The NHS Equality Delivery System 2 (EDS2) NHS North, Central and South Manchester Clinical Commissioning Groups Facilitators: Hilda Bertie, Equality and Diversity Manager, North West Commissioning Support Unit Val Bayliss-Brideaux , Senior Engagement, NHS North, Central and South Manchester Clinical Commissioning Groups

Objectives At the end of this briefing you will have a better understanding of: The Equality Act 2010 Public Sector Equality Duty Equality Delivery System 2 How to grade Your role in this process

Equality Act 2010 Replaces previous Equality Legislation Introduces a new Public Sector Equality Duty General and Specific Duties

General and Specific Duties General Duty – all public sector bodies must show “due regard” to the needs of people from the 9 protected characteristics Specific Duty – some public bodies have to prepare an annual public statement about Equality, Diversity and Human Rights, as it applies to their services and workforce General duty involves showing due regard to the needs of people from 9 protected characteristics (age, gender, sexual orientation, marriage/civil partnership, race, religion, disability). Do this by: Eliminating unlawful discrimination, harassment and victimisation Advancing equality of opportunity (in NHS case = access and experience of services) – removing or minimising disadvantages suffered by people due to their PCs Taking steps to meet the needs of people from Groups, where these are different from the needs of others Encourage people from PCs to participate in public life or in other activities where their participation is disproportionately low. Fostering good relations between people who share a protected characteristic and those who don’t, this could comply with you treating some people more favourably than others. Specific duty – some public bodies have to prepare an annual information report about EDHR relating to their services and workforce – the NHS, and specifically CCGs, are in this category

Whose included? Protected Characteristics

Important Communities of Interest People who are: Carers Homeless Living in poverty Long-term unemployed In stigmatised occupations (such as women and men involved in prostitution) Misusing drugs Isolated and have limited access to family or social networks Who are geographically isolated Military Veterans Plus others specific to your locality

What is the Equality Delivery System 2? Making sure that we commission services as fairly as possible, to ensure that the health and access needs of all communities are met Performance Management Tool to assess Equality, Diversity and Human Rights across NHS organisations A way of reviewing services and working practices Supports keeping Equality and Diversity high on the agenda 4 overarching Goals 18 Outcomes Basically, it’s just a tool to help NHS organisations make sure they are fulfilling their duties under the Public Sector Equality Duty, and to make sure they are engaging with all the protected characteristics to ensure that the services they commission are inclusive.

4 Goals The are 4 goals: Goal 1 – Better health outcomes Goal 2 – Improved patient access and experience Goal 3 – A representative and supported workforce Goal 4 – Inclusive leadership

18 Outcomes Each outcome supports one of the 4 goals Each goal is spilt into a number of “outcomes” e.g. Goal 4 is spilt into two outcomes Each “outcome” is graded, based on evidence and case studies An overall grade is given for each goal the goals are split into 18 smaller outcomes to support the goals . 2 goals refer to services that patients access and 2 refer to workforce. Some of the 18 outcomes are, 1.1 Services are commissioned, designed and procured to meet the health needs of local communities, promote well-being, and reduce health inequalities; 2.3 Patients and carers report positive experiences of the NHS, where they are listened to and respected and their privacy and dignity is prioritised; 3.4 Staff are free from abuse, harassment, bullying, violence from both patients and their relatives and colleagues, with redress being open and fair to all; Middle managers and other line managers support and motivate their staff to work in culturally competent ways within a work environment free from discrimination. (the grades assigned to each Outcomes will be considered in determining the overall Goal Grade)

Our journey so far… Established a group of managers to support this process (Task and Finish Group) Gathered evidence and case studies across the 4 goals and 18 outcomes An internal self-assessment is taking place – to demonstrate the grades that we think we are at

For information the evidence templates looks like this and managers have been collating evidence, you may see some of these at the grading session.

Equality Delivery System – Case Study Template EDS 2 GOAL (S):   OUTCOME Number(s): Case Study Title: Service: Case study overview Please provide a short summary of the work being described in the case study. Please identify what protected characteristics this case study relates to? The Key Issue(s) What are the main issues that lead the project/pilot/work to take place? How we responded What action took place in response to the issue(s)? Who was involved? How was it resourced? What engagement took place? Who did you engage with, identify which protected groups? How and where did engagement take place? How did this help your project/pilot/work? – What feedback was gained from the engagement? What difference has it made? What was the impact made because of this work? How has it made a positive difference to local patient’s lives? What would have happened if the work hadn’t taken place? Additional Information Please add any additional information that you think would be relevant and useful to include in the context of supporting your case study. Contact Please insert main contacts – name, job title, email, contact telephone number, service area and location Cases studies, again this is the template that managers have completed in relation to capture case studies. Again you will see these on 4th November event.

Internal self-assessment A group of Managers will meet and decide on the grading for each Outcome and Goal. These grading's will be open for discussion at the external grading session on 4th November 2014.

How you can support and work with us Using your experience and knowledge, tell us how we’re doing in relation to protected groups Grade us from red/amber/green/purple The grade you give us will be made public It’s your grade that counts Tell us what we still need to do Tell us how we’re actually doing in relation to protected characteristics by giving us a grade. The possible grades are Grade red/Amber/Green/Purple. I’ll explain these further later. The grade you give us will be made public so anyone can see how people from protected characteristic groups think we pay due regard to their needs. It’s your grade that counts, so if you disagree with our internal grading, you should mark us down or up, depending on what you agree. You all have to agree to whatever the final grading happens to be.

Your involvement and what is expected Read evidence and case studies on our progress Evidence will be presented in various formats Grade each outcome If you disagree with our grading, we want your views as to why At the end of the process we need an agreed grade on each outcome. It doesn’t need to be the same as the internal grading we gave ourselves, but you all need to agree on the grade. You can give different grades to different outcomes, even if they are within the same goals.

Your grading and what we would like you to consider Have we shown that we have thought about all the protected characteristics in Goals 1 and 2? In Goal 3 have we shown that our staff feel empowered, engaged and well supported across the protected characteristics? In Goal 4 have we shown how our leaders know their responsibilities and have taken Equality and diversity into account when making decisions? If not, have we shown that we have plans to improve? We need to show that we have thought about all the protected characteristics (not necessarily all the services for each characteristic) in goals 1 and 2 If not, have we shown that we have plans to plug the gaps? Here’s an example of what we mean One of the outcomes is Outcome 1.1 (in Goal 1 – Better health outcomes for all) Services are commissioned, designed and procured to meet the health needs of local communities, promote well-being, and reduce health inequalities One factor is “Through the use of best available evidence, for how many protected groups can the organisation demonstrate that the health needs of patients & carers are being met, and well-being is promoted?” No evidence at all or evidence for few or none of the protected groups is underdeveloped (red) Evidence for some protected groups is developing (amber) Evidence for most protected groups is achieving (green) Evidence for all protected groups is excelling (purple) And so on for the other factors. Plans can be taken into account, so if you think we have services that address the needs of 2 protected groups but plans to commission services for 3 more groups in the next year, you might want to give an Amber grading even though 2 groups = few therefore red would be the strict grading, but the plans mitigate this

What does each grade mean? Excelling – Purple Achieving – Green Developing – Amber Undeveloped – Red We need to show that we have thought about all the protected characteristics (not necessarily all the services for each characteristic) in goals 1 and 2 If not, have we shown that we have plans to plug the gaps? Here’s an example of what we mean One of the outcomes is Outcome 1.1 (in Goal 1 – Better health outcomes for all) Services are commissioned, designed and procured to meet the health needs of local communities, promote well-being, and reduce health inequalities One factor is “Through the use of best available evidence, for how many protected groups can the organisation demonstrate that the health needs of patients & carers are being met, and well-being is promoted?” No evidence at all or evidence for few or none of the protected groups is underdeveloped (red) Evidence for some protected groups is developing (amber) Evidence for most protected groups is achieving (green) Evidence for all protected groups is excelling (purple) And so on for the other factors. Plans can be taken into account, so if you think we have services that address the needs of 2 protected groups but plans to commission services for 3 more groups in the next year, you might want to give an Amber grading even though 2 groups = few therefore red would be the strict grading, but the plans mitigate this

How do you decide which grade to give us We need you to consider the following question: How well do people from protected groups fare compared with people overall? Your grade will depend on the outcome of the above: Underdeveloped – majority of evidence for 2 or less protected groups fare well Developing – majority of people in 3 to 5 protected groups fare well Achieving – majority of people in 6 – 8 protected groups fare well Excelling – majority in all 9 protected groups fare well In the grade descriptions, reference is made to “all”, “most”, “some” and “none/few” protected groups. As a rule of thumb: “All” means all nine protected groups “Most” means six to eight protected groups “Some” means three to five protected groups “Few” means one or two protected groups “None” means no protected groups Remember, we are showing what we have achieved and what we know we still need to do. So there will be examples of work we have done with each protected characteristic to meet their needs, and plans to work with those groups we haven’t yet worked with.

And finally… This is your opportunity to share with us any questions and queries. Are you still interested in taking part in the external stakeholder assessment on the 4th November? Refreshments and lunch will be available on the 4th, so please inform us of any specific dietary needs.

Thank You