;KPALSâ&#x20AC;? to 64446 Email: pals@kirklees.nhs.uk

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ACTION PLAN 2010–2013

Appendix 1 Single equality scheme action plan 2010-2013 Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

Human Rights

Governance and inclusive leadership at all levels 1.

Stakeholders are informed of the Trust’s work and progress on the equality and diversity b. Publish the single equality scheme on agenda our website and intranet Single equality a. Ratify the single equality scheme and action plans

Director of Corporate Services/Equality and Diversity Manager

March 2011

scheme compliant with legal duties

2.

Carry out an annual review of the single equality scheme and publish a report on progress against the action plans

Action plans monitored and stakeholders informed of progress

Director of Corporate Services/ Equality and Diversity Manager

March 2012 – then annually

3.

Prepare for the new specific duties of the Equality Act 2010 • Publish equality information

NHS Kirklees is compliant with new legal duties

Equality and Diversity Manager /All Managers

December 2011

The equality performance of NHS Kirklees is improved and equality considerations are embedded into mainstream business planning processes

Equality and Diversity Manager/ Head of Patient and Public Involvement

April 2011

• Prepare and publish equality objectives 4.

Prepare for the implementation of the NHS Equality Delivery System

Single equality scheme 2010–2013

55


Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights 5.

Identify nonexecutive equality champions to lead on the promotion of equality at board level

Equality and diversity issues are championed at board level

Director of Corporate Services

August 2010

6.

Identify equality champions in each directorate to support and advise staff

Improved capacity and support on equality and diversity issues across the organisation

All directors

August 2010

7.

Set equality objectives for all directors and include in annual appraisal document

Increased leadership engagement in equality and diversity issues.

Chief Executive

July 2010 – set annually

8.

Provide Kirklees Community Healthcare Services and GP consortia with support and guidance on meeting their equality duties throughout the transition process

Emerging commissioning and provider organisations understand their responsibilities under the equality legislation

Equality and Diversity Manager

April 2011 & ongoing

Better health outcomes for all

56

1.

Assess policies and functions for relevance to equalities

All functions and policies screened for relevance

All directors

August 2010

2.

Publish an equality impact assessment timetable on the website

Equality impact assessment timetable in place and accessible to the public

Equality and Diversity Manager

April 2011

3.

Develop a new equality impact assessment toolkit and publish on website

Equality and Toolkit is fit Diversity for purpose and meets the Manager requirements of the Equality Act 2010

April 2011

4.

Deliver equality impact assessment training to lead officers in each directorate

Staff are equipped with the skills they need to carry out equality impact assessments

Equality Champions/ Equality and Diversity Manager

June 2011 onwards

Single equality scheme 2010–2013


Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights 5.

Make sure all decommissioning decisions are fully equality impact assessed and actions are put in place to address any negative impacts

Equality considerations are embedded in the business planning framework

All directors

With immediate effect

6.

Make sure all business cases for new services are fully equality impact assessed and actions are put in place to address any negative impacts before service is implemented

Equality considerations are embedded in the business planning framework

All directors

With immediate effect

7.

Integrate actions from equality impact assessments into service planning framework and monitor progress through equality and diversity steering group

Equality impact assessment actions mainstreamed into service planning framework

All directors

April 2011

8.

Publish completed equality impact assessments on website and intranet

A robust and transparent equality impact assessment process is in place

Head of Communications

Ongoing

9.

Develop mechanisms for involving people from equality groups in the equality impact assessment process

Head of Patient People from and Public equality Involvement target groups have greater influence in the design and development of trust policy and practice

June 2011

10.

Carry out equality monitoring of the Patient and Public Involvement ‘Get Involved’ database

Establish whether the database is representative of the local population of Kirklees

March 2011

Head of Patient and Public Involvement

Single equality scheme 2010–2013

57


Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights

58

11.

Promote opportunities to ‘Get Involved’ to underrepresented groups

Database reflects the local population of Kirklees

Head of Patient and Public Involvement

March 2011, then ongoing

12.

Develop stakeholder database in partnership with Voluntary Action Kirklees, making sure that the database reflects groups from the six equality groups

Improved consultation and engagement with equality target groups

Head of Patient and Public Involvement

March 2011

13.

Make sure all questionnaires produced by and in conjunction with the Patient and Public Involvement team include equality monitoring forms

Trends can be monitored by equality group

Head of Patient and Public Involvement

March 2011

14.

Support the Disability Rights Network to review it’s current role and remit with a view to developing an effective engagement framework for disabled people

Improve the quality of life for disabled people living, working and studying in Kirklees

Head of Patient and Public Involvement/ Equality and Diversity Manager

August 2010

15.

Make sure that local interest groups are involved in health needs assessments, commissioning decisions and service design.

Services are commissioned and designed to meet the health needs of the whole community

All directors/ Head of Patient and Public Involvement

April 2011

16.

Provide an update in the joint strategic needs assessment regarding the health needs of the equality groups

Assistant Director April 2011 The joint strategic needs of Public Health assessment reflects the health needs of all communities in Kirklees

Single equality scheme 2010–2013


Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights

Improved patient access and experience 1.

Review existing availability of equality data from providers and identify any gaps

A comprehensive analysis of our data capture for equality groups is carried out

Assistant Director April 2011 of Information Analysis and Data Quality

2.

Identify areas for improvement and necessary actions to improve equality data recording

The capture of equality data from providers is improved

Assistant Director September 2011 of Information Analysis and Data Quality

3.

Identify information requirements of the equality and diversity steering group and establish regular reporting mechanisms.

The reporting and monitoring of equality data is improved

Assistant Director September 2011 of Information Analysis and Data Quality

4.

Monitor complaints/ Customer Liaison Service by equality group

Trends can be monitored by all equality strands and action taken to address any concerns

Head of Customer Liaison Service and Complaints

May 2011

5.

Make sure all contracts and service level agreements contain clauses and performance measures in relation to equality and diversity. This should include a requirement for providers to report on equality monitoring for service provision and patient outcomes.

Equality and diversity requirements are explicit in our contracts and service level agreements

Deputy Director of Commissioning and Strategic Development

April 2011 and ongoing

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Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights 6

Make sure that all our publications are available in different formats and languages, as appropriate and where requested Make it clear on all standard information leaflets where people can get information in alternative formats

All our publications are accessible to service users and the public

Head of Communications

September 2010

7.

Make sure our website is accessible to people with different language and communication needs. Involve disabled people in the process.

Our website is accessible to all our service users and the public

Head of Communications

September 2011

9.

Use sign language or subtitles and audio description on all new DVDs or similar types of media we produce

People who are deaf or hard of hearing can access videos and DVDs

Head of Communications

April 2011

Empowered, engaged and included staff

60

1.

Continue to collect and analyse equality data of our workforce to identify any areas of potential discrimination and inequality and take appropriate action to address any imbalances. Publish workforce data report on an annual basis

Any areas of inequality are identified and addressed through positive action measures

Director of Human Resources and Organisational Development

April 2010, then annually

2.

Monitor number and outcome of reported complaints/ incidents of harassment, victimisation, bullying and discrimination by equality group and address issues identified. Report findings annually to the equality and diversity steering group.

All our staff are treated with dignity and respect at work

Director of Human Resources and Organisational Development

April 2011

Single equality scheme 2010–2013


Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights 3.

a. Review the mechanism for ensuring that reasonable adjustments are made and in place - including making best use of support systems, eg, Access to Work Scheme. Involve disabled staff in this process.

Disabled staff are fully supported in all areas of their employment.

Director of Human Resources and Organisational Development

April 2012

b. Monitor responses from staff survey relating to reasonable adjustments for staff with disabilities 4.

Establish a working group to consider where positive action can be used to target applicants and staff from black and minority ethnic groups to take up employment opportunities, particularly within nursing and allied health professionals.

Improve our workforce diversity to reflect the communities we serve.

Director of Human Resources and Organisational Development

April 2011

5.

Review workforce profile (including applications, shortlists, leavers, training and promotion) for each equality strand every 6 months to identify any potential discrimination and/or areas for action to improve representation. Report findings annually to the equality and diversity steering group.

Eliminate unlawful discrimination. Improve our workforce diversity to reflect the communities we serve.

Director of Human Resources and Organisational Development

April 2011, then annually

Single equality scheme 2010–2013

61


Sexual orientation

Religion/ Belief

Timescale

Age

Lead

Gender

Outcome

Disability

Action

Race

ACTION PLAN 2010–2013

Human Rights 6.

a. Activity promote flexible working practices across the organisation.

Reduce the gender pay group within NHS Kirklees.

Director of Human April 2012 Resources and Organisational Development

Our staff are aware of their responsibilities under the equality duties and wider equality legislation.

Portfolio Manager Clinical Governance/ Equality and Diversity Manager

b. Develop strategies to encourage women and men into areas where they are underrepresented. c. Promote mentoring schemes to encourage recognition of women into higher grades. 7.

62

Establish a working group to review our range of equality and diversity training to make sure that it is fit for purpose. Report findings to the equality and diversity steering group.

Single equality scheme 2010–2013

July 2011


Appendix 2 - Existing legislation

Appendix 2 - Legislation Existing public sector equality duties until 5 April 2011 Race General Eliminate unlawful duties racial discrimination Promote equality of opportunity Promote good race relations between people of different racial groups

Disability Promote equality of opportunity between disabled people and other people

Gender Eliminate unlawful discrimination

Eliminate discrimination that is unlawful under the Disability Discrimination Act

Promote equality of opportunity between men and women

Eliminate harassment

Eliminate harassment of disabled people that is related to their disability Promote positive attitudes towards disabled people Encourage participation by disabled people in public life

Specific duties

To publish a Race Equality Scheme stating the functions and policies relevant to the general duty.

Take steps to meet disabled peopleâ&#x20AC;&#x2122;s needs, even if this requires more favourable treatment To publish a Disability Equality Scheme that contains a three year action plan on Disability Equality and how it will fulfil its general and specific duties.

Prepare and publish a Gender Equality Scheme including an action plan, showing how NHS Calderdale intends to fulfil the duties.

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Appendix 2 - Existing legislation

Race

Disability

Gender

Set out arrangements to:

Set out arrangements to:

Set out arrangements to:

Involve disabled people

Monitor policies for any adverse impact on race relations

Equality impact assess

Consult with employees, service users and others (including Trade Unions)

Assess and consult on the likely impact of proposed policies Publish results of assessments, consultation and monitoring

Gather information re: employment and functions For how the information will be used

Take into account information about how policy and practice affects gender equality

Publish a report containing a summary of the steps taken under the action plan

Consider the need to have objectives to address the cause of any gender pay gap

Ensure the public have access to information and services Train staff to implement the general and specific duties

Ensure a three year action plan is produced that outlines how NHS Calderdale will work towards achieving gender equality over the next three years Implement the GES and actions for gathering and using information over the next three years Review and revise the scheme every three years Report on progress annually, both within NHS Calderdale and externally

The specific race duty also requires us to carry out the following activities in relation to employment issues: • Monitor the ethnicity of staff in post, applicants for jobs, staff promoted or receiving training • Monitor the ethnicity of and analyse the subsequent results from grievances, • Disciplinary action, performance appraisal (when this results in benefits and sanctions), training, dismissals and other reasons for leaving Publish annually the results of the above ethnic monitoring.

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Appendix 2 - Existing legislation

Human Rights All national legislation is underpinned by the Human Rights Act 1998. The Act gives further effect in the UK to rights contained in the European Convention of Human Rights (ECHR), signed on 4 November 1950. The ECHR in turn stems from the Universal Declaration of Human Rights, adopted by the United Nations on 10 December 1948. The Act: • Makes it unlawful for a public authority to breach Convention rights, unless an Act of Parliament meant it could not have acted differently; • Means that cases can be dealt with in a UK court or tribunal; and • Says that all UK legislation must be given a meaning that fits with the Convention rights, if that is possible. The key articles relevant to the delivery of health services within the Convention include: Article 2 Everyone has the right to life, except in very limited circumstances, e.g. defending oneself or someone else from unlawful violence Article 3 No one shall be subjected to degrading or dehumanising treatment Article 5 Everyone has the right to liberty and security of person Article 8 Everyone has the right to respect for their private and family life, home and correspondence Article 9 Everyone has the right to freedom of thought, conscience and religion (subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, public order, health, morals, or the freedoms of others) Article 10 Everyone has the right to freedom of expression (subject to the same requirements as Article 9), but the exercise of those freedoms carries duties and responsibilities to the rights of others Article 11 A person has the right to assemble with other people in a peaceful way. They also have the right to associate with other people, including the right to form a trade union. These rights may be restricted only in specified circumstances Article 14 Prohibition on Discrimination. The enjoyment of the rights and freedoms set forth in the convention shall be secured without discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin

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NHS Kirklees welcomes your comments on this scheme and these can be made to: NHS Kirklees FREEPOST RSHB-GRJU-ALSL Patient and Public Involvement Broad Lea House Bradley Business Park Dyson Wood Way Bradley Huddersfield HD2 1GZ Tel: 01484 464024/5 Email: ppi@kirklees.nhs.uk

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NHS Kirklees Broad Lea House Bradley Business Park Dyson Wood Way Bradley Huddersfield HD2 1GZ Switchboard: 01484 464000

Web: www.kirklees.nhs.uk

This information can be made available in languages other than English. It can also be made available in large print, braille, or on audiotape. For copies, please telephone 01484 464000.

Date of publication: Mar 2011 • Ref: KB3680 • © Kirklees Primary Care Trust


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