Equality and diversity report 2018 – 2019

1. Introduction

North Tees and Hartlepool NHS Foundation Trust (the Trust) is committed to the practices of equality, diversity and human rights, and aims to ensure that these practices are maintained within the organisation and embedded within all aspects of service provision and employment.

The Trust focuses on ensuring that the provision of health care and employment practice takes into account the individual needs of patients and staff by promoting equality of opportunities and recognising and embracing diversity. Tackling inequality and removing barriers in respect of equality, diversity and human rights through employment and the services provided remains a key focus for the Trust.

The Trust recognises the importance of ensuring its services are fair and equitable to all.

This report seeks to highlight some of the good practice, initiatives and key achievements that have taken place within the Trust over the last 12 months.

2. Strategic overview

Equality and Diversity – The Continued Vision

The Workforce Committee provides the strategic direction for Equality and Diversity within the organisation and they are supported by the Equality and Diversity Working Group. One of the main responsibilities of the Workforce Committee is to ensure that best practice is adhered to and the systems we have in place are implemented equitably on a Trust wide basis, from employment practices through to service delivery and redesign.

The Committee has representation from across the organisation including Workforce, Senior Medical Staff, Nursing Staff and Care Group leads.

The Trust remains an active member of the Regional Equality, Diversity and Human Rights Group, where representatives from local Trusts meet to share ideas and best practice with the aim of ensuring that the northern region works together to achieve a consistent and high level approach to implementing local and national equality and diversity practices.

The Trust holds the Disability Confident employer status, which recognises our commitment to removing inequality and ensuring fairness and equity in relation to recruitment and employment processes. This is reflected further within Trust policies and practices, all of which are assessed from an equality perspective.

Our Equality, Diversity and Inclusion Group Members

Our Equality, Diversity and Inclusion Working Group have representatives from across the Trust.

• Michelle Taylor, Workforce Lead
• Sally Thompson, Services Lead (Until 30 November 2018, replacement to be confirmed)
• Carley Ogden, Disability Lead (Learning Disabilities)
• Jennie Hobbs, Age Lead (Younger People)
• Kath Tarn, Disability Lead
• Lorraine Millar, Religion/Belief Lead (Until 16 May 2019)
• Jill McGee, Occupational Health Lead
• Stuart Harper-Reynolds, Lead for Gender, Sexual Orientation, Gender assignment, Marriage and Civil Partnerships
• Sushil Munakhya, Race Lead
• Elizabeth Morrell, Employee Relations Lead
• Nicola Hogarth, Employee Relations Representative
• Rafeed Rashid, Race Lead
• Fiona McEvoy, Age Lead (Older People)
• Shirley Carter, Pregnancy and Maternity Lead
• Pam Rogers, Patient Representative

The members of the working group play a vital role in ensuring that equality, diversity and inclusion are incorporated within everyday working practices as well as those related to the provision of patient care.

The equality agenda is expanding and focuses on both local and national initiatives. We
have various mechanisms in place to support the provision of feedback from various
forums such as patient experience surveys, the friends and family test, the NHS staff
survey and the staff friends and family test; all of which help focus our local strategy and
direction for the organisation.

The support we receive from within Care Groups and through groups such as the
Workforce Committee and the Culture Group are imperative in ensuring that the workforce is able to operate at the highest level so that patients can receive the best care available.

As well as continuing to initiate, review and monitor both working and clinical practices
within the organisation, the working group also aims to achieve the objectives set out via
the Public Sector Equality Duty, whilst all the time reflecting on and reacting to situations
that may occur during the course of daily events.

3. Equality, diversity and Inclusion in Practice

As part of Equality, Diversity and Human Rights Week, the Trust ran awareness and training sessions during the week. Everyday Language Solutions who provide the Trust with interpreting services attended and shared a range of information on the services they provide to the Trust, including how to overcome language barriers.

David Sutton from Hearing Impairment and Visual Impairment Support (Hi-Vis) also delivered a full day‟s national foundation level 2 training session to the Trusts sensory loss champions. The session covered the NHS Accessibility Standards, deaf-blindness and advice and information on people living with acquired or age related combined hearing and sight impairments. The session was extremely well received and each participant who attended received a Level 2 accredited qualification.

Equality Delivery System 2

In 2012/13, the Department of Health reviewed and revised the Equality Delivery System (EDS) with a view to make it smarter and simpler to use. The review brought about the launch of EDS2, which retains much of the original framework but encourages local adaptation with a focus on local issues. It also prompts learning from, and sharing of, good practice throughout the trust.

We have worked closely with our stakeholders, both internal and external to the Trust, in relation to the implementation of the Equality Delivery System (EDS2). EDS2 enables us to provide focus for areas requiring further attention, to ensure all identified equality issues are addressed for all protected characteristics, as recognised by the Equality Act 2010.

Engagement with our staff has been a priority and this has been carried out through various forums including executive-led staff engagement sessions, promotional events and the annual NHS staff survey, with feedback from Directorates. The integration of EDS2 into all Trust practices will help us to meet its requirements.

Public Sector Equality Duty (PSED)

The principles of equality and diversity have been incorporated throughout the Trust, with inclusion of EDI considerations within business plans, carrying out equality impact assessments, right through to the implementation of new/amended services, practices and policies.

As a trust, we continue to seek to:

• Eliminate unlawful discrimination, harassment and victimisation;
• Advance equality of opportunity between different groups;
• Foster good relations between different groups;
• Seek to improve existing practices, embed new initiatives and enhance our equality and diversity activity.

We are continuing to work towards achieving the objectives identified in line with the specific duties of PSED.

Our current objectives are:

• To engage with our patients, the local community and various stakeholders, in line with the requirements of EDS2, to ensure the effective provision of services;
• To enable our staff to work alongside patients and carers to determine realistic, reasonable adjustments to deliver safe, effective care to people with literacy problems, learning difficulties and dementia.
• To promote equality, diversity and inclusion across the trust.
• To explore and reduce the discrimination experienced by our staff, as identified by the NHS annual staff survey, through the development of proactive measures and support mechanisms to be implemented trust-wide.

We aim to review our equality objectives for 2018/19, ensuring that focus is given on issues that are of particular importance to the organisation, based on feedback from our stakeholders.

Workforce Race Equality Standard (WRES)

The Workforce Race Equality Standard (WRES) aims to improve workplace experiences and employment opportunities for Black and Minority Ethnic (BME) NHS employees, including individuals who want to work in the NHS, by taking positive action to help address workforce race inequalities.

We continue to promote the Workforce Race Equality Standard (WRES), which requires us to demonstrate and publish our progress against nine indicators of BME workforce representation and progression. The Trust‟s WRES metrics are used to drive further improvements and these are monitored by the working group and workforce committee.
Our WRES report for 2018 is available on our website and we are currently working on the production of the 2019 WRES.

The staff survey metrics relating to the WRES are reported as:

We currently have one BME member on the Trust Board of Directors.

These details are monitored, reviewed and updated on an annual basis and as part of EDS2.

Gender Pay Gap

The Trust complies with the Equality Act 2010 (Gender Pay Gap Information) Regulations 2017. Our gender pay gap report as of 31 March 2018 (snap shot date) shows the Trust has an average pay gap of 34.17%, and a median pay gap of 18.75%. A further breakdown of results shows that the average and median pay gap is higher amongst the medical workforce compared to non-medical staff. Men account for 62% of all Trust medical staff compared to 38% female. There has been an increase in female medical staff commencing employment with the Trust in recent years. If this trend continues this is likely to have a positive impact on our gender pay gap results. The Trusts Trust Gender Pay Gap report is available to view on our website.

Staff Survey

The results of the 2018 national NHS staff survey are used to identify any particular areas of good practice and concern with regards to employment issues, including issues in relation to equality and diversity which need to be addressed.

A sample of 1250 staff was selected to participate in the survey and the personal characteristics of the respondents are reported as similar to the overall profile of our workforce.

The results of the recent survey indicate that, in comparison to other trusts, we have:

• more staff believing that the Trust provides equal opportunities for career progression or promotion.;
• more staff reporting managers are valuing their staff and supporting staff in their learning, training and development;
• more staff believing that the Trust takes positive action on health and well-being;
• more staff reporting appraisals have helped them to do their job and helped them to agree clear objectives;
• less staff who have experienced discrimination at work from their manager/team leader or colleagues.

As responses to the survey are anonymous, it is not possible to directly address any concerns raised through the survey on an individual basis. However, we continue to ensure that all staff are made aware of the numerous options in place where they are able to raise concerns, including details of the various support systems that are available for staff to access. There are both formal and informal measures to assist staff who may be experiencing any form of discrimination, bullying or harassment. As well as our Workforce policies on raising grievances or claims of bullying and harassment, there are also processes in place for Raising Concerns (strengthened by the implementation of Freedom to Speak Up) and also support systems seeking such as our First Stop Contact Officers (FSCOs), an internal mediation service, and occupational health support including counselling services.

We are keen to ensure that staff feel empowered to raise concerns and that, as a trust, we clearly communicate the cultures and values expected by those employed within the organisation in relation to behaviour and attitude, ensuring that these are instilled within all staff at all times.

Examples of Equality, Diversity and Inclusion in Practice

Equality and diversity is about inclusion, respect and removing barriers, whether this be in relation to the health care services we provide, or the employment of our staff.

There are numerous ways in which this is illustrated throughout the organisation, through specific initiatives as well in everyday practices. The following section highlights some examples of good practice and case studies which reflect this.

Celebrating innovative work to help refugee medics return to patient care

North Tees and Hartlepool NHS Foundation. Trust hosted a conference about its programme to retrain and employ doctors who have fled their homeland.

The Supporting Refugee and Asylum Seeker Healthcare Professionals into Employment event was held in Durham.

A partnership between the trust, the Investing in People and Culture charity in Middlesbrough and Health Education England (North East) set the scheme up in 2015.

Since then, three participants have passed their medical and English language exams and are working as doctors at the University Hospital of North Tees and several others are in clinical attachments working towards professional exams.

Professor Jane Metcalf, the trust‟s deputy medical director who leads the programme, said: “The event was a fantastic opportunity to share our experience and best practice, as well as details around the establishment and extension of similar schemes and developing and influencing national policy. We very much welcome input from those interested in working with us.

“It was an opportunity to highlight this work, as well for people to take part in workshops to discuss the many challenges facing refugee and asylum seeker healthcare professionals returning to practice in this country.

“We are delighted with how well this project has been progressing. We already have three doctors who have completed the programme and have successfully secured full time roles at the trust. People who were frustrated at not being able to do the jobs they loved and whose skills were not being used.”

Project Choice student embarks on career with North East based Foundation Trust

Katherine Long was recently appointed as an Assistant Technical Officer after completing a one year placement with Project Choice at North Tees and Hartlepool NHS Foundation Trust.

Katherine (aged 19) began her placement in September 2017. She started in the Pathology department before moving into the Quality Control laboratory (QC lab). During her time in the QC lab she shadowed staff across the department, eventually becoming part of the team responsible for distributing orders to customers.

In August 2018, Katherine applied for a role within the QC lab in which she was successful, joining the Trust in October 2018. As an Assistant Technical Officer within the plate reading team, she analyses plates allowing those results to go out to customers. Working ten hours a week over two days, Katherine is quickly getting used to the exciting and varied life in the lab.

Improvements made to children’s area

The children’s emergency department have made a number of improvements for patients and families in the waiting area.

The department at the University Hospital of North Tees now use visual ‘pain clocks’ so that poorly children can give them a clearer idea about how much pain they may be in.

Registrar doctor Sameer Sasidharan came up with the initiative to help get an immediate idea about how much pain a child is in.

After an hour this is checked again and if the pain is worse then it gets recorded in the patient’s notes.

Play specialist Dawn Taylor has also completed an information wall around deaf awareness. The board gives information around some of the things we can all do to improve our communication skills with children who have hearing issues.

Help for Dementia Patients

The Digital Programmes Team have been hard at work creating twiddlemuffs for the Trust‟s dementia patients. Emma Ward heard that the twiddlemuffs provide a distraction for patients living with dementia, and recruited Jean Bage, Rita Bloor and Carol Appleyard to help on her mission to knit.

Together the group have produced 100 muffs!

If a patient with dementia needs something to occupy their hands, they are given a twiddlemuff to prevent them pulling on medical equipment. The muffs are single use and the patient gets to take it home when they are discharged, so all donations are welcome. If you would like to get creative too, please send donations through to the Adult Safeguarding Team. Jean Bage, Digital Programme Support Officer at the Trust said: “We have all had great fun creating the twiddlemuffs and giving them a personal touch. The muffs are invaluable, not only for patients, but for the staff too! Being admitted into hospital is a scary time for anyone, anything we can do to make it easier is a job well done.”

Voice for you

Kimbo Johnson, David Lodge and Peter Nixon from Voice for You visited the University Hospital of Hartlepool. They are a group of people who represent people with a learning disability. They look at signage, how to get around the hospital and how we can make it easier for people with a learning disability.

Stepping Up Programme

A STOP smoking specialist has praised a new leadership course targeted towards helping break down barriers for health staff from ethnic minorities.

Rafeed Rashid, specialist stop smoking advisor at North Tees and Hartlepool NHS Foundation Trust, has completed the Stepping Up Programme. This is a special course run by the North East Leadership Academy for black, Asian and minority ethnic (BAME) colleagues who work in healthcare.

It aims to create greater levels of sustainable inclusion within the NHS by addressing the social, organisational and psychological barriers restricting BAME colleagues from progressing.

Raf, who is the stop smoking lead for Stockton, said: “The programme is there to encourage and give confidence to people like myself on our leadership journeys.

“It is designed to bridge the gap between where applicants are and where they need to be, to help them progress into more senior roles. It aims to empower us drive forward the inclusion agenda and develop their skills and abilities in order to grow and progress.

“It‟s very reflective – we were challenged to think about any potential barriers and stereotypes out there and to realise that there shouldn‟t be a glass ceiling for anyone. The course also gave me the opportunity to meet people from many different cultures and from across healthcare. These are contacts that will stay with me on my career path.

4. Future priorities for 2019/20

Implementing and Monitoring EDS2

In 2019/20 the Trust will continue to embed and integrate the Equality Delivery System 2 in terms of both service provision for patients and carers and also in the ethics and working practices of the workforce.

The Equality and Diversity Working Group will utilise the EDS2 assessment tool to develop and implement work plans which will be used to monitor and evaluate practices throughout the coming years.

In line with the requirements of EDS2, the Trust will aim to continuously improve services for all service users and especially those that are categorised as having protected characteristics and underrepresented groups. This will be done in partnership with staff, service users and local interest groups.

The Trust will also work towards ensuring that other groups not directly covered by EDS2 but who may also face stigma (i.e. the homeless) are able to access the services they require.

WRES and WDES

The Working group and Workforce Committee will continue to monitor the delivery of the WRES action plan; we will annually review our action plan against the WRES metrics and will focus on areas of improvement. The Trusts Staff BME Network will continue to facilitate discussion with any issues that have arisen from the WRES, and will focus on narrowing the gap, where applicable, between the various metrics reported for White and BME staff. The Equality & Diversity Working Group has two dedicated Race Leads, whose role is to work with BME staff within the organisation to highlight and communicate any key findings in relation to the treatment and experiences of BME staff.

The NHS Equality and Diversity Council have confirmed the Workforce Disability Equality Standard (WDES) will be implemented via the NHS Standard Contract for 2017-19. The standard will use data from the NHS annual staff survey and look at areas such as:

• workforce representation
• reasonable adjustments
• employment experience
• opportunity

The first WDES data reports are due to be populated by the Trust in June 2019 with the Trusts first report to be published in August 2019, based on data from the 2018/19 financial year. The Trust will review the results at that time and will develop and implement any actions that require focus.

Setting New Equality Objectives

We will continue to review and aim to set new equality objectives that will comply with the requirements of EDS2 and also focus on issues that are of particular importance to the organisation.

Promotional Events

The Equality and Diversity Working Group will help publicise and promote events that highlight best practice in equality and diversity within the organisation. This will focus on national campaigns that are linked to the protected characteristics as well as all the various initiatives that are being undertaken at a local level.

Maintaining Compliance with the Public Sector Equality Duty

The Trust has and will continue to monitor compliance with the equality agenda and ensure that staff and service users are consulted with and updated on any changes and progress. This will include ensuring that there is equality for all and eliminating discrimination.

5. Contacts for further information

If you would like any further information about Equality, Diversity and Inclusion within North Tees and Hartlepool NHS Foundation Trust, please contact our Workforce Equality and Diversity lead:

Michelle Taylor, Head of Workforce
University Hospital of North Tees
Tel: 01642 624025

Feedback

We actively seek feedback on our annual reports from stakeholders and service users so that we can continue to meet our commitment to improve service delivery. We would welcome any feedback and comments on this document which should be directed to:

The Employee Relations Team, University Hospital of North Tees, Hardwick Road, Stockton on Tees, TS19 8PE

or by email at [email protected]

PDF document download

Click the link below to view or download our equality and diversity report:

Equality and diversity report 2018 – 2019 (857kB pdf)

If you use assistive technology such as a screen reader and need a version of this document in a more accessible format, please email us at [email protected]