equality and diversity - warrington ccg and diversity...grading group and the ccg equality champions...

Equality and Diversity Annual Report

2016/2017

CONTENTS

Foreward Who we are and what we do Our Population Human Rights Act 1998 and Equality Act 2010 What the Equality Act means What is Due Regard Equality Impact Assessments Equality Delivery Systems2 Equality Objectives Governance Engagement with protected characteristics Monitoring the equality and diversity performance of our key NHS providers Our workforce Staff training Conclusion Appendix

NHS Warrington Clinical Commissioning Group (CCG) strive to commission services that meet the needs of our communities; improving access and outcomes for residents and communities in the area. There is clear evidence that people’s health, their access to health services and experiences of health services are affected by their age, gender, race, sex, sexual orientation, religion/belief, transgender, marital/civil partnership status and pregnancy/maternity status.

Warrington CCG believes that equality and diversity should be embedded into all our commissioning activity as well as addressing health inequalities.

Dr. Andrew Davies Chief Clinical Officer

FOREWORD/ EXECUTIVE SUMMARY

WHO WE ARE AND WHAT WE DO NHS Warrington Clinical Commissioning Group is a clinically led membership organisation

made up of the 28 GP practices in Warrington.

The core purpose of the CCG is to turn the £279 million budget we receive into the best possible health outcomes for the people of Warrington. We are responsible for the planning and buying (commissioning) of healthcare services for the 212,000 people registered with GPs in the town.

We work closely with all healthcare providers and monitor their performance to make sure that the people of Warrington receive the best possible quality care. We also work in partnership with Warrington Borough Council to make sure health and social care are linked together whenever possible.

The NHS is very complex, with national, regional and local organisations.

At the very heart of the complex NHS structure is people and communities.

NHS Warrington CCG places the needs of local people at the very centre of all decision making and has developed its mission statement with this in mind. ‘EXCELLENCE FOR WARRINGTON’ is what each and every member of the CCG strives to achieve.

The Annual Equality and Diversity Report sets out how the CCG has been paying ‘due regard’ to the Equality Act 2010’s, Public Sector Equality Duty’s (PSED) three objectives to:-

1. Eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act;

2. Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it;

3. Foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

This presentation outlines the CCG’s approach to embedding Equality & Diversity within the

organisations via the EDS 2 toolkit, setting Equality objectives, monitoring the equality performance of our key NHS providers, ensuring our workforce are

supported and engaged and we have robust processes in place to consider our Public Sector

Equality Duty (PSED) when we are making commissioning decisions.

The report also outlines our strategy and plans to ensure we have strong engagement with people who share protected characteristics.

Population According to 2011 Census

According to the latest figures from Public Health England…

Warrington’s life expectancy is 78.2 years for men and 82.0 years for women.

4.1% of our population recorded

their ethnicity as non-white compared

with 14.6% for England.

- Of these, the highest group is

Asian/ Asian black 2.4%

The ward with the highest (9.9%)

proportion on non- whites is Whittle

Hall

Warrington is less diverse than both the North West and

England in terms of residents country of birth 91.4% of

residents were born in England compared with 89% across the

North West. - Compared with the North

West, Warrington has slightly higher proportion of residents

born in EU countries outside the UK and Ireland 2.2%

21,843 provides unpaid care

In 2013 according to the Office for

National Statistics 19.1% of residents

were under 16 with 17.1%

over 65 82% of Warrington

residents stated they

were Christian. - The highest

other religion is Muslim 0.6%

8.9% reported that have a disability

which limits their day to day activity

There were 113 statutory homelessness acceptances

HUMAN RIGHTS ACT 1998 & EQUALITY ACT 2010

Under the Human Rights Act 1998 and the Equality Act 2010 everyone has the right to be treated fairly and with dignity and respect. The Equality Act 2010 places a duty on the organisation to offer protection from discrimination to patients and staff based on the ‘protected characteristics’ of:

› age › race › sex › gender reassignment

status › disability › religion or belief › sexual orientation › marriage and civil

partnership status › pregnancy and

maternity

The law also protects people who are at risk of discrimination by association or perception. This could include, for example, a carer who

looks after a disabled person.

WHAT THE EQUALITY ACT 2010 MEANS FOR THE NHS

The Equality Act 2010 gives the NHS opportunities to work towards eliminating discrimination and reducing inequalities in care. The NHS already has clear values and principles about equality and fairness, as set out in the NHS Constitution, and the laws under the Equality Act 2010 reinforce many of these.

WHAT THE EQUALITY ACT 2010 MEANS FOR PATIENTS

Most of us need to visit a doctor or may need hospital treatment on occasion. Others may rely on the NHS and social care services for help with long-term health conditions or disabilities. Whenever you need

healthcare, medical treatment or social care, you have the right to be treated fairly and not to be discriminated against, regardless of your ‘protected characteristics'.

LAWS UNDER THE EQUALITY ACT SET OUT THAT EVERY PATIENT SHOULD BE TREATED AS AN INDIVIDUAL AND WITH RESPECT AND DIGNITY.

The laws mean that all NHS organisations will be required to make sure health and social care services are fair and meet the needs of everyone, whatever their background or circumstances

http://www.homeoffice.gov.uk/equalities/equality-act/

http://www.nhs.uk/choiceinthenhs/rightsandpledges/nhsconstitution/pages/overview.aspx

http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/NHSGPs.aspx

http://www.nhs.uk/NHSEngland/AboutNHSservices/social-care-services/Pages/social-care-adults-old.aspx

WHAT IS ‘DUE REGARD’?

“Due regard” means that the CCG have given advanced consideration to issues of equality and discrimination before making any commissioning decision or policy that may affect or impact on

people who share protected characteristics.

IT IS VITALLY IMPORTANT EQUALITY IS AN INTEGRAL PART OF WHAT WE AS A CCG DO.

The CCG has considered their PSED by undertaking Equality Assessments on Policy and Service changes, by undertaking their Equality Delivery Systems 2 action plan over 2016 and by ensuring communities who share protected characteristics have a voice in how services are delivered.

The CCG prides itself of our involvement of local organisations within the Third Sector who have expertise or who represent the issues of communities and people who share protected characteristics.

EQUALITY IMPACT ASSESSMENTS

The CCG have introduced new tools to enable staff to more effectively undertake Equality Impact

Assessments. A screening tool has been developed to enable staff to identify if they need to then undertake

a full equality impact assessment, a quality assessment and/ or a privacy assessment.

New Equality Impact Assessments have also been introduced.

The CCG have undertaken seven Equality Impact Assessments throughout 2016 – 17. These have been for GP Out of Hours, Thrive – a new model for children and young people’s emotional health and wellbeing, Infant Mental Health service, Patient Representation Policy, Continuing Care Policy, Staff Supervision and PDR Policy, Repeat Prescribing.

EQUALITY DELIVERY SYSTEMS (EDS2) We have adopted the Equality Delivery System (EDS2) as our performance toolkit to support us in

demonstrating our compliance with the Public Sector Equality Duty (PSED). The Equality Delivery System (EDS) is a tool-kit that can the CCG improve the services we provide for our local communities, consider

health inequalities in our locality and provide better working environments, free of discrimination, for those who work with us in the NHS.

The EDS has four key goals (with 18 specific outcomes) achieving better outcomes, improving patient access and experience, developing a representative and supported workforce and finally, demonstration of inclusive leadership. Each of these goals can be assessed and a grading applied to illustrate progress in achieving the outcomes and the involvement of the communities and organisations that represent the views of people with protected characteristics is important. The grading’s applied as follows:

Excelling - if evidence shows that the majority of people in all nine protected groups fare well

Achieving - if evidence shows that the majority of people in six to eight protected groups fare well

Developing - if evidence shows that the majority of people in three to five protected groups fare well

Undeveloped - if there is no evidence one way or another for any protected group of how people fare or Undeveloped if evidence shows that the majority of people in only

two or less protected groups fare well

THE LOCAL APPROACH TO EDS 2

NHS Warrington CCG working with Midlands and Lancashire CSU has undertaken our EDS2 assessment for 2016-17 using a new toolkit and by engaging with representatives from Third Sector organisations who represent and work with the protected characteristics in the Equality Act (2010). This new approach enables the CCG to more effectively capture work that is being undertaken locally that produces better outcomes

for patients and staff.

Taking into consideration all the evidence that the CCG produced, the CCG self-graded and then held a grading event for community representatives to discuss the evidence and grading for a final grading to be agreed. The event took place in February 2017 for representatives

of Healthwatch and Third Sector Organisations to discuss the action plan and to agree the final grading.

Currently Grading for the vast majority of patient and public related services (Goals 1, 2& 4) for the CCG is assessed as ACHEIVING.

Once key issues that were highlighted are addressed and or mitigated via mainstream business plans then the CCG will aim to progress to

achieving status across all the relevant outcomes and goals. There was also some areas of work that were highlighted as EXCELLING, this was

our engagement work with people with learning disabilities and carers.

Following the work undertaken from 2015/16 EDS the CCG has changed their grading from DEVELOPING to ACHIEVING, which is a great

achievement and highlights the CCG committment to equality and diversity.

It has been agreed that six monthly meetings will take place with the grading group and the CCG Equality Champions to ensure 2017-18

action plan is progressing.

The EDS2 assessment for the CCGs can be viewed in Appendix 1 and the report from the grading day can be seen in Appendix 2.

Representatives in attendance were: › Healthwatch › WIRED Carers › Trans* Warrington › Warrington Ethnic Communities

Association › Polish Community › Children’s Society › Long Term Conditions Group › Speak Up (Learning Disabilities) › Warrington Borough Council

Vulnerable Communities Worker

EQUALITY OBJECTIVES

The CCGs current equality objectives are:-

› To make fair and transparent commissioning decisions; › To improve access and outcomes for patients and communities who experience disadvantage › To improve the equality performance of our providers through robust procurement and

monitoring practice › To empower and engage our workforce

GOVERNANCE

The Chief Operating Officer will be directly responsible to the Leadership Team and Governing Body of the Clinical Commissioning Group for providing the necessary information on progress

and compliance to the PSED as part of their update on equality and diversity.

Over the last two years reports on our compliance and issues associated with meeting our statutory duties have taken place in our Quality and Human Resources committees. These

updates will continue but on an annual basis.

To ensure the CCG are effectively monitoring the action plan from the EDS2 Action Plan the CCGs Equality Champions and community grading group will meet on a six monthly basis.

ENGAGEMENT WITH PROTECTED CHARACTERISTICS

All NHS organisations, including CCGs, have an obligation to actively involve patients and the public when they are planning the provision of health services; developing or considering proposals for changes in the way health services are provided or

making decisions that will affect the operation of health care services.

Warrington CCG has made a firm commitment to not only fulfill the requirements of the NHS Constitution and legislative responsibilities, but to really embrace the principles and make ‘NO DECISION ABOUT ME WITHOUT ME’ a reality for the

people of Warrington and firmly believe that the time spent building relationships with patients, the public and other key stakeholders is a valuable investment.

DURING 2016 – 2017 THE CCG HAVE GIVEN PATIENTS A VOICE IN VARIOUS WAYS…

Engagement with mums on a new Early Attachment Service, we asked what they

would like to see in the new service

Engagement with users of the Wheelchair service to seek their

experiences and to discuss the idea of Personal Health Budgets

Strong representation at our Health Forum - regular attendance

from Contact the Elderly, WIRED Carers, Warrington Wolves

Foundation, Warrington Parents and Carers Forum, Warrington

Borough Council Vulnerable Communities Worker (representing ethnic communities), Warrington

Chaplain and representatives from Patient Participation Groups and

individual patients and carers

Engagement work is being carried with cancer survivors

through LiveWire, LifeTime and WIRED carers. The engagement

will focus on what cancer survivors would like from a new programme for Living With and

Beyond Cancer

Engagement with parent carers on their experience of Continuing Care and the

transition to Continuing Health Care, resulting in an updated pathway and increased information on the Transition pathway

Working with people with learning disabilities as outreach from the Health Forum. Also attendance at Living Well

events to promote health messages and obtain experiences of people with learning disabilities

Engagement with Third Sector groups to discuss experiences of health including

Trans* Warrington, Speak Up, Warrington Disability Forum, Long Term Conditions

Groups, WIRED Carers Drop ins, Warrington Collegiate and Warrington

Parents and Carers co production events

ENGAGEMENT WITH PROTECTED CHARACTERISTICS

Emotional Health and Wellbeing Transformation Plans

NHS England published the Future in Mind document in April 2015 which gave details

on the expectations for emotional health and wellbeing and child and adolescent

mental health services over the next five years. As part of Warrington CCG work on

this engagement with staff, providers, children, young people and families was

integral.

The CCG used Experience Based Design (EBD) as a methodology for working with patients,

families, carers and staff to improve and co design services. The approach has been

specifically developed for use within health care settings. Experience Based Design allows us

to gather insight into how services are experienced based on the person’s emotional response

to the interaction. It helps individuals and teams to challenge assumptions and perceptions

about what we think the patient or family member feels and needs.

A three month engagement period took place; this consisted of one to one interviews

with children, young people and families, focus groups with a range of staff, including

CAMHS, Third Sector Providers and organisations, school staff and GPs and a survey

being used. This resulted in a co-design event being held to feed back the themes

from the Experience Based Design approach and to start the process of co-designing

services. This approach proved very successful and from this and further work across

Halton a model for emotional health and wellbeing services for children and young

people has been drafted for further engagement. The full report from the event is on

the CCG website http://www.warringtonccg.nhs.uk/about-

us/maternity_children_young_people

The on-going partnership work with

Warrington CCG has proved a crucial

vehicle for ensuring the voice of people

with a learning disability is heard. The

engagement team attend Speak Up

group sessions on a regular basis and

work incredibly hard to ensure that the

information they are sharing is

accessible. Creative approaches to

involving and including everyone make

for a meaningful dialogue and

opportunity to contribute.

Project Co-ordinator

Speak Up Together Advocacy Hub

http://www.warringtonccg.nhs.uk/about-us/maternity_children_young_people



MONITORING THE EQUALITY & DIVERSITY PERFORMANCE OF OUR KEY NHS PROVIDERS

During the year we collaborated with neighbouring CCGs to ensure that contracts with key local NHS

providers include requirements to achieve and improve equality and diversity standards, including through the Equality Delivery System.

Providers over 2016/17 were expected to:

› Agree an updated Smart Equality Objectives Plan; › Complete an EDS2 assessments › Provide evidence of compliance with Equality Act 2010

specific duties (including the Workforce Race Equality Standard)

› Only take decisions about service redesign after an equality impact assessment has been carried out to demonstrate due regard of the PSED

› Provide data on the use of translation and interpretation services.

› Ensure Reasonable Adjustments are embedded within provider setting

› Adhere to the Accessible Information Standard

We are working closely with our providers to improve equality performance and access and outcomes for protected groups through robust contract monitoring, via the quality contract schedules.

EQUALITY & DIVERSITY AND THE WORKFORCE The CCG is committed to developing a representative and supported workforce and we

specifically consider equality and diversity for our staff. We are aim to ensure that we have fair and equitable employment and recruitment practices as well as holding up to date information about the CCGs’ workforce. It should be noted that as the CCGs have a small workforce and as such we are not required under the Specific Equality Duty to publish our workforce data. Over the next year our Workforce Equality plan in Appendix 4 below will ensure we are cognisant of

Equality Duties and our Workforce Race Equality Standard and that our relevant committees scrutinise the data available to them and ensure we value diversity and advance equality of

opportunity for our staff.

WORKFORCE AND EDS 2 UPDATED

A key part of our EDS 2 (Goal 3) assessment focusses on our workforce and for the majority of our outcomes we are graded as ACHIEVING status. These grades can be viewed in Appendix 1.

STAFF PROFILE

NHS Warrington CCG directly employs 87 people, ranging from senior managers to our support staff. We pride ourselves on looking after Our People and have range of staff support policies, including Flexible Working and Carers Leave. In addition our approach to agile/flexible working

supports our staff to achieve work life balance.

As at 31st March 2017 the gender analysis of NHS Warrington CCG is as follows:

Role Female Male Female % Male % Total

Governing Body Members 2 8 22.0% 80.0% 10

Senior Management Team 2 4 33.3% 66.7% 6

Total CCG Staff 62 25 71.3% 28.7% 87

Staff on VSM 0 1 0 100% 1

NHS Warrington CCG has 2 employees who have declared that they have a disability The proportion of BME staff employed by the CCG is 6.58% The proportion of BME Governing Body members is 14.3%.

For the full Workforce Race Equality Standard Report please see appendix 3

STAFF TRAINING AND EIAS

Staff working within the CCGs undertakes annual equality and diversity training.

The training is designed not only as an introduction to diversity and cultural awareness, but also as a practical guide to making our organisational culture an inclusive one. It combines a focus on personal and organisational beliefs, values and behaviours and the impact they have in our interactions at workplace,

internally and externally. Furthermore programme leads within the CCG who are responsible for transforming health services have received training and one to one coaching on undertaking Equality

Assessment reports.

Additional training has taken place with staff on the importance of Equality Impact Assessments and the process of completing them. Staffs awareness and confidence has now increased.

STAFF EQUALITY CHAMPIONS HAVE BEEN IDENTIFIED WITHIN THE CCG.

The main responsibility of an Equality Champion is to raise the profile of Equality & Diversity and to

act as a driver to enable positive action on equality issues within the CCG. Champions will be a catalyst to improve services or a specific area of equality. The Champions identified are from a mix

of teams to ensure that the whole CCG will benefit from this role. Additional training and

support will be given to these staff.

CONCLUSION

The CCG will continue to strive to ensure that the services the CCG commission are accessible to all.

During the last twelve months we have made good progress around equality & diversity developing new and building on existing relationships with groups and individuals who share and represent the interests of protected characteristics.

This year’s EDS2 exercise has allowed us to fully improve our understanding of what barriers certain communities face and tackle them through mainstream processes and plans. We have developed a refreshed and long term Equality Objective Plan 2015-18 that focuses’ on the internal processes we need to improve and the actions we need to undertake to tackle barriers and disadvantages certain communities face. The CCG has developed Workforce Equality & diversity Plan which aims to build on the solid foundations that are already in place.

The CCG will continue to engage with the population and staff as a whole and continue to develop strong links with members of the population and groups who represent the interests of people who share

protected characteristics and those who don’t and ensure that their views are built into the services we commission or the policies we develop.

NHS Warrington CCG is committed to reducing health

inequalities, promoting equality and valuing diversity as an important part of everything we do. This document clearly

describes the headline activity that has taken place and more importantly it sets out the work and approaches that need to be undertaken to advance equality of opportunity.

WE WILL CONTINUE TO MONITOR OUR PROGRESS AGAINST THE ACTION PLAN AND REPORT ANNUALLY AND OPENLY ON THE DEVELOPMENT OF THIS WORK.

1. Equality Delivery System2 Assessment

2. Equality Delivery System2 grading report

3. Workforce Race Equality Standard Report

APPENDIX

Grading: (Purple) Excellent (Green) Achieving (Amber) Developing (Red) Under developed

Equality Delivery System 2– Equality Objective Action Plan 2016 - 2017

To view all the evidence please click here to go to GP Teamnet

Goal 1: Better Health Outcomes Outcome Lead Grade Actions for 2016-17 Current Position and Evidence

1.1 Services are commissioned, designed and procured to meet the health needs of local communities. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge for local communities in the way services are commissioned, procured, designed and delivered. For all protected groups, assess and grade how well services are commissioned, procured, designed and delivered. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

KH 1. Internal CCG Staff awareness and training

a) Equality Screening is carried out on new services, service reviews ect to ensure they meets the health needs of the local community. Then if appropriate a full Equality Impact Assessment is undertaken

b) All CCG staff have undergone training on the Equality Act and Public Sector duties, aswell as Equality Impact Assessments.

c) Job roles for CCG staff to be Equality Champions are being devised

2. Provider Contracts

Current Position

All new policies and new services undergo an equality impact assessment

Stage 1 EIA Stage 2 EIA STAGE 2 EIA

SCREENING TOOL V Policies_V2.0_25021 Assessment_V5 final.

Equalty Impact Assessment and risk assessement training to be provided via CSU currently one session has been done, two further sessions are planned for the forthcoming year.

Warrinton CCG

Equality Champions R

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https://portal.gpteamnet.co.uk/Topics/ViewItem/f7c0f695-665c-42df-9c60-a72e0106fe26


Outcome Lead Grade Actions for 2016-17 Current Position and Evidence

AB

KH

DM

a) In all provider contracts a session has been added to ensure providers are adhering to the Public Sector Duty, are completeing Equality Impact Assessments and are completing the EDS Action plan

3. GP Out of Hours Work

a) The CCG undertook a formal statutory consultation on the relocating of GP Out of Hours. An EIA was undertaken which highlighted no impact for any particular characteristic.

b) Throughout the consultation the engagement focused on older people and disabled people to gain an understanding of any impact due to the relocation. No impact was recorded.

4. Cancer Survivership

a) The CCG are introduing a new Cancer Survivorship Programm. An EIA has been carried out to ensure there will be no

ED

KPIs_17-19_DRAFT_

Integ GPOOH Ext

Access Consultation R

Engagement work is being carried with cancer survivors through LiveWire, LifeTime and Roy Castle Foundation and working with WIRED carers. The engagement will focus on what cancer survivors would like from the new programme.

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KH

CH

negative impact.

5. Health Forum

a) The CCG have developed a Health Forum which is the CCG sounding board for patients, carers, PPG reps and Third Sector Organisations. All new services, consultations etc will be taken and discussed with the Health Forum as the starting point of engagement. The Forum has reps from older peoples group, families, BME groups, LGBT, drugs and substance misuse support.

6. Future in Mind – Emotional Health and Wellbeing for Children and Young People

The CCG are working to ensure the Forum is as representatve as possible, work is taken place to ensure the discussions are also taking place with people with learning disabilities and young people engagement is increased.

Members of the CCG Quality Team now regularly attend the Health Forum, and it has been agreed that feedback will be shared at each CCG Gorverning Body.

Health Forum ToR

.pdf

Outreach from the Health Forum takes place to gather the views of patients with learning disabilities.

A patient representation scheme is being put in place to ensure that patients representatives are included in CCG meetings and committees. This will include training on equality and diversity.

Young Persons, families and staff engagaement has taken place using an ‘Experience Based Design’ approach. This involved one to one interviews, focus groups and a survey being undertaken to theme trends and experinces. These were then explored further in a co-design event. From this further work is being undertaken to involve young people, families and Third Sector organisations to design future services.

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YM

7. Early Attachment Service – this is a new service which will involve engagements with parents about support that is needed

Summary of

children's mental hea

Engagement report

BIBS.pdf

1.2 Individual people’s health needs are assessed and met in appropriate and effective ways Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge for local communities in the way needs are assessed and met. For all protected groups, assess and grade how well individuals’ health needs are met. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

YM 1. Continuing Care (individual funded and commissioned package of care for a child or young person who has complex needs arising from disability, accident or illness that cannot be met by existing universal or specialist services alone)

a) Engagement with families

regarding the process of Continuing Care

Outcomes of the engagement work includes:

Information leaflet has been developed for Social Workers with agreement regarding review process

CC leaflet for Social

Workers.pdf

Panel meetings have been looked at in order to develop a more timely process.

The Community Nursing Team and Children and Families Practitioner will be looking at ways to obtain the young people’s views where communication needs are complex

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b) Compliance Visit The CCG undertake Compliance Visits to ensure that any premise that a child or young person is placed is in compliant.

Section 117

a) Section 117 means patients will get free aftercare when they leave hospital if they have been in hospital under section 3, 37, 45A, 47 or 48 of the Mental Health Act 1983.

Continuing Care

Engagement with fam

Compliance Visit

V3.docx

The CCG have a new policy for section 117. This includes a training day on 20

th March for CCG, WBC and 5BPS staff.

1.3 Transitions from one service to another, for people on care pathways, are made smoothly with everyone well- informed. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge for local communities in the way needs are assessed and met. For all protected groups, assess and grade how well individuals’ health needs are met. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

YM 1. Continuing Care a) Engagement work

regarding Transition from Continuing Care to Continuing Healthcare

Pathway has been developed and implemented following the engagement work.

Engagement with Pathway v2.jpg

parents.pdf

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1.4 When people use the NHS services their safety is prioritised and they are free from mistakes, mistreatment and abuse. Choose one or more care pathway of importance to your organisation where evidence or insight suggests that there is significant local equality progress or challenge for local communities as people transit from one service to another. For all protected groups, assess and grade how well transitions are made, including how well patients, carers and professionals are kept informed of what is happening. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

Quality Team

1. Care act and MCA DoLs

The CCG works closely with providers with who they commission in terms of seeking

assurances around patients from protected groups. Those patients who may be at risk of harm due to physical or cognitive issues are affored protection under legislation such as the Care Act and MCA DoLS.

2. Compliance Visits

The CCG have robust processes in place to ensure that Compliance visits are undertaken to Commissioned Services. There are specifically undertaken to Care Home and Continuing Care venues.

3. Incidents a. Agreed Serious Incident Policy

Both the CCG and providers having the necessary polices and training in place which they must apply to practice.

Key learning from reviews of serious incidents and safeguarding concerns which may require review via a SAR or DHR are contributed to across the multiagency stakeholders.

The attached toolkits are used for the visits to ensure the CCG are assured NHS services are compliant.

Monitoring tool Compliance Visit

providers JuLY 2015 V3.docx

Serious Incident

Policy 2016 APPROV

All incidents which meet the criteria of a serious incident (definition on page 6-7 in the policy) are reported on a national database by providers who are providing NHS funded care to patients. There is a national framework (issued by NHS England) which must be complied with in relation to reporting of serious incidents, the timeframe for reporting and the timeframe for conducting an investigation and submitting the report to the commissioner. There are also Duty of Candour regulations which must be adhered to by all providers, involving the patient and/or family.

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b. The CCG holds a Serious Incident Review Group which meets each month to review and scrutinise all investigation reports.

c. Serious incidents and themes and trends are also discussed at the provider contract and quality meetings.

d. The CCG is also in the process of implementing an incident reporting database across all GP practices in Warrington.

There are a range of professionals including GPs, secondary care physician and designated nurses. The Group provides feedback to the provider in relation to any additional assurance required but seeks to ensure that a robust investigation has been carried out, contributory factors and root cause identified and a robust action plan to address any issues to ensure there is no reoccurrence of a similar incident. Occasionally, the Group requires attendance from clinicians or the investigator for further assurance and discussion before the incident is closed on the system.

A quarterly report is submitted to the CCG Quality Committee to give an overview of the incidents and any themes and trends. Serious incidents and themes and trends are also discussed, when relevant, at the provider contract and quality meetings. For example, there was a recent discussion with one provider as there was some concern about the provider process and further assurance was required.

The CCG is also in the process of implementing an incident reporting database across all GP practices in Warrington. Currently, there are five practices which have gone live but there is a plan to implement across all practices. Intelligence from incidents is being discussed at the Primary Care Medical Quality Committee to ensure that any lessons learned are cascaded where appropriate and intelligence is also used to feed into provider contract and quality meetings if there has been an incident involving another provider.

The contract and quality meetings for all main providers also include regular updates on safety issues including governance reports (including complaints, incidents, serious incidents). These reports will provide the qualitative and quantitative information about safety

1.5 Screening, vaccination and other MAH 1. Making Every Contact Count Current Position

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health promotion services reach and benefit all local communities. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge for people’s safety. For all protected groups, assess and grade how well key aspects of safety are prioritised or managed. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

KH

ZG

MAH, ZG,KH

(MECC)

a) Through the CCG Local

Enhanced Service with Primary Care Making Every Contact Training has been included.

2. Flu Jabs

a) To promote flu jabs across the communtity and to vulnerable groups

3. Public Health Campaigns

a) Through the CCG Local Enhanced Service with Primary Care six evidence based campaigns delivered per

Taken from Brand Enhanced Service Quality Requirements

Individual practices to identify a named public health

champion to be the contact for PH campaigns

Primary Care frontline staff to be trained in MECC Additional considerations

PPG representatives to support the Practice Public Health Champion

Offer MECC training to PPG reps

Outcomes

To enable prevention focused workforce, with the understanding and skills for promoting patient self-care, health promotion, good health and wellbeing, and to support the self-care agenda by developing primary care environments where people feel empowered to manage their own health

In conjunction with Public Health and Warrington’s Winter Communications the flu jab is promoted across Warrington.

WCCG Winter

Communications Plan

Regarding Carers this has been promoted through Warrington’s Carers Partnership Board. Flu jabs have has been promoted through Speak up for people with Learning Disabilities

Campaigns have been identified with Public Health and other Public Campaigns the CCG will promote include:

Alchol Awareness

C4L Food Smart

Antimicrobial Resistance

Bowel Cancer Awareness

- 8 -



annum in partnership with public health

b) Promotion of public health messages to people with learning disabilities

Blood Pressure Awareness

Change 4 Life

World Suicide Prevention Day

Stoptober

World Mental Health Day

Winter Health These will be promoted within each Practice to ensure they reach as much of the community as possible.

Public Health are to be involved in the PPG Network for PPGs to support promoting the public health campaigns

The campaigns will be promoted to the CCGs Health Forum, for them to cascade to their groups and networks

Public Health campaigns above will also be promoted to Speak Up (charity who support people with LD) in an interactive and accessible format.

The CCG support Speak Up with quarterly events, focusing on health and wellbeing. Screening and Public Health messages are key to these events. Easy read resources are available aswell as blood pressures checks and weight and height checks.

Flu vaccination.pdf Blood pressure.pdf

- 9 -



4. Annual Health Checks Learning Disability health checks within Primary care are facilitated via work provided by 5BP, to ensure that early detection of disease and onward referals for screening and intervention are provided to assit in reducing disease progressiona and reducing early deaths in this group of people

Primary Care Health Facilitaor in post

Evidence of health action plans

LD graph for comms.pdf

Goal 2: Improved patient access and experience Outcome Lead Grade Actions for 2016 - 2017

2.1 People, carers and communities can readily access hospital, community health or primary care services and should not be denied access on unreasonable grounds. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge for people when they try and access services. For all protected groups, assess and grade how well the service is accessed, taking into account the fairness of the reasons when access is denied. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

KH 1. Increase positive experiences of people with learning disabilities.

From feedback from events targeting people with learning disabilities. Work with people with Learning Disabilities to review their experiences and ensure that access to health services are not hindered on unreasonable grounds.

a) To work with 5BPS LD Team to encourage Primary Care to use the RCGP easy read template for Annual

Current Position Information included in GP Bulletin regarding Annual Health Check and support available. LD Team attended the PPG Network to speak to patients to encourage their practice to support patients with learning disabilities.

Easy read information is available to people with learning disabilities, these are disseminated at quarterly events which are attended by over 100 people and their carers.

The interface with the LD team and facilitator for primary care when hospital admissions occur assist to address matters around making reasonable adjustments, in terms of time slots, desensitisation , environment etc

Training has been given to Practice Nurses from the LD Team

- 10 -


Health Check.

b) To raise awareness of the 5BPS LD Team within GP Practices via Clinical Commissioning Bulletin and PLT sessions for GPs and Practice Nurses.

c) Information passed to WRAG Team to review the Guidance and action as appropriate.

d) To work with 5BPS and WHHFT to review if the Let’s Check information can be incorporated into the Trust, similar to Forgot Me Not for dementia patients.

2. Improve the cervical/ breast/ bowel screening rates in LD

Total number of LD patients in practice

Number of patients invited in for an annual LD health checks

No of LD health checks completed

No of patients invited to be screened

Practice to evidence working with the specialist LD Nursing Team to:-

- understand capacity and consent issues.

- commence desensitisation

including supporting patients with a learning disability, undertaking the Annual Health Check and providing appropriate support.

Let's Check PLT

Presentation Jan 201

Primary Care Development group, have agreed that year one will be to ascertain the baseline and identify the gaps. Year 2 will set the standard and to ascertain what is currently being done, with a view to a stretch target for year 2.

LD Team have worked with the PPG Network to raise awareness of the Team and their work and to encourage the PPGs to raise awareness with their patients.

- 11 -


programme

Outcomes

To reduce health inequalities and improve the quality of life for patients with an LD.

3. Veterans Through the CCG’s Local Enhanced Service with Primary Care, CCGS are actively promoting the recording of patient’s veteran and reservist status within their GP Practices.

Outcomes

To ensure veterans and their families receive priority and access to treatment that they are entitled to

4. Dementia

Through the CCG’s Local Enhanced Service with Primary Care the CCG and Primary Care will:

1. Maintaining rates of diagnosis

2. Complete advanced care planning for all dementia patients

3. Each practice to evidence of working with the CCG

GP Practices to increase the recording all military veterans on their systems. There are 11,818 veteran population in Warrington but only 1653 currently recorded on GP systems.

Number of Military Veterans on system at Q1

Evidence of communication and engagement of consistent messages to the public

Routinely asking patients directly if they have ever served in the armed forces.

GP clinical system have a prompt and template for asking patients

Displaying the official armed forces poster in waiting areas.

Appropriate use of the veteran read codes V5

CCG has created a Dementia Transformation Board to deliver on key actions from the dementia strategy. Some of the key action points are relevant to primary care. Practices are expected to support key deliverables to ensure delivery of the dementia strategy for Warrington.

This will include as a minimum the following:-

- GPs to receive training to cover learning disabilities, BME incidence and young onset presentations of dementia

- Participate in liaison arrangements (once agreed) which will enable GPs to receive regular, expert advice and support from secondary care dementia services.

- 12 -


to support the delivery of

the local dementia action plan.

Outcomes

To improve the diagnosis and care of patients with dementia. The benefits of timely diagnosis and referral will enable them to plan their lives better, to provide timely treatment if appropriate and to enhance quality of life.

5. Increasing Access to Psychological Therapies (IAPT) Expansion work is rolling out the provision of NICE approved psychological interventions, in an accessible and timely pathway, to patients in Warrington with Long Term Conditions (LTC) and Medically Unexplained Symptoms (MIUS). Evidence shows that many patients with a LTC such as diabetes or Chronic Obstructive Pulmonary Disease (COPD) will have a comorbid mental health condition such as depression or anxiety. By offering these interventions it is anticipated that patients will be able to cope with their LTCs or experience a reduction in their MUS presentations and thus reduce their need to access health care.

- Support delivery of formal pathways to improve liaison

screening and on-going patient management, between hospital and GPs and community health and social services

Utilise the primary care collaborative clusters in Warrington to provide innovation and best practice at cluster level with special interest GPs providing dementia advice and support to colleagues within each cluster

To date Mental Health Matters (Warrington’s IAPT provider) has expanded workforce to start seeing this patient cohort , working closely with a selection of GP practices to do the first cycle roll-out.

Warrington Offer

Letter.pdf

- 13 -


6. Carers

GP and Hospital Discharge Worker The CCG, as part of the a joint contract with WIRED Carers fund this post to ensure that carers are supported within Primary Care and within hospital.

7. Vulnerable Communities The CCG fund a post within Warrington Borough Council to work and support vulnerable communities in accessing healthcare. The worker predominately works with people with mental health problems, BME communities and other vulnerable groups.

There has been an increase in the numbers of carers registered at their GP Practice. The worker regularly attends the CCG Health Forum and feed in issues and carers experiences. The worker has now got a base within Warrington Hospital to support carers and staff, this has proved extremely positive and beneficial.

The worker regulars attend the CCG Health Forum to feed in issues and experiences. Below is the structure and process for the worker

SP Role and

Reporting.pdf

2.2 People are informed and supported to be as involved as they wish to be in decisions about their care. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge in relation to information and support people receive, so they can be involved in decisions about them. For all protected groups, assess and grade how well people are informed and supported. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

1. Mental Capacity Act

Support for Primary Care with the production of a MCA template which sits on the GP system to ensure capacity assessments are undertaken and recorded along with best interest decision making.

Identified training at PLT for Practice Nurses in Jan 2017 in relation to patients with LD health screening and application of MCA

MCA PLT event for GPs planned

Current Position

Primary Care has access to the CCG MCA policy

WRAG referral form now has capacity questions added after instructions from Safeguarding Lead

Supporting Indicators Training date identified and planned by 5BPS Learning Disability Team

- 14 -


for March 2017

2. Personal Health Budget a) End of life

The CCG is now successfully delivering personal health budgets to Continuing Healthcare / Continuing Care (Children), End of Life and joint health / social care funded care packages.

b) Wheelchairs

Wheelchair personal health budgets will be introduced during 2017-18 in order to offer wheelchair users more choice and personalisation of their chairs.

Personalising End of

Life Care.pdf

The CCG will be working across all ages on this. Engagement is currently being undertaken to understand people’s current experience of the Wheelchair Service and the use of PHB.

2.3 People report positive experiences of the NHS. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge in relation to people’s experiences or services. For all protected groups, assess and grade how well the service is experienced. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

Ind commi ssione

rs

KH

1. External Experiences

a) Health Forum b) PPG Network c) Carers experience d) Vulnerable groups e) Family and Friends

2. Engagement Work The CCG are committed to engaging with the community to ensure their experiences are obtained. Varying methods are used for this, including annual public events, specific focus groups, surveys, attending Third

Current Position

Information is gathered from a range of sources. Information is collected through Datix where trends and themes are able to be identified to use within Contract Meetings

027 15 Engagement Experience and Com

- 15 -


KH/ MA

KH

Sector groups and events.

3. CCG Structures a) Patient Experience and Quality Meeting

The CCG are currently in the process of setting up a Patient Experience and Quality to discuss and identify themes and trends from our provider PALS and complaints, Healthwatch data and reports, Family and Friends test information.

b) Governing Body Feedback from the Health Forum including patient experiences are shared bi monthly at the CCG Governing Body

c) Quality Committee Feedback from the Health Forum including patient experiences are shared bi monthly at the CCG Governing Body

3. Healthwatch Information

CCG receive Healthwatch Reports and Enter and View visits.

TOR Amended.pdf

Feedback from

Health Forum.docx

Process for

Healthwatch Warringt

2.4 People’s complaints about services are handled respectfully and efficiently. Choose one or more care setting or service where evidence or insight suggests that there is significant local equality progress or challenge in handling complaints. For all protected groups, assess and grade how well complaints are handled. If needs be, choose specific types of people within each

PALS &

Compl aints team

1. Monitoring information

a) Introduction of monitoring

across all protected

characteristics for formal

complaints.

Current Position

DATIX complaints process:

Confirmation of receipt of complaint by day 1 if email/tel

number provided by complainant

3 day written acknowledgement sent to complaint, Complaint

- 16 -


protected group, where key lessons can be learnt and applied. b) Any issues raised

regarding discrimination

are highlighted to the

CCG E & D Lead.

issues identified & detailed within acknowledgement for

review by comlainant. E & D monitoring form sent to

complainant with acknowledgement letter.

Complaint fielded for Investigation (once appropriate consent

in place)

Investigation/Response reviewed by CCG

Final Response/Cover Response drafted

Final Response sent to complainant

The below monitoring form will be sent out with all acknowledgement letters for formal complaints raised to NHS Warrington CCG from now, where the CCG is managing the complaint.

2016-10-12 E D

MONITORING FORM

Supporting Indicators

Equality Act 2010

Goal 3: A representative and supported workforce Outcome Lead Grade Actions for 2016 - 2017

- 17 -


3.1 Fair NHS recruitment and selection processes lead to a more representative workforce at all levels. Choose one or more pay band, specific profession, care setting or service where evidence or insight suggests that the protected groups are well or not well represented. For all protected groups assess and grade how well the workforce is representative, taking into account the fairness of recruitment and selection processes. If needs be, chose specific types of people within each protected group, where key lessons can be learnt and applied.

CSU - HW/ LG

CCG – TBC

Achieving a) Identify any gaps and any areas that require targeting regarding the protected characteristics.

b) Develop action plans for any gaps identified (consider follow up survey for new starters to evaluate their experience and feedback to shape future processes)

c) Toolkit training for managers to commence Oct 2016

Current Position

Recruitment is completed through the national NHS Jobs 2 system or via the intranet system. NHS Jobs is a web-based system allowing applications worldwide. Appointing managers have received appropriate training to ensure fair and transparent systems which can be challenged. Equality data collected at recruitment stage is not available to the shortlisting manager but is available for monitoring purposes only. Additionally when manager’s shortlist applications are anonymised. The CCG is committed to the Two Ticks symbol to guarantee disabled people an interview if they meet the minimum criteria. Recruitment and workforce equality data collated annually for review. The CCG has had no Employment Tribunal cases of grievances regarding recruitment and selection for any protected characteristics.

Supporting Indicators Equality Act (2010) Public Sector Duties

3.2 The NHS is committed to equal pay for equal work of equal value and expects employers to use equal pay audits to help fulfil their legal obligation. Choose one or more pay band, specific profession, care setting or service where evidence or insight suggests either equal pay progress or problems may be found. For all protected groups assess and grade the extent to which they receive equal pay for work of equal value. If needs be, chose specific types of people within each protected group, where key lessons can be learnt and applied.

CSU - HW/ LG

CCG – TBC

Achieving a) To continue Agenda for Change job evaluation and matching process (this process is managed externally and totally independent)

b) To identify any gaps from the pay bands equality data that would demonstrate any disadvantages for protected characteristics. Develop action plans for any gaps identified

Current Position

The CCG uses the Agenda for Change NHS national job evaluation scheme for all of its posts

The CCG has no equal pay claims regarding protected characteristics for pay or terms and conditions.


3.3 Training and development opportunities are taken up and positively evaluated by staff. Choose 10- 20 training courses and development opportunities where evidence or insight suggests that the protected groups do or do not participate. For all protected groups assess and grade participation in, and evaluation of, training and development opportunities. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

CSU - L&D team

CCG – AD/NA

Achieving a) Link to training needs analysis and training / learning uptake

b) Implement new PDR and PDP process

c) Continue and expand staff development programme

Current Position

a) Recording and reporting of all statutory and mandatory training (dashboard)

b) New PDR process developed by staff group and implemented across the organisation that highlights staff development needs and PDP

- 18 -


d) Support staff training on

individual basis when identified through PDP

c) CCG Staff development programme for all staff held on a monthly basis

d) Staff supported to attend individual training when identified through PDP. This is currently through a number of routes including 1 day courses, NVQs and structured learning programmes with the NHS Leadership Academy


3.4 When at work, staff are free from abuse, harassment, bullying and violence from any source. Choose one or more pay band, specific profession, care setting or service where evidence or insight suggests that protected groups are relatively free from, or disproportionately, subject to abuse, harassment, bullying and violence. For all protected groups assess and grade the extent of the abuse, harassment, bullying and violence. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

CSU - HW/ LG

CCG – AD/NA

Achieving a) Bullying & Harassment Policy in place

b) Development of staff networks in collaboration Comms Team - consider a network of workforce diversity champions

c) Toolkit training for managers to commence Mar 2017

d) Develop basic Q&A page for self-help guidance

e) Development of e:learning module for staff and managers

Current Position a) B&H Policy in place b) Whistleblowing Policy in place c) Staff awareness sessions held around HR policies d) Manager training held which included handling concerns

raised by staff and having difficult conversations e) On-boarding guide produced to ensure all new starters are

aware of CCG policies and culture

Supporting Indicators

a) Access for staff to support services via Occupational Health

3.5 Flexible working options are available to all staff consistent with the needs of the service and the way people lead their lives. Choose one or more pay band, specific profession, care setting or service where evidence or insight suggests that protected groups can readily access, or have difficulty accessing, flexible working options. For all protected groups assess and grade the availability of flexible working options. If needs be, choose specific types of people within each protected groups, where key lessons can be learnt and applied.

CSU - HW/ LG

CCG – AD/NA

Achieving a) Flexible Working Policy in Place

b) Toolkit training for managers to commence Mar 2017

c) Develop basic Q&A page for self-help guidance

Current Position The policy aims to address the increasing demand for more flexibility in working practices in order to accommodate the personal goals and commitments that employees experience in their working lives including a common procedure for the semi- retirement of staff. It covers part time and term-time only working, annualised hours, zero hours/bank/casual working, voluntary moves to lower pay bands, return to work after family leave, flexi- time systems, flexible self-rostering. Flexible working should be available to all employees and should enable the organisation to

- 19 -


recruit and retain skilled staff, raise staff morale, reduce

absenteeism, respond to changing market conditions more effectively and allow more mature employees a more effective work life balance in regard to flexible retirement.


3.6 Staff report positive experiences of their membership of the workforce. Choose one or more pay band, specific profession, care setting or service where evidence or insight suggests that protected groups have positive experiences, or not-so positive experiences, of their membership of the workforce. For all protected groups assess and grade how well membership of the workforce is experienced. If needs be, choose specific types of people within each protected group, where key lessons can be learnt and applied.

CSU - HW/ LG

CCG –

LG

Achieving a) Development of Staff Networks - consider a network of workforce diversity champions

b) Quarterly mini survey (survey monkey) to explore hotspots / trends

Current Position a) Annual Staff Survey – results reviewed and targeted action

plans developed and owned

Goal 4: Inclusive leadership at all levels Outcome Lead Grade Actions for 2016 - 2017

4.1 Boards and senior leaders routinely demonstrate their commitment to promoting equality within and beyond their organisations. Choose 10-20 instances when board members and senior leaders had the opportunity to demonstrate their commitment to equality in the past year or, if needs be, a longer period. For the selected instances, assess and grade the extent to which the Board and senior leaders showed a strong and sustained commitment to promoting equality, within and beyond the organisation.

CCG – DB/NA

Achieving a) Governing Body approval of 16/17 equality plans

b) Governing Body level champion for equality

c) Senior manager training on equality and equality impact assessments

d) Governing Body requires all major commissioning or service changes to have appropriate equality assessments.

a) The Governing Body approved the 16/17 equality plans for the CCG at its meet in March 2016.

b) Nick Armstrong, Chief Operating Officer, is the CCGs Governing Body identified champion for equality.

c) Senior manager training on equality issues and equality impact assessments delivered by Midlands & Lancashire Commissioning Support Unit.

d) The Governing Body has deferred decisions on some policy changes such as prescribing of over the counter medicines until full equality impact assessments had been completed and could be presented to the meeting.

- 20 -


4.2 Papers that come before the Board and other major committees identify equality related impacts including risks, and say how these risks are to be managed. Select 10-20 substantive papers that came to the Board and other major committees in the past year or, if needs be, a longer period. Assess and grade the extent to which the selected papers took account of equality-related impacts including risks, and said how risks will be managed. Impacts and risks should be related to the three elements of the general duty of the Public Sector Equality Duty.

CCG – DB/NA

Achieving a) All papers to include standard cover sheet which highlights if there are any equality related impacts.

b) All major commissioning or service changes to have appropriate equality assessments.

a) Standard cover sheets are used for all Governing Body and Committee meetings which require report writers to identify if there are equality related impacts. If impacts are identified an equality impact screening tool or full assessment are required to attached to the report to provide assurance as to what risks have been identified and how these will be mitigated.

b) In the past 12 months there have been 2 major commissioning decisions reviewed by the CCG that have required the inclusion of full equality impact assessments these have been;

a. prescribing of over the counter medicines b. relocation of GP Out of Hours

- 21 -

Equality Delivery System2 EDS2 is an assessment tool designed to measure NHS equality performance with an aim to produce better outcomes for people using and working in the NHS and to gather equality evidence that demonstrates compliance with the Public Sector Equality Duty (PSED) of the Equality Act (2010).

NHS Warrington CCG have undertaken our EDS2 assessment for 2016-17 using a new toolkit and by engaging with representatives from Third Sector organisations who represent and work with the protected characteristics in the Equality Act (2010).

This new approach enables the CCG to more effectively capture work that is being undertaken locally that produces better outcomes for patients and staff.

Taking into consideration all the evidence that the CCG produced, the CCG self- graded and then held a grading event for community representatives to discuss the evidence and grading for a final grading to be agreed.

This report is a summary of the discussions.

The event took place on Monday 27th February 2017 for representatives of Healthwatch and Third Sector Organisations to discuss the action plan and the grading.

Representatives in attendance were:

Healthwatch

WIRED Carers

Trans* Warrington

Warrington Ethnic Communities Association

Polish Community

Children’s Society

Long Term Conditions Group

Speak Up (Learning Disabilities)

Warrington Borough Council Vulnerable Communities Worker

Excelling - means doing very well. Covers all protected groups

Achieving - means is doing well but could do more. Covers over half of the protected groups

Developing - means is doing OK but needs to do more. Covers less than 3 protected groups

Undeveloped – means needs to do much more. No evidence of covering a

protected group

GOAL 1: BETTER HEALTH OUTCOMES

1.1 Services are commissioned, procured, designed and delivered to meet the health needs of local communities

CCG Self Grade

Event grading

Discussion from the day

The group felt consistent and measured mechanisms and approaches are in place to ensure services are commissioned to meet the health needs of local communities.

ACTION - The group felt the CCG could improve the monitoring of how providers are delivering services.

ACTION - Evidence of the Information Standard should be included as evidence.

1.2 Individual people’s health needs are assessed and met in appropriate and effective ways

CCG Self Grade

Event grading


ACTION - The CCGs work on unaccompanied child asylum seekers should be highlighted and used as evidence.

Work can be improved in Continuing Healthcare linking more to Social Workers

1.3 Transitions from one service to another, for people on care pathways, are made smoothly with everyone well-informed

CCG Self Grade

Event grading


More needs to be done by the CCG in order for transition pathways to be smooth and well planned, including between services and between key stages.

There needs to be more of an understanding of what is actually happening by providers. The CCG have contracts

and pathways in place but this might not always be happening.

ACTION – The CCG to identify methods to gain more of an understanding of actual experiences, to use Healthwatch, PALs and Complaints information.

1.4 When people use NHS services their safety is prioritised and they are free from mistakes, mistreatment and abuse

CCG Self Grade

Event grading


The group asked for more evidence to be forwarded to them. This was information on:

The process of Compliance Visits

The process of serious incidents

Information on incident reporting database across all GP practices in Warrington.

The contract and quality meetings

Information on Care act and MCA DoLs

Once the evidence was viewed it was agreed to be achieving

1.5 Screening, vaccination and other health promotion services reach and benefit all local communities

CCG Self Grade

Event grading


It was agreed the CCG is excelling in this goal for people with learning disabilities, in terms of engaging with this group of people to obtain their views and experiences and improving access to services. The LD team within 5BPS were also praised.

ACTION – The CCG to increase their engagement work with vulnerable communities, children and young people and the BME communities to replicate this good work. This increased engagement should result in increased understanding of health services and increased understanding of barriers to access services

GOAL 2: IMPROVED PATIENT ACCESS AND EXPERIENCE

2.1 People, carers and communities can readily access hospital, community health or primary care services and should not be denied access on unreasonable grounds

CCG Self Grade Event grading

2.2 People are informed and supported to be as involved as they wish to be in decisions about their care


2.3 People report positive experiences of the NHS


2.4 People’s complaints about services are handled respectfully and efficiently


GOAL 3: A REPRESENTATIVE AND SUPPORTED WORKFORCE

3.1 Fair NHS recruitment and selection processes lead to a more representative workforce at all levels


3.2 The NHS is committed to equal pay for work of equal value and expects employers to use equal pay audits to help fulfil their legal obligations


3.3 Training and development opportunities are taken up and positively evaluated by all staff


3.4 When at work, staff are free from abuse, harassment, bullying and violence from any source


3.5 Flexible working options are available to all staff consistent with the needs of the service and the way people lead their lives


3.6 Staff report positive experiences of their membership of the workforce


GOAL 4: INCLUSIVE LEADERSHIP

4.1 Governing body members and senior leaders routinely demonstrate their commitment to promoting equality within and beyond their organisations


4.2 Papers that come before the governing body and other major Committees identify equality-related impacts including risks, and say how these risks are to be managed


4.3 Middle managers and other line managers support their staff to work in culturally competent ways within a work environment free from discrimination


Conclusions and Recommendations

An action plan will be developed to start to address the discussions and suggested actions from the day.

A six monthly event will be organised for those present to discuss progress of the CCGs EDS2 Action Plan for 2017-18.

REPORTING TEMPLATE

Name of CCG Organisation Reporting Peri od

Warrington CCG Year 2016 Month April

Name and Title of Governing Body lead for the Workforce Race Eqiuality Standard (WRES)

Name and contact details of CM CMSU employee’s compiling this report

Hayley Moorehouse Human Resources Business Partner and Andrew Morey Workforce Information Manager

Name and contact details of co-ordinating CCG manager

Nick Armstrong

Name and contact details of CCG employee’s this report has been sent to

N/A

Unique URL link on which this report will be found (added after submisison)

N/A

This report has been signed off by the signatory below on behalf of the CCG Governing Body (Insert name and date)

REPORT on the WRES Indicators

1.0 Background Narrative

a. Any Issues with the completeness of the data being presented

The workforce and Human Resources data presented within this report is from the standard NHS Human Resources system, the ‘Electronic Staff Record’ and the personal filing and note taking procedures used by a variety of Human Resources staff. From the inception of the CCG in April 2013 both ESR and the Human Resources service has been managed on behalf of the CCG by the Cheshire and Merseyside CSU Human Resources Team using a standard set of processes and procedures. All of the records within ESR are self declared either through an application form via NHS Jobs or through an ESR paper application form which is manually input.

The ESR data is quality tested on a monthly basis by the NHS Central team and the CCG, since April 2013, has regularly been ranked as number one in the country for data quality.

b. Any matters relating to the reliability of comparisons with previous years.

Both the ESR system and the Human Resources service have been managed on behalf of the CCG since April 2013 using s standard set of processes and procedures to ensure that the results achieved are both consistent and accurate. Therefore the ESR data and Human Resources information being used within this document is directly comparable with both previous and future years.

2.0 Total Numbers of Staff

a. Employed within this organisation at the date of the report

76

b. Proportion of BME staff employed within this organisation at the date of the report

6.58%

REPORT on the WRES Indicators, continued

3.0 Self Reporting

a. The proportion of total staff who have self-reported their ethnicity

97.4%

b. Have any steps been taken in the last reporting period to improve the level of self-reporting by ethnicity

No

c. Are any steps planned during the current reporting period to improve the level of self-reporting by ethnicity

The individuals who have not stated their ethnic group will be emailed to see if they now wish to do so.

4.0 Workforce Data

a. What period does the organisation’s data refer to

The data was drawn as at April 1st 2016


5.0 Workforce Race Equality Undicators

Indicator

Data for reporting year

Data for previous year

Narrative – the implications of the data and any additional background explanatory narrative

Action taken and planned including e.g. does the indicator link to EDS2 evidence and/or a corporate Equality Objective

For each of these four workforce indicators, the Standard compares the metrics for white and BME staff.

1

Percentage of BME staff in Bands 8-9, VSM (including executive Board members and senior medical staff) compared with the percentage of BME staff in the overall workforce

BME Staff 12.9% Overall 6.58%


HRBP

The CCG has refereshed it Equality & Inclusion Strategy and will have Equality Objective linking EDS 2 Goal 3 Represented & supported workforce Goal 4 Inclusive Leadership

2

Relative likelihood of BME staff being appointed from shortlisting compared to that of White staff being appointed from shortlisting across all posts.


BME Staff 0% Overall 9.52%

HRPB

EDS 2 Goal 3 outcome 1 Fair NHS recruitment & selection processess lead to a more representative workforce at all levels

3

Relative likelihood of BME staff entering the formal disciplinary process, compared to that of White staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation* *Note: this indicator will be based on data from a two year rolling average of the current year and the previous year.

HRPB

HRPB

HRPB

No complaints have been made to date

4

Relative likelihood of BME staff accessing non-mandatory training and CPD as compared to White staff

HRPB

HRPB

HRPB

EDS 2 Goal 3 Represented & supported workforce Goal 4 Inclusive Leadership

REPORT on the WRES Indicators, continued 5.0 Workforce Race Equality Undicators

Indicator

Data for reporting year

Data for previous year

Narrative – the implications of the data and any additional background explanatory narrative

Action taken and planned including e.g. does the indicator link to EDS2 evidence and/or a corporate Equality Objective

For each of these four staff survey indicators, the Standard compares the metrics for each survey question response for White and BME staff.

5

Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months

Staff Survey

Staff Survey

HRPB

EDS 2 Goal 3 Represented & supported workforce

6

Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months

Staff Survey

Staff Survey

HRPB

EDS 2 Goal 3 Represented & supported workforce

7

Percentage believing that the CCG provides equal opportunities for career progression or promotion

Staff Survey

Staff Survey

HRPB

EDS 2 Goal 3 Represented & supported workforce Goal 4 Inclusive Leadership

8

In the last 12 months have you personally experienced discrimination at work from any of the following? b) Management/team leader or other colleagues

Staff Survey

Staff Survey

HRPB

No allegation have been made to date

Does the Governing Body meet the requirement on membership in 9?

9

Governing Bodies are expected to be broadly representative of the population they serve

Pop 7.05%

GB Pay 14.3%

There are currently 13 out of 14 Governing Body members recorded in ESR and there are two who would be classed as BME giving 14.3%


6. Are there any other factors or data which should be taken into ocnsideration in assessing progress. Please bear in mind

any such information, or action taken and planned may be subject to scrutiny by the the Co-ordinating CCG Manager or by

regulators when inspecting against the “well led domain”.

7. If the organisation has a more detailed Plan agreed by its Board for addressing these and related issues you are asked to

attach it or provide a link to it. Such a plan would normally elaborate on the steps summarised in section 5 above setting out the

next steps with milestones for expected progress against the metrics. It may also identify the links with other work streams

agreed at Board level such as EDS2.

No

No alligation have been made however we have Re Developed EDS 2 Action plan and linked it to goals 3-4

equality and diversity - warrington ccg and diversity...grading group and the ccg equality champions...

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