Equality, Diversity and Inclusion
'Equal but Different'
NHS Shropshire, Telford and Wrekin is committed to commissioning the very best care for the diverse population we serve, recognising that services need to be designed with equality, diversity and human rights at the core of business and decision making.
We are committed to eliminating unlawful discrimination and promoting equality of outcomes for our diverse population. We aim to do this by ensuring that the values underpinning equality, diversity and human rights are central to our policy making, service planning, employment practices and commissioning.
For our staff, we recognise and value difference, and aim to create a working culture and practices that recognise, respect, and value difference for the benefit of the organisation and the individual.
We work to a number of statutory and policy drivers, which underpin the Equality and Diversity Agenda. The main pieces of legislation and policy drivers are set out below.
When we think about making changes to our services or policies, it is important that we fully consider the impact that it may have on all of our population groups, along with how it may positively or negatively affect other environmental factors, such as climate change. In order to fulfil this statutory requirement, we have a robust Integrated Impact Assessment tool, which is used by our teams to assess the impact their proposed change to a service or policy may have with regards to equality, quality, safety and climate change.
This resource is available to NHS Shropshire, Telford and Wrekin employees here
Our Duties and Responsibilities
As a public sector organisation, we must comply with specific equality duties that require it to evidence how it pays due regard to the needs of diverse and vulnerable groups in the exercising of its responsibilities.
For the purposes of this strategy, this includes compliance with the Equality Act 2010, Human Rights Act 1998, and relevant sections of the Health and Social Care Act 2012.
The Equality Act was introduced to harmonise the raft of existing equality legislations, making it easier for people and organisations to understand discrimination law.
The Act provides protection to groups of people who may be discriminated against because of certain characteristics they share. It provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. The groups protected by the Act include:
- Age – People of different ages including children, young and older people
- Disability – People with a long-term condition, or with mental, physical, sensory, learning disability or impairments, or a combination of these
- Gender Reassignment – People who have changed, or are in the process of changing, their sex
- Marriage and Civil Partnership – People who are married or in a civil partnership
- Race – People characterised by shared ethnicity, language or culture
- Religion or Belief – People with or without a religion or belief
- Sex – Men and women
- Sexual orientation – People who identify as Lesbian, Gay, Bi-sexual or Transgender
- Pregnancy and Maternity – Women who are having or have just had a baby
The Equality Act sets out the Public Sector Equality Duty. This duty requires public bodies to consider all individuals when carrying out their day-to-day work – in shaping policy, in commissioning and delivering services, and in relation to their own employees. It requires us to have due regard to the need to:
- Eliminate unlawful discrimination, harassment and victimisation, and other conduct prohibited by the Act
- Advance equality of opportunity between people who share a protected characteristic and those who do not, for example:
– Remove or minimise disadvantages suffered by people due to their protected characteristics
– Meet the needs of people with protected characteristics
– Encourage people with protected characteristics to participate in public life or in other activities where their participation is low
- Foster good relations between people who share a protected characteristic and those who do not
- Tackle prejudice and promote understanding between people from different groups.
The Equality Act also sets out specific duties to help us better perform the Equality Duty. It does this by requiring us to be transparent about how we respond to the Equality Duty.
We are accountable to its service users and be open to public scrutiny. The duties, therefore, provide the public with the information they need to challenge and hold NHS Shropshire, Telford and Wrekin to account for its performance on equality.
The specific duties require us to:
- Publish sufficient information to show that it has considered the three aims of the general duty when making decisions, and the equality data that underpins those decisions
- Publish Information related to persons who share protected characteristics who are employees, or others affected, such as service users
- To publish the information in a manner that is accessible to the public
To comply with the requirements of the Equality Act 2010, we will work to continually:
- Monitor its workforce and analyse any unintended variations
- Assess the health needs of its local communities
- Commission programmes and services to address health inequalities
- Carry out Equality Impact Analysis to inform its decision making
- Involve member practices, communities, staff, patients and the public in its decision-making processes
- Produce an equality strategy and annually measure our performance against it
NHS Shropshire, Telford and Wrekin 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 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 etc.
- Dignity e.g. sufficient staff to change 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.
We will work to embed a human rights-based approach in the way that it commissions services and in its role as an employer. This approach is not new, and is evident in NHS policy initiatives such as Dignity in Care, Essence of Care, Standards of Better Health, and the Knowledge and Skills Framework.
NHS Shropshire, Telford and Wrekin 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 (joined up) way.
The Act also places duties on us to promote the NHS Constitution, to enable choice, and to promote patient, carer and public involvement. To discharge this responsibility effectively, we will need to work with our partners to reduce health inequalities among those in greatest need and embed this requirement into its joint health and wellbeing strategies. We 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.
The Act also requires us to work with local Healthwatch organisations, to provide information to the CQC and Health and Wellbeing Board about essential levels of safety and quality of its providers. Our engagement strategy sets out in greater detail how we will work with Healthwatch and its predecessor bodies to achieve this.
Analysing the equality impact of our policies, decisions, strategies and services helps NHS Shropshire, Telford and Wrekin to meet the requirements of the Public Sector Equality Duty, ensuring the needs of protected or disadvantaged groups and communities are understood and addressed appropriately.
We are required to demonstrate that we have had due regard for the general equality duty.
We are committed to ensuring that we demonstrate due regard to the general duty when making decisions about policies and services.
We have embedded the requirement to undertake an Equality Analysis into our decision making processes.
This ensures that we continually work to understand and respond to the diversity of patient experience in health access, care and outcomes, and to recognise and value the importance of using equality analysis to address health inequalities.
All committee reports require the author to consider how their report relates to equalities in general and to ensure that due regard is given to the general equality duty.
When analysing the impact of our policies and strategies, we do not limit the exploration of barriers and experiences to purely those protected characteristics detailed above.
There are other socially excluded groups, for example – homeless people, gypsies and travellers, sex workers and migrant groups who often need support and help to navigate the health system effectively and who may access healthcare in ways which do not necessarily meet their particular needs, for example an over-reliance on A&E services. In this regard, there is also a clear economic case for considering the way in which such groups access and use healthcare services.
For example there is evidence of high rates of emergency care among certain socially excluded groups:
- Homeless people are estimated to consume eight times more hospital inpatient services than the general population of similar age and make five times more A&E visits
- Gypsies and travellers are reported to be more likely to visit A&E than a GP because of issues of trust
- Alcohol misuse is associated with 190,000 hospital admissions each year. Around 70% of A&E attendances between midnight and 5am on weekend nights are alcohol related
The NHS Equality Delivery System is a performance framework enabling organisations to review their performance on equality and diversity, and to identify future priorities and actions. It is designed to help organisations to deliver better outcomes for patients and communities and better working environments for staff.
NHS England have produced a short animation video which explains what EDS2 is and how it should be implemented by local NHS organisations. This video can be used by NHS organisations to help communicate the key EDS2 messages to their workforce and communities.
Central to the EDS is a set of 11 outcomes aligned to four goals. These outcomes focus on the issues of most concern to patients, carers, communities, NHS staff and Boards. The three EDS goals are:
- Commissioned or provided services
- Workforce health and wellbeing
- Inclusive leadership
It is against these domains and the accompanying outcomes that we will assess and grade our performance and determine collectively the action to be taken. The EDS grades are set out below:
- Undeveloped activity
- Developing activity
- Achieving activity
- Excelling activity
NHS EDS2 Report 2022
NHS Shropshire, Telford and Wrekin has not finalised the external scoring of the EDS2 self assessment. However the draft self assessment which outlines the evidence collated can be viewed here.
Further information:
NHS Shropshire, Telford and Wrekin Workforce Race Equality Standard draft reporting data and draft action plan can be found here.
The reports on this page refer to the Shropshire, Telford and Wrekin Clinical Commission Group (or CCG), which was replaced by NHS Shropshire, Telford and Wrekin on 1 July 2022.
NHS SCCG WRES Reporting August 2020
NHS Shropshire CCG WRES Report 2020/21
NHS TWCCG WRES Reporting August 2020
NHS Telford and Wrekin CCG WRES Report 2020/21
STW CCGs WRES Action Plan 2020