The Equality Delivery System Medway

Talked to lots of different groups to make a web app to help local people find out information about different services Use lots of information including comments and ideas from local people before making decisions about services Talk to lots of different people when making a plan of what we will do in the next year and when replying to national consultations Have a lay member who is responsible for patient engagement Work with local Healthwatch and voluntary and community groups to make sure engagement is joined up. Recap 1.1 (Services meet peoples needs)

Write reports to our Governing Body and other committees to let everyone know what engagement we have done and what the impact has been We get the public involved at all stages of designing a service, like a procurement – when we buy a service Worked specifically with homeless, older people, carers, people with mental health needs, young people, learning disabilities, vulnerable patients and ethnic minority communities this year Have a Communications and Engagement Strategy. Recap 1.1 (Services meet peoples needs)

Recap 1.2 (Peoples individual needs are met) Talked to lots of different groups to make sure the web app we were developing met the needs of different communities Talked to parents, carers and disabled children about their needs for short breaks during a consultation Surveyed vulnerable older people to talk about their experiences of having a care manager Started a new service to support older people who have falls Talked to people with a learning disability and their carers to find out their thoughts about services to complete a health self assessment for Medway council and Medway Clinical Commissioning Group Worked with vulnerable patients who have neurological problems to find out their experiences of services to make improvements Large programme of engagement with children and families to find out their views about local service jointly with Medway Council.

Recap 1.3 (Moving between different services) Providers want to meet together to look at what projects are coming up to ensure any communication and engagement is joined up We regularly ask people, during lots of different projects, how joined up services are, so that we can solve the problems Clinicians are involved at the beginning of planning processes to make sure they can tell us where there are gaps or problems in the system We use Patient Opinion – which is a website patients can use to post comments about lots of different services – to gather patient insights.

Recap 1.3 (Moving between different services) Equality Analysis’ are completed for each project to look at the impact on different groups and communities Currently reviewing how people move from children's and adult’s therapy services for long term conditions and end of life services Talked to people with a Learning Disability about the self- assessment framework and they raised problems about moving from children’s to adult services. This has been included in a new work programme Listened to information from service users about problems with maternity service and have put plans in place to make improvements.

Recap 1.4 (Safety is prioritised and free from mistakes) North Kent Quality team make sure hospitals and services are safe and are keeping to quality standards The Quality team look at lots of indicators that tell them how hospitals and services are doing If there is a serious problem with a service or the hospital or a healthcare associated infection the Quality team make sure there is a plan to sort things out and learn from things so it doesn’t happen again There is a North Kent Safeguarding Team.

Trends in older people falling over a lot and patients in hospital that get pressure sores are looked at and the Quality Team have made lots of improvements to make sure they are supported Sometimes the Quality team do “deep dive” projects which look in lots of detail at one service or area to check that everything is ok. They do this by talking to staff, patients and looking at patient notes After the report about the Winterbourne View Hospital for people with learning Disabilities, locally we have been making improvements and looking at our services to make sure they fit for purpose. There is also a Learning disability nurse at the hospital and all relevant staff there have had training We check and make sure that male and female patients are treated on different wards, and if they can’t be, we make sure there is a good reason why the ward is mixed. Recap 1.4 (Safety is prioritised/ Free from mistakes)

Recap 2.1 (Access to services is good) Equality Analysis is done for every project to make sure the project doesn’t disadvantage a group or community When we look at buying a new service, we ask patients about how they would like to access a future service so we can make sure, where appropriate, we make this possible There are national targets for all hospitals and services about making services accessible Working on a strategy to make sure there is good access to GP services Provide translation and other formats to support people to access services There is a target to encourage hospitals to target over 75’s and, if they need it, give them an assessment to check if they have Dementia, give them the right tests and send them to a specialist if they need it. The assessment also looks at carers to make sure they are supported.

We spoke to people with a learning disability and they told us they had problems getting health checks with GPs – this has been included in plans to be improved this year NHS England buys specialist services like gender reassignment so it is their responsibility to make sure these are accessible, but it is recognised that locally more needs to be done Previously, maternity services could only be accessed online, we have made changes so that there are other ways to access the service, so that it is fair. There are also translation services and support for young women Monitor and make sure that males and females are treated on separately on hospital wards Have worked with a homeless centre to talk to clients about their access to local GP services and have taken their thoughts on board when reviewing the service. Recap 2.1 (Access to services is good)

Looking at making patient choice better on Choose and Book Medway Hospital survey has found people don’t have enough information and aren’t involved – they are looking at making improvements Medway Community Healthcare gives us information about choice and involvement, which we monitor We are looking at GP services and making sure people can be more involved in their care We have developed a web app to support people to make better choices about where they go for services during the day and at night People need more support to choose where they die and we are working to make this better. Recap 2.2 (Informed about care)

Recap 2.3 (people have positive experiences of the NHS) The Quality team get lots of information, including from Healthwatch, about what people think of the local NHS. This includes action plans of how services will be improved to make services better. Healthwatch is a permanent member of this group. As part of Medway Clinical Commissioning Groups engagement programme, there are regular projects which talk to different communities to understand their experiences of the NHS. Feedback is investigated and acted on.

Recap 2.4 (Complaints) There is a complaints policy and a complaints leaflet that is also in Easy Read which has been given out to lots of different organisations and people. Medway Clinical Commissioning Group checks on provider complaints and make sure lessons are learnt and that they are dealt with sensitively and appropriately.

Recap 3.1 (Staff are recruited in a fair and representative way) Use NHS jobs to advertise jobs, expect for Governing Body members who might be clinicians. Their jobs are also advertised in journals and local papers. Data is collected about staff to find out how representative the workforce is. There is a policy for recruitment and selection of staff Medway Clinical Commissioning Group checks on providers workforce. Medway Hospital have started a “cultural barometer” to find out how good staff are feeling.

Recap 3.2 (Equal pay) Use Agenda for Scale pay scale to pay staff Monitor staff through a system of Electronic Staff Records – this means we can check pay levels against disadvantaged groups Need to do an equal pay audit There is a HR Manager that looks over Equality and Diversity to make sure that all issues, not just pay are monitored and checked.

Recap 3.3 (Training and Development for staff) There is an induction for staff and extra training available Staff are told about all mandatory training All staff have a personal development plan At the moment we do not get information about providers training and development – this is a gap.

Recap 3.4 (Staff are free from abuse, harassment and bullying) There is a policy about Abuse and Harrassment. Counselling services are available if staff have experienced Bullying. Bullying and Harassment training is included in the induction and in complaints training for all staff.

Recap 3.5 (A representative and supported workforce) There is a flexible working policy that includes lots of choices that staff can make about how they want to work The HR Manager uses the Electronic Staff Records System to check that there are no equality and diversity trends and issues Our providers will consult with their staff on any changes to working hours.

Recap 3.6 (Staff have positive experiences of working in the NHS) There has been a staff survey in Feb/March 2014 and information from protected characteristic groups was looked over to make sure there were no trends and issues Staff survey results for providers are reported to the Quality Team, but this information is not broken down into age, gender, ethnic background and disability There is a childcare voucher scheme in place for staff There is a staff forum that talks about staff wellbeing.

Recap 4.1 (Boards and senior leaders promote equality) All Governing Body members have Equality and Diversity training, and Equality Analysis training so they know how to properly check them Governing Body members do not always receive the best equalities information to inform decisions The Governing Body gets regular reports about Equality and Diversity There is an Equality and Diversity Working Group.

Recap 4.2 (Papers to the Board make sure they talk about equality issues) Every report has a section about equality issues and about risks. However, not everyone fills these sections out in the same way There is a register of all of the risks that every project tells the Governing Body about The Clinical Advisory Group makes sure every report has an Equality Analysis and that it is detailed enough, otherwise the project can’t go ahead Once a project has started, the risks and analysis are not always checked again to make sure nothing has changed. A register is being started so that proper checks can happen.

Recap 4.3 (Inclusive leadership) Medway CCG collects equality information about its staff and reviews this across different job roles to make sure everything is fair Staff are engaged through team meetings, regular meetings with their managers, at staff briefings and the Staff Forum. There are policies in the staff handbook which explain how we will deal with discrimination.