Equality Data Analysis Staff Side (2015)

Equality Data Analysis – Staff Side (2015)

Contents

Section

1. Introduction 2

2. Staff profile 6

3. Gender pay gap and pay gaps for other characteristics 14

4. Appointments and career progression 17

5. Flexible Working 22

6. Personal development 24

7. Employment cases 26

8. Return from maternity leave 28

9. Retention and stability 29

10.Staff sickness 33

11.Staff survey equality analysis 34

Appendix: Detailed analysis of ethnic minority representation 41

1 Introduction

The NHS has a range of statutory drivers, which set the standard for our delivery of equality and diversity. They are as follows: - the Equality Act - the Public Sector Duty - the Equality Delivery System - the Care Quality Commission standards.

The Equality Act provides the basic foundation on which the other three drivers, listed above, stand.

The Public Sector Duty, as interpreted through the Equality and Human Rights Commission (EHRC) Guidance recommends that we report on a range of data, covering both staff and service users.

The Equality Delivery System is an internal NHS standard, designed to make sure we are complying with the Public Sector Duty.

The Care Quality Commission standards do not make any direct stipulations of the equality data we should be gathering, to give an overview of Trust performance in this area. The standards do, however, expect that equality should be embedded in all that we do.

If we focus on meeting the Public Sector Duty requirements, then we should automatically satisfy the expectations of the Equality Delivery System and the Care Quality Commission. The following tables show how we meet the Public Sector Duty recommendations for information publication, as regards staff-side equality.

The Public Sector Duty information recommendations include data which is beyond the immediate scope of this Report. For sake of completeness, we have included these elements in the tables which follow and shown where we publish the appropriate information.

a. Workforce data

Public Sector Duty requirement How we meet it The race, disability, gender, age Section 2 breakdown and distribution of your Staff Profile. workforce and whether they are full We collect information on sexual time or part time. orientation and religion/belief Indication of likely representation on routinely. sexual orientation and religion or belief. Information about occupational Section 2 segregation. Staff Profile. Gender pay gap information and pay Section 3 2 Public Sector Duty requirement How we meet it gaps for other protected groups. Gender Pay Gap and Pay Gaps for Other Protected Characteristics. Length of time on grade and pay gap Section 2 information. Staff Profile Appendices – we use length of time at grade as a tool for examining any anomalies which have already been identified, rather than using this indicator routinely. Success rate of job applicants. Section 4 Appointments and Career Progression. Part time and full time work by Section 1 protected characteristic. Staff Profile Take-up of training opportunities. Section 6 Personal Development. Appraisals As above. Return to work after maternity. Section 8 Return from Maternity Leave. Grievances (including about Section 7 harassment) Employment Cases. Disciplinary action (including for This section covers all employment harassment). cases, not just grievances.

Section 11 Staff Survey Equality Analysis. Section b on “Experience of abuse, harassment, bullying and violence by protected characteristic” covers the harassment element of the requirement. Dismissal Dismissals were covered explicitly in Section 9 of the 2011 Data Report. The number of dismissals in any year are so small that meaningful annual analysis is not possible. Consideration of dismissals is, however embedded within the following sections of this report: - Section 7 Employment Cases - Section 9 3 Public Sector Duty requirement How we meet it Retention and Stability Other reasons for termination like Section 1 redundancy and retirement. Staff profile information on staff aged 65+ tracks those who choose not to retire at the traditional age.

Our Management of Organisational Change Policy makes provision for monitoring redundancy by equality category, should the need arise. Compulsory redundancies are very rare at our Trust, with only two occurring in the year to September 2015.

Section 9 Retention and Stability. Applications for promotion and success Section 4 rates. Appointments and Career Progression. Return to work of employees with a Section 10 Staff Sickness provides disability, following sick leave related to disaggregation of sickness rates their disability. across the standard range of protected characteristics. Quantitative and qualitative research with Section 11 employees, e.g. staff surveys. Staff Survey Equality Analysis Complaints about discrimination and Section 11 other prohibited conduct from staff. Staff Survey Equality Analysis, section b. An indication of any issues for This is not directly covered in this transsexual staff, based on Data Report. engagement with transsexual staff or We have, however, consulted equality organisations. thoroughly on issues faced by transgender staff and have published webpages addressing those issues. Details and feedback of engagement with Consultation arrangements are staff and trade unions. summarised on our equality webpages. Information on outcomes of consultation is also available. Records of how you have had due regard The evidence in this report informs to the aims of the duty in decision- our equality impact assessments, making with regard to your employment, which are available on request. including any assessments of impact on 4 Public Sector Duty requirement How we meet it equality and any evidence used. Details of policies and programs that Our Annual Board report provides a have been put into place to address summary of activities to address equality concerns raised by staff and concerns. trade unions. b. Coverage of protected characteristics Our staff equality evidence in this report covers the following protected characteristics: - Age - Disability - Gender - Race - Religion - Sexual Orientation. - Pregnancy/maternity

5 2. Staff profile (ESR 2015) 1

Staff are our most valuable asset in delivering care that meets patients’ individual need.

We are best placed to meet that need when the profile of our staff matches that of the local community. (See a, below.)

The ethnic profile of the community we serve and our workforce is changing, so it is especially important for us to track our staff numbers by racial group. (See c, below.)

We have looked at our staff profile through two sources.

The first is the Electronic Staff Record (ESR) which is a database of all staff (c. 6500 people) and their personal details.

The second is the staff survey, where almost half of staff generally respond. We have used the survey taken in 2013 and (reported in 2014) for our staff profile information below, as this was the last full staff survey.

Most of the community data to which we compare our staff profile is based on Office for National Statistics (ONS) data, accessed in October 2015 using the latest data available. ONS data does not, however, cover every equality strand. Religion is therefore taken from the 2011 census data and the statistic for lesbian and gay people is from an official estimate made by the ONS in 2010.

a. RD&E staff compared with local community

Category % of staff % of staff % of staff % of staff % of staff Community in the in the in the in the in the data category category category category category (Local 2015 2014 2013 2012 according Authority according according according according to staff Area of to ESR to ESR2 to ESR to ESR survey Exeter) taken in 2013 Age up to 40 44% 43% 43% 42% 38%3 61%4 Age 65 and 1% (1.4%) 1% (1.4%) 2% (2.1%) 2% (2.4%) No result 5 over 10% Having 3% 3% 3% 3% 17%6 17%7

1 The gender benchmarks are for “all people aged 16+”. 2 Source data covers primary assignments only and excludes Bank, volunteers and honorary contracts. 3 The closest comparison in the staff survey is for people up to and including 40. 4 This is taken from the Annual Population Survey and is the % of those aged 16-64 (the closest parameters to the age range of our workforce) who are aged 15-39. 5 This is the % of the population aged 15-84 who are aged 65-74, according to the Population Estimate. We have chosen this benchmark because all but one of our workers aged over 65 are 75 or under, so this is the closest community benchmark to the age structure of our workforce. 6 The variance between the staff survey and ESR on this measure could be attributed to two factors. Firstly, ESR has a more restrictive question on disability and is closer in line with the legal definition than the staff survey (with the result that fewer people are likely to fall within the disability category on ESR). Secondly, staff may be more comfortable to declare a disability within the perceived anonymity of the staff survey that 6 Category % of staff % of staff % of staff % of staff % of staff Community in the in the in the in the in the data category category category category category (Local 2015 2014 2013 2012 according Authority according according according according to staff Area of to ESR to ESR to ESR to ESR survey Exeter) taken in 2013 Disability Male 24% 24% 25% 25% 22% 50%8 Ethnic 12% 10% 10% 9% 9 10 Minority 3% 9% Minority 12% 11% 12% 11% 3% 11 religion 2% Lesbian, gay, bisexual 1% (1.1%) 1% (1.2%) 1% (1.1%) 1% (1.3%) 2% 1.5%12 or other

Our staff profile is broadly the same as it was in 2014, although the proportion who are ethnic minority has risen by 2% points.

The staff profile is skewed towards older workers, when compared to the local community, which is a common pattern in the NHS.

b. Staff profile by Staff Group and Pay Band In the more detailed analysis which follows, note that: - * indicates a number under 5, which has been hidden to protect the identity of the people concerned. - The numbers of staff who have declared themselves as lesbian, gay or bisexual is 5 or under in nearly all of the staff groups and pay bands below, so is not reported. - The % column shows the % of staff in the particular staff group or band from the minority group in question. - The Trust totals will not match the sum of the individual rows, as not all staff are reported in the detailed rows. they are to declare it through ESR, where individuals' details are available to anyone with authorised access. 7 This represents the % of the Exeter population aged 16-64 with a disability as defined by the Equality Act or “work limiting disabled”. 8 This is the % of population aged 16-64 who are male, from the Annual Population Survey 9 Ethnic minority staff, as defined in the survey, are non-whites, a definition which is different from that used in the ESR analysis used in this report, where anyone who is not White British or White Irish is considered ethnic minority. 10 This is the Devon LA benchmark for the 12 months to March 2015. The source used (the Annual Population Survey) will report on the Exeter LA area but does not have complete data for ethnicity. Plymouth is the nearest large city to Exeter and has 9% of the population bme as estimated for the 12 months to September 2014, which is the most recent period for which data is available at the time of accessing the data source (23rd October 2015.) 11 This is from the 2011 Census. 12 ONS national estimate (2013) from Integrated Household Survey. Although this comes from an official source, it is disputed by some lgb groups. This benchmark assumes a broadly even gender split. At RD&E however, the staff group is predominantly female and women are less likely to be lesbian or bisexual than men are to be gay or bisexual, according to ONS in 2010. Consequently the appropriate comparator for RD&E would be a little below 1.5%. 7 The following tables show the staff profile (as above) by staff group and pay band:

Category Staff Age Age Havin Male Ethnic Minority religion Group up to 65 and g Minorit (ESR 40 over Disabil y 2015) ity Nos. % Nos. % Nos. % Nos. % Nos. % Nos. % Add Prof 4.1 Scientific and 86 45% 0 0 6 64 33% 16 9% 7 7% % Technical Additional 3.6 656 53% 15 1.2% 29 194 17% 127 12% 87 15% Clinical Services % Administrative 3.4 488 32% 28 1.8% 37 299 20% 48 3.5% 89 11% and Clerical % Allied Health 197 60% * * * * 59 18% 17 6% 14 10% Professionals Estates and 2.8 191 30% 28 4.3% 11 312 48% 97 17% 26 11% Ancillary % Healthcare 98 48% * * * * 78 38% 15 8% 11 17% Scientists Medical and 1.5 369 52% * * 7 402 56% 128 21% 67 16% Dental % Nursing and 2.1 Midwifery 886 48% 11 0.6% 28 182 10% 260 16% 83 9% % Registered Trust 2.8 2979 44% 95 1.4% 129 1594 24% 709 12% 384 12% %

The following table reports on sexual orientation by staff group where the numbers involved are more than 5:

Staff who are Staff Group lesbian, gay or (ESR 2012) bisexual Nos. % Additional 10 1.6% Clinical Services Administrative 6 0.7% and Clerical Nursing and Midwifery 11 1.1% Registered Trust 38 1.1%

8 Category Band Age up to 40 Age 65 and Having Male Ethnic Minority (ESR over Disability Minority religion 2015) Nos. % Nos. % Nos. % Nos. % Nos. % 1 128 29% 18 4.1% 9 3.4% 167 38% 83 22% 21 13% 2 601 46% 32 2.5% 34 4.0% 253 20% 125 11% 81 14% 3 301 39% 11 1.4% 23 4.2% 129 17% 37 5% 50 13% 4 192 39% * * 7 2.1% 91 19% 17 3.8% 25 11% 5 821 57% 8 0.6% 19 1.8% 241 17% 255 20% 61 9% 6 344 41% 7 0.8% 14 2.2% 125 15% 36 4.5% 53 12% 7 123 30% * * 13 4.1% 89 21% 16 4.0% 16 8% 8+ 53 21% * * * * 88 35% 9 4.1% 10 8% Medical 344 51% * * 7 1.5% 392 56% 128 21% 65 16% & Dental Trust13 2979 44% 95 1.4% 129 2.8% 1594 24% 709 12% 384 12%

The following table reports on sexual orientation by Band, where the numbers involved are more than 5:

Staff who are Band lesbian, gay or (ESR 2014) bisexual Nos. % Band 2 7 1.1% Band 5 7 1.0% Band 6 6 1.2% Trust 38 1.1%

The following is worthy of note, from the data above:

Age profile Estates have an unusually old workforce, with a higher than average proportion aged over 40 and 65+. Given that older workers can be excluded from employment, we view this positively.

Disability The distribution of staff with a disability is skewed towards the lower paybands, but not consistently so, given the over-representation at Band 7.

13 This is the Trust norm, taken from the previous table. The numerical totals do not match the total of the individual figures by Band as not all staff can be classified within the broad pay bands reported above. 9 Ethnicity Ethnic minorities are well represented in the Trust overall. At staff group level, the distribution of our ethnic minority staff is skewed towards: - Estates and Ancillary - Medical and Dental - Nursing and Midwifery Registered. Correspondingly, as regards payband analysis, they are also notably over-represented at Bands 1 (driven largely by the ethnic minorities in Estates and Ancillary) and 5 (largely due to high representation of ethnic minorities within Nursing). There is also over- representation in Medical and Dental. Over-representation within the Medical and Dental grouping is no cause for concern, from the race equality perspective, as these jobs are relatively well paid and prestigious. Bands 1 and 5 are entry level paybands for the Trust as a whole and for professional staff, consequently over-representation here could be an issue if it were accompanied by the following: - Ethnic minority staff having a longer length of stay than non-ethnic minority staff at these bands, indicating they are “stuck” at this level - Ethnic minority staff at these bands being more likely to leave then non-ethnic minorities, suggesting dissatisfaction - Ethnic minorities being less likely than white staff to rate career progression as fair in the Trust - Ethnic minorities failing to progress through the recruitment process as expected. Correspondingly, there is under-representation of ethnic minorities at Bands 2-4 and Bands 6-8+. This would also be a case for concern, were it accompanied by the final two indicators listed above. The final two indicators above are discussed under the Appointments and Career Progression section of this analysis. These potential issues of under- and over-representation for ethnic minorities are investigated in the Appendix to this report.

c. RD&E staff numbers by racial group (ESR)

% change Racial Group 2008 2009 2010 2011 2012 2013 2014 2015 since 2008

Asian 101 176 178 178 180 226 192 202 100% Black 34 47 59 55 58 63 43 47 38% White not British Isles 113 172 209 225 243 313 291 377 234% Mixed 18 25 31 33 30 39 40 38 111% Other 13 15 23 29 34 42 33 45 246% Ethnic Minority 279 435 500 520 545 683 599 709 154% White British Isles 4867 5281 5648 5751 5646 5981 5376 5251 8% Trust (known race) 5146 5716 6148 6271 6191 6664 5975 5960 16% % Ethnic Minority 5.40% 7.60% 8.10% 8.30% 8.80% 10.25% 10% 12% 120%

10 The growth in ethnic minority staff since 2008 has been significant and has been most noticeable across the “White not British Isles” category.

d. Profile of consultants

Consultants Trust staff Exeter (ESR 2015) (ESR 2015) area % aged up to 40 12% 44% 61%14

% aged 65+ 1.6% 1.4% 10%15

% known to have 1.5% 3% 17%16 disability

% who are female 31% 76% 50%17

% known to be ethnic 17% 12% 9%18 minority

% known to be 12% 12% 19 religious minority 2%

% known to be lgb 1.0% 1.1% 1.5%20

The most notable anomaly is the gender mix of our consultant body. This, however, reflects a national issue and was reported upon in the 2011 Data Report, consequently there is no further action this year.

14 This is taken from the Annual Population Survey and is the % of those aged 16-64 (the closest parameters to the age range of our workforce) who are aged 15-39. 15 This is the % of the population aged 15-84 who are aged 65-74, according to the Population Estimate. We have chosen this benchmark because all but one of our workers aged over 65 are 75 or under, so this is the closest community benchmark to the age structure of our workforce. 16 This represents the % of the Exeter population aged 16-64 with a disability as defined by the Equality Act or “work limiting disabled”. 17 This is the % of population aged 16-64 who are male, from the Annual Population Survey 18 This is the Devon LA benchmark for the 12 months to March 2015. The source used (the Annual Population Survey) will report on the Exeter LA area but does not have complete data for ethnicity. Plymouth is the nearest large city to Exeter and has 9% of the population bme as estimated for the 12 months to September 2014, which is the most recent period for which data is available at the time of accessing the data source (23rd October 2015.) 19 This is from the 2011 Census. 20 ONS national estimate (2013) from Integrated Household Survey. Although this comes from an official source, it is disputed by some lgb groups. This benchmark assumes a broadly even gender split. At RD&E however, the staff group is predominantly female and women are less likely to be lesbian or bisexual than men are to be gay or bisexual, according to ONS in 2010. Consequently the appropriate comparator for RD&E would be a little below 1.5%. 11 e. Staff profile by part time and full time (ESR 2015)

FT PT

% aged up to 40 51% 34%

% aged 65+ 0.8% 2.5%

% known to have disability 3.3% 2.0%

% who are female 76% 91%

% known to be ethnic 15% 7% minority

% known to be religious 12% 11% minority

% known to be lgb 1.5% 0.3%

Total 4120 2608

Many of the variations in the proportion of staff who are full and part time are to be expected. For example, higher proportions of part time workers who are female and who are over 65 are consistent with what is known of employment patterns among these groups. It is pleasing that, as regards people with disabilities, ethnic minorities, religious minorities and lgb people, there is no skewing towards part time work.

f. Unknowns by protected characteristic This table shows for what proportion of staff we held equality information. The higher the proportion of staff for whom we hold information, the more reliable our equality analysis. Higher rates of disclosure also suggest a working environment where staff are comfortable about their personal identity.

Protected % of staff where % of staff where we % of staff where we characteristic we held held information on held information on information on ESR in 2014 ESR in 2015 ESR in 2009 Age 100% 100% 100% Disability 63% 77% 69% Gender 100% 100% 100% Race 90% 95% 89% Religion 16% 55% 48% Sexual orientation 15% 59% 52%

It is pleasing that the rate of staff declaring sensitive equality information about themselves has increased since 2009, but disappointing that there have been drops in the completion rate for disability, race, religion and sexual orientation since 2014. 12 Under disability, race, religion and sexual orientation (characteristics where our rate of disclosure has declined over the last year) staff have an option to declare that they do not wish to disclose their identity as regards this characteristic. Whilst it is disappointing that they do not wish to declare, where this option has been chosen, the Trust does hold information from the staff concerned on that characteristic. The table below reports on rates of declaration, including where staff declare that they do not wish to tell us their identity, for the four characteristics causing concern in the above table. It is therefore a useful measure of the quality of our data collection processes for equality information.

Protected % of staff who have % of staff who have characteristic completed the completed the information on this information on this characteristic on characteristic on ESR in 2014 ESR in 2015 Disability 100% 95% Race 99% 98% Religion 100% 98% Sexual orientation 100% 98%

Guidance on the Workforce Race Equality Standard (WRES) assumes a 95% level of “self reporting” on ethnicity21, but does not directly say whether this rate should include or exclude the occasions when staff report that they do not wish to tell us their identity as regards race. In considering the issue of self-reporting, however, the WRES Technical Guidance refers to a “response rate” and “collection” of data (Section 10.2), so it could be said that when staff choose to say they do not wish to disclose their ethnicity and this is reflected on ESR, then they have responded and we have collected the data, so we have achieved requirements of the Technical Guidance. In this case, the second table above is the best data to consider as regards “unknowns”. The results are therefore pleasing, as they show our performance is above the 95% WRES threshold for each characteristic considered above.

21 https://www.england.nhs.uk/wp-content/uploads/2015/10/wres-ten-steps-leaflet.pdf Step 7 13 3. Gender Pay Gap and pay gaps for other characteristics (ESR 2015)

a. Gender pay gap Measuring the gender pay gap is an important way of showing whether men and women have equal pay. Gender pay gap analysis looks at broad patterns of pay and can suggest structural issues, for example, whether women’s careers are progressing as well as men’s. This type of headline analysis cannot in itself It prove whether individual men are being paid more than individual women to do the same job.

A gender pay gap usually arises because: - men and women are paid different rates for jobs of equal worth - women are stereotyped into lower paid jobs - women find it harder to progress up the career ladder - women enter their pay band at a lower point than men.

We believe Agenda for Change has addressed the first point, above, for the NHS.

The table below uses the standard national reporting method to show our gender pay gap. The negative percentages show where women are paid less than men. It shows the average22 hourly rate23 for basic salary24 by staff group:

Varianc Staff Group Female Male e Add Prof Scientific and Technical £14.41 £14.41 0% Additional Clinical Services £8.51 £8.65 -2% Administrative and Clerical (B1-4) £9.10 £8.79 4% Administrative and Clerical (B5+) £16.41 £17.84 -8% Allied Health Professionals £15.89 £14.41 10% Estates and Ancillary £7.86 £7.86 0% Healthcare Scientists £17.84 £17.84 0% Medical and Dental (non-consultant) £16.49 £18.13 -9% Medical and Dental (consultant) £162.382 £173.112 -6% Nursing and Midwifery Registered £14.41 £14.41 0% All Staff £11.09 £11.09 0%

The latest benchmark we have is from the Office for National Statistics, reporting the national gap, over the whole economy, as being 19% in 2014.25

22 In line with official sources, it uses the median average – see for example the Office for National Statistics Report at http://www.statistics.gov.uk/pdfdir/ashe1108.pdf 23 ESR reports doctor sessions (4 hours’ work) as an hourly rate, which therefore distorts the figures reported above for All Staff and both Medical and Dental groups. The distortion is, however, consistent for both males and females so does not invalidate gender comparisons. 24 The ESR system cannot viably report on gross pay. 25http://visual.ons.gov.uk/what-is-the-gender-pay-gap/ published September 2015 - this is based on gross median pay, with the gap expressed as a percentage of men’s pay. 14 It is pleasing that there is no overall paygap for gender and that many of the variations within staff group are very small.

b. Pay gaps for other protected characteristics NHS organisations have been encouraged to measure the pay gaps for other protected characteristics. Nationally, the pay gap is also monitored between full-time and part-time staff, so we have replicated this below.

This Trust's results are as follows, using the same methods as for the gender pay gap information, above:

Under 40 40+ Variance Age £11.09 £11.37 -2%

With disability Without disability Variance Disability £9.95 £11.37 -12%

Ethnic Race minority Not ethnic minority Variance £11.09 £11.37 -2%

Minority Not minority Religion religion religion Variance £9.95 £11.37 -12%

Lesbian, gay Not lesbian, gay or Sexual orientation or bisexual bisexual Variance £10.98 £11.37 -3%

15 Part time Full time Variance Part time / full time £9.95 £11.37 -12%

Measuring pay gaps for these protected characteristics is not well embedded, so there is a lack of well-evidenced benchmarks. The EHRC research report Pay gaps across the equality strands (2009)26 echoes this uncertainty, but makes the following comments, across the strands: - younger workers are generally disadvantaged, compared to prime age workers - there is a substantial pay gap for disability, but estimates vary widely, from 6% to 26% - there is a gap of 5% for full-time workers who are ethnic minorities - most minority religions are disadvantaged by a pay gap - the evidence as regards sexual orientation is uncertain - pay is usually lower for part-time work.

In November 2011 we checked with the EHRC that there were no more up-to-date benchmarks. The EHRC also advised that there were no plans to update this work.

Other more up to date benchmarks are hard to find.

It is pleasing to note that our pay gaps for minority groups are relatively small, when compared to available benchmarks.

c. Pay gaps within specific pay bands NHS Employers recommended that this pay gap be measured, in guidance issued during 2011. This has the potential to indicate either of the following: - Whether men and women are being paid differently for work of equal worth, on the assumption that all those within the same pay band will be undertaking a "work of equal worth". - Whether men are tending to enter the pay band at a higher level than women. Whilst this can be a cause of pay inequality, it is to some extent inevitable that men will enter an organisation at a higher pay band point than women, since they will tend to have more time in service, as they are less likely to have career breaks for childbirth and caring duties.

The analysis below is based on the two pay bands with the highest staff numbers, namely Band 2 and Band 5.

Female Male Variance Band 2 £8.07 £8.07 0%

Female Male Variance Band 5 £14.41 £12.81 12%

26 Available at http://www.equalityhumanrights.com/uploaded_files/research/14_pay_gaps_across_equalities_review.pdf (accessed 3 August, 2011). 16 It is pleasing to note that there is no disadvantage to women (as is often the case with paygaps suggested by the above data) and that the Band 5 variation is smaller than the overall national gender paygap.

17 4. Appointments 2014-15 (NHS Jobs and Staff Survey)

a. NHS Jobs

This information helps us gauge whether our selection process is treating all types of people equally. The data covers both external candidates and those applying internally, for example, existing staff seeking promotion.

It shows the proportion of all candidates at each stage of the selection process, from the various equality strands.

In theory, we would expect the proportion to be broadly the same at each stage of the selection process. Where the proportions shrink progressing through the process, then this suggests an equality gap.

For applicants with a disability, we have a Guaranteed Interview Scheme, which means that they are automatically shortlisted if they meet the minimum job requirements. Candidates who are shortlisted through this Scheme may not be the best people for the job, so this would contribute to the drop in the proportion of people with a disability between shortlisting and appointment.

The data below uses our locally devised equality indicator.

The “equality indicator” columns show where there is a notable discrepancy, when comparing actual results with what would be expected. A score in the “equality indicator” column of 100% indicates equality; the lower the score the greater the inequality. Should the score be above 100%, then this group is advantaged and has experienced a more favourable result than expected. Where the equality indicator score is lower than 80%, we consider this to be a notable gap. This methodology reflects the “4/5ths rule” developed by Coussey and Jackson.27

For example, looking at males, there are 30% of applicants who are male, so we would expect there to be 30% males at both shortlisting and appointed stages. This is not the case. The overall variation (shown by the “overall equality indicator”) between the application stage and the appointed stage is notable, although this is not the case between the individual stages within the process.

An equality concern, requiring further investigation, arises where there is a notable equality gap between individual stages, rather than overall.

They quote this rule as coming from America and being used by the Equal Employment Opportunity 27 Commission, the Civil Service Commission, the Department of Labour and the Department of Justice. (Page 56 of Making Equal Opportunities Work Maria Coussey and Hilary Jackson (Pitman, London 1991)

18 % of this % of this Equality Equality % of this group group indicator indicator group among among Overall from from shortlist NHS Jobs among those those equality application to 2015 applicants shortlisted appointed indicator to shortlist appointment Male 30% 24% 21% 70% 80% 88%

With disability 6% 4% 3% 50% 67% 75%

Ethnic Minority 27% 21% 17% 63% 78% 81%

Age 16-29 41% 38% 41% 100% 93% 108%

Age 50+ 17% 18% 16% 94% 106% 89% Religious 21% 18% 16% 76% 86% 89% minority LGB 3% 3% 2% 67% 100% 67% People with court 1% 1% 1% 100% 100% 100% conviction

Comments on data above: - For both LGB people and ethnic minorities, the proportion appointed is roughly in line with the local population profile. - For both of these groups, there would seem to be higher proportions than expected applying, which might explain the fall-off in the proportion shortlisted and appointed. For ethnic minority people, we receive a relatively high proportion of applications, where the candidates are unlikely to be successful, due to visa issues, or unrealistic expectations by the candidate. We have, however, been conducting interviews with candidates from abroad by Skype, to minimise the practical difficulties of making a long distance job application. - It is likely that the religious and ethnic minorities overlap (i.e. some of the same people are in both categories), consequently the anomaly within the religious minority group may well be connected to that noted above for ethnic minorities. - It is possible that the equality gap for males arises because there is a higher proportion of males than would be expected in the data above who are ethnic minority. The equality gap for males could therefore be driven more by ethnicity than by gender. The NHS Jobs database which provides the source data used above does not allow us to test whether a higher proportion of males are ethnic minority among job applicants. Analysis of the staff profile data used in the 2014 data report does, however, show a higher proportion of males among ethnic minority staff (35%) than among non-ethnic minority staff (23%).

The evidence above therefore suggests notable equality gaps as follows: - for people with disabilities, at both shortlisting and appointed stage The gap at the shortlisting stage (i.e. as people with a disability move from application to shortlisted stage) is surprising, given that the Guaranteed Interview Scheme might be

19 expected to have led to a greater proportion than expected of people with a disability being shortlisted. This is the case in the national data, shown below.

- for ethnic minorities, at shortlisting stage (i.e. as ethnic minorities move from application to shortlisted stage).

There is a statistical gap (in terms of the equality indicator) for lgb people between shortlist and appointment, but the percentages involved are so small that this indicator is not reliable in itself. Furthermore, the proportion appointed (2%) is still above the community benchmark (a little below 1.5%) and above the proportion of staff declared as lgb on ESR (1.1%).

The national data, equivalent to the table above, is as follows:

% of this % of this Equality Equality % of this group group indicator indicator group among among Overall from from shortlist NHS Jobs (2015) among those those equality application to National applicants shortlisted appointed indicator to shortlist appointment Male 28% 25% 22% 76% 88% 87% With disability 4% 5% 3% 81% 114% 71% Ethnic Minority 43% 33% 22% 52% 75% 69% Age 16-29 42% 35% 36% 87% 83% 105% Age 50+ 13% 16% 14% 111% 121% 91% Religious minority 29% 24% 20% 68% 83% 82% LGB 3% 3% 3% 87% 96% 91% People with court 1% 1% 1% 71% 100% 71% conviction

Points of note in benchmarking our results against the national data are as follows: - there is no notable equality gap, against the overall equality indicator, for LGB people within the national data although there is in the RDE results; neither is there a notable gap for people with a disability in the national results, although the national gap is very close to the threshold for being “notable”.

- both sources show notable equality gaps for males, ethnic minorities and religious minorities, against the overall equality indicator The gap for ethnic minorities and for people from minority religions is, however, larger in the national data than in our results.

- we do not have an overall equality gap for people with court convictions, although the national data does.

20 b. Staff survey A second measure of the fairness of our recruitment processes is in the staff survey, where we have results by protected characteristic, to the question as to whether the Trust provides equal opportunities for career progression or promotion, regardless of protected characteristic. Our results and the national average for this question are as follows, for the survey taken in 2014 and reported in 2015:

Age: Local result National result Variation between Age 16-30 Trust Equality Age 16-30 Trust Equality local and average indicator average indicator national 98% 92% 107% 90% 87% 103% 3%

Local result National result Variation between Age 51+ Trust Equality Age 51+ Trust Equality local and average indicator average indicator national 88% 92% 96% 86% 87% 99% -3%

Disability: Local result National result Variation between With No Equality With No Equality local and disability disability indicator disability disability indicator national equality indicator 80% 94% 85% 80% 88% 91% -6%

Gender: Local result National result Variation between local and national equality indicator Male Female Equality Male Female Equality indicator indicator 90% 93% 97% 83% 88% 94% 2%

Race Local result National result Variation between local and national equality indicator Ethnic White Equality Ethnic White Equality 21 minority indicator minority indicator 100% 91% 110% 75% 89% 84% 26%

Our results above, as regards the equality gap, tend to be better than the national average (i.e. showing a positive variation in the final column) and do not support a notable equality issue, either for disability or race, as could be suggested by the NHS Jobs data.

The overall staff response to this Key Finding (on whether we act fairly as regards career progression and promotion) has been above national average, consistently:

Year in which survey National (acute was taken RDE and specialist) 2014 91% 87% 2013 91% 89% 2012 91% 88% 2011 92% 90% 2010 93% 89% 2009 92% 90%

22 5. Flexible working

There is no evidence in the staff survey taken in 2014 and reported in 2015 as regards equality of access to flexible working. The evidence below is from the most recent survey which covers this.

a. Survey data (taken in 2012 reported in 2013) The RD&E has put three local questions into the staff survey which would reflect our flexibility and supportiveness in working arrangements. Because these were local questions, there are no national benchmarks available. The results below are from the survey taken in 2012.

The table below shows the proportion of respondents who agreed with the statements listed.

I can approach my My Trust is committed My immediate manager manager to talk to helping staff helps me find a good openly about balance their work and work-life balance flexible working home life Age 16-30 46% 25% 38% Age 51+ 45% 23% 34% With a disability 43% 21% 29% Without a 45% 27% 36% disability Female 45% 26% 35% Male 43% 25% 34% Ethnic minority 46% 37% 42% Not ethnic 44% 25% 35% minority Religious 37% 27% 30% minority Religious 45% 26% 35% majority LGB 53% 28% 43% Heterosexual 45% 26% 36% Trust overall 44% 26% 35% National sector This data came from locally devised questions, so there is no national average benchmark available.

Most of the above results are broadly in line with the Trust average; it is noteworthy that: - The rating from staff with disabilities is noticeably lower for the middle indicator, above - There are some particularly favourable ratings from ethnic minorities and LGB staff.

23 6. Personal development (staff survey taken in 2014 reported in 2015)

The analysis below covers the staff survey questions looking at access to appraisal, quality of appraisal and access to learning and development.

a. Access to appraisal

The staff survey asks whether respondents have received an appraisal within the last 12 months. The results by protected characteristic are as follows and show no notable equality gaps:

% saying they have had an appraisal in the last 12 months Age 16-30 85% Age 51+ 77% With a disability 71% Without a disability 87% Female 83% Male 89% Ethnic minority 90% Not ethnic minority 84% Trust 85% National average 84%

b. Quality of appraisal

The staff survey asks whether staff had a well structured appraisal. The results by protected characteristic are as follows:

% saying they have had a well structured appraisal Age 16-30 56% Age 51+ 28% With a disability 22% Without a disability 44% Female 39% Male 47% Ethnic minority 70% Not ethnic minority 39% Trust 40%

24 % saying they have had a well structured appraisal National average 38%

There are notable equality gaps, in the above indicator, for staff aged 51+ and those with a disability. The high rating from ethnic minorities is pleasing.

There is also a striking variation for this indicator by staff group, with Admin & Clerical showing a surprisingly low score:

% saying they have had a well structured appraisal Adult / General Nurses 43% Other Registered Nurses 47% Nursing/Health Care Assistants 54% Medical/Dental 47% Physiotherapy 82% Other Allied Health Professionals 40% Other Scientific & Technical 36% Admin & Clerical 23% Central Functions/Corporate Services 33% Maintenance/Ancillary 39%

The Admin & Clerical staff group has very high proportion of staff, relative to the Trust average, who are aged 51+, but is in line with Trust average as regards disability. (See the table below.)

This might suggest, therefore, that the low rating in this question as regards disability is best seen as an equality issue, but that the low rating from staff aged 51+ could better be seen as an issue lying within the Admin & Clerical staff group.

Characteristic Admin & Clerical staff group Trust average Aged 51+ 63% 28% Having a disability 3% 3%

c. Access to learning and development The staff survey also asks whether staff have received job relevant training, or learning, or development in the last 12 months. The results are as follows:

% saying they have received job- relevant training, or learning, or development, in the last 12 months. Age 16-30 80% 25 % saying they have received job- relevant training, or learning, or development, in the last 12 months. Age 51+ 73% With a disability 68% Without a disability 79% Female 77% Male 76% Ethnic minority 90% White 76% Trust 78% National average 81%

There are no notable equality gaps for this indicator.

26 7. Employment cases

a. (ESR accessed 2015)

The following analysis is based on cases linked to staff currently in post. The time range for the cases considered is from 2006 onwards, using a report run in November 2015. We increased the timespan considered from what was the case in some earlier reports, to give a wider sample. The types of case covered are grievance (those who lodge the grievance), disciplinary, capability (no underpinning health reason) and capability (underpinning health reason).

Harassment cases have been excluded, as ESR records the individual against whom the case is made, whereas from an equality viewpoint, it is the complainant information which is most relevant. Experience of harassment is, however, covered in the staff survey analysis. This gives a clearer view of harassment as such, in that it covers all staff who report experiencing it, as opposed to just those who are complainants in a formal case.

The proportion of employment cases by protected characteristic is then benchmarked against the proportion of people from that group belonging to the Trust as a whole.

An imbalance, where there is a notably higher proportion in the “% of all employment cases about someone from this group” column, can indicate potential discrimination for that minority group.

No. of all employment % of all employment % of staff cases about someone cases about someone records from from this group from this group this group in 2014 Age up to 40 299 31% 43% With a disability 39 6.3% 3% Males 198 20% 24% Ethnic Minority 57 6.3% 10% Religious minority 51 13% 11% Lesbian gay or bisexual 10 2.2% 1.2%

The two notable issues (even though the numbers involved are small) in the table above are for staff with disabilities and lgb staff.

To bring the equality gap shown above to within normal parameters, there would have to have been 4 fewer cases involving lgb people and 16 fewer involving staff with disabilities.

Eliminating cases of capability with an underpinning health reason (which might be expected to affect people with disabilities more than those without disabilities) did not make any difference to the equality gap for staff with disabilities.

The Equality Data Report published in 2014 contains detailed analysis to determine whether the issues for staff with disabilities and lgb staff are more prevalent in any particular type of case, but found no significant variation. A case study was then conducted

27 during 2014 to ascertain whether there were any equality issues arising in the cases involving lgb staff, but this was not the case. A similar case study was conducted previously, to identify issues for staff with disabilities. This case study has informed our disability work, over the last 3+ years.

b. Survey data (taken in 2011) This question has been dropped from the surveys taken from 2012 onwards, so the analysis below is the most recent, from the staff survey undertaken in 2011.

Perception of effective action towards violence and harassment Age 16-30 3.58 Age 51+ 3.61 With a disability 3.44 Without a disability 3.67 Female 3.65 Male 3.68 Ethnic minority 3.85 Not ethnic minority 3.64 Trust 3.65 National average 3.58

Overall, the Trust was in the top 20% of acute trusts nationally, for this measure.

The biggest equality gap is for staff with a disability, where their rating is below the national average. They are also disproportionately more likely to suffer from harassment.

28 8. Return from maternity leave (Payroll records 2014/15)

This indicates how well we are re-engaging women after maternity leave. We aspire that all should return, but recognise this will not always be at the same grade.

Our most recent analysis covered all whose maternity leave began during the 12 months prior to mid-May 2015. Of the 138 who were due to have returned from maternity leave by the time this report was run (late November 2015): - 98% had been retained one month (30 days) after their return.28 This has risen slightly from last year when we retained 95% after one month. - 91% had been retained 6 months (180 days) after their return.29

Women who have maternity leave have to return to their employer and stay for three months, or else they have to return maternity pay. Consequently, there is a financial penalty for those who do not stay with us for three months after their return. This year, we have included a figure for retention after six months, so the measure of retention includes a three month window within which staff can leave, without suffering financial penalty.

We are not aware of any formal benchmark for return rates, however a specialist equality journal quotes a best practice case study which achieved a 97% return rate.30 It is not clear from the source, however, how the benchmark was calculated, in particular whether any allowance was made for whether returners were still in post after one month.

28 We “lost” 2 who did not return and 1 who came back and left within 30 days. 29 We “lost” 2 who did not return and 11 who came back and left within 180 days. 30 See Equal Opportunities Review 191:7-11 on the Financial Services employer, Citi. 29 9. Retention and stability (ESR, 2014-15)

Good employers aim to retain staff. High retention rates give stability to the workforce, contribute to increased performance and cut replacement costs.

Conversely, low retention can suggest something amiss in our management of staff. If we have lower than expected retention for any one equality category, this could mean we are not managing that group of staff as well as we might.

a. ESR (2014-15)

This analysis excludes: - retirement, as most staff will retire at some stage, so the fact that they do so is not a reflection on the Trust’s ability to retain staff. - pregnancy (as this effects female staff, only and is not a measure of Trust ability to retain staff) - staff reaching the end of fixed term contracts - deaths (which is not a measure of the Trust’s ability to retain) - those who held a fixed term contract; some of these may have left early and be a reflection of the Trust’s ability to retain staff, but most will have left due to the ending of their contract - Bank staff; as above, some of these may have left early and be a reflection of the Trust’s ability to retain staff, but most will have left due to the ending of their contract

This Trust very rarely makes compulsory redundancies – there were only two in the timespan considered – consequently there is no analysis specifically on leavers through redundancy.

The table below looks at leavers in the 12 months to 25th September 2015. This reflects recent history at the Trust, but is a small sample (697 leavers).

We would expect the two proportions in the columns below to be broadly the same, although the younger workforce is more likely to be mobile and so have a higher leaving rate.

Profile of staff who left (2014- % in workforce, by equality group 15), by equality group

Age up to 40 64% 44%

With a disability 3.7% 2.8%

Females 71% 76%

Ethnic Minority 13% 12%

Religious minority 13% 12%

% in workforce, by equality group

30 Lesbian gay or bisexual 2.7% 1.1%

There is a notable disparity for younger staff, which is to be expected, as they tend to be more mobile.

The gap for people with disabilities is notable for 2015 but has only been notable in one other year out of the last five:

Profile of staff who left % in workforce, who had (2014-15), who had a Equality Indicator disability a disability 2015 3.7% 2.8% 76%

2014 2.5% 2.9% 116%

2013 3.5% 2.9% 83%

2012 3.5% 2.6% 74%

2011 2.8% 2.7% 96%

Given the small numbers involved, this is not a consistent issue warranting further action.

In 2015, we re-ran the calculation for people with disabilities by removing those leaving for a health reason, as it was felt people with disabilities would perhaps inevitably be more likely to leave, because of health reasons forcing resignation.

This adjustment did not make any difference to the gap being notable:

Staff leaving for Profile of staff who left health reasons (2014-15), by equality % in workforce, by equality groupEquality Indicator excluded from group source data Disability 3.8% 2.8% 74%

The disparity for LGB staff is very much smaller than it was last year. It is possible that as most lgb staff are under 40, that they have a higher proportion of leavers because disproportionately more of them belong to the age group which has high mobility and turnover. In order to minimise the distorting effect of age, we therefore re-ran the calculation above for lgb staff and leavers who are under 40, with the results as follows:

Profile of staff who left (2014- Under-40s only % in workforce, by equality group 15), by equality group

% in workforce,

% in workforce, by equality group

31 Lesbian gay or bisexual 3.7% 1.6% This suggests that age profile of the lgb staff was not a distorting factor in the analysis above.

Such a gap for lgb staff has been noted in past Data Reports, but this has not been taken forward for action as the proportions involved have been so small, rendering the statistic potentially unreliable for any single year. The repetition of this issue, however, as shown in the table below, suggests that the data evidence indicates a genuine and notable anomaly, even though the numbers involved are small.

Profile of staff who left % in workforce, who are (2014-15), who were Equality Indicator lgb lgb 2015 2.7% 1.1% 41%

2014 1.9% 1.2% 63%

2013 4.1% 1.1% 27%

2012 1.9% 1.3% 68% 2011 1.6% 1.4% 88%

In last year’s Data Report, we looked at those who had left in the first 6 months, i.e. during their probationary period. It was not appropriate to report this information this year, as there were so few leavers in this group (34) that the results of any analysis would have been unreliable.

b. Staff survey taken in 2012

The following table reports results against the local question, “I often think about leaving this Trust”. It reports those who agreed with that statement, so lower scores indicate better satisfaction and potentially better retention.

% who agreed or strongly agreed that they “often think about leaving this Trust” Age 16-30 33% Age 51+ 30% With a disability 38% Without a disability 30% Female 30% Male 35% Ethnic minority 20% Not ethnic minority 32% % in workforce,

32 % who agreed or strongly agreed that they “often think about leaving this Trust”

Religious minority 25% Religious majority 31% LGB 34% Heterosexual 31% Trust 31%

The only notable equality gap is for people with a disability, although the positive ratings from ethnic and religious minorities are both pleasing.

In view of the repeated issue for LGB staff, noted in the previous section, it is interesting that there is no notable equality gap for them in the analysis given above.

This question was not available in the survey taken in 2013, or subsequently.

c. Exit interviews (2013) 90 exit interviews from 2013 were sampled, to see if equality issues were reported. None of them did so.

33 10.Staff sickness (ESR 2015)

This analysis examines the sickness rate (expressed as time off sick as a percentage of total time available).

Sick Sick Rate rate 2014 2015 Age under 40 3.38% 3.18% Age over 40 4.32% 4.20% Age over 65 4.46% 3.25% Female 4.28% 4.09% Male 2.92% 2.78% With a Disability 6.26% 9.08% Without a Disability 3.65% 3.53% Ethnic Minority 2.69% 2.93% Not Ethnic Minority 4.06% 3.98% Minority religion 4.33% 4.38% Not minority religion 3.72% 3.68% Lesbian, Gay or Bisexual 4.62% 4.45% Not Lesbian, Gay or Bisexual 3.81% 3.77% Trust Average 3.92% 3.76%

34 The Trust average above varies slightly from that given in the Board Reports. This is because this report uses a slightly different reporting methodology, looking at current staff only (as above) rather than all staff in post over a period of time (as in the Board Report).

The notable equality variations are for female staff and those with a disability. The female variation occurred last year, but not the year before, but the variation for staff with disabilities occurs regularly.

The variation among those with a disability is not unexpected, as disabilities can often contribute to sickness.

35 11.Staff survey equality analysis (survey taken in 2014 reported in 2015)

a. Overarching indicators Our overarching indicators from the survey, covering equality, have remained pleasing. Reported discrimination has been consistently lower than national average, but has risen this year so we are now categorised as average within the source data.

National (acute and RDE specialist) 2014 12% 11% 2013 9% 10% 2012 7% 11% 2011 9% 13% 2010 10% 13% 2009 6% 7%

Our rating for acting fairly as regards career progression and promotion has remained stable and we remain above national average for acute trusts.

National (acute and RDE specialist) 2014 91% 87% 2013 91% 89% 2012 91% 88% 2011 92% 90% 2010 93% 89% 2009 92% 90%

The following table shows results as regards those who report a disability/health issue, who require an adjustment and say adjustments have been made. This measure is of particular interest in ensuring people with disabilities are free from discrimination, as failure to provide a reasonable adjustment is, if proven at tribunal, in itself discriminatory. Although this measure only applies to staff with disabilities, it is still an “overarching measure” as it is one of the key indicators in measuring progress against our equality objective for staff disability. Our results continue to fall and we are now below national average.

RDE National (acute) 2014 69% 72%

36 RDE National (acute) 2013 70% 72% 2012 79% 71% 2011 71% 70% 2010 84% 70% 2009 88% Not available

b. Experience of abuse, harassment, bullying and violence by protected characteristic The staff survey has 4 questions which help us measure how well we are protecting staff from abuse, harassment, bullying and violence. They are as follows: A % experiencing physical violence from patients/relatives in last 12 months B % experiencing physical violence from staff in last 12 months C % experiencing harassment, bullying or abuse from patients/relatives in last 12 months D % experiencing harassment, bullying or abuse from staff in last 12 months The numbers of staff who experience these incidents are relatively low, especially for the minority groups. If the equality analysis for these questions focuses purely on staff who experience these issues, then the statistics are likely to be relatively unreliable, due to the small numbers involved.

There is greater statistical reliability in large samples and there are large numbers of staff who never experience these incidents, in a 12 month period as per the survey questions. Consequently, the following analysis looks at staff who have never experienced these incidents, as this is the best method to show whether we have any notable equality gaps.

Staff who have never experienced an incident, as per questions A-D, above:

Survey reported in 2015 A B C D Comparison of our equality gaps to national Age 16-30 74% 96% 77% 85% Generally close to national. Age 51+ 92% 96% 83% 76% Generally close to national. With a disability 86% 93% 60% 59% Last two are notably worse than national. Without a disability 90% 98% 84% 86% n/a Female 87% 97% 79% 80% Generally close to national. Male 92% 100% 85% 84% Generally close to national. Ethnic minority 85% 100% 85% 94% Gaps generally better than national. Not ethnic minority 89% 97% 79% 79% Overall Trust score 88% 98% 79% 81% n/a Overall national score 86% 97% 73% 76%

37 Our overall results are better than national average.

There are two notable equality gaps, namely: - Staff aged 16-30 are notably more likely to experience harassment, bullying or abuse from patients/relatives in last 12 months. - Staff with disabilities are notably more likely to experience harassment, bullying or abuse from staff. The anomaly for younger staff is likely to have occurred because they are more likely than staff aged 51+ to be in front line roles so is not, therefore, cause for concern, from an equality perspective.

The results above, from the most recent staff survey, only cover 4 protected characteristics. The survey reported in 2013 had additional coverage, of religion and sexual orientation, so the results relevant to those characteristics are given below:

Survey reported in 2013 A B C D Minority religion 84% 95% 70% 73% Majority religion 86% 98% 77% 80% LGB 83% 96% 79% 83% Heterosexual 86% 98% 77% 80% Overall Trust score 86% 98% 77% 80% Overall national score 86% 97% 72% 76%

Overall, our results are better than national average and by protected characteristic they are generally close to the national picture.

It is particularly pleasing that our performance for ethnic minorities is generally above the national average.

It is of concern, however, that, for people with disabilities, our equality gap for the last two issues is notable and is appreciably larger than is the case nationally. There was also a notable equality gap for people with disabilities as regards Key Finding D reported in the previous staff survey.

c. Discrimination by theme The staff survey also reports on the theme of discrimination (by protected characteristic) where it has been experienced. The results below are from the survey taken in 2014 and reported in 2015.

Ground of discrimination % experiencing discrimination on this ground RDE National Age 3% 2% Disability 0% 1% Gender 2% 2% Race 4% 4% Religion 0% 0% 38 Sexual orientation 0% 0%

These results are broadly in line with the national picture.

d. Discrimination by characteristic of the person experiencing it The following analysis reports on Key Finding 28, which covers whether staff have experienced discrimination at work in the last 12 months.

Survey reported in 2015 % who have not Difference between our equality experienced discrimination indicator and the equality indicator under KF 28 for national results Age 16-30 85% -1% Age 51+ 89% 0% With a disability 81% -1% Without a disability 90% n/a Female 91% +6% Male 84% -5% Ethnic minority 75% +1% Not ethnic minority 89% n/a Overall Trust score 12% n/a Overall national score 11% n/a

These results are broadly in line with the national picture.

e. Relative satisfaction, by protected characteristic Staff survey results are available by protected characteristic. This is usually the case for 4 protected characteristics (age, disability, gender and race) but, in the survey reported in 2013, results were available for sexual orientation and religion. The table below shows survey results, by Key Finding, for a range of categories, across 4 protected characteristics. The comparator varies and was as follows: - Age Both groups are compared with the Trust average. - Male/female These are compared with each other. - Disability the comparison is with staff without a disability. - Ethnic minority the comparison is with staff who are White.

39 Category Much more Much less Much more Much less Much more Much less positive positive positive positive positive positive responses, responses responses, responses responses, responses, survey , survey survey , survey survey survey reported in reported in reported in reported in reported in reported in 2015 2015 2014 2014 2013 in 2013 Age 16-30 2 0 1 5 8 2 Age 51+ 0 1 5 1 2 3 Male 2 2 4 0 2 3 Female 3 1 1 4 6 1 Disability 0 8 0 5 0 5 Ethnic 7 0 5 3 24 0 minorities

Commentary on above data:

- The results for both age categories, reported above, are much more balanced in 2015 than they were in the previous years’ surveys.

- It is pleasing, as regards gender equality, that the balance between male and female is much more even this year and that, looking at gender overall, there are slightly more positives (5) than negatives (3).

- The result for staff with disabilities is disappointing, with the gap between much more positive responses and much less positive responses now standing at -8, whereas it was -5 in the previous two years reported, above. For people with a disability, the notably more negative responses, this year, were as regards: o staff having well structured appraisals o suffering work-related stress o feeling secure raising concerns about unsafe clinical practice o experience of harassment, bullying or abuse from patients, relatives or the public o experiencing harassment, bullying or abuse from staff o feeling pressure in last three months to attend work when feeling unwell o communication between senior management and staff o agreeing that feedback from patients/service users is used to make informed decisions in their directorate

- The result for ethnic minorities is very pleasing with the abundance of positive responses noticeably greater this year, than last year.

The above results omit religion and sexual orientation, which were both included in the survey reported in 2013. They were as follows:

40 Category More Much less positive positive responses responses in survey in survey reported reported 2013 2013 LGB 11 8 Religious 12 3 minority

It is pleasing that, for both groups, there is a preponderance of much more positive responses.

The analysis in the following table contrasts the equality indicator scores for the survey results for our own Trust with the equality indicator scores for the national results. This was done for each Key Finding. (The equality indicator is a locally devised way of interpreting equality data, rather than part of the standard, published results.)

Where our equality indicator score is higher than the national one, this shows a more favourable result for the group in question, but where it is lower this suggests the group is more disadvantaged in our Trust than is the case, nationally.

Category RDE equality indicator is more than RDE equality indicator is more than 5 5 percentage points better than the percentage points worse than the national indicator national indicator Age 16-30 9 3 Age 51+ 1 3 Male 5 8 Female 8 6 Disability 0 12 Ethnic minorities 19 2 As regards the protected characteristic of age, the above results show the two age groups which are most vulnerable to discrimination. Taken together, the scores for both age groups indicate a better performance at the RDE than is the case nationally.

Looking at gender, the results are broadly balanced between male and female.

The results for disability are challenging for the RDE. It might have been suggested that the proposed of negative responses from people with a disability in our local results, viewed in isolation, are indicative of the difficulties of coping with a disability, which could be experienced in working life with any employer, rather than issues peculiar to this Trust. That there are so many Key Findings where the inequality for people with disabilities is noticeably greater than the national result suggests our disappointing local results reflect issues within this Trust, rather than general challenges of living with a disability at work.

41 The Key Findings where we have a larger equality gap (and so a lower equality indicator score) than the national results are as follows: o receiving job relevant training, learning or development o receiving appraisal o having well structured appraisal o suffering work-related stress o feeling secure raising concerns about unsafe clinical practice o experiencing harassment, bullying or abuse from patients, relatives or the public o experiencing harassment, bullying or abuse from staff o feeling pressure to attend work when feeling unwell o reporting good communication between senior management and staff o staff motivation at work o believing the Trust provides equal opportunities for career progression or promotion o agreeing feedback from patients/service users is used to make informed decisions in their directorate.

Our engagement score for staff with disabilities (3.47) is noticeably lower than for staff without disabilities (3.84).

It is lower than any of our scores for individual staff groups (i.e. Nursing, Admin and Clerical, etc.) and any other demographic group.

The national average acute trust score for engagement of staff with disabilities is 3.59.

Looking at overall staff engagement scores for acute trusts, the range is from 3.35 to 3.99 and a score of 3.47 (which is what we achieve for staff with disabilities) were it achieved for staff overall would be the fourth lowest score, nationally.

42 Appendix

This Appendix examines in depth the representation anomalies highlighted for ethnic minority staff in Section 2, namely over-representation at Bands 1 and 5 and underrepresentation at Bands 3-4 and 6-8+.

1. Overrepresentation at Band 1

If ethnic minorities had a longer than expected stay at Band 1, this would suggest an equality issue, whereby they are becoming “stuck” at this level.

If ethnic minorities are more likely to leave at Band 1, this would also suggest an equality issue.

The data is as follows:

a. Length of stay in NHS Average time in NHS for Band 1 staff who are ethnic minority: 56 months Average time in NHS for Band 1 staff who are not ethnic minority: 145 months

b. Likelihood of leaving Proportion of Band 1 leavers who are ethnic minority: 12% Proportion of Band 1 staff who are ethnic minority: 22%

Although the data above indicates there is no issue, there is some limited, old anecdotal evidence to suggest ethnic minority staff are supported into Band 1 roles, then get stuck there, because they are unable to handle the Trust’s’ competitive application process.

2. Overrepresentation at Band 5 The data below looks at nurses, as this is the job role of 93% of our ethnic minority Band 5s.

a. Is overrepresentation at Band 5 matched by underrepresentation at Band 6, for nurses? If the data were to show underrepresentation at Band 6 (compared to Band 5), this would suggest an equality issue as regards upward mobility.

43 Band % of % of nurses % of nurses % of nurses % of nurses % of nurses nurses who are who are who are who are who are who are Ethnic Ethnic Ethnic Ethnic Ethnic Ethnic Minority Minority Minority Minority Minority Minority (2009) (2010) (2011) (2012) (2015) (2008) 5 9% 11% 12% 11% 12% 25% 6 3% 2% 3% 3% 3% 16%

Viewed in isolation, this would suggest the equality gap, whereby there is underrepresentation at Band 6 compared to Band 5, is shrinking.

Due to our overseas recruiting initiative a relatively high proportion of Band 5 ethnic minority nurses will be comparatively new arrivals to the NHS.

We might guess that an overseas nurse might need 4 years’ NHS experience before getting promotion to Band 6 and that many of these new arrivals from overseas will not therefore have had time to progress to Band 6.

The proportion of Band 5 nurses with 4+ years’ NHS service who are ethnic minority is 15%, which is very close to the 16% of Band 6 nurses who are ethnic minority. If we accept that this group (those with 4+ years’ NHS service) is the eligible pool from which ethnic minority Band 6s could be drawn, then the equality issue (underrepresentation of ethnic minority staff at Band 6 within nursing) disappears.

b. Time taken to reach Band 6 / “getting stuck” at Band 5 This has been reviewed by looking at:

i. Length of time between NHS first entry and beginning current Band 6 assignment This data indicates how long it is taking to reach Band 6. It is not entirely accurate as it assumes the current Band 6 assignment start date will be the first assignment at Band 6, which may not always be the case. This indicator does not, however, suggest any equality gap: Average length of time (months) in NHS before starting current Band 6 assignment: Ethnic Minority staff 78 months Non Ethnic Minority staff 168 months

ii. Stay at Band 5 for nurses with up to 8 years’ service This indicator looks at whether ethnic minority nurses are more likely to get stuck at Band 5. The 8 year boundary means we avoid looking at a period when there were notably fewer ethnic minority staff in nursing at the RDE. It also replicates the method used to gather data when the issue was first identified. The following data does not suggest any equality gap. Average length of time since entry to NHS for Band 5 nurses Ethnic Minority staff 28 months Non Ethnic Minority staff 48 months

iii. Proportion of leavers who are ethnic minority

44 If ethnic minority staff were “getting stuck” at Band 5 we night expect either that they spend longer at Band 5 than their non ethnic minority counterparts or that they get dissatisfied and are more likely to leave. The data below suggests there is no issue with Band 5 ethnic minority nurses being more likely to leave: Proportion of Band 5 nurses leaving who are ethnic minority 18% Proportion of Band 5 nurses who are ethnic minority 25%

The analysis above has suggested that there are no major concerns arising from the over- representation of ethnic minorities at Bands 1 and 5.

3. Underrepresentation at Bands 3-4 In theory, this could be resolved by attracting new entrant ethnic minorities or, in part, by ethnic minorities progressing from Band 2.

a. In which staff group(s) are the ethnic minorities at Band 2, who might be expected to progress to Band 3? At Band 2, most of our ethnic minority staff are working in the Additional Clinical Services staff group:

Nos of ethnic minority staff in this % of ethnic minority staff in this Staff group Staff Group Staff Group Additional Clinical Services 97 78% Administrative and Clerical 16 13% Estates and Ancillary 11 9% Healthcare Scientists 1 1%

b. Is there underrepresentation at Bands 3-4, in Additional Clinical Services? Within Additional Clinical Services there are almost twice as many ethnic minority staff at Band 2 as there are at Band 3 and an even lower proportion at Band 4, suggesting a progression issue:

Nos of non-ethnic % who are Nos of ethnic minority staff minority staff at this ethnic minority at this Band, in Additional Band, in Additional Clinical Services Clinical Services Band 2 97 556 15% Band 3 25 275 8% Band 4 4 77 5%

The data above is for 2015; historical data is as follows:

45 % Additional Clinical % Additional Clinical % Additional Clinical % Additional Clinical Staff who are ethnic Staff who are ethnic Staff who are ethnic Staff who are ethnic minority minority minority minority (ESR 2010) (ESR 2012) (ESR 2014) (ESR 2015) Band 2 8% 12% 13% 15% Band 3 4% 5% 6% 8% Band 4 0% 0% 3% 5%

c. Is there a longer length of stay at Band 2, for ethnic minorities in Additional Clinical Services? If the data below were to show a longer length of stay for ethnic minorities, this would suggest an equality issue whereby they are becoming “stuck” at Band 2.

Average length of stay for Band 2 Additional Average length of stay (days) in current Clinical Services staff with 2+ years NHS service31 position Ethnic minority 1120 days Non ethnic minority 1287 days This shows that ethnic minority staff in Additional Clinical Services at Band 2 do not have a longer than expected length of stay than their non-ethnic minority counterparts.

d. Are ethnic minority staff at Band 2 in Additional Clinical Services more likely to leave than expected? The table below shows ethnic minority staff are twice as likely as expected to have left during the year to Sept 2015:

Additional Clinical services Band 2 leavers Ethnic minority leavers 34 Non ethnic minority leavers 96 Total 130 % of leavers who are ethnic minority 26% % of Add Clin Servs staff at Band 2 who are ethnic minority 14%

31 The data shows those with 2+ years NHS service to allow some time for staff to have progressed to Band 3 46 e. In which staff groups are ethnic minority staff, looking at Bands 3-4? Progressing from Band 2 to 4, the proportion of Admin & Clerical jobs within the Band increases:

No. of roles which are % of roles which are % of roles which are Admin & Clerical Admin & Clerical Additional Clinical Services Band 2 387 30% 60% Band 3 361 47% 43% Band 4 291 60% 18%

f. Is there underrepresentation of ethnic minorities in the Admin & Clerical staff group? As the table below shows, there is under-representation of ethnic minority staff within the Admin & Clerical Staff Group across Bands 2-4:

% who are ethnic minority Band 2 5% Band 3 2% Band 4 3%

g. Conclusion The issues behind the uneven distribution of ethnic minority staff across Bands 3-4 would therefore appear to be: - Failure of Band 2 ethnic minority staff in Additional Clinical Services to progress - Under-representation of ethnic minority people within the Admin & Clerical staff group.

4. Under-representation of ethnic minority staff at Bands 6-8+ Securing better progression from Band 5 might, in theory, address this issue, although the review of ethnic minority nurses above has already considered progression from Band 5 to Band 6 and found this to be broadly satisfactory.

a. Which staff groups have most impact on this issue? Analysing the proportionate size of each staff group at the various Bands will show where increasing ethnic minority representation would have most impact on the payband as a whole.

Staff Group Band 6 Band 7 Band 8+ Add Prof Scientific & 4% 8% 8% Technical Additional Clinical 1% 1% Services Admin & Clerical 12% 17% 54% 47 Allied Health 16% 14% 7% Professionals Healthcare Scientists 7% 14% 11% Nursing & Midwifery 60% 46% 14% Registered

This would suggest that initiatives in Nursing would have most impact, followed by Admin & Clerical, with the latter becoming particularly important at Band 8+.

b. Is there cause for concern as regards ethnic minority progression to Band 6- 8+ in Nursing? Our preceding analysis has already shown a significant rise in the number of nurses who are ethnic minority since 2012, so the data following looks at Nursing data from 2012, to show the ethnic profile by Band, within Bands 6-8+:

Band % of nurses who are % of nurses who are ethnic minority (2012) ethnic minority (2015) 5 12% 25% 6 3% 16% 7 2% 1% 8+ 0% 3%

Given that our recent intakes of ethnic minority nurses will not yet have had time to progress beyond Band 6, the low levels of ethnic minority nurses at Bands 7 and 8+ are not surprising, so there is no cause for concern or need for action, in nursing.

c. Representation of ethnic minorities at Bands 6-8+ in the Admin & Clerical staff group The following analysis of Admin &Clerical staff by ethnicity shows those higher Bands at which we have ethnic minority under-representation (Bands 6+), but includes Band 5 as these staff (if enabled to progress) could be a potential source of ethnic minority staff at Band 6. (It only covers this year as, unlike Nursing, there has been no significant, recent increase in ethnic diversity within the Admin & Clerical staff group.)

Band % of Admin & Clerical staff who are ethnic minority (2015) 5 3% 6 5% 7 3% 8+ 4%

48 5. Might recruitment practice be a contributory factor in the relative lack of ethnic minorities at Bands 3 in Additional Clinical Services? The following tables show the progression of ethnic minorities through the recruitment process, for Band 3 posts in Additional Clinical Services, both locally and nationally.

NHS Jobs 12 months % of this % of this Equality Equality to November 2015 % of this group group indicator indicator Ethnic minorities only group among among Overall from from shortlist Additional Clinical among those those equality application to Services applicants shortlisted appointed indicator to shortlist appointment Band 3 (RD&E) 36% 22% 19% 52% 62% 84% Band 3 (national) 40% 29% 19% 48% 73% 66%

This shows the usual equality gap for ethnic minority staff, moving from application to shortlist, although our gap Is bigger than the national average, for Additional Clinical Services Band 3. Pleasingly, we do not have any equality gap moving from shortlist to appointment and, overall, our equality performance is better than national average.

6. Might recruitment practice be a contributory factor in the relative lack of ethnic minorities across the Admin & Clerical staff group?

NHS Jobs 2015 Admin staff for 12 months to Nov 2015 % of this Equality Ethnic minorities % of this group % of this indicator Equality only group among group among Overall from indicator from Admin & Clerical among those those equality application shortlist to applicants shortlisted appointed indicator to shortlist appointment All Bands (RD&E) 15% 9% 8% 52% 61% 85%

All Bands (national) 39% 27% 17% 44% 70% 63%

Band 1 (RD&E) 12% 4% 0% 0% 29% 0%

Band 2 (RD&E) 12% 9% 11% 88% 73% 120%

Band 3 (RD&E) 14% 8% 5% 35% 55% 64%

Band 4 (RD&E) 17% 11% 7% 41% 67% 61%

Band 5 (RD&E) 24% 14% 14% 58% 60% 96%

Band 6 (RD&E) 25% 9% 0% 0% 34% 0%

Band 7 (RD&E) 17% 4% 0% 0% 26% 0%

Band 8+ (RD&E) 22% 8% 11% 47% 38% 125%

The above data suggests our equality performance is, overall, slightly better than the national average. 49 We have a bigger gap than is the case nationally, from application to shortlist but our performance from shortlist to appointment is better than the national average. Locally, there is a notable equality gap at almost every stage.