Working Together with the Race Equality Guide

1
Working Together with the Race Equality Guide

• Robert Mitchell
• North Central London Strategic Health Authority
• Ila Gocoldas
• Camden Primary Care Trust

2
NCL SHA Strategy 2002-05

• Provide Leadership
• Develop the SHA as a model
• Provide feedback and guidance
• Keep race equality on the agenda
• Support Networking

3
Racial Equality Network

• RRAA Race Equality Schemes
• Refugees and Asylum Seekers
• Language Support
• Equalities training
• Ethnic monitoring
• Employment recruitment
• BME health demographics
• Sickle Cell Thalassaemia

4
SHA Race Equality Guide 2004

• To support NHS organisations
• Be systematic as they promote race equality and
  good race relations and reduce discrimination
• Set realistic goals and milestones
• Assess their own progress
• Incorporate race equality into performance
  management arrangements
• Keep the law

5
The Performance Framework

• For performance management and self-assessment
• Specific to race equality but complements other
  requirements e.g. in IWL
• Three stages of development
• Assess progress and prioritise action in each
  area
• Include action in corporate plans and the next
  RES
• Agree timescales for progress

6
The eight performance areas

• Leadership and corporate commitment
• Strategy and services
• Patient and public involvement consultation
• Health
• Workforce
• Partnership
• Finance procurement
• Information communication technology

7
Recommendations from the reviewLeadership
Performance

• All NCL trusts engaged but many still have a long
  way to go
• The SHA must continue to support networking to
  assist organisations in preparing robust second
  Race Equality Schemes for 2005-08.
• Trusts asked to address issues identified through
  the review, demonstrate how their organisation
  will reach level three of the framework.
• Performance review meetings following the
  publication of the NHS Staff Survey should ask
  how trusts interpret any differences in
  experience and perceptions related to staff
  ethnicity and outline the action they will be
  taking in response to any anomalies.

8
Recommendations from the review Workforce

• Existing patterns of disadvantage and
  discrimination experienced by many BME staff and
  communities are likely to continue without a
  concerted effort sustained over a number of years
  the
• The SHA, through the work of its Workforce
  Development Directorate, is already encouraging
  positive action initiatives by trusts targeted at
  those black and minority ethnic communities that
  are under-represented in the workforce
  particularly at senior levels. However, current
  positive action workforce initiatives in the
  sector are judged to be too small in scale to
  deliver significant progress.
• NCL trusts should be challenged to increase the
  scale and impact of such initiatives. The WDD
  should facilitate shared approaches between
  trusts, partnerships with external bodies (e.g.
  Learning and Skills Councils) share information
  on those initiatives that have proved successful
  and encourage innovation.

9
Recommendations from the review Health,
Inequalities Access

• NCL trusts to be challenged to identify specific
  initiatives designed to ensure services are
  reaching and addressing the specific health
  issues/concerns of black and minority ethnic
  communities
• Increased NHS involvement in Local Strategic
  Partnerships (trusts as well as PCTS) in order to
  link race equality initiatives with broader
  measures to tackle deprivation and disadvantage
  and health inequalities.
• All trusts in the sector to have reached the 95
  target figure set for the completeness of ethnic
  monitoring data of their patients in 2004/05.
• Performance review meetings shift their focus to
  the use being made of ethnicity data - whether
  any anomalies related to race/ethnicity have been
  identified and if so how have these been
  investigated, and any action consulted upon or
  taken

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Race Equality in the Mainstream

• 2005-08 Race Equality Schemes provide an
  opportunity to get it right this time round
• The NHS KSF Improving Working Lives include
  Equality Diversity
• Choosing Health commitment to reducing health
  inequalities
• Health Social Care Standards include Equality
  and Diversity

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Approach to promotingrace equality in the PCT

• LEADERSHIP

LINKS policies Joint working
SUSTAINING CHANGES cycle of planning
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Approach to promoting race equality in a PCT

• Leadership
• Internal (individual or group)
• External (e.g. SHA or the Healthcare Commission)
• Links and joint working
• Race equality and NSF
• Race equality and The NHS Implementation Plan
• Race equality and nGMS
• Race equality and IWL
• Sustaining changecycle of planning
• Planning delivery e.g. LDP
• Commissioning and review e.g. SLAs
• Performance management/corporate clinical
  governance
• Staff employment development

13
Using Maslows Hierarchy-of-needs to motivate
healthcare development
Growth less need for targeted services race
equality being mainstreamed and integrated in
planning, commissioning and performance
management, in functions (e. g. employment)
Developing other services replicate and
systematically transfer learning and good
practice to generic services. The Guide is a very
helpful tool.
Developing basics interpreting, translation,
diet, multi-faith facilities. Planning and
providing targeted services for specific high
prevalence diseases or conditions such as
Diabetes, CHD.
14
Structure we used for self assessment of progress

• Commissioning Public Health Services
• Voluntary sector
• Nursing Primary Care
• RES Steering Group
• Training Development HR Communication
•  
•  
• User Community Involvement Clinical
  Governance
•  

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Highlights

• Commitment of Steering Group members essential.
• The Guide and Framework
• Provided legitimacy
• Put race equality on organisational map
• Provoked dialogue and discussion
• Was comprehensive and rigorous
• Self-assessment Process provoked further
  rethinking resulted in
• Health Equity audits of smoking cessation and
  podiatry
• Race equality embedded in annual work plan of
  clinical governance clinical audit
• Review of uptake of clinical training and
  development opportunities
• Integration of equality questions in job
  interviews

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In the context of today, what will help to
further promote race equality?

• Performance Management discussions
• Race equality must be a regular agenda item
• e.g. appraisals, targets, SHA reviews
• Healthcare Commission
• 68 (approx) proposed prompts to assess equality
  human rights
• Link these to the Guide-Performance Framework
•