Equality and Inclusion
Strategy
2017/18 – 2020/21
Contents
1. Introduction
Page 3
2. Our Vision
Page 4
3. About the Equality and Inclusion Strategy
Page 5
4. Additional Standards
Page 9
5. The Equality Protected Groups
Page 11
6. Our Community
Page 12
7. Our Challenges
Page 15
8. Communication and Engagement
Page 17
9. Our Equality & Inclusion Strategy Aims
Page 19
10. Our Equality Objectives for 2017/18 – 2020/21
Page 20
11. Our CCG
Page 22
12. Commissioning
Page 27
13. Equality and Inclusion Assurance – Annual Report and Strategy
Review
Page 29
Appendix 1: The Goals and Outcomes of the Equality Delivery System
Page 30
Appendix 2: The Commissioning Process
Page 31
2|Page
1. Introduction
NHS Fylde and Wyre Clinical Commissioning Group (CCG) is the organisation responsible for
planning and buying health services in the area to meet patients’ needs. We serve a population
of approximately 151,400 people inhabiting a coastal region in the county of Lancashire. This
area includes the towns of Fleetwood, Kirkham, Lytham St Annes, Poulton-le-Fylde, Thornton and
a significant number of rural villages.
This is the second Equality and Inclusion Strategy that the CCG has published and it has been
designed to meet the duties placed upon the organisation as a public body under the Equality Act
2010 and other legislation that tackles discrimination and promotes equality and inclusion.
This strategy sets out our commitment to taking equality and inclusion into account in everything
we do. We recognise the importance of embedding equality principles and practices that will
support us as a CCG to commission the right services for our local population.
This strategy will be a flexible framework for our equality and inclusion activity which is an integral
part of the way we do business. It will support the delivery of our 2030 Vision for Health and Care
in Fylde and Wyre and is closely aligned with our constitution, organisational development and
engagement plans.
In summary this strategy aims to harness how we achieve better health outcomes, improve
patient access and experience, have a represented and supported workforce and have inclusive
leadership.
This strategy will be reviewed annually, information will be provided to the CCG’s Governing Body
on an annual basis within the Equality and Inclusion Annual Report to ensure that the aims and
objectives within this strategy are being progressed.
Jennifer Aldridge, Chief Nurse
3|Page
2. Our Vision
In April 2014 the CCG published its 2030 Vision for Health and Care in Fylde and Wyre. In it we
acknowledged that we are facing some significant challenges in the years ahead and we made a
commitment to embrace these challenges to ensure people living in Fylde and Wyre have the
very best health and health services possible.
Following extensive engagement with local
stakeholders we identified a number of vision principles.
2.1 Our vision principles
1. Everyone counts - We use our resources to benefit the whole community, making sure people
are not excluded. We recognise how we all have a part to play in making ourselves and our
communities healthier.
2. Improving lives - We are committed to improving people’s experiences of the NHS and
improving their health and wellbeing. We will work with all our partners to deliver the best
outcomes for our patients. We will be honest about our point of view and what we can and cannot
do.
3. Working together for patients - We put patients first in everything we do. By reaching out to
staff, patients, carers, families, communities and professionals outside the NHS, we put the needs
of our patients and communities before organisational boundaries.
4. Commitment to quality of care - We repay the trust that is placed in us by insisting on quality
and striving to get the basics right every time – safety, confidentiality, professional and
managerial integrity, accountability, dependable services and good communication. We welcome
feedback, learn from our mistakes and build on our successes.
5. Respect and dignity - We value all people as individuals, respect their aspirations and
commitment in life and seek to understand their priorities, needs, abilities and limits. We expect
healthy challenge from our Governing Body members and practices as we take up the challenge
of providing high quality healthcare services within available resources.
6. Value for money - Every act of commissioning commits public money. We aim to ensure every
one of these decisions is value for money.
4|Page
3. About the Equality and Inclusion Strategy
The approach to equality and inclusion set out in this strategy is to ensure it is integrated in all
mainstream activity. As such, equality and inclusion needs to be appropriately considered as an
integral part of the CCG’s high level, strategic policy direction and in our approach to transforming
patient services across Fylde and Wyre.
The strategy needs to be integral to how we identify and achieve the right outcomes in relation to
the CCG’s strategic approach to the Joint Strategic Needs
Assessment, the Health and Well Being Strategy and the CCG’s
Our strategic objectives:
Strategy and Vision.
3.1 Our Legal Duties
• Develop and maintain an
The Equality Act 2010 imposes general and specific duties on all
effective organisation
• Commission high quality, safe
public bodies.
and cost effective services that
3.2 The General Equality Duty
reduce health inequalities and
improve access to healthcare
The general equality duty applies to ‘public authorities’. Further
advice about who this includes is provided in the next section. In
• Effectively involve patients and
the public in decision making
summary, those subject to the general equality duty must, in the
exercise
of
their functions, have due regard to the need to:
• Develop excellent partnerships
that lead to improved health
outcomes
Eliminate unlawful discrimination, harassment and victimisation
• Make the best use of
and other conduct prohibited by the Act.
resources.
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.
These are often referred to as the three aims of the general equality duty. The Equality Act
explains that the second aim, advancing equality of opportunity, involves having due regard to the
need to:
Remove or minimise disadvantages suffered by people due to their protected characteristics.
Take steps to meet the needs of people with certain protected characteristics where these are
different from the needs of other people.
5|Page
Encourage people with certain protected characteristics to participate in public life or in other
activities where their participation is disproportionately low.
The Act states that meeting different needs includes taking steps to take account of disabled
people’s disabilities. It describes fostering good relations by tackling prejudice and promoting
understanding between people from different groups. To comply with the general equality duty, a
public authority needs to have due regard to all three of its aims.
3.3 The Specific Public Sector Equality Duty
As well as complying with the general duty, we must also comply with the following specific
duties:
Publish information to demonstrate compliance with the public sector Equality Duty at least
annually.
Prepare and publish equality objectives at least every four years.
This information can be found on the CCG’s equality and inclusion page on the website
http://www.fyldeandwyreccg.nhs.uk/about-us/equality-and-diversity/
3.4 The Brown Principles
These principles have been taken from the Equality and Human Rights Commission’s paper on
making fair financial decisions (Equality and Human Rights Commission, 2012).
Case law sets out broad principles about what public authorities need to do to have due regard to
the aims set out in the general equality duties. These are sometimes referred to as the 'Brown
principles' and set out how courts interpret the duties. They are not additional legal requirements
but form part of the Public Sector Equality Duty as contained in section 149 of the Equality Act
2010.
Decision-makers must be made aware of their duty to have 'due regard' and to the aims of the
duty.
Due regard is fulfilled before and at the time a particular policy is under consideration that will or
might affect people with protected characteristics, as well as at the time a decision is taken.
6|Page
Due regard involves a conscious approach and state of mind. A body subject to the duty cannot
satisfy the duty by justifying a decision after it has been taken. The duty must be exercised in
substance, with rigour and with an open mind in such a way that it influences the final decision.
The duty has to be integrated within the discharge of the public functions of the body subject to
the duty. It is not a question of 'ticking boxes'. The duty cannot be delegated and will always
remain on the body subject to it.
It is good practice for those exercising public functions to keep an accurate record showing that
they had actually considered the general equality duty and pondered relevant questions.
If
records are not kept it may make it more difficult, evidentially, for a public authority to persuade a
court that it has fulfilled the duty imposed by the equality duties.
3.5 The Health and Social Care Act 2012
The Health and Social Care Act, states that each commissioning group must, in the exercise of its
functions, have regard to the need to:
Reduce inequalities between patients with respect to their ability to access health services;
Reduce inequalities between patients with respect to the outcomes achieved for them by the
provision of health services;
Promote the involvement of patients and their carers in decisions about provision of the health
services to them;
Enable patients to make choices with respect to aspects of health services provided to them
3.6 The NHS Constitution
The NHS Constitution came into law as part of the Health Act in November 2009 and was revised
in March 2012. It contains seven principles that guide the NHS, as well as a number of pledges
for patients and the public. Several of these demonstrate the commitment of the NHS to the
requirements of the Equality Act and the Human Rights Act. For example, the first principle
requires that the NHS “provides a comprehensive service, available to all irrespective of gender,
race, disability, age, sexual orientation, religion or belief.” There are also a number of patients’
7|Page
rights in the Constitution which demonstrate the NHS’s commitment to equality and human rights,
including:
The FREDA principles
the right not to be unlawfully discriminated against in the
provision of NHS services, including on grounds of gender, race,
religion or belief, sexual orientation, disability (including learning
disability or mental illness) or age
the right to be treated with dignity and respect

FAIRNESS

RESPECT

EQUALITY

DIGNITY

AUTONOMY
the right to be involved in discussions and decisions about your
healthcare, and to be given information to enable you to do this
the right to accept or refuse treatment that is offered to you, and not to be given any physical
examination or treatment unless you have given valid consent.
3.7 The Human Rights Act
The Human Rights Act 1998 came into force in 2000.
Everyone in the United Kingdom is
protected under the Act. Fylde and Wyre CCG as a public authority are obliged by law to respect
the basic human rights of all citizens. As a public body we must at all times act in a manner
compatible with rights protected in this Act and safeguard these for patients in our care and staff
in our employment. Human Rights are underpinned by a set of common values and have been
adopted by the NHS under the acronym FREDA.
Consideration of Human Rights is also taken into account in our in our Equality Impact and Risk
Assessment process.
8|Page
4. Additional Standards
4.1 Equality Delivery System (EDS)
The main purpose of the EDS is to help NHS organisations, in discussion with local partners
including local populations, review and improve their performance for people with characteristics
protected by the Equality Act 2010. By using the EDS grading system, NHS organisations can
also be helped to deliver on the Public Sector Equality Duty in a planned manner, embedding
equality and inclusion into its day to day practices and sustaining a culture of transparency and
continuous improvement.
As a tool, the EDS2 allows systematic improvements to be made by assessing performance
against 18 outcomes (described in Appendix 1) grouped under the following four goals:
1. Better health outcomes.
2. Improved patient access and experience
3. A representative and supported workforce
4. Inclusive leadership
The CCG assesses its performance annually against the four EDS2 Goals, with stakeholders and
staff. The goals are assessed as either: undeveloped, developing, achieving or excelling.
4.2 Workforce Race Equality Standard
NHS Workforce Race Equality Standard (WRES) is a useful tool to identify and reduce any
disparities in experience and outcomes for NHS employees and job applicants of different
ethnicities. The Standard will be used by organisations to track progress to identify and help
eliminate discrimination in the treatment of Black and Minority Ethnic (BME) employees.
9|Page
4.3 Accessible Information Standard
The aim of the Accessible Information Standard is to make sure that people who have a disability,
impairment or sensory loss receive information that they can access and understand and any
communication support that they need.
The Accessible Information standard informs organisations how they should make sure that
patients and service users, and their carers parents, and families can access and understand the
information they are given. This includes making sure that people get information in different
formats if they need it, for example in large print, braille, easy read or via email.
The Accessible Information standard also tells organisations how they should make sure that
people get any support with communication that they need, for example support from a British
Sign Language (BSL) interpreter, deafblind manual interpreter or an advocate.
Commissioners of NHS and publicly funded Adult Social Care must have a regard to this
standard, in so much as they must ensure that they enable and support compliance through their
relationships with provider organisations.
10 | P a g e
5. The Equality Protected Groups
To comply with the general duty, a public authority needs to have due regard to these aims
in relation to the following nine equality protected characteristics:
Protected
Equality Group
Age
Definition
Age is defined by being of a particular age (for example being 35 years
old) or by being in a range of ages (for example being between 60 and
75 years old).
Disability
A person is classed as having a disability if they have a physical or
mental health condition and this condition has a ‘substantial and longterm adverse effect on his or her ability to carry out normal day to day
activities.’ These words have the following meanings:
Substantial means more than minor or trivial.
Long term means that this condition has lasted or is likely to last for
more than twelve months. There are progressive conditions that are
considered to be a disability.
These include:
People who have had a disability in the past that meets this disability.
There are additional provisions relating to people with progressive
conditions.
People with HIV, cancer, multiple sclerosis are covered by the Act
from diagnosis.
People with some visual or hearing conditions are automatically
deemed to have a disability.
Gender
Gender reassignment protects people who have changed their gender
Reassignment
from what they were identified as at birth. The Equality Act covers
people at any stage of this process.
Sexual
Sexual orientation means a person’s sexual preference towards
Orientation
people of the same sex, opposite sex or both.
Sex
Sex (gender) is included to protect the individual man or woman from
being discriminated against.
Race
Race refers to a group of people defined by their race, colour and
nationality (including citizenship) ethnic or national origins.
Religion or Belief Religion has the meaning usually given to it but belief includes
religious convictions and beliefs including philosophical belief and
lack of belief. Generally, a belief should affect your life choices or the
way you live, for it to be included in the definition.
Pregnancy
and Pregnancy is the condition of being pregnant or expecting a baby.
Maternity
Maternity refers to the period after the birth, and is linked to maternity
leave in the employment context. Protection against maternity
discrimination is for 26 weeks after giving birth.
Marriage
and The definition of marriage varies according to different cultures, but it
Civil Partnership
is principally an institution in which interpersonal relationships are
acknowledged and can be between different sex and same sex
partners. Same-sex couples can have their relationships legally
recognised as ‘civil partnerships’. In England and Wales marriage is
no longer restricted to a union between a man and a woman but now
includes a marriage between a same sex couple.
11 | P a g e
6. Our Community
Figure 1: Our Population
12 | P a g e
6.1 Our Local Population
NHS Fylde & Wyre CCG is the overarching consortium that oversees the 19 GP practices mainly
serving the local authority districts of Fylde and western Wyre. The CCG covers approximately
320 sq. km of coast and countryside with patients
coming from across the Fylde Coast. To the west it
borders the borough of Blackpool.
NHS Fylde & Wyre CCG is responsible for a
population of around 151,400 people. This includes
people registered with practices in the CCG and
unregistered
people
living
within
the
CCG’s
geographical area. The majority of the population
live in the urban towns of Fleetwood, ThorntonCleveleys, Poulton-le-Fylde, Kirkham and Lytham St
Anne’s but a significant proportion live in rural
villages. Figure 1shows the spread and density of
the registered population across the CCG area.
6.2 Age Distribution
The population is generally characterised by a larger proportion of adults aged over 45 years than
the England average (52% compared to 42% nationally). The CCG has a significantly greater
proportion of people aged 65 years and over (24%) compared to the national average (16%) and
a smaller proportion of children and younger adults.
6.3 Population Projection
Estimated population projections suggest that over the next ten years the population of NHS
Fylde and Wyre CCG will increase by over 7,000 people to approximately 158,800. The largest
increase will occur in the over 70 age group which will increase by 28% from 25,900 to 33,100.
This is in line with the national average. Conversely the young adult (15-30 years) and middle
aged (40-50 years) populations are projected to reduce significantly more than the national
average.
13 | P a g e
6.4 Ethnicity
The population of NHS Fylde & Wyre CCG is considerably less ethnically diverse than the
population of England. Black and minority ethnic groups account for only 5% of the population
compared to 16% nationally.
6.5 Immigration
The numbers of new immigrant registrations in Fylde and Wyre has been declining since 2007-8.
In 2010-11 there were 440 new registrations in Fylde and Wyre districts, 30% (130) of which were
from Eastern European countries of Poland, Latvia and Bulgaria. There were also 100 (22%)
registrations from India. There may be cultural barriers to accessing health services in these
communities. Intelligence on traveller populations is more difficult to ascertain. Although there are
no official sites in Fylde and Wyre there are known to be two semi-settled populations in Poultonle-Fylde and Preesall.
6.6 Local Demographics and Health Inequalities
All NHS organisations are facing some very significant challenges. These include more people
living longer with complex health conditions, rising expectations and increasing costs.
14 | P a g e
7. Our challenges
7.1 Population Challenges
The population in Fylde and Wyre has a growing number of older people. There are 2.4% more
adults aged over 70-74 years By 2022 we expect to see the numbers of people aged over 70
increase by nearly one third (28%), and by 2030 – the date by which we aim to deliver this vision
– the number of people aged over 85 will have doubled. While it is obviously good news that
people are living on average six years longer than they were 20 years ago, this increases the
pressure on services because as people become older they are more likely to develop multiple
long-term conditions such as diabetes, heart disease, breathing difficulties and dementia. Within
Fylde and Wyre there are also big differences in the health of people who live just a few miles
apart. These are known as ‘health inequalities’. In the most deprived parts of Fylde and Wyre
men die, on average, 10 years younger than those in more affluent areas. For women the
difference is six years. This is clearly unacceptable, and we must all work together to address it.
While these differences can be caused by many things such as living conditions, diet, levels of
smoking and drinking, better healthcare can have a significant impact too.
Figure 2: Our challenges
15 | P a g e
7.2 Health challenges
A higher percentage of people in Fylde and Wyre are affected by a long-term health problem than
the national average. These include diseases of the heart and blood vessels, diabetes, kidney
disease and stroke. The number of people with dementia is also higher than the national average.
Our ageing population means that these numbers are bound to increase. We need to work
together to prevent ill health and support people with long-term conditions to live healthier lives for
longer.
The current major causes of deaths in the area are:
• Cancer – 28.1%
• Diseases that affect the heart and blood vessels – 27.8%
• Diseases that affect the airways – 13.9%
• Diseases that affect the digestive system – 4.7%
In addition to this, we have some other problems that we need to tackle. More pregnant women
smoke than the national average and we have low rates of breastfeeding. In addition, there has
been an increase in alcohol-related harm in recent years both nationally and in some areas
locally. It is estimated that the numbers of people who drink at high levels will continue to increase
above the national average.
7.3 Addressing these challenges
Within Fylde and Wyre, different geographical communities face different health challenges. We
need to ensure that the most appropriate services and support are available to meet the needs of
different populations. Doing nothing is simply not an option; we cannot meet these future
challenges without change. We will only succeed if we work in partnership with others. Where we
directly commission services, influencing change is more straightforward; where we don’t we will
need to work with our partner commissioners to make sure our plans align. We are driven first
and foremost by patient need and ensuring high quality care, but we also need to ensure every
penny counts so that we can provide the best care to the maximum number of people.
16 | P a g e
8. Communication and Engagement
The CCG has an active approach to patient and public engagement through our In Fylde and
Wyre programme. This ensures that insight into patient experience, including that of patients in
protected characteristic groups, is driving decision making. Our Public and Patient Engagement
Group (PPE) meets monthly and includes representation from Healthwatch Lancashire,
disadvantaged groups, the voluntary sector, disability representatives, carers and older people.
The group reports to the Quality Improvement, Governance and Engagement Committee, which
reports to the Governing Body, and so is part of the CCG’s official governance process. This
group advises the CCG on its engagement activity and supported the commissioning of bespoke
surveys into LGBT+ and children and young people’s experiences of primary care services. The
group also supports communications and engagement officers to develop robust patient
experience recording and reporting systems via the insight database which can be triangulated
with other data and cross referenced with demographic information.
The CCG also supports patient participation groups (PPG) which are GP practice-based patient
groups. These meet regularly to discuss a range of local issues relating to primary care and
support practices to carry out an annual patient survey. The CCG holds a bi-monthly PPG chairs’
group and hosts an annual conference to support the development of PPGs in May each year.
The CCG also hosts a monthly Influence people’s panel, and circulates a bi monthly newsletter to
its membership scheme.
We hold regular listening events and focus groups offering the
opportunity for people to share their experiences in structured sessions or on a 1:1 basis. Our
working voices project is aimed at offering working age people the opportunity to share their
experiences and influence services by taking our listening events into the workplace.
8.1 LGBT+ and Children and Young People Surveys into Primary Care Experiences
In 2015/16 the CCG commissioned third sector partners Lancashire LGBT and UR Potential to
develop a peer led survey of patient experience in accessing primary care services. The survey
would focus on two protected characteristic groups, LGBT+ communities and children and young
people aged 13 – 18 years. The findings of the surveys have provided valuable insight into how
the CCG can support primary care services to make improvements. It has also provided the
17 | P a g e
impetus to build on our work with these groups.
Going forward, the CCG will develop an
engagement project which will increase opportunities for children and young people to have a
voice in the co-production and improvement of services. The CCG is also working closely with
Lancashire LGBT+ to promote the LGBT Charter Mark and will be taking this forward in our own
organisation.
18 | P a g e
9. Our Equality & Inclusion Strategy Aims
The Equality and Inclusion Strategy is based on the requirements of the NHS Equality Delivery
System (EDS) which supports the aims to embed equality into all policies and practices whilst
moving forward with performance and going beyond the legislation.
The EDS provides a robust framework against which we can assess and grade the CCG’s
performance against a range of nationally determined indicators grouped under the four goals:




Better health outcomes – Due for review in 2020/21
Improved patient access and experience – 2018/19
A representative and supported workforce – 2019/20
Inclusive leadership – 2017/18
19 | P a g e
10. Our Equality Objectives for 2017/18 – 2020/21
The Equality Strategy links to a number of key drivers but is based on the requirements of the
NHS Equality Delivery System (EDS) which aims to embed equality into all policies and practices
whilst driving up performance and going beyond the legislation.
The EDS provides a robust framework allowing the CCG and its stakeholders to access and
grade the organisation’s performance against a range of outcomes grouped under the four EDS
goals:
Overarching
Equality To reduce unacceptable differences in the health inequalities of all
Objective
people who live within Fylde and Wyre
Equality Objective 1
EDS Goal 1: Better health outcomes
1.1: Services are commissioned, procured, designed and delivered to
meet the health needs of local communities
1.2: Individual people’s health needs are assessed and met in
appropriate and effective ways
1.3: Transitions from one service to another, for people on care
pathways, are made smoothly with everyone well-informed
1.4: When people use the NHS services their safety is prioritised and
they are free from mistakes, mistreatment and abuse
1.5: Screening, vaccination and other health promotion services reach
and benefit all local communities
Equality Objective 2
EDS Goal 2: Improved patient access and experience
2.1: People, carers and communities can readily access hospital,
community health or primary care services and should not be denied
access on unreasonable grounds
2.2: People are informed and supported to be as involved as they wish
to be in decisions about their care
2.3: People report positive experiences of the NHS
2.4: People’s complaints about services are handled respectfully and
efficiently
Equality Objective 3
Equality Objective 4
20 | P a g e
EDS Goal 3: A representative and supported workforce
3.1: Fair NHS recruitment and selection processes lead to a more
representative workforce at all levels
3.2: 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
3.3: Training and development opportunities are taken up and
positively evaluated by all staff
3.4: When at work, staff are free from abuse, harassment, bullying and
violence from any source
3.5: Flexible working options are available to all staff consistent with
the needs of the service and the way people lead their lives
3.6: Staff report positive experiences of their membership of the
workforce
EDS Goal 4: Inclusive Leadership
4.1: Boards and senior leaders routinely demonstrate their
commitment to promoting equality within and beyond their
organisations
4.2 Papers that come before the Board and other major Committees
identify, equality-related impacts including risks, and say how these
risks are managed
4.3: Middle managers and other line managers support their staff to
work in culturally competent ways within a work environment free from
discrimination
21 | P a g e
11. Our CCG
In determining the equality objectives that enable us to ensure we have a representative and
supported workforce and inclusive leadership, we will be focussing on some areas highlighted for
our staff survey that was undertaken in 2016 in respect of Equality and Inclusion.
Our progress in meeting the equality objectives will be assessed and graded in discussion with
local people and our staff. The results of the EDS grading will be reported in the CCG’s Equality
& Inclusion Annual Report.
11.1 Equality Impact and Risk Assessments
The Clinical Commissioning Group has adopted the Equality Impact and Risk Assessment (EIRA)
Tool designed by NHS Midlands and Lancashire Commissioning Support Unit.
The EIRA
provides a framework for undertaking equality impact assessments. This combines three toolkits
into one consisting of equality impact, human rights screening and privacy impact. This enables
the CCG to show ‘due regard’ to the three aims of the general equality duty by ensuring that all
requirements around equality, human rights and privacy are given advanced consideration prior
to any policy decisions that the CCG’s Governing Body or senior managers make that may be
affected by these issues. CCG commissioners continue to ensure that the Equality Impact and
Risk Assessment are integral to the decision making processes.
The CCG has embedded the Equality Impact and Risk Assessment into their project
management through their Project Management Office (PMO) which defines and maintains
standards for project management within the CCG and provides Governing Body assurance. All
Equality Impact and Risk Assessments are quality checked by the CSU Equality and Inclusion
Team to ensure that CCG Commissioners and staff working on behalf of the CCG have
considered all the equality information and engaged and involved local people from Equality
Protected Groups in the decision making process.
See Appendix 2 for the Commissioning
Process
Equality Impact and Risk Assessments are presented to the Quality Improvement, Governance
and Engagement Committee (QIGEC) for approval. The PMO monitors projects and provides
assurance that the process has been followed for all projects and the relevant committee has
reviewed and authorised documentation.
22 | P a g e
Figure 3: The Equality Impact and Risk Assessment Process
11.3 Priority Service Areas for the CCG
By analysing the health needs of our population within the context of the challenges we face, we
have prioritised eight specific areas to focus on. When we tested these with the public there were
seven, but people consistently felt that learning disabilities should have a greater focus. We
agree, and so have added this as an eighth service area. Almost without exception people also
told us that preventing ill health should be a priority for us too – this is why it forms a key theme
across all service areas.
23 | P a g e
Our eight priority service areas are:
 OUR VISION FOR CANCER: Ensuring patients receive a faster diagnosis and better
treatment.
 OUR VISION FOR CHILDREN AND MATERNITY: To ensure high quality, accessible, userfriendly services are available for children, young people and pregnant women. To support
children, young people and pregnant women to be aware of their own health and wellbeing
and to be engaged in maintaining good health.
 OUR VISION FOR END OF LIFE: To ensure that high quality services are available in
hospitals, care homes and community settings for all patients and carers, regardless of
diagnosis, that offer dignity, choice and support in the last year of life.
 OUR VISION FOR LEARNING DISABILITIES: Ordinary and specific learning disability
services will work together to bring the appropriate expertise and skills to meet a patient’s
needs. People with learning disabilities and their carers will have the information and support
they need to understand their condition and feel confident to manage their own health and
wellbeing.
 OUR VISION FOR LONG-TERM CONDITIONS: Community-based services, particularly
general practice, will play a central role in proactively supporting patients with long-term
conditions through high quality, integrated and personalised care. People will have the
information and support they require to understand their condition and feel confident to
manage their own health and wellbeing.
 OUR VISION FOR MENTAL HEALTH AND DEMENTIA: The support of good mental health
and wellbeing will be central to all healthcare. Support for mental and physical health will be
delivered through coordinated community based services. People will have the information
and support they need to understand their condition and feel confident to manage their own
health and wellbeing.
 OUR VISION FOR PLANNED CARE: Our vision is to make sure that patients are seen by the
right person in the right place at the right time by high quality coordinated services that fit
around their needs.
 OUR VISION FOR URGENT CARE: People who need urgent care will receive consistently
high quality services in the right place, at the right time. Wherever possible, services will be
joined up between health and social care and provided seven days a week in a person’s home
or local community.
24 | P a g e
11.4 Inclusive Leadership
A fundamental role of the CCG’s Governing Body is to promote, challenge discrimination and
foster good relationships as set out in the Equality Act 2010. The CCG’s Executive Lead for
Equality is the Chief Nurse.
Our leadership approach ensures that there is fairness in our commissioning decisions and that
business is planned and conducted to meet our equality duties.
Our Quality, Improvement,
Governance and Engagement Committee monitors our performance against our equality
objectives, escalating to the Governing Body
Figure 4: CCG Governing Body clinical members
25 | P a g e
11.5 Our Staff
The CCG has an Operation Development Strategy and action plan. This strategy is being
refreshed in 2016 and the action plan will be implemented by the OD forum with representation
from Heads of Service and reporting through our formal governance structure. Staff have regular
1:1s and annual appraisals which are reviewed every six months. HR services are procured from
MLCSU, mandatory training compliance is monitored, regular team briefs from the Executive
team and an internal weekly staff newsletter ‘Your Week’. In 2016 the CCG has commissioned
the Picker Institute to conduct the National NHS Staff Survey.
This is reported on via the mandated NHS EDS Goal 3 A represented and supported workforce
(see page 16 for CCG’s equality objectives).
Figure 5: Culture
26 | P a g e
12. Commissioning
12.1 Commissioning, Procurement and Service Redesign
Each year, the CCG enters into contracts for buying clinical services.
Procured and
commissioned work provides core services to many of our local population and sustains and
generates thousands of jobs. The CCG has a statutory duty to ensure that public money is spent
in a way that ensures best value and provides equality of access and outcome for all residents.
Staff responsible for commissioning or procurement should ensure we are meeting our equality
and inclusion duties and meeting the needs of our diverse community.
Service redesign is the way the CCG reflects on existing or past commissioned service provision
and plans for the future, establishing key objectives and targets for the coming year.
Staff
responsible for service redesign should take this opportunity to assess whether the service is
meeting its equality and inclusion duties and ensure due regard for access to services and
outcomes of satisfaction with the service they deliver are not different or worse for some patients
or communities.
This is achieved via the EIRA process see Figure 3 on page xxx These are reviewed and signed
off by the QIGEC.
Provider compliance with equality and inclusion is in all NHS Standard
contracts and these are reviewed at quarterly contract meetings.
12.2 Contract and Quality Reviews
Contract or quality reviews are a more fundamental assessment of commissioned services not
just covering how, when and where services are delivered but whether they are delivered at all.
Staff responsible for carrying out service contract or quality reviews need to evaluate how
services currently meet the CCG’s equality and inclusion legal duties and take due regard in
considering whether any review will have a detrimental effect on any of the Equality Duties.
12.3 Policy Development and Review
The CCG produce a range of both clinical and corporate policies to ensure that patients receive
high quality care and treatment and staff are represented and supported.
Staff responsible for policy development need to ensure the policy they are developing and
implementing meets our legal duties in relation to equality and inclusion and takes on board the
views of the local population and our staff.
27 | P a g e
12.4 Quality and Performance Management
The CCG’s Quality and Performance Framework covers a range of activity from how we plan our
finances and services, how we set objectives and targets, how we monitor and measure
performance of our providers and our staff through personal development plans and appraisals
and our corporate objectives.
The CCG has a set of performance indicators for measuring progress and performance; many are
linked to equality of access and outcomes of service delivery, we will continue to work on defining
our approach to measuring our health and progress relating to equality issues.
12.5 Using feedback to improve patient experience.
Midlands and Lancashire Commissioning Support Unit (the CSU) manage complaints on our
behalf. We are committed to working with the CSU to provide the best service for patients, their
families and carers.
FWCCG place a high priority on the handling of concerns, comments, compliments and
complaints (the 4 Cs) and the CCG recognise they are a valuable aid to improving services.
The primary objective of the complaints policy is to provide a high quality investigation and
resolution of a concern or complaint as quickly as is possible. The aim is to satisfy the
complainant that his/her concerns have been addressed, while being fair to staff and the
complainant alike.
The CCG is committed to equal opportunity. No patient, or any other person involved in the
investigation and resolution of a complaint, will receive unfair treatment on the grounds of age,
colour, ethnic or national origins, religious and political beliefs, gender, marital status, sexual
orientation or disability or trade union membership. The CCG monitor each complaint within the
‘Insight’ database and there will be a record of whether there is any Equality Impact issue, if so,
the CCG will be notified.
All complaints made to the CCG are in confidence and do not affect the provision of treatment.
28 | P a g e
13. Equality and Inclusion Assurance - Annual Report and Strategy
Review
During each year the CCG will gather, store and publish evidence such as Equality Impact and
Risk Assessments, Consultation, Engagement and Involvement exercises for the purpose of
demonstrating our legal compliance and also any Freedom of Information requests.
The CCG’s Assurance Group will monitor activity in relation to our organisational priorities for
Equality and Inclusion. The Equality and Inclusion Team, MLCSU will produce an annual report,
which will provide progress and action on our equality objectives each year and at least every four
years will lead on a review of our strategy objectives.
29 | P a g e
Appendix 1: The Goals and Outcomes of the Equality Delivery System
Objective
Better
outcomes
Narrative
health The
NHS
should
achieve improvements
in patient health, public
health
and
patient
safety for all, based on
comprehensive
evidence of needs and
results
Improved patient The
NHS
should
access
and improve
accessibility
experience
and information, and
deliver
the
right
services
that
are
targeted,
useful,
useable and used in
order to improve patient
experience
A
representative The
NHS
should
and
supported increase the diversity
workforce
and quality of the
working lives of the
paid
and
non-paid
workforce, supporting
all staff to better
respond to patients’
and
communities’
needs
Inclusive
leadership
30 | P a g e
NHS
organisations
should ensure that
equality is everyone’s
business, and everyone
is expected to take an
active part, supported
by
the
work
of
specialist
equality
leaders and champions
Outcome
1.1 Services are commissioned, procured, designed
and delivered to meet the health needs of local
communities
1.2 Individual people’s health needs are assessed
and met in appropriate and effective ways
1.3 Transitions from one service to another, for
people on care pathways, are made smoothly with
everyone well-informed
1.4 When people use NHS services their safety is
prioritised and they are free from mistakes,
mistreatment and abuse
1.5
Screening, vaccination and other health
promotion services reach and benefit all local
communities
2.1 People, carers and communities can readily
access hospital, community health or primary care
services and should not be denied access on
unreasonable grounds
2.2 People are informed and supported to be as
involved as they wish to be in decisions about their
care
2.3 People report positive experiences of the NHS
2.4 People’s complaints about services are handled
respectfully and efficiently
3.1 Fair NHS recruitment and selection processes
lead to a more representative workforce at all levels
3.2 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
3.3 Training and development opportunities are taken
up and positively evaluated by all staff
3.4
When at work, staff are free from abuse,
harassment, bullying and violence from any source
3.5 Flexible working options are available to all staff
consistent with the needs of the service and the way
people lead their lives
3.6
Staff report positive experiences of their
membership of the workforce
4.1 Boards and senior leaders routinely demonstrate
their commitment to promoting equality within and
beyond their organisations
4.2 Papers that come before the Board and other
major Committees identify equality-related impacts
including risks, and say how these risks are managed
4.3
Middle managers and other line managers
support their staff to work in culturally competent ways
within a work environment free from discrimination
Appendix 2: The Commissioning Process