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Embracing Equality & Diversity,
      Dignity & Respect through
              „Inclusion‟




www.trustinterventions.co.uk2012-2013
                                        Brought to you by Trust Interventions
Learning Outcomes
To know why equality and diversity issues are important

To have increased understanding of the legal framework and
the NHS context including policies and initiatives.

Be aware of the legal responsibilities of employer and
employee

To have identified key equality and diversity issues and
implications for the service.

To gain understanding of the origins of negative attitudes,
prejudice, discrimination and explore the effects discrimination
has on people.

To inspire positive attitudes

                     www.trustinterventions.co.uk2012-2013
EXERCISE
Have YOU ever felt excluded? What
 does it FEEL like to be excluded?




           www.trustinterventions.co.uk2012-2013
Exclusion - Learning Point
We may have all felt excluded at some point in our lives

By remembering how it felt, we can better empathise
with colleagues or service users who are different to us,
or who represent an opinion that is different from the
majority.

Wherever there is difference, there is more potential to
be excluded or treated differently.

Some people are more likely to experience this than
others.




                       www.trustinterventions.co.uk2012-2013
Our inclusion vision
Our Inclusion vision is to “make regional NHS
organisations the best NHS commissioner
and providers within the United Kingdom and
beyond, by proactively including individuals
and groups that may feel, or are being,
excluded from the services and employment
opportunities provided by NHS organisations
within the East Midlands.”

www.nhseastmidlands.co.uk

            www.trustinterventions.co.uk2012-2013
Government's Social Exclusion Unit (2004)
definition of exclusion, which can occur:

“when people or areas suffer from a
combination of linked problems such as
unemployment, discrimination, poor skills,
low incomes, poor housing, high crime,
bad health and family breakdown” leading
to them being excluded from the services
and opportunities enjoyed by those in the
political, economic and social mainstream
of society.
              www.trustinterventions.co.uk2012-2013
NHS East Midlands lead on the Equality
Delivery System (EDS)

At the heart of the EDS has set four goals.
The goals are:
• Better health outcomes for all
• Improved patient access and experience
• Empowered, engaged and included staff
• Inclusive leadership at all levels




            www.trustinterventions.co.uk2012-2013
The EDS helps us:
• to meet the public sector Equality Duty
  deliver on the dignity and respect agenda
• to deliver on the NHS Outcomes
  Framework and the NHS Constitution
  and,
• if they are providers, to meet the Care
  Quality Commission‟s “Essential
  Standards of Quality and Safety”



            www.trustinterventions.co.uk2012-2013
Question:
What do you understand
 by the term „Equality‟?



      www.trustinterventions.co.uk2012-2013
Equality
   Equality is about creating a fairer society where everyone can
    participate fully and have the opportunity to fulfil their potential.
 It is summarised in terms of equal access, equal shares, equal
outcomes and equal treatment.
 Equal treatment does not mean treating everyone the same.       It is
about giving people an equal opportunity to have their own individual
needs considered / met.
   Equality is backed by Legislation to promote:
   - equality of opportunity
   - good relations between different people, and to
   - tackle unfair discrimination


                          www.trustinterventions.co.uk2012-2013
Question: What do you understand by
the term „Diversity

Question: What are the six dimensions
of Diversity



            www.trustinterventions.co.uk2012-2013
Parental
                                            Status
                        Income                               Education

                                         Gender &
            Marital Status               Assignment
                             Sexual                                      Postcode
                                                        Religion
                             Orientation
                             Ethnicity
            Part time                                        Age
                                         Physical                      Social Class
                                         Qualities
Secondary                                (Disability)
                 Opinions                                          Experiences
Primary

                                     Work Background



                     www.trustinterventions.co.uk2012-2013
‘Common Sense is the collection of prejudices acquired by the
age of eighteen‟. (Einstein)

                               Behaviour Iceberg
           Discrimination                                                   En
                                                                              vir
                                          ent       ES
                                                       )                         on
                                       nm        ICI                               me
                                nv iro     LP
                                              OL                             (LA     nt
                               E         A                                       W)
                                       ON I
                                     AT
                               NIS
                       (OR
                          GA                             Our
                                                      Behaviour

           Stereotype
                                                   Skills & Knowledge




                                                                                          Pe
                          ce




                                                                                             r
                           n




                                                                                            so
                        ie




                                                   Emotional Intelligence




                                                                                              na
                     er
                   xp




                                                                                                 lE
                  lE




                                                                                                 xp
                   a




                                                                                                   er
                on




                                      Values, Beliefs, Principles & Attitudes




                                                                                                      ie
              rs




                                                                                                         n
                                                                                                        ce
             Pe




           Prejudice




                                                    Group Think

                                              www.trustinterventions.co.uk2012-2013
The Equality Act 2010
                          Protected Characteristics

Age
Disability inc. carers
Gender Reassignment
Marriage and Civil Partnership
Pregnancy and Maternity inc. breastfeeding
Race
Religion / Belief
Sex
Sexual Orientation

                         www.trustinterventions.co.uk2012-2013
BENEFITS OF DIVERSITY

   Greater access to a wider pool of skills, strengths,
experiences &       perspectives
   Greater understanding of diverse groups
   Attracts staff
   Retains staff
   Motivated staff
   Time and money saved in dealing with harassment &
    discrimination issues, conflict resolution & employment
    tribunals
   Good NHS image
   Happy fulfilled workforce with diverse skills

                     www.trustinterventions.co.uk2012-2013
Question: Why do we have equality law?

Answer: Wherever there is a difference, there is a potential for
                     discrimination



         Definition: Discrimination
   To act and single out a particular person
                   or group


                     www.trustinterventions.co.uk2012-2013
www.nhseastmidlands.co.uk

 Inclusion and fairness for all is at the heart of our business
  which supports the first principle of the NHS Constitution:

 “The NHS provides a comprehensive service available to all
irrespective of gender, race disability, age, sexual orientation,
  religion or belief. It has a duty to each and every individual
      that it services and must respect their human rights.
    "At the same time, it has a wider social duty to promote
equality through the services it provides and to pay particular
        attention to groups or sections of society where
 improvements in health and life expectancy are not keeping
               pace with the rest of the population.”
                                                         (NHS Constitution:2009)

                      www.trustinterventions.co.uk2012-2013
Equality Act 2010

 Introduces a new Equality Duty on all „strands‟ now called
„protected characteristics‟.
 End age discrimination in service delivery
 Ensure transparency – need to report on pay gaps and
employment statistics relating to diversity.
 Ensure equality is promoted through purchasing and
procurement processes.
 Extend the scope of positive action.
 Strengthens enforcement, including discrimination on
intersectional grounds as well as representative actions.




                       www.trustinterventions.co.uk2012-2013
Harassment
1   Unwanted conduct related to a
    protected characteristic which has the
    purpose or effect of:
    a) Violating the other person‟s dignity,
    or
    b) Creating an intimidating,hostile,
    degrading, humiliating or offensive
    environment for him/her.



                 www.trustinterventions.co.uk2012-2013
Third Party Harassment

The Act has extended protection against harassment of
employees by customers, clients and contractors to apply
to all protected characteristics.

Liability will arise where an employer becomes aware that
an employee has been harassed on at least two
occasions by a third party (doesn‟t matter if it‟s different
customers etc) and they fail to take reasonable steps to
prevent it happening for a third time.

                     www.trustinterventions.co.uk2012-2013
Harassment Examples

E.g. a patient who felt patronised by a clinician or a
receptionist because of their age, would potentially have
a claim.
Extends the existing provisions in relation to harassment
by 3rd parties into the other strands of discrimination law.
This means that where the employer is aware that one of
its employees has been subjected to harassment (say,
by a patient) and has not taken reasonable steps to
prevent a recurrence of that harassment, then the
employer may be liable for 3rd party incidents from the
2nd incident onwards.
Need to be responsive to both formal and informal
complaints by staff.
                      www.trustinterventions.co.uk2012-2013
Betari’s Box


   MY                                          MY
                     Affects
ATTITUDE                                    BEHAVIOUR



Affects                                            Affects



YOUR BEHAVIOUR Affects               YOUR ATTITUDE



           Likely Outcome = Conflict
     Question – How do we manage conflict?

           www.trustinterventions.co.uk2012-2013
Collusion is co-operation with others, knowingly or unknowingly, to
reinforce stereotypical attitudes, prevailing behaviours, and norms.



     Types of collusion include:
     Silence
     Denial
     Active Co-operation



                         www.trustinterventions.co.uk2012-2013
COLLUSION: BULLYING & HARASSMENT

Bullying & Harassment, Racism and Homophobia is not only caused by
bullies, racists or homophobes.

Bullying & Harassment, Racism and Homophobia thrive because of the
SILENCE of the MAJORITY quietly condones it.



     CHALLENGE it and REPORT it



                      www.trustinterventions.co.uk2012-2013
KNOWN HEALTH INEQUALITIES

The incidence of lung cancer among men and women in the most deprived areas is
around twice that in the most affluent areas, and death rates are about two and a
half times higher.
Lesbian, Gay and Bisexual people are more likely to be self-harmers or consult
mental health professionals than heterosexual people.
Pakistani and Black Caribbean women are much more likely to have high blood
pressure than women in the general population.
Men typically develop heart disease ten years earlier then women.
People with learning disabilities have higher rates of obesity and respiratory
disease, and high levels of unmet needs.




                              www.trustinterventions.co.uk2012-2013
KNOWN HEALTH INEQUALITIES

Lesbian and Bisexual women are more likely to be overdue for cervical screening
than heterosexual women.
Women in routine occupations are twice as likely to be obese as women in
professional occupations.
Women are around 2.7 times more likely than men to develop an auto-immune
disease such as diabetes.
People with mental health problems have higher rates of obesity, smoking, heart
disease, hypertension, respiratory disease, diabetes, stroke and breast cancer than
other citizens.




                          www.trustinterventions.co.uk2012-2013
Diagnostic Overshadowing
People with learning difficulties are much more likely than other citizens to have health
problems, including obesity and respiratory disease.

People with mental health problems are more likely to have problems such as heart
disease, high blood pressure and diabetes.

People with schizophrenia are almost twice as likely as other citizens to have bowel
cancer.

Women with schizophrenia are 42 per cent more likely to get breast cancer.

The rate of obesity among people with learning difficulties is 28 per cent, compared with
20 per cent for the overall population

In primary care both groups are less likely to receive some of the expected health
checks and treatments

                                                                DRC ‘Closing the Gap’ Report

                              www.trustinterventions.co.uk2012-2013
Many thanks for your participation
   There is a bank of resources available on the
               following web pages:

         www.equalityhumanrights.com

              www.nottsdeaf.org.uk

             www.equalities.gov.uk/

          www.dh.gov.uk/en/Managingyourorganis
ation/Workforce/Equalityanddiversity/index.htm

              www.disabledgo.com
               www.stonewall.org.uk




           www.trustinterventions.co.uk2012-2013

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Embracing equality & diversity, dignity & respect (a)

  • 1. Embracing Equality & Diversity, Dignity & Respect through „Inclusion‟ www.trustinterventions.co.uk2012-2013 Brought to you by Trust Interventions
  • 2. Learning Outcomes To know why equality and diversity issues are important To have increased understanding of the legal framework and the NHS context including policies and initiatives. Be aware of the legal responsibilities of employer and employee To have identified key equality and diversity issues and implications for the service. To gain understanding of the origins of negative attitudes, prejudice, discrimination and explore the effects discrimination has on people. To inspire positive attitudes www.trustinterventions.co.uk2012-2013
  • 3. EXERCISE Have YOU ever felt excluded? What does it FEEL like to be excluded? www.trustinterventions.co.uk2012-2013
  • 4. Exclusion - Learning Point We may have all felt excluded at some point in our lives By remembering how it felt, we can better empathise with colleagues or service users who are different to us, or who represent an opinion that is different from the majority. Wherever there is difference, there is more potential to be excluded or treated differently. Some people are more likely to experience this than others. www.trustinterventions.co.uk2012-2013
  • 5. Our inclusion vision Our Inclusion vision is to “make regional NHS organisations the best NHS commissioner and providers within the United Kingdom and beyond, by proactively including individuals and groups that may feel, or are being, excluded from the services and employment opportunities provided by NHS organisations within the East Midlands.” www.nhseastmidlands.co.uk www.trustinterventions.co.uk2012-2013
  • 6. Government's Social Exclusion Unit (2004) definition of exclusion, which can occur: “when people or areas suffer from a combination of linked problems such as unemployment, discrimination, poor skills, low incomes, poor housing, high crime, bad health and family breakdown” leading to them being excluded from the services and opportunities enjoyed by those in the political, economic and social mainstream of society. www.trustinterventions.co.uk2012-2013
  • 7. NHS East Midlands lead on the Equality Delivery System (EDS) At the heart of the EDS has set four goals. The goals are: • Better health outcomes for all • Improved patient access and experience • Empowered, engaged and included staff • Inclusive leadership at all levels www.trustinterventions.co.uk2012-2013
  • 8. The EDS helps us: • to meet the public sector Equality Duty deliver on the dignity and respect agenda • to deliver on the NHS Outcomes Framework and the NHS Constitution and, • if they are providers, to meet the Care Quality Commission‟s “Essential Standards of Quality and Safety” www.trustinterventions.co.uk2012-2013
  • 9. Question: What do you understand by the term „Equality‟? www.trustinterventions.co.uk2012-2013
  • 10. Equality  Equality is about creating a fairer society where everyone can participate fully and have the opportunity to fulfil their potential.  It is summarised in terms of equal access, equal shares, equal outcomes and equal treatment.  Equal treatment does not mean treating everyone the same. It is about giving people an equal opportunity to have their own individual needs considered / met.  Equality is backed by Legislation to promote:  - equality of opportunity  - good relations between different people, and to  - tackle unfair discrimination www.trustinterventions.co.uk2012-2013
  • 11. Question: What do you understand by the term „Diversity Question: What are the six dimensions of Diversity www.trustinterventions.co.uk2012-2013
  • 12. Parental Status Income Education Gender & Marital Status Assignment Sexual Postcode Religion Orientation Ethnicity Part time Age Physical Social Class Qualities Secondary (Disability) Opinions Experiences Primary Work Background www.trustinterventions.co.uk2012-2013
  • 13. ‘Common Sense is the collection of prejudices acquired by the age of eighteen‟. (Einstein) Behaviour Iceberg Discrimination En vir ent ES ) on nm ICI me nv iro LP OL (LA nt E A W) ON I AT NIS (OR GA Our Behaviour Stereotype Skills & Knowledge Pe ce r n so ie Emotional Intelligence na er xp lE lE xp a er on Values, Beliefs, Principles & Attitudes ie rs n ce Pe Prejudice Group Think www.trustinterventions.co.uk2012-2013
  • 14. The Equality Act 2010 Protected Characteristics Age Disability inc. carers Gender Reassignment Marriage and Civil Partnership Pregnancy and Maternity inc. breastfeeding Race Religion / Belief Sex Sexual Orientation www.trustinterventions.co.uk2012-2013
  • 15. BENEFITS OF DIVERSITY  Greater access to a wider pool of skills, strengths, experiences & perspectives  Greater understanding of diverse groups  Attracts staff  Retains staff  Motivated staff  Time and money saved in dealing with harassment & discrimination issues, conflict resolution & employment tribunals  Good NHS image  Happy fulfilled workforce with diverse skills www.trustinterventions.co.uk2012-2013
  • 16. Question: Why do we have equality law? Answer: Wherever there is a difference, there is a potential for discrimination Definition: Discrimination To act and single out a particular person or group www.trustinterventions.co.uk2012-2013
  • 17. www.nhseastmidlands.co.uk Inclusion and fairness for all is at the heart of our business which supports the first principle of the NHS Constitution: “The NHS provides a comprehensive service available to all irrespective of gender, race disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it services and must respect their human rights. "At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.” (NHS Constitution:2009) www.trustinterventions.co.uk2012-2013
  • 18. Equality Act 2010  Introduces a new Equality Duty on all „strands‟ now called „protected characteristics‟.  End age discrimination in service delivery  Ensure transparency – need to report on pay gaps and employment statistics relating to diversity.  Ensure equality is promoted through purchasing and procurement processes.  Extend the scope of positive action.  Strengthens enforcement, including discrimination on intersectional grounds as well as representative actions. www.trustinterventions.co.uk2012-2013
  • 19. Harassment 1 Unwanted conduct related to a protected characteristic which has the purpose or effect of: a) Violating the other person‟s dignity, or b) Creating an intimidating,hostile, degrading, humiliating or offensive environment for him/her. www.trustinterventions.co.uk2012-2013
  • 20. Third Party Harassment The Act has extended protection against harassment of employees by customers, clients and contractors to apply to all protected characteristics. Liability will arise where an employer becomes aware that an employee has been harassed on at least two occasions by a third party (doesn‟t matter if it‟s different customers etc) and they fail to take reasonable steps to prevent it happening for a third time. www.trustinterventions.co.uk2012-2013
  • 21. Harassment Examples E.g. a patient who felt patronised by a clinician or a receptionist because of their age, would potentially have a claim. Extends the existing provisions in relation to harassment by 3rd parties into the other strands of discrimination law. This means that where the employer is aware that one of its employees has been subjected to harassment (say, by a patient) and has not taken reasonable steps to prevent a recurrence of that harassment, then the employer may be liable for 3rd party incidents from the 2nd incident onwards. Need to be responsive to both formal and informal complaints by staff. www.trustinterventions.co.uk2012-2013
  • 22. Betari’s Box MY MY Affects ATTITUDE BEHAVIOUR Affects Affects YOUR BEHAVIOUR Affects YOUR ATTITUDE Likely Outcome = Conflict Question – How do we manage conflict? www.trustinterventions.co.uk2012-2013
  • 23. Collusion is co-operation with others, knowingly or unknowingly, to reinforce stereotypical attitudes, prevailing behaviours, and norms.  Types of collusion include:  Silence  Denial  Active Co-operation www.trustinterventions.co.uk2012-2013
  • 24. COLLUSION: BULLYING & HARASSMENT Bullying & Harassment, Racism and Homophobia is not only caused by bullies, racists or homophobes. Bullying & Harassment, Racism and Homophobia thrive because of the SILENCE of the MAJORITY quietly condones it. CHALLENGE it and REPORT it www.trustinterventions.co.uk2012-2013
  • 25. KNOWN HEALTH INEQUALITIES The incidence of lung cancer among men and women in the most deprived areas is around twice that in the most affluent areas, and death rates are about two and a half times higher. Lesbian, Gay and Bisexual people are more likely to be self-harmers or consult mental health professionals than heterosexual people. Pakistani and Black Caribbean women are much more likely to have high blood pressure than women in the general population. Men typically develop heart disease ten years earlier then women. People with learning disabilities have higher rates of obesity and respiratory disease, and high levels of unmet needs. www.trustinterventions.co.uk2012-2013
  • 26. KNOWN HEALTH INEQUALITIES Lesbian and Bisexual women are more likely to be overdue for cervical screening than heterosexual women. Women in routine occupations are twice as likely to be obese as women in professional occupations. Women are around 2.7 times more likely than men to develop an auto-immune disease such as diabetes. People with mental health problems have higher rates of obesity, smoking, heart disease, hypertension, respiratory disease, diabetes, stroke and breast cancer than other citizens. www.trustinterventions.co.uk2012-2013
  • 27. Diagnostic Overshadowing People with learning difficulties are much more likely than other citizens to have health problems, including obesity and respiratory disease. People with mental health problems are more likely to have problems such as heart disease, high blood pressure and diabetes. People with schizophrenia are almost twice as likely as other citizens to have bowel cancer. Women with schizophrenia are 42 per cent more likely to get breast cancer. The rate of obesity among people with learning difficulties is 28 per cent, compared with 20 per cent for the overall population In primary care both groups are less likely to receive some of the expected health checks and treatments DRC ‘Closing the Gap’ Report www.trustinterventions.co.uk2012-2013
  • 28. Many thanks for your participation There is a bank of resources available on the following web pages: www.equalityhumanrights.com www.nottsdeaf.org.uk www.equalities.gov.uk/ www.dh.gov.uk/en/Managingyourorganis ation/Workforce/Equalityanddiversity/index.htm www.disabledgo.com www.stonewall.org.uk www.trustinterventions.co.uk2012-2013