Quality & Equality Workshop

Delegates: Primary Care Staff 2012

Julia Allen, Equality & Diversity Manager

Learning Objectives & Outcomes

Programme AimsThe course will introduce participants to the Equality Act 2010

By the end of the course participants should be:

Familiar with the concepts of “protected characteristic groups” and “prohibited discrimination”

Able to identify circumstances and situations where discrimination may occur

Have an understanding of what is required of public authorities and their contractor partners ie those carrying out public functions

Be able to understand in a commissioning or provider context what is lawful and unlawful under the Equality Act 2010 and the PSED

Workshop Aims To raise awareness and increase knowledge of diversity and equality of

opportunity issues as an: employer, commissioner & service provider or contractor partner

To evidence the essential link between quality and equality To explore the enabling role that managers, staff & partner organisations

are expected to play in the delivery of fair and accessible services to a diverse range of patients, carers and colleagues

Raise confidence sufficiently to enable managers, staff & partners to recognise & challenge inappropriate behaviour and prohibited discrimination

To raise awareness of Hate Crime - how to recognise & report & our duty of care to recognise, act & support alleged victims of hate crime

What will we cover today that impacts on our practice in NHS?

Equality Act 2010 Equality Duty from 6 Apr 2011 & 10 Sept 2011 New Discrimination Framework & new types of discrimination Diversity + Inclusion = Equality Case Studies & Scenarios Interactive sessions to put some of this information into practice

What is Equality?The Equalities Review, led by Trevor Phillips in

2007, defined the meaning of equality as follows:

“An equal society recognises people’s different needs, situations and goals, and removes the barriers that limit what people can do and be.”

Quality service provision is a key component of creating a fairer society.

E&D: A broad inclusive concept

Overview: What’s it all about?

It’s about understanding people & the workplace implications of their differences and their similarities

It’s also about how people access information, services, premises and employment

How the NHS commissions inclusive services

What is Equality?Diversity + Inclusion = Equality

Equality Equal opportunities is focused on the eradication of discrimination

•• creating an environment where everyone has equal access to a range of benefits such as employment, training – and healthcare

• providing the right to equivalent opportunities for employment regardless of difference that is irrelevant to someone’s ability to do the job properly

• a legal requirement

• Problem focused

What is Diversity?Diversity + Inclusion = Equality

Diversity Recognising & valuing difference & deriving business benefits

from the added value diversity brings Reaching all parts of our local communities with our information

& services Developing a more representative workforce Improving our business performance.

Diversity is about more than remaining within the law It’s widely agreed to be positive for business

Opportunity focused

No equality without inclusion

Diversity + Inclusion = Equality

Quality can’t be delivered successfully without equality as an integral part of our practice

Our attitudes, behaviours & assumptions in the workplace can make the difference in achieving inclusion

In an interview situation how are we ‘seduced by sameness’?

How much of the decision making process for who is recruited is based on what the candidate:

Halo & Horns research Says? % How they sound? eg tone of voice, accent % How they look? % Bletchley Park 1940 - Alan Turing Famous code breaker Laid foundations for the first PC - Colossus Urban legend – Apple logo?

Human Rights overview

Human rights seek to ensure that people are treated with fairness, respect, equality, dignity and autonomy in their everyday experience of public services

- Fairness - Respect- Equality- Dignity - Autonomy ie self directed

Demographic profiling:NHS T&G serves a population of approx

245,000 people of which: Disability: 20% have at least 1

disability or long term health condition (49,000 people)

Age: 24.8% are 60 & over (>60,000 people)

LGB: Around 19,000 people or 5% to 7% of people in Tameside are estimated to be lesbian, gay, bisexual. Of these people, many access the specialist services delivered by the Lesbian & Gay Foundation in Manchester each year.

This figure is an estimate based on the Treasury’s 5-7% estimate of the LGB population that they made in advance of civil partnership legislation back in 2005.

Race: 7.32% belong to the BAME population (<18,000 people)

Latest Equality Legislation

Harmonising existing plethora of legislation into one new Act

New Equality Act 2010 – 90% came into force from 1 October 2010 providing a modern, single legal framework with clear, streamlined law to more effectively tackle disadvantage and discrimination.

6 April 2011 introduced new Single Equality Duty on all public bodies & their contractor partner organisations

More accountable to the public – under transparent rights & responsibilities

Equality Act 2010 – the background

Pre 1 Oct there were 116 pieces of discrimination legislation & 13 Codes of Practice

After more than 30 years of discrimination legislation:

Women are still paid on average 22% less per hour than men. Nearly one in five people of working age have a disability and are twice

as likely to face bullying or harassment in the workplace as non-disabled people.

People from ethnic minorities are significantly less likely than average to be in work and when in work are paid less than average.

The big changes Public Sector Equality Duty (6 April 2011) Strengthened discrimination framework (includes new

types of discrimination) Pre-employment health questions removed (1

October 2010) Third party harassment Positive action provisions of the Equality Act come into

force 6 April 2011 Age discrimination in GFS likely 2012 – no specific

exception for health & social care Publication of information to demonstrate compliance

with the public duties by 31 January 2012 Publication of equality objectives by 6 April 2012

EDSThe Equality Delivery System is designed as a tool to be used to

help all staff and NHS organisations understand how equality can drive improvements and strengthen the accountability of services to patients and the public.

It will help ensure that everyone - patients, public and staff - have a voice in how organisations are performing and where they should improve.

Sir David Nicholson KCB CBE , NHS Chief Executive and Chair of NHS Equality & Diversity Council

29 July 2011

EDS 4 Goals   1. Better health outcomes for all

2. Improved patient access and experience

3. Empowered, engaged and included staff

4. Inclusive leadership at all levels [* includes required sign up to E&D Leadership Competency Framework]

Who is protected?The Act protects people who have a protected characteristic (theseused to be called grounds or strands). The relevant characteristics

are: •Age•Gender•Gender Variance (definition changed)•Disability (definition changed) •Race –this includes ethnic or national origins, colour & nationality •Sexual Orientation•Religion or Belief •Marriage and Civil Partnership•Pregnancy, Maternity & Breastfeeding Mums Carers * Military veterans *

What the Law prohibits

Discrimination is illegal

It is when someone acts based on assumptions, stereotypes or prejudice that discrimination can happen.

Discrimination means treating someone less fairly because they are from a particular group or background or because of perceived difference.

Types of discrimination *

Direct (Hate Crime) Indirect Positive Action Positive Discrimination Harassment (& 3rd party

harassment) Victimisation

New since 1 Oct 2010:

By perception

By association

Failure of duty to make reasonable adjustments

Types of DiscriminationWhat you need to knowDirect discrimination, includes eg Hate

Crime•Indirect discrimination•Harassment•Victimisation•Positive discrimination•Positive action √•Discrimination by perception•Discrimination by association•Discrimination arising from disability•Failure of duty to make reasonable

adjustments

ILLEGAL

Objective justification

• Direct discrimination, harassment and failure of duty to make reasonable adjustments cannot be justified.

• Indirect discrimination and discrimination arising from disability have an objective justification defence.

What is Hate Crime?

• Hate crime is a serious criminal offence committed against a person or property due to hatred of that person’s protected characteristic - gender, race, religion, colour, ethnicity, disability, gender variance or sexual orientation.

• Hate Crime is a form of direct discrimination (treating someone to a lesser service because of their protected characteristic(s)

• ILLEGAL

Disability Hate Crime

• The Association of Chief Police Officers (ACPO) and the Crown Prosecution Service have a nationally agreed definition of Disability Hate Crime

• Any criminal offence which is perceived, by the victim or any other person, to be motivated by a hostility or prejudice based on a person's disability or perceived disability.

• ILLEGAL

Recognise & Report Hate Crime Incidents

No incident is too small.Make a record of any incident and actions taken, for future reference.Alert the Safeguarding team where appropriate.

How you can report Hate Crime• Call the Police

In an emergency call 999. Ask for an officer to attend the victim’s home

• In a non-emergency victims should call 0161 872 5050 in Tameside• Reports of Hate Crime can be made anonymously• Report via Another Agency

There are a number of third party reporting centres in Tameside.

Discrimination by perception

Direct discrimination also includes: discrimination because a person is wrongly thought to have a particular protected characteristic or is treated as if they do.

ILLEGAL

Discrimination by association

Protecting carers from discrimination – arises from the above extension to discrimination

Means an employer could not refuse to recruit or promote someone because of their caring responsibilities

eg caring for a disabled person, or having caring responsibilities at any point on the age spectrum, that is caring for a child or elderly relative or other

The mother of a disabled child who is not herself disabled but who is treated less favourably because of her association with her disabled child (Coleman case)

ILLEGAL

What is harassment & victimisation?

Harassment Harassment is seen when

someone’s dignity is violated or an intimidating, hostile or offensive environment is created by unwanted behaviour or attitudes. Remember it is the victim’s perception that is most relevant here. Perception is reality.

ILLEGAL

Victimisation Being unfairly singled out for bad

treatment of some kind. Less favourable treatment of an employee because they have taken some action in relation to discrimination (e.g. they have made a complaint of direct or indirect discrimination or they have been a witness in such a case).

ILLEGAL

Failure of duty to make reasonable adjustments

A reasonable adjustment is a change a public body like the NHS needs to make to your practices (the way you plan and deliver a service for example), premises or business in order to meet the duties of the Equality Act 2010.

An example of a reasonable adjustment includes providing a reasonable number of parking spaces for disabled people near to the entrance to your GP surgery or hospital, or providing TypeTalk to deaf or hearing impaired patients or Text resize on your website pages for visually impaired patients or it may be a change to working practices, or to your workstation after assessment by Access to Work from Dept Work & Pensions or phoning a blind patient with appointment details or to request to come in for test results instead of by letter.

Scenario A

Jonathan is the partner of Kate, who is a resident of a local authority care home. Jonathan decides to undergo gender reassignment and staff at Kate’s care home discover this. As a result Kate is now treated less favourably by staff compared with other residents.

Is this:A) direct discriminationB) indirect discriminationC) discrimination by associationD) not discriminatory

Scenario B

A local dental service has a policy of reminding patients of forthcoming appointments by telephone. This puts deaf people who cannot use the telephone at a disadvantage, as they do not receive a reminder of their appointment.

Is this: (select 2)A) direct discriminationB) failure of duty to make reasonable adjustmentsC) not discriminatory

Scenario C• Jenny was the chair of an interview panel of four. • There were 7 candidates to interview, 3 men and 4 women, when

the last candidate came into the interview room, it was clear that the interviewee was different, she was well groomed and interviewed well.

• At the end of the interview Jenny asked the panel for their scores and their thoughts regarding the interviewees presentation and answering of the questions posed.

• There were two candidates who scored the same with little chance of splitting the two and both were female, however during the discussions regarding which candidate to appoint one panel member raised the issue about the final candidate being ‘obviously Trans’ and that this might cause issues with other staff and make them feel uncomfortable in relation to using same sex facilities such as the toilets.

• Was this discussion legal in the workplace?

Scenario D You are required to find a solution to a work based problem & need

to seek input from a qualified colleague who seems to have a ‘difficult communication style’

The other person is not helpful in response to your e-mail requests & has repeatedly sent you obstructive e-mails (at work) in reply to your reasonable questions & requests for help

This is the 4th separate occasion this has happened.

Is this treatment (towards you):A) harassmentB) victimisationC) not discriminatory? When could the person be personally liable for any damages

awarded?

Act brings new

Equality Duty

6 April 2011

CCG Authorisation Equality training included in the CCG Development Plan CCG is an active partner in the design, development and follow through of the next JSNA 2011 Service Strategies are developed with the full engagement of public / service user representative as

appropriate (QIPP leads and commissioning managers) AoEs are required for all commissioning decisions and business cases subject to inclusion in our

targeted Rolling Programme of AoEs for the next 12 months (QIPP leads and commissioning managers)

AoE targeted training is available monthly to nominated AoE Lead staff across the CCG. The CCG will require assurance from those working in its name (eg Commissioning Support Services) that due regard has been taken to evidence our compliance with the Equality Duty in terms of analysing any key decisions for likely adverse impact on protected groups.

CGG has established a relationship with and regular attendance at the Consumer Advisory Panel meetings, who carry out a scrutiny recommendation function for the PCT / CCG going forward.

Draft the CCG Communication and Engagement plan Analysis of Effects assurance: Question be inserted into CCG equivalent of Exec and Board Papers

for organisational assurance at sign off stage Adopt new national NHS equality performance framework – EDS (Equality Delivery System) EDHR Schedule within all provider partner contracts 

CCG Authorisation & EDHR

Act brings new Single Equality Duty

• The Equality Act 2010 replaces the current public sector duties to promote equality with a single equality duty extending to other protected characteristics. This means each having due regard to the need to eliminate discrimination, harassment, victimisation and other prohibited conduct in our day to day practice and planning.

Key dates for the equality duty

• 6 April 2011 General Duty came into force

Publication of information to demonstrate compliance with the public duties by 31 January 2012

• 6 April 2012 listed bodies to publish objectives via a 4 year new Strategy

Compliance with the general equality duty is a legal obligation, but it also makes good business sense.

The 3 aims of the general duty• Eliminate unlawful discrimination, harassment and

victimisation and other conduct prohibited by the Act.

• Advance equality of opportunity between people who share a protected characteristic and those who do not.

• Foster good relations between people who share a protected characteristic and those who do not.

What does having ‘due regard’ mean?

• Removing or minimising disadvantages suffered by people due to their protected characteristics.

• Taking steps to meet the needs of people from protected groups where these are different from the needs of other people.

• Encouraging people from protected groups to participate in public life or in other activities where their participation is disproportionately low.

Summary of duty requirements

Principles:• General and specific duties: As with previous

duties, the essence of the equality duty remains the requirement to have due regard to the need to achieve the three general duty aims.

The public sector Equality Duty, requires public bodies to consider all individuals when carrying out their day to day work – in shaping policy, in delivering services and in relation to their own employees. 

It requires public bodies to have due regard to the need to eliminate discrimination, advance equality of opportunity, and foster good relations between different people when carrying out their activities.

•

Specific Duties

The Equality Act 2010 (Specific Duties) Regulations 2011 came into force on 10 September 2011.

The specific duties help public bodies perform the Equality Duty better. They do this by requiring public bodies to be transparent about how they are responding to the Equality Duty – requiring them to publish relevant, proportionate information showing compliance with the Equality Duty, and to set equality objectives. 

The Government believes that public bodies should be accountable to their service users.  Publishing information about decision-making and the equality data which underpins those decisions will open public bodies up to informed public scrutiny.  It will give the public the information they need to challenge public bodies and hold them to account for their performance on equality.  Moreover, knowing that such information will be published will help to focus the minds of decision-makers on giving proper consideration to equality issues.

What do the Specific Duties require?

The specific duties require public bodies to:

• publish information to show their compliance with the Equality Duty, at least annually; and

• set and publish equality objectives, at least every four years.

All information must be published in a way which makes it easy for people to access it.

Equality Information required

• The NHS must publish sufficient information to demonstrate that we have complied with the general equality duty. This must be done by 31 January 2012, and at least annually after that.

• The information to be published must include: information on the effect that our policies and practices have had on employees and people from the protected groups; evidence of the analysis undertaken to establish whether our policies and practices will (or have) furthered the three equality aims in the general equality duty; details of the information used in that analysis, and details of the engagement we undertook.

• By 6 April 2012, and at least every four years after that, we also need to publish equality objectives and details of the engagement we undertook in developing them.

Commissioning & Procurement

• The duty applies to procurement and commissioning by public authorities. The requirement to comply with the general duty applies to all contracts, regardless of the value.

• The equality duty applies to all of our work, including services, policymaking, employment, planning, procurement and statutory decision-making.

The power of attitudes, behaviours & assumptions in the workplace

The platinum standard for E&D is treating people the way they would like to be treated.

It also means not stereotyping people in response to perceived differences eg age, gender, gender variance, disability, race, sexual orientation, religion or belief, marriage and civil partnership, pregnancy maternity & breastfeeding mums, and carers.

‘Reasonableness’ is the key.

TIP: Be prepared for the unexpected.

True or false?

Decide whether statements on next slides are

true or false?

Definition of disability

‘a physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities’

Formerly Disability Discrimination Act 1995True or False?

There are at least approx 8.6 million

disabled people in the UK=

20%=

1 in 5True or False?

Invisible disabilities:

Q: Keira Knightly, Sir Richard Branson and Jamie Oliver

– what disability do they all have in common?

A: Diabetes True or False?

From 5th December 2006, lesbian and gay couples gained the legal right to a civil ceremony & many (if not all) of the same rights as married couples

True or False?

LGB people cannot marry LGB people cannot marry and there are some

important differences between civil partnership and marriage. The ban on civil partnerships being held in religious premises is only just being lifted, and there are differences in the pension rights and divorce /dissolution process between marriage and civil partnership.

The Government has said it is starting to consult on allowing LGB people to marry (and heterosexuals to have civil partnerships) but there is likely to be some strong opposition (from the Church of England, the Vatican amongst others).

True or false?

When is Ramadan 2012?

Ramadan begins in the ninth month in the Islamic calendar.

Ramadan will begin on the Friday 20 July 2012.

It will continue for 30 days until the 18th of August 2012.

Ramadan is the act when Muslims all over the world must ritually fast and abstain from certain acts or foods and liquids which are prohibited during this holy time of year. Fasting is one of the five pillars of Islam which all Muslims are expected to follow.

True or false?

Ramadan 2012

Ramadan in 2012 will start on Friday, the 20th of July and will continue for 30 days until Saturday, the 18th of August.

Note that in the Muslim calendar, a holiday begins on the sunset of the previous day, so observing Muslims will celebrate Ramadan on the sunset of Thursday, the 19th of July.

Protected Characteristic Groups or PCGs now include:

Age Gender (male / female) Gender Variance (Trans) Disability (including invisible disabilities & long term health conditions) Race (ethnicity) Sexual orientation (LGB & T) Religion or belief Carers Homeless people Pregnancy maternity & breastfeeding mums Marriage & civil partnership Military veterans

Which 3 are not PCGs in strict legal terms?

Default retirement age of 65 has now been phased out

which makes it unlawful to dismiss an employee on the grounds of age unless there is objective justification.

Major demographic change within the UK has resulted in an ageing population.

One of the economic outcomes associated with this change is the need for people to work longer and the removal of the default retirement age.

True or false? see ‘Working Without the Default Retirement Age’ http://www.acas.org.uk/CHttpHandler.ashx?id=2976&p=0

Balancing health inequalities for LD:Research has demonstrated that many people with LD have a

range of undiagnosed & untreated health issues

Often do not recognise the symptoms of illness or that they are unwell

They may be unaware that help is available or what to do about it even if they are aware that they are unwell

Inviting people with LDs for a regular Health Check could recognise & help to prevent or treat conditions & could also help detect if patients are being subjected to any LD Hate Crime incidents.

True or false?

What are reasonable adjustments at work?

Conducting a proper assessment of what reasonable adjustments may be required.

Allowing flexible working, such as part-time work, annualised hours, non-standard start and finish times.

Allowing a disabled employee to take a period of disability leave.

Modifying disciplinary or grievance procedures.

Adjusting redundancy selection criteria.

Modifying performance-related pay arrangements.

True or false?

Liability for acts of discrimination at work: employers

Employers are liable for the actions of their employees, done in the course of their employment

It doesn’t matter whether it was done with the employer’s approval

However, an employer is not liable for the actions of their employees if:

The employer took all reasonable steps to prevent the employee from breaching the Act

[section 109]

True or false?

HarassmentAn employer must not harass: An employee, or job applicant Employers may be liable for harassment if an employee is

harassed by a third party The employer must know of at least two previous

occasions of harassment (not necessarily by same person) Employer can avoid liability if they took reasonably

practical steps to prevent harassment

[section 40]

True or false?

Thank you

Any questions