Making Race Equality stick in a PCT

1
Making Race Equality stick in a PCT

• Our commission - re-drafting the scheme
• building involvement communication and
  connection
• Senior Executive commitment
• Staff workshops
• Linking to corporate objectives and business
  plans
• limited priorities, clear commitments, lead
  responsibilities

2
2 Figure A PCT Dimensions
Finding their way
Naive
Astute
Organisational Maturity
Swamped
Structural Chaos
External Challenge
Dinosaurs
Struggling
Phoenix
Surviving
New Borns
3
Mainstreaming at different levels
Purpose
Identity
What do you want to achieve - Maturity
Values beliefs
Capability
Systems and processes in place to deliver -
Structure
Behaviour
Impact of the external environment - Challenge
Environment
4
Steps to competence
Unconscious competence
practice
Conscious competence
process
Conscious incompetence
content
Unconscious incompetence
5
Learning model Implications for implementing RRAA




Conscious incompetence
Conscious competence
Unconscious incompetence
Unconscious competence
Will implement RRAA if told how and what to do -
unlikely to learn or make further connections
Will work hard to set up processes for RRAA, but
unlikely to integrate into strategic or
operational plans
Proactive in raising and reviewing equitable
access, appropriate services delivery and
community consultations Collects uses
monitoring data Invests in staff training
Clear vision strategy for how diversity is
integrated throughout the organisations
processes and people Data systems support
integration Community is fully involved in
service planning development
6
Not rocket science
more marathon running
7
Learning model - where are most NHS organisations?
Conscious incompetence
Working on competence - conscious competence
Unconscious incompetence
Becoming competent
Early majority
Late majority
Innovators
Early Adopters
Laggards
Adoption curve descriptions
8
Applying adopter characteristics to NHS
organisations
2nd/3rd wave developments request guidance on
implementation join established developments will
seek to apply good practice
Dont initiate developments wait for
circular/guidance compliant - follow
instructions strongly influenced by peers need
support - likely to implement form rather than
spirit
Early members of collaboratives participate in
pilot programmes Leaders members of learning
partnerships Potential for good practice
Resistant to change until instructed will not
introduce new practices unless they are made a
requirement require heavy performance
management do not respond to good examples
Participate in national pilots linked to
DoH associated with research centres transformati
onal project leaders
2.5
13.5
34
34
16
Innovators
Early Adopters
Early majority
Late majority
Laggards
9
Success factors

• Leadership
• Applying corporate values
• Senior diversity specialist
• On-going support and training
• Systematic integration into all business
  functions

10
Naive
Astute
Finding their way
No vision, framework or plan Lacks systems
procedures -Survive by following
instructions unclear of local needs Risk
management not on the agenda
Clear vision - prioritise national and local
agenda Delivery systems in place Able to manage
risks Focused on meeting local health needs Good
at sustaining partnerships
Systems processes at early stage Struggling to
develop partnerships Culturally Risk averse Link
local health needs into national priorities
Dimension 1 Organisational maturity
Implications for implementing RRAA
Need to understand how RRAA helps meet local
health needs May be innovative - potential
source of good practice Will be influenced by
lead of significant others
Need to see RRAA as explicit national
priority Encouraged by being shown benefits of
RRAA implementation Will follow lead of
influencers, examples of good practice Opportunist
ic - may seek resource for implementation
Require instructions - will implement RRAA if it
is a low risk must do Will only do what they
perceive as being a national requirement Need to
be shown how to connect race equality with other
aspects of business
11
Dinosaurs
New Borns
Phoenix
PCT welded onto structure of former Community
Health Services Trust Not yet thinking through
new role(s) - struggling with commissioning Inheri
ted problems - policies, practice,
premises Regurgitated CHS policies procedures
No organisational history - context of total
change throughout local health economy Leadership
recently appointed No organisational memory Lack
of systems and procedures
Built from predecessor Primary Care group(s) -
reinventing everything! Lacks history of
experience as former organisation - little former
development to build on Lacks skills capacity -
also struggling with commissioning role
Dimension 2 Structural Chaos
Implications for implementing RRAA
Opportunity to integrate RRAA into planning and
systems development Need to be stimulated to
recognise opportunities to implement RRAA
Need to be pushed to implement RRAA Need to be
shown benefits Need information to involve
stakeholders
Likely to take procedural approach May have
previous policies and structures to rely on Will
be seen to comply - letter more than spirit
12
Struggling
Surviving
Swamped
Serious financial constraints High deprivation
indices High staff and population
mobility pressure to address race equality
No major financial challenge Stable
population Staff retention good Involved public
Balancing the books with difficulty Adequate
local health economy infrastructure
Dimension 3 External Challenge
Implications for implementing RRAA
Have capacity to invest in systems to deliver
race equality e.g. ability to collect use
ethnicity data Unlikely to be under pressure for
change locally - need external stimulus to
initiate action
Attention likely to be focused on national
priorities Will implement RRAA if it is
identified on the list of must do requirements
difficult in mainstreaming Potential to work
effectively within local health economy
Will need to see specific benefits of
implementing RRAA in terms of the rest of the
must do agenda Need to be convinced of need
for population data and encouraged to use it
13
Opportunities for integration..

• Business plan, Corporate Objectives
• Local Development Plan
• Service and Financial Framework (SaFF)
• Clinical governance framework
• National Service Framework implementation
  plans
• Health Improvement Programme
• IWL - workforce plan, retention and
  recruitment strategy
• Patient and Public involvement

14
Core principles of our approach

• Builds on your existing work
• Links to mainstream targets and objectives
• Action focused
• Sets achievable priorities
• Reviewable