Note: This document has been sent out for consultation. The final analysis document will be uploaded onto the Trust website by 06.04.2012 The Equality Act : Data Analysis Dr Christine Rivers January 2012 Contents 1.0 Introduction ……………………………………………………………………………………………………………………..…………………………...…………..……….…..3 1.1 Equality Delivery System…………………………………………………………………………………………………………………………………………..…………..…….6 1.2 Local Population Data……………………………….……………………………………………………………………………………………………………..….…..…………7 1.3 Structure of the report…………………………………….………………………………………………………………………………………………………..……....…….…..9 2.0 Service User Analysis ….……………………………….……………………..……………………………………………………………………………...........................…10 2.1 Engagement…………………...……………………………………………………………………………………………………………………………………..…………...…11 2.2 Equality and Human Rights Training ………………….……………………….………………..…………………………………………………………………..…………....12 2.3 Gender…………………………………………………………………………………………………………………………………………………..……………….………..….13 2.4 Race/ethnicity………………………………………………………………………………………………………………….……...…………………………………….……….13 2.5 Age…………………………………………………………………………………………………………………………………………………………….…………….………..15 2.6 Sexual Orientation……………………………………………………………………………………………………………………………………………...…….……….…….15 2.7 Religion/Belief……………………………………………………………………………………………………………………………………………………………………..…16 2.8 Transgender………………………………………………………………………………………………………………………………………………………..………..…..…..16 2.9 Pregnancy/Maternity…………………………………………………………………………………………………………………………………………………………..…….17 2.10 Disability………………………………………………………………………………………………………………………………………………………………….…….…...17 2.11 Civil Partnership/marriage……………………………………………………………………………….……………………………………………………………………..…18 3.0 Workforce Analysis……………………………………...……………….………………………………………………………………………………………………….…….19 3.1 Engagement……………………………………………………………….………………………………………………………………………………………………….....…..19 3.2 Training data……………………………………………………………………………………………………………………………………………………………………..…..19 3.3 Gender………………………………………………………………………………...……………………………………………………………………………………………...19 3.4 Race/Ethnicity…………………………………………………………………………..……………….……………………………………………………………………..….…20 3.5 Age……………………………………………………………………………..……………………………………………………………………………………………...….…..22 3.6 Sexual Orientation …………………………………………………...………………………………………………………………………………………………………..……22 3.7 Religion……………………………………………………………………………………………………………………………………………………………...……….……….23 3.8 Transgender…………………………………………………………………………………………………………………………………………………………….......…….…23 3.9 Pregnancy/maternity……………………………………………………………………………….……………………………………………………………………….……....23 3.10 Disability………………………………………………………………………………………...………………………..…………………………………………….….…...…..24 3.11 Civil Partnership/marriage…………………………………………………………………………………………………………………………………………….….……….24 4.0 Objectives …………………………..……………………………………………………………………………………………………….…………….…….......…….…..……25 Appendix A Data Sources…………………..……………………………………………………………………………………………………………………………………..…..27 Appendix B Meeting the General Duty………..………………………………………………………………………………………………….…………..................................29 Appendix C Scoping Document….……………………………………………………………………………………………………………………………………………………33 2 1.0 Introduction This report reviews equality data in Oxleas NHS Foundation Trust, providing the Trust with a series of ‘health checks’, showing areas where data is lacking, or where the data itself flags up areas that lead into existing or future equality objectives. It also provides the Trust, stakeholders, service users, staff, carers and partner organisations with a factual overview of equality, which allows for informed discussion about priority areas. This data also provides some of the groundwork for the delivery of the Equality Delivery System (EDS); this is a new framework for delivering action on equality, and is outlined in more depth in section 1.1. The Trust’s objectives, which are built from the analysis in this report, are outlined on page 25. In addition, the report provides an overview of views gathered through consultation with staff, staff networks, service users, third sector organisations and a wide-ranging series of datasets. The collation of this data provides Oxleas NHS Foundation Trust with information, which can then be used to understand local communities, the workforce and the way that services are provided. The report focuses on the nine protected characteristics outlined in the Equality Act (2010); these are gender, race/ethnicity, disability, pregnancy and maternity, age, sexual orientation, religion and belief, gender reassignment, civil partnership/marriage 1 This analysis draws from existing quantitative documents such as the Workforce Reports, Complaints, Incidents and Total Service User Reports. In addition, the report draws from qualitative data such as the Annual Equality Report, Patient Experience Survey, Borough Focus Groups and discussions with the staff networks. Most of the data is available in summary form on the Trust website 2. The report also highlights gaps in the data, as well as existing initiatives to improve data capture or embed data in existing structures. In a period of significant change for NHS organisations, this review offers an opportunity to scan existing equality practices and structures within the Trust, and integrate Equality Act (2010) recommendations into the Trust’s business planning, quality improvement, patient experience, stakeholder engagement, and Human Resources (HR) processes. The report has been written to signal how the Trust is delivering compliance with the general duty of the Equality Act (2010), which requires that public bodies pay due regard to: • Foster good relations between different groups • Eliminate unlawful discrimination, harassment and victimisation • Advance equality of opportunity between different groups 1 The Equality Act (2010) includes civil partnership/marriage, but this area is included only in the duty to eliminate unlawful discrimination. 2 Equality data, available at http://www.oxleas.nhs.uk/equality-and-diversity/equality-data/ The report also reflects a wider aim, which is to develop equality objectives in the spirit of the Equality Act (2010), as well as ensure compliance with the Act’s legal requirements. Equality and diversity has been an area of significant change over the last two years, with the introduction of a new and strengthened law, along with the addition of new protected characteristics and changes to the Public Sector Equality Duty (PSED). There are also forthcoming changes, for example in Age discrimination in the delivery of goods and services. These changes have posed challenges for the organisation and the composite elements that make up the Trust’s core functions, as well as for the delivery of a range of services across the Trust. These are briefly outlined below: Challenges • A shifting external environment, in which the NHS as a whole is being shaped differently, with changing priorities, a period of transition and a tighter financial environment • Diverse agendas across a wide service remit, including mental health, learning disability, prison and community health services • A wide geographical area with three Boroughs, each with differing demographic, socioeconomic and health profiles • Disparate professional groups, with differing equality profiles • A context of recent change and cuts to local third sector organisations, affecting equality provision and particularly affecting some BME communities • A historical context of a separate equality scheme, and consequent lack of integration into core trust functions, systems and processes • The diversity, plurality and complexity of the equality agenda itself; structurally defined as one area, but with legal responsibilities towards 9 areas; each with sub-categories, and with duality (crossover) between the categories • A lack of explicit links to Care Quality Commission (CQC) core standards, inspection and monitoring requirements, and Monitor regulations; a separate legal framework and regulator • The need to pay attention to individual protected characteristics and their subsets (for example, learning disability, as a subset of disability), whilst integrating these into whole Trust systems that cut across all groups • The need to establish a cultural shift, both in understanding the Equality Act (2010) and its rationale, and moving the equality agenda forwards for all protected characteristics 4 • The settling of the new equality legislation, with new areas, further development of the legal duties in progress, and the continuing development of guidance • Diversity of response to equality requirements across the sector, with a lack of standardisation in relation to the provision of information, action points and the measurement of progress The EDS (see 1.1 below) will support change in relation to some of the challenges above, as systems and information requirements move towards a common framework. In addition to the challenges posed by the legislation and the need to scope the Trust’s position, there are also a series of drivers that present opportunities for close and increasingly integrated co-operation with equality and human rights, providing the Trust with opportunities to use existing areas of development and momentum to embed equality within them: Drivers • Increasing accountability through members and governors • Increasing emphasis on service user and carer experience, and the importance of this in moving forwards towards GP commissioning structures • Moving towards more integrated, personal and holistic care • Development of the Quality agenda • Increasing engagement