Equality, Diversity and Inclusion (EDI) Plan 2019 2022 - NHS East ...
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Equality, Diversity and Inclusion (EDI)
Plan 2019 – 2022
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG
Why does equality, diversity and inclusion matter?
First and foremost, we have a moral responsibility to treat people equitably,
fairly and to optimise the commissioning levers we at our disposal to address
the inequalities that exist in our population.
Secondly, it makes sound business sense. All evidence now points to the
conclusion that diverse organisations are more effective and efficient.
Thirdly, as public sector bodies, we are bound by the law to treat people fairly
eliminate discrimination and tackle health inequalities. This includes our
duties under the Equality Act 2010 and Health and Social Care Act 2012 and
reporting requirements in relation to:
• Equality Delivery System 2 (ESD2)
• Workforce Race Equality Standard (WRES)
• Workforce Disability Equality Standard (WDES)
• Gender Pay Gap
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGOur Commitment
The CCGs in SES are committed to
recruiting, retaining and developing people
according to their potential, thereby ensuring
we have a workforce that better reflects the
population we serve.
Additionally, we are fully committed to
optimising the commissioning levers at our
disposal to reduce the inequalities in health
that persist within and across our populations.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGDevelopment of the Plan
• This plan builds on the earlier good work of the Alliance, Coastal West Sussex CCG,
Eastbourne, Hailsham and Seaford and Hastings and Rother CCGs in tackling
discrimination in the workforce, reducing health inequalities and improving health outcomes
in their respective populations and combines this into one overarching document for the
eight CCGs in SES.
• It describes our priority areas and actions within the framework of ESD2, namely:
– A Representative and Supported Workforce
– Inclusive Leadership
– Better Health Outcomes
– Improved patient access and experience
• Together with the Appendices, sets out the Key Performance Indicators (KPIs) against
which we will monitor our impact and how we will deliver and report on this regularly.
• This plan has been developed in consultation with staff, and in particular those with a
protected characteristic aligned to our Staff Equality Network alongside colleagues in public
health.
• The plan will be further developed and refreshed with our stakeholders during the first six
months of delivery.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGA Representative & Supported Workforce
• We still have a high percentage of staff not declaring details on our electronic
staff record, in particular, in relation to sexual orientation and disability. Without
this key information it is impossible to track whether we are doing the right thing
by staff and creating an inclusive and diverse workforce. We will therefore run a
campaign promoting awareness of the need to record protected characteristics
on individual’s Electronic Staff Record (ESR), with the aim of reaching the best
achieving NHS organisations coverage by the end of 2019.
• We will further strengthen our mechanisms for internal leadership and
engagement related to our workforce priorities including:
– Continuing to develop and support our Staff Equality Network which
coordinates our inclusion workforce agenda and establishing firm
sustainable arrangements for our LGBT, BAME, Age, Disability and Gender
Equality Working Groups.
– Confirming EDI leads within our Governing Bodies, and Executive
Management Team.
– Establishing a twice yearly meeting of all Ambassadors, Executives and
Governing Body Champions to support the development and achievement
of our EDI goals and objectives.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGA Representative & Supported Workforce – Continued
• Our Staff Equality Groups will be lead by Staff Ambassadors and supported
by Executive Leads, the Head of EDI. They will each develop specific
action plans aligned to national reporting requirement where appropriate i.e.
WRES, WDES, and the Gender Pay Gap.
• Our Disability Working Group will ensure that SES becomes a Disability
Confident Employer and our LGBT Working Group will progress our work
towards achieving accreditation as a Stonewall Workplace Equality Index
employer.
• As part of National Inclusion Week, we will promote an annual programme
of staff engagement events and awareness raising around inclusion and
protected characteristics, led by Ambassadors, Executives and staff but co-
ordinated and supported by our Communications and Engagement Team.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG1. 1 Our Black, Asian and Minority
Ethnic (BAME) Staff
• We need to do more to better recruit, support and develop our BAME staff:
– Our staff composition when analysed by ethnicity, does not reflect the populations we serve.
Additionally, the more senior within the organisation you get, the less likely you are to be
from a BAME background.
– From our WRES submission we also know that you are 1.4 times more likely to be recruited
from shortlisting to SES vacancies if you are white and that in some CCGs this can be as
high as 2.4 times.
– We also know that our BAME staff are significantly more likely to report having experienced
discrimination at work from colleagues and feel that the organisation does not offer fair and
equitable opportunities for career progression.
– The annual WRES analysis and action plan is attached as Appendix 1 for more detail but the
priority actions SES will take over the coming months to address this include:
• more proactively promoting job opportunities within our local BAME communities;
• strengthening the feedback mechanism following interviews, particularly for BAME candidates;
• setting up a BAME Network for staff; and
• offering a bespoke talent management programme of training, coaching and support to our BME staff
and putting in place diverse recruitment panels and diversity recruitment training.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG1. 2 Our Female Staff
• It is clear from the evidence in our gender pay gap submission, that
there is more we could do to provide equitable opportunities for flexible
working and addressing the cultural barriers which may discourage
women from progressing to more senior roles.
– our gender pay gap across SES is 21% overall in favour of men.
– whilst overall the workforce is 73% female, this proportion is not carried into the more senior roles
where there is a more even balance between men and women.
– the Alliance was one of the national pilot sites exploring the culture of the NHS. Staff reported
feeling that more traditionally masculine traits were valued and rewarded above those of females
and this was seen as a barrier to career progression.
• Through discussions with our staff there are a number of actions we will
be taking forward including:
– Establishing a womens network across the STP area. This will be launched via a conference in
then co-designed with women from each of the constituent organisations.
– Roll out of agile working; enabling more flexible working solutions for women who are carers, to
keep them in the workforce and enable career progression.
– Addressing values and behaviours both within and outside of the organisation through our Inclusive
and Compassionate Leadership Programme.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG1. 3 Our Staff with a Disability
• Over one third of our staff have not recorded whether or not they have a
disability on the ESR so it is hard to draw any firm conclusions about how
representative we are of the population more generally.
• We do know however, that staff with a disability report a lower level of
satisfaction on a number of indicators in the national staff survey including:
support from line managers, resources to do the job well and equitable
opportunities for career progression.
• In order to test some of these issues out in more detail with our staff the
Ambassadors for disability have carried out a more detailed survey to gain more
feedback on the experience of staff and identify specific actions that would
improve their working conditions and career opportunities. This will be analysed
and progressed over the next six months.
• We are currently at level 2 – Disability Confident as an employer with plans to
apply for level 3 and aspire to level 4 within the next two years. An action plan
is in place which will be overseen by the disability working group and feed into
annual submission for the WDES.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG1. 4 Our Staff who are Lesbian, Gay, Bisexual or
Transgender (LGB or T)
• Again, about one third of our staff do not record their sexual orientation
on their ESR and we will take action to improve this.
• Stonewall will be working with SES on a year long programme to
develop a more inclusive working environment for LGBT staff.
• The LGBT working group have benchmarked SES against the
Stonewall Work Equality Index and made an initial submission in
September 2019.
• An action plan arising from this self assessment will be produced with
support from Stonewall and include:
– the development of an LGBT network across SES;
– actively promoting any job opportunities through the Proud Employers website;
– conducting an analysis of SES policies and procedures;
– strengthening engagement with the LGBT community; and
– optimising our commissioning levers with providers and suppliers.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG1. 5 Our Older and Younger Staff
• Our age profile is somewhat skewed across SES, with less than
10% of our staff under the age of 30 and almost 50% in the 50+ age
group.
• Age was often raised during staff engagement sessions and there is
more we could be doing to support our workforce as they approach
the end of their careers and prepare for retirement.
• Conversely we need to do more to attract younger people into the
workforce including, for example, through the roll out of
apprenticeship schemes across the sites.
• A working group for age will be established, to agree a more
detailed action plan over the summer months.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG2. Inclusive Leadership
• We will embed EDI throughout the CCGs, with a clear EDI focus at
Chief Executive Officer (CEO), Governing Body and Executive level.
A revised schedule of Executive/Governing Body leads will be
finalised and published.
• Governing Body members and all staff will receive appropriate EDI
training as part of the Leadership and Development Programme.
• A twice yearly report on progress against the EDI Plan will be
considered by the Senior Management Team and presented to
Governing Bodies.
• We will continue to cut and analyse the staff survey results by
protected characteristics and include specific actions within the
overall staff survey action plan.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG3. Health Outcomes
• The SES Operating Plan 2019 sets out a clear commitment to take action in order to
reduce the health inequalities that exist across our geography.
• In partnership with public health colleagues across Sussex, we established a task and
finish group to consider health inequalities across SES, agree how we collectively respond
to the guidance on this aligned to the Long Term Plan and develop an integrated
commissioning framework in order to address inequalities in the 2020 planning round.
• We have an opportunity to make more use of the contractual levers at our disposal to
assure ourselves that providers are complying with their equality duties and responsibilities
to tackle health inequalities. The Quality Team will incorporate this focus into Clinical
Quality Review Meetings (CQRMs) and request that providers report more systematically
and regularly report on this.
• We need to ensure that any decisions we make are underpinned by due care and attention
to our duties under the Equality and Health and Social Care Acts. We therefore continue to
strengthen our processes for Equality Health Impact Assessments (EHIAs and in particular
will:
– incorporate quality and equality into one consistent, integrated impact assessment process;
– provide training on EHIAs for all commissioners and senior leaders; and
– establish a SES EHIA Reference Group to quality assure EHIAs and sign off Assessments for
publication.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGCommissioning to Address Inequalities
• The NHS Long Term Plan proposes reducing health
inequalities as a result of:
• effectively managing multiple conditions
experienced by the aging population;
• preventing premature deaths exacerbated by
individual health behaviors (smoking, diet,
physical activity); and
• receiving timely and effective care.
• However, our ambition is to go further and embed
this explicitly in the development of Primary Care
Networks (PCNs) and new models of care.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGWider Determinants of Health
According to Dahlgreen and Whitehead (1992), health is impacted by wider
factors other than health services, including but not limited to, lifestyle, social
and community networks, living and working conditions, and
socioeconomic status.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGNHS’ Historical Role in Determinants of Health
Source: Kaiser Family Foundation
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGNHS’ Widening Role in Determinants of Health
Source: Kaiser Family Foundation
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGNHS’ Future Role in Determinants of Health
Source: Kaiser Family Foundation
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGWhat is the potential impact?
85%
There exists a missed
opportunity to influence
individuals' health by
addressing these wider
determinants of health in
addition to providing health
services.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGDelivering our commitment to tackling health inequalities
To support and inform our commitment to
tackling health inequalities across SES, we
hosted a Yale (USA) Intern during July and
August 2019 from the Public Health Faculty.
The Intern undertook a two month review of our
commissioning arrangements and in partnership
with Yale Professors made a number of
recommendations which have been agreed as
follows.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGRecommendation 1
Take action to tackle the wider determinants of health by:
• Ensuring access to advice and support services (disability,
housing, employment, welfare, legal aid, befriending /social
support, etc) embedded within new care models and PCNs.
• Ensure consistent high quality access to social prescribing
across SES embedded within emerging PCNs.
• Weight resources in areas of greatest need and deprivation
to prevent exacerbation of health inequalities and to
support this work with Local, District and Borough Councils
and third sector organisations to maximise investment.
• Take a more person centred approach, recognising the
needs and wishes of individuals.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGRecommendation 2
Ensure our commissioning is intelligence driven by:
• Strengthening commissioning efforts by investing in a single platform to ensure data
quality and public access with the aim of:
– Enabling professionals to identify health needs
– Supporting the integration of PCN and CCG analytical functions
• Recruiting staff with skills pertaining to the analytical needs of organisations e.g.
supplying analytical support to PCNs.
• Forming a SES Joint Strategic Needs Assessment (JSNA) Board, to oversee
monitoring, metrics, publishing, data collection and data evaluation and use this to:
– Agree on inequality and inequity metrics to be used across SES in addition to
those that are employed nationally.
– Include a comparison of health outcomes with the financing of certain sectors by
financier (ie: Quality-adjusted life year (QALYS) vs public health investments vs
CCG/Local Authority)
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGRecommendation 3
Spread a culture of engagement to ensure
people with lived experience are informing our
commissioning:
• Engagement will vary depending on the
populations served.
• Widen culture of engagement
• Develop PCN-level engagement strategies that
have a grassroots approach and ensure that
practices respond to patient feedback and
feature co-design principles.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCG4. Patient Access
• In order to identify and remove barriers to services, especially for protected
groups, we need to have a greater and more consistent focus on
engagement, particularly with more hard to reach or seldom heard groups,
across all of SES. A review of our engagement mechanisms will be
undertaken over the second half of 2019/20.
• We need to ensure all of our communication with patients and the public is
jargon free, accessible and in a range of appropriate languages and formats
as part of our delivery of the Accessible Information Standard. In order to do
this we will refresh our AIS work and plans and set KPIs for improvement.
• The CCG website, including the Complaints section, is often the first port of
call for patients and the public requiring more information about all aspects
of our work. We will ensure this is easily located and sends a clear and
positive message about our inclusive approach, including the AIS. We are
committed to refreshing the diversity of our website by for example,
improving the diversity of images, increasing the availability of video clips
and signposting to our work on equality and diversity.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGDelivery and Accountability
• In order to maintain the focus on EDI, ensure our statutory duties are effectively discharged
and the commitments in this plan are delivered, a dedicated EDI central resource, working
with and co-ordinating the efforts of all departments, is required.
• The Head of EDI will report into the Director for Organisational Development (OD) and
Human Resources. As we continue to develop and firm up our new operating model we will
also explore and confirm arrangements for support to this post for example in relation to
programme management and administration.
• We will also continue to develop our wider EDI team and network through internal EDI
meetings which bring together colleagues across HR, Communications, Engagement and
Commissioning to take forward the EDI work programme. We will also broaden this
network to more formally include external stakeholders such as Public Health.
• A Report incorporating regular progress on delivery of this plan and performance against
the key performance metrics will be produced every six months for Governing Bodies.
• Governance - the EDI programme currently reports into the Our People Our Future
Programme. This will need to be revised in due course and align with revised
commissioning and accountability structures as appropriate.
Brighton and Hove CCG | Coastal West Sussex CCG | Crawley CCG | East Surrey CCG | Eastbourne, Hailsham and Seaford CCG
Hastings and Rother CCG | High Weald Lewes Havens CCG | Horsham and Mid Sussex CCGYou can also read
