Cultural Awareness in ARCPs Workshop 2 – Oxford Suite C O G PE D Cultural Awareness in ARCPs Workshop 2 – Oxford Suite Alan Cook, DME Weston Area Health Trust January 17 2017

Aim To explore how and where national and organisational cultural differences can adversely affect an ARCP and decide what we can do to stop this happening

Workshop objectives To describe where in the ARCP process cultural differences can lead to unfair or illegal behaviours and treatment of others To raise our awareness of which personal behaviours and work practices can be fundamentally affected by one’s own organisational and cultural background To list a number of ways we can ensure that ARCPs are not unfairly or inappropriately affected by organisational or national cultural factors

Workshop outline – 60 minutes 1 minute Aim and objectives 4 minutes Fast introductions 5 minutes What you want 10 minutes Presentation 20 minutes Groups discuss 15 minutes Feedback 5 minutes Summary and main message

33. Are you alert to practices here and throughout the world which discriminate against people on the basis of who or what they are or because of their beliefs? Bear witness to the humanity of all people ...’ Advices and queries – The Yearly Meeting of the Religious Society of Friends in Britain 2008

Case study At a day of ARCP assessments all the white male trainees (n = 9) get an Outcome 1 (satisfactory, can make progress with training), but all the black and minority ethnic and female trainees (n = 8) gain unsatisfactory outcomes (no’s 2 – 5). One female trainee from overseas was asked what her long term plans are. Most panel members state that this reflects patterns that are typical in that specialty and do not see this as a concern. What are your own views on this? What additional information would you seek to assess how fair this day has been? What does the law recommend in terms of equality actions that might apply here?

Summary ARCP Process For Foundation For Core and Specialty Placement, reviews and reports Panel and paperwork organised by MEM within Trust An outcome is decided by the ARCP panel Outcome communicated to trainee Further planning by the F/TPD, Educational Supervisor and Trainee For Core and Specialty Placement, reviews and reports Information from trainee, Educational Supervisor and Trust (employer) sent to Postgraduate Medical Education by given date Documentation is presented to the ARCP panel by PGME An outcome is decided by the ARCP panel Outcome communicated to trainee Further planning by the TPD, Educational Supervisor and Trainee

Equality Act 2010 For 4 decades legislation was complex Discrimination persists and progress on some issues stubbornly slow Equality Act 2010  provided a new cross-cutting legislative framework Protects the rights of individuals and advances equality of opportunity for all Updates, simplifies and strengthens previous legislation

Main elements of the Act Personal Protected Characteristics Definitions of unlawful discrimination Disability related aspects Provision of services, goods and facilities Positive Action Employment matters and pay reviews Duty to advance equality Procurement Data Occupational requirements Duty to tackle socio-economic inequalities

What characteristics are covered?

Protected characteristics Age Disability Gender reassignment Marriage and civil partnership Pregnancy and maternity Race Religion or belief Gender Sexual orientation

Equality and Diversity – key concepts Direct discrimination Indirect discrimination Positive action Genuine Occupational Qualification or requirement Targets () and Quotas() Monitoring Harassment Victimisation Reasonable instructions Flexible working

Indirect discrimination occurs when A condition, requirement, or practice is applied This in effect excludes or has adverse impact on a group covered by law The condition is not justified or appropriate Proportionate effect is identified

Example of indirect discrimination The ARCP was held in a meeting room on the fourth floor of an old building which did not have a lift. There were six review meetings scheduled for that day. One of the trainees asked to attend had limited mobility due to a recent accident and was not able to climb stairs and therefore could not attend. In such a situation reasonable adjustment, i.e. relocating rooms, is a must

Further examples Evening meetings when trainees have dependants Differential treatment between trainees – time given, support, guidance or behaviours Less engagement with some trainees – eye contact, interest shown, use of inclusive or excluding gestures Inappropriate interest in irrelevant matters or expectations that alienate some people

Further discussion Where and how else might indirect discrimination on the grounds of race, national or cultural background, or ethnic origin occur in ARCPs? What actions should we therefore be taking to genuinely create equality and fair treatment for all in ARCPs?