North Tees and Hartlepool NHS Foundation Trust continues to work towards meeting
the legal requirements set out by the Public Sector Equality Duty (PSED) of the Equality
Act 2010. This report is compiled from information provided by different departments
and seeks to highlight the good practice, initiatives and key achievements that are ongoing across the organisation.
The trust is keen to work towards eliminating discrimination, promoting equality and to
advance positive and good relationships between people with protected characteristics
and those without.
North Tees and Hartlepool NHS Foundation Trust (the trust) recognises the importance of ensuring its services are fair and equitable to all.
We are committed to Equality, Diversity and Inclusion (EDI) in all aspects of the services we provide and the employment of our staff. We strive to ensure that existing and future practices meet the needs of those that we serve and employ.
The trust strives to ensure that our culture is one that enables all patients and staff to feel free to share their experiences with us, without any fear of reprisal or harassment and for them to have the same opportunities to access the best possible health services, whilst being treated with dignity and respect. It is our aim to ensure that the provision of health care and valuing our staff are at the heart of everything we do and that the quality of our services are not adversely affected by any protected characteristic(s) an individual holds. We will seek to develop the required capacity and capability to eradicate risks of discrimination and promote equality in a positive way.
This report seeks to highlight some of the good practice, initiatives and key achievements that have been taken place within the trust over the last 12 months.
Interim Director of Workforce
2. Strategic overview
Equality and Diversity – The Continued Vision
The Equality and Diversity Steering Group provides the strategic direction for the organisation and they are supported by the Equality and Diversity Working Group. One of the main responsibilities of the working group 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.
These groups have representation from across the organisation including Workforce, Occupational Health, Senior Medical Staffing, Nursing Staff, Directorate leads as well as patient services representatives.
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 continues to hold the ‘two ticks’ 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.
Equality, Diversity and Inclusion Steering Group
The Equality and Diversity Steering Group has been instrumental in directing and supporting the work that has been carried out by the Working group and also throughout the organisation. The group provides strategic guidance and helps set the on-going equality and diversity agenda.
Interim Director of Workforce leads the Steering Group and is supported by clinicians and senior managers across the organisation.
There are links with managers throughout the trust which help build a core foundation to embedding equality and diversity within everyday working practices and also in employment matters.
The future strategic direction of the group involves expanding upon existing practices in relation to the evolving requirements of service users and we continue to strive to remove barriers in accessing both healthcare and employment. It is important that we continue to ensure balance between equality for all, whilst at the same time embracing the diverse needs of both our workforce and our service users. Engagement with local groups and feedback from patients, carers and their families is a vital part in helping shape the strategic direction for the trust.
Our Equality and Diversity Steering Group members for 2017/18
- Alan Sheppard, Interim director of workforce
- Sally Thompson, Associate director of operations
- Michelle Taylor, Assistant director of workforce
- Julie Clennell, Clinical governance lead
- Lindsey Robertson, Deputy director of nursing, patient safety and quality
- Chris Greaves, General manager representative
- Shirley Mealing, Nursing representative
- Dr Santosh Gupta, Medical staff representative
- Sushil Munakhya, E&D working group representative
- Steven Yull, Staff side representative
- Jim Scollen, Healthcare user group representative
- Elizabeth Morrell, Employee relations manager
- Nicola Hogarth, Employee relations advisor
- Claire Nixon, Communications lead
- Kath Tarn, Community services representative
Equality, Diversity and Inclusion Working Group
Our Equality, Diversity and Inclusion Working Group have representatives from across the
- Sally Thompson, Services Lead
- Michelle Taylor, Workforce Lead
- Carley Ogden, Disability Lead (Learning Disabilities)
- Jennie Hobbs, Age Lead (Younger People)
- Kath Tarn, Disability Lead (Physical)
- Sue Leather, Disability Lead (Sensory)
- Lorraine Millar, Religion/Belief Lead
- Stuart Harper-Reynolds, Lead for Gender, Sexual Orientation, Gender assignment, Marriage and Civil Partnerships
- Sushil Munakhya, Race Lead
- Elizabeth Morrell, Employee Relations Lead
- Jill Ness, Occupational Health Lead
- Nicola Hogarth, Employee Relations Representative
- Stephen Yull, Staff Side Representative
- Rafeed Rashid, Race Lead
- Fiona McEvoy, Age Lead (Older People)
- Shirley Carter, Pregnancy and Maternity Lead
- Pam Rogers, Patient Rep
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 directorates 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
This year‟s annual Equality and Diversity event highlighted the important work being undertaken by dementia services, which are available to people who are living with and/or caring for someone with dementia. During the week, the trust held information stalls to share information about the range of support services available. Dementia Voices attended the event to offer further advice and support, and resources were also made available with regards to community dementia support.
In the last year, the trust has promoted Equality and Diversity by raising awareness of the range of support services that are available for staff. This included dedicated, executive-led Equality and Diversity engagement sessions where all staff were invited to attend and we continue to promote EDI initiatives through the Trust‟s quarterly Inclusion newsletter.
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. In line with the requirements of EDS2, the trust has developed four local objectives and we will also focus on issues and concerns that are raised by service users and staff. The trust‟s EDS2 is available to view on our website.
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 both the EDI Working and Steering groups.
Our WRES report for 2016/17 is available on our website and we are currently working on the production of the 2017/18 WRES. The staff survey metrics relating to the WRES are reported as:
|Question||% White||% BME|
|Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months:||29%||36%|
|Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months:||23%||38%|
|Percentage of staff reporting most recent experience of harassment, bullying or abuse||49%||39%|
|Percentage of staff believing that the organisation provides equal opportunities for career progression or promotion:||94%||80%|
|Percentage of staff personally experiencing discrimination at work from manager/team leader or other colleagues||5%||14%|
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 2017 (the snap shot date) shows that the mean gender pay gap for the Trust is that female staff are paid 27.65% less than male staff. The median gender pay gap for the Trust is that female staff are paid 13.16% less than male staff.
A further breakdown of the results clearly shows that both the average and the median pay gap is much higher amongst the medical workforce, as compared to non-medical staff. It also shows that the Trust‟s medical staff are predominantly male at 61%, as compared to 39% of females.
As part of the Gender Pay Gap reporting requirements, the trust is also required to publish data relating to bonus pay. The trust does not operate a bonus scheme; however NHS consultant medical staff are eligible to apply for clinical excellence awards (CEA) as part of their terms and conditions, and these are considered to be a bonus payment. The trust‟s bonus mean average is reported as 20.57%, with a bonus median of 13.16%. The trust‟s results have been reported to the Government Equalities Office and these are available to view on our website.
NHS Staff Survey
The results of the 2017 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 850 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, and;
- more staff reporting experiences of abuse, violence and discrimination at work.
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.
Volunteers visit to a Hindu temple
In a diverse society such as ours, the Chaplaincy service at the University Hospital of North Tees has become more aware of how important it is for individuals to have an understanding of the traditions and beliefs of faiths other than their own. To facilitate this process, one of our staff nurses who is a practising Hindu, made arrangements for the chaplains to visit the Hindu Temple based at North Ormesby.
A group of chaplains and chaplaincy volunteers were welcomed to the temple where, as a sign of respect, they began by removing their shoes and any leather goods before entering the worship area. After a brief introduction, there was a short act of worship followed by a talk about the underlying beliefs of Hinduism. Following the teaching session, the chaplaincy team witnessed a further act of worship in which the contrast between good and evil, light and dark was prominent. The morning ended with a shared meal – table fellowship being an important part of Hindu hospitality. Lorraine Millar, the trust‟s chaplaincy lead said “one lesson that we learnt was the value of being open with one another and asking perhaps how we can build on what we have in common to serve the community more effectively”.
Project helping young people with learning disabilities
Project Choice is a scheme that offers young adults with learning difficulties, disabilities or autism, the opportunity to receive structured support via a work placement. This enables them to make an active contribution and to feel valued for what they achieve. In turn, this will help develop them to become positive role models for others. This project equips students with work-based, transferable skills enabling them to be work ready after completion of an academic year and also provides a recognised qualification in employability skills. 13
Dominic Cain and Ryan Watson are two of the students from Project Choice that are currently on placement within the trust.
Peer support group visits the trust to share ideas
A peer support group for people with learning disabilities visited the physiotherapy service at the University Hospital of Hartlepool.
Wendy and Paul from the ‘Youth for You’ group met with the nurse advisor for adult safeguarding and learning disability Carley Ogden, the clinical lead for physiotherapy Fiona Hardie and two nursing students. They spoke to staff and patients and asked questions about the care provided to people with a learning disability and also the nature of any reasonable adjustments that put in place within the department to support someone with a learning disability.
The group put forward some useful suggestions as to how we can make further improvements, to make it easier for people with a learning disability to access services. This was the first visit from the group with more visits planned over the year to different departments.
Overseas doctors training
The trust holds a regular training session for overseas doctors who have trained abroad and have therefore not worked in the NHS before.
The programme is based around communication skills and cultural differences. It also includes clinical skills, the patient journey through the NHS, sessions from the General Medical Council and career planning.
This year the trust had the largest number of doctors involved in the three day programme. Mr Milind Rao, consultant surgeon and Trust Doctor Tutor, held a one to one session at the end of the course with each delegate and an individual personal development plan was written and agreed.
The programme received excellent feedback from the doctors with praise regarding the way in which the course had been ran, the real-life scenarios encountered and the support given and the sharing of good practice.
Helping refugees return to patient care
The trust is helping refugees who have settled in the area to make a return to clinical practice. Health Education England North East (HEE NE), the Middlesbrough charity Investing in People and Culture (IPC) and the trust are all involved in the new programme.
The trust provides each refugee with a mentor to support them through the process of returning to work, with the opportunity to volunteer in the hospital and attend clinical teaching. Professor Jane Metcalf (pictured second from right), the trust‟s deputy medical director, said: “We are delighted to be able to welcome our first group of healthcare professionals into this programme. Bini Araia (pictured right) said: “Despite the enormous challenges they face, refugee health professionals in the project have shown a great commitment and determination to reconnect with their profession in the UK, and joined up support is key to helping the individuals to succeed.
Maternity focus week
Our maternity service held a focus week to help embed “Situation, Background, Assessment, Recommendation” or “SBAR” into everyday practice for all patient
related communication between staff. Staff should challenge if patient information is not handed over to them using the SBAR technique. The focus week will be followed by regular spot check audits to improve patient safety and team working.
Walk the labyrinth in the chapel
The Chaplaincy Team invited staff, patients and visitors to visit the Chapel/Oasis
Spirituality Centre to take the opportunity to walk the Labyrinth and spend some time,
reflecting on compassionate care.
The labyrinth was based in the Chapel/Oasis Spirituality Centre at the University Hospital
of North Tees for a week to allow numerous people the opportunity to get involved.
Participants were asked to take a card, each of which contained different instructions
and they were than invited to walk the labyrinth in „somebody else’s shoes‟. There were
also to use props such as spectacles to impair sight, to help people understand the
difficulty of being partially sighted or blind.
Rafeed Rashid’s stop smoking support for local BME communities across Stockton and Hartlepool
Rafeed Rashid from the Stop Smoking Service promotes equality and diversity by engaging with communities that are traditionally hard to reach.
Rafeed works in partnership with the Arrivals GP Practice at Endurance House which is based in Stockton on Tees and he runs a weekly stop smoking clinic on a Monday afternoon for refugees and asylum seekers, who are mainly from Eastern European, African and South Asian nationalities. Many of whom are non-English speakers. Rafeed organises regular Ramadan campaigns with posters (picture attached) and banners in Asian languages to encourage smokers to quit during the annual fasting period.
Rafeed coordinates information sessions and displays in Thornaby, Bowesfield and Marlborough mosques in Stockton on Tees and also in the Murray Street mosque in Hartlepool. He is well known within the South Asian community in his work role, which is undoubtedly facilitated by his proficiency in three Asian languages.
The “All About Me” documentation is in place for many of the patients that visit our trust. These passports support people with dementia, as well as children and adults with a learning disability. Their „passport‟ is created using a series of questions answered around their likes and dislikes, personal interests and behaviours. So for example, Joe likes his cup of tea with milk and two sugars, he doesn‟t like digestive biscuits and he taps the side of his bed when he is in pain.
This information follows the patient on their journey throughout our hospital, and it makes their experience as pleasant and personal as possible. When patients visit us, often they are scared and feel vulnerable. These passports help us to understand any challenges that are often the result of an unmet need.
4. Future Priorities for 2018/19
Implementing and Monitoring EDS2
In 2017/18 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 and Steering group 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. We plan to launch our new Staff BME Network which will help facilitate further 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 that a 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
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 on.
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.
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.
Strengthen Links with Local Interest Groups
The Working Group will continue to liaise with local interest groups to obtain relevant feedback regarding the services we provide, which will in turn help to set the equality agenda.
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 Equality and Diversity leads:
Michelle Taylor, Assistant Director of Workforce
University Hospital of North Tees
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]
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