1. Maqsood Ahmad Director for Equalities and Inclusion NHS Midlands and East Improving Equality and Reducing Health Inequalities in Practice via Equality Delivery System

2. 22 June, 20161 1 Equality Delivery System (EDS) I ntroduction Commissioned by Equality and Diversity Council (EDC) EDC Formed in 2009. Membership: NHS Chief Executives, DH and Vol. Sector. Reports to NHS Management Board Chaired by Sir David Nicholson Vision:  deliver fair and personalised services  promote workplaces free from discrimination and  foster continuous improvement

3. 22 June, 20162 I ntroduction: Equalities and Inequalities Only 17% of women with a Learning disability take up breast screening compared with 76% of the general population Gypsies and travellers have worst health status of any disadvantaged group – often due to poor engagement from health services 44% of Bangladeshi men smoke compared with 27% of the general population. South Asian people are 50% more likely to die from coronary heart disease than the general population

4. 22 June, 20163 28X lower - Cervical screening uptake for women with learning disabilities living at home 4X higher – Missed NHS appointments by deaf or hearing impaired patients (19% more than 5 appointments) because of poor communication Men are 16% more likely to develop cancer and almost 40% more likely to die from cancer I ntroduction: Equalities and Inequalities

5. Provide a better service to diverse patients, carers and local interest groups. Support and develop our staff and leadership Tackle health inequalities Meet the NHS Equality & legal commitments 22 June, 20164 The NHS EDS will help to: Public Sector Equality Duty (PSED): Eliminate unlawful discrimination Advance equality of opportunity Foster good relations Specific Duties of the PSED: Information on compliance Set and Publish Equality Objectives

6. 22 June, 20165 NHSCB, CCGs, DH and NHS organsiations duties to: Promote the NHS Constitution Improve quality of service Promote involvement of each patient and patient choice Promote innovation and integration Reduce inequalities Involve and consult members of the public NHSCB, CCGs, DH and NHS organsiations duties to: Promote the NHS Constitution Improve quality of service Promote involvement of each patient and patient choice Promote innovation and integration Reduce inequalities Involve and consult members of the public

7. 22 June, 20166 With local interests, organisations analyse and grade their equality performance against 18 EDS outcomes grouped into 4 EDS goals: EDS - Analysis 1 2 3 4 Better health outcomes for all Improved patient access and experience Empowered, engaged & well- supported staff Inclusive leadership at all levels Account is taken of the FREDA principles that support the Human Rights Act 1998

8. 22 June, 20167 EDS grades - overview For each outcome, one of four grades can be chosen, and related to a RAG rating: Excelling - Purple Achieving - Green Developing - Amber Undeveloped - Red Very good outcomes, evidence fully used, local interests fully engaged & equality part of mainstream business Poor outcomes, evidence not used, local interests not engaged & equality not part of mainstream processes Protected Groups: All (9) Most (6 to 8) Some (3 to 5) Few (1 or 2) None (0)

9. 22 June, 20168 EDS – Positive Outcomes and Impact Recent Independent evaluation (S.I) has shown many initial positive impact of the EDS including: Improving engagement mechanisms, prioritisation of equality issues, identifying gaps in equality data and better partnership working around equality and engagement. Changes in perceptions and behaviour within NHS organisations, the most notable being raising the priority of equality work with senior leaders. increased awareness and commitment of equality across organisations, including equality in the workforce and evidence of the EDS helping to change attitudes and behaviours of staff around equality.

10. 22 June, 20169 EDS – Positive Outcomes Outcomes and Impact of EDS: Cases Studies EDS helped to employ people from learning disabilities (South Devon NHS Healthcare Foundation Trust). Effective engagement - set equality objectives through better engagement of users and staff (West Midlands Ambulance Service) Improved evidence to tackle health inequalities faced by those with protected characteristics, helped to focus on services to excluded groups (trans people) and provided meaningful partnership with Trusts and local groups (NHS Airedale, Bradford and Leeds)

11. 22 June, 201610 Next Steps A Tailored EDS? – Evaluation has shown that EDS has been well- received by NHS organisations and local interest groups but need to explore the possibility of the EDS being tailored to different types of trusts (including mental health trusts and CCGs). Support for CCGs and commissioners – work with CCG members to see how we could support them in implementing the EDS. Continue EDS support and sharing practice – a significant demand for sharing EDS practice across organisations has been very well received to date (peer to peer support, training/earning days and sharing good practice conferences). Trusts have stated that they would continue to benefit from more of this type of learning and support.

12. 22 June, 20161122 June, 201611 EDS - Publications www.eastmidlands.nhs.uk/eds www.dh.gov.uk