Page | 1
Public Sector Equality Duty Report
April 2016
BaNES CCG
Public Sector Equality Duty Report
April 2016
Public Sector Equality Duty Report April 2016
Page | 2 Contents
Page
Introduction
3
Public Sector Equality Duty and the purpose of this document
3
Profile of equality groups in B&NES
5
Information about our employees
12
Demonstrating how we consider equality in governance processes
13
Equality in Commissioning
14
Equality in Communication and Engagement
17
Equality Delivery System 2
18
Equality Objectives 2016-2017
19
BaNES CCG
Public Sector Equality Duty Report
April 2016
Introduction
Page | 3
About NHS Bath and North East Somerset Clinical Commissioning Group
NHS Bath and North East Somerset Clinical Commissioning Group (BaNES CCG) is a commissioning organisation; we
commission (buy) health services for BaNES residents. We do not provide health services ourselves. We use our clinical
knowledge to commission the best services to meet local people’s needs. You can see our Five Year Plan here
We publish our commissioning intentions each year. You can see the latest list here:
http://www.bathandnortheastsomersetccg.nhs.uk/documents/commissioning-intentions/commissioning-intentions-for-201617
For more information on what health services we commission, please visit our web site BaNES CCG
Public Sector Equality Duty and the purpose of this document
BaNES CCG is subject to the legal obligations arising from the Equality Act 2010. Section 149 of the Equality Act 2010 places a
Public Sector Equality Duty (PSED) on all statutory public authorities and those who act on their behalf. CCGs may not delegate
these duties and are responsible for ensuring compliance by providers to whom the CCG commissions the delivery of services.
The general duty has three aims. Each CCG must in the exercise of their functions, have due regard to the need to:
1
Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited under the Act.
2
Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not
share it.
3
Foster good relations between persons who share a relevant protected characteristic and persons who do not share it.
BaNES CCG
Public Sector Equality Duty Report
April 2016
The specific duties of the public sector equality duty require CCGs to publish, in a manner that is accessible to the public,
information to demonstrate their compliance with the public sector equality duty at least annually. This information must include, in
particular, information relating to people who share a protected characteristic who are its employees – (public authorities with fewer
Page | 4 than 150 employees are exempt) and people affected by its policies and practices. We must also set equality objectives at least
every four years.
During 2016-2017 the Clinical Commissioning Group will be reviewing and updating our equality and diversity action plan to show
how the CCG plan to comply with our equality obligations: Our previous plan can be found at the following link: equality duty update
BaNES CCG has published this report as a requirement of the Public Sector Equality Duty (PSED) which is a specific duty placed
on public authorities requiring us to publish equality information to demonstrate our compliance with the Equality Act 2010. This
document highlights the work BaNES CCG has undertaken towards meetings the general PSED duty, gaps it has identified and
actions it is going to take to improve quality outcomes.
We use the Joint Strategic Needs Assessment JSNA to inform our commissioning intentions and decision making. The JSNA is a
collection of research about the local people, places and communities that B&NES Local Authority and BaNES CCG deliver
services to. This is much more detailed than just equality data. We use the JSNA to try to understand what needs to be done in
collaboration with local knowledge and community feedback. It is a ‘wiki’ style resource which is continually updated with live
information. This meets many of the Equality and Human Rights Commission’s recommendations on publishing annual equality
information as the data is online, easily available, more up to date, cross referenced and more comprehensive than previously
issued annual reports.
We know that we need to make full use of the JSNA in our commissioning practices; in 2015-2016, all staff including the Board
received further equality and diversity training which will include information on evidence based commissioning.
BaNES CCG
Public Sector Equality Duty Report
April 2016
Profile of equality groups in BaNES
We use a range of data and information when consulting on and commissioning services. We work closely with the Local Authority
Page | 5 public health and research and intelligence teams to ensure we share the most up to date information available. Knowing our
community and recognising its diversity is pivotal to the commissioning of modern, high quality health services.
Population
There were 182,021 residents of Bath and North East Somerset in 2014. This is lower than the
GP registered population of 197,040. Bath and North East Somerset has a significantly higher
proportion of residents (10.6%) aged 20-24 than nationally (7.9%), this can be attributed to the
high student population
.
Age
Children and young people
The 2011 census shows that 16.7% of the population of Bath and North East Somerset are 15 years or under, and that 6.3% are
16-19 year olds.
BaNES CCG
Public Sector Equality Duty Report
April 2016
Adults
There are projected to be large increases in the number of older people in B&NES in the coming years. For example, by 2021 the
Page | 6 number of over 75's in the population is projected to increase by 20% (approximately 4,400 people) and the number of over 90's
are projected to increase by 44%. We note that services for older people are likely to experience increases in demand. 2014
estimates suggest that there are currently 11,807 people aged 65+ in B&NES who are unable to manage at least one self-care
activity on their own. This is expected to increase to 16,408 by 2030.
Gender
The population’s gender balance is almost 50/50; women 51.1% men 48.9%.
In line with national trends, our local information shows us that life expectancy for women (84.5) is greater than for men (80.9),
(2011-2013) although the gap is expected to narrow as the population ages. For men, this was higher than the South West (79
years) and England (78 years) averages. For women life expectancy is higher than the South West and England average of 83
years.
Ethnicity
Approximately 10% (17,500 people) of the BaNES population define as non-white-British. The second most common ethnicity is
'Other White' (6,600 people) and this population group is increasing. It is likely that a large proportion of these people will be from
the EU accession states. There are also approximately 4,500 people of Asian or Asian British descent living in BaNES.
Our information shows we have a disproportionate number of children in care from Black and minority ethnic groups with 12.5% of
children in care from a black or minority background but only 10% of the population is BME.
Language use
BaNES CCG
Public Sector Equality Duty Report
April 2016
In a commissioning exercise undertaken in 2014-2015 to find a single provider of Translation and Interpreting Services for the CCG
and four partners organisations (Bath and North East Somerset Council; Avon and Wiltshire Mental Health Partnership; The Royal
United Hospital; and Sirona Care and Health), the following languages were identified as being the most frequently requested in the
Page | 7 BaNES area between 2013-14:
Face to face interpreting: Arabic, Bengali, Italian, Punjabi and Polish
Telephone interpreting: Polish, Cantonese, Italian, Bengali and Arabic
Religion & Belief
In the 2011 Census, 56.5% of people in Bath and North East Somerset identified as Christian; a large proportion (32.7%) stated
they have no religion. B&NES has generally lower levels of other faith groups than the national average: Buddhist, Hindu, Jewish,
Muslim and Sikh are each 0.5% of the population or less.
Ill Health and Disability
Ill health and disability refers mainly to people with long term conditions, which are those that experience illnesses which cannot
currently be cured but can be controlled with the use of medication and/or other therapies.
Rates of long term conditions in Bath and North East Somerset are comparatively low, but rising in line with the rest of the country.
Estimates suggest there are approximately 2,469 people aged 18-64 with a significant physical disability in B&NES. Almost half of
people with long-term conditions surveyed in 2011 felt that they were able to manage their condition. People with long term
conditions are more likely to be older people living in deprived areas.
BaNES CCG
Public Sector Equality Duty Report
April 2016
7% of people with long term health condition or disability living in B&NES state their day-to-day activities are limited a lot, 9.1%
state they are limited a little and 83.9% state they are not limited by their ill health or disability.
Page | 8
GP Registered Conditions
The table below outlines the numbers of the registered GP population of Bath and North East Somerset that were recorded to have
one of the following long term conditions in 2012-2013:
Condition
Hypertension*
Asthma
Diabetes Mellitus (Diabetes) Register (ages 17+)
Hypothyroidism*
Coronary Heart Disease Register (CHD)
Heart Failure
Heart Failure due to LVD (Left Ventricular Dysfunction)
Cardiovascular Disease Primary Prevention
Chronic Kidney Disease (ages 18+)
Cancer
Stroke or Transient Ischaemic Attacks (TIA)*
Atrial Fibrillation
Chronic Obstructive Pulmonary Disease (COPD)*
Osteoporosis: Secondary prevention of fragility fractures
Peripheral Arterial Disease (PAD)
Epilepsy (ages 18+)
BaNES CCG
Public Sector Equality Duty Report
Number
25,395
12,353
7,460
6,093
5,824
1,545
862
4,522
5,232
4,338
3,488
3,396
2,693
267
1,134
1,162
April 2016
Dementia
Learning Disabilities (ages 18+)
Mental ill Health
Page | 9 Depression ages 18+
Palliative Care
Obesity (ages 16+)
1,140
733
1,595
8,931
439
13,446
Sexual orientation
There are likely to be approximately 9,000 adult residents of B&NES identify as lesbian, gay or bisexual. Our data and research
demonstrates that LGB people are more likely to be vulnerable to adverse health and wellbeing outcomes compared with the
general population, including: hate crime, domestic violence, shorter life expectancy, higher rates of smoking, poorer sexual health,
higher rates of self-harm and suicide, school absenteeism and homelessness.
Gender identity
There are an estimated 1760 people who identify as transgender in B&NES, this equates to 1% of the population.
Transgender people are vulnerable to prejudice and hate crime (including physical attacks) because of their gender identity. Trans
and ‘other’ gendered people may face particular barriers to participation in physical activity.
Gypsy traveller & boat dwellers
The most recent study done locally into the Travellers and Gypsy Traveller communities has been The Bath and North East
Somerset Gypsy, Traveller, Boater, Showman and Roma Health Survey, 2012. Significant information was gathered from all
communities included in the sample in relation to access to services (including emergency care and experiences of A&E services),
health needs, barriers to registration with GP and other primary care services; prevalence of particular conditions and preferences
and experiences of terminal care for members of their communities. Data was also collected on the strength of community
BaNES CCG
Public Sector Equality Duty Report
April 2016
networks/availability to support from peers during times of illness. Needs are characterised by increased risk factors across a range
of issues including mental ill-health, physical disabilities and lifestyle factors such as smoking. For example, Traveller and Gypsy
Traveller women are more than twenty times more likely to experience the death of a child than the population as a whole. These
needs are often coupled with a reluctance to engage with public services, although satisfaction with health services was considered
Page | 10
reasonable.
http://www.bathnes.gov.uk/services/your-council-and-democracy/local-research-and-statistics/wiki/travellers-and-gypsy
Overall 32.5% of respondents to the Professional/Practitioner survey reported having had contact with Gypsy/Traveller/Boater
communities in their practice but there is a general absence of recognition of the needs of these communities by health
practitioners who in the main are reported as failing to monitor their health status and access to services. To address some of these
issues, the CCG has supported the funding of a bespoke Health Visiting Service to work with these community groups
BaNES CCG
Public Sector Equality Duty Report
April 2016
Page | 11
BaNES CCG
Public Sector Equality Duty Report
April 2016
Information about our employees
At 31st December 2015, BaNES CCG had 64 employees in post. As this is below the threshold of 150, the CCG is not required to
Page | 12 publish equality data about their staff as it is very difficult to publish some aspects of the data without compromising staff confidentiality.
A detailed work force profile is made available to the Executive team and data taken from a report as at 31st December 2015 is
shown below. We have made sure that this data does not identify individuals.
Disability
3.1% of staff self identified as Disabled; 79.7% as not Disabled. 17.1% did not respond.
Ethnicity
89% declared themselves as White British; 4.6% of other ethnicity and 6% did not respond.
Gender
82% female; 17.1% male.
Sexual orientation
71% declared heterosexual; 4.6% LGBT; 23% did not respond.
Part time / full time employees
48.5% of employees hold full time posts. 51.5% hold part time posts.
BaNES CCG
Public Sector Equality Duty Report
April 2016
Demonstrating how we consider equality in governance processes
NHS BaNES CCG Constitution’s principles of good governance include observing and working within the Equality Act 2010.
Page | 13 In 2015-2016 the CCG had delivered the key functions it had defined in order to meet the public sector equality duty by:


delegating responsibility for equality legislation to the Chief Officer –Tracey Cox and
designating an Equality and Human Rights operational lead – Dawn Clarke, (Director of Nursing and Quality).
We have established a robust governance and accountability reporting mechanism to the Board via the Quality Committee.
Responsibility to seek assurance on the robustness of arrangements relating to equality and human rights stays with the CCG
Board. An equality and diversity update was reported to the CCG Board in July 2015 and to Quality Committee. Updates are
scheduled quarterly to the Quality Committee and annually to the Board. We have delegated responsibility for the review of
arrangements relating to equality and human rights to the Quality Committee. This includes arranging mandatory equality and
diversity training for all of its employees.
We have developed a clear specification for training staff in equality and diversity issues which includes public sector equality duty
requirements; equality analysis; equality in decision making and how to scrutinise equality analysis; equality and health inequality
aspects of BaNES JSNA; inclusive leadership and cultural competence.
In 2015-2016, we worked with the BaNES Independent Equality Advisory Group (comprising public services and crossrepresentation of voluntary sector organisations) for consultation, feedback and sharing good practice.
During 2015-2016 we committed to ensuring that equality & diversity is routinely included in job descriptions and job descriptions
have been reviewed to confirm this.
BaNES CCG
Public Sector Equality Duty Report
April 2016
Equality in Commissioning
Our aim is to commission modern, high quality health services that recognise and value the diversity of our communities and
Page | 14 believe that meeting equality needs is pivotal to this aim. To turn this intention into a reality we carry out equality analysis (equality
impact assessment) as an integral part of commissioning projects.
Equality analysis uses a process of systematically analysing a new or existing policy or service to identify what impact or likely
impact it will have on people of differing groups within our community. It aims to identify any discriminatory or negative
consequences for a particular group or sector of the community, and to prompt us to consider what positive actions we need to take
in order to meet the needs of people with protected characteristics. Equality analysis can be carried out in relation to service
delivery as well as employment policies and strategies.
As we commission jointly with the B&NES Council, equality analyses are published on the CCG website or on the Council website.
BaNES equality analysis
We publish our annual commissioning intentions as well as making them available for public scrutiny at the BaNES Health and
Wellbeing Board. The commissioning intentions documentation details our priorities and any re-commissioning / contract awards
requiring on-going funding: Commissioning intentions 2016-2017 can be found at:
http://www.bathandnortheastsomersetccg.nhs.uk/documents/commissioning-intentions/commissioning-intentions-for-201617
Examples of commissioned services during 2015-2016
The following examples demonstrate that we have paid due regard to the need to promote equality as part of the public sector
equality duty.
BaNES CCG
Public Sector Equality Duty Report
April 2016
Your Care Your Way: http://www.yourcareyourway.org/
We believe that everyone in Bath and North East Somerset should be able to access the best possible health and care services in
their community and feel supported to live happy, healthy and independent lives. That's why, with B&NES Council
Page | 15 we launched your care, your way; an ambitious two year project to review, design and deliver integrated community services in
partnership with local people. Phase Three, which aims to score and evaluate potential providers, began in February 2016. A team
of volunteers who have a wide experience of community health and care services have been appointed as Community Champions
to support us with this process to ensure that equitable, high quality services are commissioned for all
Our joint work with the Council to support people with learning disabilities is a specific example of how we strive to improve access
to health services and reduce health inequalities for people with protected characteristics.
Identification and Referral to Improve Safety (IRIS) for people suffering from Domestic abuse. The IRIS team are commissioned by
BaNES CCG to offer a free training and advocacy package to all BaNES GP practices. The training is for all clinicians working
within the practice- doctors, nurses, midwives, pharmacists and the Reception Admin team as well, equipping the entire practice
team with the knowledge & skills to identify and respond to patients who are experiencing domestic abuse
With the Council, the CCG has committed recurring budget to the Alcohol Liaison Service at the RUH. This service has significantly
increased its reach year on year since it started in 2013/14. Clients referred to the service have on average a 67% reduction in
hospital spells 3 months post contact with the services
An Independent Domestic Violence Advisor at the RUH. Since April 2015, The IDVA has been providing advice and support to patients and
staff, providing domestic abuse training, attends B&NES and Wiltshire MARAC and supports safeguarding supervision within the Trust. This
one-year pilot, funded by BaNES CCG, has already begun to embed a co-ordinated domestic abuse response across the organisation
Wellbeing College: http://wellbeingcollegebanes.co.uk/
BaNES CCG
Public Sector Equality Duty Report
April 2016
The College provide courses, activities and groups to Bath & North East Somerset residents aged 16 or over, or those who are
registered with a GP in the area. Courses cover a range of areas including physical and mental wellbeing, stress, nutrition, social
support, IT and many more. These may be one-off workshops or longer courses and are provided across the locality in various
Page | 16 community venues. Most courses, activities and groups are free.
Equality and Diversity in Health Providers
Section 149 of the Equality Act 2010 places a Public Sector Equality Duty (PSED) on all statutory public authorities and those who
act on their behalf. In August 2015, the CCG prepared a report for its Quality Committee providing an overview of compliance within
our health providers. Examples of good practice were identified
Equality in Communication and Engagement
The CCG is working to improve consultation and engagement arrangements so that voices of people with protected characteristics
and other vulnerable groups are taken into account in the CCG’s planning processes. Examples of what actions we have taken/will
be taking to demonstrate that we have paid due regard to our public sector equality duty include:
In 2014 the CCG set up ‘Your Health Your Voice’ Patient and Public Involvement Group. The aim of the group is to support the
work of the CCG in meeting the strategic objectives in order to, amongst other things, improve quality, safety and individuals
experience of care, reduce inequalities and social exclusion, support our most vulnerable groups and improve the mental health
and wellbeing of our population. Meetings of Your Health, Your Voice are scheduled a few weeks before CCG board meetings and
a feedback report will be presented to each meeting. Whilst every attempt has been made to ensure that the Your Health Your
Voice group is made up of a diverse range of individuals, further efforts will be made as the group becomes established to attract
additional members with a broad range of protected characteristics. It is also recognised that the group does not replace the need
to proactively engage with hard to reach groups and other stakeholders on CCG decisions whose voice may not be represented
through Your Health, Your Voice.
BaNES CCG
Public Sector Equality Duty Report
April 2016
Equality Delivery System 2
Page | 17
BaNES CCG continues to implement the Equality Delivery System 2 to continually review and improve our equality performance for
people with characteristics protected by the Equality Act 2010. We carry out our EDS reviews in discussion with local partners and
local people.
In 2015, the Care Forum and B&NES Council equality team facilitated our latest EDS2 review. The results of the review were
received by the CCG during March 2015.
In order to ensure that issues and barriers faced by hard to reach groups and equality groups are identified on an ongoing basis,
the Director of Nursing and Quality attends the B&NES Independent Equality Advisory Group (IEAG) (comprising public services
and cross-representation of voluntary sector organisations). The IEAG group is made up of members who are ‘experts’ in a number
of equalities fields (e.g. disability, sexual orientation, ethnicity), and consultation with this group is helping to highlight equalities
issues and barriers not raised by Your Health, Your Voice. A review of the draft End of Life Strategy by the group is planned for
April 2016
Equality Objectives 2016-17
Equality Objectives for 2014-17 are as follows:
1. Further improve health and reduce the variations in access, experience and outcomes
2. Further improve the collection and use of data and evidence for all protected groups
3. To communicate and engage well with protected groups
BaNES CCG
Public Sector Equality Duty Report
April 2016
4. Further develop our CCG Staff so that they are confident and competent in equality and diversity issues
5. Further develop the CCG’s Leadership and Corporate commitment to Equality & Diversity
Page | 18
Our equality & diversity strategy and action plan set out the steps we are taking to achieve our objectives. This is currently being
revised
BaNES CCG
Public Sector Equality Duty Report
April 2016