equality and diversity annual report qmsnhsuk

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This annual report updates the Board on progress on implementation of the single Equality Scheme 20062009.


The Board is asked to note the contents of the report.

Deborah Tarrant Director of Human Resources and Organisational Development


Annual Report on Equality & Diversity 2007-08
1. Introduction This report summarises work undertaken at Queen Mary’s Sidcup over the 12 months up April 2008 to promote equality and diversity and to progress the aim of the Equality Scheme. Queen Mary’s has made good progress on the equality and diversity agenda and will continue with this work in the coming year and beyond to ensure that diversity is recognised at all levels and is in the mainstream of our values, culture and planning. The report describes below the progress and achievements of the various work streams that have formed parts of the annual equality action plan. Each of these has been led by an Executive Director with progress reviewed by the Equality and Diversity Steering Group and reported to Executive Management Team and the Non-Clinical Risk Management Group.

2. Leadership and Corporate Commitment At the end of 2006 the Trust Board decided that the Race Equality Scheme should be integrated within and replaced by a wider equalities framework that takes in race, disability, gender, age, sexual orientation and religion or belief. The move to a single equality scheme aims to focus on making services accessible and more effectively delivered to patients and staff from different diversity groups. To help imbed awareness and understanding of the single equality scheme with staff the induction programme was revised and new induction material provided to doctors. Annual Equality and Diversity training for all staff changed with the introduction of a new e-learning ‘training tracker’ module and this is now mandatory for staff at all levels. Executive and Non Executive Directors received refresher training on the statutory equality duties of the Board as well as completion of the ‘training tracker’ module. The mainstreaming of equality and diversity so that it is part of ‘business as usual’ is important to the Trust. The inclusion of equality and diversity as one of the 6 core dimensions that make up the Knowledge and Skills Framework (KSF) profiles for all posts is an important part of the framework for achieving this. The ETD department has been proactive in supporting the development of KSF profiles across the Trust and currently 92% of posts have agreed KSF profiles.


3. Health, Strategy and Services Functions and policies relevant to the statutory equality duties are equality impact assessed and the standard template used has been extended to include all 6 main equality dimensions and to reflect the single equality scheme. A new ‘policy for policies’ has been implemented to ensure that all new policies are equality impact assessed before formal approval and implementation. Work has been undertaken by Information to develop patient monitoring and analysis by diversity. This has enabled data about waiting times in A&E to be broken down and analysed by race, gender, and age. Analysis of waiting times presents a complex picture that shows differences in the experience of patients from different diversity groups although there is no evidence that suggests actual patterns of discrimination. Monitoring systems are now in place so that trends and changes in data can be compared and measured over time. 4. Workforce Monitoring and analysis of the workforce is carried out quarterly and generally provides a good understanding of the diversity of the workforce. A Workforce Diversity Report for quarter 4 2007/08 is provided as an appendix to this document. Information about disability and sexual orientation is not so complete as other diversity data because of the higher level of sensitivity about disclosure and confidentiality. This will continue to be developed and improved over time. Overall the QMS workforce is more racially diverse than the local Bexley Borough population, however, there is some difference between the various professional staff groups. The staff groups with the highest proportion of BME staff are Medical, Nursing and Midwifery. This is similar to other NHS Trusts and reflects the mobility and international recruitment market for these healthcare professions. Other staff groups that are less mobile and subject to wider market forces are more representative of the local population which is predominately white. The majority of the QMS workforce is female (80%) which is not untypical for an NHS Trust. The percentage of men is higher than would be expected in bands 8b and above but the overall number in these higher bands is small and can have a disproportionate effect. Monitoring shows that a higher percentage of men are subject to disciplinary and poor performance procedures than would be expected but there is no clear reason for this. Analysis of the workforce by age shows a pattern of standard distribution across the Trust. The Trust Retirement Policy provides the right to ask not to retire at age 65 in order to prevent age discrimination.


The number of staff who chose when asked to describe themselves as having a disability is very low. This contrasts with a much higher number who categorise themselves as having a disability or long term medical condition when asked anonymously in staff surveys. This may be due to not wanting to make an open disclosure or because they do not regard themselves as having a disability. Therefore there is a lack of accurate information about the true proportion of staff with a disability; During the year Queen Mary’s obtained approval from Job Centre Plus to continue to use the ‘2 ticks’ symbol to show that we will offer all disabled applicants an interview if they meet essential criteria for a job. Revalidation of this accreditation by Job Centre Plus is expected at some time. E-recruitment through NHS jobs is now used for all posts and all applicants are asked to provide diversity data for all 6 diversity dimensions. It is acknowledged there is still sensitivity about disclosure of sexual orientation, belief and disability. By adopting a policy that supports openness and diversity in the workplace it is expected that this will change over time and provide a better understanding of the diversity of the workforce and barriers to gay or disabled staff in employment policies and practice. Equal opportunities monitoring is carried out quarterly and reported to the Equality & Diversity Steering Group. A sample of 10% of posts advertised is selected for analysis each quarter covering all stages of the recruitment process. Any unusual patterns or possible anomalies are investigated with departmental managers and reported on by HR Resourcing. In 2007 the Trust participated in the Stonewall Equality Index to benchmark current employment policies and practice against other employers in the UK. Queen Mary’s was ranked 167 of 241 employers across a wide range of employment sectors. This was the first time that we have applied and received favourable feedback from Stonewall. Monitoring and analysis of the workforce by race showed that there is a concentration of BME nurses in band 5. A survey by questionnaire was carried out of band 5 nurses to identify possible barriers to career progression. From this a number of recommendations were made and actions taken to reduce barriers and help the integration of overseas staff into the workplace including:  Ensuring all staff have a KSF outline, appraisal and personal development plan.  Ensuring all staff have an understanding of equal opportunities as it applies to recruitment and study leave.  Including an introduction to the Bexley area and awareness of local culture as part of induction and adaptation courses.


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Providing mentors to new staff to help assess initial learning needs. Providing welcome evenings for new staff new to the area or to the UK. Access to English as a Second Language (ESOL).

Arrangements have been made to ‘twin’ with other local Trusts to provide an interagency mentoring scheme to staff. The scheme provides a pool of mentors and mentees from each member agency so that it is possible to cross match across different organisations. This provides larger scope for openness where staff find it difficult to be open about barriers associated with race, sexual orientation or disability. 5. Patient and Public Involvement The ‘Healthy Diversity Factfile’ is a resource to be used by staff to source information about the different needs of patients from different diversity groups so that they can understand, anticipate and meet their needs better. The factfile has been revised to include new sections on gender and age and additional information about disability and sexual orientation. A new version, renamed ‘Healthy Diversity Handbook’, will be printed and distributed soon. Information from patients about service provision has been collected by survey. This has been used to develop new Customer Care Standards and a Customer and Staff Promise. Feedback about the needs of disabled patients and visitors has also been used to help the design and planning of ward refurbishment and to make improvements to the general environment. (More information is provided under Facilities and Physical Access). The Patient Survey questionnaire has been revised to include more information about the diversity of respondents. This has enabled information from patients to be analysed by gender, age, disability and race. Monitoring and reporting will continue to be developed and improved. One dependency is feedback from different groups used to find new ways of improving the patient experience and meeting particular needs. 6. Finance and Procurement The format of tender specifications and instructions has been revised to include the requirement to promote Equality and Diversity in accordance with Trust policy and statutory duty. New supplier contracts have been revised to include express terms to require providers to support Equality and Diversity policy and help meet the statutory duty. A revised code of conduct has been issued to existing contractors specifying practice required to promote equality, prevent discrimination and unacceptable behaviour.


All the main contractors on site have been surveyed to monitor how their policies and practices comply with Trust policy and support the Equality Scheme. 7. Facilities and Physical Access An assessment of the physical and sensory features of the site that affect access and use of services was undertaken and an action plan developed. Information obtained from patient survey work was fed into the planning process. Capital costs were prioritised, funding identified and contractors commissioned to complete works required. Examples of particular work to meet the needs of disabled service users are listed below:        Ward refurbishment including walk in baths and showers and improved wheelchair access. Dropped kerbs and resurfaced pavements. Increased toilet facilities for the disabled. Audible floor level indicators in lifts. Adaptations to reception areas to provide lower desks to suit wheelchair users. Additional disabled parking bays. Lowering of the height of car park ticket machines to suit wheelchair users.

Other works to improve the fabric of the building and to improve wheelchair access are ongoing as part of the overall works programme.

8. Summary Good progress has been made over the past year to improve systems for gathering, reporting and analysing information about patient and workforce and to feed this into planning and policy development. Good information helps identify where change is needed and allows resources to be focused so that patient and staff experience is improved. Our Single Equality Scheme and action plan is to be cited as an example of good practice in guidance that has been commissioned by the Department of Health to help implement single equality schemes in the NHS. An equality action plan for 08/09 is currently being compiled. Work to make Equality and Diversity part of everything we do can now be seen in many different ways; customer care standards, building refurbishment, staff development, procurement. This work needs to continue so that Equality & Diversity becomes mainstream business as usual and is championed by staff across the organisation.