Equality workshop: improving

local health services using the

Equality Delivery System

28 November 2017

Equality workshopNHS Southwark Clinical Commissioning Group held an equality workshop to look at improving local services using the Equality Delivery System (EDS). We looked at 3 services the CCG commissions:• Extended Primary Care Service (8am – 8pm GP

Access Hubs)• Talking Therapies Southwark Service• Continuing Healthcare Service

The workshop was attended by approx 30 people including CCG staff and lay member, service provider staff, people working for voluntary sector organisations and users of the services and local people.

11 people filled in equal opportunities forms:

Ethnicity:

• 40% identified as White British

• 20% as White European

• 30% as Black or Black British -Caribbean

• 10% as Black or Black British – African

Gender

• 87.5% identified as female

• 12.5% identified as male

Sexual orientation

• 90% identified as heterosexual

• 10% as gay

Religion

• 70% identified as Christian

• 30% as having no religion

Age

• 40% were aged 30 - 44

• 40% were aged 45 - 59

• 10% were aged 60 – 64

• 105 were aged 65 - 74

Disability / long term condition (LTC)

• 34% identified as deaf / hard of hearing

• 11% identified as having a learning disability

• 34% identified as having mental ill health

• 11% identified as having a long term illness

• 11% identified as having a physical disability

• 34% identified as having no disability

Equality workshopThe purpose of the workshop was to help the CCG understand the extent to which the services we commission are delivering the following goals:• better outcomes, • improved access and • better experience for everyone in Southwark.

Equality workshopWasia Shahain, the Senior Equality , Diversity and Inclusion Manager explained the Equality Delivery System and how participants will be looking at one service area as a group in a detailed way and grading the service against a number of set outcomes.

Excelling: The CCG is

doing very well

Achieving: The CCG is

doing well, but could

still do more

Developing: The CCG

is doing OK, but

needs to do more

Undeveloped: The

CCG needs to do

much more

Outcomes we were measuring Goal Description Outcome

1 Better health

outcomes

The NHS should

ensure that the

people who use

services are free

from harm and

experience

different services

in an integrated

way

1.1 Services are commissioned, procured, designed

and delivered to meet the heath needs of local

communities

1.2 Individual people’s health needs are assessed and

met in appropriate and effective ways

1.3 Transitions from one service to another, for people

on care pathways, are made smoothly with everyone

well-informed

1.4 When people use NHS services their safety is

prioritised and they are free from mistakes,

mistreatment and abuse

*1.5 Screening, vaccination and other health

promotion services reach and benefit all communities

Outcomes we were measuring Goal Description Outcome

2 Improved

patient access

and experience

People can readily

access services that

they need, and

experience services

positively

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

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

Equality workshop

Mark Kewley, Director of Transformation, gave an overview of Southwark’s population using data from the Council’s Public Health Intelligence Unit.

• Approximately 313,300 people live in Southwark, and the local population is much younger than the national average

• Southwark is an ethnically diverse borough with almost half of the population identifying as a minority group

• Ethnic minority communities are concentrated across the middle of the borough with pockets in the north

• Approximately 13% of people living in inner London have a disability, equating to 40,700 people in Southwark

• Estimates indicate that Southwark has the second largest gay or lesbian population in the UK, after Lambeth

Equality workshopDr Katharine Rimes gave a presentation on how the Talking Therapy Service (TTS) is meeting the needs of Lesbian, Gay, Bi and Queer (LGBQ) service users in Southwark.

Issues:• LGBQ people are more at risk for mental

health problems• More LGBQ people in Southwark than in

most parts of UK• Risk of mental health problems in LGBQ

people in Southwark is greater than for LGBQ people nationally

• LGBQ people, especially women and bisexual

• service-users have poorer treatment outcomes

What the service did:• Set up an on-going course for LGBQ people using

“cognitive behavioural” therapy (CBT) techniques• Male and female therapist who identify as LGBQ• Includes LGBQ-related examples• Discusses LGBQ issues such as coming out,

coping with stigma and discrimination

More

confidence

being LGBQ.Came out to

people at

work for the

first time

ever

Better coping

with negative

thoughts and

feelings

More

hopeful

about the

future

Feel less

alone or

weird

Equality workshop We then broke up to into three groups to look in detail at the outcomes in the service areas, using evidence that had been provided. For each service, participants were asked to tell us:• If the picture portrayed matched their or their communities’ experiences• Their ideas for how the service could be improved• A grade that everyone was comfortable with

Next steps We thanked everyone for attending and explained the next steps:• Validation of the grades• Identify action for service improvement or action plans • Monitor any actions or improvements identified • Publish the grades, actions and write up of the workshop

Evaluation 11 people filled in evaluation forms:• 55% found the information received before the event useful and 27% found it

adequate• 73% found the presentations easy to understand • 64% agreed the purpose of the event was clear from the outset• 90% felt able to contribute to the process

The hard work in

preparation was in

vein because

people hadn't read

[the evidence] and

didn't understand it

I found it

comprehensive

and informative

You need to

make sure

people have

used the

service

As a service user,

it was helpful to

hear about what

was happening in

the background

by the

professionals.

Thank you

for a great

event

People

were

unable to

contribute

Condense

and less

paper work

Grading

The table below is a table of grades as agreed at the workshop. We have also developed an equality objectives and action plan which you can see by clicking here.

Commissio

ning areaGoal 1 Goal 2

Continuing

Healthcare 1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4

Talking

Therapies

Southwark

1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4

Extended

Primary

Care

Service

1.1 1.2 1.3 1.4 2.1 2.2 2.3 2.4

Equality objectives and

outcomes Better health outcomes:• Commissioners to carry out equality analysis as part of development,

engagement and procurement process. EIA to be presented with business case / strategy at relevant committee.

• CCG to request and review activity data from key providers by protected characteristics as part of service monitoring / quality meetings (on at least 6 monthly cycle)

• CCG to ask key providers what E&D training is provided within their service• CCG to assure itself that access to interpreting services is available for the

hours of operation of services• CCG to work with key providers to update Serious Incident (SI) reporting to

include demographic categories: age, gender, ethnicity and sexual orientation

Equality objectives and

outcomes Improve patient access and experience:• CCG to work with key providers to review waiting list data by relevant

protected characteristics, to understand whether this has an impact of access to services for the local communities

• CCG to work with key providers to identify how information on reasonable adjustments, for patients, carers and local communities, are made, recorded and reported

• CCG to work with key providers to enable patient experience data to be analysed and reported by protected characteristics

• CCG to work with key providers to enable complaints data to be analysed and reported by protected characteristics and included within the patient experience reporting