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Key Areas of Work 2008/9
The CIT’s current priority areas of work aim to support the development of an organisation which continuously improves its response to inequalities.
These activities work towards an NHSGGC that addresses the causes as well as the results of poor health and which recognises that discrimination can lead to poor health as a result of unequal opportunities for education, employment, income and involvement in society.
A range of activities are outlined below, falling under five key areas of work:
For further information see: The 10 Goals
CIT Contact: Sue.laughlin@ggc.scot.nhs.uk
Supporting the System
Equality leads have been established across NHSGGC to drive the equality legislation specifically.
These leads meet quarterly to:
The Quarterly Equality meetings also provide a forum for local Equality Leads to come together and problem-solve system wide issues such as Learning and Education and Estates.
CIT Contact: Jac.ross@ggc.scot.nhs.uk
Long Term Conditions
Using diabetes as a working example, CIT is examining the impact of the new Long Term Conditions Strategy on inequalities. Some of the issues for people with diabetes in relation to inequality include-
It is hoped that the methodology used here will be applied to other long term conditions to tackle health inequality.
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Gender-Based Violence Action Plan
NHSGGCs first Gender-based Violence Action Plan was produced for consultation in July 2008. The purpose of the plan is to create a health service that understands and meets its responsibilities around gender-based violence as part of fulfilling its duty of care to service users and complying with equalities legislation. The plan aims to ensure routine enquiry of gender-based violence in key settings together with dissemination of guidance, robust employee policies and strengthened multi-agency collaboration. A Chief Executive’s Letter was issued on 30th September by the Scottish Government requiring all NHS Boards to develop and deliver action plans on gender- based violence and the NHSGGC Plan has been developed in keeping with these requirements.
For further information see: GBV Plan (draft) Summary
CIT Contact: kath.gallagher@ggc.scot.nhs.uk
Communication Support and Language Plan
The CSLP is a detailed plan looking at how to improve communication support and therefore access to services for people who require it. Those who will benefit from the plan include: those whose first language is not English; people with sensory impairment, stroke survivors, those with learning disabilities and those who have literacy issues. Actions within the plan include standardised appointment letters, an accessible written information policy and streamlining access to interpreters and other forms of communication support.
For further information see: CSLP
CIT Contact: Jac.ross@ggc.scot.nhs.uk
Transgender Policy
NHSGGC’s Transgender Policy sets out our commitment to provide non-discriminatory and inclusive health services and employment rights for transgender people. A multi-agency group oversaw the initial draft policy development and will be re-formed once the consultation period for the policy comes to a close in November 2008. This development will help NHSGGC meet its legislative requirements as set out in the Gender Equality Duty.
For further information see: Transgender Policy (draft)
CIT Contact: alastair.low@ggc.scot.nhs.uk
EQIA
Equality Impact Assessment (EQIA) is a requirement of the equalities legislation - NHSGGC has to ensure all its functions do not discriminate, even unintentionally, against identified groups such as disabled people and Black/Minority Ethnic communities. Guidance and an associated tool have been developed to assist the various parts of the organisation with this process and support and advice is available. Progress on the organisation’s EQIAs forms part of NHSGGCs Equality Scheme Annual Report.
For further information: Click on link below
http://www.equalitiesinhealth.org/equality_impact_assessment.html
CIT Contact: John.crawford@ggc.scot.nhs.uk
Consulting with Inequalities Groups
Involving equalities groups is a mainstay of the equalities legislation. A process is in place which ensures that any new piece of planned work incorporates user involvement. For example, the Communication Support & Language Plan was written with service users comments at the forefront and there will be a service user group attached to the plan’s implementation. A Disabled Staff Forum is also in place which aims to provide informal support and comment on work across the health service relating to staff or patients.
CIT Contact: Jac.ross@ggc.scot.nhs.uk
Commonwealth Games Health Impact Assessment
The Joint Health Improvement Officers Group has developed the use of Health Impact Assessment (HIA) along with Glasgow Centre for Population Health to look at how the NHS, the Council and other partners can influence major developments in the City from a health perspective. A sub-group are currently developing an HIA on the Commonwealth Games and a large launch event was held in Celtic Park Football Ground on the 29th of August. The event identified some of the ways in which the Commonwealth Games could impact positively and negatively on inequality and health in the East End and in Glasgow. The CIT has been advising on the inequalities aspects of the HIA.
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Employability Framework
The NHS has clearly identified roles in employability which lifts people out of poverty.
The Employment and Health Strategic Group has attempted to bring together different parts of the system to develop delivery frameworks for employability which fit in with local partnership strategies.
The Group’s action plan covers the roles of the NHS as:
For further information see: Employment & Health Strategic Group Action Plan
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Financial Inclusion Work
Financial inclusion means that individuals have access to appropriate financial products and services. This includes people having the skills, knowledge and confidence to use these products and services. Living without financial products is a significant disadvantage in an age where cash is slowly being replaced by debit cards and automated transactions, and living on credit is the norm.
Being financially excluded can cost and it is the most deprived who pay the price. Factors leading to financial exclusion include being on a low income or unemployed, long term illness or disability and being from an inequalities group such as Black/Minority Ethnic or older people.
A group has been set up in the NHS to take a strategic approach to work on benefits maximisation within a framework of financial inclusion. An NHS event is organised for 17th November to consult with practitioners and develop an action plan.
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Glasgow Works: BME Action Plan
Glasgow Works Partnership has developed a Black/Minority Ethnic (BME) Action Plan which aims to reduce the BME employment gap in Glasgow which is at least 10%.
At a recent action planning event, Glasgow’s 5 local planning areas shared information on their services around engaging with BME people, learning, employment advice and support into work. The groups then agreed what actions they need to take locally in partnership to tackle the BME employability gap.
Jackie Erdman, Inequalities Manager (Socio-economic), NHSGGC Corporate Inequalities Team has chaired the BME Sub Group for a year. NHSGGC is involved in the Glasgow Works Partnership and the Chief Executive is an active member of the Board.
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Child Poverty
Recognising the association between child poverty and poor health, NHSGGC produced a proposal on the development of child poverty indicators in relation to employability activity carried out by Glasgow Works.
Since then, a Child Poverty Sub Group of Glasgow Works has met to develop indicators to measure the effect of employability programmes on child poverty and to develop an action plan on tackling child poverty and lone parent poverty in Glasgow. The Child Poverty Action Group has also developed an on-line tool for local authorities to measure child poverty which the Scottish Government are interested in developing for Scotland.
For further information see: Proposal on Child Poverty
www.childpovertytoolkit.org.uk
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Voluntary Sector Compact
The Voluntary Sector is crucial for its input to policy development and service delivery and plays a key role in responding to and meeting local needs.
A ‘Voluntary Sector Compact’ is an agreement between the public sector and the voluntary and community sector that all partners have signed up to which sets out the underlying “best practice” principles and support for the voluntary sector.
The CIT are supporting the development of the Glasgow Compact with other community planning partners and also working with Heads of Planning to develop a set of core principles across NHSGGC on voluntary sector engagement.
CIT Contact: Jackie.erdman@ggc.scot.nhs.uk
Masculinity/Violence Reduction
There is an ongoing liaison between the CIT and the Violence Reduction Unit regarding intra-gender violence. This is being combined with an operational shadowing of A&E services to better understand the impact of violence within our services
CIT Contact: alastair.low@ggc.scot.nhs.uk
Sandyford Initiative
CIT has been in involved in the joint development of an inequalities sensitive induction programme for all new starts which includes a specific module on inequalities and sexual health. The programme has been piloted and will be delivered by members of Sandyford’s Sexual Health Inequalities Group. Development work of Sandyford as an exemplar of delivering inequalities sensitive practice is ongoing.
CIT Contact: alastair.low@ggc.scot.nhs.uk
Developing an Inequalities Sensitive Workplace
The CIT alongside members of NHSGGC’s Human Resources Executive Team have established an Inequalities Sensitive Workplace/Workforce Group to support the strategic development of related work and consistency in approach. A range of issues are linked into this group. These include: national and local developments with higher and further education providers; compliance with the employment legislation, staff equalities data collection and the development of an inequalities sensitive learning and education framework for staff.
CIT Contact: John.crawford@ggc.scot.nhs.uk
Mental Health & Sensory Impairment
The Mental Health Partnership and CIT are working in tandem to deliver a range of work in line with the HDL (2005 / 27) to ensure that mental health service are accessible for those with sensory impairment. This work includes redefining the Integrated Care Pathway for mental health services with Deaf, deafened and Deafblind people and a consideration of our role in a potential national specialist service for British Sign Language users in particular.
CIT Contact: Jac.ross@ggc.scot.nhs.uk
Maternity Services User Report
The Inequalities Sensitive Practice Initiative (ISPI) is working in the diverse health and social care settings of addictions, children’s services, maternity and primary care health. In maternity services, a user engagement survey was carried out with women who had multiple and complex needs. The women’s views and accounts of their experiences provide a valuable overview of the characteristics of inequalities sensitive practice from a user’s perspective. Key elements of this type of practice include:
For further information see: Maternity User Survey
CIT Contact: christine.duncan@ggc.scot.nhs.uk
Inequalities Sensitive Practice Initiative (ISPI) Evaluation
From the outset it was recognised that ongoing monitoring and evaluation would be crucial to the success of ISPI. An external consultancy Avante Consulting were appointed to fulfil this role in the spring of 2007. The evaluation of ISPI is both iterative and formative. An interim report of the evaluation process and key finding was published at the end of 2007. This interim evaluation is based upon 4 key elements
For further information see: ISPI Evaluation report
CIT Contact: christine.duncan@ggc.scot.nhs.uk
Evidence Base Publications
An evidence briefing was written for ISPI by Avante consulting. The briefing paper summarises key evidence from literature which supports an inequalities sensitive practice approach to tackling health inequalities. The briefing paper is intended to provide useful information for those involved in developing and supporting inequalities sensitive practice at all levels.
For further information see: ISPI Evidence Briefing
CIT Contact: christine.duncan@ggc.scot.nhs.uk
Cancer work/A & E
Working with Regional Cancer Services and the Health Improvement Team (Acute Planning), a pilot programme of work exploring patient attitudes with specific focus on experience of inequalities is underway. Funded by the Scottish Government’s Better Together Programme and staged over a three-year period, the work will deliver a better understanding of the barriers into, through and out of cancer services, and help service users find the confidence to express their needs to help re-orientate service planning.
This work has included an in depth literature review of inequalities and their impact on colorectal cancer screening and treatment. The work was a collaboration between CIT, PHRU and Public Health and will be available by the end of October
CIT Contact: alastair.low@ggc.scot.nhs.uk
/ACCOUNTABILITY
Leadership programme
Co-ordinated by the OD Corporate function, an inequalities-focused leadership programme will be delivered to the top 500 managers within NHSGGC to help understand the impact of discrimination and exclusion within service provision. The approach will draw on new methods of delivery, including forum theatre to constructively challenge and inform change.
CIT Contact: alastair.low@ggc.scot.nhs.uk
Inequalities indicators and Performance Monitoring
CIT is working closely with the Head of Performance and Corporate Reporting to facilitate developments within HEAT targets to ensure that they are more sensitive to addressing the health gap and the differential needs of equalities groups. There is also ongoing work to develop NHSGGC indicators which can help assess progress in relation to the 10 Goals. Opportunities to utilise Organisational Performance Reviews to identify good practice as well as areas of difficulty are also being explored.
CIT Contact: sue.laughlin@ggc.scot.nhs.uk
Directory of champions
This work will look at the feasibility of developing the champion model as a means of promoting and supporting the embedding of inequalities sensitive planning and practice across NHSGCC. It will seek to co-ordinate and share learning from existing activity in this area from across NHSGGC.
CIT Contact: kath.gallagher@ggc.scot.nhs.uk
Web site development
The Equalities in Health web site was launched in August 2008. The web site gives examples of how health is affected by discrimination and highlights the various ways in which NHSGGC is working towards a health service which is sensitive to inequalities.
Designed to provide a focus for equalities work being undertaken throughout NHSGGC, the site acts as a resource for health professionals and anyone with an interest in equalities in health.
Managed jointly by the Corporate Inequalities Team and Equality & Diversity Team, the site will be regularly updated and feedback and contributions are welcome.
For further information see: www.equality.scot.nhs.uk
CIT Contact: susan.thompson@ggc.scot.nhs.uk
October 2008