Presentation heading

Next Steps for Improving
Equality Across Healthcare
Ruth Passman
Deputy Director, Equality
and Health Inequalities
June 2014
NHS England Strategic Priorities - Context
• Set within the context of the Equality Act 2010 and the
Health and Social Care Act 2012
• Reflective of the NHS Constitution values and pledges
• Approved by NHS England Board, December 2013
• The 9 strategic priorities reflect the different roles of NHS
NHS England’s role as a system leader
NHS England as a commissioner
NHS England as an employer of ~6500 staff - Equality,
Diversity and Inclusion in the workplace strategy
What are the priorities?
• As a system leader, re-launch and support the Equality and
Diversity Council
• Support NHS Organisations to improve equality performance
and meet the public sector Equality Duty (EDS2
• Robust Data to measure equality and health inequalities,
determine priorities and drive improvement
• Creating an NHS Workforce and leadership that is reflective
of the communities we serve and that are free from
• Resource allocation supports duties around inequalities
The Strategic Priorities (cont’d)
• Incentivise and prioritise improvements in primary care
towards communities and groups who experience
inequalities in healthcare and outcomes
• Embed equality and tackling health inequalities into CCG
assurance regime
• Remove derogations which permit geographic variations in
care standards
• Support the reduction of mental illness inequalities through
the parity of esteem programme
• Programme Board for Equality and Health Inequalities
under development
Equality and Diversity Council
• Formed in 2009, with members from DH, NHS and other
partner organisations
• NHS reforms and transition – transferred to NHS England
and refreshed
• Scope covers equality and tackling health inequalities
• Chaired by the CEO of NHS England with diverse
membership from system leaders, NHS, patient
representation, staff and staff side, local authority, academia,
think tanks, community and voluntary sector
• Values and principles of the NHS Constitution – NHS Values
Summits an enabler for meaningful engagement
EDC work priorities
1. Equality Delivery System – EDS2
Supporting implementation and effective use
2. System alignment
Embedding equality and tackling health inequalities
within the key policy levers for the NHS
3. Leadership and workforce
Values based recruitment / talent management
4. Data measurement
Equality and health inequality monitoring / disaggregation
5. Communications
Equality Delivery System for the NHS
Organisations analyse and grade their
equality performance against 18 EDS
outcomes grouped into 4 EDS goals:
Better health outcomes for all
Improved patient access and experience
Representative and supportive workforce
Inclusive leadership
System data to measure equality and
health inequalities
• Expand and improve data available to measure equality and
health inequalities
• A National Equality and Health Inequalities data group is
being established to determine data collection, monitoring
and dissemination requirements and drive delivery within
NHS England and the wider system
Workforce Equality Issues:
Leadership Diversity
• The lack of diversity in boardrooms needs addressing as a
priority in order to bring the best resources to leadership,
culture, innovation, ethics and behaviour;
• In 2012, just 1% of NHS chief executives came from a BME
background, whilst there was just one non-white face in the
2012 Health Service Journal list of the one hundred most
influential people in healthcare;
• A snapshot of CCG leadership on governing bodies shows
that 12% are from BME, and 37% are women. However
this masks significant variation, with over 40 CCGs without
any female GP leadership on their governing bodies.
BME Staff engagement and satisfaction
• An established link between the treatment of BME staff and
the care patients receive;
• “Research suggests that the experience of black and
minority ethnic (BME) NHS staff is a good barometer of the
climate of respect and care for all within the NHS”
• “Put simply, if BME staff feel engaged, motivated, valued
and part of a team with a sense of belonging, patients were
more likely to be satisfied with the service they received”
NHS Staff Survey and Related Data West, M et al,(2012)
NHS Staff survey data and ethnicity
• The 2011 NHS Staff Survey found that harassment, bullying
or abuse was experienced more by Black staff (25% rising
to 26%) and for mixed race staff in acute trusts than by
white British staff (13%)
NHS Health and Wellbeing, Benefit Evaluation Model, 2008
• The 2012 NHS Staff Survey found bullying and harassment
(including that linked to a ‘protected characteristic’ in
equality law) from colleagues and managers was reported
by 24% of staff, a much higher level than that reported
outside the NHS
…Workforce representation
• Link between representative workforce and better health
outcomes for patients is well-known
• Under-representation of BME staff at senior and leadership
levels within NHS organisations exists
• This is a priority area for the EDC going forward – Simon
Stevens speech at Kings Fund Leadership event in May
• EDC-led ‘expert group’ to produce strategic approach for
July EDC meeting
• Commitment to make a meaningful and sustainable
difference on this issue
Next steps…
NHS England has:
• Published EDS2 on its website from 4 November 2013
• Agreed shared governance with Equality and Diversity
• Continued to play in the NTDA, CQC, HEE, Monitor,
community voluntary sector, and NHS colleagues
Developments underway:
• Embedding equality within key policy levers
• Equality Hub and the EDS Dashboard
Embedding equality within key policy levers
• CCG Assurance Framework – building upon equality (EDS
uptake) lines that featured in CCG authorisation
• CQC inspection regime – building upon existing
collaborative work with CQC (Essential Standards) and
ensuring that inspectors are equipped to identify equality
performance evidence
• Corporate Governance Statement – mandated annual
response from NHS organisations (work just beginning on
14 NHS England
Equality Hub and the EDS Dashboard
• Tools, guidance, good practice examples, news and
events, links and contacts, interactive communication – all
located in one online ‘hub’
• Proposal to host a national EDS Dashboard on the ‘hub’
• Dashboard to facilitate sharing of good EDS
implementation across the country and ascertain EDS
uptake levels across the NHS
15 NHS England
Finally…people not processes
• Keep the EDS under review so that it
is a force for good
• High quality care for all, now and
for future generations
• Values and principles of the
NHS Constitution: ‘making sure
everyone counts’
• ‘Flexing’ our services and
arrangements to meet needs

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