Improving Gender Equality Practice in NHS Scotland - NHS Scotland and the Gender Equality Duty
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NHS Scotland and the Gender Equality Duty Improving Gender Equality Practice in NHS Scotland
Report by:
Fitzgerald Associates
Equality and Policy Specialists
28 Ancaster Drive
Glasgow
G13 1NB
Tel: 0141 579 9984
Fair For All – Gender
Project Lead, Marese O’Reilly
March 2008
Designed by Irwin Stuart Design
www.irwinstuart.com
1NHS Scotland and the
Gender Equality Duty
Improving Gender Equality
Practice in NHS Scotland
Contents
1. Introduction and Context 3
2. Gender Equality Duty and Workforce 8
3. Workforce Examples 9
4. Gender Equality Duty and Service Delivery 16
5. Service Delivery Examples 17
2INTRODUCTION AND CONTEXT
1. Introduction
This resource sets out to provide some guidance and practical examples on how gender could be
integrated into the work of NHS Boards in Scotland, with particular reference to informing further
development of Gender Equality Schemes.
The resource draws on some of the activities identified in the Status Report on NHS Scotland
Gender Equality Schemes, commissioned by Fair For All-Gender, to illustrate examples of
practice development that integrates gender equality considerations and that is consistent with
good practice.
In selecting examples, the judgement is not about whether NHS Boards have met the
requirements of the Gender Equality Duty, but about identifying activities that respond to the Duty
which actively promote gender equality. The Equality and Human Rights Commission will make
the adjudication about compliance.
The objective of the resource is to provide NHS Boards with clear examples of practice that
integrates gender equality considerations into workforce and service delivery activities and that
demonstrates a mainstreaming approach to building gender equality into every level of activity.
The aims are:
• Supporting the development, delivery and assessment of gender sensitive services to
individuals and communities across Scotland
• Assisting NHS Boards in practice, management, clinical services, policy and service redesign
• Providing an educational tool to act as a catalyst for cultural change and learning across NHS
Scotland
3INTRODUCTION AND CONTEXT
Context
Fair for All is an initiative led by the Scottish Government’s Directorate of Health and Wellbeing
to support the NHS in Scotland. It encourages health practitioners and managers to strive for
best practice that goes beyond compliance with the law and promotes the rights, independence,
choice and inclusion of health service users and members of the community.
The initiative brings together a number of areas of policy and practice to address equality and
diversity issues in the health service, moving towards an approach of service planning and
delivery that takes into account individual service users needs, whatever their life circumstances.
Fair For All-Gender is a partnership between the Scottish Governments Directorate of Health
and Wellbeing and the Equality and Human Rights Commission (EHRC) to support NHS Boards
in Scotland in implementing the Gender Equality Duty and help embed gender equality
considerations into policy and planning and the delivery of services.
The Gender Equality Duty (GED)
The Gender Equality Duty is the most significant change to sex equality legislation since the
original equal pay and anti-discrimination Acts of the 1970’s. Compliance with the Duty requires
fully integrating gender issues into all activities from workforce practice to the design and delivery
of services.
NHS Boards are subject to both the general and specific duties. The general duty requires
listed public bodies to pay due regard to the need to eliminate discrimination (including pay
discrimination) and harassment, and to promote equality between men and women. There are
also a series of ‘specific duties’ which outline the steps listed public bodies must take to help
them meet the general duty. All listed public bodies are required to take positive steps to meet
the statutory requirements of the Gender Equality Duty (GED). The general part of the Duty came
into force across Britain on 6 April 2007 and the deadline for producing Gender Equality Schemes
in Scotland was 29 June 2007. In addition, listed bodies with 150+ staff were required to publish
an Equal Pay Policy Statement by 28 September 2007.
4INTRODUCTION AND CONTEXT
NHS Boards in Scotland
The examples used to illustrate practice in this document are drawn from the first Gender
Equality Scheme of NHS Boards in Scotland and from existing gender good practice within
Boards. The Boards include territorial boards that deliver services to geographical communities
and national boards that provide expert services like research or education. Some national
boards have a service delivery function.
Pro-active approach
As with the Disability and Race Equality Duties, the Gender Duty requires a pro-active approach.
For NHS Boards, this means meeting the challenge of both differentiating and integrating gender
equality considerations into data collection, consultation, research, resource allocation, service
design and delivery, performance management and monitoring and appraisal.
This requires an understanding of gender as a key variable in respect of labour market
participation as well as a critical factor in the design and delivery of services. For example,
women make up nearly half (47%) of the Scottish workforce (ONS, 2006). However, although
the numbers of women and men in jobs may be on a par, the evidence relating to rates of pay,
conditions of employment, benefits – including pension rights and patterns of occupational
segregation show the persistence of major gender based inequalities.
In service delivery areas, there is evidence of differential outcomes for women and men and a
growing understanding that gender rather than biology or sex, plays an important role in this
difference. The challenge for NHS Boards is to ensure that analysis is informed by the recognition
that gendered roles and related behavioural choices have an impact on health outcomes. This
understanding and analysis will assist in making connections with poverty, social exclusion and
the intersection with other characteristics such as race, disability, age, sexual orientation, religion
and belief.
The aim: better
health services
for all
5INTRODUCTION AND CONTEXT
Key facts
Some health differences between women and men are:
Biological:
• Men typically develop heart disease 10 years earlier than women
• Man to woman infection with HIV is more than twice as efficient as woman to man HIV
infection
• Women are around 2.7 times more likely than men to develop and auto-immune disease such
as diabetes
Social:
• Women are more likely to suffer from anxiety or depression, however men are more likely than
women to commit suicide
• Boys are twice as likely as girls to be killed or seriously injured in pedestrian road accidents
• Men are more likely than women to die of injuries, but women are more likely to die of injuries
sustained in the home
• The gap between women’s and men’s smoking rates is changing, with more young girls taking
up the habit than boys.
Gender =
Women and Men
6INTRODUCTION AND CONTEXT
What makes a good gender equality objective?
Gender equality objectives should be specific, measurable, achievable, realistic and time-bound.
The specific duties require listed public bodies to set objectives for a (maximum) three-year
period (with the option to review earlier), although Boards may also wish to set interim objectives
for each year to allow progress to be measured. The focus should be on achieving gender
equality outcomes – specific identifiable improvements in policies, in the way services are
delivered, in the exercise of public functions, and in outcomes for employees and service users.
In order for an objective to be measurable, it does not necessarily need to contain a numerical
target. Boards could aim for ‘a significant improvement’ in an area, measured by service user
feedback or other qualitative means. Even if hard quantitative data is available, Boards do
not have to predict a precise number by which take-up will improve, however, when setting
objectives they will need to think about how to track progress over the three years to establish if
the objective has been met by that time.
Structure
This document is broken down into two sections of good practice across a range of areas:
• Workforce including equal pay, gender based occupational segregation, sexual harassment
and discrimination, issues for transsexual staff, governance and data collection.
• Service delivery including consultation, data collection, the local priority on gender based
violence and national priorities in respect of mental health, cancer and coronary heart disease.
7GENDER EQUALITY DUTY AND WORKFORCE
2. Gender Equality Duty and Workforce
The Gender Equality Duty (GED) sets out a number of requirements in respect of workforce. This
section begins with a brief summary of these requirements to set the scene. It then provides a
number of worked illustrations drawn from NHS Board Gender Equality Schemes and existing
examples of good practice.
GED Requirements
• Consultation with staff, stakeholders and trades unions
• Clear outcome objectives and actions on equal pay, occupational segregation
• Clear objectives and actions on tackling discrimination and harassment
• Specific reference to transsexual staff issues in workforce objectives and
action plans
• Monitoring and reporting systems that collect sex disaggregated data
• Clear actions to promote equality of opportunity including consideration of
working time, working conditions, recruitment and selection.
The following are some examples of outcome-focussed objectives that NHS Boards included in
their Gender Equality Schemes:
• Increasing the numbers of male and female staff taking up flexible working options
• Increasing the number of senior positions offering flexible working – for example consultants
and surgeons
• Undertaking pay monitoring or an equal pay review
• Encouraging males and those without caring responsibilities to take up flexible working
• Introducing personal objectives for senior management that include accountability for equality
issues
• Reviewing recruitment policies to encourage gender representation
• Developing policy and training programmes to raise awareness in respect of transgender
people and employment
• Introducing conditions of service and a working culture that enhances the recruitment and
retention of men and women, including transsexual people.
8WORKFORCE EXAMPLES
3. Workforce Example 1:
Flexible Working For Men
Who carried out the Good Practice? What is the good practice?
NHS Forth Valley, Territorial Board The commitment is to ensure that flexible
Who was involved? working is open to all staff regardless of
The NHS Forth Valley Fair for All Operational gender. This will be monitored as part of the
Group Gender Equality Scheme and also as part of
the policy review process.
What was the situation before?
Flexible working has been open to all staff but What is the situation now?
has typically been accessed by women. The The policy is being reviewed at mid-year to
new policy specifies that flexible working is assess uptake. A ‘staff wellbeing’ booklet is
open to all staff, both women and men. nearing launch that promotes the fact that the
Flexible Working Policy is for both women and
How was it undertaken? men. A Gender Equality Update will also feature
In preparation for the Board’s Gender Equality within this information, along with information
Scheme, gender analysis of working patterns on equal pay.
was undertaken, which highlighted the high
proportion of women that work for the Board What difference has it made (if any)?
and their patterns in terms of flexible or part- There is a policy in place, and workforce
time work. In order to address occupational monitoring is being undertaken to track
segregation, the board opted to highlight to data for changes in the workforce profile,
staff that the flexible working policy is also particularly if there is an increased use of
open to men. flexible working options by men.
Top tips...things to remember
The GED requires boards to address inequality including pay access to uptake of
flexible working
It also requires boards to tackle issues like occupational segregation and working
conditions that impact differentially on women and men.
Men and women are covered by the GED
Contact: Alison Richmond-Ferns, Deputy Director of Human Resources,
NHS Forth Valley, Carseview House, Castle Business Park, Stirling, FK9 4SW
E-mail: catherine.wallace@fvpc.scot.nhs.uk Tel: 01786 457222
9WORKFORCE EXAMPLES
Workforce Example 2:
Governance To Support The Gender Equality Duty
Who carried out the Good Practice? How was it undertaken?
NHS Greater Glasgow & Clyde, Territorial BoardThis was initiated before Gender Equality Duty;
Who was involved? however, the CIT now has a strategic role in
NHS Greater Glasgow & Clyde (NHSGG&C) facilitating the Board’s Equality Scheme and
Board and a 2006 Short Life Working Group on wider actions on inequalities, including gender.
Inequalities What is the good practice?
What was the situation before? A Corporate Inequalities Team (CIT) was
Inequalities were not considered in a established within the Corporate Planning
systematic Board-wide way. There were Directorate in recognition of the need to
pockets of good practice, often developed in undertake long term development and policy
isolation of core planning structures and any work on inequalities, including gender. This
learning was either lost or maintained on a was in the context of a new transformational
local basis only. A review by the Short Life (“aspirational”) theme of ‘mainstreaming a
Working Group on Inequalities revealed a lack response to inequalities in all functions” after
of understanding among senior management major board re-organisation.
on the nature and prevalence of inequalities The CIT has a leadership role in terms
per se and the ways in which they contribute of developing the NHSGG&C response to
to poor health. Coupled with the lack of clarity inequalities. The team works within system-
was a limited grasp of their leadership role wide planning and delivery structures to
in tackling these issues, which tended to be ensure it understands and takes account
considered primarily in relation to addressing of inequalities in all aspects of the Board’s
race equality. functions.
It could be argued that the absence of an What is the situation now?
inequalities governance structure perpetuated Each part of the Board, for example mental
the view that inequalities work was secondary health services or acute services, has a local
to core business, rendering it a fragile and Equality Scheme Action Plan, which includes
abstract idea rather than an integral part of gender and is monitored alongside other
service planning and delivery. actions on inequalities, for example on socio-
economic inequality.
10WORKFORCE EXAMPLES
What difference has it made (if any)?
There is a strategic approach to building
equality considerations across all functions.
In terms of gender, the immediate impact has
been to help clarify what gender means in
considering how we better plan our services.
From initial planning around routine data
collection to specific work streams around
gender-based violence, NHSGG&C has adopted
and integrated a new way of working that will
put the context of people’s lives (including their
gender) at the forefront of how we deliver our
services.
Top tips...things to remember
The duty requires listed public bodies to pay ‘due regard’ to the need to eliminate
unlawful discrimination and harassment and to promote equality of opportunity in all
their functions.
This includes the high-level functions of a health board, such as business planning,
budget allocation, annual reporting and organisational development.
Influencing key processes across the organisation will embed a mainstreaming
approach to tackling gender inequality
Contacts: Noreen Shields, Corporate Inequalities Team,
NHS Greater Glasgow and Clyde, Dalian House, 350 St Vincent Street, Glasgow, G3 8YZ
Email: noreen.shields@ggc.scot.nhs.uk
Alastair Low, Corporate Inequalities Team,
NHS Greater Glasgow and Clyde, Dalian House, 350 St Vincent Street, Glasgow, G3 8YZ
Email: alastair.low@ggc.scot.nhs.uk
11WORKFORCE EXAMPLES
Workforce Example 3:
Flexible Working For Women In Senior Positions
Who carried out the Good Practice? What is the good practice?
NHS 24, National Health Board NHS 24 now has an outcome focused objective
Who was involved? to increase the number of women who elect
NHS 24, Equality and Diversity Manager, to work part-time and be employed at senior
working group of national boards, focus levels in the organisation.
groups, staff and trade unions What difference has it made (if any)?
What was the situation before? There is now awareness of the issue at all
There was no set policy for flexible working in levels of the organisation, there is a policy
senior positions within NHS 24. in place, and workforce monitoring is being
undertaken to track changes in the workforce
How was it undertaken? profile, including the use of flexible working
By setting it as one of the Strategic Goals of options by all staff and particularly by women
NHS 24’s Gender Equality Scheme. in senior roles.
Research was commissioned and a
consultation process undertaken that included
external focus groups and engagement with
NHS 24 staff.
Top tips...things to remember
By promoting change in the pattern of how senior positions are filled, health boards can
address occupational segregation and contribute to tackling the gender pay gap.
Securing change at the most senior level will provide highly visible ‘leadership by
example’.
Increasing flexibility in the workplace will benefit women and men
Contact: Wladyslaw Mejka Equality & Diversity Manager,
NHS24, Delta House, 50 West Nile Street, Glasgow G1 2NP
Email: Wlad.Mejka@nhs24.scot.nhs.uk Tel: 0141 225 0099
12WORKFORCE EXAMPLES
Workforce Example 4:
Developing and Promoting a Policy on Transgender Staff
Who carried out the Good Practice? What is the situation now?
NHS Fife, Territorial Board A policy is being developed on transgender
Who was involved? staff and what is expected of a Human
The Gender Equality Task Force comprising Resources department in supporting them.
members of staff from Human Resources, The policy will account for:
Training and Public Health, Patient Focus and • Awareness raising and training opportunities
Public Involvement staff, as well as Race and for managers and staff
Disability leads
• Providing HR with the opportunity to play a
What was the situation before? larger role in supporting transgender issues
There was no specific Board policy concerning
transgender staff. • Consideration of how line managers will be
supported when managing transgender staff
How was it undertaken?
As part of the Board’s preparation for their • Confidentiality issues for transgender staff in
Gender Equality Scheme, evidence suggested respect of line management
that there was no fixed policy on transgender • Ensuring transsexual people feel supported
staff. The Gender Equality Duty means that and valued as employees and potential
health boards are required to take action employees
to eliminate discrimination and harassment • Ensuring that transsexual employees
against transsexual people in employment. undergoing transition are retained as valued
What is the good practice? members of your staff?
Developing and publishing a policy in respect • Identifying any barriers to the recruitment
of transgender workforce issues. In addition,
and retention of transsexual staff
disseminating the policy, and providing training
for staff. This new policy will be a living document, open
to revision based on new information and staff,
as well as changes in procedures. The policy
will also cover issues such as when or if a staff
member wants to disclose their transgender
status and procedures to ensure that in moving
jobs their previous gender will not be disclosed
when references are sought.
13WORKFORCE EXAMPLES
What difference has it made (if any)?
There is a draft policy soon to become final,
a commitment to changing culture, support
at a number of levels, and consideration of
how monitoring of transgender issues will be
integrated into workforce monitoring.
Top tips...things to remember
The GED specifically requires employers to address issues for transsexual staff
Staff training on all aspects of the duty will ensure better understanding
Monitoring of staff profiles is a key requirement of the duty
Contact: John Docherty, Gender Equality Lead,
NHS Fife, Memorial Hospital, Abbey Walk, St Andrew’s, Fife, KY16 9LG
Email: johndocherty@nhs.net Tel: 07791 025769
14Evidence Base
Gathering and analysing information is critical for NHS Boards as they respond to the
requirements of the Gender Equality Duty. The Equal Opportunities Commission guidance on
Gathering and Using information underlines a number of tips and things to remember.
Top Tips and Things to Remember
The Gender Equality Duty is not just about collecting information, it is about analysing
and using it to identify priorities, set and monitor objectives and assess impact.
Good information is crucial to your ability to conduct effective gender impact
assessments of policies and procedures.
Collecting and using information is an ongoing process to help deliver the duty, not
just something you have to do to set your objectives and write your scheme.
You are required to collect information across all your work including services,
representation/decision-making, procurement and employment.
When collecting information on pay you need to look at all three causes of the
gender pay gap – pay systems discrimination, occupational segregation and caring
responsibilities.
It’s not just about disaggregated information by sex: to identify gender inequality
issues, you need to collect and analyse information on caring responsibilities, part-
time working and issues for transsexual people as well.
Check to see what information already exists. Remember to look at national
information from your sector, as well as local and in-house information.
Remember that your systems should allow you to cross reference information across
equality areas such as age, disability, race, religion and sexuality.
Be clear on why you want information and how you are going to use it. Collection
methods should be determined by the type of information you are seeking. Ensuring
people understand why you are collecting information is a critical step.
Seek advice on handling information of a sensitive nature if you are unsure.
15GENDER EQUALITY DUTY AND SERVICE DELIVERY
4. Gender Equality Duty and Service Delivery
The Gender Equality Duty sets out a number of requirements in respect of service delivery. This
section begins with a brief summary of these requirements to set the scene. It then provides
a number of worked illustrations drawn from the gender equality schemes of NHS Boards and
existing good practice.
GED Requirements
• Consultation with service users and stakeholders
• Collection and analysis of disaggregated data
• Outcome objectives and actions on gender based violence
• Outcome objectives and action on gender issues in mental health, coronary
heart disease and cancer
• Improving outcomes across the age spectrum for men and women, boys and
girls
The following are examples of outcome-focussed objectives that NHS Boards included in their
schemes
• Increasing numbers of men using primary care services
• Ensuring that patients have same sex clinicians, when requested
• Recruiting a female police surgeon as part of dealing with gender based violence
• Improving the sexual health of young males
• Improving the take-up of advocacy services by male carers
• Addressing mental health for young Asian women
• Ensuring the needs of all survivors of gender based violence are identified and addressed
including specifically addressing the needs of black and minority ethnic women and women
with a disability and lesbian women in a gender based violence plan
• Further investigation of and action in respect of the needs of men who have
been raped and sexually abused
16SERVICE DELIVERY EXAMPLES
5. Service Delivery Example 1:
Reviewing Recruitment To Encourage Gender Representation With Specific Reference
To Recruiting A Female Police Surgeon
Who carried out the Good Practice? What is the good practice?
NHS Highland, Territorial Board NHS Highland has both a strategic approach
Who was involved? and specific actions in their Gender Equality
Equality and Diversity Steering Group and Scheme and Action Plan. This involves
Violence against Women training consortium reviewing recruitment to encourage equal
and strategy group. gender representation, particularly by recruiting
a female Police surgeon.
What was the situation before?
There was constructive partnership working What is the situation now?
across Highland on tackling Violence against A female Police surgeon is available now,
Women. The Police employ forensic surgeons ahead of the timescales indicated in the Gender
through an external contract but it was unclear Equality Scheme. This was seen as a priority
whether a female surgeon would always be by both the Police and the NHS. Partnership
available. The provision of a same sex service work continues productively across Highland on
is crucial when working with Violence Against tackling the Violence Against Women agenda.
Women and was potentially undermining the What difference has it made (if any)?
pan-Highland activity on tackling Violence It offers women a service that is appropriate
Against Women. and has also shown that reviewing recruitment
How was it undertaken? from a gender perspective can supply some
Through partnership working with the Police, significant service improvements. This is an
contractual agreement was secured to ensure issue that is not exclusive to Highland and is
that a female Police surgeon is available. now being addressed by the Police and the
Attending officers also ask female victims if NHS nationally to ensure that women, who are
they would prefer a female police surgeon. victims of violence, regardless of where they
live in Scotland, have access to female police
surgeons.
17SERVICE DELIVERY EXAMPLES
Top tips...things to remember
The outcome approach encouraged by the GED requires public authorities take the
necessary steps both to prevent gender-based violence from occurring and to provide
support to those affected.
Addressing gender- based violence is a local priority for NHS Boards
Recruitment needs to be monitored across partners to ensure that gender inequalities
can be addressed.
The importance of linking workforce and service delivery issues
Contact: Moira Paton, Head of Community and Health Improvement,
NHS Highland, Beechwood Park, Inverness, IV2 3BW
Email: moira.paton@hhb.scot.nhs.uk Tel: 01463 70 49 29
18SERVICE DELIVERY EXAMPLES
Service Delivery Example 2:
Addressing Gender Based Violence
Who carried out the Good Practice? How was it undertaken?
NHS Greater Glasgow and Clyde (NHSGG&C), As a key priority in the Board’s Equality
Territorial Board Scheme. As one of the clearest indicators of
Who was involved? gender inequalities in our society, the Board
Multi-agency Partnership on Violence Against is committed to establishing clear and robust
Women including NHS Greater Glasgow and mechanisms for identifying and responding to
Clyde Corporate Inequalities Team incidence of GBV where it occurs. Ensuring the
needs of all survivors of GBV are identified and
What was the situation before? addressed across the system is a core objective
There was a multi-agency response to policy, within NHSGG&C’s Equality Scheme is a non-
planning and performance on Violence Against negotiable commitment to action in the related
Women, built up over 10 years on all forms Equality Action Plans from each NHSGGC entity.
of Gender Based Violence, not just domestic This joined up approach could not have been
abuse. This included men and Gender Based achieved within this timescale without the
Violence issues (i.e. as perpetrators, abuse structure afforded by our Equality Scheme and
within same sex couples, survivors of child so by direct association without the introduction
sexual abuse and involvement in prostitution). of GED legislation.
The work has received international recognition
from the World Health Organization (WHO) in
the form of the Glasgow WHO Collaborating
Centre for Gender Mainstreaming.
19SERVICE DELIVERY EXAMPLES
What is the good practice? would have been difficult to get pan-NHSGGC
The Gender Equality Duty (GED) allowed this agreement to progress work in this area or to
work to be packaged more effectively, making establish champions and early adopters within
it more visible and viable in terms of agreeing services.
a Board-wide approach and consistent and What is the situation now?
quantifiable responses within services. The strategic approach has a comprehensive
The NHSGG&C, Gender Based Violence Action NHS Greater Glasgow and Clyde cascade effect
Plan 2008-11, takes a targeted approach with named leads in our diverse entities who
to improving care pathways, including the take responsibility for the implementation of the
use of routine enquiry, strengthening service GBV plan The Board will name a lead Director
standards and competencies, requirements for with Board-wide responsibility for this work.
inequalities and GBV data recording, supported What difference has it made (if any)?
supervision of staff and consultation with There will be a targeted and consistent
service users. approach to working with issues relating to
Audits of current practice on gender GBV across NHSGG&C including involvement
sensitivity and Gender Based Violence are of key staff at various levels within the
for 2008/9 priority settings (mental health, organization, linked to Knowledge and Skills
women & children’s directorate, addictions, Frameworks, Personal Development Plans and
homelessness and sexual health). Another other responses to inequalities. NHSGG&C has
NHSGG&C work stream is masculinity and made a formal commitment to addressing GBV,
violence, which has links with the National quantified within new Planning & Performance
Violence Reduction Unit. The GED has given indicators that relate directly to GBV. This is
a significant lever to integrate work on Gender a significant step forward and serves to re-
Based Violence (GBV) into service design iterate our commitment to addressing GBV and
and delivery. While there is a strong local acknowledging it as part of our core business
history of work in this area, without the GED it and not an add-on or parallel consideration.
Top tips...things to remember
Territorial boards need to address the issue of Gender Based Violence strategically but
in a targeted way. Ensuring integration of action with other inequalities action will have a
more effective impact.
Monitoring against objectives will improve staff ownership, and transparency and
accountability to stakeholders; it will also identify what works best.
Contact: Noreen Shields, Corporate Inequalities Team,
NHS Greater Glasgow and Clyde, Dalian House, 350 St Vincent Street, Glasgow, G3 8YZ
Email: noreen.shields@ggc.scot.nhs.uk 20SERVICE DELIVERY EXAMPLES
Service Delivery Example 3:
Domestic Abuse Polices and Action Plan
Who carried out the Good Practice? had anticipated. The Report also highlighted
NHS Grampian, Territorial Board that possible changes in Scottish Law to
Who was involved? introduce the crime of “male rape” would also
NHS Grampian Diversity Working Group lead to more survivors coming forward.
What was the situation before? What is the good practice?
There has been on-going work in respect Extending work on domestic abuse/gender
of domestic abuse including partnership based violence to include identifying needs
work with a range of local gender interest of men who have been raped and sexually
groups and their involvement in initiatives. abused.
For example, the Terence Higgins Trust, the What is the situation now?
Aberdeen Cares Diversity Centre and IDL The Diversity Working Group, in co-operation
Counseling and Social Work Services. with the Public Health Department, have
How was it undertaken? now submitted a bid to the NHS Grampian
As part of the Gender Equality Scheme 2007- Board for funding for a 1 year pilot service
2010. The Diversity Working Group set about in 2008/2009, employing two full time
scoping the problem and collected data from counselors, to work as part of the GUM team.
the GUM Service, Grampian Police, Terence What difference has it made (if any)?
Higgins Trust for Scotland, the Aberdeen The needs of men who are survivors of male
Counseling Information Service and the rape and sexual abuse are now being actively
Aberdeen Cares Diversity Centre (AC/DC). The considered in NHS Grampian. There is every
data was compiled into a report which showed prospect of the pilot being funded, which may
that male rape and historic sexual abuse was a lead to a permanent service, if the demand is
much bigger problem in Grampian than anyone established.
Top tips...things to remember
The outcome approach encouraged by the GED requires public authorities to take the
necessary steps both to prevent gender-based violence from occurring and to provide
support to those affected
The GED applies to men and women
Working strategically with partners will target resources more efficiently
Contact: Nigel Firth, Equality and Diversity Manager,
Ashgrove House, Foresterhill Aberdeen, AB25 2ZA, NHS Grampian
Email: nigel.firth@arh.grampian.scot.nhs.uk Tel: 01224 552 245
21SERVICE DELIVERY EXAMPLES
Service Delivery Example 4:
Wide-ranging Distribution Service For Condoms
Who carried out the Good Practice? Shetland Health Board region and islands.
NHS Shetland Territorial Board Condoms are available in GP practices but not
Who was involved? all men visit their GP practice, nor do all men
NHS Shetland Local Diversity Task Force and feel comfortable about asking for condoms.
Health Promotion Team The Board tried to make sure condoms were
available where men actually go.
What was the situation before?
Condoms were not widely available throughout What is the situation now?
the Board’s region and were less likely to be As a result free condoms were made available
accessed by young men. in a variety of places including GP practices,
village halls, barber shops, Shetland Youth
How was it undertaken? Information Service and Shetland Community
A condom survey was undertaken to assess Alcohol and Drug Service. The condom survey
whether people knew where to get condoms is due to be repeated this year to ensure
from and whether they felt these places to be availability and accessibility.
accessible. Following the survey free condoms
were made available in a variety of places. What difference has it made (if any)?
There is more access to condoms for all age
What is the good practice? groups and particularly for men as well as
Providing a more widespread and far-reaching women.
condom distribution service throughout the
Top tips...things to remember
The gender duty is about men and women
Service redesign in response to identified needs is important to meet requirements of
the GED
Recognising needs and patterns in different age groups is an important part of
identifying service needs for men and women
Contact: Health Promotion Department, NHS Shetland
Brevik House, South Road, Lerwick, Shetland ZE1 0TG
Email: Health.promotion@shb.shetland.scot.nhs.uk
22SERVICE DELIVERY EXAMPLES
Service Delivery Example 5:
Advocacy Service Targeting Boys And Men
Who carried out the Good Practice? How was it undertaken/what did they do?
NHS Highland, Territorial board Through partnership work with Princess Royal
Who was involved? Trust for Carers Advocacy Service, and Health
Equality and Diversity Steering Group, Princess Promotion, baseline data was established to
Royal Trust for Carers Advocacy Service, and begin the groundwork required to commence
Health Promotion. the work. Although the two actions in the
Board’s Gender Equality Scheme Action Plan
What was the situation before? are distinct, some of the work can be shared
It was found through consultation and data in terms of developing publicity that better
analysis, that men and boys were less likely to addresses boys and men’s needs.
use carer advocacy services, than women and
girls. What is the situation now?
Work is progressing with partners to develop
What is the good practice? publicity materials that are better able to target
The Board has a Gender Equality Scheme boys and men. The publicity work will address
Action Plan objective to: the kind of materials and images used, as well
• increase the number of male carers using as the relevance of locations they are placed at.
advocacy services Discussions are taking place with partners
• increase the number of men with a carers to develop recruitment plans for volunteers
role accessing primary care services. that are better targeted to men. This will help
Some of the good practice shows the recruit more male volunteer advocates and, so,
importance of establishing baseline and it is hoped, help increase the number of male
quantitative data from/with partners. From this carers using the service.
baseline information, actions to target boys
and men in terms of advertising services and
recruiting volunteers will be developed with
partners.
23SERVICE DELIVERY EXAMPLES
What difference has it made (if any)?
It has encouraged partners to think of the
gender impact of their work. Part of this will
result in the development of more complete
data broken down by gender. Ultimately, it will
make a difference by increasing the numbers
of men and male carers who use advocacy
services.
Top tips...things to remember
The gender duty is about men and women
Consultation provides useful information
Gender analysis of information is critical
Identifying specific outcomes is a key requirement of the duty
Working strategically with partners will target resources more efficiently
Contact: Moira Paton, Head of Community and Health Improvement,
NHS Highland, Beechwood Park, Inverness, IV2 3BW
Email: moira.paton@hhb.scot.nhs.uk Tel: 01463 70 49 29
24Key Issues in Gender Impact Assessment (GIA)
Gender Impact Assessment is most effective if it is if carried out at the start of the
planning, policy or budgetary cycle but it may also need to be carried out in response to
monitoring data, following a review or as a result of research findings.
The focus of GIA should be on outcomes and improvements and not just the process that
is being followed. GIAs do not always need to be time-consuming or complicated.
Gathering disaggregated data is critical, but it is only the starting point, gender analysis is
essential to understand the need for service redesign or for workforce action.
It is useful to share the impact assessment with stakeholders including affected
communities and undertake revisions based on feedback.
A pro-forma or workbook is useful for working out your impact assessment. It will provide
you with evidence and assist in identifying further actions, information or consultation
required.
The impact assessment is complete when the policy, employment practice or service delivery
has been either modified or found to be in order.
25Notes
26Fair For All – Gender Equality and Human Rights Commission The Optima Building 58 Robertson Street Glasgow G2 8DU 0845 604 5510 - Scotland Main 0845 604 5520 - Scotland Textphone 0141 228 5912 - Scotland Fax www.fairforallgender.org.uk www.fairforall.org.uk www.equalityhumanrights.com Health board contact information:
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