NHS Highland Equality Outcomes
Progress Report
2013 – 2015
The following report describes the work undertaken in NHS Highland to take forward the Equality Outcomes published in 2011. It is
acknowledged that some of the outcomes set have not been achieved as hoped. Evidence to show improvement has also been
challenging in the main due to the lack of monitoring systems that would allow us to show progress in some areas via quantitative
data.
Progress has been illustrated however via qualitative feedback from staff across the organisation showing how we have progressed
over the past 2 years.
We remain committed to our long term equality outcomes but recognise that a review is needed to set achievable, realistic and
measurable shorter term outputs and actions. Included in this report therefore is information that describes our progress and a
review of the outcomes and actions required to move forward.
In order to report on progress, the original outcomes have been grouped under each of the following 6 Long Term Equality
outcomes below.
These outcomes meet the general duty by ensuring that people have access to and a positive experience of our services. They
also ensure opportunity is available for equality groups in our community to help shape & influence services and provide
opportunities for our staff to be treated fairly and consistently.
1. Health Improvement: Everyone will feel able to access screening and health improvement support
2. Access to Services: Everyone will be able to access services when they need them
3. Patient Experience: Everyone will have a positive experience of using NHS Highland services
4. Involvement: Everyone will have the opportunity to be involved in the planning, delivery and evaluation of services
5. Workforce: All staff will feel that they are treated with dignity, respect and due regard for their needs as employees
6. Community: People in Highland will feel that they live in a safe, inclusive and fairer community
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Overarching outcome(s)
Health Improvement: Everyone will feel able to access screening and health improvement support
Access to Services: Everyone will be able to access services when they need them
Shorter Term Equality Outcome 1: More lesbian women, autistic women, women with learning disabilities, and women from ethnic
minority groups will undergo routine smear testing, and have the opportunity to benefit from the same early detection rates of cervical
changes that are accessed by women who do not belong to these groups.
Relevant Protected Characteristics
Sexual Orientation, disability, race
During 2013-15
NHS Highland has disseminated information in relation to cervical smears and lesbian women via local community groups and GP
surgeries.
Women from ethnic groups and women with autism haven’t been specifically targeted over the past 2 years but are supported via
our mainstreaming actions in relation to the provision of accessible information and interpreting services.
Moving forward
The outputs set in relation to this outcome included gathering data that would allow us to understand actual uptake of Cervical
Smear services by people with learning disabilities and by sexual orientation and ethnicity, this has not been possible because the
data in relation to screening is recorded Nationally and does not capture this information. To move this forward we need to better
understand how equalities data is collected and responded to across the organisation,
Further work is required to connect with individuals and community groups who can provide feedback on cervical screening services
and any issues with access faced locally. Work is also required to assess whether this is still an area of priority.
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Shorter Term Equality Outcome 2: Men of working age will have increased opportunity for health improvement as a result of
specially targeted health improvement services
Relevant Protected Characteristics
Gender, age
During 2013-15
Keep Well - Men accessing health improvement support
The Keep Well programme is aimed at improving the health of individuals who are at higher risk of ill health. This includes those
living in socio-economically deprived communities and those in vulnerable groups such as the homeless. In the programme, eligible
individuals aged between 35 and 64 years were invited to attend a health check and / or are offered a health check during
opportunistic engagement. The health checks include screening for cardiovascular disease (CVD) and its main risk factors, such as
high blood pressure, smoking and diet as well as discussions around wider life circumstances such as employment and literacy.
Individuals were also provided with advice, and with any further monitoring or referral to services if appropriate.
An evaluation of the NHS Highland Keep Well programme has been carried out over the past eight months with the final report due
to be published by the end of April 2015. In terms of demographics, findings from the evaluation will highlight that 45% of men
accessed health checks in comparison to 55% of women.
In order to promote the service further among working aged men;
 Public health practitioners visited a construction site in Tain to deliver Keep Well health checks for the men working there. A
range of health improvement advice was given (including smoking cessation, bowel screening, and diet related advice).
 Other employers in Easter Ross (with male dominate workforces) have also been approached to promote the Keep Well
service to their staff which has had a good response.
Men’s Health Group
NHSH provide funding for a local Men’s Health Group http://www.mens-health-highland.org.uk/ and also provide health improvement
information and support at local events. For example NHSH Public Health practitioners supported the Men's Health Group at a
registration event for the University of the Highlands and Islands Campus to promote the Heath Behaviour Change message.
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Bowel Screening
In Highland the most recent figures (Nov 2011 – Nov 2013) show that male uptake of the service is 6.4% lower for men than women
(57.5% for men vs 63.9% for women). Promotion of the service across Highland will attempt to lessen this gap. It must be noted that
the target age for bowel screening is 50-74 years and these figures can not be broken down to show only working aged men. By
way of promoting the bowel screening service 643 reminders were provided as part of the Keep Well check during April 2013 –
March 2014 (we are not able to interrogate this any further to show the split between men and women receiving these reminders)
Health at every size
NHSH have a tiered approach to weight management which offers different level of intervention depending on need. In communities
we run Well Now groups which are based on the Health at Every Size philosophy, and we also offer a specialist 1:1 intervention.
Both of these approaches were piloted. In the first instance we trialled a men only Well Now group but uptake was low. In the
mainstreaming of services, all the programmes are open to both men and women and an inclusive approach is taken to ensure that
both genders feel comfortable attending. We are continuing to explore how to expand opportunities for men so they feel comfortable
accessing the programme. The team delivering the programme are also focusing their efforts on expanding the network of
facilitators to deliver the programme Highland Wide. At present there are 2 male facilitators and discussion is ongoing in relation to
whether the gender of the facilitator affects whether men will access the programme.
No.s (%) men
engaging with the
service
Well Now groups:
Pilot 2012/13
2013/14
2014/15
2 (3%)
No data captured
26 (27%)
Specialist service:
20 (29%)
23 (27%)
14 (34%)
Men’s Shed
A Men's Shed has been established in Inverness and Invergordon, and other are being established throughout Highland. The Shed
is a resource for older men to meet, take part in physical and mental activity to benefit themselves and the community, and to
interact socially. The Men’s Shed model has proven successful in engaging with older men worldwide, and there is clear evidence of
numerous health benefits. The Men’s Shed is an effective way to address isolation, mental well being, and is an ideal setting to
discuss health topics in a friendly, informal setting. No data is captured in relation to who attends so it is therefore not possible to
describe the number of men of a working age who are engaging with Men’s sheds
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The Men’s Shed in Invergordon currently meets weekly, and the catchment area includes both Alness and Invergordon. The Shed
has been running since January 2015, and we hope to expand the membership and capacity over the next year. We also have a link
with Alness and Invergordon Youth activities and aim to develop inter-generational work in the future.
The Men’s Shed project was led by the Community Health Co-ordinator (CHC), and received start-up funds from the CHC’s
discretionary budget. The CHC provides ongoing support.
Inaccuracies exist in our initial Outcomes Report in relation to promoting the Still Game programme to men of working age: the Still
Game Programme is aimed at an older age profile and thus has not been reported here
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Shorter Term Equality Outcome 3: Better Health is accessible for Gypsy Traveller people through wider uptake of health
improvement support & services
Relevant Protected
Race
Characteristics
During 2013-15
Following health and social care integration, Highland Council provides a universal health visiting service to the Gypsy Traveller site
in Inverness. NHS Highland’s Health Improvement Nurse for Vulnerable Groups has provided services, to “settled” Gypsy
Travellers living in Inverness who can attend clinics provided by the Homelessness Healthcare Team where clients can access
services from a GP and Community Psychiatric Nurse (Addictions).
In Argyll & Bute, the Nurse Co-ordinators for Homeless, Gypsy Travellers and Looked After and Accommodated Children work with
members of the Gypsy Traveller community to assess needs and ensure access to appropriate services.
Keep Well Checks
The gypsy traveller site manager meets with all families that come on to both official and unofficial sites and provides information to
all families about initiatives such as the Keep Well health checks. Despite several visits to the official site in Inverness, the offer of a
health check was not taken up by travellers. However, adhoc visits to some unofficial sites in the Highland area resulted in 11 health
checks being delivered to the Gypsy Traveller community during 2012 to 2014.
Moving Forward
At present we have limited quantitative data to inform us about levels of access to health improvement support by Gypsy Travellers.
To move this forward we need to better understand how equalities data is collected and responded to across the organisation.
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Shorter Term Equality Outcome 5: Improved sexual health amongst men and women with learning disabilities through
easier access to services and to appropriate advice about contraception and other aspects of sexual health
Relevant Protected
Disability, Gender
Characteristics
During 2013-15
Love Is
NHSH developed a programme called ‘Love Is’ that sets out guidelines for all staff in Highland supporting adults with learning
disabilities in non school settings who wish to develop personal relationships and/or to explore their sexuality. The policy is available
on the NHS Highland Intranet site.
Brook Sexual Health Clinic
Brook Highland provide sexual health and well-being services for young people under 25 living in Highland. The service includes
clinical services, counselling and health promotion activities. A contract between NHS Highland and Brook Highland specifies that
the monitoring of equalities data is required so that NHS Highland staff can begin to build an understanding of uptake of this service.
This contract is monitored quarterly and covers: gender, ethnicity, sexual orientation and disability, economic and geographical
disadvantage. Postcodes are also monitored to give an overview of uptake from areas of deprivation. During 2014-15
approximately 1% of the 1620 client visits to our clinical service were from young people with a disability.
In order to promote access to young people with learning disabilities organisations supporting this clientele are proactively targeted
in order to carry out consultation on how best they can meet their needs and to seek out opportunities to provide appropriate
services these young people. For example, the service is currently working with the Looked After Children's Lead Nurse and
Practice Lead for Health and Disability to build confidence among young people with a disability so they feel they can make
independent access to the clinic whenever they need it. Visits have been arranged when the facility is closed, in order to improve
understanding of the service offered and build relationships with staff in a safe environment.
Brook Highland also actively encourage and prioritise referrals into its grant funded education programmes (e.g. All Different, All
Beautiful) and their goal focused one-to-one My Life programme from professionals working with young people.
Monitoring data has also consistently highlighted that the majority of service users were female and thus work has been ongoing to
increase the uptake of males using the service.
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Moving Forward
At present we have limited quantitative data to inform us about levels of access to sexual health services amongst men and women
with learning disabilities Highland wide. To move this forward we need to agree how equalities data is collected and responded to
across the organisation.
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Shorter Term Equality Outcome 6: People with access support needs will experience improved access to NHS services
Relevant Protected Characteristics
During 2013-15
Disability and race
These outcomes are supported by our mainstreaming activities:
 Making our accessibility guidance document available to all staff
 Via training activities that promote equalities within each service
 Taking a person centred approach to practice
 Provision of interpreting services
Areas of good practice that relate to improving access to services include:
 Continuing to provide simplified appointment letters within our patient focused booking department so that they show only
relevant clear information
 Developing a less confusing patient flow in out patients so that patients no longer have to move from room to room, instead
health care practitioners come to them
 An Accessible Information Officer and Lead Consultant Nurse for Learning Disabilities employed to support people with
learning disabilities in practice
 A field on the referral reports (via SCI gateway) where interpreting needs and access support needs can be highlighted by the
GP when making a referral.
 From Jan 2014 – Dec 2014 5009 face to face interpretation sessions and 1055 telephone interpreting sessions were provided.
The most common languages for these were Polish, Cantonese and Latvian (face to face) and Polish, Russian and Spanish
(telephone).
 From March 2013 - April 2014 268 BSL interpreting sessions were provided for patients, and from March 2014 – April 2015
the figure was 279 NHS Highland only jobs and 157 joint Highland Council and NHS Highland jobs.
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Moving Forward
Although we can show that work is ongoing in the area of access support we have limited quantitative evidence to show how people
are individually supported within our services. To move this forward the priority set in our mainstreaming work, to develop processes
to capture and respond to accessibility data must be addressed.
The outputs set in relation to this outcome also involve gathering data to monitor access to services by particular equalities groups
including autistic people and people with learning disabilities and deaf blind people. Again this relates to the need to progress a
mainstreaming priority; to agree how we capture and respond to equalities data.
Overarching outcome(s)
Patient Experience: Everyone will have a positive experience of using NHS Highland services
Shorter Term Equality Outcome 7: People who have mental health problems will be able to access NHS services without
fear of stigma or discrimination
Relevant Protected Characteristics
During 2013-15
Disability
These outcomes are supported by our mainstreaming activities; making our accessibility guidance document available to all staff, via
training activities that promote equalities within each service and taking a person centred approach to practice.
An older adults worker from Highland User Group (HUG), a network of people who have experienced mental health problems, holds
facilitated discussion groups and 1:1 sessions to enable people to speak about their experiences of using mental health services.
HUG representatives are involved in all meetings where decisions about the service are taken. This includes the group which
shaped questionnaires circulated to all patients.
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A report: Who is least likely to attend? An analysis of outpatient appointment DNA data in NHS Highland (March 2015)
highlighted that those living in more deprived areas, males, young adults and those accessing general psychiatry outpatient services
were at greater risk of DNAs when they had an appointment. General psychiatry also had greatest ratio between appointments in
populations in the most deprived and least deprived areas of 15:1. These factors together suggest general psychiatry may be among
the largest contributors to inequity in access out of the 10 specialties we studied. These patterns have been relatively stable for the
past 10 years. Further work to examine why these particular groups are at higher risk is required. This will include work to examine
differences in the needs of these groups (e.g. different types of health problems or issues with negotiating through the health system)
and differences in the services provided for them.
http://www.healthscotland.com/uploads/documents/25050-DNA%20analysis%20NHS%20Highland.pdf
Moving Forward
Although we can show that work in ongoing in the area of supporting people with mental health problems to shape and access our
services we do not have a system to accurately monitor whether our patients experience stigma in relation to the services they
access and if so whether this is decreasing over time. This needs further review and development alongside both staff and service
users in order to prioritise activities and set appropriate outputs and actions. This again relates to the need to progress a
mainstreaming priority; to agree how we capture and respond to equalities data.
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Shorter Term Equality Outcome 8: People with visual impairments and autistic people will have a prescribing service that meets
their specific needs
Relevant Protected Characteristics
Disability
During 2013-15
The ability to respond to individual need is a requirement of professional standards for pharmacists as stated below:
1.7 Be satisfied that patients or their carers know how to use their medicines
3.3 Not unfairly discriminate against people. Make sure your views about a person’s lifestyle, religion or belief, race, gender
reassignment, identity, sex and sexual orientation, age, disability, marital status or any other factors, do not affect how you provide
your professional services
4.1 Communicate effectively with patients and the public and take reasonable steps to meet their communication needs
4.2 Work in partnership with patients and the public, their carers and other professionals to manage their treatment and care. Listen
to patients and the public and respect their choices
http://www.pharmacyregulation.org/sites/default/files/standards_of_conduct_ethics_and_performance_july_2014.pdf
Below are examples of how staff have responded to this requirement;

A Pharmacist working in Belford hospital adapted their practice by printing instructions for a particular medication in a larger
font to ensure that a patient with a visual impairment understood their medication.

In Raigmore hospital when required large print labels can be produced in our pre-packing unit. In Lorne and Isles Hospital the
lead pharmacist has a template to produce large print labels for anyone who requiring this.
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
Pharmacy in Lorne and Isles hospital worked with nursing staff, carers, occupational therapists and other care staff to support
an individual with learning difficulties. Through rationalising the medication regimen to twice daily and affixing pictures of
breakfast and evening meals to a compliance aid they identified a way to guide appropriate medication administration.

NHSH organised access to the choice and medication (C&M) website via NHS Inform. This provides information to patients,
relatives and carers about psychotropic medication at 3 levels of comprehension and in different font sizes. C&M also
signposts to other appropriate sites e.g. for people with a learning disability it signposts to the Elfreida society and Birmingham
University patient information leaflets. Access to this is via the NHSH home page.
The Scottish Inpatient Patient Experience Survey 2014 Volume 1: National Results shows overall a high satisfaction in relation to
patients’ understanding and knowledge of their medicines. This however shows the response from all respondents and can not be
broken down by equalities group.
 Patients understood what their medicines were for. (96%)
 Patients understood how and when to take their medicines. (98%
 Patients understood the possible side effects of their medicines. (84%)
Moving forward
The outputs set in relation of this outcome were not able to be measured. At present there is no formal system to identify patients
with autism or visual impairments if they present to our community pharmacy services and no standard good practice shared
between pharmacists (although the examples do show that the pharmacy staff are responding to individual need as it arises). To
move this forward the priority set in our mainstreaming work, to develop processes to capture and respond to accessibility data, must
be addressed, alongside working with the community and pharmacy teams and their patients to review and prioritise actions as
appropriate.
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Shorter Term Equality Outcome 9: People with a learning disability and autistic people will have an increased understanding of
their NHS consultation and care as interaction, communication and engagement with NHS staff is improved
Relevant Protected Characteristics
Disability
During 2013-15
Learning about patient experience
Our Consultant Nurse; Learning Disability is in the process of drafting a report on a detailed study of the experiences of 5 people with
learning disabilities stay in hospital care. The report is there to ensure the voices of people with learning disabilities are heard.This
report will inform a more structured approach to capture data, about hospital experiences of people with learning disabilities, using
the ‘Talking Mats’ format. The focus will be on elements of the patient experience questionnaires already used in our hospitals, but
that are often not accessible to people with learning disabilities. This type of format is evidence based and can be used with other
groups of the population who have communication impairments.
A survey of women’s experiences of support received during pregnancy and in the initial stages following giving birth is also currently
under review. A pilot survey has been conducted (using Talking Mats) and we are working with Health and Happiness (a local group
who support people with learning disabilities) to identify a group of women that we can work with to capture wider feedback.
The Pink Box
The ‘Pink Box’ is a communication resource that was produced 5 years ago by the NHS Highland Learning Disability team. It is an
A4 bright pink box file which contains various communication tools and information. It is aimed at staff who may be unfamiliar with
working with people with learning disabilities. The pink box has been promoted at awareness sessions run by NHS Highland’s
Learning Disabilities Liaison Nurses, and when working on wards demonstrations are given to staff in relation to how to effectively
use this resource.
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Gathering feedback about the use of the Pink Box has been difficult. A short 5 question feedback sheet was included with the box
but very little feedback was gained through these. Face to face consultation with staff on the wards allowed the team to gather the
best feedback. Overall feedback was positive and highlighted that it was also used with other patient groups who presented with
communication support needs, not just those with learning disabilities.
This feedback has lead to joint review of the ‘Pink Box’ by the Accessible Information Officer, Learning Disability Liaison Nurse,
Dementia Nurse Practitioner, Specialist Speech and Language Therapist and Clinical Lead Speech and Language Therapist for
Stroke Services. The aim is now to develop the resource so it can be used with other patients across the organisation by August
2015.
The pink box is also referenced and discussed in the Learnpro module on learning disabilities, which has been completed by 200
staff.
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Shorter Term Equality Outcome 10: Older LGB and T people in residential care and end of life care have their relationships
respected and supported by staff
Relevant Protected Characteristics
Age, Sexual orientation, Gender reassignment
During 2013-15
Prior to 2013 Care home staff were offered Equality and Diversity training and specific awareness raising sessions with the Highland
Rainbow Folk (an LGB and T group for older adults)
Care plans in residential care units now comprehensively capture data around end of life care and the resident specifies who their
preferred contact is in relation to their care, where this is the partner of a person in a same sex relationship this will be respected.
Moving forward
No data is available in relation to experiences of LGB and T communities in care homes and end of life care. Work is required to reengage with the Highland Rainbow folk to review the current outputs and gather feedback in relation to experiences of care. Where
necessary new actions will be agreed to take this work forward. This again also relates to the need to progress a mainstreaming
priority; to agree how we capture and respond to equalities data.
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Shorter Term Equality Outcome 12: People who share protected characteristics will enjoy the benefits of good
communication from NHS Highland (This output refers to corporate and day to day communication)
Relevant Protected Characteristics
During 2013-15
All
For progress please refer to mainstreaming activities; Communicating with patients and the public, and to Equality Outcome 6
above showing the range of support available to help improve access to our services (e.g through the availability of
Interpreting services).

NHSH continue to develop ways to communicate with the population they provide services for. There has been
increased use of social media via twitter and facebook. Board meetings are now streamed live and short video
messages are made available via youtube and face book.

Changes have been made to our website over the past 2 years to make it more accessible, however it is recognised
that more work is required in this area.
Moving forward
Work is still outstanding to assess whether equalities groups have benefited from our work over the past 2 years. See
outcome 11 below in relation the need for NHSH to re-build relationships with groups and people from particular equality
groups to establish a forum where equalities issues can be discussed and addressed.
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Overarching outcome(s)
Involvement: Everyone will have the opportunity to be involved in the planning, delivery and evaluation of
services
Shorter Term Equality Outcome 11: People who share a protected characteristic will be more directly involved in the planning
and delivery of NHS Highland services
Relevant Protected Characteristics
All
During 2013-15
This outcome is more generally picked up in our mainstreaming activities involving people and in the work of the specific
improvement committees.
Due to staff changes over the past year, NHS Highland has not progressed work to form a group representing people with
protected characteristics. It is also unable to gather evidence to show quantitative evidence of whether equality groups feel satisfied
with their level of involvement in the planning and delivery of mainstream services.



Moving forward
The mainstreaming focus area to help us address this outcome is as follows; to re-establish links with local diverse communities
and equalities groups to ensure we receive constant feedback about how we are progressing.
This outcome requires review once the vacant post for equalities work is filled. Consultation will be carried out to ensure that the
appropriate approach is taken to ensure people with protected characteristics have a voice and can influence our services.
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Overarching outcome(s)
Workforce: All staff will feel that they are treated with dignity, respect and due regard for their needs as
employees
Shorter Term Equality Outcome 14: LGBT staff working in NHS Highland will feel respected in the workplace, and supported at a
leadership level
Relevant Protected Characteristics
During 2013-15
Disability
Staff survey 2014
The responses within the staff survey show that staff members who have identified as heterosexual/straight (n= 2878)
give in general more positive responses to questions that relate to being treated with dignity and respect than staff members who
have identified as other sexuality (n=67, these have been grouped as low numbers do not allow us to publish data about the
specific sexual orientation identified)
When asked; does your line manager encourage you work 61% for those identified as heterosexual/straight gave a positive
response compared to 48% in the group identified as other sexuality.
For those identified as heterosexual/straight 6% compared to 14% in the group identified as other sexuality said they’d experienced
unfair treatment from their manager during the past 12 months, and 7% identified as heterosexual/straight compared to 18% in the
group identified as other sexuality experienced unfair treatment from colleagues. Of those who reported this 11% in the group
identified as other sexuality were happy with the response received vs 29% for the those identified as heterosexual/straight.
Similarly those identified as other sexuality are more likely to report experiences of managerial bullying and harassment (12% vs
9%) and bullying and harassment from colleagues (29% vs 16%)
Moving forward
This clearly highlights that we need to work more closely with LGB and T staff members to understand these responses, along with
others given in the staff survey, and take action to reduce the gap in staff experience over the coming year. This will be a priority
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for the new staff member focusing on equalities work and for the Human Resources team. Re-visiting the Affirm Network, the LGB
and T staff network is also required.
Shorter Term Equality Outcome 13: NHS staff who experience mental ill health will feel supported in the workplace by managers
who understand their specific issues
Shorter Term Equality Outcome 15: All NHS Highland employees will be treated with dignity and respect by colleagues, patients
and others
Relevant Protected Characteristics
All
During 2013-15
Staff survey
One of the largest improvements is to a question/statement of whether NHS Highland acts fairly and offers equality of opportunity
with regard to career progression/promotion. In 2014, 56% of staff had a positive perception of this statement compared to 43% in
2013, showing an overall thirteen percentage point increase between the years.
The percentage of staff saying they have experienced unfair discrimination from their manager in the last 12 months has seen a
positive change from 7% in 2013 to 6% in 2014 and from 8% to 7% in relation to unfair discrimination from other colleagues.
http://www.nhshighland.scot.nhs.uk/Meetings/BoardsMeetings/Documents/Board%20Meeting%203%20February%202015/Item%2
04.2%20NHS%20Scotland%202014%20Staff%20Survey%20-%20Nhs%20Highland%20Results.pdf
Although this is an overall improvement when results from staff who identified themselves as having a disability are looked at
(n=267) compared to those with no disability (n=2741) reports of unfair discrimination from managers is 13% compared to 5% and
from colleagues is 13% compared to 6%. In relation to the question about equality of opportunity 45% of those with a disability
compared 59% of those with no disability give a positive response.
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Progress
In order to build an environment where people with mental ill health feel supported in the workplace the revised Management of
Employee Capability Policy has been agreed and a series of raising awareness/training sessions have been delivered by NHS
Highland’s Personnel Team to NHSH Managers in respect of the main requirements of utilising this policy. A key part of the
training was to explore the responsibility of the employer in considering reasonable adjustments in the workplace to support staff
who are suffering from either a physical and or mental health problem, which is impacting upon their performance in the workplace.
This awareness raising session is being developed into a Learn-Pro module, which Managers will be able to access as part of
their learning & development to keep their knowledge/skills updated.
Support will continue to be provided to staff to allow them to continue perform in their role. This will be discussed, agreed and
documented in a supported improvement plan. Each plan is individual but the process of support will be consistent with review
dates set to monitor progress or adjust as required.
NHS Highland’s Occupational Health Service is the key to providing staff and their managers with support for psychological
concerns. This can be provided in the form of therapy, counselling, training, advice and other sources of help. The service
promotes self-help literature to support managers and staff with mental health issues. The following self-help literature and/or
guidance is available:
SHIFT... Line Managers' Resource
Glasgow STEPS
Self-help resources
Self-help leaflets
Choose Life
WellScotland
See Me Scotland
The Scottish Recovery Network (SRN)
Breathing Space
Mentally Healthy Workplace Training
Work Positive
Scotland's Mental Health First Aid Training
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A revised national PIN policy on Preventing Bullying and Harassment has been implemented and is being utilised to investigate
Dignity at Work concerns raised by staff.
A raising awareness/training programme has been developed by the Personnel Team and has been used with a number of teams
across NHS Highland to promote respect and dignity at work. These programmes are delivered in partnership with Trade Union
representatives.
Details of confidential contacts were promoted via the launch of the revised Preventing Bullying and Harassment Policy
Work is ongoing in relation to working with the Violence and Aggression team to ensure that there are consistent messages across
the agendas
Moving forward
As with the LGB and T responses this clearly highlights that work in relation to disability (inc mental ill health) is required and NHSH
need to take action to reduce the gap in staff experience over the coming year. Although work is ongoing in this area it will remain
a priority for the new staff member focusing on equalities work and for the Human Resources team. Re-visiting the EDEN
(Employee Disability Equalities Network) to review progress and re-invigorate work in this area is required.
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Shorter Term Equality Outcome 16: Recruitment, & selection processes in NHS Highland will be fair, inclusive & transparent to
everyone
Relevant Protected Characteristics
All
During 2013-15
Since 2013 a framework was developed to support Sociably Responsible Recruitment across NHS Highland. This framework
demonstrates the Board’s overall approach and engagement with partner agencies to ensure that the workforce reflects the
Highland population and that opportunities for education and employment for all groups in society are equitable and accessible.
The approaches taken are as follows:
Supported Employment, which includes working with a range of partner agencies such as Job Centre plus, Social Work,
Barnardos, Leonard Cheshire, Shaw Trust, Calman Trust and Shirlie Project. Work undertaken during 2013 -2015 is work
experience placements in 15 departments. 8 of which resulted in securing NHS Highland Employment.
Health & Social Care Career for School Pupils, which allows NHS Highland to engage with pupils at an early age and informs
them about the diversity of NHS careers. During 2013-2015 a series of exploring careers in Health events have been held. The
target audience has been S4-S6 students. Work Experience also offered to S3 students as a taster for working in a hospital
environment.
Looked after Children-Family Firm and Corporate Parenting, by working partnership with Barnardos and Aspire North NHS
Highland endeavours to provide work experience placements for looked after children with an aim of building skills and self belief to
help participants secure future employment.
Youth Employment, NHS Highland is working in partnership with local authorities in line with the public sector wide pledge to offer
an opportunity to engage with the world of work to 1 young person to every 100 employees within an organisation. Young people
from socially disadvantaged backgrounds are particularly targeted through partnership working with Job Centre Plus.
Internships, NHS Highland participates in the NHS Scotland wide Internship programme for newly registered Nurses & Midwives,
which offers a 1 year fixed term (22.5 hours per week) contract to develop practical clinical skills/work experience.
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Improve recruitment from health deprived areas of Highland, NHS Highland has endeavoured to strengthen partnership and
collective responsibility between public and private sectors to provide meaningful employment for disadvantaged groups.
Positive about Disabled People, continuing to work with Jobcentreplus and evidencing on an annual basis what has been
achieved and future plans to ensure NHS Highland can continue to use the two-tick disability symbol
Overarching outcome(s)
Community: People in Highland will feel that they live in a safe, inclusive and fairer community
Shorter Tem Equality Outcome 4: Women who experience Gender Based Violence will receive health services that meet their
needs
Relevant Protected Characteristics Gender
During 2013-15
Routine or selective enquiry of domestic abuse
Routine enquiry is in place for initial booking appointments in midwifery, and during mental health and substance misuse
assessments.
Reducing repeat victimisation and improving safety for the women at highest risk
In 2013/14 of the women accessing the Multi Agency Risk Assessment Conference (MARAC) process there were 55 women in
Highland who were repeat victims (experiencing 2 or more incidents). The figure for repeat male victims was 7. These figures will
be compared to the 2014/15 figures once published to assess any reduction in this area.
To further assess women’s perceptions of their safety a quality of life check has been developed by Women’s Aid for use before
and after any MARAC, these quality of life checks will be undertaken with women using Women’s Aid services during 2015
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Service pathway for women experiencing sexual violence
The Responding to Sexual Violence group (developed as a sub group of the Violence Against Women Partnership in March 2015)
have identified and are working on a number of issues relating to sexual violence in the Highlands including:
 Improving access to psychological therapies for survivors of sexual violence
 Holding an event which will contribute to the development of a psychological trauma pathway in the Highlands
 Improving access to sexual health and treatment through forensic services for survivors of sexual violence
 Improving police responses to reports of sexual assault
 Improving criminal justice processes
 Establishing a Sexual Assault Referral Network in Highland
 Reviewing existing policies relating to sexual violence and identifying training needs for staff
The violence against women partnership is currently made up of representatives from NHSH, THC, Police Scotland, Scottish
Prison Service, Women’s Aid, Victim Support Scotland, HADP and MARAC.
Moving forward
As yet there is no data so show whether women with other protected characteristics are more likely to report hate incidents. This
requires discussion as per our mainstreaming priority; to agree how we capture and respond to equalities data.
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Shorter Term Equality Outcome 17: The population of Highland have an increased understanding of hate incidents and of their
impact on individuals and communities.
Shorter Term Equality Outcome 18: People who experience or witness hate crimes will feel more confident to report them, and
will feel satisfied with the response received from NHS Highland
Relevant Protected Characteristics
During 2013-15
Race, Disability, Sexual Orientation, Gender Reassignment, Age
NHS Highland works alongside it’s partners to encourage the reporting of hate incidents and crimes through a range of options
including online and through local third party reporting organisations. At present the majority of hate incidents and crimes are still
reported through the police.
The most accurate information available in relation to Hate Crimes and Hate Incidents is available via the Highland Council:
Measures
While the number of hate incidents being reported to Police had risen slightly in 2013-15, the actual number of crimes and offences
involved have decreased.
Information on attitudes and awareness from the Council’s annual Public Performance survey support this outcome:
 There is increased understanding in Highland of hate incidents and of their impact on individuals and communities. In 2013,
60% of respondents were aware of impact of hate incidents compared to 71% of respondents in 2014.
The survey also provides information about prejudice, diversity and feelings of safety:
 The survey has seen a reduction in the % of adults who feel there is sometimes good reason to be prejudiced against
certain groups - 23% in 2014; 26% in 2013; 30% in 2012; 33% in 2011.
 There is a slight increase in % of adults who would prefer to live in an area with lots of different kinds of people from 46% in
2011 to 52% in 2014.
 There is a greater level of worry about being a victim of crime in general found amongst people who are disabled.
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Work going forward includes:
 Continue the work with our partners to support local third party reporting organisations
 Continue to monitor trends in reported incidents and community attitudes
 Identify new opportunities to encourage reporting of hate incidents and crimes and raise awareness of their impact amongst
relevant staff groups in NHS Highland and community groups
 Police Scotland (Highland and Islands Division) is to undertake a survey of all victims of hate crimes which may inform
partnership activity
Highland Local Police Area – Hate Incidents, Hate Crime and Gender Based Violence 2014
http://www.highland.gov.uk/download/meetings/id/67084/item_8_-_hate_incidents_hate_crime_and_gender-based_violence__update
Highland Local Police Area – Hate Incidents, Hate Crime and Gender Based Violence 2013
http://www.highland.gov.uk/download/meetings/id/16042/item_10_highland_local_police_area_%E2%80%93_
hate_incidents_hate_crime_and_gender_based_violence
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