Equality Act 2010
Compliance
Report
January 2013
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Contents
Foreword ............................................................................................................................................4
Executive Summary............................................................................................................................5
1.
Introduction ............................................................................................................................... 13
1.1
Legal framework................................................................................................................ 13
1.2
Meeting the public sector equality duty.............................................................................. 14
1.3
Report Structure ................................................................................................................ 15
1.4
Methodology...................................................................................................................... 16
1.5
About CNWL ..................................................................................................................... 16
1.6
CNWLs 4 Year Equality Objectives ................................................................................... 17
1.7
NHS Equality Delivery System .......................................................................................... 18
2.
Equalities and Diversity within CNWL ....................................................................................... 19
2.1
Board of Directors ............................................................................................................. 19
2.2
E&D Structure and processes ........................................................................................... 19
2.3
Policies and Guidance....................................................................................................... 20
2.4
Information Systems.......................................................................................................... 21
2.5
Foundation Trust ............................................................................................................... 22
2.6
Mirembe Link Project, Tanzania ........................................................................................ 23
2.7
2012 Equality Act Compliance Report Action Plan ............................................................ 24
3.
Workforce actions and initiatives to meet the Public Sector Equality Duty................................. 25
3.1
Learning and Development ............................................................................................... 25
3.2
Recruitment....................................................................................................................... 27
3.3
Staff Relations................................................................................................................... 28
3.4
Staff Support and Involvement .......................................................................................... 29
3.5
Reasonable Adjustments................................................................................................... 30
3.6
Pregnancy and Maternity................................................................................................... 30
3.7
Specific events .................................................................................................................. 31
4.
Service Delivery actions and initiatives to meet the Public Sector Equality Duty ....................... 32
4.1
Race and Ethnicity ............................................................................................................ 32
4.2
Disability............................................................................................................................ 37
4.3
Gender .............................................................................................................................. 39
4.4
Religion or Belief ............................................................................................................... 41
4.5
Sexual orientation.............................................................................................................. 44
4.6
Age.................................................................................................................................... 46
4.7
Gender Re-assignment ..................................................................................................... 47
4.8
Pregnancy and Maternity................................................................................................... 48
4.9
Marriage or Civil Partnership ............................................................................................. 49
5.
Corporate Functions.................................................................................................................. 49
5.1
Complaints and Patient Advice and Liaison Service (PALS).............................................. 49
5.2
Involving Carers ................................................................................................................ 52
5.3
Vocational Services........................................................................................................... 52
5.4
Service User Involvement.................................................................................................. 53
5.5
Recovery College and Peer Support Workers ................................................................... 54
5.6
Incident Reporting and Patient Safety ............................................................................... 55
5.7
Communications................................................................................................................ 56
5.8
Contracting........................................................................................................................ 57
5.9
Procurement...................................................................................................................... 58
5.10 Freedom of Information ..................................................................................................... 58
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CNWL NHS Foundation Trust
6.
Equality Act 2010 Compliance Report, January 2013
Next Steps ................................................................................................................................ 58
Appendix A. Workforce Profile and Survey Results.......................................................................... 59
A1
Workforce Profile............................................................................................................... 59
A2
Staff Surveys..................................................................................................................... 64
Appendix B Service User Profile and Survey Results ...................................................................... 67
B1
Service User Profile........................................................................................................... 67
B2
Service User Surveys ........................................................................................................ 70
Other languages or formats .............................................................................................................. 73
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Foreword
I am very pleased to write the Foreword to the Trust’s second Equality Act Compliance Report. I and
my Board colleagues wholeheartedly support the work that is represented in this publication.
During 2012 the Trust Board of Directors discussed at great length and agreed on a set of 5 Equality
Objectives which really do represent vitally important themes for addressing equality and diversity:
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recording demographic information and thereby creating opportunity for openness and dialogue
more community engagement events to facilitate understanding both of community need and the
services we offer
more learning and development opportunities for our staff to help and support them in responding
to the diverse needs and backgrounds of service users
reducing the violence and abuse that frontline staff in particular experience when dealing with
mentally unwell service users
improving the staff’s experience and perception of the Trust as a fair employer.
CNWL is well placed to demonstrate innovation in its responses to the equality and diversity agenda,
and we see this report as an opportunity to not simply showcase what we are doing, but also to offer
ideas for others. At the same time, we also welcome the Reports of other organisations that we, too,
may discover new ideas that can have application in the services that we deliver and in supporting
the staff who work for us.
Looking through the pages that follow I am deeply impressed by the range of initiatives that have
taken place within the Trust to meet the requirements of the Equality Act’s Public Sector Equality
Duty. That is not to say that we have the answers to all of the many challenges that arise as a
diverse employer and service provider. We are ourselves on a learning curve, engaging in dialogue
with service users, staff and specialist organisations to understand how we can improve staff and
service user experience.
As the Report shows, there have been many events taking place within CNWL over the course of the
year: our first LGBT and Health Conference, a collaboration with West London Mental Health Trust
and the Tamil Community in a conference addressing the health needs of the Tamil community, our
third Faith and Spirituality Conference, Black History Month celebrations across the Trust. Links
continue to be forged and built on across the Trust to engage with communities so that service
delivery can be more sensitive and responsive to the diverse needs of individuals. And all of this is
against a backdrop of significant organisational change and the financial challenges present within
the NHS.
The diversity of our staff was really brought home to me this year with the Olympics and Paralympics
‘coming to town’. In order to mark this occasion I suggested that we invite staff to display their
national flags in their workspaces at our headquarters offices. Little did I know the riot of colour that
would follow, transforming the office space with flags and banners some large, some small.
Everywhere were flags with staff asking colleagues where they were from when they saw flags they
did not recognise. It was a genuine celebration and expression of diversity that was greatly valued by
staff, and those visiting our offices.
So, I am pleased to see this Report published and look forward to the coming year in which, I am
sure, we will see further innovations, and during which we will continue to listen to the views and
experiences of our staff and service users in order to continue the work of improving further our
reputation as an employer and service provider that really does care.
Claire Murdoch
Chief Executive
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Executive Summary
This is the Trust’s second Equality Act Compliance Report. In this Report we present data and set
out actions that have been and are being taken to ensure that the Trust is fulfilling the Public Sector
Equality Duty of the Equality Act 2010 since the last Report. The public sector equality duty, states
that a public authority must, in the exercise of its functions, have due regard to the need to—
(a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited
by or under this Act;
(b) advance equality of opportunity between persons who share a relevant protected
characteristic and persons who do not share it;
(c) foster good relations between persons who share a relevant protected characteristic and
persons who do not share it.
The Equality Act 2010 (Specific Duties) Regulations 2011 require the Trust to publish information to
demonstrate compliance with the duty imposed by section 149(1) of the Equality Act 2010 not later
than 31st January 2012, and subsequently at intervals of not greater than one year beginning with
the date of last publication.
This year’s report follows the same structure as last years with an Introduction, 5 sections plus 2
Appendices. First there is a section describing Equalities and Diversity structures with CNWL. This is
followed by two sections providing detailed descriptions of actions and initiatives being taken within
the Trust to further the aims of the public sector equality duty. There then follows a section describing
actions and initiatives within particular functions of the Trust. This is followed by a Next Steps section
which incorporates an Action Plan for the next 12 months. Appendix A contains a summary of
Workforce Equalities Demographics and Staff Survey results. Appendix B contains a summary of
Service User Equalities Demographics and Service User Survey results.
Again, we have not structured this Report around the three requirements of Public Sector Equality
Duty. Many of the actions described in this report reach across the duty to have due regard to
eliminate discrimination, harassment and victimisation…, advance equality of opportunity…, and
promote good relation between different groups…. We believe that presenting the evidence
contained within this report in the way that we have will make it more readable and accessible to the
public. However, we have included within the Executive Summary and the Introduction a headline
summary of some of the actions and initiatives reported on under the three key requirements of the
Duty.
From the findings of the Report it is clear that there is a wealth of actions and initiatives taking place
within the Trust to meet the public sector equality duty and that areas that continue to need
addressing are largely being addressed via the 4-year Equality Objectives that the Trust put in place
in April 2012: Improving staff understanding and sensitivity through training and community
engagement, improving data collection for service user equality demographics, improving staff
experience of the Trust through targeted staff development initiatives and tackling staff experience of
violence and abuse.
About CNWL
Central and North West London NHS Foundation Trust is one of the largest health service providers
in London with over 5,000 employees serving more than 100 sites and services. It serves a highly
diverse population of 2.5 million across a total of eight boroughs. Within the organisation’s catchment
area are some of the most affluent, and some of the most deprived, areas in London. It is also an
area having particular diversity features:
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Brent – the most ethnically diverse local authority in the country.*
Camden –has the highest rate of alcohol-related hospital admissions in London at 462 per
100,000 people.*
Ealing – home to the largest Sikh community in London and is home to Sri Guru Singh Sabha
Gurdwara, the largest Sikh temple outside India.*
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CNWL NHS Foundation Trust
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Equality Act 2010 Compliance Report, January 2013
Enfield – Just over half of all children in the Borough live in low income families.*
Hammersmith and Fulham – large Polish and Irish communities.
Harrow – The most religiously diverse Borough within London * as well as being home to the
largest Afghani community in the UK.
Hillingdon – Migrant populations entering our catchment area via Heathrow and a significant
Traveller community.
Islington – the second highest number of lone-parent families in England and Wales (at 45%)*
Kensington & Chelsea – A large, well established, Arabic-speaking population of various
national origins. Most marked health inequalities than anywhere else in the UK when comparing
life expectancy of the richest and the poorest.
Westminster – the highest proportion of Buddhist residents in the country*, and the centre of the
UK Chinese Community in Soho.
Students from all over the world attending London universities.
A significant Lesbian, Gay, Bisexual and Transgender population that is attracted to central
London from across the UK.
A high number of foreign nationals within the Offender Care System.
* Facts taken from London Councils – Ten Interesting Things about London Boroughs 2009
The Trust provides in-patient and community Adult and Older Adult Mental Health, CAMHS,
Addictions and Learning Disability services, Community Health Services within the London Borough’s
of Camden and Hillingdon, eating disorder services, a Forced Migration Trauma Service, and mental
health and substance misuse services within prisons.
Methodology
This Report will make reference to other Trust publications:
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CNWL Equality and Diversity Workforce Monitoring Report 2011/121, which provides detailed
data and analysis of our workforce and areas of employment practice by equality characteristic.
CNWL Equality and Diversity Service Delivery Monitoring Report 2011/122, which provides
detailed data and analysis of our services by equality characteristic.
In addition, the Trust’s previous Equality Act Compliance Report January 20123 report gives added
evidence of CNWL’s track-record in addressing equality and diversity issues and in developing
initiatives to eliminate discrimination and harassment, advance equality and promote good relations
between diverse groups.
As well as gathering data from the above reports and surveys, data and evidence has also been
obtained through discussions with key senior staff responsible for Trust functions, and utilising a
questionnaire to create an audit trail for the data and information identified.
Equalities and Diversity Structures
Equalities and Diversity is represented at Board level by the Director of Operations and Partnerships
(who also chairs the Trust’s Corporate Equalities and Diversity Group), and the Trust’s Director of
Human Resources. Both have Executive lead responsibility for Equalities and Diversity.
Equalities and Diversity is regularly addressed at Board meetings and E&D considerations are taken
account of in Board decision-making. During 2012, E&D Reports and Papers were presented to the
Trust’s Board of Director’s meetings in: January (Equality Act Compliance Report 2012), March (4Year Equality Objectives) and September 2012 (Equalities and Diversity Workforce Monitoring
Report 2011/12).
1
CNWL Equality and Diversity Workforce Monitoring Report 2011/12 http://www.cnwl.nhs.uk/aboutcnwl/equality-and-diversity/documents/
2
CNWL Equality and Diversity Service Delivery Monitoring Report 2011/12 http://www.cnwl.nhs.uk/aboutcnwl/equality-and-diversity/documents/
3
CNWL Equality Act Compliance Report January 2012. http://www.cnwl.nhs.uk/about-cnwl/equality-anddiversity/documents/
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Policies and Guidance
The Trust has a number of equalities related policies which provide a governance framework to
ensure that staff actions address the equalities and diversity agenda in a positive way, whilst making
clear which behaviours are unacceptable to the Trust. During 2012 all Equality and Diversity specific
policies within the Trust have been reviewed and further updates made as necessary.
The Trust’s Equality, Diversity and Human Rights Policy (Employment) and Equality, Diversity
and Human Rights Policy (Service Delivery) both include explicit reference to all nine protected
characteristics and state that:
Managers and staff therefore have a joint responsibility to ensure that in the course of their
employment no employee, or job applicant is discriminated against, or harassed in relation to
any of the ‘protected characteristics’ as defined by the Equality Act 2010, or social
background, HIV status, trade union membership or non-membership, political affiliation,
domestic circumstances or employment status.
Managers and staff have a joint responsibility in the course of their work to protect service
users from being discriminated against in relation to a ‘protected characteristics’ as defined by
the Equality Act 2010; or their social background, HIV status, trade union membership or nonmembership, political affiliation, domestic circumstances or employment status.
The Trust has also produced a number of Equalities and Diversity Related Guidance documents to
support policy implementation.
During 2011/12 the following policies have been revised and updated:
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Equality, Diversity and Human Rights Policy (Employment)
Equality, Diversity and Human Rights Policy (Service Delivery)
Disability Policy Employment)
Disability Policy (Service Delivery)
Transgender Policy
Interpreting Policy
Workforce and Service user profiles and surveys
Staff demographics
Within CNWL as at 31st March 2012 the Trust employed 5159 staff.
Compared to the population served the Trust has most notably higher percentages of staff having
Black African ethnicity, and most notably lower percentages of staff having White British, White Other
and Indian ethnicities. White staff more concentrated generally in bands 7 and above, staff from other
ethnic grouping more likely to be in lower bands, most noticeably Black staff.
The highest proportion of staff are between 41 and 50 years of age and the lowest over 60. The age
group that is most represented at senior levels is the 41-50 year old group, an age group that is also
the most represented at the lowest seniority bandings 1-4.
Just over a quarter of staff are male and just under ¾ are female. The male to female ratio is broadly
similar across pay band groupings, although there is a slightly lower proportion of female staff at
higher grades and a slightly higher proportion of male staff at lower grades. The greatest variance is
at band 4 in terms of the highest proportion of female to male staff, and the lowest is at band 8d.
Only 2% of staff have declared a disability although 65% have not defined a disability status. There is
a reduction in the proportion of staff declaring having a disability at higher pay bands.
The highest proportion of staff are heterosexual. About 2% of staff have disclosed being lesbian, gay
or bisexual, however data is affected by 36% sexual orientation not defined and 10% of staff
choosing not to disclose. The highest proportion of staff at all levels of seniority are heterosexual,
however the % of gay staff increases with seniority. Data is affected by the high proportion of sexual
orientation being undefined.
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Equality Act 2010 Compliance Report, January 2013
Just over a third of staff are Christian but a further third have not disclosed a religion or belief. The
next highest group is Atheist (6%). In terms of seniority, the data is affected by about 1/3 undefined.
Whilst Christians are the highest group at senior levels, Atheists have the most noticeable positive
variance between lower and higher grades.
Staff Surveys
From the CNWL Staff Survey 2011:
In the last 12 months, 14% of respondents indicated experiencing discrimination at work from service
users, carers or members of the public (a slight increase from 13% in 2010). 7% of respondents
indicated experiencing discrimination at work from a manager/team leader or work colleagues (a
noticeable decrease from 13% in 2010. Of the 76 staff survey respondents reporting experiencing
discrimination:
• 61% (46) indicated that this was race-related (an increase from 57% in 2010).
• 17% indicated that this was gender-related (a decrease from 18% in 2010)
• 7% indicated that this was related to religion (an increase from 5% in 2010)
• 11% indicated that this was related to sexual orientation (an increase from 9% in 2010)
• 3% indicated that this was related to disability (no change from 2010)
• 9% indicated that this was related to age (no change from 2010)
More information is available Appendix A
Service User Demographics
Within CNWL the main area of service delivery is adult mental health services.
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Within in-patient services Trust-wide there is under-representation of service users having
White British and Indian ethnicity, and an over-representation of service users having Black
ethnicities and service users having Other Ethnic Group ethnicity4.
Within community mental health services service users having White British and Indian
ethnicity are under-represented. The most significant over-representation is of service users
within the Other Ethnic Group ethnicity.
Within other services there is no consistent pattern of over or under-representation except for White
British and Indian ethnic groups which feature most as being under-represented. Data for community
health services in Hillingdon is unfortunately affected by high ethnicity not known rates which is being
addressed. Within Camden community health services there is no notable over-representation and
under-representation of Black African, Bangladeshi and White Other service users.
In terms of the Trust’s use of the Mental Health Act, service users having a Black or Other Ethnic
Group ethnicity are over-represented amongst section 2, 3 and 136, and Supervised Community
Treatment. White British and Indian service users are under-represented.
The Trust’s low recording rate for service users means disability data remains an issue with 95%
disability not recorded, and it is therefore not possible to draw meaningful conclusions. Addressing
this low recording rate is targeted within the Trust’s 4-year Equality Objectives.
There is a higher proportion of female service users compared to male within the Trust community
mental health, older adults mental health, CAMHS, Eating Disorders and community health services.
In other service areas there is a higher proportion of male service users.
Within adult mental health services and Addictions in-patient services the highest proportion of
service users by age band are 40-49 years. In other service areas service users within age bad
4
The over-representation of service users within the Other Ethnic group category is likely to be in part due to
increased numbers of people within this category entering the UK since the 2001 census, and within this group
there is an increasing number of people identifying as Arab (from the Middle East and North Africa). The Trust
has an Arabic-speaking CAMHS service. Prayer times and Ramadan information is publicised and prayer
rooms and access to faith support is provided although there is some inconsistency in provision in some areas
of the Trust which is being addressed.
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
under 30 years are the highest. Across community health services the age of service users is vey
much governed by the services being offered, many of which will be age specific, hence a high
proportion of service users will be children and young people. And for adult services the proportion of
service users tends to increase with age.
Across the Trust the most represented faith is Christian, with Not–religious, Other Religion and
Muslim most consistently next highest across services. The Trust is also targeting improving its
recording rate which is included within the Trust’s 4-year Equality Objectives.
Across the Trust the highest % of staff are heterosexual with up to 5% of staff identifying as lesbian
gay or bisexual (varying % across services). However, data is affected by the recording rate,
particularly as some areas have not historically collected this data. Addressing this low recording
rate is targeted within the Trust’s 4-year Equality Objectives.
Service User Surveys
Data is not available for analysis by equalities characteristic in all surveys. We have therefore only
been able to include data where it is recorded.
Community Mental Health Service User Survey 2012
The Community Mental Health Service User Survey 2012 showed that across all questions:
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service users having Black ethnicity had the highest number of highest satisfaction scores,
followed by Asian and Other ethnicities. White service users had the lowest number of highest
satisfaction scores.
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women had more higher satisfaction scores than men, a reversal from the previous year. There
was an overall increase in satisfaction scores for both men and women. In terms of service users
reporting being treated with dignity and respect by the last professional they saw, 84% of female
service users responded’ yes, definitely’ compared to 79% of male service users. For both
genders this was a slight fall from the previous year.
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service users identifying as Other Religion and Muslim had more highest satisfaction scores for
services. Service Users identifying as Christian or No Religion had the lowest number of highest
satisfaction scores compared to the other religion or belief categories.
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service users preferring not to disclose their Sexual Orientation had more highest satisfaction
scores for services; service Users identifying as Lesbian, Gay or Bisexual had the lowest number
of highest satisfaction scores.
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service users with age band 25-45 had more highest satisfaction scores for services; service
Users with age band 55-64 had the lowest number of highest satisfaction scores compared to the
other religion or belief categories.
Community Mental Health Service User Survey 2012 did not include a question with regard to the
service users disability status.
Inpatient Mental Health and AddictionsTelephone Surveys 2012
The Trust has introduced routine telephone surveys of service users, focusing on priority areas that
have been identified from previous survey results. The areas of focus and the combined results for
quarters 2 and 3 in 2012/13 are summarised in the table below.
Question
Q1 While you were in hospital recently did you
have as much say as you wanted in decisions
about your care and treatment
Q2 Did you feel safe during your most recent stay
in hospital?
Q3 Prior to your discharge from hospital were
you given a telephone number and details of who
Ethnicity
Gender
Age
Ethnicity
Gender
Age
Ethnicity
Gender
9
highest levels of
satisfaction/
positive responses
Asian
Male
18-25
Asian and Other
Male
51-65
White
Female
lowest levels of
satisfaction/
positive responses
Black
Female
66+
Black
Female
26-35
Black
Male
CNWL NHS Foundation Trust
to contact in an emergency or crisis?
Q4. Prior to your discharge did you have
discussion with ward staff about your follow up in
the community?
Q5 Overall how would rate the care and treatment you have received in hospital Did you feel
safe during your most recent stay in hospital?
Equality Act 2010 Compliance Report, January 2013
Age
Ethnicity
Gender
Age
Ethnicity
Gender
Age
66+
Asian
Female
51-65 and 66+
Asian
Male
51-65
18-25
Black
Male
36-50
Black
Female
26-35
Inpatient Survey conducted by Advocacy for Mental Health
In 2012 a service user survey was also undertaken by Advocacy for Mental Health at two inpatient
mental health sites. This drew the Trust’s attention to issues concerning the experience of: physically
and learning disabled service users; lesbian, gay, bisexual and transgender service users, language,
literacy and culture. In response an action plan has been formulated and actions are being taken to
improve service user experience in the identified areas of concern (See Appendix B). The Trust is
grateful to Advocacy for Mental Health in undertaking this survey so that targeted improvements can
be made to services.
Hillingdon Community Health
Patient Satisfaction Surveys have been carried out in 2012 - Complex Wound Clinic, Speech and
Language Therapy, Health Visiting Service. Whilst these surveys present positive levels of
satisfaction, there has not been an analysis by equalities characteristics to identify any areas of
disparity. Including diversity monitoring within surveys will be discussed in 2013 to ensure this data is
available.
Camden Provider Services
Following organisational changes, the process and content of service user surveys is currently under
review to establish systems for implementation during 2013. Equalities and diversity requirements will
be part of this process. This will, therefore, result in the Trust being in a better position to report on
service user experiences within next year's report.
Examples of actions to meet the public sector equality duty
The following is a summary of some of the actions that have been or are being taken to address the
public sector equality duty. Further detail and more examples are included within the full report.
Due regard to the need to eliminate discrimination, harassment, victimisation and any other conduct
that is prohibited by or under this Act;
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Race Relations Advisors have been trained during the course of the year and are now
actively providing support and mediation for staff experiencing discrimination or harassment.
The Trust’s Staff Lesbian, Gay, Bisexual and Transgender Support Network continues to
develop and an Advice, Information and Support Service for LGB&T staff has been launched.
Cultural Competency for Managers training is provided and a Cultural Competency for
Managers Forum is held to discuss and identify good practice, both in terms of staff
management and service delivery.
The Trust’s Transgender Policy, developed in consultation with trans organisations and staff,
is used to manage staff and service users undertaking transition.
A new poster entitled ‘Our Commitment to Equalities and Diversity’ was distributed to all sites
and services early in 2012. This communicates the Trust’s commitment to equality across all
protected characteristics, commitment to the public sector equality duty, and zero tolerance
towards racist, homophobic, transphobic and other form of abuse.
A staff survey has been developed for completion in 2013 to drill down to a deeper
understanding of experiences of discrimination, harassment and violence towards staff
The 2011 Staff Survey showed a reduction in staff reporting personally experiencing
discrimination at work from manager / team leader or other colleagues from 13% to 7%
compared to the previous year.
The Trust has a clear Maternity Leave Policy which includes paternity.
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Equality Act 2010 Compliance Report, January 2013
Over 9,000 face-to-face interpreting sessions we provided during 2011/12. Training provided
in Working with Interpreters. Interpeting Policy revised and updated in 2012. The Trust is
currently developing a CNWL-wide interpreting service, following the merger with Camden
Provider Service which has it’s own interpreting service.
Hillingdon Community Health’s dedicated Health Visitor team run a Community Engagement
Programme across Hillingdon, incorporating the health needs of homeless people and other
marginalised communities, including Travellers and Gypsies.
Due regard to the need to advance equality of opportunity between persons who share a relevant
protected characteristic and persons who do not share it;
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The Trust has a Network of Equalities and Diversity leads across the Trust who champion and
co-ordinate local initiatives and action planning.
A Community Engagement Conference was held in Ealing with the Tamil community and
West London Mental Health Trust in 2012 attracting involvement from the Tamil community
from a number of London Borough’s. The Report was publicised to all CNWL staff.
Reasonable adjustments are made routinely for disabled staff with liaison with the Trust’s
Occupational Health Service as appropriate.
In April 2012 the Board of Directors agreed five 4 Year Equality Objectives5, linked to the
Trust’s Strategic Objectives.
The Trust participated in Stonewall’s Workplace Equality Index 2013. Stonewall posters are
being displayed at Trust sites with the CNWL logo.
Flexible working arrangements are made for staff returning from maternity leave.
In 2012, the Trust produced full reports on staffing and service users by ethnicity, disability,
gender, religion or belief, sexual orientation and age.
The Trust’s Recruitment Interviews: Guidance on inquiring about Cultural Competency and
understanding of Equality and Diversity provides managers involved in recruitment with
information and good-practice ideas to support interview processes and recruitment decisionmaking.
A Learning Disability Resource Pack for working with people having a learning disability has
been developed and distributed within Hillingdon Community Health to sites and services.
The Trust’s Occupational Therapy services run an extensive range of support groups to
respond to cultural, gender and other related needs, for instance: Asian Women’s Group,
ESOL Classes, Cultural Awareness Group.
Camden Sexual Health Service co-ordinates the ‘Habari’ Project, which provides a first point
of contact with African people. Participants or provided with opportunities to learn about
sexual health and how to access services.
Due regard to the need to foster good relations between persons who share a relevant protected
characteristic and persons who do not share it.
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Multi-faith support for in-patients includes Chaplaincy, faith visiting and faith celebrations
which are open to all staff and service users.
During LGBT History Month 2012, the Trust held its first conference addressing
understanding and responding to the needs of Lesbian, Gay, Bisexual and Transgender
patients, service users and carers.
A Celebrating Diversity event was held at Trust HQ during Black History Month and
celebrations were also held in different areas of the Trust.
The Trust’s User Employment Programme enables and supports service users having a
disabling mental health condition to gain work experience.
5
CNWL Equality Objectives: April 2012 to March 2016. http://www.cnwl.nhs.uk/about-cnwl/equality-anddiversity/documents/
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Equality Act 2010 Compliance Report, January 2013
Community engagement events organised by the Trust foster understanding of the disabling
effects of mental illness, having a learning disability, or the physical and psychological impact
of substance misuse, and thereby promote greater community support.
An extensive Equalities and Diversity section on Trustnet provides accessible information
about all protected characteristics and the Trust publishes a quarterly newsletter, Inclusion
News.
Service users from the Trust’s Learning Disability Service attend external sessions which
helps service users gain confidence in using external services independently. This creates
opportunities to ‘normalise’ such activities in the broader community with the local population,
thus helping to foster good relationships and understanding.
Next steps
Having been approved by the Trust’s Board of Directors, this Report will be circulated to all Service
Directors, Human Resources Managers and other senior managers. It will also be publicised to
external stakeholders and partners. We are not including a specific action plan within this Report as
the Trust’s Equalities and Diversity priorities are identified within the Trust’s 4-year Equality
Objectives, and progress will be reported in during April or May 2013 for the first year of the Equality
Objectives.
Major areas of on-going work will include:
•
•
•
•
•
•
•
•
Improving data collection rates for staff and service user disability, religion or belief and sexual
orientation
Training development and delivery to include: LGB&T awareness, migrants and refugees
awareness, faith and spirituality awareness
Strengthening the Equality and Diversity Leads Network within the Trust to cater for major
organisational changes
Extending Chaplaincy and Faith Visiting further across Trust services
On-going community engagement work, in particular, a focus on working with the Tamil
community to develop greater community support and counseling
Actions to be identified from a staff survey to address violence, harassment and discrimination
towards staff from service users, carers and the public
Organising a second LGB&T and Health Conference
Continued support for, and development of, Staff Networks. This will create greater opportunities
for staff to contribute their knowledge and experience to developments within the Trust.
_______________________________________
12
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
CNWL Equality Act Compliance Report 2010
1.
Introduction
This is the Trust’s second Equality Act Compliance report. In this Report we present data and set out
actions that have been and are being taken since the last Report in January 2012 to ensure that the
Trust is fulfilling the Public Sector Equality Duty of the Equality Act 2010 Act.
1.1
Legal framework
The Equality Act 2010 (Specific Duties) Regulations 2011 require the Trust to publish information to
demonstrate compliance with the duty imposed by section 149(1) of the Equality Act 2010 not later
than 31st January 2012, and subsequently at intervals of not greater than one year beginning with
the date of last publication. The Regulations further require that the information a public authority
publishes must include, in particular, information relating to persons who share a relevant protected
characteristic who are, (a) its employees; (b) other persons affected by its policies and practices. The
publication of information is required to be in such a manner that the information is accessible to the
public. The information can be published within another document.
The duty imposed by section 149(1) of the Equality Act 2010 is the Public Sector Equality Duty
(1) A public authority must, in the exercise of its functions, have due regard to the need to—
(a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited
by or under this Act;
(b) advance equality of opportunity between persons who share a relevant protected
characteristic and persons who do not share it;
(c) foster good relations between persons who share a relevant protected characteristic and
persons who do not share it.
Further sections of the Act then clarify the meaning of this duty and where it applies:6
6
(2) A person who is not a public authority but who exercises public functions must, in the exercise of those
functions, have due regard to the matters mentioned in subsection (1).
(3) Having due regard to the need to advance equality of opportunity between persons who share a
relevant protected characteristic and persons who do not share it involves having due regard, in particular,
to the need to—
(a) remove or minimise disadvantages suffered by persons who share a relevant protected
characteristic that are connected to that characteristic;
(b) take steps to meet the needs of persons who share a relevant protected characteristic that are
different from the needs of persons who do not share it;
(c) encourage persons who share a relevant protected characteristic to participate in public life or in
any other activity in which participation by such persons is disproportionately low.
(4) The steps involved in meeting the needs of disabled persons that are different from the needs of
persons who are not disabled include, in particular, steps to take account of disabled persons’ disabilities.
(5) Having due regard to the need to foster good relations between persons who share a relevant protected
characteristic and persons who do not share it involves having due regard, in particular, to the need to—
(a) tackle prejudice, and
(b) promote understanding.
(6) Compliance with the duties in this section may involve treating some persons more favourably than
others; but that is not to be taken as permitting conduct that would otherwise be prohibited by or under this
Act.
(7) The relevant protected characteristics are—age, disability, gender reassignment, pregnancy and
maternity, race, religion or belief, sex, sexual orientation.
13
CNWL NHS Foundation Trust
1.2
Equality Act 2010 Compliance Report, January 2013
Meeting the public sector equality duty
The following section provides an overview of some of the ways in which CNWL complies with the
Public Sector Equality Duty. More comprehensive information is contained within sections 3 and 4 of
the Report. It should also be noted that within Equality and Human Rights Impact Assessment
processes there is a requirement to document how the subject of the assessment contributes to the
Duty.
From the findings of the Report it is clear that there is a wealth of actions and initiatives taking place
within the Trust to meet the public sector equality duty and that areas that continue to need
addressing are largely being addressed via the 4-year Equality Objectives that the Trust put in place
in April 2012: Improving staff understanding and sensitivity through training and community
engagement, improving data collection for service user equality demographics, improving staff
experience of the Trust through targeted staff development initiatives and tackling staff experience of
violence and abuse.
Due regard to the need to eliminate discrimination, harassment, victimisation and any other conduct
that is prohibited by or under this Act
1. Race Relations Advisors have been trained during the course of the year and are now
actively providing support and mediation for staff experiencing discrimination or harassment.
2. The Trust’s Staff Lesbian, Gay, Bisexual and Transgender Support Network continues to
develop and an Advice, Information and Support Service for LGB&T staff has been launched.
3. Cultural Competency for Managers training is provided and a Cultural Competency for
Managers Forum is held to discuss and identify good practice, both in terms of staff
management and service delivery.
4. The Trust’s Transgender Policy, developed in consultation with trans organisations and staff,
is used to manage staff and service users undertaking transition.
5. A new poster entitled ‘Our Commitment to Equalities and Diversity’ was distributed to all sites
and services early in 2012. This communicates the Trust’s commitment to equality across all
protected characteristics, commitment to the public sector equality duty, and zero tolerance
towards racist, homophobic, transphobic and other form of abuse.
6. A staff survey has been developed for completion in 2013 to drill down to a deeper
understanding of experiences of discrimination, harassment and violence towards staff
7. The 2011 Staff Survey showed a reduction in staff reporting personally experiencing
discrimination at work from manager / team leader or other colleagues from 13% to 7%
compared to the previous year.
8. The Trust has a clear Maternity Leave Policy which includes paternity.
9. Over 9,000 face-to-face interpreting sessions we provided during 2011/12. Training provided
in Working with Interpreters. Interpeting Policy revised and updated in 2012. The Trust is
currently developing a CNWL-wide interpreting service, following the merger with Camden
Provider Service which has it’s own interpreting service.
10. Hillingdon Community Health’s dedicated Health Visitor team run a Community Engagement
Programme across Hillingdon, incorporating the health needs of homeless people and other
marginalised communities, including Travellers and Gypsies.
Due regard to the need to advance equality of opportunity between persons who share a relevant
protected characteristic and persons who do not share it;
1. The Trust has a Network of Equalities and Diversity leads across the Trust who champion and
co-ordinate local initiatives and action planning.
2. A Community Engagement Conference was held in Ealing with the Tamil community and
West London Mental Health Trust in 2012 attracting involvement from the Tamil community
from a number of London Borough’s. The Report was publicised to all CNWL staff.
14
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
3. Reasonable adjustments are made routinely for disabled staff with liaison with the Trust’s
Occupational Health Service as appropriate.
4. In April 2012 the Board of Directors agreed five 4 Year Equality Objectives7, linked to the
Trust’s Strategic Objectives.
5. The Trust participated in Stonewall’s Workplace Equality Index 2013. Stonewall posters are
being displayed at Trust sites with the CNWL logo.
6. Flexible working arrangements are made for staff returning from maternity leave.
7. In 2012, the Trust produced full reports on staffing and service users by ethnicity, disability,
gender, religion or belief, sexual orientation and age.
8. The Trust’s Recruitment Interviews: Guidance on inquiring about Cultural Competency and
understanding of Equality and Diversity provides managers involved in recruitment with
information and good-practice ideas to support interview processes and recruitment decisionmaking.
9. A Learning Disability Resource Pack for working with people having a learning disability has
been developed and distributed within Hillingdon Community Health to sites and services.
10. The Trust’s Occupational Therapy services run an extensive range of support groups to
respond to cultural, gender and other related needs, for instance: Asian Women’s Group,
ESOL Classes, Cultural Awareness Group.
11. Camden Sexual Health Service co-ordinates the ‘Habari’ Project, which provides a first point
of contact with African people. Participants or provided with opportunities to learn about
sexual health and how to access services.
Due regard to the need to foster good relations between persons who share a relevant protected
characteristic and persons who do not share it.
1. Multi-faith support for in-patients includes Chaplaincy, faith visiting and faith celebrations
which are open to all staff and service users.
2. During LGBT History Month 2012, the Trust held its first conference addressing
understanding and responding to the needs of Lesbian, Gay, Bisexual and Transgender
patients, service users and carers.
3. A Celebrating Diversity event was held at Trust HQ during Black History Month and
celebrations were also held in different areas of the Trust.
4. The Trust’s User Employment Programme enables and supports service users having a
disabling mental health condition to gain work experience.
5. Community engagement events organised by the Trust foster understanding of the disabling
effects of mental illness, having a learning disability, or the physical and psychological impact
of substance misuse, and thereby promote greater community support.
6. An extensive Equalities and Diversity section on Trustnet provides accessible information
about all protected characteristics and the Trust publishes a quarterly newsletter, Inclusion
News.
7. Service users from the Trust’s Learning Disability Service attend external sessions which
helps service users gain confidence in using external services independently. This creates
opportunities to ‘normalise’ such activities in the broader community with the local population,
thus helping to foster good relationships and understanding.
1.3
Report Structure
This year’s report follows the same structure as last years with an Introduction, 5 sections plus 2
Appendices. First there is a section describing Equalities and Diversity structures with CNWL. This is
followed by two sections providing detailed descriptions of actions and initiatives being taken within
the Trust to further the aims of the public sector equality duty. There then follows a section describing
actions and initiatives within particular functions of the Trust. This is followed by a Next Steps section.
Appendix A contains a summary of Workforce Equalities Demographics and Staff Survey results.
7
CNWL Equality Objectives: April 2012 to March 2016. http://www.cnwl.nhs.uk/about-cnwl/equality-anddiversity/documents/
15
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Appendix B contains a summary of Service User Equalities Demographics and Service User Survey
results.
We have not structured this Report around the 3 ‘legs’ of the public sector equality duty. Many of the
actions described in this report reach across the duty to have due regard to eliminate discrimination,
harassment and victimisation…, advance equality of opportunity…, and promote good relation
between different groups…. We believe that presenting the evidence contained within this report in
the way that we have will make it more readable and accessible to the public.
The intention is not to provide an overwhelming amount of data and detail, but rather to provide
specific evidence that reflects the commitment and achievements the Trust has towards not only
complying with the Equality Act but to more widely respond positively and inclusively to the equalities
and diversity agenda.
Whilst the many initiatives that have taken and are taking place to eliminate discrimination,
harassment and victimisation, advance equality of opportunity and foster good relations, these are
only as good as what is practiced in front line services. It is staff and service user experience that is
the true litmus test of compliance, supported by service user access to services and staff profile data.
Bearing this in mind, reference is made in this report to the results of staff and service user surveys
as well as monitoring data of staff and service users. Not all of the data available can be included as
there is simply too much, but certain key areas are highlighted and more information is then made
available in other reports and papers and will be cited accordingly.
1.4
Methodology
This Report will make reference to other Trust publications:
•
•
CNWL Equality and Diversity Workforce Monitoring Report 2011/128, which provides detailed
data and analysis of our workforce and areas of employment practice by equality
characteristic.
CNWL Equality and Diversity Service Delivery Monitoring Report 2011/12 9, which provides
detailed data and analysis of our services by equality characteristic.
In addition. the Trust’s previous Equality Act Compliance Report January 201210 gives added
evidence of CNWL’s track-record in addressing equality and diversity issues and in developing
initiatives to eliminate discrimination and harassment, advance equality and promote good relations
between diverse groups. This Report builds on the work done in the past and, where possible, we
have sought to not repeat what we included in last year’s report.
As well as gathering data from the above reports and surveys, data and evidence has also been
obtained through discussions with key senior staff responsible for Trust functions, and utilising a
questionnaire to create an audit trail for the data and information identified.
1.5
About CNWL
Central and North West London NHS Foundation Trust is one of the largest health service providers
in London with over 5,000 employees serving more than 100 sites and services. It serves a highly
diverse population of 2.5 million across a total of eight boroughs. Within the Trust’s catchment area
are some of the most affluent, and some of the most deprived, areas in London. It is also an area
having particular diversity features:
•
Brent – the most ethnically diverse local authority in the country.*
8
CNWL Equality and Diversity Workforce Monitoring Report 2011/12 http://www.cnwl.nhs.uk/aboutcnwl/equality-and-diversity/documents/
9
CNWL Equality and Diversity Service Delivery Monitoring Report 2011/12 http://www.cnwl.nhs.uk/aboutcnwl/equality-and-diversity/documents/
10
CNWL Equality Act Compliance Report January 2012. http://www.cnwl.nhs.uk/about-cnwl/equality-anddiversity/documents/
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
•
Camden –has the highest rate of alcohol-related hospital admissions in London at 462 per
100,000 people.*
• Ealing – home to the largest Sikh community in London and is home to Sri Guru Singh Sabha
Gurdwara, the largest Sikh temple outside India.*
• Enfield – Just over half of all children in the Borough live in low income families.*
• Hammersmith and Fulham – large Polish and Irish communities.
• Harrow – The most religiously diverse Borough within London * as well as being home to the
largest Afghani community in the UK.
• Hillingdon – Migrant populations entering our catchment area via Heathrow and a significant
Traveller community.
• Islington – the second highest number of lone-parent families in England and Wales (at 45%)*
• Hounslow – Over 120 languages spoken in the Borough.*
• Kensington & Chelsea – A large, well established, Arabic-speaking population of various
national origins. Most marked health inequalities than anywhere else in the UK when comparing
life expectancy of the richest and the poorest.
• Westminster – the highest proportion of Buddhist residents in the country*, and the centre of the
UK Chinese Community in Soho.
• Students from all over the world attending London universities.
• A significant Lesbian, Gay, Bisexual and Transgender population that is attracted to central
London from across the UK.
• A high number of foreign nationals within the Offender Care System.
* Facts taken from London Councils – Ten Interesting Things About London Boroughs 2009
The Trust provides in-patient and community Adult and Older Adult Mental Health, CAMHS,
Addictions and Learning Disability services, Community Health Services within the London Borough’s
of Camden and Hillingdon, eating disorder services, a Forced Migration Trauma Service, and mental
health and substance misuse services within prisons.
1.6
CNWLs 4 Year Equality Objectives
In April 2012 the Trust published five 4 Year Equality Objectives11, linked to the Trust’s Strategic
Objectives.
E&D Objective (over 4 years)
CNWL Strategic Objective
1. Increase the range of Equalities and Diversity-related
awareness raising opportunities available to Trust staff,
focusing on the needs of service users having particular
‘protected characteristics’ (race/ethnicity, disability,
gender, age, sexual orientation, gender re-assignment,
religion or belief) with a minimum of one new
opportunity introduced each year.
Provision of integrated, high
quality, timely services based on
the needs of the individual.
2. A minimum of one Community Engagement Event with
service users, carers and local communities takes place
within each Service Line or Borough served by the Trust
each year, focusing on the top identified underrepresented groups accessing services.
Engaging meaningfully with
service users, carers and the
local community to improve and
align our services to meet needs,
and to ensure effective local
accountability to the populations
we serve.
Improving Trust information
systems to support improvement
3. Improve the recording rates for new service users for
Religion or Belief, Sexual Orientation by at least 10%;
11
CNWL Equality Objectives: April 2012 to March 2016 http://www.cnwl.nhs.uk/about-cnwl/equality-anddiversity/documents/
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
and Disability to a recorded rate of 50%.
(Hillingdon Community Health and Camden Provider
Services will be addressed separately with discussions taking
place in 2012 to identify actions and targets.)
in patient care and performance
management.
4. Achieve a 25% reduction in the level of violence,
discrimination and harassment, bullying and abuse at
work from patients/service users, their relatives or other
members of the public towards staff
Baseline 2011: Violence:12%; Discrimination: 14%;
Harassment: 20%
Recruiting, retaining and
developing a skilled and
motivated workforce that is
proud to work for the Trust and
that the Trust is proud to employ.
5. Achieve a 20% increase in staff perception of the Trust
as an organisation that acts fairly with regard to career
progression / promotion, regardless of ethnic
background, gender, religion, sexual orientation
disability or age.
Baseline 2011: 55%
A set of in-year actions were then identified along with targets and these will be reported on in April
or May 2013.
1.7
NHS Equality Delivery System
In 2011, the NHS introduced an Equality Delivery System for NHS Trusts. Trusts, if they chose, could
use this as a framework to guide their actions and reporting of Equalities initiatives, and to provide a
grading system for assessing achievement s against the. 4 Goals and 18 associated Outcomes that
have been defined for action and monitoring.
CNWL recognises and supports the principles and the key areas of emphasis contained within this
system. The Trust’s Board of Directors have voiced concern at the complexity and bureaucracy of
this system. The Trust is therefore choosing to concentrate on its own framework of building on the
achievements of its previous Single Equality Scheme and the areas of priority that have been
identified from this and from Staff and Service User Surveys and demographic monitoring.
The Trust already has many strong links with service users and carers, as well as individuals and
groups interested in progressing the Public Sector Equality Duty with respect to the protected
characteristics. Staff networks and an on-going community engagement programme will ensure that
dialogue continues so that developments and priorities within the Trust continue to be informed by
their views.
___________________________________
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Equality Act 2010 Compliance Report, January 2013
2.
Equalities and Diversity within CNWL
2.1
Board of Directors
Diversity is represented within the membership of the Trust’s Board of Directors, with members either
identifying as or having had experience of representing a protected characteristic.
Equalities and Diversity is represented at Board level by the Director of Operations and Partnerships
(who also chairs the Trust’s Corporate Equalities and Diversity Group), and the Trust’s Director of
Human Resources. Both have Executive lead responsibility for Equalities and Diversity.
Equalities and Diversity is regularly addressed at Board meetings and E&D considerations are taken
account of in Board decision-making. The Trust’s Board of Directors have in place three E&D
Leadership Objectives:
1. ‘Develop a representative diverse staff group at middle and senior levels of the organisation
2. Raise awareness of diversity issues at Board and senior levels
3. Develop awareness and understanding of, and engagement with, diverse communities at
Board level’
Equalities and Diversity is regularly addressed at Board meetings and E&D considerations are taken
account of in Board decision-making. During 2012, E&D Reports and Papers were presented to the
Trust’s Board of Director’s meetings in: January (Equality Act Compliance Report 2012), March (4Year Equality Objectives) and September 2012 (Equalities and Diversity Workforce Monitoring
Report 2011/12). Board members have attended community engagement events and this is an area
we are currently promoting further. We are also developing further systems for ensuring staff seeking
coaching or mentoring from Board members are suitably matched.
2.2
E&D Structure and processes
The Trust has an Equalities and Diversity Team, reporting to the two E&D Executive Lead Directors
indicated above. The E&D Team comprises a Head of Equalities and Diversity and an Equalities and
Diversity Co-ordinator. This Team works with a network of E&D Leads/Champions from the Service
Lines/Directorates who are then accountable to their respective Directors of Service in taking forward
the E&D agenda.
A quarterly corporate E&D Group meets involving Executive E&D Leads, the E&D Team, Directorate
E&D Leads and Head of Patient and Public Involvement, Head of Inclusion, and the Chair of the
Trust’s Faith and Spiritual Implementation Group. This Group provides a Forum for debate and
discussion as well as for E&D Leads to report on actions and outcomes and for corporate direction to
be agreed.
Directorate E&D leads have E&D Networks and/or groups through which the corporate E&D agenda
(where applicable) is implemented and the local agenda is identified, co-ordinated and taken forward.
Membership of the local groups varies, but across the Trust there is involvement or connection with
interested parties, often through partner agencies and service users, as they are most closely
associated with front-line service delivery.
In addition, the Trust has a range of E&D-related groups taking the agenda forward in relation to
specific areas and characteristics, each reporting back to the Corporate E&D Group:
1.
2.
3.
4.
5.
6.
7.
Faith and Spirituality Implementation Group
BME Staff Network
Staff Disability Equality Network
Men’s Health and Well-being Strategy Group
Lesbian, Gay, Bi-Sexual and Transgender (LGBT) Staff Network
Community Development Workers Network
Men’s Health and Well-being Strategy Group
Further information on the contribution of these groups and networks is provided later in this Report.
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Equality Act 2010 Compliance Report, January 2013
In addition, for many years the Trust also had a Better Services for Women initiative, promoting
awareness raising, resources and appropriate response relating to women’s needs and concerns,
with particular emphasis on acute care settings. Recently the Trust has taken the step of
mainstreaming this work into the newly created Acute Care Service Line.
2.3
Policies and Guidance
The Trust has a number of equalities related policies which provide a governance framework to
ensure that staff actions address the equalities and diversity agenda in a positive way, whilst making
clear which behaviours are unacceptable to the Trust. During 2012, many of the Equalities specific
policies have been reviewed and updated where necessary.
The Trust’s Equality, Diversity and Human Rights Policy (Employment) and Equality, Diversity
and Human Rights Policy (Service Delivery) both include explicit reference to all nine protected
characteristics and state that:
Managers and staff therefore have a joint responsibility to ensure that in the course of their
employment no employee, or job applicant is discriminated against, or harassed in relation to
any of the ‘protected characteristics’ as defined by the Equality Act 2010, or social
background, HIV status, trade union membership or non-membership, political affiliation,
domestic circumstances or employment status.
Managers and staff have a joint responsibility in the course of their work to protect service
users from being discriminated against in relation to a ‘protected characteristics’ as defined by
the Equality Act 2010; or their social background, HIV status, trade union membership or nonmembership, political affiliation, domestic circumstances or employment status.
The Trust’s Zero Tolerance Policy further states that:
The Trust has a policy of zero-tolerance towards the use of language and behaviour by
service users, carers or visitors that could be perceived as, or has the effect of being, racist,
sexist or demeaning to any of the groups covered in this policy.
The Trust also has in place:
1.
2.
3.
4.
5.
6.
7.
Disability Policy (Service Delivery)
Disability Policy (Employment)
Transgender Policy
Interpreting Policy
Equality and Human Rights Impact Assessment Policy
Gender Requests Policy
Faith and Spiritual Support Policy
All policies have been updated to take account of the Equality Act 2010.
The Trust also has a number of Human Resources Policies providing direction in different aspects of
staff relations and behaviour. These include:
1.
2.
3.
4.
Dignity at Work Policy
Grievance Policy
Sickness and Absence Policy
Disciplinary Policy (which includes a staff code of conduct)
All of these policies are publicised to new staff and available on the Trust’s electronic information
system, Trustnet.
The Trust has continued to complete Equality and Human Rights Impact Assessments, believing
these to be a valuable process to ensure E&D-related issues are identified and addressed. Since the
Equality Act 2010, however, the Trust has updated its policy and associated training so that all
Equalities characteristics are covered and a section addressing evidence for compliance with the
Equality Act 2010 has been added. The Equality and Human Rights Impact Assessments Policy
states that:
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
‘Whilst the Equality Act 2010 refers to Equality Analysis rather than Equality Impact
Assessment, the aim remains to ensure that decisions taken by the Trust in any area of its
functioning are informed by an analysis of Equalities data and considerations’.
This has been further embedded into practice as the Trust’s Policy on Policies includes a
requirement for all policies to be equality and human rights impact assessed.
The Trust has also produced a number of Equalities and Diversity Related Guidance documents:
1. Deafness and the Deaf Community
2. Guidance for Managers on ‘Reasonable Adjustment’ in the Application of the Trust’s Disability
Policy
3. Guidance on Service Users Equalities Data Entry in Jade
4. Blindness and Partial-Sightedness
5. Recruitment Interviews: Guidance on inquiring about Cultural Competency and understanding
of Equality and Diversity.
2.4
Information Systems
As well as using ESR for collecting workforce data, the Trust uses the Jade, RiO and SystmOne
systems for collecting service user data. RiO is used within Community Health Services (Camden
Provider Services and Hillingdon Community Health), SystmOne is used within all the prison sites
and the rest of the Trust uses the Jade information system.
ESR
Along with most other NHS Trusts, CNWL uses the national ESR electronic information system to
capture and report on workforce data. In terms of the equalities protected characteristics, ESR has
the capacity to collect ethnicity, disability, gender, age, sexual orientation and religion or belief and
marital or civil partnership status. It can also record maternity leave. It does not have capacity to
record gender reassignment. Because it is a national system the Trust is limited by its functionality.
The following table gives the staff recording rates as at 31st March 2012:
Equality Characteristics
Ethnicity
Disability
Gender
Age
Religion or Belief
Sexual Orientation
Recording rate (not
Including preferred
not to say)
98%
34.2%
00.0%
100.0%
55.%
53.4%
Preferred not to
say (where option
available)
0.7%
10.8%
10.6%
Not Known
2.0%
65.2%
34.2%
36.0%
Periodically, the Trust has undertaken staff census’ to update workforce information and we plan to
undertake another one, probably in 2013.
Jade
In terms of the equalities protected characteristics, Jade has the capacity to collect ethnicity,
disability, gender, age, sexual orientation and religion or belief and marital status and civil partnership
status. It also captures Country of Origin and Preferred Language which provide additional
information for monitoring purposes and understanding the populations served. It does not have
capacity to record pregnancy or maternity or transgender. We have not, however, reported previously
on marriage or civil partnership for service users and will be promoting completion of this field for
future monitoring and reporting purposes.
The Trust’s guidance document for service user data entry on to Jade includes details of the fields to
be completed and the options available for recording ethnicity, disability, gender, age, religion or
belief and sexual orientation. The Trust did add a trans category to the gender categories on the
Jade data system, however, because this is not a recognised code under the Mental Health Minimum
Data Set the Trust was penalised for recording service user Trans data in this way. Additionally, there
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
was concern that this could breach confidentiality. The Trust is in process of removing the
transgender option.
An update is being made to the disability categories so that they are more reflective of the types of
disability covered by the Equality Act 20210, and in order to make monitoring of services users more
useful. We are also making the disability fields multi-choice so that a service user can select more
that one disability where this is reflective of their disability status.
On 31st March 2012, across mental health, addictions, eating disorder and learning disability
services the recording for gender, age and ethnicity was 98% or over. For religion or belief it was
85.7%, sexual orientation 20.7% and disability 3.5%. In order to improve this, increasing the
recording rate for new cases is one of the Trust’s Equality Objectives. These are being reported on
and monitored on a quarterly basis and local managers are promoting recording with the aim of
improving these rates.
Whilst it is recognised that under the Equality Act there is not a direct requirement to record and
monitor sexual orientation and religion or belief, the Trust does nevertheless believe that such
recording and monitoring must take place in order to effectively monitor whether equality of access to
services is being advanced. Obtaining this data from service users is undertaken sensitively and with
reassurance, and there will always be the option of entering ‘preferred not to say’.
RiO
Rio is used within the Trust’s Community Health Services to collect equalities information. It has
capacity to record ethnicity, disability, gender, age, sexual orientation and religion or belief. Systems
for ensuring data collection and for reporting on this data have been developed to address low
recording rates.
SystmOne
SystmOne is used by the Trust’s Offender Care Services within prison settings. This has the capacity
to collect ethnicity, age, gender, religion, marital status. Disability and sexual orientation has to be
collected through other systems. We are continuing to work at developing data collection and
reporting systems so that more comprehensive monitoring can be reported on in future years.
2.5
Foundation Trust
CNWL is a Foundation Trust (FT) and during 2011-12 the constitution was changed to allow
membership from the whole of England and Wales. Membership records indicate the following
demographic information of non –staff members:
Gender - 41% of the membership are male and 59% are female which shows a significantly higher
interest in the Trust from women compared to the population served and service users accessing
services. However, it is close to the 1/3 to 2/3 ratio male to female of Trust staff, the vast majority of
whom are also members but not included in the figures below. Only 4 staff members out of 5000
have chosen to opt out becoming members of the Trust
Disability - 16% of CNWL FT members have indicated that they have a disability.
Ethnicity – FT members are recruited from all ethnicity groups and all have equal access to all
opportunities for engagement. The membership database identifies the ethnicity of all members and
this is reported as part of the Trust’s FT monitoring process. Current FT membership at December
2012 has representation of members from all ethnicity groups (see table below).
When compared to the national ethnicity profile the Trust membership is broadly representative
across all ethnicities, however, we are aware that there is some under-representation of White Other
and Other Asian ethnicities compared to the demographics of the main London boroughs that the
Trust services and there is on-going work by the Patient and Public Involvement Department to
increase membership from these groups.
In addition, membership also includes people from a range of religions and from LGB communities
although specific data in this area is currently not recorded. We have not included the comparative
22
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
population as the 2001 census data is now out-of-date and the 2011 data is not yet available for
adults only.
Ethnicity
White British
White Irish
White Gypsy or Irish Traveller
White Other
Mixed
Indian
Pakistani
Bangladeshi
Other Asian
Black Caribbean
Black African
Black Other
Chinese
Other Ethnic background
Unknown
2011
No. of FT
Members
2011
% FT
Members
2012
No. of FT
Members
2012
% FT
Members
4009
254
46.65%
2.96%
4084
257
46.42%
2.92%
590
390
1027
221
85
295
321
425
51
53
505
368
6.87%
4.54%
11.95%
2.57%
0.99%
3.43%
3.74%
4.95%
0.59%
0.62%
5.88%
4.28%
610
402
1043
233
90
304
332
437
53
56
515
381
6.93%
4.55%
11.85%
2.64%
1.02%
3.45%
3.77%
4.96%
0.60%
0.64%
5.85%
4.33%
%
Population
(2011
census)
35.7%
3.0%
0.1%
15.9%
4.8%
11.6%
2.7%
1.5%
7.1%
3.4%
5.0%
1.9%
1.7%
5.5%
--------
The membership have been consulted in the past through the use of a questionnaire to ascertain
views of Equalities and Diversity priorities. It is intended that further consultations will take place in
the future following the publication of this Report.
2.6
Mirembe Link Project, Tanzania
The Trust is keen to share its expertise in developing countries. In last year’s report we included a
section describing the Mirembe Link Project in which the Trust has formed a link with Mirembe
Hospital and School of Nursing in Dodoma, Tanzania. Since its inception the aims and objectives of
the Link have progressed through five successful visits. During these visits much work has taken
place to create good working relationships and agree a set of priorities, they include:
1) Training in the therapeutic management of violence & aggression and breakaway
techniques (immediate priority)
2) Supporting the opening of the new substance
misuse centre at Mirembe Hospital (medium-term
priority)
3) IT development (medium-term priority)
4) Developing occupational therapy at Mirembe
(medium-term priority)
All of these areas are progressing and as a result staff
within both CNWL and Mirembe are developing their
skills and capacity in a range of areas, including cultural
awareness. Staff feedback from the November 2011
scoping visit said:
“I have a better understanding of the stigma of mental
illness and substance use in Tanzania. This will help me
have a better understanding about the reluctance of
some patients (at CNWL) have in involving their families
in their recovery.”
23
CNWL staff training Mirembe staff in
the Therapeutic Management of Violence
and Aggression
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
“By being immersed in another culture I can now appreciate how difficult it must be for people from
other cultures within the UK. This is important due to the cultural and ethnic diversity of both staff and
clients within CNWL.”
It is a wonderful example of fostering good relations and advancing equality of opportunity at an
international level. Importantly, the Link is extremely valuable to Mirembe’s staff and service users.
Feedback from a Mirembe social worker who spent a month at CNWL in April 2011 for TMVA tutor
training said:
“I have learnt to involve service users in their treatment /management and to consider them as
individuals who deserve care and respect”.
The Link gives CNWL the opportunity to share its knowledge and resources with Tanzania/ Africa,
where so many of our staff and patients originate from. As the Link develops, it is likely that benefits
to both partners will grow. Throughout 2012 further visits have taken place.
A fund raising / awareness raising stand was recently located in the main reception are for the
building in which the Trust’s HQ is located, an opportunity to foster understanding not only to CNWL
staff, but to staff and visitors to other organisations within the building.
The Tanzania Link Committee includes Tanzanian Diaspora staff from the Trust which enriches the
work of the Link. Next year, The Link is aiming to hold a high profile fundraising event with the
Tanzania High Commissioner. The Committee regularly reports to the Trust Board of Directors which
takes a keen interest in the development.
2.7
2012 Equality Act Compliance Report Action Plan
The Trust’s 2012 Equality Act Compliance Report included an action plan. This was produced ahead
of the Equality Objectives which now underpin the Trust’s Equality and Diversity Agenda. We report
below on progress against the action points identified in last year’s Report.
•
Review data recording and reporting for Workforce element and develop where necessary.Review has taken place and data is now combined for annual staff and service user
Equalities Monitoring.
•
Review process for undertaking Staff Census to update records and undertake Staff Census
to update Equalities data for future monitoring reports - Discussions are currently on-going to
identify the most efficient way of updating staff records given the size of the organisation. This
will be resolved early in 2013 and decision
•
Improve Service User data collection rates, in particular for: Disability (from 5% to 10%) by 6
months; Religion or belief (from 73% to 78%) by 6 months; Sexual orientation (from 49% to
60%) by 6 months. Feedback on any difficulties made on the process to be developed and a
revised timescale - Reports produced and distributed quarterly. Indications of improvements
being made. To be fully reported on in the Trust’s Equality Objectives Report in May 2013.
•
Extend service delivery reporting to include other protected characteristics as the Jade and
Rio systems allow - Meeting has taken place to improve data recording on the Rio systems
and data is now being recorded. To be fully reported on in the Equality Objectives Report.
•
Develop further the role of Staff Groups/Networks in providing Staff support and Expert views
on Trust plans and developments - LGB&T Staff Network contributing to LGB&T Awareness
Training development. Series of events organised by or involving BME Staff Network during
the year; also the establishment of Race Relations Advisors.
•
Establish reporting systems for staff accessing Coaching and Mentoring by Equalities
characteristic – Data is now available for ethnicity, disability, gender, age sexual orientation
and religion.
•
Further review incident reporting system to identify scope for monitoring support to staff –
specifically relating to assaults on staff, the Health and Safety Team are following up with
local managers all incidents that have resulted in a period of sickness absence. This ensures
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Equality Act 2010 Compliance Report, January 2013
that both RIDDOR reporting requirements are met and acts as a prompt to managers of the
need to ensure that appropriate support is provided.
•
Community engagement with service users, carers and local communities takes place within
each Borough served by the Trust, focusing on identified under-represented groups - Service
re-organisation has impacted on the ability to complete this action point in some areas,
however, as one of the Trust’s Equality Objectives, this will be more fully reported on in the
Trust’s Equality Objectives Report.
3. Workforce actions and initiatives to meet the Public Sector
Equality Duty
Given the diversity profile of both staff, service users and population served, the Trust has a
significant track record in initiating actions to meet the requirement of successive pieces of Equalities
legislation. The following section highlights a range of actions that contribute to the meeting of the
requirements of the Public Sector Equality Duty which include staff networks and consultations, staff
training and development initiatives, recruitment and staff relations demonstration due regard to the
Public Sector Equality Duty.
3.1
Learning and Development
Training sessions within the Trust are made available with reasonable adjustments provided where
necessary and access to space for prayer where attendees require this. As well as the E&D-related
training identified below, equalities and diversity considerations are included within other training
sessions including: Health and Safety Training (Zero-Tolerance), Managing People (harassment and
bullying), Recruitment, Care Programme Approach (PCA) and Customer Care Training.
In addition, the Trust’s Equalities and Diversity also offer E&D sessions in other Training for particular
groups of staff: Section 12 Doctors, Health Care Assistants, PALS, RCN Clinical Leadership Course,
Junior Doctors Induction, for instance.
The Trust has a wide portfolio of training options specifically to address discrimination, advancing
equality of opportunity and promoting understanding and good relations. Access to training is
recording and monitored quarterly.
1. All new staff undertake an Equalities and Diversity Induction e-learning package as part
of their induction. This describes the diversity within the Trust and the population served, and
includes an overview of Equalities legislation and interactive sections addressing diversity
issues within service delivery. A Workbook version of this e-learning has also been produced
in 2012 which has been used by Camden Provider Service.
2. The Trust's 'Diversity in the Workplace' e-learning is also completed as part of Induction
and all other staff are encouraged to complete this. It addresses what is required of staff in
the workplace from Equalities legislation. This particular training is prioritised within the Trust
with completion rates for staff distributed to Directors of Departments and Services.
3. Cultural Competency for Managers is a case study based face-to-face training day for
managers and clinicians. The Trust has also run a similar session for medical staff. A
quarterly Cultural Competency for Managers Forum is held for staff who have attended this
training.
4. Reasonable Adjustment for Managers is a training session for managers providing for an
understanding of disability requirements under legislation and addressing managing staff
disability issues.
5. Equality and Human Rights Impact Assessment (EHRIA) training sessions enable staff to
understand and undertake EHRIAs.
6. Working with Interpreters provides staff with an understanding of 'good practice' when
working with and through interpreters.
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Equality Act 2010 Compliance Report, January 2013
7. Skillbooster training DVDs are available to be used within services to raise awareness of
working with diversity.
8. Faith and Spirituality awareness sessions have been developed and incorporated into the
Trust’s Recovery College programme. These sessions are attended by both staff, service
users and their carers.
During the 2012 the Trust has been developing ‘Sexual Orientation Awareness’ training which is to
be piloted with acute service line inpatient staff. In addition, Religion, Belief and Spirituality training is
also being developed specifically for ward staff and work has begun on developing ‘Working with
Migrant and Refugee Communities’ training. In addition, a new training and development programme
is being developed targeting front-line ward staff to address a range of good practice issues which
will include diversity considerations and will involve service users communicating their experiences.
We are exploring the use of vodcasts to support this learning.
The Trust also has an extensive E&D section within its electronic information system giving staff
access to reports, papers, websites and other resources for learning, with regular news items to
promote and publicise new information. The Trust’s E&D Department also publishes a quarterly E&D
Newsletter, Inclusion News, to further publicise E&D-related developments, national and local
publications and ‘good practice’ initiatives (see 5.6 for more information).
Learning Disability Awareness Training Programme:
A Trust-wide e-learning awareness package is being developed to complement staff awareness of
Learning Disability (LD) issues relevant to the level of contact with LD service users. Further
enhanced training being provided via a workshop approach relative to the knowledge of staff.
Workshops have already been rolled out to a range of professionals across the Trust. The Trust’ LD
directorate is looking at how they can develop future workshops to include LD service users in
delivering the training (having used service users in employment interviews and other training
successfully). In November 2012 an LD awareness training was hosted for 5 faith leaders from the
local community churches to help establish better links with the local communities and foster
understanding of learning disability.
Healthcare Assistants Training
NMET funding for training unqualified nursing workforce (Health Care Assistants) the greatest
proportion of whom are Black staff members, has been targeting literacy and numeracy (through
offering an opportunity to gain qualifications in Maths and English) for staff whose English is not their
first language. This is being achieved by providing an in-house course in partnership with Barnet
College. It represents the first step in the pathway to gaining vocational qualification which we
also support staff to be released for.
Cultural Competency for Managers Forum
Run quarterly, this awareness raising and discussions session was developed in response to
expressed interest from staff attending the Cultural Competency for Managers training and it is
attended by staff who have completed this training day. The aim of the Forum is to provide an
opportunity for managers to meet, discuss issues and situations that have arisen, share good
practice and receive updates on equalities and diversity matters. It addresses both service delivery
and workforce issues. It is facilitated by the E&D Team and is also attended by the Deputy Director of
Human Resources. Notes from the meeting are distributed. Discussions have informed policy and
systems development.
Coaching and Mentoring
The Trust has implemented an on-line system for staff to apply for coaching and mentoring Access
is being encouraged for staff having protected characteristics that are associated with disadvantage.
The aim is for 50% of staff accessing coaching and mentoring to have such a protected
characteristic, with 25% of the total having a BME background. Data for 2012 shows the following
although for each characteristic 22% of records do not have an attributed equality characteristic.
•
Ethnicity – White 37,0%, Asian 16.7%, Black 22.2%, Not stated 1.9%
•
Gender – Female 48.1%, Male 29.6%
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
•
Age – 20-29 years 18.5%, 30-39 years 18.5%, 40-49 years 25.9%, 50-59 years 11.2%, 60-69
years 3.7%
•
Disability – Disabled 1.9%, Not Disabled 31.5%, Not disclosed 1.9%, Undefined 42.6%
•
Sexual orientation – Lesbian, Gay, Bisexual 5.6%, Heterosexual 46.3, Do not wish to disclose
1.9%, Undefined/not known 24.1%
•
Religion or belief – Christianity 25.9%, Hinduism 9.3%, Atheism 7.4%, Do not wish to disclose
5.6%, Jainism 1.9% Other 1.8%, Undefined/not known 25.9%
54 staff have received or are receiving mentoring or coaching via this system during 2012.
Women in Management
The Trust’s Women in Management programme, which provides an opportunity for female (including
trans female) staff members to shadow senior staff up to Chief Executive to empower them in their
confidence and career development, has been on hold during 2012 due to significant organisational
changes. The programme, which over the years has been much valued by staff, and which includes
ring-fenced places for Black female staff, is to be re-launched during 2013.
3.2
Recruitment
Ensuring equality of opportunity within the Trust’s recruitment processes are of particular importance
given the diversity of candidates that apply for employment. It is also important for the Trust to ensure
that newly recruited staff are culturally competent in order to respond to the diverse needs of service
users, and to be able to work within multi-cultural teams. Developments are currently taking place on
the NHS Jobs recruitment package that the Trust uses which may enable the Trust to have more
control over the equalities information that is / is not made available to recruiting managers.
The Trust’s recruitment team pro-actively identify job applicants who have declared having a
disability, to thereby ensure that recruiting managers are reminded that if these applicants meet the
short listing criteria they will automatically be offered an interview. This also ensures that the Trust
meets its commitment as a Two Ticks Employer.
Sickness records are not requested ahead of interviews to ensure that this information does not
impact on recruitment decisions.
The Trust’s Recruitment Team works closely with the Trust’s User Employment Programme (see
section 5.3) to ensure that service users, many of who have disabling health conditions, are given
pro-active support and encouragement in gaining access to vacancies within the Trust.
Centralised Assessment Centres for band 5 nurses have been established in part to remove the risk
of inconsistent recruitment practice, and to ensure
consistency in responding to job applicants diverse needs,
for instance reasonable adjustments in relation to interviews.
Introducing Assessment Centres has meant that by testing
basic numeracy and literacy we are selecting by basic ability
Recruitment Interviews:
rather than any other personal or professional bias. The
Trust has undertaken targeted recruitment campaigns in
Guidance on inquiring about
Scotland to increase the diversity of our workfoce which has
Cultural Competency
changed the ethnic mix of newly qualified nurses employed
and understanding of
at band 5 in the Trust. The ethnic monitoring of the staff has
Equality
and Diversity.
shown an under-representation of White nurses. Before the
introduction of Assessment Centres, only 8.9% of band 5
nurses recruited had a White ethnicity which increased to
Updated 29 September 2010
34.62 % in 2011.
th
The Trust’s Recruitment Interviews: Guidance on inquiring
about Cultural Competency and understanding of Equality
and Diversity provides managers involved in recruitment with
information and good-practice ideas to support interview
27
CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
processes and recruitment decision-making. The Guidance contains the following statement:
‘1.1 The first purpose of the Trust’s existence is to provide appropriate and accessible care for
all the residents of the boroughs the Trust serves. For delivering the necessary range of skills
and expertise to service users and to staff, employees of the Trust must be both culturally
competent and have an understanding of Equality and Diversity and its application in the
workplace both in relation to colleagues and to service users.’
The Guidance addresses the use of person specifications to target specific competency requirements
for posts, and scenarios that are inclusive of all protected characteristics that can be used to identify
competency and the level of knowledge and understanding of candidates.
Training in recruitment is provided for all new managers within the Trust with recruitment
responsibilities, and this training includes awareness raising and requirements in relation Equalities
legislation and diversity good practice.
3.3
Staff Relations
The main function of the Trust’s Employee Relations Team is to ensure consistent application of
Trust Human Resources policies across the Trust. The Dignity at Work Policy, Grievance Policy,
Sickness and Absence Policy, and Disciplinary Policy are all written with a view to ensure that all
staff (including managers) are clear as to what is expected of them. The Trust’s Dignity at Work
policy has been reviewed following the merger with Community Health Services in Hillingdon and
Camden, and a new version has been agreed and is in operation. These policies are routinely used
to manage situations that arise where there are equalities considerations to be addressed. The
following are examples of some of the ways that these policies have been utilised to address issues
of discrimination and harassment, and in ensuring that equality of opportunity is advanced and good
relations encouraged.
1. Using the Trust’s Disciplinary Policy to address individuals who have breached the Trust’s
code of conduct by making inappropriate comments of a potential (and actual) offensive
nature. For instance, if a member of staff brought a racially offensive item into the workplace
causing offence to a colleague resulting in a formal disciplinary sanction being issued.
2. Allowing staff to raise concerns regarding discrimination in relation to their managers decision
making so that these can be addressed within a policy framework, thereby ensuring
consistency. For instance, the allocation of shifts where certain individuals were favoured over
others was raised, and as a result additional checks were put in place to reduce the risk of
discrimination in this area through the e-rostering system. The introduction of e-rostering in
2011 has provided a valuable tool for ensuring transparency and identifying causes of
concern and with an updated version to be implemented early in 2013, it will be possible to
extend the availability of this tool to services across the Trust irrespective of different IT
systems.
3. Use of mediation to resolve issues that have arisen between staff having different cultural
heritages. An example was in addressing cultural styles of working where there were different
styles and attitudes between colleagues which can impact on the working environment.
4. Supporting individuals with disabilities to return to work through looking at reasonable
adjustments and seeking support from Access to Work (See section 3.5 Reasonable
Adjustment).
5. The Trust has amended its practice in relation to retirement in line with legislative
requirements. The Trust no longer imposes a retirement age on staff.
6. Maternity advice in terms of employee rights is given as a matter of routine to all staff taking
maternity or paternity leave, or adoption leave, and advice is also given to the relevant
managers to ensure they also understand staff rights in this area.
7. Managers are actively supported in ensuring that flexible working is considered where
requested by staff and any refusal has to be justified. Currently this is an area not being
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Equality Act 2010 Compliance Report, January 2013
monitored, however, systems are currently being put in place to do this so that this can be
reported on in the future.
8. The Trust has in place a Transgender Policy setting out the expectations of staff and
managers in relation to working with a staff member undergoing any aspect of the gender
reassignment process. This was developed with input from Trans staff and has been applied,
for instance, in dealing with a staff member referring to someone by their previous gender
identity, and with managing confidentiality processes in relation to a staff member’s
reassignment.
3.4
Staff Support and Involvement
BME Staff Network
The Trust initiated a BME Staff Network in 2008 with the following mandate agreed by members of
the Network:
•
Race Equality is the over-arching principle that guides the work of the CNWL BME network.
•
To create a Forum to enable the sharing of ideas and experiences, with a view to provide support
and development for the empowerment of staff.
•
To be an effective voice for BME staff to ensure that the Trust delivers on its statutory duties
regarding race equality.
•
To work with the Trust to remove ‘barriers’ for BME staff in recruitment, development and
promotion
The Network is chaired by the Trust’s Recruitment Manager. As well as publicising events and
information to BME staff, the Network holds focus groups and other awareness raising events. During
2012 these have included a Celebrating Diversity event (within Black History Month), the launch of a
Race Relations Advisory Service and a Discussion Panel addressing BME Staff Development.
Staff Disability Equality Network
The Trust has had a Staff Disability Equality Group established prior to the Disability Discrimination
Act of 2005, however, maintaining regular meetings and attendance has become a difficulty. A
telephone conferencing system has been introduced in 2012 and it is hoped to attract more
involvement in the coming year. A BSL interpreter is available at all meetings.
Lesbian, Gay, Bisexual and Transgender (LGB&T) Network
In January 2011 the Trust initiated a meeting to explore the possibility of setting up an LGB&T Staff
Group or Network. As a result a CNWL LGB&T Staff Network was established which has been
meeting quarterly since that time.
As a result of discussion within the CNWL LGB&T Staff Network,
the need for a system for providing support and advice to LGB&T
staff who experience harassment or discrimination was identified.
In response, a Lesbian, Gay, Bisexual and Transgender
Advice, Information and Support Service has been set up. It
aims to provide advice, information and support to LGB&T staff in
relation to experienced homophobic or transphobic attitudes,
behaviours or language during the course of their work. It was
formerly launched at the Trust’s first LGB&T and Health
conference in February 2012
The Group has been consulted on ways of tackling homophobia
and transphobia, the development of lesbian, gay, sexual and
trangender awareness training, the content of the Trust’s first
LGB&T Health Conference and generally advancing sexual
orientation equality through posters and other material made
visible to staff. The training is currently under development and we
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
plan for this to be introduced during 2013.
The Trust is mindful that it has included Trans staff within this network and this was discussed at the
first meeting at which Trans staff agreed that, for practical purposes, it was of value for the Network
to be included.
Minutes of meetings are made available Trust-wide and have been circulated to Executive Directors.
Two social events have also taken place during the year for Network members – a guided walking
tour of Soho on the theme of LGB&T history in the area, and attendance at the Royal National Opera
including a backstage tour.
3.5
Reasonable Adjustments
The Trust provides a range of reasonable adjustments to support staff who have a disability to
undertake their roles. The Trust's Occupational Health Service has lists of general and specific
adjustments that can be made for staff where required. The Service works closely with the Trust's
managers to identify how best to respond to the needs of disabled staff where reasonable
adjustments have been identified as required, and to make specific recommendations. The following
are some examples of reasonable adjustments made for staff during the past year:
•
•
•
•
•
•
•
•
•
•
•
•
•
Adjustment to duties involving no requirement to take minutes as per job description.
Allocation of particular tasks to other team members, for instance in relation to manual
handling.
Time off agreed for disabled staff members to attend disability related hospital appointments.
Transfer to another place of work.
Adjustment to the trigger points where normally absence management process would be
initiated to allow for extra sickness relating to a disabling condition.
Flexible working arrangements agreed, for instance to alter work starting time, to allow
attendance at disability-related support sessions, to not be required to cover an evening clinic
session.
Phased return to work following sickness absence.
Reductions to caseload
Having a break at regular times to enable taking medication.
Adjustments to a shift roster so that a staff member does not have to work more than three
shifts in a row.
Staff member not being asked to accompany patients on visits off the ward.
Provision of a Positive Plus chair to support a staff member with long term back problems.
Offering 9 day fortnight working, plus some flexibility in start and finish times,
to accommodate MS fatigue symptoms.
In addition to the above, the Trust provides British Sign Languages (BSL) Interpreters for service
users and staff. During 2011/12, 268 BSL interpreting sessions took place for both staff and service
users, contributing to ensuring that equality of opportunity is advanced for Deaf staff and service
users whose language of choice is BSL. The Trust has also arranged for a training session with
within Child Health Community Health Services in Camden to allow them to communicate more
easily with a colleague who is deaf. The session looked at how we involve the individual in
conversations as well as better finger spelling and signing.
3.6
Pregnancy and Maternity
Staff are made aware of the policies relating to pregnancy and maternity leave and managers are
expected to support staff with requests for Maternity and Paternity leave arrangements. Pregnancy
Risk Assessments are carried out as appropriate throughout a staff member's pregnancy whilst still at
work and action plans agreed to support the person through this period of their employment. Details
of the child care voucher scheme is available from the Employee Benefits Manager and Trustnet.
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Equality Act 2010 Compliance Report, January 2013
There are also policies specifically covering paternity and adoption entitlements. All policies are
available for staff to read or download from Trustnet.
3.7
Specific events
Celebrating Diversity - In October CNWL staff had
the opportunity to learn about the various cultures that
make up the Trust’s workforce at a vibrant celebration
of Diversity Day at some of our locations. Spurred on
by the celebration of diversity during the London 2012
Olympic and Paralympic Games and ‘to show the
extensive and elaborate celebration of our cultural
differences’, organisers from the CNWL Human
Resources department held an event at CNWL Trust
HQ. Staff in Kensington and Chelsea marked the day at South Kensington & Chelsea Mental Health
Centre. Many staff responded to the invitation to wear their national, cultural or ethnic dress and to
bring national dishes and artefacts to display and share with colleagues. The day was not only for
Black, Minority and Ethnic staff but rather for everyone in the Trust, and 10 countries from across the
globe were represented at the HQ event. Staff were eager to sample different dishes enjoyed from
India, France, Nigeria, Poland, Guyana, Hungary, South Africa, UK, Chile and literature was made
available from Colombia.
Race Relations Advisors (RRA) – Following discussions the previous year, this new role was
suggested by the CNWL Black Minority Ethnic (BME) Network to help build more confidence
amongst staff, especially BME staff, regarding race equality issues and inclusive management
practice. The role involves supporting and advising staff on addressing and resolving race related
issues. This RRA role will support the Trust Board of Directors in creating a positive climate for race
equality and to support individuals seeking help through coaching and appropriate advice and
guidance. There will be ongoing peer support and supervision to help review interventions. Learning
from the work of the Race Relations Advisors work will be shared with the BME Staff Network
executive sponsor, Robyn Doran, Director of Operations and Partnerships, who will advise the Board
on any organisational issues or recommendations.
12 of the Trust’s Race Relations Advisors have completed a six month training programme aimed at
preparing them to support staff needing help with addressing race related issues in the work place
and the service was launched on the 16th October 2012. At the launch, the Trust’s Chief Executive,
Claire Murdoch, showed great support to the concept and realisation of Race Relations Advisors by
attending and giving a heartfelt ‘Launch Remarks’.
BME Staff Development – panel discussion. As part of the Trust’s on-going work to advance race
equality, eliminate discrimination and promote good relations, a panel discussion was held on 24th
September 2012 entitled: Examining the Role of Managers in Facilitating the Development of
BME Staff. This meeting, held on the 24th September 2012, was well attended by staff and senior
managers from several areas across the Trust. Discussions began with the summation of a project
outcome regarding Racial Discrimination and Reporting. The main focus for the project was
developed from the 2009/2010 Staff Attitude Survey and based on perception of staff on racial
discrimination and percentage of actual formal or informal complaints recorded by the Trust.
Following on from the above, the attendees were able to cover the following areas: current Initiatives;
perceptions held by managers; local and trustwide issues.
The conclusion of the meeting was fruitful, with several recommendations for the Trust to move
forward, with which were led by the BME Network. These included references to cultural competency
training, training to assist BME staff to understand UK culture, proper application of policies,
transparency, mentoring, greater use of secondment and greater awareness of the experience route
to promotion (not simply academic).
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Equality Act 2010 Compliance Report, January 2013
International Day events. The Trust’s Learning Disabilities Directorate hold periodic “International
Day” events which help to engage staff to foster cultural awareness and engagement. Everyone is
invited to bring in their national dish and shared discussion around cultures and backgrounds is
encouraged as a result. These events
prove to be very popular amongst staff.
London 2012 – Olympics and
Paralympics – throughout the period of
the London 2012 Olympic and
Paralympic Games, the Trust
encouraged staff at HQ to display their
Example of national flags displayed at Trust HQ during
national flags. Bunting in the form of
Olympics and Paralympics
national flags was also displayed across
the foyer by the HQ entrance. Staff
really engaged with this initiative with the office transformed by large (and some small colourful flags
and banners. There was even a series of ‘olympic’ events held within the office, bringing staff
together and further helping to foster good relations and understanding, with staff also encouraged to
attend work wearing national dress. A special newsletter was also issued regularly during this period
which acknowledged the opportunity of the Games to celebrate diversity.
4. Service Delivery actions and initiatives to meet the Public
Sector Equality Duty
The Trust is experienced in managing the complexity of a diverse workforce providing a range of
services to diverse service users across all of the Equalities characteristics. Understanding the needs
of our service users and responding sensitively and appropriately is at the heart of high quality
service delivery. Assessments include sections addressing individual needs as part of the drive
towards greater personalised care.
The Trust is working with Local Authority partners on how to implement personalisation into mental
health services. This work will look at the potential impact of personalisation on the ongoing mental
health issues faced by marginalised communities. The work will include looking at what needs to
happen to make personalisation a reality for marginalised groups, in terms of more appropriate
services and the development of service user led services and support. Some key objectives will be
1. Increase understanding in marginalised communities about what personalisation is and the
opportunities it can offer to people experiencing mental health issues
2. Develop the voice of marginalised communities and allies so they feel more able to actively
shape the personalisation agenda in mental health and make it work for them
3. Develop the capacity of the workforce and service user led initiatives to better deliver choice,
control and power to marginalised groups
4. Look at the need for an evidence base around personalisation and marginalised communities
Many of the actions and initiatives described in this section are designed to ensure that services
provided contribute to advancing the equality of opportunity for our service users having a protected
characteristic (or characteristics) in the receipt of the treatment and support that they need. The
section includes examples of community engagement processes, group support, provision of
interpreting, provision of reasonable adjustments, faith support, and events designed and organised
to both celebrate diversity and to foster good relations and understanding.
4.1
Race and Ethnicity
4.1.1 Engagement conferences have been organised with local communities within the Trust.
Following a successful Afghan and Mental Health Day in 2008, and Iranian Mental health Day in
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2010, a third event took place in 2012 to address mental health issues with the Tamil community.
Entitled Promoting Wellbeing in the Tamil Community: An event for the Tamil community and
professionals, the event was organised in collaboration with West London Mental Health Trust and
the Tamil Community Centre. 128 people attended the Conference and a full report12 was written and
published, and publicised to CNWL staff. These events bring CNWL staff and members of the
respective communities together to foster good relations and understanding, and advance equality of
opportunity in accessing services, with practical recommendations made to promote the mental
health and well-being of community members. This has been followed up by an initiative from Mind in
Harrow who have made successful links with the local Tamil Community Organisation and will
facilitate better engagement with CNWL Services through ongoing joint working. Work is also being
initiated by CNWL to develop Tamil-speaking counseling provision and to provide support to Tamil
community organisations.
4.1.2 Building on work undertaken during the period when the Trust was a Focused
Implementation Site for Delivering Race Equality, a number of initiatives are taking place within
the Trust to address Race Equality in terms of service delivery.
•
•
•
•
A BME Reference Group in Harrow for discussion between CNWL managers and the local
community.
Training for Managers on Cultural Competency was designed and implemented and continues to
be delivered 4 times a year.
An email resource and distribution list of community groups is maintained which is as a means of
distributing health-related information and events that CNWL hears about (often from within the
NHS), that may not normally be distributed, to community groups and networks
Work has taken place during 2012 to further develop Community engagement guidance which
will be completed in 2013.
4.1.3 A CNWL community development worker is working in close partnership wiith Paiwand, a
local Afghan community group and MIND in Harrow. They are working jointly on a programme of
mental health awareness raising sessions for the Afghan community and a possible Health and
Social Care Careers Fair. Work is also continuing jointly with MIND in Harrow to further improve links
with the Iranian Community and access to our services. Links are also being established with the
Somali community. The Hayaan project run by MIND continues to offer very effective support to the
local Somali communities of Harrow and Brent and is now seeking health funding to expand their
project to Ealing. CNWL continues to work in partnership with this project, offering training sessions
and updates on Mental Health as requested.
4.1.4 CNWL Harrow Mental Health Services are involved in an advisory group for an initiative run
by PLIAS, a voluntary sector organisation in Brent, covering the populations of both Brent and
Harrow offering mentorship to BME ex-offenders as a pathway back to employment in line with
recommendations from Lord Bradley's report.
4.1.5 Work continues in Westminster with engaging with BME communities through outreach
and linking in with the BME Health Forum. Project work is continuing with six identified groups: the
Chinese community, the Somali community, Asian Men, BME young people, BME homeless people
and BME asylum seekers and refugees. The Trust’s Wellbeing Team runs workshops promoting
awareness of mental health issues which have included:
• a mental health awareness workshop was delivered at the Muslim Cultural Heritage Centre to
members of an Arabic-speaking women’s group attended.
• a workshop delivered on 'How you enable wellbeing outcomes' to 40 people from community
organisations attended.
• A workshop delivered to the Migrant Resource Centre in partnership with CLCH NHS Trust on
emotional health and alcohol use to attendees from BME communities. The workshop included
education about mental health, stigma experienced in different communities, access to support,
experiences had by group members, suggestions on how to health issues. encourage people
from different backgrounds and communities to be more open about mental health.
12
http://www.cnwl.nhs.uk/about-cnwl/equality-and-diversity/initiatives/
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The Wellbeing service is also pro-actively supporting the CNWL Recovery College in attracting more
BME course participants.
4.1.6 The Trust’s The Marlborough Cultural Therapy Centre (MCTC) is a nationally and
internationally recognised specialist service integrated into CNWL CAMHS, it provides culturally and
religiously sensitive services in clients’ preferred languages. Staff speak a range of languages and
are themselves first or second-generation migrants. The MCTC team combines expertise in
mainstream mental health settings with knowledge of intra-cultural, spiritual and religious practice to
provide a therapeutic service to children and families. Cultural awareness courses have been
provided for the duty social work and assessment team and with other Westminster Social Services
teams to do follow up work.
4.1.7 Camden Provider Service continues to co-ordiinates the ‘Habari’ Project (reported on more
fully in the Trust’s 2012 Equality Act Compliance Report. The service provides a first point of contact
with the African people to learn about the Sexual Health Clinics and how to access them. It has
become the leading campaigner of HIV Testing and provider of space to where African people can
positively be encouraged to go for HIV testing and creates an environment where Africans can freely
express their views and perceptions of the health services in the UK.
4.1.8 In response to the population of migrant people within Westminster and Kensington &
Chelsea, the Trust’s Forced Migration Trauma Service provides treatment for service users aged
18 years and over resident or GP registered within these Boroughs. Service users accessing the
service should be assessed as having a primary diagnosis of PTSD. Referrals are accepted from
anyone:
• who has a history of being an asylum seeker, refugee or forced migrant.
• who has a primary diagnosis of PTSD. If the person is showing signs and symptoms of
trauma, we can arrange to assess him or her for PTSD.
• Where the PTSD relates to an adult trauma (such as war, violence, torture or rape).
Generally, the trauma will have occurred in the service user’s country of origin, but referrals are
considered for refugees, asylum seekers or forced migrants with UK-based trauma. The service also
provides a point of specialist advice and information within the Trust
4.1.9 The Trust’s Occupation Therapy services run a number of support groups to respond to
cultural and other related needs Harrow: Asian Women’s Group (The Bridge), Brent & K&C: ESOL
Classes, Learning Disability/ Kingswood: Cultural Awareness Group. OTs make recommendations
and referrals to culturally appropriate day centers or residential places is done when considered
appropriate and requested by the person concerned and are involved in organising transport etc to
local cultural events
4.1.10 The Trust’s Addictions Directorate positively reaches out to groups who are underrepresented and offers a range of services to service users from all racial and ethnic groups. The
directorate undertakes an annual Differential Equality Impact Analysis to monitor service key
performance indicators and patient outcomes by ethnicity and gender to monitor performance and
improvement.
Services in Hillingdon work with EACH amongst the Somali community. Brent services work in
partnership with the Junction Project to provide support to the Irish Community. Also, our services in
Kensington & Chelsea are working in partnership with partner agencies to provide a link worker to
offer counselling to services to the fixed travellers site in the borough. The directorate will be
targeting service users with these characteristics to attend its annual staff and service users
conference.
4.1.11 Within the Trust’s adult mental health services with Kensington and Chelsea, the Trust works
with the Oremi Centre who provide mental health outreach services, advice and information to the
African and Caribbean communities.
At St Charles in Kensington and Chelsea a quarterly social network group is organised to which
representatives from the Oremi Centre, Somali Centre, Moroccan Womens Group, Portuguese and
Chinese community groups. CNWL staff will also take staff to the actual centres to meet members of
the groups to help them form their own links for further support.
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4.1.12 The Trust’s Medicines Policy reminds practitioners of their duty under the Equality Act 2010
to provide care with due respect for service users' protected characteristics. In terms of race and
ethnicity, the relevant factor can be in relation to the accessibility of information about medicines if
service users preferred language is not English. The Trust’s Patient Information Leaflets on
medicines (PILs) have been revised this year to improve their readability. A design firm assisted with
the layout and an expert on written communication advised on the text. All 51 leaflets have been
updated in the new house style. However, the cost of producing stock translations was too high to
undertake at the same time. As an alternative, our Medicines Information Service is able to access
some translated leaflets from an on-line information service for service users on request.
4.1.13 In 2012, Black History Month was celebrated in all units within the Trust’s Rehabilitation
Service Line. In Brent and Harrow the event
included displays, competitions, speeches and
music, and there was also Asian, African and
Caribbean food. These events help to foster good
relations and understanding between people
having different ethnic and cultural backgrounds as
well as providing an opportunity to present factual
information about Black History and the important
contributions of Black people in all walks of life.
In Hillingdon the programme comprised of a carer
Black History Month Celebration, Brent
telling her story as a health professional with a lived
experience of caring for children with enduring with enduring mental illness. As an African doctor who
settled in the UK and then became a widow when her children were very young; she talked of the
adjustments she had to make and how she has supported her now adult children. There was
inspiring discussion from three female African-Caribbean Service Users, who spoke of their recovery
journeys and how being involved in the development of their Health and Well-being plan assisted
with them.
4.1.14 Hillingdon Community Health’ (HCH) dedicated Community Engagement Team continues to
work across Hillingdon with families, individuals and communites of all age groups. Their specialist
knowledge incorporates engaging with and responding to the health needs of:
1.
2.
3.
4.
Homeless people (both families and single people).
Marginalised communities i.e. Asylum seekers, Afghani and Somali families.
Travellers and Gypsies.
Other ethnic groups within the local Hessa Centre, e.g. Tamil Groups.
By supporting vulnerable communities to access health care to improve their quality of their life the
Team works towards reducing health Inequalities. The focus is on early health promotion
interventions at the individual, family and community levels, raising awareness promoting health.
The various interventions engaged in by the Community Engagement Team, include nutrition, active
lifestyles, parenting and self esteem groups, NHS Checks, 'Get up and GO' programme - which is
looking at reducing obesity, interventions at workplaces, local faith groups, childrens centres, YMCA.
The Team uses a holistic approach to health and wellbeing and is taken forward in partnership with
the health visiting teams, GP's, children’s centres, public health department, smoking cessation
teams, YMCA and other local stakeholder organisations.
4.1.15 As reported on last year, CNWL CAMHS has an Arabic-speaking Service which was sent
up in response to there being over 80% of school children in the North Kensington who spoke Arabic.
The service attracts service users from a range of communities, from North Africa, the Arabian
peninsular and Europe. Most of the service users are Muslim, however, responding to their needs is
not simply a matter of language, but also responding to the cultural needs in the context of faith and
belief. Services and support groups are offered in non-stigmatised locations, for instance, two
socially-based groups: an antenatal group and a parental group. In this work it is important to be able
to talk in the language of the mother with an ethos that respects the cultural role of motherhood,
drawing together mainstream approaches and psychodynamic processes with Islamic belief.
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4.1.16 Commitment to the provision of interpreting is a key feature of Trust services, thereby
advancing equal access to services and treatment for people whose preferred language is not
English. During 2011/12 there were over 9,000 face-to-face interpreting episodes provided for,
catering for 65 different spoken languages. Additionally, telephone interpreting sessions were also
provided. This represents a significant investment by the Trust in ensuring that equality of opportunity
in service delivery is advanced for service users whose preferred language is not English. Also
during 2012 the Trust updated its Interpreting Policy. The Trust provides training to staff in the use of
interpreters and ensures mental health awareness training is provided to interpreters.
4.1.17 In addition to the above, an exciting new development in 2012 has been the development of
the Trust’s own in-house interpreting service following the integration of Camden Provider Service
into CNWL which has its own interpreting service (Camden Interpreting Service). Much time has
been spent this year in expanding this service to cater for the requirements of CNWL and towards the
end of 2012 the Trust took over the management of the service. This service has been operating
successfully for over 30 years and consistently provides health professionals with a high quality
service, delivered by qualified and experienced interpreters. All interpreters abide by a Code of Ethics
and Code of Practice. The service also offers training in interpreting and it is hoped to further develop
this to provide specialist training for interpreters to work within a mental health context.
4.1.18 The Trust’s Older People and Health Ageing Directorate is currently involved in a project in
partnership with the Alzheimer’s Society to work with BME communities to raise awareness of
dementia and to increase referral and engagement with services. Additionally team meetings (e.g.
breakfast meetings in Harrow) continue to feature discussions on care and treatment provided to
people from different ethnicities and this has helped professionals to understand the needs of this
ethnic group so that care and treatment are delivered sensitively. Staff in the Memory Service
recently attended an event on dementia and ethnicity in Willesden to further develop their skills and
understanding of caring for people with dementia from ethnic backgrounds. There is also a monthly
carers support group in Harrow for carers of people with dementia and here issues relating to
ethnicity are discussed and carers are given support and advice on caring for their loved ones.
4.1.19 At the Trust’s longer term rehabilitation unit at Horton Haven, there is a rich cultural diversity
within the service users on the Villas. A range of events are held at the patient's centre reflecting
cultural difference, for example, a music of black origin afternoon was hosted by the music therapists
with a poster display of black athletes. Cultural events are well attended and greatly appreciated.
Service users are also encouraged to prepare a wide range of food as part of their recovery process
and this has led to some service users cooking food from many cultures and sharing with others.
Within music therapy, instruments from Africa (e.g. djembe and congo drums) are popular and
patients choose songs from a range of cultures to share within the open and more recreational
groups.
4.1.20 In order to ensure that positive diversity messages are communicated on our wards,
dedicated Equality and Diversity noticeboards are to be installed to provide an equalities focus for
staff and service users. Information will also include good practice in equalities and diversity
guidance.
4.1.21 The Trust is actively discussing ways of developing greater awareness of local community
groups and resources amongst front-line acute care staff on our in-patient wards. Links are being
fostered, for instance by organising lunch meetings to bring communities, staff and service users
together. A nurse will be identified within each ward as the community link person so that the
positive, collaborative relationship being developed can be maintained and utilised for the benefit of
service users.
4.1.22 A cultural diversity event was held at the Riverside Centre, Hillingdon, to which staff were
invited to attend wearing national costumes, and to bring national dishes and artefacts to display and
share with colleagues. Over 50 dishes were brought from virtually every corner of the globe. The
event really helped to foster good relations and understanding between people having very different
cultural and ethnic backgrounds.
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4.2
Equality Act 2010 Compliance Report, January 2013
Disability
4.2.1 Most Trust premises providing services are adapted for disability access, and where this
is not fully the case, the Trust’s Estates Department has a rolling programme to ensure building work
and other adjustments are made to ensure compliance with disability legislation. This includes wider
doorways for wheelchair access, ramps, visual as well as audible entry systems, toilets for disabled
people.
4.2.2 The annual corporate audit reviews our sector community premises against established NHS
PEAT standards, and reviews disabled access to parking, premises and clinical areas; and access to
portable hearing loop equipment.
4.2.3 Following on from the Trust’s Occupational Therapy Department’s comprehensive review of
disability-related aids and equipment that are available on wards, (reported on in lat year’s Report)
Occupational Therapists across the Trust continue to assess and provide equipment which will assist
individuals to manage their physical disability in order that their independence is increased and
enhanced; enabling them to more easily access mainstream services; and promoting and
maintaining their independence in relation to where they live.
4.2.4 On the Older Adults and Healthy Ageing Service Line wards, patient's who have identified
mobility issues have Falls Assessments and where appropriate referral to Physiotherapy for further
advice and management. Staff are trained in Moving and Handling to ensure that they are able to
transfer patients with mobility / physical conditions safely.
4.2.5 Harrow Older Adults day unit has facilitated driving assessment at DVLA test centre for clients
as required in order to ensure independent assessment of their ability to continue to drive safely;
4.2.6 As reported last year, the Trust has guidance documents for supporting and
communicating with people who are Deaf or hard-of-hearing and those who are blind or
partially sighted.
4.2.7 Promoting wider awareness and understanding of mental health within the wider
community is an important aspect of community engagement. People with mental health problems
can and do experience stigma and workshops and other events to is an important element in
fostering good relations between people who have a mental health condition and those who do not.
Two health promotion events held for World Mental Health Day at the Soho Centre for Health
attracted lots of people and provided an opportunity to engage with people about mental health and
wellbeing. Learning and awareness raising is a two-way process and as a result of these events
more information is also being made available to CNWL nursing staff about BME organisations and
the barriers that BME communities face in accessing services.
4.2.8 The Learning Disability Directorate continues to provide a range of group activities both within
and external to the Trust, the latter affording opportunity to foster good relation between Learning
Disability service users and the wider community. External sessions include accessing services
such as the Aspire Centre, Swimming, badminton, etc. As a result, service users gain confidence in
using external services independently whilst also creating an opportunity to ‘normalise’ such activities
in the broader community with the local population. Internally, groups include Relationship and
Friendship sessions; Speak-up Workshop, Basic Job Group, Independent Living, Communication
Skills, Healthy Living and Editorial Group, Sports Coaching, Physiotherapy and Occupational
Therapies offer the opportunity for 1-2-1 and group sessions to maximise independence and promote
healthy life styles and activates during their stay. Community sessions include developing safety
awareness that is related to service users i.e. Police input for safety awareness in the community;
Transport for London training to gain independence skills while understanding dangers of travelling in
the community, thus helping to foster good relation and understanding.
The Learning Disability Directorate discusses communication needs with service users and carers on
admission or when services are accessed to identify the best approach. The Directorate has
considerable Easy Read documentation, which we provide routinely (e.g. Service User Carers
pack, Mental Health Act information, medication, etc.) and which are available on central computer
drives for staff across the Trust to use. Further use of Makaton (sign language) is utilised as needed
as too is PECS (Picture Exchange Communications System). Learning disability service users are
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Equality Act 2010 Compliance Report, January 2013
always provided with easy read documentation for all key work involving their needs e.g. all Care
Plans are provided in an easy read format and service users discuss these with the independent
advocate.
4.2.9 Reasonable adjustments for people with Learning Disabilities accessing mental health
services are also made, for instance the use of easy read material where appropriate and allowing
more time for assessments.
4.2.10 Hillingdon Community Health (HCH) have an A-Z of services available in an easy read
format. When learning disability is evident on a patient referral, HCH will whenever possible aim to
give the patient the first appointment of the clinic session to avoid any delays that may incur and
HCH also allow extra time to review those patients identified with a learning disability. A Learning
Disability Resource Pack for working with people having a learning disability has been developed
and distributed within Hillingdon Community Health to sites and services.
4.2.11 The Hillingdon Community Health Learning Disability, Health and Sensory Team is a
multidisciplinary team that provides support to adults with Learning Disabilities within the London
Borough of Hillingdon community. The team provides a range of services to individuals aged 18 and
over who have a diagnosis of learning disability. Alongside various assessments and interventions
provided directly to the individual, the service also liaises with carers, medical professionals, support
workers, and accommodation services to ensure the best outcomes for our service users.
4.2.12 The Trust provides British Sign Languages Interpreters for service users and staff. During
2011/12, 268 BSL sessions were booked for both staff and service users, contributing to ensuring
that equality of opportunity in service delivery is advanced for Deaf service users whose language of
choice is BSL.
4.2.13 Supporting wheelchair users and their carers and encouraging independent living is an
important aspect of the work of the Trust’s community health services. Camden and Islington
Wheelchair User Group has been rejuvenated in the last few months and although numbers
attending remain small the group is beginning to take an active role in the development of the
service. For example two members of WUG have observed shortlisting and interviewing for staff and
are now willing to help the service implement its pledge to have wheelchair users on the panel each
time the Service recruits. The group is about to start investigating how it might take an active role in
evaluating the Service, specifically looking at whether the Service has helped people to achieve their
mobility goals. The Wheelchair Service is also trying to visit groups and forums which wheelchair
users or their carers use so we can receive feedback from a range of service users.
Hillingdon Community Health also either facilitates or is involved in wheelchair user groups. In
Hillingdon there is an independent user group which meets jointly with the local authority tenants and
residents group and which the HCH Wheelchair Service attends by invitation. There is also a large
user group for the Hillingdon Centre for Independent Living (HCIL), with monthly meetings and a
monthly user group in Harrow Covering both Harrow and Hillingdon, wheelchair training courses for
carers are held at HCIL (generally 1-2 times per month).
4.2.14 The Trust has a mental health ward at St Charles Hospital designated for any patient with a
learning disability. Staff on this ward have received additional training in the Green Light tool kit. All
Inpatient sites also have a Learning Disability Champion.
4.2.15 The Bridge Team, a team in the Sexual Health Service which is part of Camden Provider
Services (CPS), works specifically with people with Learning Disabilities. Staff have received
training called “An Introduction to Personal Relationships and Sexuality in People with Learning
Disabilities”. All staff in the CPS Wheelchair Service were trained in Disability Awareness by a local
group of young wheelchair users called Young People for Inclusion. This training was arranged
following staff attending a Local Authority Disability Forum where a young person in a wheelchair
complained that she felt the staff did not listen to her properly.
4.2.16 The Pharmacy Department’s Patient Information Leaflets are available in 'Easy-Read'
format and these are used in the learning disability service. A limited amount of information in Braille
can be obtained for blind patients. The dispensary at St. Charles Hospital was adapted to provide a
hatch to allow eye level contact with wheelchair users. The CNWL Clinical Pharmacy Standards for
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Equality Act 2010 Compliance Report, January 2013
the service remind pharmacists to ensure that the specific characteristics of patients are considered
when treatment is agreed such that medicines are selected which are appropriate for the individual,
for instance, taking account of medicine a patient may be receiving for the treatment of a disability. A
side effect rating scale is used to assess the effects of medication and this may assist in picking up
problems in patients with a disability compounding their health condition. Patients who need
additional help with the administration of medicines to themselves will be assessed for adaptations
and devices such as compliance aids or administration aids e.g. tablet cutters, spacer devices for
inhalers, or eye dropper aids.
4.2.17 As part of the continuing work to ensure that people how have a Learning Disability and a
mental illness are able to access mainstream mental health services for treatment, a dual diagnosis
steering group in Westminster across all mainstream mental health services. It is attended by a range
of health and social care professionals from the Westminster Learning Disability Service and Adult
Mental Health Services. The Group is also attended by representatives from the local Dual Diagnosis
User Involvement Project which was set up over a year ago to ensure that the views and experiences
of service users are fully taken account of in service developments. In addition to this, the CNWL
Wellbeing Centre has been asked by the Westminster Learning Disability Partnership to hold
sessions for their staff and service users on Wellbeing and mental health.
4.2.18 The Trust’s Offender Care Service offers services to all who may have a disability. For
example ensuring those who are in wheelchairs are located appropriately on the levels as there are
ongoing concerns regarding wheelchair access in prisons. All Offender Care staff are completing the
Disability at Work training. A Learning Disability screening tool is in use at HMP Holloway, HMP
Wormwood Scrubs and the Hammersmith Magistrates Court. There is also a Learning Disability
practitioner at HMP Holloway for follow up assessments and a specialist Learning Disability Nurse at
HMP Wormwood Scrubs.
4.3
Gender
4.3.1 The Trust’s longstanding Better Services for Women initiative sought primarily to ensure
awareness of and response to women’s needs specifically on in-patient units. This work has now
been mainstreamed into the Trust‘s newly developed Acute Care service line allowing for greater
consistency of provision across the Trust.
4.3.2 The Trust continues to raise awareness amongst staff of safeguarding issues and
identifying where there are concerns, particularly in relation to vulnerable women under our care. We
provide local training for in-patient nurses with regard to Safeguarding, delivered by senior nursing
staff within the Trust. The Trust is also in the process of setting up training sessions for staff to be run
by Violence Against Women, a community-based group which provides support for women
experiencing any type of abuse. CNWL has established links with this support group. The Trust is
also in the process of setting up a Safeguarding Group with representatives from all in-patient sites to
develop a consistent approach to enhancing the service we provide to women who are victims of
abuse. Whilst the main focus is on support for women, The Trust is mindful of men as targets and
this will also be taken account of.
4.3.3 The Trust runs a number of gender-specific groups across the Trust. Some examples of
group activities include:
•
•
•
•
•
•
•
•
•
•
K&C: Women only gym session in South Kensington and Chelsea Mental Health Service
Westminster Recovery Support Service: accommodates women who want to attend women only
swimming as and when the need arises
Harrow: Asian Women’s Group
Harrow: Women’s Group
Harrow: Northwick Park have developed Men's and Women's group in the inpatient service
Hillingdon: Men’s Group and Women’s Group
Hillingdon Riverside: Women's Pamper Group, Art & Smoothie
Hillingdon Riverside: Men's Pamper/ Social Group, Art & Smoothie Group
Men’s Group and Women’s Group at Belevedere Day Hospital
Westminster, Gordon Hospital: Womens & Men's Groups on wards
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CNWL NHS Foundation Trust
•
•
•
•
Equality Act 2010 Compliance Report, January 2013
Brent: Men's and Women's ward based groups
Bentley House Day Assessment Unit for Older People has run a Men's Group at local Social
Services Day Centre.
K&C, St Charles Men's Group. Women only Chill Out Group, Women only Gym sessions
Horton Haven: Men’s Group active in model-making
Gender-specific groups are generally client-led in relation to content. Specifically, groups for women
frequently focus on protecting oneself and on sexual health and relationship.
4.3.4 With the enacting of the Equality Act 2006, the Trust formed a Men’s Health and Well-being
Forum, to further develop working with men within the Trust. The primary focus has been on men’s
support groups and activities, and annual events are held within the Trust to celebrate National Men’s
Health Week. This year's National Men's Health Week took the theme of Taking Heart: Promoting
Heart Health in Men. A number of events were held around the Trust, the following being jexamples.
On Colne Ward (Riverside Centre, Hillingdon) the aim of the celebration of Men’s Health Week was
to highlight Men's health issues to the current service users on the ward: recovery, tobacco, drug and
alcohol use, healthy heart, sexual health and medication managements. Activities included
discussion, interactive sessions, quizzes, advice and support, distribution of factual leaflets and a
song competition.
At St Charles Hospital (Kensington and Chelsea), the objectives set for the Men’s Health Week
events were:
• Education about key early indicators and symptoms of heart disease in men
• Promote healthy behaviour for men as a preventative measure for heart diseases
• Engage patient supporters to encourage the men in their lives in being proactive about their
health and lifestyle
• Empower men to adopt healthy behaviours, to consider regular health screening and to use of
other available health services
• Provide men with local opportunities and resources to improve their health
A range of teaching sessions took place during the week, looking at the effects of diet, exercise and
substance abuse on the heart. Exercise groups took place and there was also a health information
afternoon, visits to a local library, green gym and local park. A highlight of the week was an afternoon
Basic Life Support training for service users, facilitated by Mark Singleton. Feedback on the activities
was positive with a recommendation that the week should continue to be held each year.
At the Gordon Hospital (Westminster), as part of this year’s men’s health week, a basic CPR training
course was held in conjunction with St. John Ambulance. Patients who attended received a certificate
of attendance after the session.
A specific men's health event was run by the Sports Therapist and Psychologist at the Horton Haven
rehabilitation centre.
4.3.5 In 2012 a Men’s Health and Well-being Strategy Group was initiated, chaired by the Trust’s
Director of Operations and Nursing, to provide Trust-wide direction and collaboration in promoting a
more co-ordinated response to men’s health issues, involving mental and community health services,
addictions, offender care and other specialist services within the Trust. A representative from the
national organisation, Men’s Health Forum, attended one of the meetings to present on the national
position which led to him being invited to talk at the Trust’s annual Nursing Conference.
4.3.6 Recognising the particular risks and needs or service users, the Trust has gender-specific
Psychiatric Intensive Care Units (PICU). The Trust has three male-only PICU and one female only
PICU. Within Hillingdon there are female only and male only wards.
4.3.7 Within the Older Adults and Healthy Ageing wards, where the Observation and Engagement
policy is required as part of the treatment plan, cultural diversity is respected and will be carefully
considered when a patient needs to be placed on Close Observation. The gender of the staff
undertaking the Close Observation is also considered as some patients will request this due to their
cultural background.
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4.3.8 All incidents of sexual safety are reported via the Trust’s Incident Reporting system, these
incidents are reviewed by local managers who determine the level of investigation that is required. As
per all incidents, it is possible to record whether any of the equalities protected characteristics were
linked to each incident and undertake analysis by gender and ethnicity. During the 2011/2012
reporting period there was a reduction of 2% in the number of sexual safety incidents reported,
analysis over the last 5 years shows a continued trend for year-on-year reduction.
4.3.9 The Hillingdon Community Health Community Engagement Team, (described more fully at
4.1.14) provides health awareness sessions for men at a local bus garage, including blood
pressure and BME index measurements. One of the aims of the work at the garage is to offer men
and women healthier dietary options which can suit their shift work. Work is also on-going with the
staff in the canteen to provide healthier lunch options. The Team also works in partnership with the
Diabetic, Public health team and the smoking cessation teams at the bus garage as well as the local
mosque.
4.3.10 Breast screening services and sexual health clinics are provided by CNWL services for the
women at HMP Holloway and young people at HMPYOI Feltham. A GUM clinic is also provided to
the men at HMP Wormwood Scrubs
4.3.11 Female sex-workers can in particular be disadvantaged in accessing health care services.
The Camden Provider Services’ Sexual and Reproductive Health Service runs an outreach service to
female sex workers many of whom do not have English as a preferred language. As well as outreach
to saunas and clubs the service at CLASH (Central London Action on Sexual Health) also runs clinic
sessions twice a week on Mondays( appointments preferred) and Fridays (walk-in and appointments
preferred). During our busy Friday morning session interpreters are present routinely for women
whose preferred language is from Central or Eastern Europe, or Mandarin and Cantonese. The
service has recently been refurbished to a high standard to offer the best possible clinical care
maintaining the warm feel which is very precious to our hard to reach clients.
4.3.12 The Trust’s Addictions Directorate provides a women only drop-in to encourage better
engagement of women accessing services. In-patient services provide separate areas of
accommodation for male and female clients. All services operate some flexible opening hours (some
late evenings and weekend services).
4.3.13 The Trust’s Arabic Speaking Families Service offers a service in community at the
Alhassaniya Women's Centre.
4.3.14 The Trust has undertaken a 'Think Families' audit, with the aim of maintaining family/child
friendly services to attract more women into treatment.
4.3.15 The Trust’s Medicines Policy reminds practitioners of their duty to respect the privacy and
dignity of service users and that all efforts to provide a practitioner of the same gender should be
made when intimate procedures e.g. depot injections into gluteal muscle are undertaken.
Chaperones are used wherever appropriate.
4.3.16 The Trust has a Gender Requests Policy in place which sets out the circumstances in which
service users may request professionals of a particular gender to provide treatment and care.
4.4
Religion or Belief
4.4.1 The Trust’s Faith and Spirituality Implementation Group co-ordinates Trust response to
the faith and spiritual support agenda primarily for service users. The Trust continues to development
further faith and spiritual support for service users, building on the Chaplaincy Services serving the
two in-patient units in K&C, and the voluntary Faith Links initiative in Brent:
Multi-faith mental health Chaplaincy services are provided to service users at St Charles
Hospital and South Kensington and Chelsea in-patient units. As well as providing one-to-one
support, religious ceremonies and services are also provided for service users. Also, at the
two sites, faith and spirituality groups are facilitated for service users, run by a matron at
South Kensington and Chelsea MH Centre and a ward manager at St Charles Hospital.
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Special events are held to celebrate important religious festivals. At St Charles the Muslim
Chaplain provides Ramadan support and other activities including calligraphy workshops.
The Faith Links initiative has received national recognitions for its work which includes the
provision of voluntary faith visitors, training for faith visitors and staff, the celebration of faith
festivals and faith needs assessments. Awareness raising events are held within Trust sites
creating an opportunity to promote understanding and good relations between different faith
groups.
4.4.2 Throughout in-patient services within the Trust, particular diets are catered for (religious and
cultural) and arrangements are made for service users to observe fasts in line with their beliefs. Inpatients units have prayers rooms and many service users have their own rooms and therefore
space for personal prayer and other religious practice. Religious texts are also available.
4.4.3 Harrow Mental Health Services launched a Faith Visitor Project in March 2012 with a
number of faith visitors from different faiths who were had trained by, and recruited to, the Trust with
Honorary Contracts. Whilst the initial focus was to be upon the In-Patient Unit at Northwick Park
Hospital, the service has actually developed to include the Learning Disability Service at Kingswood
and the Older Adults Dementia and Memory Clinic Service. Faith Visitors have been offered top-up
training in these specialties
4.4.4 In Hillingdon, a local Chaplaincy Service from Hillingdon Hospital attends CNWL wards. In
addition, Voluntary Faith Visitors are currently being recruited to the Trust on Honorary Contracts
and a pilot for voluntary faith visiting is shortly to be launched on one of the in-patient wards. This will
help to extend the service and the range of faiths specifically catered for.
4.4.5 Chaplaincy services are provided for a
variety of religions within the Prison Services
within which CNWL provides mental health,
addictions and primary care services. Religious
practices can be maintained, including diet,
religious services and places to practice through
the use of chapels and prayer rooms within the
prisons.
4.4.6 The Trust’s Faith and Spiritual Support
Policy provides a governance framework for
providing faith and spiritual support, in particular in
relation to the provision of faith visiting.
Claire Murdoch, Chief Executive CNWL,
4.4.7 In November 2012 the Trust held its 3rd
Speaking at the 3rd Faith and Spirituality
annual Faith and Spirituality Conference. The
Conference
focus of the Conference was to encourage staff
and teams across the Trust to engage with their
local Faith Communities and to build partnerships between the Trust and these communities to
promote better understanding and mutual support in addressing the Faith and Spiritual needs of our
service users. Dr Sarah Eagger, Trust Lead for Faith and Spirituality set the scene and Claire
Murdoch Chief Executive CNWL gave a very encouraging opening address.
The key presentation was titled ‘The Westminster Story’ and showcased the critical developments in
Westminster where a very productive partnership has been forged between the Anglican Church,
local Faith Communities and CNWL Westminster mental health services. The Westminster speakers
were the key players in the project: Reverend Chris MacKenna, Director of Marylebone Healing and
Wellbeing Centre, Reverend Neil Bunker, Mental Health Liaison Priest from the Diocese of
Westminster who plays a very active role in linking the local Faith Groups to the Westminster
Service, Pete Raimes, Westminster’s Service Director, who provided background of how the
foundations of the partnership were laid and Nadra Gadeed, Mental Health Promotion Specialist from
the Westminster Wellbeing Team, talking about her current role outreaching to faith communities and
raising awareness of mental health issues. The aim of this session was to encourage elements of this
successful model can be adopted in other boroughs in the Trust.
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Staff from the Trust then [presented development in their services in relation to Faith and Spirituality.
Di Hurley, Lead Occupational Therapist (OT) within Harrow, talked about the Faith Visitor Project at
Northwick Park Hospital. From Brent, OT Amy Daniels and Faith Visitor Annette Dennis told us about
how Faith Groups are welcomed onto the wards at Park Royal Centre for Mental Health and finally
Charlene Alfred, Matron at St Charles Hospital in Kensington and Chelsea, talked about the excellent
relationships with the Multi-Faith Chaplaincy from Imperial Healthcare NHS Trust and how the visiting
Chaplains are able to offer regular spiritual and religious solace to the patients in the Mental Health
Unit at St Charles.
This was followed by a very moving personal testimony from one of our service users from the
Recovery College. In conversation with Dr Sarah Eagger, Willelmina Joseph-Loewenthal told us of
the critical role that faith had played in her recovery. Her honest and brave account made a powerful
impact on the listening audience and was very persuasive in emphasising the positive role of faith
and spirituality in a patient’s wellbeing.
The final session of the morning was devoted to a panel of speakers representing different faiths who
were able to talk about their faith’s perspective in relation to mental illness. Fatima El-Guenuni from
the Arabic Family Service talked about her Muslim faith. Geoff Morgan and Ari Cohen, both
Chaplains from Imperial Healthcare NHS Trust, gave us details of their Christian and Jewish
perspectives respectively and Dr Chetna Kang, Consultant Psychiatrist, spoke from a Hindu vantage
point.
4.4.8 The Palliative Care Service within Camden Provider Services makes a point of ensuring that
the spiritual and faith needs of patients are responded to and catered for. As well as ensuring that
spiritual needs are part of the initial assessment of all Palliative Care patients, a religious leader is
also present at in-patient multi-disciplinary team meetings.
4.4.9 The Westminster Wellbeing team has delivered mental health awareness sessions to faith
communities in Westminster. These include events at Methodist central hall, Westminster Christian
mental health forum and the fo guang Buddhist temple. These events raise awareness of the
services that CNWL provides and support faith communities in early intervention for those who attend
their establishments. A series of mental health awareness workshops for faith communities are
planned for the new year. The local CNWL faith and spirituality implementation group in Westminster
has representation from Sikh, Anglican Christian scientist, Muslim and Buddhist communities. The
group acts as a reference point for local faith and spirituality needs and will also provide support to
clinical staff and patients. The group has been co-chaired by the Westminster Mental Health Liaison
Priest.
4.4.10 Based in the Royal Borough of Kensington and Chelsea where there is a significant Arabicspeaking community, the Trust has an established Arabic-speaking service within CAMHS
providing psychotherapy and support from an Islamic perspective. The experience and expertise of
staff has been used to promote awareness and understanding of specific needs and therapeutic
approaches to colleagues within the Trust and currently there is discussion regarding the
development of an Islamic-awareness training session. This is a response to the noted increase in
people having Arab heritage who are accessing services across the Trust as identified through ethnic
monitoring reporting.
4.4.11 Hillingdon Community Health’s Community Engagement Team is working very closely with
the Local Mosque, where mini health awareness sessions are offered to both men and women,
including Blood Pressure measurements, NHS health checks, BMI index measurements, as well
advice on life style, people from a range of communities are engaged with, including: people from
Somalia, Afganistan, Sri Lanka, Nepal, India, Pakistan and the Eastern European area.
4.4.12 The Pharmacy Medicine Information Service is able to provide information on medicines
which contain products that some service users having a particular religion or belief may wish to
avoid and information to assist practitioners to make adjustments to treatment regimens when clients
refrain from oral ingestion during fasting.
4.4.13 As with other Trust services, the Addictions directorate offers appointments to suit the
service user’s religious practices, for instance observance of Muslim prayer times, observance of
the Sabbath. Addictions services in Hillingdon are forging relationship with local faith leaders to build
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collaborative relationships for the support of service users. The directorate offers an inclusive service
to all persons regardless of their religion or belief The Max Glatt Unit (MGU) for in-patients has a
weekly programme that includes prayer times for different religions, e.g.: Friday prayers for Muslim
patients, Sunday church for Christians. There is a quiet room available for prayers on the MGU.
4.4.14 The Trust produces data to monitor service user access to services by religion or belief
on a quarterly basis. This information is distributed to all directorates to inform local actions as well as
to encourage routine recording of this information.
4.4.15 During the period of Ramadan over 4 weeks a weekly session on the open acute wards at St
Charles was held where Imam Shahid would visit and speak to Muslim patients. However in order to
make this an inclusive event, he suggested doing Arabic calligraphy and inviting anyone who was
interested. It was called 'Arabic Art Session' and proved very popular. The patients responded
positively and they were encouraged to learn and practise this attractive art form. The session was
co-facilitated by an Activity Co-ordinator who was instrumental in planning and organising the
sessions. Imam Shahid conducted a similar session on the male PICU ward which was also well
received and again co-facilitated by an Activity Co-ordinator.
4.5
Sexual orientation
4.5.1 On 16th February 2012, during LGBT History Month, the Trust held its first half-day
conference addressing understanding and responding to the needs of Lesbian, Gay, Bisexual
and Transgender patients, service users and
carers. The event took as its theme, “You can’t
ask about that (…or can you?)” in order to focus
on issues associated with data collection and
assessment processes, and the importance of
enquiring about service users’ sexual
orientation. The event was chaired by Robyn
Doran, Director of Operations and Partnerships
at CNWL. As well as stands from local LGBT
organizations, an LGBT time line display was
loaned to the Trust by NHS North West to
display at the event. This comprised 18 display
Robyn Doran, Director of Operations and
boards together providing a 9 metre display
Partnerships, CNWL, speaking at the Trust’s first
presenting the history of the LGBT
LGBT and Health Conference
communities, with reference to pioneers in
developing scientific understanding, rights, justice and the law.
Robyn Doran, officially launched the CNWL LGB&T Advice, Information and Support Service which
has been set up through the Trust’s LGBT&T Staff Network and through which LGB&T staff can be
put in touch with members of the network to receive confidential advice, information and support in
relation to difficulties that may arise in the workplace.
Two presentations were then given. Tim Franks, Chief Executive of PACE, an LGBT organisation
addressing primarily mental health but also wider health issues that arise for LGBT people accessing
services, addressed the topic of ‘LGBT and mental health’. This was followed by Christina
Beardsley, Vice Chair of Changing Attitude. presenting ‘Trans Issues in the Provision of Healthcare’ .
Three workshops followed: Lukasz Konieczka from Mosaic Youth, facilitated a workshop entitled
‘Supporting LGBT Young People’; Nick Maxwell from Age UK Camden facilitated a workshop entitled
‘“Opening Doors London” - Supporting Older Lesbian, Gay, Bisexual and Transgender People’;
James Taylor, Senior Health Officer, Stonewall, facilitated ‘Developing and maintaining an inclusive
team’. A Panel discussion involving all of the speakers and workshop facilitators followed with a
number of valuable points and recommendations made to further advance sexual orientation
Equality. For more information please access the full report on the Trust’s public website. 13
13
http://www.cnwl.nhs.uk/about-cnwl/equality-and-diversity/initiatives/
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4.5.2 In 2010 the Trust was accepted as a participating organisation in the Stonewall Healthy
Lives Initiative. As a result, the LGBT agenda within CNWL was given a timely boost and as a result
the CNWL LGB&T Staff network was formed (which also includes service users representation). The
Network continues to meet quarterly. Consultation processes have been undertaken, greater support
for LGB&T staff has been developed, more visible commitment to sexual orientation equality has
been undertaken within the Trust, a working group has been formed to develop training for staff on
sexual orientation awareness, and there has been greater more general awareness-raising within
CNWL in relation to the LGB&T communities.
The poster campaign has involved the printing of 250 copes of two Stonewall posters with the Trust
logo printed on them, ‘Same Families. Same Care’ and ‘’Some People are Gay. Get Over It’. These
posters have been distributed and displayed in all Trust sites and services. The poster distribution
was supported by a letter from the Trust’s Chief Executive which included the statement:
‘The first poster provides a visual message that goes beyond sexual orientation equality, with
images of a range of diverse families. The second provides for a very simple yet direct and
pertinent message.
All of these posters both I, and the Trust Board, strongly endorse.’
4.5.3 In 2012 the Trust signed up to the Stonewall Diversity Champions programme and
submitted to the 2013 Workplace Equality Index. Undertaking the submission has provided a
valuable exercise in reviewing how the Trust has been performing in relation to sexual orientation
equality and to help identify areas for action in the future. The Trust was 5 points short of being within
the top 100, which we have been told is a commendable achievement for an organisation submitting
for the first time. We will be obtaining detailed feedback and taking actions to improve our
performance, and drawing on this to identify actions we could take to improve our work with groups
having other of the ‘protected characteristics’ identified by the Equality Act 2010.
4.5.4 The Trust has also provided a submission to the new Stonewall Healthcare Equality Index,
designed to focus more specifically on service delivery. Again, the submission process is proving a
valuable exercise in identifying good practice and areas for further development with regard to sexual
orientation equality.
4.5.5 Camden Provider Services (CPS) held a half-day conference at The London Irish Centre on
5th December to raise awareness of Lesbian, Gay Bisexual And Transgender health issues in the
context of service delivery. The event was chaired by Eamann Breen, Business Development
Project Manager. Robyn Doran, CNWL Director of Operations and Partnerships, provided an
overview of health issues for LGBT service users, and Alison Devlin, CNWL Equalities and Diversity
Co-ordinator, gave an overview of the Equality Act 2010 and what it means for service delivery to
LGBT people. This was followed by, Nuno Nodin from PACE speaking on the topic of risk and
resilience for attempted suicide among young LGBT people with reference to a recent study
undertaken by PACE, and Nick Maxwell providing an overview of issues for Older LGBT people and
the work of Opening Doors London (ODL), supported by John Cordingly who is an Ambassador for
ODL. There then followed a series of three workshops addressing ‘Specific issues for older people
and barriers to service provision’; ‘Young people and families – Understanding sexual orientation and
gender diversity’ and ‘Sexual health – improving support and understanding for the LGBT service
users’.
4.5.6 Where a service user identifies as LGBorT, Camden Provider Services Looked After
Children Service supports them with an appropriate placement and are placed with LGBorT foster
carers if preferred.
4.5.7 The Trust has innovatively developed and established a National Club Drug Clinic which
currently attracts mainly people from the LGB&T communities. Links have been established with
LGB&T communities and groups and promotional material designed to be distributed to LGB&T
people. The service is run in partnership with Antidote the LGBT community support group
4.5.8 The Trust produces data to monitor service users access to services by sexual
orientation on a quarterly basis. This information is distributed to all directorates to inform local
actions as well as to encourage routine recording of this information.
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4.5.9 CNWL Mental Health Services in Harrow continue to run a local LGBT Multi-agency group
with Harrow Council and local voluntary sector organisations and in October 2012 facilitated a local
conference titled 'Getting to Know You' to raise awareness of LGB&T Issues for staff and service
users. As a consequence of this, a new initiative is under way to expand the group to become a wider
umbrella forum for the local LGB&T Community where mental health will be prioritised within an
associated working group.
4.5.10 Camden Provider Services provide Outreach services to drug using LGB&T communities
in partnership with the Hungerford Project.
4.5.11 The Trust’s Addictions Directorate continues to provide a support group for LGB&T service
users, run jointly with the Community Alcohol Support Service in Hammersmith & Fulham, and a
Substance Misuse Support Group specifically for gay men. Both of these services provide an
opportunity to offer support to LGB&T people that takes full account of their specific needs.
4.5.12 The Trust offers a monthly Gay Women’s group held at HMP Bronzefield. Within CNWL
Offender Care Services, dental dams are provided to women at HMP Holloway and condoms to men
at HMP Wormwood Scrubs. Currently, a sexual orientation question is being added to the Reception
screen at HMP Holloway and CNWL services in other prisons will follow this. This is also being
implemented within Offender Care community services.
4.5.13 The Trust has made use of information provided by Stonewall to engage LGBT students
through mental health promotion events at universities within London: (SOAS, Kings College and
UCL) as part of World Mental Health Day celebrations.
4.6
Age
4.6.1 The Harrow ‘Young Person’s Group’ (The Bridge) continues for individuals aged 18 – 30.
The Group was established in response to the fact that the general population of the Bridge tend to
be much older and there were no specific activities catering for a much younger group.
4.6.2 The Harrow Older Adults and Health Ageing service regularly offer age-appropriate
interventions such as reminiscence and life story work on a group or individual basis. Harrow Day
Services have run 'Lifestyle Matters' groups which use an evidence-based approach to addressing
issues related to ageing and wellbeing. Seated exercise sessions are run in both inpatient and
day service older adult settings in Harrow and clients are encouraged and facilitated to join in
community exercise sessions for older people.
4.6.3 The effects of medicines can be different in older people and children than adults and
the Trust’s Pharmacy service establishment includes a specialist pharmacist for these two age
ranges. Patient Information Leaflets for children and adolescents are written in language designed to
be accessible to this age range of service user.
4.6.4 The Trust’s Club Drug Service is targeted at people who are 18+, however, recognising that
many younger people also require information and support, the service accepts people who are
under 18 and provides an under18s programme, particularly assessing young people using 'legal
highs'
4.6.5 Across the Trust, CAMHS offers different age appropriate services with specific teams set up
to meet the needs of specific service users, for example. Adolescent Teams, TAMHS Workers, YOT
Workers. Every effort is made to ensure the environment such as waiting rooms and clinic rooms are
age appropriate, which includes age-relevant reading material and therapeutic toys/materials.
CAMHS also has age-specific information leaflets, e.g. medication leaflets designed for a younger
audience and easy read information.
4.6.6 Ensuring young people in need of emergency admission are catered for is important. Ganges
Ward at St Charles Hospital is the nominated ward for patients under 18 years old, if admission is
necessary and an age-specific bed is not available. This only occurs in emergency circumstances,
until a more appropriate ward becomes available. The young person will remain on close observation
during their stay and staff on Ganges Ward are additionally trained to work with under 18 year olds.
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4.6.7 Ensuring that service users within mental health services are not discriminated is an important
feature of the Trust’s recently re-organised service line structure. Older adults remain part of the adult
mental health service when they reach the age of 65, and do not automatically transfer to the Older
People and Healthy Ageing services, unless their needs change, such as developing significant
physical frailty and/or a dementing illness. This maximises continuity of care with the team who
knows them best and ensures that they are not discriminated against in terms of service
provision because of their age. Referrals are accepted based on need not age and assessments
are carried out as far as possible in people's homes.
4.6.8 CAMHS staff work within Youth Offending Teams. In K&C the Muslim Cultural Heritage
Centre is currently undertaking liaison and consultation work with the Team to with outreach to
families, children and young people having Islamic backgrounds offering clinical interventions
and bridging the gap for young people and their communities.
4.6.9 The Addictions Directorate is generally commissioned to provide inclusive services to all
persons from the age of 18 and upwards in most of its boroughs. Hillingdon sector is additionally
commissioned to provide dedicated Young Persons sessions at the local youth counselling
service.
4.6.10 The Addictions Family Therapy Team within Hammersmith & Fullham and Kensington &
Chelsea is additionally commissioned to provide specialist family based therapy with the local
CAMHS and Youth Offending Teams, targeting those young people at most risk of mental
distress and offending. Addictions services consult with local CAMHS teams where a young person
is assessed as substance misuse dependent, as part of that child's multi-agency care plan.
With regard to services for older people, where necessary, detoxification may be facilitated through
local Older Adults and Health Ageing teams, where alcohol related dementia or cognitive impairment
needs specialist assessment.
4.6.11 CNWL health services within HMP Holloway provides a targeted clinic for people who are
over 50 to respond to health and substance misuse issues for this age group.
4.6.12 The Wellbeing Service in Westminster continues to liaise with Open Age. Clients who attend
the Wellbeing Centre’s drop-in sessions are signposted to the Open Age counselling service for
service users who are aged over 50.
4.6.13 The Sexual Health Service in Archway has been assessed to be ‘Young People friendly’ in
a local authority scheme called Young Ambassadors. This scheme sends groups of trained young
people in Camden to assess services and help them become young people friendly. It is a vigorous
process but other Sexual Health Services and the Wheelchair Service are currently participating.
The Integrated Primary Care Service and the ‘frailty register’ were implemented this year. This is an
initiative across Camden which recognises frailty as a treatable condition in itself and identifies the
most frail people and actively case manages them. Frailty does not just occur amongst the elderly but
is more common in older populations so this Service is particularly relevant as the number of people
over the age of 85 years old in Camden is predicted to increase by 10% over the next three years.
Health Care Assistants working in Integrated Primary Care have received training in the Aging
process and Ageism.
4.7
Gender Re-assignment
4.7.1 The Trust’s comprehensive Transgender Policy provides governance and direction for staff
working with trans patients, in particular in relation service provision for people in transition,
confidentiality and the requirements of the Gender Recognition Act. During 2012 work has begun on
reviewing the Policy to ensure that it is fully in line with current legislation and to revisit the way the
Policy is structured to ensure that its content can be easily accessed. The revised version will be
published and publicised early in 2013.
4.7.2 The Trust is experienced in providing in-patient care for transpeople, having had a
number of transpeople requiring in-patient care and support, as well as treatment and support within
addictions services.
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4.7.3 The department of psychological medicine at CNWL’s South Kensington and Chelsea Mental
Health Centre, linked to Chelsea and Westminster Hospital, works closely with the specialist
gender reassignment service at Charing Cross Hospital.
4.7.4 The Trust has developed a specific gender re-assignment care pathway to the specialist
gender assignment clinic at Charing Cross Hospital for people entering HMP Wormwood Scrubs for
whom this is required.
4.7.5 As well as presenting on ‘Trans Issues in the Provision of Healthcare’ Christina Beardsley,
Vice Chair of Changing Attitude, also presented to an LGB&T and Health event organised by
CNWL’s Harrow Mental Health Services for staff.
4.7.6 Following the survey results described more fully at Appendix B2.3 and with a new Lead
Nurse across the Acute Care Mental Health Service Line, issues of providing appropriate care for
Trans service users in a more consistent manner across the Trust has been identified as an area
for action in 2013.
4.8
Pregnancy and Maternity
4.8.1 Prescribers and clinical pharmacists are alert to the risks of medicines in pregnancy and
maternity and will always consider the patient's condition when advising on appropriate treatment.
4.8.2 The Trust has good working relationships with children’s centres, a women’s only
charity spanning different ethnic groups and with charities, voluntary and statutory
organisations tackling domestic violence within Westminster. These are important links given that
the risk of a women experiencing domestic violence increases during pregnancy. Trust services also
work closely with the Women’s Trust, for example, who offer a counseling service and share the
space used by the IAPT and Westminster Wellbeing to promote access to mental health services.
Stronger links have also been developed with perinatal services.
4.8.3 The Addictions Directorate, as with all other CNWL services, offers an inclusive service to all
persons regardless of their state of pregnancy through to delivery and beyond. The service offers
flexible appointments to pregnant women and mothers to meet their parental needs. The
directorate also has established links with maternal services and Child and Family services to route
and engaged pregnant women swiftly into treatment. Written care pathways are in place in all
boroughs. Pregnant substance misusers are prioritised for inpatient detoxification at the Max Glatt
Unit, with due regard to the assessed risk in the community, the trimester of pregnancy, risk to the
foetus, and any local child protection requirements.
4.8.4 CAMHS also provide Mother & Baby facilities (Coombe Wood) to ensure mothers who
require in-patient services have every opportunity to remain with their child. The acceptance criteria
for Coombe Wood has recently been extended to include pre-birth admissions and a father's group
has also been started.
4.8.5 The Trust works in partnership with perinatal services within the Borough’s that it has services
within, and with other mental health services within the Trust as appropriate, to ensure an effective
multi-disciplinary service is provided for pregnant and newly-delivered women with mental
health needs.
4.8.6 The Hillingdon Community Health Community Engagement Team, (described more fully at
4.1.14) takes referrals from maternity staff for women who are vulnerable both in the antenatal and
post natal stages. This contributes to reducing health inequalities and complications in particular for
members of communities that may historically not have had the same level of engagement with
services, or fully understand the range of services and support that are available.
Community Health Services in Hillingdon also provide an Afghani Women’s Support Group. The
Group is for women who are pregnant or who have children under 5. Crèche facilities are available
as are interpreters for women whose preferred language is not English and advocacy. It particularly
reaches out to Afghani women who are feeling isolated or unsure in relation to accessing healthcare.
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4.8.7 Pregnancy and maternity services are available to all females within HMPYOI Holloway.
Links are in place with the local maternity services. There are also crèche facilities for those women
who give birth whilst in prison and for those women serving a sentence who may have very young
children.
4.9
Marriage or Civil Partnership
4.9.1 The Trust is not undertaking specific initiatives relating directly to service users who are
married or in a civil partnership, although there are factors relating to communicating with LGB
service users that involve sensitivity. This includes ensuring that when enquiring about marital
status, both marriage and civil partnership are mentioned, and in a manner that shows that the
staff member is comfortable making the enquiry and in their use of language, for instance, partner.
4.9.2 Palliative Care Services often facilitate marriage and civil partnership ceremonies taking
place before the death of a partner where this is requested.
4.9.3 The Addictions directorate offers an inclusive service to people who are married or in a civil
partnership. Partners, as defined by the patient, can be included in that patient's care, as agreed with
the patients in their personalised care plan. The Addictions Carer pathway contains an inclusive
definition of carer and family member to reflect the broadest range of formal and informal
relationships.
5.
Corporate Functions
5.1
Complaints and Patient Advice and Liaison Service (PALS)
This section describes Complaints handling and PALS.
5.1.1
PALS
An annual PALS report is present to the Trust Board. Information regarding sepecifics cases and
activity in this section are taken from that report. During 2011/12 only 8 PALS enquiries related to
discrimination issues.
Not everyone who uses the PALS service is a service user, and some people are very upset at the
point of contact or wish to use the service anonymously. As a result there are limits on the
completeness of statistical data available on the “protected characteristics” of people.
To build up an ethnicity profile of patients coming to PALS, data from the Patient Information System
is compared with statistics of the Trust caseload as a whole. The ethnicity of patients who make
PALS enquiries is recorded for monitoring purposes against the ethnic profile of the Trust caseload
as a whole, to ensure different groups have equal access to the service, and to also identify where
over-representation may indicate particular concerns. In 2011/12 this profile generally followed that of
the Trust caseload, with over-representation in PALS use by Other Asian and Black African people,
and under-representation compared with the Trust patient groups of people of “other” ethnicity.
PALS publicity material is available in 16 languages. PALS workers receive Equalities and Diversity
training addressing all protected characteristics as part of their initial training package, in addition to
training they may access during the course of their work.
The Trust’s PALS linkworkers are ethnically diverse with a high representation of Black African and
Black Caribbean link workers compared to the Trust caseload. It is hoped that this could ease access
to the service from service users from these ethnic backgrounds who tend to be under-represented in
their use of PALS. The service does not have a policy of matching link workers specifically to service
users. However, it is hoped that this will contribute to fostering good relations between people of
different ethnicities.
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The disability of patients making PALS enquiries are recorded to help monitor their access to the
service. Where appropriate, patients are supported to make a formal complaint. PALS material is
available in Easy-Read, Braille and on CD. Linkworkers receive a half-day training in Deaf
Awareness as part of their initial training package. A number of useful observations have been made
by service users to help improve disability provision within the Trust.
•
•
•
•
•
Ward signs not available in Braille which lead to a reassessment of signage.
Lack of provision for doors to open up automatically for wheelchair users in a ward context.
The need for more consistency in the provision of transport support for disabled service users
attending appointments.
The need for appropriate assessments for people in need of mobility support on wards or
attending services.
The need for staff in general adult mental health units to be adequately prepared and trained for
caring for people having a learning disability, arising from the handling of an individual with an
autistic spectrum disorder, in particular the need to provide a settled environment.
An Age-related concern raised related to an enquirer who was not being allowed to go into
rehabilitation following an inpatient detoxification as he was over the age of 65. This issue was taken
up with the Commissioners by the patient’s Consultant.
No specific concerns were raised through PALS in respect of the above this year in relation to
Gender, Sexual Orientation, Gender Assignment and Religion or Belief
An enquirer who needed a female interpreter was unhappy that a male interpreter had been
arranged. This highlighted the need to remind staff to identify and communicate specific needs in
relation to interpreters at the point of referral, so that staff making the booking can communicate this
on; and where a client has expressed a preference, to book the same interpreter for repeat
appointments. It is made clear within guidance and the Trust’s interpreting policy that as much detail
should be given to the interpreting agency so that an interpreter can be identified to match as far as
possible the requirements of the service user.
5.1.2
Complaints
From April 2012 to the present there have been 6 complaints recorded from service users in relation
to equality or diversity for any of the equality protected characteristics.
Complaints are analysed for Equalities issues as part of the Complaints Team’s monitoring for issues
of discrimination or perceived discrimination. In line with the Department of Health’s requirements,
complaints are recorded under a specific set of categories referred to as KO41, one category being
that of discrimination. Where the main issue is one of discrimination, the individual case is reviewed
to ascertain whether there is any learning to be obtained from the complaint that has been raised.
Whilst not all Equalities characteristic of the complainant/patient are recorded, this is under review.
Plain English is encouraged in responses - as a proportion of complainants have low educational
attainment and jargon is discouraged.
Complaints Information Leaflets are printed in the 11 most used languages in the Trust population.
Assessment over the past 2 years has shown changes in the most popular language. Complaints are
received in the complainant’s preferred language which is translated where necessary. Responses
are also provided in the preferred language of the complainant. Interpreters are provided where
needed to assist the complainant concerned.
The ethnicity of patients involved in a complaint (the complainant is sometimes not the patient) is
collected from the Jade database where this information is recorded by the Trust. This is reviewed
against the ethnic profile of service users to identify whether there is proportional access to the
complaints service. The four complaints relating to ethnicity related to: a service user felt her
treatment was less favourable due to her ethnicity, that staff had not challenged racist comments;
that an interpreter have not been provided; that racist remarks had been made. Three are currently
being investigated. The last one was not upheld as the complainant agreed that she might have
misunderstood what had been said in the context of the conversation that was taking place with her
care co-ordinator.
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Disabilities are not recorded on the Complaints database routinely, except where they are the
subject of the complaint itself. Publicity material for complaints is available in Easy-Read. In
responding to a complainant with a learning disability the Trust would consider it vital that the
investigator meets with the complainant to go through the response to their complaint, or at least
assist in the draft of any written response. The one complaint relating to disability received between
April 2012 to the present concerns issues relating to a service user not accepting the diagnosis of a
‘mentally ill’.
The gender of patients submitting complaints is recorded. No complaints relating to gender have
been received between April 2012 to the present
There has also been no known complaints from trans service users or complaints relating to
transgender issues between April 2012 to the present.
The sexual orientation of patients submitting complaints is not currently routinely collected. It is
collected on Jade patient database so this information can be cross-referenced for monitoring
purposes. Where sexual orientation is a named issue in a complaint, it will be looked at on its own
merit for learning with the staff directly concerned, as well as consideration given more generally to
whether there is wider learning via, for example, the Organisational Learning Group and the CNWL
LGB&T Staff Network. No complaints relating to sexual orientation have been received between April
2012 to the present
The religion or belief of people contacting the Complaints Team is not recorded, except where the
complaint concerns a religion or belief-related issue. The religion of patients is recorded on Jade and
this information could be collected from Jade. One complaints relating to religion or belief was
received between April 2012 to the present relating to a family’s concerns regarding a family member
not receiving a Hindu vegetarian diet. The situation was complicated by issues of capacity. It has now
been resolved with the service user being transferred to a service more able to respond to his
particular cultural needs.
The age of service users is not collected on the complaints database, and age would be looked at
from the basis of which service accessed – i.e. CAMHS, an adult or older adult service. No
complaints relating to age have been received between April 2012 to the present
.
Pregnancy or maternity is only recorded for complainants/patients concerned if they have raised it
as relevant to a complaint. No complaints relating to pregnancy or maternity have been received in
the past 3 years.
Marriage and Civil Partnership is not routinely recorded, unless the complainant provides that
information, and currently would only be if was the subject of the complaint in order for learning to be
identified. No complaints relating to marriage or civil partnership have been received in the past 3
years.
5.1.3
Camden Provider Service’s Patient Support Service (PSS)
Camden Provider Service’s Patient Support Service (PSS) encompasses both Complaints and
PALS. An easy read version of the PSS leaflet is available which was produced in association with
the Camden Advocacy Project, a group of volunteers with learning disabilities who assist and review
literature for easy read purposes. Interpreters (including BSL) are available on request to attend
meetings with service users. Comments and complaints can be made either verbally, through sign
language or in writing and translation can be provided where required.
The PSS try to assure service user’s care will not be affected in a negative manner as a result of
raising a complaint or concern
• PSS information sheet: ‘Please be assured that making a complaint will not affect the care
you receive, either now, or in the future and your contact will be treated confidentially.’
• PSS Easy Read leaflet: (page 3) ‘If you did not get a good service we can help you to be
treated better. You will not get into trouble for talking to us.’
Between April 2012 to the present there were no equality and diversity-related complaints received.
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Equality Act 2010 Compliance Report, January 2013
Involving Carers
Further to the work with carers and the community collaborations reported on in last years Report,
further initiatives have taken place in 2012.
A carer telephone survey was conducted in February 2012 to establish a baseline of carer
experience of services, particularly with regard to their experiences of feeling supported by staff,
being involved in care planning and being listened to when the cared for person was experiencing a
crisis. Following this work, Carer Focus Groups have been run to gain a better understanding of what
support, involvement and crisis means to carers. Carer Focus Groups have been run with young
carers, carers from Black and Minority Ethnic communities, as well as carers supporting someone
with a first episode of psychosis, carers of an older person and carers who have been caring for a
number of years. The aim of the groups is to better understand the carer experience of services,
information that has helped, what information have they been given, support that has helped, their
involvement in care planning, whether they were given telephone numbers to contact in a crisis, and
how services have responded to their concerns.
We have also been asking what three things would have made a difference to them in their role as a
carer for a family member or friend accessing services. This work focuses on the needs of family
members or friends providing support to someone accessing any of the services we provide,
however we recognise that carers have diverse needs and as such met with carers who identified
themselves as BME; we also sought to meet with young carers (under 18), older people caring for a
spouse or elderly parent; family members new to caring and carers who have been caring for a
number of years.
Within this work we have identified that carers from the LGBT community were more hidden to
services which has developed into an action to work more collaboratively with organisations providing
support to members of the LGBT community. Throughout this work we have been mindful of the
diverse needs of carers who may also have needs related to age, pregnancy, sexual orientation,
trans-identity, disability and cultural and religious needs.
Outcomes from this work will inform a long-term plan to ensure that family members are identified
early, are included when ever possible in the care planning process, are provided with appropriate
information and signposted to partner community organisations for support.
We have also revised the information for carers available on the Trust website, providing emails for
young carers, BME carers and carers in general (to use to contact the Trust), and revised the
information available on the Trust website (phase 1) to include more information on local support for
carers and young carers. Phase 2 will include developing information for carers from diverse
communities.
Staff from the Westminster Wellbeing Team have met with members of the Westminster Carers
Network to discuss ways of promoting wellbeing for carers. Staff at the Carers Network work
with different groups of carers (e.g BME, Mental Health, Older Adults) so work is in process to
develop health promotional approaches to meet the wellbeing needs of these different groups.
The Admiral Nursing Service in Hillingdon have provided a service to carers as ranging from 16 to 95
years and have indirectly worked with children and grandchildren as young as 4 and 5. They have
been able to provide age appropriate material such as 'The Milk is in the Oven' and 'Visiting
Grandad's New Home' for young children. For adults there is a wide range of material available such
as the Dementia Booklet, Carers Information Day and Carers Information Programme.
5.3
Vocational Services
The Trust continue to engage service users in a variety of ways within its vocational services
programme (as reported on last year). Vocational services are delivered across the organisation in
adult mental health and addiction services and provide 3 streams of work across CNWL:
1. Delivery of an internal User Employment Programme to enable to the trust to become an
exemplary employer for people recovering from mental health/and or addictions. The programme
supports individuals in applying for posts within the Trust, and then sustaining their role. In some
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cases individuals have also been supported to move into higher grade positions. The programme
also offers time limited work experience placements to enable individuals to improve their
competitiveness for employment, and also offers on-going job seeking and in work support.
2. Delivering of the Individual Placement and Support Model across the trust which involves
Employment Specialists being integrated into mental health teams, to enable the team to become
more effective at supporting service users to access paid work and education opportunities.
3. The development of tools to assist care co-ordinators in becoming more effective at supporting
the vocational goals of service users.
Vocational Services always ensures that any cultural issues are taken into account when supporting
individual's return to work, e.g. avoiding days which have any religious significance for some
individuals. We work in partnerships with a range of external agencies and employers, who offer
support for people from particular backgrounds. This includes ESOL programmes, the Language to
Work Programme, and employers within specific communities.
The Trust Employment Specialists ES are trained to assess the impact of the indvidual’s health
condition on their return to work, taking into account any disabling mental health, addiction-related,
physical and cognitive health issues. They work closely with clinical teams and employers to ensure
that the return to work is sensitive to any health issues, and their work can include advising on
reasonable adjustments.
Employment Specialists are also based within all Early Intervention in Psychosis teams to assist
teams to ensure that young people at risk of exclusion are provided with help to return to university,
and or paid employment. They are also based in other Adult Teams to assist individuals from all age
groups to return to employment. We also have links with agencies that support particular age groups,
e.g. young people, people over 50, to advance age equality in access to work..
We continue to work in partnership with external agencies to support specific gender groups e.g. the
Dress for Success programme aimed at giving women access to affordable clothes to support their
return to work, as well as the 'Suited and Booted Service' which offers a similar programme for men.
Each individual who gains paid employment is provided with an In Work Support Plan to assist them
in their return to work.
The Trust also continues to provide a User Employment Programme (as reported on last year) to
enable people with lived experience of mental health and/or addictions to access paid work within the
Trust, as well as time limited work placements with active job search.
5.4
Service User Involvement
The Trust has well established systems for involving service users in a wide variety of ways in Trust
processes. The Trust’s Head of Patient and Public Involvement (PPI) takes the lead in service user
involvement initiatives and works closely with the Trust’s Head of Equalities and Diversity. The
Trust’s Head of PPI also works closely with the Trust’s Community Development Workers Network in
setting up local events and opportunities for dialogue with diverse communities. Some PPI activity to
date has been targeted at distinct ethnic groups, and in 2012 activities for World Mental Health Day
focused on working with local universities and colleges across the Trust’s catchment areas, where
there is a highly diverse student population, to promote positive mental health and provide
information for students and staff of local services and support agencies.
Surveys
A team of service users and carers have been recruited to conduct various PPI initiatives including
satisfaction surveys, staff training and recruitment etc. These teams have representation from all
Ethnicity groups which is broadly similar to the FT membership. A new software package to gather
service user and carer feedback has been procured which can hold translated versions of survey
questionnaires to enable respondents to participate in the language of their choice.
Service user and carer feedback surveys capture data related to ethnicity, disability, gender, sexual
orientation, religion and age from which responses can be measured and monitored. In some cases
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the survey data can be pinpointed to individuals (where they have agreed to be identified) and from
this data actions can be taken to ensure that the service they are provided with can be improved.
The team is regularly liaising with the Learning Disability service to improve access to engagement
opportunities for people with learning disabilities.
Particular areas of development that are currently being addressed are:
1.
2.
establishing contact with other ethnicity groups to identify specific areas for involvement.
ensuring interpreting services are identified and available for service user and carer
surveys.
3.
establishing a process for ensuring that trans service users and communities are engaged
with so that they are included in opportunities for providing feedback of their experiences.
The team has also undertaken ‘mystery shopping’ to ascertain the responsiveness of services to
telephone calls and to attendance at clinics. A current mystery shopping programme is investigating
carer experiences of inpatient and community services. A targeted approach to identify the
experiences of particular groups of people is possible using the mystery shopping medium by
selecting samples of people to participate from the Trust clinical databases and Foundation Trust
membership data.
User Experience Forum
The Trust has an established Trust-wide User Experience Forum (UEF) which has a membership
that includes representatives of White, Black, Asian and Other communities. Membership also
includes a lay preacher who fosters links with some of the faith communities to alert them to the
needs of mental health service users in the community. Another member, from the LGBT community,
takes a particular interest in service provision issues to these communities. The Forum meets
monthly (chaired by the Trust’s Director of Operations and Nursing) and links through its membership
to local LINks and Service User Groups and Networks. The User Experience Forum is currently
being re-modelled to ensure a closer link with the newly developed service lines, whereby service
lines are being encouraged to engage service users within local quality forums and select
representatives to be part of the UEF.
5.5
Recovery College and Peer Support Workers
The two year Implementing Recovery through Organisational Change (ImROC) Project concluded in
December 2012. Progress has been made across the Trust to embed the concept of co production
which involves creating a different kind of relationship between mental health workers and those
whom they serve. Co-production recognises ‘two sets of experts’: experts by profession and experts
by ‘lived experience’. A key feature of this development is sensitivity and responsiveness to diversity
considerations including those relating to cultural, belief-based and sexual orientation.
As a part of the ImROC initiative the Trust addressed organisational challenges which resulted in
CNWL:
1) Changing the nature of the workforce, i.e. the Trust employs and trains individuals with lived
experience as peer support workers and peer trainers
The Trust has developed and appointed to a Peer Support Manager and Peer Support Employment
posts within the Trust and a range of Peer Recovery Trainers (Recovery College) and Peer Support
Workers (clinical settings) have been introduced into the workforce. This is providing employment
opportunities for those with valuable “lived experience” and complements the skill mix of teams,
contributing to reducing stigma and discrimination. Peer support workers role model the potential for
recovery increasing hope for service users. They encourage principles of co-production to be at the
heart of service line development, delivery and review of services.
The Trust is currently recruiting a peer support worker in Brent to enable service users to navigate
the personalisation process, to support service users in identifying and meeting their individual goals.
A Peer Project lead (carer) has been recruited to work with service users and carers to identify the
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needs of service users with dementia and develop the role of peer support within dementia care in
CNWL.
The Trust has also established an accredited ‘Developing Expertise in Peer Support’ course in
partnership with London South Bank University, to support those service users employed in peer
support roles, to follow nationally accredited training and career pathways.
2) Developing a Recovery College, for CNWL service users, their supporters and staff, where all of
the courses are co-produced.
The work of the Recovery College builds upon the national drive to create a society in which people
with mental health problems have access to the same opportunities in life as everyone else and are
able to play a full role in their local communities. A key feature in the delivery of the Recovery College
is to ensure that all courses are co-developed and co-facilitated by a service user trainer (Peer
Recovery trainer) and a mental health practitioner trainer so that the expertise of both mental health
professionals and of people with lived experience of mental health conditions work collaboratively to
develop and deliver the courses. The initiative will target diverse communities in recruiting to the peer
trainer roles. The Recovery College can offer a wide range of courses, and has the ability to tailor
specific course to meet particular local needs.
During 2012, a BME Advisory Group has been set up involving representation from external, third
sector BME organisations, to help steer the on-going development of the Recovery College to ensure
responsiveness to diverse and cultural needs. The first action flowjng from this is the re-design and
delivery of one of the existing short courses; ‘Navigating the Mental Health System’ to be tailored for
Arabic speaking communities and delivered in Arabic by a bilingual health professional and bilingual
mental health service users.
The Recovery College is working the Learning Disabilities (LD) service and has been thinking with
them about what recovery means in terms of this service user group. At the initial meeting it was felt
that “discovery” felt more ‘fitting’ than “recovery”. People wanted to work on discovering who they are,
what they wanted to do with their lives and how they wanted to look after themselves. Work also
continues in developing a ‘Discovery Plan’ and adapting the Recovery College course Taking Back
Control for the Learning Disabilities service. The course will be co-produced and co-delivered with
further themed courses planned for the future.
Links are also currently being established with the Older Adults and Healthy Ageing service and a
Peer Carer has been appointed into post, starting in January 2013. Work will then begin in
developing courses and adapting courses relevant for this service group
A Quality Assurance Panel has been set up with the purpose of reviewing all new workshops and
courses submitted to the Recovery College. Within this review process equality and diversity
consideration will be included. This will help ensure that all who provide or benefit from this initiative
have a fuller understanding of diverse needs.
The co-development and co-facilitation approach in particular breaks down huge barriers, helps
eliminate disability discrimination and advances equality of opportunity in recovery and in providing
opportunities to those who might have in the past been excluded from learning and developing
opportunities. Partnerships with higher education establishments has resulted in courses being
delivered from local colleges, encouraging and supporting users and their supporters to access
mainstream learning and development opportunities. It also promotes good relations through the
involvement of people who have experienced the disabling effect of mental illness.
5.6
Incident Reporting and Patient Safety
The Trust has an on-line incident reporting system, Datix Web, which has capacity to record
equalities and diversity-related incidents. On all reports the question is asked specifically whether the
incident relates to any of the equalities protected characteristics with boxes provided to indicates
where this is the case. There is currently also a box for the person affected to indicate their ethnicity
and gender. In addition, there is space for free text for any other Equalities related factors to be
identified. The system allows for assault and verbal abuse to be reported.
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The provision of real time incident reports via Datix Web ensures that diversity factors can be
followed up at a local level in a timely manner. This is often in the format of local managers providing
support to people who have been involved in an incident. The availability of these incident reports
can also be used to support the Trust in pursuing criminal acts further in partnership with the Police
and Crown Prosecution Service. Currently there is discussion as to how best to use the system to
ensure and monitor that staff affected by incidents are responded to and provided with the necessary
support from managers.
5.7
Communications
The Trust’s public website has recently been redeveloped by the in-house communications team
and an accessibility accredited web development agency. The specification, software and
development process ensured that the website was designed to meet ‘AA’ compliance, as required
by all NHS websites. A second development phase is now underway that aims to raise this to an
'AAA' compliance standard.
The Trust’s public website has a range of easily accessible Easy Read information which includes
healthy advice, the care programme approach (CPA) to delivering care and the mental health act.
The Trust’s E&D team work closely with the Trust’s communications team, advising and contributing
to material, guidance and policies that shape the Trust’s communications agenda.
A key element of communication about Equalities and Diversity within CNWL is the Trust’s internal
internet (Trustnet). An image of the front page of the extensive E&D section is reproduced below:
Each of the links in the Diversity strand section takes you to a page with a similar layout providing
information, web links and news items specific to that particular diversity strand. The pages are
regularly updated and all new pages and news items also appear on the main intranet home page for
all staff to see.
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In addition, the Trust produces a quarterly Equality & Diversity Newsletter, Inclusion News,14 which
includes policy developments and updates, news from within and outside of the Trust on E&D
matters, reviews and web links to reports and other
documents, news of upcoming events, Conference
reports, an Equalities and Diversity ‘good practice’
section, Trustnet updates, Training information and a
section of book reviews.
The Trust has also launched a book loan library. Over 60
titles are currently available for loan covering the various
equality characteristics in the context of health and social
care. The library has been publicised to all staff.
The Trust has developed and publicised Guidance for
ensuring that Events organised by the Trust are
Equalities and Diversity compliant. This Guidance
document addressing issues pertaining to choosing the
right venue, conference organisation and considerations
before and during the event. It encompasses ensuring
that delegates have the opportunity to communicate their
needs, and that the venue and organisational processes
are responsive to those requirements. It addresses
location and building layout issues, date considerations,
publicity and booking, catering, delegate packs,
communication issues relating to the format of the event
and a comprehensive checklist for event organisers.
Equalities and Diversity posters have been on display at all sites and services. In the past these
specifically addressed the requirements of previous legislation. A new poster entitled ‘Our
Commitment to Equalities and Diversity’ was distributed to all sites and services early in 2012 which
communicates the Trust’s commitment to equality across all protected characteristics, commitment to
the public sector equality duty, and zero tolerance towards racist, homophobic, transphobic and other
forms of abuse.
The Trust also has Zero-Tolerance posters visible within
services and Stonewall posters promoting LGB equality and
more general diversity equality.
The Trust provides a language translation on all patient
information to highlight the availability of Trust information in
other languages and formats on request. The Trust also
seeks to ensure that diverse communities are represented in
the images portrayed in our communications materials and
within reports and other public documents.
As noted in an earlier section, the provision of interpreting
is a key feature of Trust services, thereby advancing equal
access to services and treatment for people whose preferred
language is not English. During 2011/12 there were over
9,000 face-to-face interpreting episodes provided, catering
for 65 different languages. In addition, telephone interpreting
is now also used routinely where appropriate.
5.8
Contracting
When reviewing the Trust’s template for contracts whilst preparing for last year’s report it was
identified that there needed to be an update to the text to fully take account of the requirements of the
14
Inclusion News, http://www.cnwl.nhs.uk/equality_diversity_news.html
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Equality Act 2010 and the Equality Act 2010 (Statutory Duties) Regulations 2011. A revised section
was drafted and forwarded as an addendum by the Trust’s Contracts Department to organisations
with whom the Trust contracts. In 2013 a new contracts template will be introduced which includes
the revised wording.
5.9
Procurement
As reported last year, in reviewing the Trust’s template for Terms and Conditions, based on the NHS
conditions of contract for the supply of services, it was noted that both the guidance and therefore the
Equalities and Diversity section within the current CNWL Terms and Conditions statement required
updating to fully take account of the requirements of the Equality Act 2010 and the Equality Act 2010
(Statutory Duties) Regulations 2011. A supplementary Terms and Conditions has therefore been
produced.
5.10
Freedom of Information
During 2011/12, 5 Equalities-related Freedom of Information requests were received by the Trust.
These related to staff age; disciplinaries; consultations with disabled people, staff ethnicity and the
employment of Chaplains. All were responded to fully with the required information provided.
6.
Next Steps
Having been approved by the Trust’s Board of Directors, this Report will be circulated to all Service
Directors, Human Resources Managers and other senior managers. It will also be publicised to
external stakeholders and partners. We are not including a specific action plan within this Report as
the Trust’s Equalities and Diversity priorities are identified within the Trust’s 4-year Equality
Objectives, and progress will be reported on during April or May 2013 for the first year of the Equality
Objectives.
Major areas of on-going work will include:
•
•
•
•
•
•
•
•
Improving data collection rates for staff and service user disability, religion or belief and sexual
orientation
Training development and delivery to include: LGB&T awareness, migrants and refugees
awareness, faith and spirituality awareness
Strengthening the Equality and Diversity Leads Network within the Trust to cater for major
organisational changes
Extending Chaplaincy and Faith Visiting further across Trust services
On-going community engagement work, in particular, a focus on working with the Tamil
community to develop greater community support and counseling
Actions to be identified from a staff survey to address violence, harassment and discrimination
towards staff from service users, carers and the public
Organising a second LGB&T and Health Conference
Continued support for, and development of, Staff Networks. This will create greater opportunities
for staff to contribute their knowledge and experience to developments within the Trust.
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Appendix A. Workforce Profile and Survey Results
A1
Workforce Profile
Within CNWL as at 31st March 2012 the Trust employed 5159 staff.
The Trust uses the ESR system for collecting staff data, with additional Census’s held to update
these records. The data is used to monitor the profile of staff to identify areas of disproportionality
and for workforce planning. The Trust has most detail and analysis relating to ethnicity as
proportionately this is the equalities characteristic where there is greatest need for monitoring and
where, as will be shown below, there is clearest evidence of a ‘glass-ceiling’. The following tabular
summaries are taken from the Trust’s Equality and Diversity Monitoring Report 2011/12. Further data
has been produced for this report in relation to dismissals and redundancies.
A1.1 Ethnicity
Comparing all CNWL employees to the combined population of Brent, Harrow, Westminster,
Kensington & Chelsea and Hillingdon Trust has most notably higher %’s of staff having Black African
ethnicity, and most notably lower %s of staff having White British, White Other and Indian ethnicities.
Comparing staffing to population at a Borough level within Adult Mental Health Services, Community
Health Services and cross-Borough services (grouped into White, Asian, Black and Other) reveals:
Directorate
Ethnicities over-represented
Ethnicities under-represented
Brent and Harrow
Adults MHS
Black staff
White and Asian staff
Hillingdon Adult
MHS
Black staff
White staff
K&C Adult MHS
Black and Asian staff
White staff
Westminster Adult
MHS
Black staff
White and Other staff
CAMHS
White and Black staff
Asian staff
Addictions
Black staff
White. Asian and Other staff
Older Adults
Black staff
White staff and to a lesser degree
Asian staff
Learning Disabilities
Black or Other staff
White staff
Hillingdon
Community Health
Black staff
White staff
Camden Provider
Service
Black staff
White staff
Horton Haven
Black and Other staff
White and Asian staff
Eating Disorders
Black and White staff
Asian and to a lesser extend
Other staff
Offender Care
Black staff
White, Asian and Other staff
At Trust HQ – there is a higher proportion of Black staff and a lower proportion of Asian staff
compared to the five Boroughs
Ethnicity data for particular groups of staff and in relation to other Human Resources functions
reveals the following:
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CNWL NHS Foundation Trust
Nursing workforce
Medical workforce
Other groups
Seniority
Recruitment
New Arrivals and
Stayers
Leavers
Promotion
Disciplinaries
Grievances
Training
Equality Act 2010 Compliance Report, January 2013
Highest proportion of staff have White British and Black African ethnicities.
Black nursing staff are proportionately more concentrated in grades below
band 7, and White nursing staff at band 7 and above. The effect of the added
nursing staff from HCH and CPS makes meaningful comparison to previous
years difficult.
There continues to be significant under-representation of Black doctors and
an over-representation of White doctors at Consultant level.
Highest % of Black staff within the Additional Clinical groups and of White
staff within A&C bands 8+ and Allied Health Professionals.
White staff more concentrated generally in bands 7 and above, staff from
other ethnic grouping more likely to be in lower bands, most noticeably Black
staff.
White applicants are more likely to be offered interviews and posts whilst
Black African in particular but also Asian and White Other applicants are less
likely to be offered interviews and posts. The trend is towards more White
British and less Black African applicants being offered posts.
Comparing new arrivals with stayers the profile if broadly similar although
there are slightly higher levels of new arrivals for Indian, Pakistani and
Bangladeshi staff, and lower levels of White British and Black Caribbean new
arrivals.
Comparing leavers to employees overall, there are higher proportions of
Indian, Asian Other and White Other staff leaving, and significantly lower
proportion of Black African staff leaving.
Comparing to the workforce overall, the most notably lower % of staff being
promoted are those having Black Caribbean, Black African and Asian Other
ethnicity, and higher % of White British and Mixed are promoted.
113 formal disciplinary cases during 2011/12 compared to 84 cases in
2010/11. Staff having Black African and Black Caribbean ethnicities have a
higher rate of disciplinaries compared to their share of the workforce.
Only 13 formal grievances lodged in the last twelve months, the highest
proportion involving Black or White staff.
A slightly higher proportionate access by White British staff, and lower
proportionate access by Black African staff to training overall.
A1.2. Age
Overall staff profile
Seniority
Recruitment
Starters and leavers
Promotions
Disciplinaries
Grievance
Training
The highest proportion of staff are between 41 and 50 years of age and the
lowest over 60.
The age group that is most represented at senior levels is the 41-50 year old
group, an age group that is also the most represented at bands 1-4.
The highest proportion of applicants, interviewees and people offered posts
are under 30. However, the % of people offered posts from within this age
band is lower than the % of applicants within this age group.
Higher proportion of starters compared to leavers are under 49; lowest
proportion of starters compared to leavers aged 60+.
A higher proportion of people under 39 are promoted compared to their share
of the workforce. Staff over 50 have lower rates of promotion compared to
their share of the workforce.
Staff in age bands 40-49 and 50-59 have a higher rate of disciplinaries
compared to their share of the workforce. All the other age bands have lower
rates of disciplinaries.
As the number is so small it is not possible to draw meaningful conclusions in
comparison to the workforce.
Access by age band is broadly similar to the overall workforce.
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A1.3. Gender
Overall staff profile
Seniority
Recruitment
Starters and leavers
Promotions
Disciplinaries
Grievance
Training
Just over a quarter of staff are male and just under ¾ are female. A higher
proportion of female staff are part-time compared to the proportion of male
part-time staff.
The male to female ratio is broadly similar across pay band groupings,
although there is a slightly lower proportion of female staff at higher grades
and a slightly higher proportion of male staff at lower grades. The greatest
variance is at band 4 in terms of the proportion of female to male staff, and
the lowest is at band 8d.
The highest proportion of applicants, interviewees and people offered posts
are female, and female applicants are more likely to be offered posts than
male applicants.
Little variance between starters and leavers for male and female staff.
Promotions are comparable to their % of the workforce overall for both male
and female staff.
Male staff have a higher rate of disciplinaries compared to their share of the
workforce. Female staff have a lower rate.
As the number is so small it is not possible to draw meaningful conclusions in
comparison to the workforce.
Slightly higher rate of access to training for male staff compared to the
overall male workforce, and lower rate for female staff compared to the
female workforce.
A1.4. Disability
Overall staff profile
Seniority
Recruitment
Starters and leavers
Promotions
Disciplinaries
Grievance
Training
Only 2% of staff have declared a disability although 65% have not defined a
disability status.
There is a reduction in the proportion of staff declaring having a disability at
higher pay bands.
The highest proportion of applicants and people offered interviews and posts
are not disabled. A slightly lower proportion of staff offered posts are
disabled compared to the % of disabled applicants.
A higher proportion of leavers compared to starters are disabled and a lower
proportion of leavers compared to starters are not disabled. The data is
affected by the high and unequal levels of religion undefined between the
two sets of staff.
Non-disabled staff have a slightly higher rate of promotion compared to their
% of the workforce overall, whilst disabled staff have a lower rate, however,
the data is significantly affected by high levels of disability undefined.
Both staff declaring a disability and non-disabled staff have a higher rate of
disciplinaries compared to their share of the workforce. However, the data is
significantly affected by high rates of disability not known.
As the number is so small it is not possible to draw meaningful conclusions in
comparison to the workforce.
The proportion of disabled staff accessing training is similar to the access of
non-disabled staff. Data is affected by high rate of disability status undefined.
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Equality Act 2010 Compliance Report, January 2013
A1.5 Religion or Belief
Overall staff profile
Seniority
Recruitment
Starters and leavers
Promotions
Disciplinaries
Grievance
Training
Just over a third of staff are Christian but a further third have not disclosed a
religion or belief. The next highest group is Atheist (6%).
In terms of seniority, the data is affected by about 1/3 undefined. Whilst
Christians are the highest group at senior levels, Atheists have the most
noticeable variance between lower and higher grades.
The highest proportion of applicants, and people offered interviews and posts
are Christian. Within the different groups, Atheists and those having Other
religion or not disclosing are more likely to be offered posts, and Muslims
and Hindus less likely.
a higher proportion of starters than leavers are Christian, but the
comparisons are affected by the high and unequal levels of religion
undefined between the two sets of staff.
Christian staff have a higher rate of promotion compared to their % of the
workforce overall, as to a lesser extent do staff having Other religion.
However the data is affected by the levels of religion or belief undefined.
No group of staff having a particular religion or belief have higher rates of
disciplinaries compared to their share of the workforce, however, the data
use is significantly affected by high rates of religion or belief not known.
As the number is so small it is not possible to draw meaningful conclusions in
comparison to the workforce.
Access to training is broadly similar between religion and beliefs compared to
their share of the overall workforce. Data is affected by high level of religion
or belief undefined.
A1.6 Sexual Orientation
Overall staff profile
Seniority
Recruitment
Starters and leavers
Promotions
Disciplinaries
Grievance
Training
The highest proportion of staff are heterosexual. About 2% of staff have
disclosed being Lesbian, gay or bisexual, however data is affected by 36%
sexual orientation not defined and 10% of staff choosing not to disclose.
The highest proportion of staff at all levels of seniority are heterosexual,
however % of gay staff increases with seniority. Data is affected by the high
proportion of sexual orientation undefined.
The highest proportion of applicants and people offered interviews and posts
are heterosexual. A slightly higher proportion of staff offered posts are gay
compared to the % of gay applicants.
A higher proportion of starters compared to leavers are heterosexual, but the
comparisons are affected by the high and unequal levels of religion
undefined between the two sets of staff. Although numbers are low, lesbian,
gay and bisexual staff also have higher rates of starting than leaving.
Heterosexual staff have a higher rate of promotion compared to their % of
the workforce overall, as do gay staff to a lesser extent, and staff not wishing
to disclose their sexual orientation have a lower rate. The data is significantly
affected by high levels of sexual orientation undefined.
No group of staff having a particular sexual orientation have higher rates of
disciplinaries compared to their share of the workforce, however, the data
use is significantly affected by high rates of sexual orientation not known.
As the number is so small it is not possible to draw meaningful conclusions in
comparison to the workforce.
Access to training is broadly similar between sexual orientations. Data
affected by high rate of sexual orientation undefined.
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A1.7 Gender Re-assignment
The ESR system does not have capacity to record whether a person’s current gender identity is the
same as their birth gender identity. The Trust does employ transpeople within its workforce, which
includes staff who have previously undergone gender re-assignment and who have undergone
gender re-assignment during the course of their employment with the Trust. Trans staff were involved
in the development of the Trust’s Transgender Policy and are members of the Trust’s LGB&T Staff
Network.
A1.8 Pregnancy and Maternity
The ESR system does record staff pregnancy and this can be analysed to identify whether staff
return to work, or not, and if so whether they returned on a flexible working arrangement.
During 2011/12, 34% of staff returned to work with adjusted hours (33% the previous year); 11% left
the Trust 20% the previous year). 1% took a career break (this was not recorded for the previous
year).
Analysis by protected characteristic shows:
•
•
•
•
•
•
•
•
Highest % of Chinese (100% - 4) and Black Caribbean 56% - 5) staff, and lowest % of Asian
Other (13% - 1) and Asian Pakistani (20% - 1) staff changing hours following pregnancy.
Highest % of Asian Other (25% - Mixed (25% - 1), White Other (22% - 6) and White British (13% 15) with very low or zero levels of staff of oher ethnicities leaving following pregnancy.
Staff aged 41-50 most likely to change their hours following pregnancy and those aged 21-30
least likely,
Staff aged 21-30 most likely to leave following pregnancy and staff aged 41-50 least likely.
Staff identifying as Jewish, Other Religion or Atheist most likely to change their hours following
pregnancy; staff identifying as Buddhist or Sikh least likely..
Staff identifying as Buddhist, Christian or Hindu most likely to leave following pregnancy. All other
religions or believes have low levels of leaving following pregnancy
As only 2 Disabled staff were pregnant during the year, comparison with non-disabled staff is not
of statistical value.
Only 1 person identifying as lesbian was pregnant during the year.
A1.9 Marriage and Civil Partnership
The ESR system does not record staff marital or civil partnership status.
A1.10 Additional Staff Data Analysis
•
Length of service/time on pay grade - We are not currently reporting on this as our ESR
records only go back 5 years which would not be a significant time. This is an area that we will
discuss further in 2012 as to what data we could produce that could be analysed in order to
produce meaningful conclusions.
•
Pay gap information - Most employees are employed under the Agenda for Change (AfC)
system. AfC was implemented to modernise the terms and conditions for the NHS workforce who
had previously been employed on Whitley Council terms and conditions. It was to ensure a fair
system of pay for NHS employees in support of modernised working practices. This was
nationally agreed in partnership between employers and trade union representatives and among
the principle objectives are:
•
•
•
•
Ensure the pay system leads to more patients being treated, more quickly and being given
higher quality of care
Assist new ways of working which best delivery the range and quality of services required in
as efficient and effective a way as possible
Assist the goal of achieving a quality workforce with the right numbers of staff, with the right
skills and diversity and organised in the right way
Improve the recruitment, retention and morale of the NHS workforce
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•
•
Equality Act 2010 Compliance Report, January 2013
Improve all aspects of equal opportunity and diversity, especially in the areas of career and
training opportunities and to ensure working patterns that are flexible and responsive to family
commitments
To meet equal pay for work of equal value criteria, recognising that pay constitutes any
benefits in cash or conditions.
Nationally there was a legal challenge as to whether AfC was non-discriminatory but this was not
proven and therefore remains the national terms and conditions. NHS jobs have been evaluated
nationally and national job profiles developed. Jobs within CNWL are matched or evaluated using
nationally set down criteria. AfC was fully implemented across the whole of CNWL and is
consistently applied. We have therefore not sought to report separately in this area as we believe
AfC to be a proven system for ensuring equal pay for equal work.
•
Flexible Working – whilst the Trust does have a Flexible Working Policy, data is not available to
compare flexible working requests with flexible working agreed or approved. The reason for this is
that many requests for flexible working are agreed informally. We have included flexible working
in this report in relation to maternity leave as agreed flexible working in this instance is generally
of a formal nature.
•
Dismissal – There were 23 dismissals during the year. The only areas where there is evidence
of disproportionality are in terms of:
• Gender- 61% of dismissals were male staff compared to 28% male staff employed by the
Trust.
• Ethnicity – 26% of dismissals were of staff having an Asian ethnicity compared to 11% of
Asian staff overall, 39% were staff having a Black ethnicity compared to 25% of Black staff
overall and 9% were staff having a White British ethnicity compared to 41% of White British
staff overall
• Age – 61% of dismissals were staff in the 41-50 age group which makes up only 32% of staff.
For other protected characteristics high levels of data not disclosed makes comparisons to the
workforce difficult.
•
Redundancy – during the period 1st April 2011 to 31st March 2012 there were only 7 compulsory
redundancies with no indication of any disproportionalities in relation to protected characteristics.
A2
Staff Surveys
The following information is taken from the 2011 Staff Survey in relation to the questions that are
Equalities and Diversity specific, with 2010 results for comparison. We are currently awaiting the
2012 results.
In the last 12 months, 14% of respondents indicated experiencing discrimination at work from service
users, carers or members of the public (a slight increase from 13% in 2010). 7% of respondents
indicated experiencing discrimination at work from a manager/team leader or work colleagues (a
noticeable decrease from 13% in 2010.
Of the 76 survey respondents reporting experiencing discrimination:
•
•
•
•
•
•
61% (46) indicated that this was race-related (an increase from 57% in 2010).
17% indicated that this was gender-related (a decrease from 18% in 2010)
7% indicated that this was related to religion (an increase from 5% in 2010)
11% indicated that this was related to sexual orientation (an increase from 9% in 2010)
3% indicated that this was related to disability (no change from 2010)
9% indicated that this was related to age (no change from 2010)
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Further findings from the survey are given in the tabulation below:
Question
5. Have you had any training, learning or development
(paid for or provided by your
Trust), in the following areas?
a. Equality and diversity training (e.g. awareness of age,
disability, gender, race, sexual orientation, religion).
18. Does your Trust act fairly with regard to career
progression / promotion, regardless of ethnic background,
gender, religion, sexual orientation, disability or age?
30a In the last 12 months have you personally
experienced harassment, bullying or abuse at work from
patients / service users, their relatives or other members
of the public?
30b In the last 12 months have you personally
experienced harassment, bullying or abuse at work from
Manager / team leader or other colleagues?
44a Do you have a long-standing illness, health problem
or disability?
44b Has your employer made adequate adjustment(s) to
enable you to carry out your work?
Response
Yes in the last 12
months
Yes more than 12
months ago
2010
42%
2011
50%
29%
32%
Yes
56%
55%
No
Yes
9%
21%
9%
20%
Yes
14%
12%
Yes
16%
14%
Yes
56%
62%
* In particular, 24% of Black staff receive the highest levels of this unacceptable behaviour, a higher
proportion compared to other ethnic groups.
As a result of this the Trust is undertaking a separate survey to gain further insight and understanding
with regard to the violence, harassment and discrimination that staff indicate experiencing. The
survey also includes a question regarding the experience of the Trust as acting fairly with regard to
career progression and ideas for actions to improve staff experience.
In addition to the above survey findings:
Higher % of male staff reported experiencing discrimination from patients, relatives, the public
(15% v 10%) – similar to 2010 (15% v 11%)
• Slightly higher % of female staff reported experiencing discrimination from managers/team
leaders/colleagues (10% v 9%) – reduction from 2010 (12% v 10%).
• Higher % of disabled staff reported experiencing discrimination from patients, relatives, the public
compared to non-disabled staff (14% v 11%) – a reduction from 2010 (16% v 12%).
• Higher % of disabled staff reported experiencing discrimination from managers, team leaders,
colleagues compared to non-disabled staff (15% v 9%) – a reduction from 2010 (18% v 10%).
• 4% of disabled staff reported their experience of discrimination as relating to disability (same as
2010).
• Higher % of staff in age bands 18-30 and 31-40 reported experiencing discrimination from
patients, relative, the public; staff with age bands 51-65 and 66+ least likely (13% v 10%).
• Higher % of staff in age band 51-65 reported experiencing discrimination from managers, team
leaders, colleagues; staff in age bands 21-30 and 66+ least likely (11% v 8%).
• Higher % of staff in age band 21-30 reported experiencing age-related discrimination (7%). Other
age bands ranged between 1 and 2%.
• Higher % of gay staff reported experiencing discrimination from patients, relatives, the public
compared to heterosexual staff (18% v 11%)
• Higher % of staff who prefer not to disclose their sexual orientation reported experiencing
discrimination from managers/team leaders or colleagues compared to gay and heterosexual
staff (15% v 9%)
• Of those who report experiencing discrimination, gay staff more likely to experience sexual
orientation related discrimination (12% compared to heterosexual staff (0%) and those preferring
not to disclose a sexual orientation (1%)
•
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•
•
•
Equality Act 2010 Compliance Report, January 2013
Higher % staff who are Christian reported experiencing discrimination from patients, relatives, the
public compared to other religion or belief groups; staff having no religion have lowest % (13% v
8%). However, Christian is the highest religion amongst staff, and in particular front-line staff.
Higher % of staff who prefer not to disclose a religion reported experiencing discrimination from
managers, team leaders, colleagues compared to other religion or belief groups; staff having no
religion are the lower % (15% v 7%).
3% of non-Christian staff reported experiencing of discrimination related to their religion or belief
but numbers are low.
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Appendix B Service User Profile and Survey Results
Apart from the Community Health Services (Camden Provider Services (CPS) and Hillingdon
Community Health (HCH) which use RiO), the Trust uses the Jade electronic information system for
recording and reporting on service user equalities demographics. Service User Surveys have been
analysed by protected characteristic where this data is recorded and is also reported in this section.
B1
Service User Profile
The chart below shows the ethnic profile of all service users accessing CNWL services (not including
the community provider services) during 2010/11. Data is largely taken from the CNWL Equality and
Diversity Service Delivery Monitoring report 2011/1215.
B1.1
Ethnicity
Directorate
Acute admissions
Adult community
Older Adults
In-patients services
Ethnicities Over-represented
Black Caribbean, Black African,
Black Other and Other Ethnic
Group
Other Ethnic Group
Ethnicities under-represented
White British and Indian
Indian
White Other, Other Asian and
Other Ethnic Group
White Other, Other Asian and
Other Ethnic Group
White British
Other Ethnic Group, Black Other,
Mixed, Black African, White
Other
Other Ethnic Group, Mixed, Black
Caribbean
Indian, White British, Black
Caribbean and White Irish
White British, Indian and Other
Ethnic Group
Addictions
In-patient services
White Irish
Community services
Other Asian
Indian, White Other and Black
ethnic Caribbean
Black Caribbean and Black
African
Community services
CAMHS
In-patient services
Community services
Learning Disabilities
In-patient services
White British
Black Caribbean, Black African,
Black Other
Black Other, Black Caribbean,
Black African,
Indian, White Other, White British
White Other, Indian, White British
Black Caribbean, Black Other,
White British and White Irish
Black African, Black Caribbean,
Black Other and White Irish
Other Asian, Black African. Data
affected by 16.8% ethnicity
unknown.
White Other and Indian
Camden Provider Services
Adult
No notable over-representation
Children and Young
People
Black Other, Other Ethnic Group
(data affected by 25% ethnicity
Black African, Bangladeshi and
White Other
White British (data affected by
25% ethnicity unknown)
Community services
Horton Haven
Inpatient services
Community services
Hillingdon Community
Health
15
Indian and White Other
White British. Data affected by
16.8% ethnicity unknown.
CNWL Equality and Diversity Service Delivery Monitoring Report 2011/12. http://www.cnwl.nhs.uk/aboutcnwl/equality-and-diversity/documents/
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unknown)
Offender Care
Do not have overall prison population for comparator but highest % of
service users are generally White British across Offender Care
Services.
The over-representation of service users within the Other Ethnic group category is likely to be in part
due to increased numbers of people within this category entering the UK since the 2001 census, and
within this group there is an increasing number of people identifying as Arab (from the Middle East
and North Africa). The Trust has an Arabic-speaking CAMHS service and is currently develop Islamic
Awareness training for staff. Prayer times and Ramadan information is publicised and prayer rooms
and access to faith support is provided although there is some inconsistency in provision in some
areas of the Trust which is being addressed.
Use of the Mental Health Act
The following are comparisons with the population served.
Sections 2 admissions
Section 3 admissions
Section 136
Supervised Community
Treatment
B1.2
Ethnicities Over-represented
Other Ethnic Group, Black African,
Black Caribbean, Black Other
Other Ethnic Group, Black Other,
Black African, Black Caribbean,
Mixed
Black African, Black Caribbean,
Black Other, Other Ethnic Group,
Black African, Black Caribbean,
Black Other, Mixed, Other Ethnic
Group
Ethnicities under-represented
White British and Indian
White British and Indian
White British and Indian
White British, Indian, White
Other, White Irish
Disability
The Trust’s low recording rate for service users means disability data remains an issue with 95%
disability not recorded, and it is therefore not possible to draw meaningful conclusions.
Addressing this low recording rate is targeted within the Trust’s 4-year Equality Objectives.
B1.3. Gender
Directorate
Acute admissions
Adult community
Older Adults In-patients services
Older Adults Community services
CAMHS In-patient services
CAMHS Community services
Addictions In-patient services
Addictions Community services
Learning Disabilities In-patient services
Learning Disabilities Community services
Eating Disorders In-patient services
Eating Disorders Community services
Horton Haven In-patient services
Horton Haven Community services
Hillingdon Community Health
Gender comparison
higher % of male to female service users
higher % of female to male service users
higher % of female to male service users
higher % of female to male service users
higher % of female to male service users
(includes Mother and Baby Unit)
higher % of female to male service users
higher % of male to female service users
higher % of male to female service users
higher % of male to female service users
higher % of male to female service users
higher % of female to male service users
higher % of female to male service users
higher % of male to female service users
higher % of male to female service users
higher % of female to male service users
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Camden Provider Service
Offender Care
B1.4
Equality Act 2010 Compliance Report, January 2013
Higher % of female to male service users within
children’s services
In non-gender specific services there tend to be
more male than female service users
Age
The following table shows the highest age bands for service users accessing services and a
comparison between inpatient and community to show where there are the most significant
contrasts.
Directorate
Acute admissions
Adult community
Older Adults In-patients services
Older Adults Community services
CAMHS In-patient services
CAMHS Community services
Addictions In-patient services
Addictions Community services
Learning Disabilities In-patient services
Learning Disabilities Community services
Highest age band
Inpatient/community
comparison
40-49 years
Under 50 higher
40-49 years
Over 50 higher
Data over 60 years not broken down
Data under 30 years not broken down
40-49 years
30-39 years
Under 30 years
Under 30 years
50-59 years higher
Under 30 years
Under 40 higher
Over 40 higher with 60+
highest variance
Below 30 and over 39
years higher
30-39 years higher
Over 60 years higher
30-39 hears higher
All other age bands
Eating Disorders In-patient services
Eating Disorders Community services
Under 30 years
Under 30 years
Horton Haven In-patient services
Horton Haven Community services
Hillingdon Community Health
Over 60 years higher
30-39 hears higher
Under 30, and slight for
60+
For adults, number increases with age. For children
and young people, the largest group are under 7 with
numbers concentrated under 4s.
Camden Provider Service
B1.5
Religion or Belief
Across the Trust the most represented faith is Christian, with Not–religious, Other Religion and
Muslim most consistently next highest across services. The Trust is also targeting improving its
recording rate which is included within the Trust’s 4-year Equality Objectives.
B1.6. Sexual Orientation
Across the Trust the highest % of staff are heterosexual with up to 5% of staff identifying as lesbian
gay or bisexual (varying % across services). However, data is affected by a n average recording rate
across most of the Trust of around. Some areas of the Trust, for instance many of the community
health services, have historically not collected this data. Addressing this low recording rate is
targeted within the Trust’s 4-year Equality Objectives.
For a fuller and more detailed breakdown of service users by equality characteristic, please see the
CNWL Equality and Diversity Service Delivery Monitoring Report 2011/12. 16
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B2
Equality Act 2010 Compliance Report, January 2013
Service User Surveys
In this section is summary information taken from the 2012 Community Mental Health Service User
Survey. In last years Equality Act Compliance Report the Trust highlighted the results of the 2010
Inpatient Mental Health Survey. This particular survey has not been repeated, rather the Trust has
undertaken quarterly telephone surveys for in-patients following discharge. We have included
equalities data below where this is available from the most recently conducted telephone survey.
We have also included a section in relation to a survey of service users accessing in-patient services
in Westminster and K&C undertaken by Advocacy for Mental Health, an independent third sector
organisation, which raised concerns in a number of areas in relation to the experience of service
users from diverse backgrounds.
B2.1
Community Mental Health Survey 2012
Ethnicity
Across all questions service users having Black ethnicity had the highest number of highest
satisfaction scores, followed by Asian and Other ethnicities. White service users had the lowest
number of highest satisfaction scores. Asian services users had the highest increase in scores
compared to the previous year; Other service users had the lowest.
In terms of service users reporting being treated with dignity and respect by the last professional they
saw, the highest proportion responding’ yes, definitely’ had White ethnicity (84%) the lowest had
Other ethnicity (78%). Black and Asian service users were 80% and 81% respectively.
Disability
The Community Mental Health Service User Survey 2012 did not include a question with regard to
the service users disability status.
Gender
Women had more higher satisfaction scores than men, a reversal from the previous year. There was
an overall increase in satisfaction scores for both men and women. In terms of service users
reporting being treated with dignity and respect by the last professional they saw, 84% of female
service users responded’ yes, definitely’ compared to 79% of male service users. For both genders
this was a slight fall from the previous year.
Religion or Belief
Across all questions service users identifying as Other Religion and Muslim had more highest
satisfaction scores for services. Service Users identifying as Christian or No Religion had the lowest
number of highest satisfaction scores compared to the other religion or belief categories.
In terms of service users reporting being treated with dignity and respect by the last professional they
saw, the highest proportion responding’ yes, definitely’ wer Muslim (86%) and Christian (84%).
Service users who preferred not to disclose their religion had the lowest proportion (70%).
Sexual Orientation
Across all questions service users preferring not to disclose their Sexual Orientation had more
highest satisfaction scores for services; service Users identifying as Lesbian, Gay or Bisexual had
the lowest number of highest satisfaction scores compared to the other religion or belief categories.
In terms of service users reporting being treated with dignity and respect by the last professional they
saw, the highest proportion responding’ yes, definitely’ were those identifying as Heterosexul (82%)
and Prefer not to say (80%). Service users who identified as Lesbian, Gay or Bisexual had the lowest
proportion (73%).
Age
Across all questions service users with age band 25-45 had more highest satisfaction scores for
services; service Users with age band 55-64 had the lowest number of highest satisfaction scores
compared to the other religion or belief categories.
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In terms of service users reporting being treated with dignity and respect by the last professional they
saw, the highest proportion responding’ yes, definitely’ were those within age band 75-84 (92%);
service users within age band 35-44 had the lowest proportion (75%).
Gender Re-assignment
The Trust did add a transgender category to the gender categories on the Jade data system,
however, because this is not a recognised code under the Mental Health Minimum Data Set the Trust
was penalised for recording service user trans data in this way. Additionally, there was concern that
this could breach confidentiality. We understand that national transgender organisations are currently
discussing how this can best resolved within healthcare data recording systems and we will not make
any further changes until we have received their conclusions.
Pregnancy and Maternity
This information is currently not collected on Jade or on RiO, however, it is expected that there will be
in due course a national requirement for these fields to be added which will allow for data collection,
monitoring and analysis.
Marriage and Civil Partnership
Jade has capacity to collect this information, however, it is not a field that is routinely completed. Staff
are being encouraged to complete this.
B2.2
Inpatient Mental Health and AddictionsTelephone Surveys 2012
Inpatient Mental Health and AddictionsTelephone Surveys 2012
The Trust has introduced routine telephone surveys of service users, focusing on priority areas that
have been identified from previous survey results. The areas of focus and the combined results for
quarters 2 and 3 in 2012/13 are summarised in the table below.
Question
Q1 While you were in hospital recently did you
have as much say as you wanted in decisions
about your care and treatment
Q2 Did you feel safe during your most recent stay
in hospital?
Q3 Prior to your discharge from hospital were
you given a telephone number and details of who
to contact in an emergency or crisis?
Q4. Prior to your discharge did you have
discussion with ward staff about your follow up in
the community?
Q5 Overall how would rate the care and treatment you have received in hospital Did you feel
safe during your most recent stay in hospital?
B2.3
Ethnicity
Gender
Age
Ethnicity
Gender
Age
Ethnicity
Gender
Age
Ethnicity
Gender
Age
Ethnicity
Gender
Age
highest levels of
satisfaction/
positive responses
Asian
Male
18-25
Asian and Other
Male
51-65
White
Female
66+
Asian
Female
51-65 and 66+
Asian
Male
51-65
lowest levels of
satisfaction/
positive responses
Black
Female
66+
Black
Female
26-35
Black
Male
18-25
Black
Male
36-50
Black
Female
26-35
Inpatient Survey 2012 – Westminster and K&C
In 2012 a service user survey was also undertaken by Advocacy for Mental Health, an independent
third sector organisation, at two in-patient mental health sites. 58 service users participated in the
survey over a 6 month period. Questions focused on support, respect and disclosure and discussion,
and the survey was categorised into seven areas: Language, Literacy (Reading and Writing), Ethnic
and Cultural Background, LGBT Experience, Physical Disability, Learning Disability, and Religion or
Spiritual Beliefs. Feedback consisted of both quantitative and qualitative data which drew the Trust’s
attention to issues concerning the experience of service users and in response an action plan has
been formulated and actions are being taken to improve service user experience. The Trust is
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grateful to Advocacy for Mental Health in undertaking this survey so that targeted improvements can
be made to services.
Actions being taken include:
• All staff have been reminded about not conversing on the ward in a language other than English
with other staff, This is being re-inforced in the regular ward team meetings.
• The therapy programme has now been translated into a number of different languages and
a pictorial programme is also available for 'easy read'. Patients are signposted to groups where it
is possible to engage in the activity with little English ability such as pottery, gym, dance and
movement and creative groups.
• On-going discussions with Westminster Adult Education Service (WAES) regarding offering
literacy sessions (although there are issues over the numbers to satisfy WAES funding criteria).
• Discussions taking place as to how more literacy support could be provided by staff..
• Greater dialogue and with service users regarding their faith and spiritual needs drawing on the
learning from the Trust 2012 Faith and Spirituality Conference. An SLA is due to be signed in
January to provide additional access to Chaplains.
• Development of training to address LGB&T awareness.
• Identifying where to target Learning Disability awareness training
• Ensuring liaison with our physical healthcare teams and action is taken on any recommendations
from them regarding individual treatment plans where complex physical and disabling conditions
are present
B2.4
Camden Provider Services
Following organisational changes the process and content of service user surveys is currently under
review in order to establish systems for implementation during 2013. Equalities and diversity
requirements will be part of this process. This will therefore place us in a good position to report on
service user experience within next year's report.
B2.5
Hillingdon Community Health
Patient Satisfaction Surveys have been carried out in 2012 (Complex Wound Clinic, Speech and
Language Therapy, Health Visiting Service). Whilst these surveys present positive levels of
satisfaction, there has not been an analysis by equalities characteristics to identify any areas of
disparity. Including diversity monitoring within surveys will be discussed in 2013 in order to develop
capacity for analysis.
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Other languages or formats
If you would like information in another language or format (large print, braille,
audio, BSL), please ask us.
Albanian
Arabic
Bengali
Chinese – Cantonese
Chinese - Mandarin
Farsi
French
German
Gujarati
Kurdish
Polish
Portuguese
Somali
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Spanish
Tamil
Turkish
Urdu
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CNWL NHS Foundation Trust
Equality Act 2010 Compliance Report, January 2013
Central and North West London NHS Foundation Trust
Stephenson House
75 Hampstead Road
London NW1 2PL
Direct line: 020 3214 5700
Typetalk: 18001 020 3214 5700
www.cnwl.nhs.uk
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