Equality and Diversity Demographics 2019 Comparative Data The

Equality and Diversity Demographics 2019

Comparative Data

The following graphs indicate patient demographics for the local population compared with Chesterfield Royal Hospital NHS Foundation Trust (CRH) demographics and those patients who have responded to the Friends and Family Test.

The Trust data (CRH Patients) summarises the characteristics of all patients who attended either an outpatient appointment, inpatient admission or presented at ED from October 2018 to November 2019. NB. Each patient is only counted once, regardless of the number of attendances. Data for those patients who have completed Friends and Family Test (FFT) feedback is taken from our real-time patient experience feedback system and mirrors the time period of Trust data: October 2018 to November 2019. Where possible, we have also identified the main themes arising from patient comments for each demographic group.

England and Local Authority (Bolsover, Chesterfield, Derbyshire Dales, High Peak, NE Derbyshire) data are taken from the Office of National Statistics (ONS); where the ONS indicates that more recent data is unreliable or unavailable, the 2011 Census data has been used. When reviewing data for long-term conditions, only data for the whole of Derbyshire is available.

Figure 1: Population breakdown by age

19%

17% 17% 16% 16% 15% 14% 14% 14% 14% 13% 13% 12% 12% 11% 11% 11% 11% 10% 9% 10% 9% 8% 7%

0-15 16-24 25-34 35-44 45-54 55-64 65-74 75+

England Local* CRH Patients (Nov 18-Oct 19)

*Bolsover, Chesterfield, Derbyshire Dales, High Peak, NE Derbyshire Source: Population Estimates for UK, England and Wales, Scotland and Northern Ireland 2017 - Office for National Statistics © Crown Copyright 2018

We are currently unable to report on our FFT feedback for the category of age; we are working with our real-time feedback system provider to ensure we are able to analyse this data in the future.

1 Figure 2: Population breakdown by gender

Figure 2 suggests that more female patients leave feedback; whilst there were slightly more female patients than male who attended the Trust between November 2018 and October 2019, additional analysis demonstrates that 32% of female patients responded to the FFT question, whilst only 26% of males responded. In addition, those patients recorded as not identifying with a gender have not left comments about their care and treatment. This tells us that we should work with patients from different gender identity backgrounds to understand any boundaries and enablers relating to providing feedback about their experiences.

We have recently raised the rainbow flag and launched the rainbow badge scheme at the Trust to demonstrate that this is an open, non-judgmental and inclusive place for people who identify as LGBT+; an additional objective for the Trust is to ensure our transgender patients are cared for in a compassionate way that respects people’s dignity. We are working to develop a policy for the care of transgender patients and are revising Trust record-keeping policies to ensure transgender patients’ details are recorded appropriately.

Table 1: Key themes identified from FFT by gender

Gender Positive Sentiments Opportunities for Improvement Friendliness (3,288) Waiting (962) Female Emotional and Physical Support (2,314) Parking (168) (14,493) Compassion (2,234) Comfort (105) Friendliness (1,965) Waiting (495) Male Professional and Competent (1,609) Parking (194) (10,055) Emotional and Physical Support (1,153) Comfort (49) NB – numbers in brackets indicate the number of sentiments left regarding that theme

Table 1 indicates that patients feel well-looked after by friendly staff. Opportunities for improvement are mirrored for both male and female patients; these are common themes across the Trust and improvement work is ongoing to address these, as highlighted in reports to Trust Board and Quality Assurance Committee. 2

Figure 3: Population breakdown by ethnicity

Figure 3 shows that the majority of the local population are from a white ethnic background; Trust data demonstrates that there is a slightly higher percentage of patients from other ethnic backgrounds, compared to local data.

Figure 3 also demonstrates that less than 2% of FFT respondents are from non-white ethnic backgrounds; it is important that we understand any reasons for this. Additional analysis (see table 2) demonstrates that our highest response rates are from ‘Other ethnic group’ and Black / African / Caribbean / Black British backgrounds. The lowest response rate is from the Asian / Asian British ethnicity group and it is important that we understand whether there are any barriers to providing patient feedback.

Table 2: % Response Rates for FFT by Ethnicity:

Ethnicity Response Rate Asian/ Asian British 19% Black/ African/ Caribbean / Black British 37% Mixed/ Multiple ethnic groups 22% Other ethnic group 38% White 33%

In addition to the data above, 11% of patients at CRH had no recorded ethnicity; this may have been patient choice, however, we need to investigate whether our internal processes are impacting on the recording of this information.

The categories for ethnicity data for FFT are very broad; we want to work with our real-time system provider to improve how we record this, as this will help us to better understand the experiences of our patients.

3 Table 3: Key themes identified from FFT by ethnicity

Ethnicity Positive Sentiments Opportunities for Improvement Asian/ Asian Friendliness (34) Waiting (10) British Emotional and Physical Support (29) - (175) Compassion (29) - Black/ African/ Friendliness (17) Waiting (12) Caribbean / Professional and Competent (11) - Black British (90) Compassion (11) - Mixed/ Multiple Friendliness (55) - ethnic groups Emotional and Physical Support (31) - (174) Helpfulness (25) - Other ethnic Emotional and Physical Support (25) - group Professional and Competent (23) - (112) Friendliness (23) - Friendliness (8,616) Waiting (1,645) White Professional and Competent (5,915) Parking (374) (34,721) Emotional and Physical Support Comfort (205) (5,825) NB – ‘-‘ indicates too few responses to identify opportunities for improvement

Table 3 suggests that the majority of our patients are cared for by friendly, supportive, compassionate and professional staff, regardless of ethnic background. Waiting is the key opportunity for improvement and work is ongoing across the Trust to address this. We will work with the Derbyshire BME Forum to identify any opportunities for increasing feedback from different ethnic groups, such as access to different language options.

Figure 4: Population breakdown by religion

NB – Data related to religion is not currently collected via FFT *Bolsover, Chesterfield, Derbyshire Dales, High Peak, NE Derbyshire Source: Annual Population Survey - January to December 2018 - Office for National Statistics © Crown Copyright 2018

4 Figure 4 shows that the majority of our patients are Christian, which mirrors the local population, but is higher than England’s. In contrast, we are showing a higher number of other religions than have been recorded locally. An additional 2% of CRH patients had no recorded religion.

The Trust's new Head of Spiritual Care was appointed at the beginning of 2019; since taking up post he has established a new Chaplaincy & Spiritual Care Department. This is a multi-faith team, consisting of three chaplains, faith advisors from various religious communities and a Chaplaincy Pastoral Care Team; the service offers spiritual and religious care to patients, staff, visitors and volunteers and the team is here to listen to, talk to and support people. There are good links between the Trust and local faith groups.

The Trust’s Multi-Faith Centre is always open, aiming to create a space where people feel free to come in, whether for peace and quiet, reflection or prayer. Work has recently begun on a new multi-faith room, which will be a purpose built area to accommodate people of all faiths and none, with the facilities and space to worship and pray according to their beliefs. It will be an open area available for anyone to use. The Trust has worked very closely with colleagues from different faiths to ensure the room is appropriate for everyone and the plans have been very well received.

Figure 5: Population breakdown by affects of a long-term condition

NB – Data related to long-term conditions is not currently available for the Trust (CRH Patients) - Unable to break data down into Bolsover, Chesterfield, Derbyshire Dales, High Peak, NE Derbyshire, therefore, data is for whole of Derbyshire Source: 2011 Census (27 March) - Office for National Statistics © Crown Copyright 2018

Table 3: Key themes identified from FFT by affects of a long-term condition

Positive Sentiments Opportunities for Improvement Not Friendliness (1,188) Waiting (659) limited Professional and competent (1,053) Parking (152) (8,050) Compassion (755) Politeness (58) Limited a Friendliness (510) Waiting (270) little Professional and competent (434) Parking (113) (3,932) Emotional and physical support (308) Politeness (24) Limited a Friendliness (300) Waiting (194) lot Emotional and physical support (233) Parking (65) (2,778) Compassion (222) Comfort (24)

5 Figure 5 demonstrates that the percentage of patients affected by a long-term condition is similar for Derbyshire to the rest of England. For the next update, we will strive to get data relating to affects of a long-term condition for our patient population to support data analysis and greater understanding of experience.

Examples of Good Practice at the Trust related to the Protected Characteristics:

 Launch of rainbow badges and raising of the rainbow flag, to demonstrate and identify support for our LGBT+ patients.  Attendance at Chesterfield Pride to gather feedback on experiences of the LGBT+ community as service users, to help improve dignity and respect.  Development of transgender care and records policy, to help improve dignity and respect.  The Head of Spiritual Care has established a new Chaplaincy & Spiritual Care Department, which is a multi-faith team, offering spiritual and religious care to patients, staff, visitors and volunteers and the team is here to listen, talk and support people. Work has recently begun on a new multi-faith room, which will be a purpose built area to accommodate people of all faiths, with the facilities and space to worship and pray according to their beliefs.  Implementation of Partners in Pregnancy (PiP) Team, to provide continuity of carer for women Chesterfield with mild to moderate mental health conditions; increased continuity of care aims to reduce incidents of stress and anxiety during pregnancy and birth.  Maternity Always Event® to improve the experiences of post-natal women and their partners/families; Always Events® are defined as “those aspects of the patient and family experience that should always occur when patients interact with healthcare professionals and the health care delivery system”. The team worked in partnership with service users to co-design and implementing reliable solutions to transform care experiences; for the maternity service this was: “I will always get a message from the community midwife, or maternity support worker, telling me who will be visiting that day and what time they will arrive.”  Introduction of RITA (Reminiscence Interactive Therapy and Activities), a digital therapy system which allows patients to use apps, games and other leisure activities as part of their hospital recovery; it is effective at calming distressed or anxious patients and can be particularly beneficial for elderly patients with cognitive impairments, such as dementia  Autism Awareness guidance and training resources to help staff in supporting and communicating with our patients with autism and improve their experience of our services.  Autism and dementia resource boxes to help calm distressed and anxious patients.  ‘About Me’ booklet to support patients to communicate additional needs/sensitive information.  Trust equality and diversity E-Learning package and policy to increase staff knowledge and understanding.  Implementation of regular ‘Be Yourself’ meetings; these are meetings focused on experience of staff and patients related to Equality, Diversity and Inclusion and development of associated improvement ideas. The group also plan celebrations and awareness raising events.  Development of a Trust Respect and Civility Group, which is currently working on developing training, toolkits and branding based on culture and ethos; the group aims to ensure that staff and patients treat one another with respect and civility.  The Trust works with external groups, including the Derbyshire BME Forum, Chesterfield Borough Council’s Equality and Diversity Forum and Healthwatch to gather feedback, talk to patients and identify opportunities for improvement.  The Trust also hosts regular Deaf Forum meetings to support improvements for our deaf patients and invites deaf patients to Trust activities and meetings as appropriate.