Equality Objectives Action Plan
April 2015 – March 2017
Contents
Page No.
Introduction
3
Our Community Health Needs
4
Reducing Inequalities
5
Equality Act 2010
6
Developing our Equality Objectives through the Equality Delivery System
9
Equality Objectives in full
12
Equality Governance
13
Monitoring Progress
13
Publication
13
Equality Objective 1 – Reducing health inequalities – Rationale, Action Plan and Key Performance Indicators
14
Equality Objective 2 – Effective Communication and Engagement – Rationale, Action Plan and Key Performance Indicators
21
Equality Objective 3 – Employer of Choice – Rationale, Action Plan and Measures and Key Performance Indicators
25
Equality Objective 4 – Effective Equality Leadership – Rationale, Action Plan and Measures and Key Performance Indicators
30
2
Introduction
This document sets out the Equality Objectives that Birmingham CrossCity Clinical Commissioning Group (CCG) intends to achieve over the
next four years. Each objective is supported by a detailed action plan covering the first two years of the objectives, after which we will conduct
an Equality Delivery System (EDS) review to check progress and identify further actions to achieve the objectives and make improvements on
our EDS grading.
Birmingham CrossCity CCG is committed to embedding Equality and Diversity into everything we do, both as a commissioner of services and as
an employer. Our aims are to reduce health inequalities and serve our local population and employees in a way that efficiently and effectively
meets each individual's needs and concerns whilst ensuring services and management are open, transparent and free from discrimination.
CCG Vision for the future
Our vision is that by 2019 we will have fully integrated, sustainable health and social care services so that every patient in Birmingham receives
proactive joined-up care, resulting in the best possible outcomes. We want people to live as independently as possible and to live longer and
healthier lives.
To achieve our vision for patient focused care, we have five strategic priorities:





to develop primary care
to join up primary and secondary care
to transform the way our urgent care system currently operates
to make a big change in quality and access to mental health services
to improve children’s and maternity services
Underpinning these priorities, and at the heart of everything we aspire to, are quality and equity. We want to commission high quality services
while addressing health inequalities and inequity in provision. This means fair access to services for all - particularly for the most vulnerable.
We will work actively with patients and the public to ensure their needs are central.
3
We will achieve our vision through:







Offering everyone high quality, accessible Primary Care encompassing prevention and the best possible management of long-term
conditions - we call this a 'Universal offer'
Better community provision with a range of options in health, social care and the third sector to support patients through crisis
situations and discharge step down
Excellent and responsive mental health care provision for patients throughout the duration of their mental illness and specifically those
in crisis
Providing holistic services to those people and carers experiencing dementia
Commissioning elective care based on achieving better outcomes from interventions, supported by enhanced specialist advice, patient
pathways (the route that patients take) and patient decision support
Joining the whole health and social care system through a single, look-up access to patient information
An urgent care system that is easy to access and meets the needs of our population.
We understand how important it is to make sure that our commissioning activity meets the needs of a 'super diverse’ city, particularly in light
of the range of health inequalities experienced by our local population.
Our Community Health Needs
We have worked closely with key partners, through the development of the Joint Strategic Needs Assessment (JSNA) and the Health and
Wellbeing Strategy, to understand the health needs of our population so that these can inform our commissioning priorities.
Our population is characterised by its diversity, relative to the national average, our demography is:

Younger – especially in the inner city and while the population of England is projected to age, our population aged over 64 is set to
remain stable with many retirees continuing to move out of the City;

Poorer – around six in ten of our population live in the 20 per cent most deprived neighbourhoods in England;

More ethnically diverse – Birmingham is the most ethnically diverse city in the UK.
4
The health needs of our population in summary are:

A relatively unhealthy start in life. The health of children in Birmingham is worse than England overall. This is reflected in a high level of
infant mortality, low birth weight babies and high childhood obesity rates. Birmingham’s teenage conception rate is one of the highest
in the country.

Worst health prospects in adult life. Birmingham’s life expectancy is lower than England as a whole for both men and women. Men in
Birmingham live an average of 76.8 years compared to 78.6 years in England. Women in Birmingham live an average of 81.6 years
compared to 82.6 years nationally.

From our work with public health colleagues we know that seven clinical conditions account for 70 per cent of the life expectancy gap
in Birmingham compared to England; the conditions are:
o Infant mortality
o COPD
o Coronary heart disease
o Stroke
o Lung cancer
o Pneumonia
o Alcoholic liver disease
Reducing Inequalities
To address health inequalities we need more preventative interventions aimed at lifestyle choices:


Birmingham has lower rates of health eating and physical activity compared to England as a whole, and 26 per cent of our population is
obese, which puts Birmingham in the top 20 per cent of local authorities for obesity.
34.2 per cent of Birmingham is green space but just 10.5 per cent of over 55s do 30 minutes of moderate physical activity at least three
times per week.
5



21.3 per cent of Birmingham’s population smoke compared to 20.6 per cent regionally and 21.2 per cent across England. Rates of
smoking are greater in the most deprived wards of the city, in some places reaching 45 per cent.
Child obesity is an important issue in Birmingham, with rates of 10.9 per cent in 4-5 year olds and 23.4 per cent in 10-11 year olds. This
places Birmingham in the top 20 per cent of local authorities for both groups. National rates of obesity are 9.4 per cent in 4-5 year olds
and 19 per cent in 10-11 year olds
Children in Birmingham were less likely to participate in three hours of sport a week than children in England as a whole.
Based on our analysis we will prevent premature deaths by addressing conditions that shorten life expectancy and commissioning preventative
interventions.
We will focus on our prevention agenda, which has a range of initiatives improved screening, patient education and targeting healthy lifestyles.
Equality Act 2010
The Equality Act 2010 provides legal protection for nine protected characteristics –
Age
Disability
Marriage &
Civil
Partnership
Gender
Reassignment
Pregnancy &
Maternity
Religion or
Belief
Race
Sexual
Orientation
Sex
6
The General Equality Duty contained within the Act requires organisations such as the CCG to demonstrate due regard to the need to:
1. Eliminate unlawful discrimination, harassment and victimisation
2. Advance equality of opportunity between people who share a protected characteristic and those who do not
3. Foster good relations between people who share a protected characteristic and those who do not
Additionally, the CCG is also subject to the Specific Equality Duties, which require


Annual publication of information which demonstrates compliance with the General Equality Duty; this includes information relating to
persons who share a protected characteristics who are employees and other persons affected by its policies and practices (for example,
service users); and
Preparation and publication of at least one specific and measurable equality objective that it thinks it should achieve to do any of
the things mentioned in the general equality duty.
Health and Social Care Act 2012
The CCG has a legal duty under the Health and Social Care Act 2012 to reduce inequalities between patients regarding their ability to access
health services, and with respect to health outcomes, as well as to ensure that services are provided in an integrated way. The Act also places
duties on the CCG to promote the NHS Constitution, to enable choice, and to promote patient, carer and public involvement. To discharge this
responsibility effectively, the CCG will need to work with its partners to reduce health inequalities among those in greatest need and embed
this requirement into its joint health and wellbeing strategies. The CCG will also need to demonstrate how it will provide culturally sensitive
services and ensure all patients can exercise choice and be involved in decision making.
7
Human Rights Act 1998
The CCG has obligations under the Human Rights Act 1998 that, as a public body, it must at all times act in a manner compatible with the rights
protected in this Act and safeguard these for patients and staff in its care and employment. Human Rights are underpinned by a set of
common values and these have been adopted by the NHS under the acronym FREDA. The FREDA principles represent:





Fairness e.g. fair and transparent grievance and complaints procedures
Respect e.g. respect for same-sex couples, teenage parents, older people
Equality e.g. not being denied treatment due to age, sex, race, religion etc.
Dignity e.g. sufficient staff to changed soiled sheets, help patients to eat/drink
Autonomy e.g. involving people in decisions about their treatment and care
The Equality and Human Rights Commission states that putting human rights principles into public service practice is in the public interest.
Evidence shows that public bodies taking human rights seriously treat people better. The CCG will endeavour to embed a human rights based
approach in the way that it commissions services and in its role as an employer.
NHS Constitution
The CCG is committed to upholding the NHS Constitution which outlines a number of commitments and pledges to uphold patient dignity and
human rights. The constitution can be accessed via this link:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170656/NHS_Constitution.pdf
8
Developing our Equality Objectives through the Equality Delivery System
The Equality Delivery System (EDS) is an NHS equalities framework tool which has enabled us to assess our equality performance on the
outcomes for patients and staff. EDS consists of four goals and 18 outcomes which relate to the issues that matter the most to people who
use, and work in the NHS. They support the themes of, and deliver on, the NHS Outcomes Framework, the NHS Constitution and the Care
Quality Commission's key inspection question areas. The Goals and Outcomes are detailed below:
EDS Goal
Better Health
Outcomes
No.
1.1
1.2
1.3
1.4
1.5
2.1
Improved Patient
2.2
Access & Experience
2.3
2.4
3.1
3.2
A representative
and supported
workforce
3.3
3.4
3.5
3.6
Description of EDS Outcome
Services are commissioned, procured, designed and delivered to meet the health needs of local
communities.
Individual people’s health needs are assessed and met in appropriate and effective ways.
Transitions from one service to another, for people on care pathways, are made smoothly with everyone
well-informed.
When people use NHS services their safety is prioritised and they are free from mistakes, mistreatment and
abuse.
Screening, vaccination and other health promotion services reach and benefit all local communities.
People, carers and communities can readily access hospital, community health or primary care services and
should not be denied access on unreasonable grounds.
People are informed and supported to be as involved as they wish to be in decisions about their care.
People report positive experiences of the NHS.
People’s complaints about services are handled respectfully and efficiently.
Fair NHS recruitment and selection processes lead to a more representative workforce at all levels.
The NHS is committed to equal pay for work of equal value and expects employers to use equal pay audits
to help fulfil their legal obligations.
Training and development opportunities are taken up and positively evaluated by all staff.
When at work, staff are free from abuse, harassment, bullying and violence from any source.
Flexible working options are available to all staff consistent with the needs of the service and the way
people lead their lives.
Staff report positive experiences of their membership of the workforce.
9
EDS Goal
Inclusive Leadership
No.
4.1
4.2
4.3
Description of EDS Outcome
Boards and senior leaders routinely demonstrate their commitment to promoting equality within and
beyond their organisation.
Papers that come before the Board and other major Committees identify equality-related impacts including
risks, and say how these risks are to be managed.
Middle managers and other line managers support their staff to work in culturally competent ways within a
work environment free from discrimination.
The CCG conducted a thorough evaluation of its performance as a commissioner of services and employer against each of the EDS Goals and
Outcomes, taking into account the impact and outcomes against the nine protected characteristics identified in the Equality Act 2010. The
evidence was graded both internally and externally (through the CCG Patient Council and CrossCity Voice members).
There was four possible outcomes for each EDS goal and outcome:
Excelling
Achieving
Developing
Undeveloped
Our overall grading for each goal was:
Goal
Grading
Better Health Outcomes
Developing
Improved Patient Access
and Experience
Developing
Goal
A Representative and
Supported Workforce
Inclusive Leadership
Grading
Achieving
Achieving
10
A full report on the outcomes of EDS is available on the CCGs website: http://bhamcrosscityccg.nhs.uk/ in the Equality and Diversity section.
The following equality objectives and associated actions have been developed to reflect and address the gaps and issues raised when gathering
evidence for EDS and also from the consultation feedback. It is intended that the equality objectives will not only support our commitment to
delivering on our equality duties but also to make real improvements where most needed.
The four equality objectives and action plan connect to EDS which will enable the CCG to evaluate its equality performance by reviewing
progress against the goals and outcomes of EDS.
•EDS Goal 1
•Better Health
Outcomes
•EDS Goal 2:
•Improved
Patient Access
and Experience
Equality
Objective 1:
Equality
Objective 2:
Reducing
Health
Inequalities
Effective
Communication
& Engagement
Equality
Objective 4:
Effective
Equality
Leadership
•EDS Goal 4:
•Inclusive
Leadership
Equality
Objective 3:
Employer of
Choice
•EDS Goal 3:
•Representative
& Supported
Workforce
11
Equality objectives in full:
The equality objectives detailed below will support the CCG to achieve its vision of: by 2019 we will have fully integrated, sustainable health
and social care services so that every patient in Birmingham receives proactive joined-up care, resulting in the best possible outcomes. We
want people to live as independently as possible and to live longer and healthier lives.
Equality Objective 1:
To ensure that the five CCG strategic priorities of developing primary care, joining up primary and secondary care, transforming urgent care,
improving quality and access to mental health services and improving children’s and maternity services reduce health inequalities in the most
vulnerable and disadvantaged groups.
Equality Objective 2:
To ensure on-going involvement and engagement of protected groups and enable participation of vulnerable, seldom heard groups in shaping
our services.
Equality Objective 3:
To be an employer of choice through increasing the diversity profile of our workforce at all levels and providing development opportunities for
staff.
Equality Objective 4:
To demonstrate effective leadership that values and promotes equality, diversity and inclusion both within and outside of the CCG.
Each equality objective is supported by a number of actions. Measurements have been identified which will enable the CCG to review progress
towards achieving the intended outcomes. The rationale for each objective is provided together with information on how it connects to the
general equality duty and which protected characteristic(s) are covered.
12
Equality Governance
The Governing Body has the overall responsibility for discharging the CCGs statutory equality duties.
Birmingham CrossCity NHS Clinical Commissioning Group has in place constitutional and governance arrangements which set out the legal
responsibilities and delegation of authority and accountabilities for the equalities agenda.
Birmingham CrossCity NHS Clinical Commissioning Group has a Board level lead with strategic responsibility for equality and diversity
delegated to the Quality and Safety Committee. There is an operational Equality and Diversity Implementation Group with representation
from across the organisation, and is chaired by the Governing Body Equality Lead. There is also a dedicated resource in place with a Manager
for Equality and Diversity post, to ensure operational expertise and support.
Monitoring Progress
The Equality objectives have been set for a four year period (2015 to 2019) the action plan is for a two year period (2015 to 2017); it is
anticipated that implementation of some actions will lead to further work being identified. Where new actions are required, the action plan
will be updated accordingly.
A second EDS assessment will be conducted by the end of March 2017, which will identify progress made and outstanding areas for
improvement against the 18 EDS outcomes. A further two year action plan (2017 to 2019) will be developed with actions which will address
any identified gaps or issues.
The Equality and Diversity Implementation Group meets on a bi-monthly basis and is responsible for overseeing the development,
implementation and evaluation of the CCGs Equality Objectives Action Plan.
Progress updates for each equality objective will be presented quarterly to the Quality and Safety Committee for approval. A set of key
performance indicators have been identified for reporting on, to the committee.
Publication
These Equality Objectives will be published on-line in the public area of the CCGs website; annually a report will be published providing an
update on progress over the previous year.
13
Equality Objective 1: To ensure that the five CCG strategic priorities of developing primary care, joining up primary and
secondary care, transforming urgent care, improving quality and access to mental health services and improving children’s
and maternity services reduce health inequalities in the most vulnerable and disadvantaged groups.
This objective and associated actions support achievement of the General Equality Duty aims:
 Eliminate unlawful discrimination, harassment and victimisation
 Advance equality of opportunity between people who share a protected characteristic and those who do not
 Foster good relations between people who share a protected characteristic and those who do not
Rationale for Objective
The EDS evaluation identified the following issues and gaps which provides the rationale for equality objective 1:
Subject
Issue
Protected Characteristics & Vulnerable
Groups
Serious Incident
Reporting
Currently the serious incident reports include protected characteristic data however
improvements are required to ensure that this data is routinely collected by all, is
monitored and analysed
Data is collected on Sex, Age and Race;
Vulnerable groups include: older and the
very young.
Understanding the
availability and
effectiveness of
health services for
vulnerable groups
More detailed understanding is needed to ensure that services are meeting needs for
vulnerable groups
Gender Reassignment
Lesbian Gay and Bisexual People
Travelling Communities and Gypsies
Migrants/Asylum Seekers & Refugees
Female Genital Mutilation
14
Subject
Issue
Health Screening
Prevention is important to reducing health inequalities and it is understood that for
some vulnerable groups accessing health screening is not without difficulty (for
example people with a learning disability) and also that some ethnic minority groups
will have a higher prevalence of particular cancers (for example prostate cancer and
BME people). It is important to ensure that access to health screening it targeted and
promoted effectively to reach vulnerable groups and improve their health outcomes.
Measuring Impact in
terms of Equality and
reducing Health
Inequality
We have a programme of Improvement Interventions looking at Primary Care, Mental
Health, Urgent Care, Children and Maternity. We need to determine the impact and
outcomes for patients, reviewing accessibility and patient experience under the
framework of equality and considering the protected characteristics.
Monitoring
Complaints
Information on numbers of complaints are provided regularly to the CCG from our
providers; it is unclear if some groups are more adversely affected by services (which
leads to a complaint) than others. We do not understand who (by protected
characteristic) is making a complaint.
Protected Characteristics & Vulnerable
Groups
Sex
Race
Age
Learning Disability
Mental Health
Pregnancy and Maternity
Travelling Communities and Gypsies
Migrants/Asylum Seekers & Refugees
Mental Health
Older People/ Children
Pregnancy and Maternity
Learning Disability
Sex
All protected characteristics
15
Equality Objective 1 – Action Plan
Equality Objective 1: Actions
1
2
3
4
5
6
All contracts to include reporting requirements around
equality and diversity; commencing for the 2015/16 contract
round.
Raise awareness of the issue of Female Genital Mutilation;
support the strategy and action plan being developed by the
Safeguarding Team.
Evaluation report to the Quality and Safety Committee on
the equality performance of the four large providers (HEFT,
UHB, ROH, BSMHFT) as per contract requirements
Which
Protected
Characteristic
is covered?
All
Gender
All
EDS Goal &
Outcome
Key
Performance
Indicator
Lead
Delivered by
end of:
Goal 1 –
Outcome 1.1
32
Equality and
Diversity
April 2015
Goal 1 –
Outcome – 1.1,
1.2
Goal 1 –
Outcome 1.1
32
Safeguarding
Equality and
Diversity
Equality and
Diversity
August 2015
32
September
2015;
April 2016
To produce an equality evaluation report on the impact of
ACE Foundation Scheme 2014 linked to the outcome
measures within the Scheme which include: engagement and
involvement; patient experience; needs of carers; effective
communication with vulnerable patients; access to services
for people with learning disabilities; reducing vaccine
preventable illnesses; take up of physical activity plans for
prevention and treatment of chronic diseases and increased
identification and diagnosis of Atrial Fibrillation in patients
over 65.
All
Goal 1 –
Outcomes - 1.1,
1.2, 1.3
Goal 2 –
Outcomes –
2.1, 2.2, 2.3
10, 12, 13, 20,
32, 33
Primary Care
Development
Equality and
Diversity
September
2015
To monitor and report on the performance of the Non-Acute
In-Patient (NAIPS) service and report findings to Quality and
Safety Committee
Mental Health
Goal 1 –
Outcomes 1.1,
1.2
7, 8, 15, 32
Joint
Commissionin
g Team
Report:
October 2015;
April 2016
To produce and implement an on-line Equality Audit Tool for
GP practices to self-assess their equality performance and
All
Goal 2 –
Outcomes 2.1,
9, 33
Equality and
Diversity
December
2015
16
Equality Objective 1: Actions
7
8
9
10
11
publish this information on the CCG webpages (the audit
would include for example wheelchair accessibility; access to
male and female GPs, language provision etc.).
Research and report on the availability and effectiveness of
health services locally for Lesbian, Gay and Bisexual people;
present report and further actions to Quality and Safety
Committee.
Which
Protected
Characteristic
is covered?
EDS Goal &
Outcome
Key
Performance
Indicator
2.2
Sexual
Orientation
Research and report on the availability and effectiveness of
health services locally for Gender Reassignment; present
report and further actions to Quality and Safety Committee.
Gender
Reassignment
Research and report on the availability and effectiveness of
health services locally for Travelling Communities, Gypsies
within Birmingham; present report and further actions to
Quality and Safety Committee.
Race
Research and report on the availability and effectiveness of
health services locally for migrants/asylum seekers/refugees;
present report and further actions to Quality and Safety
Committee.
Race
Explore opportunities to work with Public Health and Primary
Care to ensure that health screening is targeted and
Learning
Disability
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes 2.1,
2.2, 2.3
Goal 1 –
Outcomes 1.1,
1.2,
Goal 2 –
Outcomes 2.1,
2.2, 2.3
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes
2.1,2.2,2.3
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes 2.1,
2.2, 2.3
Goal 1 –
Outcome - 1.5
Lead
Delivered by
end of:
Primary Care
Development
32, 33
Equality and
Diversity
March 2016
32, 33
Equality and
Diversity
March 2016
1, 2, 32, 33
Equality and
Diversity
March 2016
32, 33
Equality and
Diversity
March 2016
9, 32
Equality and
Diversity
March 2016
17
12
13
14
15
Which
Protected
Equality Objective 1: Actions
Characteristic
is covered?
promoted effectively to reach vulnerable groups and improve Pregnancy &
their health outcomes.
Maternity
Race; Sex;
Gypsies and
Travelling
Communities;
Migrants/Asylu
m Seekers and
Refugees
Monitor the performance and implementation of the
Race
Palliative Care and End of Life Strategy focusing on access to
services for BME communities. Produce a monitoring report
for analysis and discussion by the CCG EDIG.
Compile an analysis report of serious incidents utilising
protected characteristic data by type of incident to identify
any themes, issues or concerns. Report presented to Quality
& Safety Committee for review and further action.
Produce an evaluation report on the impact of the
redesigned Anticoagulation Community Services focusing on
accessibility and patient experience
Sex, Age and
Race
To review the equality outcomes following the redesign of
the 0-25 CAMHS service and report findings to Quality and
Safety Committee.
Age
Disability
All
EDS Goal &
Outcome
Key
Performance
Indicator
Lead
Delivered by
end of:
LCN Chairs
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes 2.2,
2.3
Goal 1 –
Outcome - 1.4
11, 32, 33
Planning and
Delivery
April 2016
32
Quality Team
June 2016
Goal 1 –
Outcomes 1.1,
1.2, 1.3
Goal 2 –
Outcomes 2.1,
2.2, 2.3
Goal 1 –
Outcomes 1.1,
1.2, 1.3
Goal 2 –
32, 33
Performance
and Delivery
Equality and
Diversity
August 2016
8, 32, 33
Joint
Commissionin
g Team Mental Health
March 2017
18
Equality Objective 1: Actions
16
17
All providers to monitor and report on Complaints by
protected characteristics - insert an information request into
contracts from 2016/17 contract.
To produce an evaluation report on impact on reducing
health inequalities made through the ACE Excellence
Scheme. The scheme focused on people aged over 75;
vulnerable adults; end of Life patients; patients with mental
health needs and management of long term conditions. The
review to also include Stable Prostate Cancer care.
Which
Protected
Characteristic
is covered?
All
Age
Disability
Gender
Race
EDS Goal &
Outcome
Outcomes 2.1,
2.2, 2.3
Goal 2 –
Outcome 2.4
Goal 1 –
Outcomes 1.1,
1.2, 1.3
Goal 2 –
Outcomes 2.1,
2.2, 2.3
Key
Performance
Indicator
33
2, 9, 32, 33
Lead
Equality and
Diversity
Quality Team
Primary Care
Development
Equality and
Diversity
Delivered by
end of:
April 2017
September
2017
19
Equality Objective 2: To ensure on-going involvement and engagement of protected groups and enable participation of
vulnerable, seldom heard groups in shaping our services.
This objective and associated actions support achievement of the General Equality Duty aims:
 Eliminate unlawful discrimination, harassment and victimisation
 Advance equality of opportunity between people who share a protected characteristic and those who do not
 Foster good relations between people who share a protected characteristic and those who do not
Rationale for Equality Objective 2
The EDS evaluation identified the following issues and gaps which provides the rationale for equality objective 2:
Subject
Issue
Protected
Characteristics &
Vulnerable Groups
Effective
Engagement and
consultation
We have in place a number of mechanisms for engaging and consulting with the public however through
lack of consistent collection of equality data we are unable to evidence that all protected and vulnerable
groups are afforded a voice.
All protected
characteristics and
vulnerable groups
Meeting
Communication and
Language needs
The 2011 Census revealed that 15.3% (156,553 people) in Birmingham identified their first language as not
English. 47,005 people stated that they were non-proficient (cannot speak English or cannot speak English
well). When the response to the Census question on general health and English language proficiency were
analysed together, it revealed that:
Of the 4.6% aged three and over who were 'non-proficient' in English, 44.9% reported themselves as not
having good health (compared to the Birmingham total of 21.4% reporting not good health).
It is important that we ensure that the communication and language needs (including sign language) are
being met for the people of Birmingham as this will enable greater access to prevention activities, improve
health outcomes and reduce inequalities.
Race
Disability
20
Equality Objective 2 – Action Plan
Equality Objective 2: Actions
Produce and Publish a Translation statement for the CCG
1
2
3
4
5
Which
Protected
Characteristic
is covered?
Race –
Language;
Disability; Age
Publicise the CCG Complaints policy using alternative
sources apart from the Internet and monitor the ‘source’
(for example: how the complainant found out how to make
a complaint) and the protected characteristics of
complainants. Analysis and report to be included in the
CCG Annual Equality Report.
Identify a process for capturing the views of minority
groups more effectively as part of on-going consultation
exercises and events.
All
Develop an equalities themed visit protocol for secondary
care looking at patient experience through an ‘equality
lens’ to support site visits; outcomes of visits to be
included in equality report to Quality and Safety
Committee.
Report on the usage and provision of Translated material
and Interpreters and how other communication needs are
met by all major health providers (HEFT, ROH, UHB,
BSMHFT) to Quality and Safety Committee
All
All
Race –
Language;
Disability; Age
EDS Goal and
Outcome
Key
Performance
Indicator
Lead
Delivered by
end of:
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes 2.1,
2.2
Goal 2 –
Outcome 2.4
32, 33
Communications June 2015
Team
Equality &
Diversity
9, 33
Complaints
July 2015
Team
Communications
Team
Goal 1 –
Outcome 1.1;
Goal 2 –
Outcome 2.1
Goal 2 –
Outcome - 2.1,
2.3, 2.4
32, 33
Engagement
Team
September
2015
33
Equality and
Diversity
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes 2.1,
2.2
32, 33
Equality and
Diversity
September
2015 (for
protocol); ongoing
thereafter
September
2015
April 2016
21
Equality Objective 2: Actions
6
7
8
9
10
Collate and analyse protected characteristic data on the
membership of the Patient Council and CrossCity Voice
members, information published as part of CCG Annual
Equality Report.
Collate and analyse protected characteristic data on the
membership of Patient Participation Groups, information
published as part of CCG Annual Equality Report
Which
Protected
Characteristic
is covered?
All
All
Identify activities to address barriers to any groups
underrepresented in the Patient Council, CrossCity Voice
and PPGs – present action plan to Quality and Safety
Committee.
Any identified
underrepresented
group
CCG complaints process available in alternative formats
and languages to reduce communication barriers. To
include (but not limited to) alternative languages, Large
Print and Easy Read.
Research and report (including engagement and
consultation) on the access barriers (including language
needs and communication barriers) faced by the
community of Birmingham using health services, with an
action plan detailing how the CCG can promote equality of
opportunity.
Race –
Language
Disability; Age
Race –
Language;
Disability
EDS Goal and
Outcome
Key
Performance
Indicator
Lead
Delivered by
end of:
Goal 1 –
Outcome 1.1
Goal 2 –
Outcome 2.1
Goal 1 –
Outcome 1.1;
Goal 2 –
Outcome 2.1
Goal 1 –
Outcome
1.1Goal 2 –
Outcomes 2.1,
2.2
Goal 2 –
Outcome 2.4
32, 33
Communications January 2016
Team
32, 33
Communications January 2016
Team
32, 33
Communications March 2016;
Team/Equality
update report
and Diversity
in March 2017
33
Goal 1 –
Outcomes 1.1,
1.2
Goal 2 –
Outcomes 2.1,
2.2
9, 10, 32, 33
Complaints
April 2016
Team
Communications
Team
Communications October 2016
Team
Equality and
Diversity
22
Equality Objective 3: To be an employer of choice through increasing the diversity profile of our workforce at all levels
and providing development opportunities for staff.
This objective and associated action support achievement of the General Equality Duty aims:
 Eliminate unlawful discrimination, harassment and victimisation
 Advance equality of opportunity between people who share a protected characteristic and those who do not
 Foster good relations between people who share a protected characteristic and those who do not
Rationale for Objective
The EDS evaluation identified the following issues and gaps which provides the rationale for equality objective 3:
Subject
Issue
Protected Characteristics &
Vulnerable Groups
Representing the
Community we serve
Our aim is to ensure that we have the right staff in the right place at the right time supporting
the organisation to commission high quality healthcare services to our local population.
Through a representative workforce we will be better placed to achieve this aim. Effective
recruitment, selection and employment practices are important; this includes staff induction.
All protected characteristics
with a focus on:
Age
Disability
We are a small employer (around 130); analysis of our staff profile reveals that we employ very
few younger people and people with a disability. As our workforce grows older we need to plan
for the future.
Supporting Staff
A representative workforce brings a diversity of needs - gaps or issues in terms of support were
identified around flexible working, access to support networks and disability related absence
All protected characteristics
with a focus on: Disability;
Lesbian, Gay and Bisexual; Race;
Staff with Parental/Caring
responsibilities
23
Subject
Issue
Protected Characteristics &
Vulnerable Groups
Understanding our
Staff
We need to improve the understanding of staff needs and outcomes in terms of the effect
policies and processes have on them; to do this we need to ensure that anonymous and nonidentifiable information around protected characteristics is used within internal reports. (this is
linked to Employee Relations, Training, Staff Survey's, sickness absence, harassment and
bullying and flexible working)
All protected characteristics
Equality Objective 3 – Action Plan
Equality Objectives 3: Actions
1
2
3
Communications brief to reiterate need to undertake
return to work interviews following sickness absence.
Which
Protected
Characteristic
is covered?
All
Key
Performance
Indicator
Goal 3 –
Outcomes 3.4,
3.6
Monitor PDR’s undertaken by anonymised protected
characteristics and department, published as part of
Annual Equality Report.
All
Goal 3 –
Outcome 3.3
34
Update the CCG Equality Statement for Job Descriptions
All
34
Introduce policy and process on exit interview monitoring
ALL
Goal 3 –
Outcome 3.1
Goal 3 –
Outcome 3.6
Implement the NHS Workforce Race Equality Standard
(WRES)
Race
Goal 3 –
Outcome 3.1,
3.3, 3.4, 3.6
23, 24, 25, 26,
27, 28, 29, 30,
31
4
5
EDS Goal and
Outcome
34
Lead
Delivered by
end of:
Operational
Delivery Group
Communicatio
ns
CSU (L&D)
In place by
April 2015
Equality and
Diversity
CSU (HR)
HR Policy
Group
Equality and
Diversity
June 2015
In place by
May 2015
June 2015
July 2015
July 2016
24
Equality Objectives 3: Actions
6
7
8
9
10
11
12
13
Track participation in mandatory and statutory training by
protected characteristics (anonymous data), reported as
part of NHS WRES.
Research and report on the introduction of a tracking
process around applications for development training and
improve evaluation methods, reported as part of NHS
WRES.
Explore opportunities to provide staff with opportunity to
connect with networks around BAME and LGBT
Review and report on the effectiveness and impact of the
introduction of flexible working
Review and report on current staff induction process;
identifying future practices to ensure that new employees
are fully aware of their responsibilities and the CCGs
commitment to equality and human rights.
Complete a review on existing mandatory equality and
diversity training
Explore ability to introduce tracking of internal promotion
of staff in order to be able to provide information for the
Annual Equality Report (part of Public Sector Equality
Duty).
Review staff survey to incorporate measures on Bullying
and Harassment, staff perception of equality and
experience of discrimination, reported as part of NHS
WRES.
Which
Protected
Characteristic
is covered?
All
Key
Performance
Indicator
Lead
Goal 3 –
Outcome 3.3
26
CSU (L&D)
In place by
July 2015
All
Goal 3 –
Outcome 3.3
26
CSU (L&D)
Equality and
Diversity
July 2015
Race
Sexual
Orientation
Transgender
All
Goal 3 –
Outcome 3.6
Goal 4 –
Outcome 4.1
Goal 3 –
Outcome 3.5
35
Equality and
Diversity
September
2015
34
Equality and
Diversity
September
2015
All
Goal 3 –
Outcome 3.1
34
CSU (L&D)
Equality &
Diversity
October 2015
All
Goal 3 –
Outcome 3.3
Goal 3 –
Outcome 3.3
35
Equality and
Diversity
CSU (HR)
Equality and
Diversity
November
2015
December
2015
Goal 3 –
Outcome 3.4,
3.6
27, 28, 29, 30,
34
Communicatio
ns
Staff Council
Equality and
December
2015
All
All
EDS Goal and
Outcome
24, 29, 34
Delivered by
end of:
25
Equality Objectives 3: Actions
Which
Protected
Characteristic
is covered?
EDS Goal and
Outcome
Key
Performance
Indicator
Introduce exit interview monitoring, with results analysed
by protected characteristics reported annually to ODG and
in Annual Equality Report
Analysis of staff survey responses should include
anonymised protected characteristics and pay banding to
understand the impact on different groups.
All interview panel members to have undertaken
recruitment and selection training with past 3 years
Improve information provided on Employee Relations
activity to ODG through the inclusion of anonymous
information on protected characteristics (reported every 6
months)
Investigate and report on opportunity to participate in
Stonewall Champions programme for organisation to make
a decision
All
Goal 3 –
Outcome 3.6
34
All
Goal 3 –
Outcome 3.6
27, 28, 29, 30
All
Goal 3 –
Outcome 3.1
Goal 3 –
Outcome 3.6
24, 34
Research and report on opportunity to introduce an
‘apprenticeship scheme’
Age
Provide managers guidance on succession planning.
Age
Design and deliver Harassment and Bullying training for all
staff.
All
21
22
Conduct a disability audit of Bartholomew House (Building
Disability
14
15
16
17
18
19
All
Sexual
Orientation
20
Lead
Diversity
CSU (HR)
Delivered by
end of:
December
2015
Staff Council
Equality and
Diversity
CSU (L&D)
Dependent on
date of 2015
survey
March 2016
25, 34
CSU (HR)
Equality and
Diversity
March 2016
Goal 3 –
Outcome 3.6/
Goal 4 –
Outcome 4.1
Goal 3 –
Outcome 3.1
34, 35
Equality and
Diversity
March 2016
34
April 2016
Goal 3 –
Outcome 3.1,
3.3
Goal 4 –
Outcome 4.1
Goal 3 –
Outcome 3.4
34
Equality and
Diversity
CSU (HR)
CSU (LD)
Operational
Delivery Group
July 2016
Goal 3 –
34
CSU (L&D)
Equality and
Diversity
Equality and
27, 28, 34
April 2016
September
26
Equality Objectives 3: Actions
and Car Park) in collaboration with disabled staff and
visitors.
Promote the CCG as an employer of choice with particular
focus on younger people and people with a disability.
Which
Protected
Characteristic
is covered?
Disability
Age
EDS Goal and
Outcome
Outcome 3.1,
3.6
Goal 3 –
Outcome 3.1
Key
Performance
Indicator
34
23
24
Provide staff with learning opportunities around Religion,
Harassment and Bullying, Gender Reassignment, Gypsy,
Roma, Traveller Communities and Equality Analysis
Religion
Gender
Reassignment
Race
Goal 3 –
Outcome 3.3
34, 35
Lead
Delivered by
end of:
Diversity
2016
Equality and
Diversity
External
Communicatio
ns
Equality and
Diversity
December
2016
March 2017
27
Equality Objective 4: To demonstrate effective leadership that values and promotes equality, diversity and inclusion
both within and outside of the CCG.
This objective and associated action support achievement of the General Equality Duty aims:
 Eliminate unlawful discrimination, harassment and victimisation
 Advance equality of opportunity between people who share a protected characteristic and those who do not
 Foster good relations between people who share a protected characteristic and those who do not
Rationale for Objective 4
The EDS evaluation identified the following issues and gaps which provides the rationale for equality objective 4:
Subject
Issue
Protected
Characteristics/Vulnerable
Groups
Demonstrating a commitment
to equalities leadership
Examples of the CCG's commitment to Equalities both within and outside of the
organisation were identified. Further work is required to embed and further promote
equalities leadership and support a culturally competent workforce
All groups; specific focus on:
Cultural Competence
Mental Health and wellbeing
Robust and informed decision
making
Equality Analysis has been successfully embedded into the architecture of the CCG;
improvements have been identified which would enable a more robust, effective and
transparent process.
All protected characteristics and
vulnerable groups; Human Rights
Health Inequalities
Support at a Primary Care
Level to embed good equality
practice
A need has been identified to provide guidance to GP practices on a range of practical
issues such as employment, equality monitoring, migrant health, registration
guidance. All of which will enable practices to demonstrate a commitment to
equalities, improve access and effectiveness both for patients and staff.
All protected characteristics; with
specific focus on: Migrant Health;
Race
28
Equality Objective 4 – Action Plan
Equality Objective 4: Actions
1
2
3
Apply to become an Equality and Diversity Partner (part of NHS
Employers) and host event promoting Equality, Diversity and
Human Rights week.
Board, Senior Leaders and staff encouraged to sign up to be a
Personal Fair Diverse Champion (NHS Employers)
Which
Protected
EDS Goal and
Characteristi
Outcome
c is
covered?
All
Goal 4 –
Outcome 4.1
All
35
Delivered
by end of:
Equality and
Diversity
QSC
Equality and
Diversity /QSC
April 2015
May 2015
35
35
Equality and
Diversity
October
2015
Communicatio
ns Team
Equality and
Diversity
Equality and
Diversity/
Governing
Body
ODG
Equality and
Diversity
LCN Chairs –
Primary Care
Development
September
2016
All
All
Goal 4 –
Outcome 4.3
35
Sign up to the Mindful Employer charter and publicise
involvement
Disability
34
Develop a package of support for GP Practices in consultation
with LCN’s as part of the co-commissioning agenda. For example
good practice guides on: Safe and Effective Recruitment and
Selection Practices; Commitment to being an Equal
Opportunities Employer; Dealing effectively with complaints;
All
Goal 3 –
Outcome 3.1/Goal 4 –
Outcomes 4.1,
4.3
Goal 4 –
Outcomes 4.1,
4.3
5
Lead
Goal 4 –
Outcome 4.1,
4.3
Goal 4 –
Outcome 4.2
Review the Equality Analysis process and forms to improve the
highlighting of risks and recording of decisions by Boards and
Committees. Equality analysis should clearly identify both
benefits and potential risks and demonstrate how it relates to
the aims of the General Equality Duty and which EDS outcome it
supports.
Hold a development day around staff culture
4
6
Key
Performance
Indicator
33
May 2015
October
2016
March
2017
29
Equality Objective 4: Actions
Which
Protected
EDS Goal and
Characteristi
Outcome
c is
covered?
Key
Performance
Indicator
All
35
Lead
Delivered
by end of:
Equality and
Diversity/ QSC
Equality and
Diversity
March
2017
March
2017
Involving and Engaging Patients; Communicating Effectively;
Equality Monitoring patients; Migrant health; Registration
guidance on people without identification or of no fixed abode
7
8
Explore the potential for Board and Senior Leaders to
individually champion a protected characteristic
Universal offer of Cultural Competence Training in place for
staff.
Religion
Goal 4 –
Outcome - 4.1
Goal 4 –
Outcome - 4.1,
4.3
35
30
Key Performance Indicators
Potential years of life lost from causes amendable to healthcare – adults; children and young people
Protected Characteristic/
Health Inequality
Age; Life Expectancy
Life expectancy at 75 – Males; Females
Age; Sex; Life Expectancy
Neonatal mortality and still births
Pregnancy and Maternity;
Life Expectancy
Age; Mental Health; Life
Expectancy
Age; Life Expectancy
No.
1
2
3
4
5
6
7
8
9
10
11
12
Key Performance Indicator
Excess under 75 mortality rate in adults with serious mental illness
Infant mortality
Excess under 60 mortality rates in adults with learning disability
Access to community mental health services by people from black and minority ethnic groups
Access to psychological therapies services by people from black and minority ethnic groups
Improving access to primary care services: Access to GP services
Improved access to services for patients with Learning Disabilities:
 All eligible LD patients are offered a patient passport agreed between GP and hospital providers
Improving the experience of care for people at the end of their lives: Bereaved carers’ views on the quality of care in
the last 3 months of life
Protect the most vulnerable patient groups by ensuring effective communication channels are in place between all
health professionals involved in caring for them:
 All practices meet at least quarterly with their named Health Visitor to discuss current case load and any high
risk children and their families;
 All practices have written standards/protocols in place for joint working with their Health Visitor
 All practices are able to evidence awareness and understanding of services available and referral processes
Age; Learning Disability;
Life Expectancy
Mental Health; Race;
Access
Mental Health; Race;
Access
All Protected
Characteristics; Access
Learning Disability; Access
Patient Experience;
Carers; End of Life
Age; Safeguarding
31
No.
Key Performance Indicator
Protected Characteristic/
Health Inequality
for ‘early help’ children’s safeguarding services
13
Reduce vaccine preventable illness across the CCG population through a comprehensive, system-wide approach to
improve uptake:
 Vaccination and flu targets included
Patients with moderate or severe COPD who have a self-management plan and rescue medication
14
15
Non-Acute Inpatient Service (NAIPS) rehabilitation service – monitor the services to reduce the length of stay and
rehabilitation of patients:
 On-going monitoring of length of stay levels for all patients
 On-going monitoring of referrals of BME patients from BSMHFT and length of stay levels, ensuring access for
BME patients
Improving women and their families experience of maternity services: Women’s experience of maternity services
16
17
18
Improving experience of healthcare for people with mental illness: patient experience of mental health services
Sex; Pregnancy and
Maternity; Patient
Experience
Mental Health; Patient
Experience
Improving children and young people’s experience of healthcare: children and young people’s experience of inpatient
services
Age; Patient Experience
Improving people’s experience of integrated care: people’s experience of integrated care
All Protected
Characteristics; Patient
Experience
All Protected
Characteristics; Carers;
Patient Experience
19
20
Age; Pregnancy and
Maternity; ill Health
Prevention
All Protected
Characteristics; LTC
Management
Mental Health; Referrals
Ensure the needs of carers are recognised and that carers feel empowered to better support themselves and those
that they care for:
 All practices hold an active carers register over 2014/15
 100% of carers are offered signposting support
 Positive experience reported by carers receiving additional support from their GP practice
32
No.
21
22
23
24
25
26
27
28
29
30
31
32
Proportion of frail older people who have an active personalised care plan
Protected Characteristic/
Health Inequality
Age; Involvement
Proportion of patients on the End of Life Care Register who have an integrated care plan
Age; Involvement
Key Performance Indicator
NHS Workforce Race Equality Standard Indicators
Percentage of BME staff in Bands 8-9, VSM (including executive Board members and senior medical staff) compared
with the percentage of BME staff in the overall workforce
Relative likelihood of BME staff being appointed from shortlisting compared to that of White staff being appointed
from shortlisting across all posts
Relative likelihood of BME staff entering the formal disciplinary process, compared to that of White staff entering the
formal disciplinary process, as measured by entry into a formal disciplinary investigation.* (note: this indicator will be
based on data from a two year rolling average of the current year and previous year).
Relative likelihood of BME staff accessing non-mandatory training and CPD as compared to White staff.
Race and Sex
Race and Sex
Race and Sex
Race and Sex
For each of these four staff survey indicators, the Standard compares the metrics for each survey question response for White and BME staff
Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in the last 12
Race and Sex
months, analysed by BME and White staff.
Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months, analysed by BME and
Race and Sex
White staff.
Percentage believing that trust provides equal opportunities for career progression or promotion, analysed by BME
Race and Sex
and White staff.
In the last 12 months have you personally experienced discrimination at work from any of the following? B)
Race and Sex
Manager/team leader or other colleagues, analysed by BME and White staff.
NHS Workforce Race Equality Standard Indicators - Board
Workforce Race Equality Indicator – Does the Board meet the requirement on Board membership?
Race and Sex Race
 Boards are expected to be broadly representative of the population they serve
NHS Equality Delivery System
Progress evidenced in review of EDS Goal 1 – Better Health Outcomes with at least two of the five outcomes moving
All Protected
from Developing to Achieving
Characteristics
33
No.
33
34
35
Key Performance Indicator
Outcomes are:
 Services are commissioned, procured, designed and delivered to meet the health needs of local communities;
 Individual people’s health needs are assessed and met in appropriate and effective ways;
 Transitions from one service to another, for people on care pathways, are made smoothly with everyone
well-informed;
 When people use NHS services their safety is prioritised and they are free from mistakes, mistreatment and
abuse
 Screening, vaccination and other health promotion services reach and benefit all local communities.
Progress evidenced in review of EDS Goal 2 – Improved Patient Access and Experience with at least two of the four
outcomes moving from Developing to Achieving
Outcomes are:
 People, carers and communities can readily access hospital, community health or primary care services and
should not be denied access on unreasonable grounds;
 People are informed and supported to be as involved as they wish to be in decisions about their care;
 People report positive experiences of the NHS;
 People’s complaints about services are handled respectfully and efficiently.
Progress evidenced in review of EDS Goal 3 – A Representative and Supported Workforce with all six outcomes
graded as Achieving
Outcomes are:
 Fair NHS recruitment and selection processes lead to a more representative workforce at all levels;
 The NHS is committed to equal pay for work of equal value and expects employers to use equal pay audits to
help fulfil their legal obligations;
 Training and development opportunities are taken up and positively evaluated by all staff;
 When at work, staff are free from abuse, harassment, bullying and violence from any source;
 Flexible working options are available to all staff consistent with the needs of the service and the way people
lead their lives;
 Staff report positive experiences of their membership of the workforce.
Progress evidenced in review of EDS Goal 4 –Inclusive Leadership with all three outcomes graded as Achieving
Outcomes are:
 Boards and senior leaders routinely demonstrate their commitment to promoting equality within and beyond
Protected Characteristic/
Health Inequality
All Protected
Characteristics
All Protected
Characteristics
All Protected
Characteristics
34
No.
Key Performance Indicator


Protected Characteristic/
Health Inequality
their organisation;
Papers that come before the Board and other major Committees identify equality-related impacts including
risks, and say how these risks are to be managed;
Middle managers and other line managers support their staff to work in culturally competent ways within a
work environment free from discrimination.
35
Bartholomew House
Equality and Diversity
Hagley Road
Birmingham
B16 9PA
Telephone: 0121 255 0809
36