EQUALITY AND HUMAN
RIGHTS SCHEME
2010 -2013
Final Version following engagement and formal
consultation
This scheme can be made available in other formats and
languages on request. Please contact the Equality Adviser:
01352 803253
 
Contents
Page
Contents
Foreword by Chair, Chief Executive and Equality Champion
Introduction
Human Rights Based Approach (Table 1)
1
Background and context
1.1 General
1.2 Vision
1.3 Values
1.4 Local Context / profile
1.5 Local Context – Engaging with Disabled People
1.6 Establishing The Evidence Base
1.7 Welsh Language
2
Public Sector Race Equality Duties
2.1 Assessing functions & policies
2.2 Assessing and consulting on the
likely impact of proposed Policies
2.3 Monitoring
2.4 Publishing results
2.5 Access to information & services
2.6 Training staff
3
Workforce: Powys THB as an Employer
3.1 Implementation of the Specific Duties
3.2 The Employment Duties and Equal Pay
3.3 Training and Development
3.4 Recruitment and Selection
4
Access to Powys THB
4.1 Introduction
4.2 Priorities
4.3 How Can People Access Information & Services?
4.4 The Social Model of Disability
4.5 Interpretation and Translation
4.6 Access for Disabled People
5
Engagement and Consultation/PPI
5.1 Public and Patient Involvement (PPI)
5.2 Powys Teaching Health Board Consultation
5.3 Single Equality and Human Rights Scheme
6
Equality Impact Assessment
6.1 Introduction
6.2 What is Equality Impact Assessment?
6.3 Governance
7
Dealing with Complaints
8
Powys THB Next Steps
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Appendices
Appendix
Appendix
Appendix
Appendix
1
2
3
4
Appendix 5
Appendix
Appendix
Appendix
Appendix
6
7
8
9
Appendix 10
Page
Structure of Powys THB
The Equality Improvement Plan
Equality Impact Assessment (EqIA) Process
Gender-Related Issues Identified
Through Stakeholder Consultation
Issues Identified During Consultation
with Disabled People
Employment
The Legal Background
Engagement Stakeholders
Staff Engagement Questionnaire and
Synopsis of Feedback
Documents/Links referred to in this Scheme
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Foreword
Powys Teaching Health Board (PTHB) is fully committed to the
principles of equality, diversity and fairness, and to the elimination of
unlawful discrimination and harassment of whatever form. This
commitment extends to other elements of the Public Sector Duties that
require us to demonstrate how we are actively promoting equality of
opportunity and good relations between people from different groups.
Health Boards work within statutory instruments, legislation and
various corporate policies which set out how they will promote equal
opportunities regardless of race, gender, disability, age, religion/belief
or sexual orientation, in the delivery of services and employment of
staff. Further information on the legislative background can be found
at Appendix 9.
PTHB is committed to ensuring equality for all in its service provision
and in its responsibilities as an employer. Inequality, disadvantage
and prejudice could arise on one or multiple dimensions and as a
major commissioner of health services, we want to ensure that
services provided are accessible to everyone and that no-one is
disadvantaged.
This first Single Equality and Human Rights Scheme has been drawn up
in line with the experience gained during the operation of our Race
Equality, and Disability Equality Schemes. Work undertaken in
developing the previous schemes proved to be a positive challenge and
underlined the importance of involving appropriate people if Powys
THB is to live up to its commitment to equality.
The adoption of this Single Equality Scheme is seen as an important
step in the overall programme of activity to ensure that equality issues
are properly addressed. This programme will encompass all the
activities of Powys Teaching Health Board.
Powys THB acknowledges the importance of ensuring that the Scheme
demonstrates commitment at the very highest level of the authority.
This foreword is therefore jointly signed by the Chief Executive,
Chairman and Board Equality Champion, who in doing so accept overall
responsibility on behalf of the Board for the successful implementation
of the Scheme.
Chris Mann
Chairman
Andrew Cottom
Chief Executive
Page 4 of 64
Paul Dummer
Equality Champion
Introduction
This first Single Equality and Human Rights Scheme of Powys Teaching
Health Board (Powys THB) has been produced in line with the General
and Specific Duties contained in equality legislation as follows:
 Race Relations (Amendment) Act 2000
 Disability Discrimination Act 2005
 Equality Act 2006
The aim of the duties is to make equality a central part of the way
public authorities work, by placing it at the centre of policy making,
service delivery and employment practice.
Under the General Duties Powys THB must aim to:
 eliminate unlawful discrimination and harassment;
 promote equality of opportunity and good relations between people
of different groups
 promote positive attitudes towards disabled persons
 encourage participation by disabled persons in public life; and
 take steps to take account of disabled persons’ disabilities, even
where that involves treating disabled persons more favourably than
other persons
Powys THB is also subject to a number of Specific Duties which are
intended to enable it to meet the General Duty to eliminate unlawful
discrimination and harassment, and to promote equality and good
relations. Under the specific duties covering policy and service delivery,
Powys THB is required to publish:

a Race Equality Scheme and a Disability Equality Scheme which:
state the functions and policies assessed as being relevant to the
general duty to promote equality and sets out various arrangements
the organisation has for, for example, monitoring policies for any
adverse impact on equality;
Powys THB is also subject to specific employment duties to monitor, by
reference to the various equality groups to which they belong:


staff in post;
applicants for employment, promotion and training;
and staff who:
 receive training;
 are involved in grievance procedures;
 benefit or suffer detriment as a result of our performance
assessment procedures;
Page 5 of 64


are the subject of disciplinary procedures; or
cease employment with the organisation.
PTHB does not have any benefit or detriment system currently as a
consequence of performance assessment.
The THB recognises that an individual’s identity is made up of
multiple aspects, and can include any number of the ‘protected
characteristics’. UK government is currently working towards
developing a Single Equality Act, which will, amongst other things,
harmonise and simplify existing Equality Laws. Following discussions
at its Equality Action Group, and in view of the setting up of a Single
Equality and Human Rights Commission, the THB took the decision
to develop this Single Equality and Human Rights Scheme.
Powys THB understands that promoting equality will improve public
services for everyone, and this is entirely consistent with our Corporate
Purpose which is:
“To improve the health, social care and wellbeing of the people of Powys
by working in partnership with the Local Authority and others.”
Our aim, therefore, is to make equality a central part of the way the
Board works by mainstreaming equality into all decisions and activities,
placing it at the centre of policy making, service delivery, and
employment practice.
How we are mainstreaming equality
Powys THB has adopted the following definition of mainstreaming:
"Mainstreaming' equality is about the integration of respect for
diversity and equality of opportunity principles, strategies and
practices into the every day work of the THB. It means that equality
issues should be included from the outset as an integral part of the
policy-making and service delivery process and the achievement of
equality should inform all aspects of the work of every individual
within the organisation. The success of mainstreaming will be
measured by evaluating whether inequalities have been reduced".
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General Principles and Supporting Strategies/Policies
PTHB is mindful of its duties as a public authority under the
Human Rights Act 1998 to ensure that the principles of equality,
dignity, respect, autonomy and fairness underpin all its actions.
Table 1 (below) sets out how these principles are embedded into
everything we do and shows links to the appropriate Health Care
Standard(s).
A clear aim of this scheme is that equality is not dependent on a few
committed individuals, but is core to our every day work and
responsibilities as an employer, a commissioner of services, and a
provider of services to the people of Powys.
This scheme is intended to give effect to a range of Welsh Assembly
Government strategies and policy documents including:• Designed for Life- A long term strategy intended to give effect toe
the Welsh Assembly Government’s [WAG] vision of transforming the
NHS “from the national illness service it currently is into a truly
national health service”
• Making the connections – which emphasises putting the citizen at
the centre of public services, public engagement, more coordination between providers to deliver sustainable, quality and
responsive services, making the most of our resources
• One Wales: A progressive agenda for the government of Wales
This scheme is also intended to give effect to recommendations
from research and investigations relevant to equality and human
rights such as: • Fairness and Freedom: The Final Report of the Equalities Review
• Equal treatment, Closing the Gap: a formal investigation into the
inequalities in physical health experienced by people with mental
health problems and learning disabilities
• Count me in Census: Results of the national census of inpatients
in mental health and learning disability services in England and
Wales etc
• Counted In: A report for Stonewall Cymru and the Welsh
Assembly Government SME Equality Project All Wales Lesbian, Gay
and Bisexual [LGB] Surveys and Needs Assessment Reports
This scheme will serve as a vehicle for the implementation of
aspects of equality and human rights set out in the following
National Service Frameworks for Wales
• Children's NSF
• Coronary Heart Disease NSF
• Diabetes NSF
• Mental Health NSF
• Older People's NSF
Page 7 of 64
• Renal NSF
This scheme is supported by various LHB strategies and policies
including our Health, Social Care & Well Being Strategy, our Equality
Policy and our Welsh Language Scheme, all of which can be
accessed through our website at: www.powyslhb.wales.nhs.uk
Each set of outcomes and objectives within the Scheme will be
delivered through a series of actions as detailed in the Action Plan
attached as Appendix 2. Some of the activities that appear in the
Action Plan are commitments identified for earlier schemes and
work plans. Others have been developed as a result of further
consideration of equality issues and those highlighted during
consultation on this scheme.
Overall, our work on equality, diversity and human rights is
underpinned by the following core principles:






Building a solid evidence base about health inequalities;
Embedding equality and diversity into our policy and strategy
development through using Equality Impact Assessment;
Working closely with our stakeholders, including our staff and
partners to progress our work;
Ensuring that the citizens of Powys have a voice in policy
development and implementation;
Considering and promoting cross strand and joint working
opportunities;
Regularly monitoring and reflecting on our work to ensure it
meets the needs of those we serve.
The Equality Action Group review the actions contained in the Action
Plan every six months and will publish a progress report every
twelve months alongside our Annual Report.
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Table 1: Human Rights Approach
Principle
Fairness
Respect
Equality
Dignity
Autonomy
Human
Rights
Example
Healthcare Example
Fundamentals of Care
Right to a fair
trial
Ensuring grievance
procedures are fair and
transparent
Respect for
family and
private life
Having respect for all
diverse families, e.g.
same sex couples
The care environment
(People feel comfortable,
safe, reassured, confident
and welcome)
Rights not to
be
discriminated
against in the
enjoyment of
other human
rights
Ensuring that people are
not denied treatment just
on the basis of their age
Communication (Patients and
carers experience effective
communication sensitive to
individual needs and
preferences – including
interpreters)
Right not to be
tortured or
treated in an
inhuman or
degrading way
Ensuring sufficient staff
and resources to change
wet and soiled sheets
promptly
Right to
respect for
private life
Involving people in
decisions made about
their treatment and care
Privacy and dignity (Patients
experience care in an
environment that actively
encompasses individual
values, beliefs and personal
relationships)
Principles of self care
(Patients are enabled to
make choices about self care
and those choices are
respected)
Dignity In Care
KSF Core 6
Health Care
Standard
Ensure people feel
able to complain
without fear of
retribution
The worker:
Recognises the importance of
people’s rights and acts in
accordance with legislation.
Policies and procedures (level 2)
Treats everyone with whom s/he
comes into contact with dignity
and respect (level 1)
2, 24
Recognises that people are
different and makes sure they do
not discriminate against other
peoples (level 1)
Identifies and takes action when
own or others` behaviour
undermines equality and diversity
(level 2)
Treats everyone with whom s/he
comes into contact with dignity
and respect (level 1)
1, 2, 3, 4, 6,
8, 9, 11, 14,
19, 23, 24,
25, 26
Acts in ways that acknowledge
and recognize people’s expressed
beliefs, preference and choices
(level 2)
2, 6, 7, 8, 9,
14, 15, 19
Support people with
the same respect
you would want for
yourself or a
member of your
family
Treat each person
as an individual by
offering a
personalised service
Assist people to
maintain confidence
and a positive selfesteem
Enable people to
maintain the
maximum possible
level of
independence,
choice and control
2, 7, 11, 14
2, 7, 11, 14,
15, 23
1 Background and
Context
1.1
General
The role of Powys Teaching Health Board (PTHB) is to improve the health
and well being of the people of Powys. It provides a range of hospital,
community, mental health and learning disability services. PTHB is also
responsible for commissioning secondary health care and hospital
services and co-ordinating the delivery of primary care services for the
people of Powys.
Powys THB has a joint statutory duty with Powys County Council to
develop and implement a Health, Social Care and Well-Being Strategy for
Powys.
Powys is a pathfinder organisation, with different responsibilities from
other former LHBs. It commissions (i.e. ‘buys’) services from other
professionals for the people of Powys, and it also provides community
services.
1.2
Vision
Powys THB works to uniform and equitable standards across Powys,
delivered operationally through a functional management structure. This
operational structure is supported by a planning and commissioning
process that includes input from specialist planning groups as well as
Shire Planning Commissioning Teams.
Powys THB is a primary care based organisation that offers high quality,
locally delivered primary, community and intermediate care and
commissions complementary secondary care for the people of Powys,
recognising as well the need to support carers.
Whilst the re-structuring of the NHS in Wales due to be implemented
from October 2009 will undoubtedly change some of the above functions,
there will continue to be a strong focus on the co-ordination of health
and social care to create a seamless service delivery for patients and
clients.
1.3
Values
Powys Teaching Health Board:

is aware of the need to develop culturally sensitive health services
that recognise and respond to the different needs of the individuals
and groups within the communities served;

regularly reviews it’s employment policies and procedures to
reflect the latest legislative developments and best practice, and to
create an environment free from discrimination and harassment;

is commited to promoting fair and equal treatment in its approach
to the delivery of healthcare whether provided or commissioned;

understands and embraces the need to work in partnership with
the wider community and values the contribution which people
living in its communities can make;

recognises that effective leadership is crucial to making progress
and sustaining a culture that promotes fair and equitable
treatment.
The Chief Executive and Board members have overall responsibility for
mainstreaming equality and diversity into the corporate objectives and
activities.
1.4
Local Context /Profile
Powys is the largest and most sparsely populated county in Wales
(population of 126,354 - 2001 census) with a high proportion of
elderly people. It therefore faces major challenges relating to access,
rurality, housing, transport, economic life and demography. It has a
relatively low mortality and social deprivation rate but there are
pockets of real poverty with restricted employment opportunities, and
housing issues. There is reasonably good access to primary health
care (including 30 GP Practices, 24 Dentists, 21 Opticians and 23
Pharmacies) but access to secondary care is more problematic and
there are particular challenges associated with prevention and chronic
disease management. The particular challenges are outlined in the
Health Social Care and Well Being Strategy (2005-8) for Powys.
PTHB acts as both commissioner and provider of health services for
Powys. There are 10 community hospitals offering out-patient and inpatient services supported by diagnostic and therapeutic services. Minor
injuries units are also available in many of the sites. There are currently
around 225 staffed available beds. There are no district general
hospitals in Powys and much of the secondary health service is provided
by acute hospitals outside the County in both England and Wales.
Community health services and primary care are provided from clinics,
health centres, dentists, pharmacists and 17 main G.P. surgeries plus 13
branch surgeries.
Page 11 of 64
A needs assessment undertaken in 2003 as part of the first stage of the
development of the Health, Social Care and Well Being Strategy
identified the following issues:

Demography: Powys has an ageing population and a continuing
out-migration of young people. These present a major challenge to
health and social care services, compounded by an increase in the
number of people living alone

Lifestyle issues: these present probably the greatest challenge
particularly in the areas of diet, exercise, smoking, drug misuse
and alcohol misuse including binge drinking. Such challenges are
not restricted to adults; increasingly children and young people are
affected

Health: related to these lifestyle issues are the major cause of
premature death, illness and disability; cardiovascular disease,
cancers, mental illness particularly depression and suicide,
arthritis, accidents, degenerative disease of the CNS and
respiratory disease. The rapidly rising rates of obesity and diabetes
are a particular cause for concern

Geography: these challenges facing the Health and Well Being of
people in Powys are exacerbated by the particular feature of Powys
as a very rural county with a geographically dispersed population
(as illustrated by the table below) that is relatively distant from
major centres of population.
Sparse Rural Population
40
35.6
35
30
25
20
Persons Per 10
Hectares
14.3
15
10
2.5
5
0
England and
Wales
Wales
Powys
This results in:
difficult geographical access to services;
poor or non existent public transport and the high cost of
private transport;
Page 12 of 64

a restricted range of employment opportunities often of a
seasonal nature and generally poorly paid;
a substantial level of poverty which is made worse by a
tradition of not claiming benefits and the perceived stigma
of asking for help;
private sector housing is of a poor average standard in
terms of facilities, state of repair and insulation.
Renovation is more expensive in a rural setting;
a major contributor to depression and lack of civic
engagement is the inevitable isolation resulting from living
in the country. There is real evidence of rural stress;
education - high number of disadvantaged low achievers.
Providing local services: on the supply side of the equation the
same rurality and scarcity of population makes providing a full
range of quality services to meet these needs a challenge.
Specialist expertise is limited and the small population base simply
does not generate enough caseload to assure proficiency at
provider level
The 2001 Census, indicated that Powys has a resident population of
124,780 of which 49.5% were male and 50.5% female. The resident
population of people from a black and minority ethnic background was
recorded as 0.9% or a total of approximately 750 people. Table 3 shows
the ethnic composition of the population of Powys.
Long term limiting illness – of the population in Powys 24,754 were
recorded in 2001 as having a ‘limiting long-term illness’, meaning 1
in 5 people have a disability.
A more recent survey from 2007 (ONS Mid Year Estimates) shows the
total population of Powys has increased to 132,000 and an analysis by
age bands reveals the following:
Table 2.
Age
Band
Number
%
0 - 15
24,519
19.4%
Powys Population Age Profile
16 19
5,663
4.5%
20 24
4,950
3.9%
25 29
6,111
4.8%
30 - 44
45 - 59
25,232
20.0%
27,395
21.7%
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60 64
7,279
5.8%
65 - 74
Over 75
13,056
10.3%
12,149
9.6%
Table 3.
Powys Racial Groups
(Census Data 2001 – Powys Population 126,307)
Ethnic Group
White - British
White - Irish
White - Other
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Mixed - Other
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Asian or Asian British - Other
Black or Black British - Black Caribbean
Black or Black British - Black African
Black or Black British - Other
Chinese or other ethnic group - Chinese
Chinese or other ethnic group - Other ethnic group
Number Percent
123173
97.5%
594
0.5%
1498
1.2%
101
0.1%
52
0.0%
144
0.1%
115
0.1%
39
0.0%
27
0.0%
43
0.0%
228
0.2%
22
0.0%
52
0.0%
24
0.0%
116
0.1%
79
0.1%
Whilst we are aware that the overall population and its make-up will
have changed in the intervening years since the last census in 2001
little accurate and up-to-date data exists to provide information on the
numbers of the population from each ethnic group.
Brecon is home to a group of Nepalese soldiers and their families at its
Army barracks which accounts for the proportionately high number of
people in this category.
Powys County Council has indicated that there is one permanent site for
Gypsies and Travellers. This is located in Welshpool, and comprises 15
caravans where 18 adults and 6 children live permanently. The County
Council also indicated that there was an unofficial site at Builth Wells,
which is used during the week of the Royal Welsh Agricultural Show. At
the time of writing this report no figures are being recorded or
maintained.
In April 2005, Powys County Council and Powys Local Health Board
published a joint Gypsy and Traveller Policy (currently subject to review)
the aim of which is to:
“…accommodate distinctive minorities, with respect for their varied
traditions and wishes, and in accordance with human rights, race
relations, and other legislation in order to create stable, safe
communities and to minimise friction with the settled population.”
Page 14 of 64
Powys THB intends to introduce a process for recording travellers and
gypsies passing through who require access to any of its services during
their stay in Powys.
It is recognised that as a statutory service provider Powys THB must
have access to accurate and current demographic information. Powys
THB is working in collaboration with other service providers and agencies
to develop an accurate, reliable and factual demographic profile of Powys
together with a model that can be used by public authorities to more
effectively engage with all sections of the community.
The data in Table 3 above showing the incidence of racial groups in
Powys demonstrates that numbers are small. In some villages there are
individuals or small families. It is therefore difficult for Powys THB to
consult and take a meaningful account of these groups.
Since enlargement of the European Union in 2004 there has been an
inflow of East European migrant workers into Powys, mainly from Poland.
There are no sources for a complete count, but three administrative
registers give overlapping counts as follows;
• NINO: 460 workers from Poland and 130 from other East European
countries registered for new National Insurance Numbers from Powys
addresses in the period from 2004 to 2006.
• WRS: 405 workers from Poland and 140 from other East European
countries were recorded in the Workers Registration Scheme taking up
short-term jobs in Powys between May 2004 and March 2007. 85% were
aged between 18 and 25. One in twenty of them were accompanied by a
dependant child, and one in twenty by a dependant adult.
• FHS: 347 people from Poland and 126 from other East European
countries were recorded as immigrants when registering with a GP
surgery in Powys between April 2004 and January 2007.
We are also aware of increases in the numbers of patients registering at
General Practices in Powys recorded as ‘Immigrants’ between April 2004
and December 2006, more than half (58%) of whom did so either at
Brecon, Welshpool or Newtown, as the following table shows:
Table 4.
Patients Registering with Powys General Practitioners
recorded as ‘Immigrants
2004
2005 2006 Total
(Apr-Dec)
Numbers of Patients recorded as ‘Immigrants 83
273
597
953
1.5
Local Context /Profile – Engagement with Disabled People
Page 15 of 64
Following criticism by the Disability Rights Commission of some public
organisations for not effectively involving people with disabilities in
the development of their schemes, Powys THB decided to involve as
many disabled people as possible by using the existing communication
channels to access the disabled community, visiting local groups and
individuals to gather their views that will inform the scheme.
In supporting this work a questionnaire was produced for those people
who would prefer to use this method of communication. We also
offered telephone assisted completion of the questionnaire.
To achieve this level of engagement, two groups were established;
1. Powys Local Health Board’s Disability Equality Scheme
Stakeholder Group; and
2. Powys Local Health Board’s Disability Equality Scheme Employee
Network.
Both of these groups were key communication channels in which
disabled people were involved in the development of our scheme.
Disabled people were involved in all key aspects of the development
of the scheme, such as:



Identifying the barriers faced by disabled people and
unsatisfactory outcomes;
setting priorities for action plans; and
assisting planning activity
Some of the groups that were involved (information provided to the
LHB):
Brecknockshire Disability Access Group
Deaf & Hard of Hearing Support Group
Brecon & District Disabled Club
PAVO
Learning Disability Groups
US Machynlleth
Ponthafren Newtown
Powys MIND
Ystradgynlais Carers Support Group
Disability Powys
Visual Impairment Group
Royal National Institute for the Deaf (RNID)
Brecon and District Disabled Club
Friends of Penmaes School
Triangle Group Welshpool
Ystradgynlais Community Contact Group
M.S. Society, Llandrindod Wells & District Branch
The Stroke Association
Page 16 of 64
1.6
Establishing the evidence base.
As described above, the involvement of disabled people was
encouraged and undertaken through two main methods;
a.
b.
Face to face meetings; and
Questionnaires.
We received in excess of 200 replies to the questionnaires of which
69% considered themselves to have a disability and 30% did not
consider themselves to have a disability. However, if you look at the
conditions identified in the Act, then a large number of the 30% would
be classified as having a disability.
The range of disabilities identified during this work includes, hearing
difficulties, visual impairment, walking and balance, mental health
issues, speech difficulties, hand, arm and back problems, learning
disabilities, physical difficulties including wheelchair users, multiple
sclerosis, ME, arthritis, epilepsy etc.
**Note: A more detailed analysis of issues identified during
engagement and consultation with disabled people in Powys as part of
the development of our Disability Equality Scheme is contained in
Appendix 7. Actions developed to tackle the issues identified have
been included in the action plan in Appendix 4.
1.7
Welsh Language
Powys THB shares the Welsh Assembly Government’s commitment to
creating a bilingual Wales, as set out in “Iaith Pawb”, its action plan
for the language.
There is, of course, specific legislation for the language, namely the
Welsh Language Act, 1993. The THB operates in accordance with its
Welsh Language Scheme, which was prepared under the Act – and
approved by the Welsh Language Board. The Scheme describes how
the English and Welsh languages will be treated on a basis of equality
as we deliver health services to the people of Powys – and as we plan
and develop new policies, services and initiatives.
In addition to our obligations under our Welsh Language Scheme we
intend to fully consider Welsh Language issues insofar as they are
relevant to our equality and human rights obligations by integrating
considerations into our equality impact assessments described in
section 6 of this document.
Page 17 of 64
2 Public Sector Equality
Duties
In developing our first Single Equality Scheme, one of our over-riding
priorities was to ensure that, as an absolute minimum, the new scheme
embodied all of the public sector duties contained in current legislation, a
summary of which is shown in the following table:
Table 5.
Summary of the General Duties
Statutory Equality General Duties
When carrying out their functions, all public authorities must have
due regard to the need to:
Race
1. eliminate unlawful racial discrimination;
Equality
2. promote equality of opportunity; and
Duty
3. promote good relations between people of different racial
groups.
Disability
1. eliminate discrimination that is unlawful under the Act;
Equality
2. eliminate harassment of disabled persons that is related to
Duty
their disabilities;
3. promote equality of opportunity between disabled persons
and other persons;
4. promote positive attitudes towards disabled persons;
5. encourage participation by disabled persons in public life;
and
Gender
Equality
Duty
6. take steps to take account of disabled persons’ disabilities,
even where that involves treating disabled persons more
favourably than other persons.
1. eliminate unlawful sex discrimination and harassment; and
2. promote equality of opportunity between men and women.
In order to ensure Powys THB meets its statutory responsibilities with
regard to the General and Specific Duties, a number of actions were put
in place and have been monitored through the Action Plan that is a
standing item on the agenda of our Equality Action Group. This section
describes what we have done since 2005 to ensure we continue to
develop as an organisation towards going beyond statutory compliance
and fully integrating equality into the day to day business of the THB in
order to achieve improved patient outcomes.
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2.1 Developing the Scheme: Assessing the Functions and
Policies for Relevance to the General Duty
Powys THB has taken the following steps in meeting the General Duty:

we identified in 2005 (and reviewed in 2008) which of our functions
are relevant to the duties and assessed how the relevant functions
and any related policies may affect race equality;

this assessment of relevance of functions and policies now
incorporates all strands of equality;

revised priorities have been set for these functions, based on the
reviewed assessment of relevance to all strands of equality;

a process has been put in place to consider how the policies might be
changed where necessary to meet the general duty and to make
those changes.
Using an assessment grid Powys THB has developed a system to
determine the relevance of existing functions and policies in meeting all
aspects of the General Duty, and the priority they will be given in the
action plan. Functions and policies rated of high relevance will assume
the highest priority for impact assessment.
The three highest priorities identified were as follows:



Strategic planning and partnership
Staff development and training
Public and patient involvement
2.2 How we assess and consult on the likely impact of proposed
policies
PTHB has a specific duty to establish arrangements for assessing and
consulting on the likely impact of our proposed policies on the promotion
of equality.
The process contained in the Powys THB Policy on ‘Managing Policies,
Procedures, Guidelines and Protocols’ confirms what steps all staff must
follow when submitting a policy / protocol or guideline for approval.
Powys THB has adopted the revised NHS Centre for Equality and Human
Rights Equality Impact Assessment Toolkit. This is a generic equality
toolkit which will be used to assess functions and policies identified as
relevant to the Race (and other) General Duties.
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Powys THB consults people who may be affected by proposed policies
and as part of its process for developing plans for improving healthcare
and commissioning of services. We use clear consultation methods and
explain them to staff and to the public and we work with other
organisations to ensure that consultation is as wide ranging and
extensive as possible. We make effective use of a variety of methods for
reaching as many individuals and groups as possible – via meetings
with:
-
Community Health Councils
-
Local Health Alliance
-
-
Professional Bodies
Children & Young Peoples Groups -
Local Community Fora
Voluntary Sector organisations
Trade Unions
-
GPs
Nursing and Residential Homes
Powys THB recognises that for many people religious identity is as
important as their racial identity and accordingly we engage with
religious centres and faith groups. We ensure that the results of
consultation are reported back to the organisation in a fair and open way
and use people’s views to inform our decision-making process.
2.3 How we monitor policies for adverse impact on the
promotion of Equality
PTHB has a specific duty to ensure arrangements are in place for
assessing the relevance of all of its functions to the Equality Duties, and
for monitoring policies for any adverse impact on the promotion of
equality. This was a priority in the first year of the previous schemes,
and we continue to develop Equality Impact Assessment systems that
will produce information for analysis and review by the Equality Action
Group and the Board that will ensure action is taken to address any
unjustifiable discrimination found through the monitoring processes.
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Patient Equality Monitoring Project
A project aimed at developing and implementing a model to capture and monitor the equality
profile of patients accessing health services across Wales is nearing
completion and will be implemented in Powys THB in the coming months.
In short, the aims of the Project are to:
 deliver a programme of change that improves the collection of equality data
within NHS Trusts across Wales; and
 in so doing, to distinguish the impact of health service policies and practices
upon different groups of patients, according to their racial group, gender, age, disability,
sexual orientation, religion or belief.
An equality dataset has been developed through consultation with the former Equality
Commissions, the Welsh Assembly Government (WAG), the Office of National
Statistics and the NHS in Wales to ensure consistency and inclusion in data collection. The
equality dataset has been submitted to the Welsh Information Governance & Standards Board,
and it is hoped that the submission will be approved shortly.
Powys THB was one of the pilot sites for the initial stages of the project and staff have
attended training on how to capture and log patient equality data.
PTHB will use the following methods to monitor and analyse the effects
of their policies on different groups:
 statistical analysis of data;
 usage and satisfaction surveys (analysed by the groups to which
the people surveyed belong);
 random or targeted surveys;
 meetings, focus groups or citizens’ panels;
 consultation through employee forums.
NHS Jobs is a national, NHS recruitment and post advertising system that was
adopted by all NHS organisations in Wales during 2007 and Powys THB was one of
the first organisations to implement the live system. All vacancies are now advertised
through this internet-based medium which we believe makes our jobs much more
accessible to all parts of the community. The system also enables us to produce and
monitor reports on the equality profile of job applicants, and those short-listed and
appointed across all equality strands, and this information is considered by the equality
group at it’s regular meetings.
A special link has been established through JobCentre plus and they are supporting and
helping applicants, giving them a hotmail address if necessary.
Data is presented to the Equality Action Group on a quarterly basis, and
this Group is responsible for ensuring that the action plan is delivered.
The data is aimed at helping the Group develop answers to the following
questions:
Page 21 of 64











Are PTHB policies and procedures fair to all groups?
Are members of some groups more likely than others to use its
services?
Are there differences in outcomes for different groups?
Are any of these differences due to other policies or procedures?
Is the difference due to some underlying pattern or disadvantage?
Are the factors it has considered sufficient to explain the size of the
differences?
What other data or analysis might be needed to investigate
further?
Is there any obvious reason for the difference, or their size, and
what else can it do? Is direct discrimination a possible cause?
Is there evidence that these patterns are changing?
Has the action taken led to improvements?
What lessons can be learnt for the future?
2.4 How we publish assessment, consultation and monitoring
reports
PTHB has a specific duty to publish the results of any assessments,
consultations and monitoring it undertakes to identify any adverse
impact on equality.
Arrangements for publishing assessments, consultation and monitoring
results will include the main points highlighted in the report, such as:





why the consultation took place;
how it was carried out;
a summary of the responses or views it produced;
an assessment of the policy options;
what PTHB has decided to do.
PTHB will also use relevant outcomes from the Health, Social Care and
Well Being Strategy consultation process to inform its equality initiatives.
A summary of all the responses to the First Stage of this strategy will be
readily available and will be incorporated in the final version of the latest
version of the strategy.
Mechanisms for publishing include:

electronically on the PTHB website plus key partner websites;
the equality section of the Powys THB website has recently
been significantly updated to provide improved support,
guidance and information, and ready access to reports, policies,
statistics and documents such as Equality Impact Assessments;
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












2.5
paper format to be distributed widely to libraries, leisure
centres, GP surgeries and other health, council and voluntary
sector facilities;
Use of council newsletter;
Use of media e.g local newspapers and radios;
Town Councils;
Community Councils;
Health Board meetings;
Community Health Councils;
Internal staff channels;
Staff magazine – Insiders;
Annual Report;
Annual Equality Report;
Patient Information leaflets;
Health Focus groups.
How people can access information and services:
See section 4 below.
2.6
How we train our staff
PTHB has a specific duty to train all its staff in connection with the
General Duties to promote equality and any specific duties.
A training needs analysis is undertaken on an annual basis, across all
disciplines of Powys THB, to ensure that training is appropriate to
individual need and organisational objectives. The findings are used to
inform the core training to be delivered/ facilitated internally from the
central training department.
As part of this process Powys THB has integrated equality and human
rights into mainstream essential training activity of the organisation. All
existing staff receive appropriate mandatory training to raise their
awareness and understanding of the THBs Equality Schemes and action
plans.
PTHB’s Corporate Induction programme is designed so that all new
starters within the organisation are made aware of the Equality Schemes
along with other equality policies and procedures.
Those staff who are identified as having responsibility for managing and
delivering PTHB’s Single Equality scheme have received specific training.
This training covered Equality Impact Assessment, the implementation
and monitoring of policy and the process for review and revision.
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Powys tLHB Board Members took part in an equality training workshop in February
2007 to help increase awareness of the Board’s responsibilities, working towards
equality being ’mainstreamed’ to all that the tLHB does. Further training around
equality, diversity and human rights is planned following the restructuring of the
Board during the recent NHS Reform.
PTHB Partnership Board, which is a joint meeting of staff and management
representatives established in April 2006, received equality training from the BSC
Equality Manager in July 2006 and this has been updated during the year to include
gender equality and equality impact assessment.
The provision of training will continue to be recorded, monitored and
evaluated and progress reports made to the Board on an annual basis.
Attendance of staff on all of PTHB’s essential training is recorded on a
database and quarterly reports are provided to Managers so that they
can target any necessary staff.
Work is currently taking place to identify extracts from Powys THB’s
training records system (AT-Learning) to produce reports on the profile
of staff requesting and attending training within PTHB.
Work by managers and staff on creating Knowledge and Skills (KSF) outlines for
all posts in the organisation is continuing, as part of the Agenda for Change Pay
Modernisation. Equality is one of the six core competencies which all staff will be
required to demonstrate, at levels appropriate to their responsibilities. Generic
equalities training forms part of the essential ‘core’ requirements under the
Knowledge and Skills Framework for NHS employees and this will also be a
requirement under the annual Personal Development Plans for all employees.
This information will be captured on the tLHB’s KSF electronic system, which
means that the Development and Training department will be able to monitor the
levels of training required to the meet the competencies across the organisation.
This will mean that training can be better focussed on identified need.
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3 Workforce: Powys THB
as an Employer
3.1
Implementation of the specific employment duties
To meet the equality duties as an employer, Powys Teaching Health
Board is committed to ensuring that we pay due regard to the need to
eliminate unlawful discrimination and harassment in our employment
practices and that we actively promote equality within our workforce
across all strands. This includes eliminating discrimination and
harassment of transsexual people on grounds of their gender
reassignment.
Powys THB is a major employer employing almost 2,500 staff plus BSC
staff. The tables in Appendix 6 show various analyses including staff in
post as at 31st March 2009, and those who left the organisation between
1st October 2008 and 31st March 2009.
Out of the total number of employees who have declared their ethnic
origin (2,074), 43 (2.1%) are from non-white ethnic backgrounds
compared to a population proportion of 0.9% for Powys County and
2.1% for all Wales (2001 Census). This is an increase from 30 (1.5%) as
at the same time last year.
Powys THB has introduced a comprehensive equality monitoring system
that monitors its employment processes to meet all statutory and
regulatory requirements. We use a standard monitoring format for all job
applications through NHS Jobs and ensure that all groups are included.
Data on all employment issues is reported to the Equality Action Group
on a regular basis. This information is used to inform future policy, target
setting and any other action as appropriate. The results of the
monitoring are published regularly in the Annual Equality Report of
Powys THB.
The Equality Action Group has membership from across Powys tLHB. In
this way, all functions of PTHB are represented and the monitoring and
reporting arrangements are robust.
“In some occupations little has changed. In 1971 women held the majority of
clerical and service jobs, and today four-fifths of people employed in personal
services, administrative and secretarial work are women.”
Sources: NAW (1985) Digest of Welsh historical statistics 1700 –1974; ONS
(2005) Labour Force Survey Spring 2005 dataset.
Page 25 of 64
Powys THB Employee Equality Data
One of the issues we identified through employment monitoring is the large
number of “Not Declared” or “Not Stated” across equality characteristics.
We are starting to address this through a data cleansing exercise that is
due to commence in October 2009 and run for 12 months.
Each month, a group of (approximately 1/12th of) employees will be sent
details of information held on them within our computer systems, and they
are being asked to check and update these details so that we can update
our systems.
We have also undertaken a major communication exercise to coincide with
the exercise as we were aware from employee feedback of issues around
confidentiality and data security. Communications have included a personal
message from the Chief Executive and regular articles in monthly Key Brief
documents.
The whole exercise has been undertaken in consultation and through
Partnership arrangements with the Trade Unions who have supported the
exercise by jointly signing the covering letter that is being used to explain
to staff exactly what is required of them, and why it is important.
3.2
Implementation of employment duties on equal pay
The Gender Equality General Duty includes a requirement to have due
regard to the need to eliminate discrimination that is unlawful under the
Equal Pay Act 1970. The specific duties require listed public authorities,
when setting their overall objectives, to '…consider the need to have
objectives that address the causes of any differences between the pay of
men and women that are related to their sex'.
Public authorities that do not set their own pay systems are still
expected to gather information and take appropriate action on any
causes of the gender pay gap within their organisation which remain
within their control.
The NHS has already taken significant action to address the pay gap
in the form of “Agenda for Change” which aims to bring fairer pay to
more than one million non-medical staff in the NHS, including women.
The new pay system ensures fair pay and a clearer system for career
progression. For the first time staff are now paid on the basis of the
jobs they are doing and the skills and knowledge they apply to these
jobs. This reform is underpinned by a job evaluation scheme
specifically designed for the NHS. There is also a commitment that all
Page 26 of 64
staff, whatever their post, whether full or part time, day or night
workers, will be supported to learn and develop throughout their
working lives in NHS.
Within Powys Teaching Health Board, more than 97% of our staff are
subject to National Terms and Conditions under Agenda For Change.
3.3
Training and Development
Powys Teaching Health Board is totally committed to the development
of all its employees so that they are able to achieve their full
potential. There are a number of ways in which this is demonstrated
throughout the employment cycle, and with the development of the
NHS Knowledge and Skills Framework (KSF) – see below - we now
have a Nationally Implemented process which includes as a Core
Competency, Equality and Diversity.
Training in Equality and Diversity commences with Induction Training
as soon as successful candidates join the organisation. This includes
coverage of basic awareness of equality and diversity issues, together
with an overview of the Equality Policy and Procedure, and a brief
introduction to the Public Sector Duties with regard to Race, Disability
and Gender.
Regular Awareness-Raising and refresher sessions are offered across
the organisation covering all equality and diversity issues in an
interactive way to reinforce learning, and tailored equality and
diversity training is provided to all staff and managers involved in the
Recruitment and Selection processes.
As part of the Agenda for Change programme for modernising the
National Health Service, NHS employers and unions have worked in
partnership to identify the key skills and competencies needed for all
NHS employees. The Knowledge and Skills Framework (KSF) covers
taught, experiential, tacit, and acquired skills, and focuses on how
those skills are applied to the job being undertaken.
Under the national pay framework, pay scales have been shortened,
and employees have two competency assessments, which are linked
to pay progression: first, after one year of service, and then before
the employee reaches the maximum. Assessments are meant to
identify skills needs early and to encourage employers and employees
to appraise and manage the career development of the employee.
The KSF also establishes a stronger link between competence and pay
progression which will reduce the incidence of equal pay issues for NHS
employers.
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The NHS Agenda For Change Terms and Conditions Handbook
includes the provisions:
“Equality of Access to opportunities for the development of skills should
apply regardless of hours worked or any other non-standard term in the
contract of employment”. This reinforces our commitment to gender
equality as part-time working is an area traditionally dominated by
women.
3.4
Recruitment and Selection
We also want to ensure that our recruitment activities remain fair and
transparent, and in addition to existing monitoring we will provide
ongoing awareness training to ensure that all Panel Chairs and those
involved in the recruitment process continue to be fully conversant
with their equality responsibilities.
Powys Teaching Health Board has adopted the All Wales Human
Resources Policies in relation to employment practice. These policies
have recently been reviewed as part of a regular updating exercise,
and have been Impact Assessed for equality and human rights using
the Toolkit developed by the NHS Centre for Equality and Human
Rights. This gives us a high degree of assurance that all of our
employment policy and practice meets the highest possible standards
of best practice and legislative requirements, and as far as
practicable, are free from discriminatory practice and language.
Despite having a wide range of policies that enable staff to access
flexible working patterns we do not have adequate information about
uptake and potential (or even perceived) effects on staff progression.
Development work on the new Electronic Staff Record (ESR) and
online recruitment system will soon allow consistent detailed
monitoring of personnel practices and performance in these areas. It
is therefore anticipated that we will undertake a formal scrutiny
exercise to identify uptake and impact of flexible working
opportunities.
A key area in which we intend to utilise this information specifically will
be for Workforce and Organisational Development to investigate any
perceived impact of caring responsibilities on internal progression.
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4 Access to Powys THB
4.1
Introduction
Improving accessibility is a key priority for Powys THB and we recognise
that this is not confined to the physical access to our hospitals and other
premises.
There is a growing body of evidence that tells us people face barriers
when accessing healthcare and this can lead to inequalities in health
outcomes. These barriers may well be physical, but will also include
barriers related to language, for example, for those who’s first language
is neither Welsh nor English, or are related to awareness concerning the
existence of services among people who are isolated by rurality or by
other reasons from such assumed knowledge.
4.2
Priorities
Powys THB is committed to transparency and openness, and recognises
that improving access to information and services for people who
experience barriers will lead to improvements in health outcomes for all
sections of our community.
The identification and elimination of barriers to improve accessibility to
information and services for people from under-represented groups will
be a high priority during the three years of this Scheme.
4.3
How People Can Access Information and Services
PTHB has a specific duty to ensure that arrangements are in place which
ensure that the public have access to information and services they
provide.
Powys THB is committed to effective communication with all of its
communities, because it recognises that there are potential barriers that
may prevent some groups and individuals being able to access
information. It will continue in a variety of ways and formats to meet
different needs detailed previously, and continue to explore other
avenues e.g. Braille upon request. As groups in Powys are widely spread
across the county (which is the biggest geographical county in area in
either England or Wales) it is difficult to ensure equality of access to
services and information.
PTHB will continue to look at how other organisations have approached
this problem and seek to achieve greater equality of access. The Equality
Action Group will monitor progress.
Page 29 of 64
Workshops and public meetings are held with a number of groups on
general and specific issues. These workshops and meetings may be held
by Powys THB itself, or in partnership with other organisations, such as
the Community Health Council or Local Authority. Groups involved
include:
Local Health Alliance
Voluntary Sector Organisations
4.4
Local Community Fora
Community Health Council
The Social Model of Disability and Inclusive Design
In the past, many public services framed the issue of disability as a
'medical' model where the solutions tended to focus around the idea
of curing the person or making them 'better'.
The social model moves beyond this by aligning services to
accommodate disabled people on the basis that we are all equal
whether we have a disability or not. This means that we will adopt the
principles of inclusive design and inclusive services wherever possible
in terms of designing, managing and monitoring the built environment
and service delivery.
Following the social model should result in a better environment for all
service users and the entire community, and better access for
disabled people and service users generally.
Inclusive design is a process that delivers an environment where
everyone can access and benefit from a full range of services. It aims
to remove barriers that create undue effort and enables everyone to
participate equally.
However, by designing and managing our built environment
inclusively the difficulties experienced by many others including older
people and families with small children will also be overcome. We all
benefit from an accessible and inclusive environment.
Inclusive design:
 places people at the heart of the design process;
 responds to human diversity and difference;
 offers dignity, autonomy and choice;
 provides for flexibility in use.
The adoption of inclusive design principles will enable people to:
 use health care developments safely, with dignity and confidence;
 be independent and in control;
 have enough space to ensure their comfort and convenience;
 know where they are and find their way around.
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4.5
Interpretation and Translation Services
Interpretation and translation facilities for service users in Powys THB
are primarily provided through a service called “Language Line”.
During 2008, the Welsh Assembly Government established a project known as Wales Interpretation and Translation Services (W.I.T.S) - to
explore the feasibility of establishing a National service to provide
interpretation and translation services.
This project revealed an overwhelming support for a high quality, coordinated, collaborative, interpreter service in Wales providing for
public service providers and the voluntary sector. Organisations are
seeking easy access to a supplier of quality interpreters at a
reasonable price.
It has recommended a ‘One-Stop-Shop’ approach to offer the best
solution for Wales. This would also be able to monitor the changing
needs in Wales and then respond to those changes by, for example,
training new interpreters in the languages that are needed. It is
expected that a Pilot Scheme will soon be established to take this
work forward.
4.6
Access Issues for Disabled People
A detailed analysis of issues identified during engagement and
consultation with disabled people in Powys as part of the development of
our Disability Equality Scheme is contained in Appendix 5. Actions
developed to tackle the issues identified have been included in the action
plan in Appendix 2.
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5 Engagement and
Consultation
5.1
Public and Patient Involvement
Public and patient involvement is integral to meeting corporate
objectives. The approach taken by Powys THB is set out within the Public
and Patient Involvement 3 year plan, which has been developed in
conjunction with the Signpost Guidance issued from the Health Division
of the Welsh Assembly Government. The Public and Patient Involvement
plan is part of the THB’s commitment to involve as effectively as possible
local communities in Health, Social Care and Well Being.
While there are clearly similarities between the statutory duties, there
are also differences. Wherever practical, the development of this Single
Equality Scheme has been based upon use of the ‘higher’ standard. For
example, one requirement of the Disability Discrimination Act 2005 is to
‘involve’ disabled people in the publication of the Scheme, whereas the
Race Relations (Amendment) Act 2000 requires proper ‘consultation’. In
future, Powys THB will therefore aspire to ‘engage’, as well as consult in
the production and subsequent review of this Single Scheme.
It is also important to explicitly acknowledge that true consultation and
engagement cannot be a ‘one-off’ process or isolated event, and must be
an ongoing process.
Following on from a successful joint initiative with Powys County Council
on gender equality, we are currently exploring how we can work
collaboratively with other public and voluntary sector partners to develop
a model for public sector consultation and engagement with all sections
of the Powys community that we expect will lead to much more
meaningful and robust engagement and consultation in the future. A
workshop was held during October 2008 and principles agreed as a
result of this workshop will be adopted in the future development of this
Scheme and in exploring more collaborative working between public and
voluntary sectors in Powys.
5.2
Powys Teaching Health Board Consultation
In developing our draft Gender Equality Scheme in 2007, a Joint Task
and Finish Group determined an approach to involving stakeholders in
determining gender equality objectives and priorities based upon:
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




Raising awareness amongst both service users and employees
by:
o Publishing a briefing document which has been distributed
widely across the county of Powys through NHS premises,
doctors and dentists surgeries, pharmacies etc;
o Making the document available through our internet site,
and in a range of formats and alternative languages (on
demand);
Linking the document to a questionnaire that service users are
invited to complete and return; (**see below)
Distributing both information and questionnaire to specificallytargeted stakeholder individuals and organizations; (**see
below)
Developing a questionnaire that was sent to all employees of
Powys THB inviting them to identify any gender specific issues
in relation to their employment;
Inviting both service users and employees to indicate whether
they would be prepared to become more actively involved in
the development of our Gender Equality Scheme through
further initiatives such as focus groups or other consultation
events, or perhaps through becoming a member of the Joint
Task and Finish Group;
The above approach is the first stage in what Powys Teaching Health
Board believes will become an ongoing dialogue with people in the
communities we serve to better inform our policy and decisionmaking.
** In order to facilitate the consultation and engagement process, and
to minimize the incidence of ‘consultation overload’ on local
organizations in particular, a partnership was formed with Powys
County Council whereby questionnaires seeking views on gender
issues arising from either council services or health issues were
distributed jointly under a single covering letter to a group of
stakeholder organizations and individuals.
A total number of 1,500 questionnaires were distributed, out of which
103 were returned (7%). The results and key themes from this joint
consultation exercise as they relate to health issues in Powys are
listed in Appendix 6 to this Scheme. These will be the subject of
further consultation within the organization to determine the key
actions required to start to address the main issues raised.
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When developing our Disability Equality Scheme in 2006, Powys tLHB
decided to involve as many disabled people as possible by using the
existing communication channels to access the disabled community,
visiting local groups and individuals to gather their views that will
inform the scheme.
In supporting this work a questionnaire has been produced for those
people who would prefer to use this method of communication. We
also offered a telephone assisted completion of the questionnaire.
To achieve this, two stakeholder groups were established;
1. Powys Local Health Board’s Disability Equality Scheme
Stakeholder Group; and
2. Powys Local Health Board’s Disability Equality Scheme Employee
Network.
Both of these groups were the key communication channels in which
disabled people were involved in the development of the scheme.
Disabled people were involved in all key aspects of the development
of this scheme, such as:



Identifying the barriers faced by disabled people and
unsatisfactory outcomes;
setting priorities for action plans; and
assisting planning activity
Some of the groups involved in providing information to the tLHB are
listed in Appendix 8.
5.3
The Single Equality and Human Rights Scheme
In developing this Scheme we have made every effort to both follow and
define examples of best practice for the public sector in Wales. We have
focused on engaging and listening to the views, experiences and
aspirations previously presented to us by individuals and representative
organisations and we have used this information to design our Scheme.
We believe that an open and frequent dialogue will help us to develop
policies and services which better meet the needs of women and men in
Wales. However, we have also been sensitive to feedback from
stakeholders that indicates a degree of “consultation fatigue” and have
therefore determined the following approach to engaging and consulting
stakeholders for the purpose of informing the development of this
Scheme.
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(a) The issues and priorities that have been identified by the people
who have been involved with us during previous engagement and
involvement has been the starting point for the development of our
Scheme and the actions that underpin it.
(b) We also undertook a comprehensive review of reports and
research documents relevant to equality issues in healthcare. Whilst this
confirmed that health inequality information disaggregated by equality
characteristic and specific to Powys County is rare, it did nevertheless
provide useful information in areas such as learning disabilities and
mental health. The following Table shows the documents reviewed and
strand/characteristic to which they relate:
Strand of equality that the report Title of report
Date
of
predominantly focus’ on
publication
Race

The independent inquiry into the 2003
Disability
death of David ‘Rocky’ Bennett (Lord
Language
Laming)
Culture
Religion
Race
Language
Culture
Race
Culture
Language
Race
Gender
Language
Culture
Religion/belief
Gender
Sexual Orientation
Gender
Sexual Orientation
Gender
Sexual Orientation
Race
Language
Culture
Religion/Belief
Race
Gender
Age
Language
Sexual Orientation
Religion/belief
Race
Gender

The Victoria Climbiè Inquiry (Lord 2003
laming)

The Stephen Lawrence
(Macpherson report)

Experience of Maternity Service – A 2004
Muslim Women’s Perspective (the
Maternity Alliance)

Trans – A practical guide for the 2008
NHS
Double Stigma (LGB Experiences) 2009
Stonewall
The Inside Out project (Stonewall)
2007


Inquiry 1999

The BEST report (NWREN and The 2004
University of Wales, Bangor)

Seeing the person in the patient (The 2008
Kings Fund)

‘Who do you see?’ (EHRC)
Page 35 of 64
2008
Age
Language
Sexual Orientation
Religion/belief
Human Rights
Disability (specifically mental
health and deafness)
Sexual Orientation
Gender
Ethnicity
Age
Gender
Gender
Religion/Belief
Language
Human Rights (specifically article
16 (2))

A Simple Cure (RNID)

The Double Glazed glass ceiling – 2008
lesbians in the workplace (Stonewall)

Coming of age (Older Peoples 2008
Commissioner for Wales)
Forced
marriage
–
Statutory 2007
Guidance (Home Office)

2004
Given this information has been gathered over a significant period of
time, we considered that there was a need to ‘test’ this understanding
with our stakeholders, and this would enable us to:
(a)
(b)
(c)
ensure the information remains valid and current;
identify any gaps in the information, particularly relating to Age,
Religion or Belief and Sexual Orientation that has not previously
been collected; and
seek stakeholders views on what should be the priorities for our
actions going forward.
We have therefore commissioned a questionnaire which will be circulated
once the draft scheme has been approved by the Board for publication,
through existing networks and contacts to as wide a cross-section of
people and organisations as possible in Powys (and beyond). A draft list
of those we believe should be involved in this exercise is included as
Appendix 8 and work is on-going to develop this in the meantime. The
questionnaire will also be available to be completed electronically
through our website together with a facility for telephone-assisted
completion.
At the same time, the facility for direct contact through focus groups or
individual meetings will be offered for those who prefer to meet staff
from PTHB face to face. These discussions will centre the subject-matter
contained in the questionnaire.
(c) Finally, and acknowledging that our employees and the Trade
Unions that represent them are also key stakeholders in the
organisation, we developed a questionnaire to seek the views of our staff
on working for the organisation asking for them to help us identify
Page 36 of 64
barriers that hinder or prevent equality of opportunity, particularly to
people from groups currently under-represented in Powys THB.
Again, the facility for face-to-face discussion either individually or
through focus groups was offered, and the whole approach was
considered and agreed through the Partnership Board.
We received a total of 18 responses from staff and a copy of the
questionnaire, together with a synopsis of the comments received is
contained in Appendix 9.
(d) Looking to the future, we are planning the development of a
network for staff from under-represented backgrounds. This will provide
the opportunity, for the first time, for staff from under-represented
backgrounds to meet and discuss issues of concern that can be raised
directly with the management team through the Equality Steering Group.
To date, little interest has been expressed in the formation of such a
group, however further initiatives are being planned over the next 12
months to offer support to, and promote interest in, such a group.
Page 37 of 64
6 Equality Impact
Assessment
6.1
Introduction
Undertaking Equality Impact Assessments (EqIAs) is a central tenet of
compliance with equality legislation that originated within the Race
Relations (Amendment) Act 2000. Public bodies are now required by law
to complete EqIAs relating to race, disability and gender, and as Powys
THB is planning to adopt a Single Equality Scheme approach, our EqIAs
will also address age, religion or belief, and sexual orientation in addition
to Human Rights and Welsh Language issues.
Impact Assessments provide an effective mechanism for directorates
within Powys THB to identify existing or potential unintended differential
impacts, which, unless mitigated, would be disadvantageous to certain
groups of individuals. The EqIA process focuses on assessing, consulting
upon, recording and acting upon the likely equality impact of an LHB
function or policy.
Powys THB recognises that inequalities in health persist across the
equality spectrum (race, disability, gender, age, religion and belief, or
sexual orientation), and that these factors often overlap. It is thus vital
that PTHB policy implementation acts to mitigate these inequalities
whenever possible, both to meet organisational aims and to act within
equality legislation.
This does not, however, mean simply ‘treating everybody the same’.
Rather, the process of undertaking an EqIA reveals where and how
differential inputs may be required to drive towards equality of outcome.
When an EqIA reveals a potential unfavourable differential impact, Powys
THB is committed to exploring alternative means of achieving the same
objective that cause no (or fewer) adverse impacts.
6.2
What is Impact Assessment?
Impact assessment is simply a process which enables an organisation to
consider the effects of its decisions, policies or services on different
communities, individuals or groups.
It involves:
• anticipating or identifying the consequences of this work on individuals
or groups of service users/employees;
• making sure that any negative effects are eliminated or minimized;
• maximising opportunities for promoting positive effects.
Page 38 of 64
As a result of this, the services provided should be improved and meet
the needs of those using them. Impact assessment is used across a
range of issues from health and safety, to sustainability and
environmental considerations.
Equality impact assessment considers the effects that decisions, policies
or services have on people on the basis of their gender, race, disability,
sexual orientation, religion or belief, age, Welsh language and human
rights. Recent equality and human rights legislation has imposed legal
duties upon public bodies to ensure that the impact of their activities on
specific groups is assessed.
Powys THB has adopted the revised Equality Impact Assessment Toolkit
developed by the NHS Centre for Equality and Human Rights and
includes 10 steps within a process split into three parts:
- Part A: Preparation & Assessment of Relevance and Priority;
- Part B: Equality Impact Assessment;
- Part C: Outcome, Monitoring, Publication and Review.
A flowchart that describes the overall process adopted by Powys tLHB is
included as Appendix 5.
A policy has now been developed and agreed and an implementation plan
is being prepared to include staff training to ensure the revised toolkit is
mainstreamed into all aspects of Powys THB’s day to day business.
6.3
Governance
To coincide with the development of the Policy on Impact Assessment for
Equality, we have also revised our policy that governs the development of
new or revised policies, procedures, protocols and guidelines. This now
requires that all documents drafted or revised in the future, and submitted
for approval must be able to demonstrate evidence of an assessment for
equality impact.
Further, the cover sheet that accompanies all papers submitted to
Committees and the Board now contains a similar requirement to assure
Committee/Board members that equality impact has been considered
during the development of the proposal, policy or other document
submitted.
These measures will help ensure that Equality Impact Assessment is
mainstreamed into all day-to-day activities of the organisation.
Page 39 of 64
7 Dealing with Complaints
7.1
How we deal with complaints
Powys THB welcomes comments, suggestions and complaints on the
services it provides. It believes in honest and effective communications
with patients, relatives, clients, carers, visitors and staff. This
consultative dialogue contributes to the climate of trust and openness it
strives towards. The complaints procedure is designed to give a prompt
and positive response to patients’ comments and complaints.
The complaints procedure has been designed to comply with the Welsh
Risk Management Standard and the National NHS Complaints procedure.
The Medical Director together with the Clinical Governance Team and
Complaints Manager are responsible for monitoring of complaints,
identifying trends and developing action. Currently complaints are not
monitored by equality strand, although any complaints that are related
to specific issues around equality or discrimination in any way will be
given the utmost priority.
Anyone wishing to make a complaint should do so in writing to:
The Complaints Manager,
Powys Teaching Health Board,
Mansion House,
Bronllys Hospital,
Bronllys,
POWYS.
LD1 0LS
Tel:
01874 712697
Page 40 of 64
8 Powys THB – The Next
Steps
Even with a significant amount of planning, there remain a number of
actions needed to complete the transition from our previous three
Schemes (Race, Disability and Gender) to this new, more holistic
approach.
The following are seen as the immediate priorities in taking this work
forward to ensure equality and human rights are mainstreamed into the
day-to-day activities of Powys THB.
1.
Map the information and feedback from public consultation on this
draft Scheme to identify and confirm priorities for the Action Plan;
2.
Bring this information together into a plan with target dates for
achievement of equality impact assessments;
3.
A revised Equality Steering Group made up of a cross section of
PTHB staff including a Non Officer Member and community
representatives will ensure that these targets are achieved;
4.
Promote and develop collaborative working with Powys County
Council and other partners in the public and voluntary sectors to
gain further knowledge of minority communities in Powys;
5.
Develop and implement an engagement and consultation model
to ensure more robust involvement of all sections of the
community;
6.
To set up processes for capturing information on travellers
‘passing through’ Powys;
7.
Ensure the Equality Steering Group meets regularly and:
 monitors the implementation of this Scheme;
 monitors progress against the Action Plan;
 receives and reviews reports on job applicants, employed staff,
access to training, complaints and grievances.
Page 41 of 64
Appendix 1: Structure
POWYS TEACHING HEALTH BOARD MANAGEMENT STRUCTURE
Chairman
Vice Chair
Chris Mann
Jo Mussen
Executive Directors
Chief Executive
Andrew Cottom
Medical Director
Finance Director
Nursing Director
Primary Care Director
Community and Mental Health Director
Director of Planning
Workforce and Organisational Development Director
Public Health Director
Therapies & Health Science
Brendan Lloyd,
Rebecca Richards
Carol Shillabeer
Andrew Powell
David Evans
Chrissie Hayes
Marcus Adams
Chris Potter
(to be determined)
Page 42 of 64
Appendix 2:
The Equality Improvement Plan
Appendix 3 EqIA Process
1
Identify the title and aims of the policy or service, who owns it and who needs to be involved in
the EqIA
Collect, but do not analyse available information and evidence to inform the EqIA
2
Initial
Screening
3
Could the
impact be
discriminatory
under equality
legislation?
No
Could any
communities
or groups be
negatively
affected?
Yes
Is the policy
or function
of high
significance
?
No
Yes
Yes
No
Prepare Report/Recommendations
4
Review
No
Full Impact
Assessment
Required?
11
Record decision
with supporting
evidence in the
EqIA Report.
Yes
Consider Relevant Data and
Research
Policy is not fit for purpose.
Consider alternative ways of
achieving policy objectives.
Full
Impact
Assessme
nt
5
Involve and engage with
stakeholders
7
No
Yes
Does the policy
disadvantage
any community
or group?
Can this be
justified
within the
legislation?
6
8
No
Yes
No
Does the
policy promote
equality?
Change policy to reduce adverse
or negative impact.
Review policy again to
see if the promotion of
equality can be
embedded.
Yes
8
Produce Action Plan
9
Establish monitoring and set review
date
Publish the EqIA Report
10
Appendix 4
Gender-Related Issues Identified Through
Stakeholder Consultation
Stakeholder questionnaires asked the question: “Name Three Things We Could Do
Better in Delivering Gender Equality In Health Services”.
A total of 103 public questionnaires were returned that contained a total of 111
comments where those questioned felt there were areas where services could be
improved from the perspective of gender equality. These comments were then
summarised into ‘key themes’ emerging from the public consultation exercise.
The following is a table summarising the number of responses received under each
key theme:
No. of
Responses
% of Total
Responses
More Male Nurses, Health Visitors and
Receptionists
18
16.2%
More Female Doctors
14
12.6%
9
8.1%
8
7.2%
4
3.6%
Key Theme
Single Sex Wards in Hospitals
More Health Screening Services for Men, for
example, for early detection of prostate cancer.
Greater Flexibility in GP and other appointments,
for example, to offer evening or weekend
appointments more suited to people who work
full time.
Employee questionnaires were distributed electronically to all staff in Powys
tLHB and were structured to ask whether staff felt there were gender-related
issues at various points within the entire employment cycle, including
recruitment, promotion, training and access to flexible working opportunities.
From the 16 responses received, only one comment was submitted which
indicated the respondent felt that “male employees are not granted the same
rights as women within the workplace when it comes to special leave for
children and time off for dependency.”
As indicated in the action plan, we will be gathering data in this area to
determine whether there is equal access to flexible working opportunities
between women and men.
Page 45 of 64
Appendix 5 Issues
Identified During
Consultation with
Disabled People
a.
Access to services
Almost half of the respondents to the questionnaire had experienced
problems accessing services. Views expressed included long waiting
lists especially for Physiotherapy, GP’s, Podiatry, Speech and
Language services.
There was also a perception that the majority of dental services were
at first floor level in most practices, however on investigation that did
not appear to be the case and only a minority of Dentists were at first
floor level. Concern was also expressed about the lack of NHS
Dentists available in Powys.
Concerns were also expressed at the number of times appointments
were cancelled at the last minute.
The timing of appointments was also criticised with respondents
highlighting examples where they received early morning
appointments and had difficulty making transport arrangements to
attend.
b.
Out of Hours
There is a perception that being triaged over the phone is
unacceptable and also access to a Pharmacy to obtain medication can
be problematic. One respondent who was confined to bed asked
someone to collect their medication for them. The Doctor was
unwilling to give the patient’s representative the medication and the
patient subsequently received the wrong medication. Difficulties in
accessing services were more difficult over the bank holidays.
There was a strong view expressed that patients are passed from one
person to another, repeating the same information over and over
again, when reassurance is needed that someone will help. On several
occasions there were long delays in speaking to someone.
Page 46 of 64
Literacy is also a problem and some respondents have called 999, as
they did not know what else to do. Concern was expressed about Out
of hour’s access for Mental Health, the perception is that there doesn’t
appear to be sufficient service provision. There also does not appear
to be a qualified professional to deal with Mental Health issues Out of
Hours as medical staff are usually GP’s often with no experience of
Mental Health.
c.
Communication
Many issues were raised with regards to communication from the tLHB
and GP’s about appointments and basic information about service
provision.
Concern was expressed about some staff attitudes towards people
with a disability and many would like to see staff training implemented
to raise awareness about the difficulties people with a disability
experience.
Concern was also expressed that clinical staff do not always appear to
listen to patients and can make inaccurate assumptions about them.
It was suggested that communication needs to be kept simple with
alternative formats and methods available. Sign language and
interpreters should be readily available. It is essential the LHB engage
with the disabled community to identify the best methods of
communication.
d.
Written Communication
There was a call from patients for the tLHB to pay attention to detail
when using written communication and to use plain English to make it
easier to read. It was considered good practice to have a one stop
shop for patients to access information about tLHB services. There
was a request for more use of tapes, CD’s and audio equipment for
the visually impaired and people with literacy issues. Concern was
expressed about the visual display boards used at surgeries and the
difficulties this causes patients with visual impairments.
e.
Issues identified with Appointments
There was repeated concern about appointments being cancelled at
short notice. Concern was also expressed about Patient Focus Booking
and why patients need so many letters plus a phone call, it was felt
that this is waste of resource that could be better used elsewhere.
There have been problems experienced accessing GP’s and OPD
appointments, there is a perception that patients are all given the
same times and then seen on a first come, first served basis. There
Page 47 of 64
was also frustration expressed about not having any communication
when clinics are running late.
There was repeated concern about early appointment times. For
example Singleton Hospital is problematic as the buses don’t start
running until 9am, so this makes even a 10 or 10.30 appointment
very difficult to attend.
One patient missed 9 appointments as they had no one to read the
letter to them. Another respondent expressed concern as the wrong
date was on the letter so this was classed as a “did not attend” but
the respondent did attend on the day specified.
f.
Disabled Parking
It was stressed that disabled Parking can be a long way from main
entrances, parking can be very expensive and the lack of disabled
parking spaces at some Hospitals can cause stress and difficulties.
g.
Transport
The view was it is extremely difficult to travel to some hospitals as the
transport is so infrequent. Some hospitals are very difficult to get to if
you don’t drive and rely on public transport.
Ambulance cars do not always turn up to collect patients for
appointments and when they do they have several passengers which
make long journeys very uncomfortable.
h.
Mental Health
Improved provision of occupational therapy was seen as essential.
More support is also required to help Mental Health patients back into
meaningful employment. There is also an unacceptably long waiting
list for Cognitive and Psychotherapy.
Staff attitudes can sometimes appear to be poor and do not always
appear to be caring or sympathetic to Mental Health needs. More
training and awareness is needed to educate staff. There also needs
to be a positive attitude from staff toward rehabilitation and recovery.
It sometime appears staff haven’t got enough time available for
Mental Health patients.
There was a perception that Mental Health Services are poor with
particular reference to service provision Out of Hours, concern was
raised that there is a need for a 24hrs crisis service, as there is a
perception that it is difficult to access services during an acute phase
of illness out of hours.
Page 48 of 64
i.
Physical Access to the Healthcare facilities,
Access and egress to healthcare facilities is an issue for people with a
disability for example GP’s, Dentists and some hospitals. Reception
desks should be lower in some facilities to take account of wheelchair
users. Dispensaries are sometimes remote from the areas that
patients use, which mean a long walk for some patients to collect
prescriptions. There was a request for Healthcare premises to have
electronic doors to allow easier access and egress.
Other specific concerns include disabled parking, which is not always
accessible at healthcare premises. While other respondents believe
there is a need for provision for carers to stay during hospitals
admissions.
j.
GP Services
There is a perception that GP’s have long waiting lists and emergency
appointments can take up to 2 working days.
There was also a call for more evening surgeries to make the service
available to those who are working during the day.
k.
Dental Services
There is a perception that access to Dental services is difficult for
people with special needs and especially difficult for wheelchair users.
l.
Training
Training is required to help staff become better equipped to look after
disabled patients.
m.
Prescriptions
It’s difficult to get prescriptions at weekends. Concern was also
expressed about the small print on prescription sheets that visually
impaired people cannot read and sign.
n.
Service-Specific Issues
Concern was expressed about the lack of service provision especially
for Speech Therapy, Podiatry, X-ray at Knighton, Multiple Sclerosis,
Physiotherapy and Lymphodema.
There is a lack of choice for inpatient meals for special diets.
Page 49 of 64
o.
Other specific problems.
Charging disabled drivers for parking at Nevill Hall, Action taken contacted Nevill Hall who confirmed that no payment is necessary for
disabled people and Nevill Hall have agreed to display a large sign to
reflect this.
Poor lighting at some premises
Page 50 of 64
Appendix 6 - Employment
Powys tLHB Staff In Post at 31st March 2009
16-19
yrs
AGE BAND
Grand Total
GENDER
Grand Total
5
Female
1921
20-24
yrs
97
Male
468
25-29
yrs
137
No
Yes
196
11
45-59 yrs
1124
Grand Total
2389
ETHNIC ORIGIN
White - British
White - Irish
White - Any other White background
White English
White Scottish
White Welsh
White Polish
Mixed - White & Black Caribbean
Mixed - White & Asian
Mixed - Any other mixed background
Asian or Asian British - Indian
Asian or Asian British - Bangladeshi
Asian or Asian British - Any other Asian background
Black or Black British - Caribbean
Black or Black British - African
Black or Black British - Any other Black background
Chinese
Any Other Ethnic Group
Other Specified
Not Stated
Grand Total
DISABILITY
Grand Total
30-44 yrs
809
Not
Declared
2182
RELIGIOUS BELIEF
Atheism
Buddhism
Christianity
Hinduism
Islam
Other
Do not wish to disclose
Undefined/Not Stated
Grand Total
Total
SEXUAL ORIENTATION
Gay
Heterosexual
Do not wish to Disclose
Lesbian
Undefined/Not Stated
Grand Total
Total
Total
1747
3
2
98
2
178
1
1
2
1
17
1
3
3
2
1
1
10
1
315
2389
Grand Total
29
5
303
4
1
44
66
1937
2389
2
413
34
3
1937
2389
Page 51 of 64
2389
60-64
yrs
181
65-75
yrs
36
Grand
Total
2389
Appendix 6 - Employment
Powys tLHB Leavers Report 1st October 2008 to 31st March 2009
Age Grp
16-19 yrs
20-24 yrs
25-29 yrs
30-44 yrs
45-59 yrs
60-64 yrs
65-74 yrs
Totals
Oct-08
1
1
1
5
5
1
14
Gender
Female
Male
Totals
Oct-08
11
3
14
Nov-08
Dec-08
Jan-09
1
6
6
1
13
1
5
3
4
8
2
23
11
Nov-08
9
4
13
Dec-08
17
6
23
Jan-09
8
3
11
Disability
Yes
No
Not Stated
Totals
Oct-08
14
14
Nov-08
1
2
10
13
Religion/Belief
Atheism
Buddhism
Christianity
Hinduism
Islam
Undefined
I do not wish to disclose my religion/belief
Totals
Sexual Orientation
Heterosexual
Undefined
Totals
Oct-08
2
12
14
Dec-08
1
2
20
23
Oct08
Mar-09
18
1
19
Grand
Total
74
19
93
1
Nov-08
7
1
1
1
14
1
3
13
Jan-09
Feb-09
2
9
11
Nov-08
Dec-08
16
5
1
1
Jan-09
7
2
1
Feb-09
4
1
3
Mar-09
10
1
4
1
11
5
13
4
19
23
Mar-09
3
10
13
Dec-08
1
Feb-09
1
Mar-09
2
1
2
2
1
10
19
9
13
22
11
9
1
13
14
1
19
2
12
14
Dec-08
4
19
23
Jan-09
Page 52 of 64
2
9
11
Feb-09
4
9
13
1
14
93
2
13
78
93
4
15
19
Jan-09
Grand
Total
56
5
15
1
1
Grand
Total
1
3
2
Nov-08
3
10
13
Feb-09
11
2
13
Mar-09
1
1
5
6
2
5
3
Oct08
12
Ethnic Origin
White British
White English
White Welsh
White Polish
Asian or Asian British – Indian
Asian or Asian British–Any other Asian
background
Not Stated/Undefined
Totals
13
1
4
2
3
7
2
19
Grand
Total
1
4
11
19
29
24
5
93
Feb-09
Mar-09
5
14
19
Grand
Total
Grand
Total
20
73
93
2
1
13
1
1
73
2
93
Appendix 6 - Employment
Gender Pay Gap
All listed public authorities have a duty to undertake a process of
ascertaining if there is a gender pay gap in our workforce, and if so
determining whether our policies and practices are contributing to the
causes of the gender pay gap.
The way in which POWYS Teaching Health Board approached this
objective was to gather information analysed between male and
female staff across pay bands. This revealed the following:
Full Time
Equivalent
Salaries
Pay Band
10001 - 15000
15001 - 20000
20001 - 25000
25001 - 30000
30001 - 35000
35001 - 40000
40001 - 45000
45001 - 50000
50001 - 55000
55001 and over
Grand Total
Female
%
Male
%
448
19.0%
121
23.0%
650
27.6%
102
19.4%
335
14.2%
83
15.7%
433
18.4%
69
13.1%
270
11.5%
57
10.8%
134
5.7%
43
8.2%
36
1.5%
8
1.5%
26
1.1%
17
3.2%
10
0.4%
8
1.5%
14
0.6%
19
3.6%
2356
527
Full Time and Part Time Working
A snapshot of full and part time workers in Powys THB taken during
October 2009 shows:
Employee
Category
Full Time
Part Time
Grand Total
Female
%
Male %
833
35.4%
378
71.7%
1523
64.6%
149
28.3%
2356
527
Page 53 of 64
Appendix 7 - The Legal
Background
The Human Rights Act 1998
The Human Rights Act 1998 brings the main rights and freedoms (“the
Convention Rights”) set out in the European Convention on Human Rights
(ECHR) into UK law and sets out the legal responsibilities of public authorities in
relation to those rights and freedoms.
The Gender Equality Duty
From 6 April 2007, the Equality Act 2006 amended the Sex Discrimination Act
1975, creating a general gender equality duty which requires public authorities,
when carrying out functions of a public nature, to have due regard to the need:
• to eliminate unlawful discrimination and harassment; and
• to promote equality of opportunity between men and women.
The Sex Discrimination Act 1975 (Public Authorities) (Statutory Duties) Order
2006 also introduces specific duties requiring a number of public bodies to
develop a Gender Equality Scheme setting out, among other things, how they
will fulfil their general gender equality duty.
Powys tLHB published a draft Gender Equality Scheme in 2008. This scheme
has now been replaced by this Single Equality and Human Rights Scheme.
The Disability Equality Duty
The Disability Discrimination Act 1995 (as amended by the Disability
Discrimination Act (2005) is intended to drive forward a culture of positive
change across the public sector and in doing so remove many of the barriers
disabled people encounter in their daily lives. The amended Act imposes a
general duty on public authorities, when carrying out their public functions to
have due regard to:
• The need to eliminate discrimination that is unlawful under the Disability
Discrimination Act 1995;
• The need to eliminate harassment of disabled persons that is related to their
disabilities;
• The need to promote equality of opportunity between disabled persons and
other persons;
• The need to take steps to take account of disabled persons’ disabilities, even
where that involves treating disabled persons more favourably than other
persons;
• The need to promote positive attitudes towards disabled persons; and
• The need to encourage participation by disabled persons in public life.
In addition, Powys tLHB is also subject to specific duties under The Disability
Discrimination (Public Authorities) (Statutory Duties) Regulations 2005 which
state that a public authority should:
• Publish a Disability Equality Scheme demonstrating how it intends to fulfil its
general and specific duties; and
• Involve disabled people in the development of the Scheme.
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The scheme should include a statement of:
• The way in which disabled people have been involved in the development of
the scheme;
• The authority’s methods for impact assessing its policies and practices;
• Steps which the authority will take towards fulfilling its general duty (the ‘action
plan’);
• The authority’s arrangements for gathering information on the effect of its
policies and practices on disabled persons, particularly in relation to recruitment
and employment and other functions;
• The authority’s arrangements for putting the information gathered to use, in
particular in reviewing the effectiveness of its action plan and in preparing
subsequent Disability Equality Schemes;
• A public authority must, within 3 years of the scheme being published, take
steps set out in its action plan (unless it is unreasonable or impracticable to do
so) and put into effect the arrangements for gathering and making use of
information;
• A public authority must publish a report containing a summary of the steps
taken under the action plan, the results of its information gathering and the use
to which it has put the information.
Powys tLHBt published a Disability Equality Scheme on 4 December 2006. This
scheme has now been replaced by this Single Equality and Human Rights
Scheme.
Race Equality Duty
The Race Relations (Amendment) Act 2000 amended the Race Relations Act
1976 to impose a general duty on specified public authorities. The general duty
requires that, in carrying out its functions, the tLHB shall have due regard to the
need:
• To eliminate unlawful racial discrimination; and
• To promote equality of opportunity, and promote good relations between
persons of different racial groups.
A series of specific duties has also been created which require public authorities
to establish a proactive approach to race equality. This includes the preparation
of a Race Equality Scheme, which should set out those of the authority’s
functions, policies and proposed policies which the authority has assessed as
relevant to the general duty.
The Scheme must also set out the authority’s arrangements for:
• Assessing and consulting on the likely impact of proposed policies on the
promotion of race equality;
• Monitoring policies for adverse impact on the promotion of race equality;
• Publishing the results of assessments, consultation and monitoring;
• Ensuring that the public have access to information and services provided by
the authority;
• Training staff in connection with the general and specific duties; and
• Reviewing the assessment of functions, policies and proposed policies every 3
years.
In addition, Powys tLHB has the following employment-related specific duties
which include:
• Monitoring, by racial group, the numbers of applicants for employment, training
and promotion;
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• Monitoring, by racial group, the numbers of staff who: are in post; receive
training; benefit from, or suffer detriment, as a result of the LHB’s performance
assessment procedures; are involved in grievance or disciplinary procedures; or
cease employment with the LHB; and
• Publishing, each year, the results of employment monitoring.
Powys tLHB published a revised Race Equality Scheme in 2008. This Scheme
has now been replaced by this Single Equality and Human Rights Scheme.
Equality Act 2006
The Equality Act received Royal Assent on 16 February 2006. Its main provision
is the establishment of the Commission for Equality and Human Rights from
October 2007. The Commission will take on the work of the existing three
equality Commissions and promote an understanding of the importance of
equality, human rights and good relations.
Future Equality Legislation
There is much legislation around equality, and there has been a commitment to
harmonise and rationalise the different laws. A Single Equality Bill has been
announced which will begin its passage through Parliament in the next session.
The aim of the Equality Act will be to assist in making progress towards a fair
and equal society. There will be a single Act to replace the different legislation
for different equality “strands”. It is intended to make it easier for people to know
their rights and obligations.
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Appendix 8 –Engagement
List of organisations and individuals invited to inform the development of
this Scheme and priorities for action.
Organisations involved in informing the development of our Disability Equality
Scheme:
Rhayader & District PHAB
The Stroke Association
Newtown & District Dial A Ride
Montgomeryshire Community Health Council
Brecknock Access Group
Mid & West Wales ME Group
Radnor Deaf & Hard of Hearing Support Group
Visual Impairment Breconshire
Brecon & District Disabled Club
Age Concern Brecknock
Care & Repair in Powys
Link-Line Magazine
Play Montgomeryshire
Newtown Visually Impaired Club
Powys Mental Health Alliance
Brecknock & Radnor Community Health Council
Brecon Volunteer Bureau
Ystradgynlais Volunteer Centre
Brecknockshire Citizen Advocacy
Builth Wells Community Support
PAACS (Powys Autism & Asperges Carers Support)
M.S. Society, Llandrindod Wells & District Branch
Montgomeryshire Crossroads
Diabetes UK Cymru Newtown & District Voluntary Group
Ystradgynlais Carers Group
RNID Hear to Help Project (Rhayader)
Multiple Sclerosis Society
People First
Disability Powys
Powys Association of Voluntary Organisations
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Appendix 9 – Staff
Engagement Questionnaire
Powys tLHB Single Equality Scheme
Dear Colleague:
Powys Teaching Local Health Board, together with all other Public Sector
organisations, has a statutory duty to demonstrate it is meeting the
requirements of the Equality Duties contained in relevant legislation. One
of the ways in which we do this is by developing an Equality Scheme.
In recent years, and in responding to emerging legislation, this has meant
developing individual schemes relating to Race, Disability and Gender. We
have now decided that these should be combined into a Single Equality
Scheme, that will also be extended to take into account other
characteristics including age, religion/belief and sexuality.
I am writing to all staff in Powys tLHB to offer you the opportunity to
contribute to this development work; as an employee, you are one of the
key stakeholders in identifying how we can improve equality of
opportunity for current and prospective employees, and you may choose
to do so in one or more of the following ways:
1.
2.
3.
4.
Completion of staff opinion questionnaire (enclosed): this will help
to inform our priorities in developing our new Scheme;
Participation in regular meetings of the Equality Action Group;
Contribute to the establishment of, and/or participation in an
Employee Network for Staff from Under-Represented Groups;
Some other form of contribution or participation.
I sincerely hope you will embrace this opportunity to “Help Us Get It
Right”.
Yours sincerely
Marcus Adams
Director of HR and OD
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Help us get it right
In Powys we are currently developing a Single Equality
Scheme. This is about making sure people are treated fairly
and with dignity and respect. As a member of staff, we need
to know if you have experienced any barriers at work
because of any one or combination of the following:Male... Female... Married … Single… Gay… Lesbian…
Parent… Bi-Sexual… English… Welsh… Adult…
Heterosexual… Disabled… Transgender... Sensory
impaired… Non-Disabled… No Children… Caring
responsibilities… Religious Belief… Cultural
background… Spirituality… Faith… Race… Minority…
Majority… Mental Health… Learning disability… Part
time worker… Full time worker… Carer …
We need your views to help us ‘get it right!’

In relation to any of the above, in your experience, what do we
do well as an employer? Please list and explain

In relation to any of the above how we could make things better
for you? Please list and explain
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Further Contact/Involvement
1.
Employee Network for Staff From Under-Represented
Groups:
We are interested to hear from staff who are prepared to be
further actively involved with our work in this area and are
exploring the possibility of establishing a network for staff from
under-represented groups. Meetings will be arranged
depending upon interest and a commitment to attend (please
tick as appropriate).
YES (local network)
details below
YES (LHB-wide network)
details below
[
] please give your contact
[
] please give your contact
Name
Address
Email
Telephone
Number(s)
Fax
2.
Employee Engagement – Direct Contact:
If you would prefer to contribute to this engagement directly by
speaking to a member of the equality group or perhaps
attending a local focus group, we will be happy to arrange this
(depending upon numbers/interest) if you will please give your
contact details below, indicating if you have a specific area of
interest.
Name
Address
Email
Telephone
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Number(s)
Fax
Area of Specific
Interest (If any)
This part of the questionnaire can be returned to me under separate
cover to the same address:
Mike Townson, Equalities Officer, Business Services Centre,
Preswylfa, Hendy Road, Mold. CH7 1PZ or forward by return of
email by no later than Friday 28th September
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Date of Birth
Month-
Disability
Year-
Gender
Female
Male
Are you undergoing, have undergone or planning
to undergo gender reassignment?
Yes
Do you have a physical or mental health condition or other
impairment that has lasted, or is likely to last, at least 12 months; or
is of a progressive nature?
Yes
No
Prefer not to say
Please state the type of impairment which applies to you. You may
indicate more than one.
No
Prefer not to say
Mobility impairment
National Identity
Dexterity impairment
Please tick all that apply
Blind or Visually impaired
Welsh
Deaf or Hearing impaired
English
Mental health condition
Scottish
Learning/Cognitive impairment/difficulty
Northern Irish
Long-standing illness or health condition
British / Mixed British
Other impairment (please specify)
Irish
European
Religion
Other (state if desired)
Christian
Buddhist
Prefer not to say
Hindu
Racial Group
Jain
White / White British
Jew
White
Muslim
Black / Black British
Sikh
Black Caribbean
None
Black African
Other (state if desired)
Black Other
Asian / Asian British
Prefer not to say
Indian
Preferred Language
Bangladeshi
English
Pakistani
Welsh
Asian Other
British Sign Language (BSL)
Mixed / Mixed British
Other (state if desired)
Mixed White and Black Caribbean
Mixed White and Black African
Sexual Orientation
Mixed White and Asian
Heterosexual / Straight
Mixed other
Gay Man
Other / Other British
Gay Woman / Lesbian
Chinese
Bisexual
Arabian
Other (state if desired)
Gypsy / Traveller
Other (state if desired)
Prefer not to say
Prefer not to say
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Synopsis of Feedback- Staff Questionnaire
Staff Training/Awareness
Offer Welsh lessons to all staff.
I feel that managers need more training in this area (Equality and Diversity).
There are very clear inequities in respect of training opportunities for nurses.
There needs to be better training for staff in a management role, this should include matrons,
hospital facilities managers, etc
Carers
Carers seem to get a poor deal with only 3 days careers leave allowance after which annual leave
has to be used.
Workers with young children do well with Powys’ family-friendly policy. Flexibility doesn’t always
apply to those without children but who are still ‘carers’. Too much emphasis on children. What
about your older workers?
Bullying and Harassment/Dignity at Work
There is a noticeable inequality between the grades of staff in the LHB which is evident in the way
some higher graded staff treat lower grades of staff. Not only do some managers use their position
of power for a personal ego trip, the way they speak to and treat staff can very often amount to
bullying. We all have a right to be treated with dignity and respect regardless of what level we work
at within Powys LHB.
Disability
It would be fairer if sickness relating to treatment (including surgery) for a disablement was
separated from normal sickness. This is discrimination. Some public bodies recognize the
difference but the NHS in Powys does not.
My son applied for a job but didn’t even get to the interview stage. He has a hearing problem which
he stated on the application form.
Flexible Working/Flexibility/Time Off
Feel that decisions regards home working/flexible working have had focus on the person alone and
not the service or other people in that team. In my view, compromising both and undermining
equality/equity principles.
Our current departmental Flexi Policy is extremely rigid and only allows for one whole day a quarter
to be taken ie four days per year. Other departments within the BSC do not operate this rigid policy
and have a more generous arrangement and this is grossly unfair. Policies should be the same
across all departments in the BSC.
My only experience has been due to bereavement. My line manager was very understanding but
the policy should be flexible to take into consideration each case. For example, it should consider
who you have lost and in what circumstances. I understand that as an employer every eventuality
cannot be covered, but when dealing with people there are times when a more flexible approach
could be adopted as life is not always black and white and we all have a duty to care.
Change the compassionate leave arrangements. I felt the regulations didn’t represent my need. I
know this is not really a minority group issue but maybe worth raising.
You offer no retirement planning whatsoever compared with other NHS Trusts etc. Opportunity for
side-stepping as we get older, more help for those with ‘age-disability’ – still fit but not to do same
job as before. Lose a lot of talent this way!! The body may not be so active, but the mind is active.
Provide easy access to information regarding Full Time/Part Time regulations.
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Appendix 10 –
Documents/Links Referred
To In This Scheme

















Race Relations (Amendment) Act 2000
http://www.opsi.gov.uk/acts/acts2000/ukpga_20000034_en_1
Disability Discrimination Act 2005
http://www.opsi.gov.uk/acts/acts1995/ukpga_19950050_en_1
Equality Act 2006
http://www.opsi.gov.uk/acts/acts2006/ukpga_20060003_en_1
Human Rights Act 1998
http://www.opsi.gov.uk/acts/acts1998/ukpga_19980042_en_1
Equalities Review
http://archive.cabinetoffice.gov.uk/equalitiesreview/
Equal Treatment Closing the Gap: A report following the Formal
Investigation carried out by the Disability Rights Commission into
health inequalities experienced by people with mental health
problems and learning disabilities.
Count me in Census: Results of the national census of inpatients in
mental health and learning disability services in England and
Wales: http://www.countmeinonline.co.uk/
Counted In: A report for Stonewall Cymru and the Welsh Assembly
Government SME Equality Project All Wales Lesbian, Gay and
Bisexual [LGB] Surveys and Needs Assessment Reports
Children's NSF
http://www.wales.nhs.uk/sites3/home.cfm?OrgID=441
Coronary Heart Disease NSF
http://www.wales.nhs.uk/sites3/home.cfm?orgid=442
Diabetes NSF
http://www.wales.nhs.uk/sites3/home.cfm?orgid=440
Mental Health NSF
http://www.wales.nhs.uk/sites3/home.cfm?orgid=438
Older People's NSF
http://www.wales.nhs.uk/sites3/home.cfm?orgid=439
Renal NSF http://www.wales.nhs.uk/sites3/home.cfm?orgid=434
Welsh Language Act, 1993
http://www.opsi.gov.uk/ACTS/acts1993/ukpga_19930038_en_1
Policy on ‘Managing Policies, Procedures, Guidelines and Protocols
http://www.wales.nhs.uk/sites3/Documents/501/Managing%20Poli
cies%20Procedures%20Guidelines%20and%20Protocols.doc
Signpost Guidance issued from the Health Division of the Welsh
Assembly Government
http://www.wales.nhs.uk/sites3/page.cfm?orgid=719&pid=32853
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