Working Together with the Race Equality Guide
Robert Mitchell North Central London Strategic Health Authority
Ila Gocoldas Camden Primary Care Trust
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
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
SHA Race Equality Guide 2004To 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
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
The eight performance areas Leadership and corporate commitment Strategy and services Patient and public involvement &
consultation Health Workforce Partnership Finance & procurement Information & communication technology
Recommendations from the review:Leadership & 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.
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.
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
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
Approach to promotingrace equality in the PCT
LEADERSHIP
LINKS: policies & Joint working
SUSTAINING CHANGES: cycle of planning
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 change:cycle of planning• Planning & delivery e.g. LDP• Commissioning and review e.g. SLAs • Performance management/corporate & clinical
governance • Staff employment & development
Using Maslow’s Hierarchy-of-needs to motivate healthcare development
Developing basics: interpreting, translation, diet, multi-faith facilities. Planning and providing targeted services for specific high prevalence diseases or conditions such as Diabetes, CHD.
Developing other services: replicate and systematically transfer learning and good practice to generic
services. The Guide is a very helpful tool.
Growth: less need for targeted services; race equality being mainstreamed and integrated in planning, commissioning and performance management, & in
functions (e. g. employment)
Structure we used for self assessment of progress
Commissioning Public HealthServices
Voluntary sector
Nursing Primary Care
RES Steering GroupRES Steering Group
Training & Development HRCommunication
User & Community Involvement Clinical
Governance
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
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’