RACE EQUALITY AWARENESS SESSION Steve Baldwin Barnet and Chase Farm Hospitals

Aims and Objectives To eliminate unlawful race discrimination in the workplace. To value diversity in staff and patients. To raise awareness of why Trust has to achieve 95% coding on patient ethnic data. To raise awareness of using routine patient data to inform service improvements. To raise staff awareness of Trust’s Race Equality Scheme. Barnet and Chase Farm Hospitals

At the end of the session you will: have an awareness of race equality legislative requirements. be more aware about the impact of health inequalities and the diverse needs of patients. be able to demonstrate an appreciation of the need to collect ethnic group information. be able to deal with patients questions and concerns. challenge race discrimination when it occurs. Barnet and Chase Farm Hospitals

Race Relations Act 1976 Race Relations (Amendment) Act 2000 The Race Relations Act 1976 (Amendment) Regulations 2003 Trust must eliminate racial discrimination. Promote equality of opportunity . promote good relations between people of different ethnic backgrounds. Publish Race Equality Scheme. Record and monitor policies and services. Barnet and Chase Farm Hospitals

Section 20 Race Relations Act 1976 Makes it: unlawful for anyone concerned with the provision of healthcare services to discriminate on racial grounds by refusing or deliberately omitting to provide the service; or as regards quality; or the manner in which, or the terms on which they are provided. Barnet and Chase Farm Hospitals

Direct Race Discrimination When you treat a person less favourably on The basis of their race either in employment provision or service provision. Barnet and Chase Farm Hospitals

Indirect Discrimination Indirect Discrimination is when applying requirements, conditions or practice which although applies to all, can only be met and benefited by a considerably smaller proportion of a minority group and cannot be justified other than on racial grounds. Barnet and Chase Farm Hospitals

Race Relations Act 1976 Race Relations (Amendment) Act 2000 Section 71 – 1976 Act places a duty on all public sector employer to eliminate unlawful race discrimination. Stephen Lawrence’s case and Macpherson’s Report on Metropolitan Police conduct led to further legislative requirements - Race Relations (Amendment) Act 2000. Race Relations (Amendment) Act 2000 came into force on 31 May 2002 requiring all public sector organisations to: promote good relations between people of different ethnic backgrounds, publish Race Equality Scheme and monitor policies and services. Barnet and Chase Farm Hospitals

Race Relations (Amendment) Act 2000 To eliminate institutional race discrimination. To factor fairness into the modernisation of public services. To instill government commitment to change. To rebuild trust in the public sector. Barnet and Chase Farm Hospitals

Who is liable ? The legal person liable in any public law action against the Trust will be the: Chief Executive and the Trust Board. Individual Employees can be named in a case. Barnet and Chase Farm Hospitals

Enforcement Equality and Human Rights Commission. Able to enforce duties within the Race Relations (Amendment) Act 2000. If they are not satisfied with remedial action they can issue a compliance notice. Further non-compliance may lead to a court order on the employer. Barnet and Chase Farm Hospitals

General Duties The general duty means the NHS must have due regard to the need to: eliminate unlawful racial discrimination promote equality of opportunity promote good relations between people of different racial groups Barnet and Chase Farm Hospitals

Specific Duties To assist in delivering the general duty, specific duties have been placed on public bodies. There are two types of specific duties: on the policy/service delivery side, the requirement is to set out information on a number of actions that will help deliver non-discriminatory services to local people. on the employment side there is a requirement to collect and publish a specific set of information. In particular, NHS organisations must review and consult on their Race Equality Schemes. This is a statutory requirement. Barnet and Chase Farm Hospitals

Specific Duties Contd. Make arrangements to ensure access to information and services are available. Make arrangements to train all staff on relevant duties within the Act. Monitor staff ethnically for jobs and promotion. Monitor the ethnicity of all staff for grievances,disciplinary, appraisals,dismissals, and reasons for leaving the Trust. Monitor 3rd party contractors to ensure they have policies, procedures and systems in place to eliminate race discrimination. Barnet and Chase Farm Hospitals

Benefits of the duties Improve Trust’s ability to deliver suitable and accessible services that meet varied needs. Develop good practice and encourage greater openness. Increase confidence in public services, especially among ethnic minority communities. Barnet and Chase Farm Hospitals

Equality in Service Delivery Staff and professional involvement Equality in Service Delivery Promoting and providing an equal service is not about giving all people the same service but meeting the needs of the individual patient. Barnet and Chase Farm Hospitals

Equality Impact Assessments Assess whether the ways our service are carried out meet the general duty. Consider whether any changes need to be made to address identified imbalance. Assess impact and implement changes. Barnet and Chase Farm Hospitals

Questions for Everyone Does the way we provide our service have an adverse impact on some racial groups in the local communities we serve ? Is the adverse impact avoidable ? Could it be considered to be unlawful discrimination ? Could the adverse impact be reduced by taking particular measures ? Is further research needed and is it likely to lead to a different outcome ? Barnet and Chase Farm Hospitals

Relevance The weight given to race equality should be proportionate to its relevance. Give greater consideration and resources to functions and policies that have the most effect on the public or employees. Barnet and Chase Farm Hospitals

What is Ethnic Monitoring ? Obtaining and managing ethnic origin data of patients and staff systematically. Analysing the data regularly and reporting outcomes to the Trust Board. Acting on the results and addressing any adverse impacts identified. Barnet and Chase Farm Hospitals

Obtaining the Data Is not the beginning and the end of ethnic monitoring, but It is crucial for successful implementation Incomplete and/or inaccurate data may lead to inadequate or misleading analysis. Misleading analysis may lead to inappropriate action. Barnet and Chase Farm Hospitals

How to collect ethnic group data Use prompt card Patient must self classify If patient appears unwilling, explain reason why data is needed. If patient refuses, this must be coded Z. It is acceptable to ask as many times as necessary until data is collected. Barnet and Chase Farm Hospitals

Where are we up to? Current Local Figures available in the Trust’s Race Equality Scheme. Current Local Demographics Health Improvement Programme Focus on providing main healthcare needed by the local people. Focus on how we develop services to meet these needs. Engagement Barnet and Chase Farm Hospitals

Needs of Diverse Patients Multi- ethnic Multi-faith Multi-cultural Provide high quality care Barnet and Chase Farm Hospitals

Inequality in Health 46% increased CHD mortality in South Asian women. 110% increased CVA mortality in African Caribbean women. 300% greater suicide amongst South Asian women. 300% increased prevalence of and mortality from diabetes in the Asian population. Barnet and Chase Farm Hospitals

Questions Inequality in Health Raises Are we acting fairly ? For example does the Diabetes service we provide meet the needs of all the communities it’s meant for and does it meet their needs ? Are experiences and outcomes of patients accessing our services differ according to their ethnicity ? Barnet and Chase Farm Hospitals

Cultural Competency Asking questions Replace anecdotes and assumptions with clarity. Recognising and respecting differences. Understanding and meeting the needs of the individual. Barnet and Chase Farm Hospitals

Definition of Ethnic Group A group of people with a long shared history. A common cultural tradition. A common geographical origin from a small number of ancestors. A common language. A common literature. A common religion. Have a distinct identity seen by both themselves and others. Barnet and Chase Farm Hospitals

Ethnicity Refers to aspects of shared history, language and culture, a group defined from within. Group identity defined by social pressures from the group linked with a psychological need to belong Barnet and Chase Farm Hospitals

Any Questions ? Barnet and Chase Farm Hospitals

Thank you for listening. Barnet and Chase Farm Hospitals