appendix 1 - nhs highland€¦ · web viewall pdms . dec 2009 5.3 webpages . create an up to date...
TRANSCRIPT
NHS Highland Race Equality Scheme 2008 - 2011
Appendices
Appendix 1 NHS Highland Action Plan 2008 – 2011 Page 2
Appendix 2 Background information: ThePopulation of the NHS area
Page 29
Appendix 3 Race Equality in the Highlands: Survey Results
Page 41
Appendix 4 NHS Highland’s Progress against previous action plan
Page 50
Appendix 5 NHS Highland EQIAs Page 74
Appendix 6 Workforce Monitoring Statistics Page 77
1
Appendix 12008 – 2011 action plan
For all new actions an EQIA will be carried out to ensure that the specific pieces of work are free from any negative impact upon BME individuals or any other group in the community who may experience discrimination, and do all they can to promote good relations and equality.
Action 1 - Responding to the needs of our community
Every action in this RES can only be successfully achieved if there is an understanding that the views of patients, their families, carers, staff and any other person in the community are heard and responded to. This requires us to have an understanding of our community and have effective channels of communication and consultation that reach BME individuals in our community. To support this, it is imperative that we work in partnership with other public agencies and organisations across Highlands to share key information and best practice, avoid over consultation with community groups and share work load. This is the foundation of making sure the work contained within this RES is delivered appropriately, fairly and sensitively.
Linked to previous action: 2 and 21 (appendix 4)
Supports: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsPolicy and Service Delivery
Our roles: Improving healthPlanning and providing health careEmployer rolePublic sector organisation and partner
Involve patients and carers and the design and delivery of services.
2
Action Status Expected outcome Responsibility Achieved by1.1 Collect the views and opinions of service users and staff and react to the feedback received. There are 4 levels at which this will be sought:
1.1a Staff and patients will be encouraged to give ongoing feedback at any point in the service.
1.1b Patient satisfaction audits and surveys developed in house are implemented with cultural competence to make sure that the opinion and feedback of the diverse population is heard
1.1c National patient surveys are used and implemented with cultural competence in NHSH - to make sure that the opinion and feedback of the diverse population is heard
Ongoing BME populations feel able to report any issues with health care in the highlands.
The organisation can provide evidence to show that services have changed and developed as a result of feedback from BME individuals and groups
Monitoring data shows that the BME individuals have been involved (or invited to be involved) in any consultation process.
The Patient Experience questionnaire and Staff surveys show that individuals feel that opinions and views are valued and reacted to.
Gill Keel
All staff
Gill Keel
Ongoing
3
Action Status Expected outcome Responsibility Achieved by1.1d Effective communication channels are maintained with BME individuals and groups to ensure that the delivery of health care is appropriate and that BME individuals are provided with accessible information about the services we provide.
NHSH services respond to feedback from BME individuals and communities and can evidence change in practice as a result.
Gill KeelEsther Dickinson
Ongoing
1.2 Continue to work in partnership with voluntary and public agencies across Highland
Ongoing Work is co-ordinated between partners to achieve efficiencies, avoid duplication and reduce work load. Evidenced by a yearly list of outputs driven by community need and delivered in partnership with Highland organisations.
Moira Paton Ongoing
4
Action 2: Increasing access and removing barriers to all NHSH services
This action concentrates upon 5 key areas that staff from all service areas can develop in order to remove any barriers to services experienced by any individual. These areas include: developing systems for monitoring patient ethnicity, carrying out EQIAs, providing an interpreting service, providing a translation service and training our staff.
Linked to previous Action 2,3 ,7,20 ( appendix 4)
Supports: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsPolicy and Service Delivery
Our roles: Improving healthPlanning and providing health care
Action Status Expected outcome Responsibility Achieved by
2.1 Patient monitoring
Equality Profiling of all service users is carried out at point of entry into service and analysed by NHSH
NHSH patient assessment protocols include clear guidance for staff and information for patients about meeting patient support needs
ongoing
New action
Targeted work can be undertaken where it is identified that our patient profile does not fit what we know of our population We can provide examples of positive
action based on equalities profiling undertaken by NHSH
Patients and staff report that care delivery is adapted appropriately to individual need.
Natalie Morel
Data Information and Implementation network
2010
2009
5
Action Status Expected outcome Responsibility Achieved by
2.2 EQIAEQIA training is delivered across Highland to develop staff skills in carrying out assessments
40 staff a year receive training in EQIA delivery
New EQIAs completed: 35 new EQIAs are signed off
and published each year All EQIAs are quality assured
and published online
Ongoing All work relating to the EQIA can provide examples to highlight existing good practice and/or to show where changes have improved services for staff and/or patients.
Natalie Morel Ongoing
2.3 Interpreting A partnership contract for the provision of an interpreting service is signed and agreed.
All services across Highland receive information in how to effectively work with interpreters via a revised guidance document, supporting materials and training.
Ongoing
Ongoing
Any patient that needs an interpreter is offered one for every appointment evidenced by: An increase in usage following the
launch of the new guidelines and information.
Positive feedback from the Polish and Chinese association members and other BME groups
A decrease in problems fed to the team arising as a result of interpreting booking and usage.
An evaluation of the service shows positive feedback from both staff and
Esther Dickinson March2009(Ongoing monitoring)
6
patients.
7
Action Status Expected outcome Responsibility Achieved by
A system is put in place to track any patient with accessibility needs (including interpreting) through the whole service
Any patient who requires an interpreter is recognised within the system and an interpreter is provided along with any appointment.
Esther Dickinson and Natalie Morel
2010
BME individuals have access to ‘interpreting cards’ that they can hand to any member of staff to inform them of the need to book an interpreter and the language required.
Patients are supported to request an interpreter whenever one is needed.
Feedback from staff members that the cards are being used by their patients
Feedback from the Polish and Chinese association members and other BME groups that they have found them useful
A decrease in problems fed to the team taking forward the E&D agenda, arising as a result of interpreting booking and usage.
Esther Dickinson March 2009
8
Action Status Expected outcome Responsibility Achieved by
2.4 Translation
A partnership contract for the provision of translated information across NHSH is signed and agreed – this ensures NHS staff have one company to approach when they are producing translated information.
New action Staff are able to supply existing translated materials or produce new materials for any patient who needs it. Evidenced by: The number of new translated
materials held in the data base. Community feedback shows that
information is being offered in appropriate formats.
Esther Dickinson Translation organisation
July 2009
The company awarded the contract manages one central data base of materials translated over the period of the contract - accessible by partnership agencies in Highland
The number of ‘hits’ on the webpage holding translated information increases.
Esther Dickinson Translation organisation
An online resource is developed within NHSH holding both old and new translated information – accessible to both staff and patients.(Other mechanisms to access this information will also be developed for anyone not in the intranet)
Community feedback shows that information is being offered in appropriate formats.
Staff feedback indicates that translated information is easy to find and relevant to their work
Niall HendersonShirley Noble Esther Dickinson
Dec 2009
9
Action Status Expected outcome Responsibility Achieved by
2.5 Training
A comprehensive timetable of training is offered and evaluated throughout the year in NHS Highland. This will be delivered at a variety of times and in different formats to suit staff need. Training will cover:
Core Principles of E&D Accessibility Interpreting best practice EQIA training E&D for Trainers E&D for HR Inequalities in health and its
relationship to Equality and Diversity
100 members of staff per year complete training from each area in Highland (Raigmore, North CHP, Mid CHP, SE CHP, A&B CHP and pan Highland Staff).
Ongoing
Evidence of application of theory to practice is gathered via post training feedback.
Staff choose to access training and development opportunities in creative ways across NHS Highland.
Staff feed their work back to the community and Health Improvement planning team for upload to the staff Equality and Diversity page to share good practice.
CHP and Raigmore managers can report areas of good practice within their services
Lead Esther Dickinson
Raigmore Andrew Ward
North CHPSheena Craig
Mid CHPGill McVicar
SE CHPNigel Small
A&B CHP Caroline Champion
Pan Highland StaffEsther Dickinson
Ongoing
10
Action Status Expected outcome Responsibility Achieved by
A framework to support staff to take ownership of their own development around the E&D agenda is developed. Guiding staff towards training, resources and best practice to encourage change in work place practice.
An E&D checklist for all staff delivering any training across NHSH is developed and agreed organisation wide.
Work with the Learning and Development team to develop a system to evaluate the effectiveness of training delivery Highland wide
All training is designed and delivered in a culturally sensitive and supportive way
Staff will receive training which is culturally sensitive and supportive.
Feedback/evaluation at all levels showing how learning has been applied in the workplace to improve experiences for patients and staff from BME communities and is integrated throughout all training opportunities.
Esther Dickinson
Judith Mackelvie
Paul Maber Michelle Williams
June 2009
Jan 2009
Sept 2009
11
Action Status Expected outcome Responsibility Achieved by
2.6 Focused pilot One service (the Chemotherapy Unit at Raigmore Hospital) has been chosen to focus upon all activities covered above (2.1 – 2.5).
The chemotherapy unit has been identified due to staff commitment and the discrete nature of the unit
Within the unit staff will be supported to identify how Equality and Diversity can be embedded into their practice in relation to:
Monitoring, EQIAs, InterpretingTranslation and training
Lessons will be learned from this piece of work. From this we will identify strategies to introduce sound E&D practice to all services
Improvements to the service and best practice will be identified. This will be shared with the management team in Raigmore Hospital to encourage other units to see the benefit of this work.
Learning points will be shared; online, via word of mouth, at presentations and in articles.
Best practice will be drawn up and a second area will be identified to take on this work.
Andrew WardNichola Summers
Dec 2009
12
Action 3: Achieving our duties as an employer
Delivering fair and sensitive services is not only about supporting patients but also about supporting employees. For this action we have promised to address any inequalities as they arise from analysis of our staff monitoring data. This includes data for potential employees and employees leaving NHS Highland, in addition to data relating to significant events that can happen while at work, such as grievances or training. We also need to ensure that all of our policies and processes are written and applied in such a way as to support employees in all ethnic groups. This action is designed to assure ourselves that the way in which we advertise jobs, select, recruit and support our staff to fulfill their potential is fair and sensitive.
Linked to previous actions 18,19 (Appendix 4) Supporting data for these actions are attached in appendix 5.
Supports: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsEmployment
Our roles: Employer role
13
Action Status Expected outcome Responsibility Achieved by
3.1 Equality and diversity employment action plan:
Data –staff in postThe data is used to inform investigation into specific job families and work units. To increase the return rate, promotional materials are being prepared in advance of the next mail out.
3.2 Applications for employment and promotionApplications are analysed and entered on to a local database.
3.3 Applications for and participation in learning and developmentAT Learning system (AT-L) allows adequate monitoring of applications. Before AT-L is fully functional attendance sheets are being used for monitoring. (This links to the training section in action 2)
Ongoing 100% of staff will have returned their SWISS monitoring data
There will be a better understanding of the distribution and levels of staff from different ethnic groups. NHSH will be able to ensure that there is a diversity of staff, reflective of the local community in different job families and units.
A complete dataset will allow NHSH to better use different and varied channels of advertisement, ensuring that under represented groups can access vacancies.
Analysis at present shows that study leave forms broadly fall in line with what is shown on SWISS returns. The response rate for SWISS is actually much lower so achieving better SWISS response rates and standardizing returns will support future analysis.
For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum)
Next Mail out Dec 2009
Ongoing thereafter
14
Action Status Expected outcome Responsibility Achieved by
3.4 Performance assessment proceduresSenior manager staff groups and executive cohort data has been analysed and incomplete returns will now be targeted
3.5 PIN policies: Grievance and disciplineAnnual analysis of the grievance and discipline ethnicity data. Most recent data shows that staff subject to disciplinary procedures are far more likely not to have their ethnic background data held.
3.6 Staff who leave NHS Highland employmentMonitoring data is in place and is published annually, which informs positive action to increase retention rates.
Ongoing A full dataset will allow some analysis of this small staff group to inform understanding about access to these roles from equality groups.
From targeting low return areas, we can better analyse and address grievance issues.
The exit interview process also provides qualitative data to improve retention and identify and problem areas in the organisation.
For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum)
Ongoing
Ongoing
Ongoing
15
Action Status Expected outcome Responsibility Achieved by
3.7 PIN policies: Equal opportunities policy
The Equal opportunities policy was to be re-launched with a different heading, but this outcome will now follow on from the national review and impact assessment.
3.8 Promoting equality and diversity in our role as an employerEnsuring all employees can access and provide pertinent information through appropriate use of interpretation and translation
3.9 Reporting and monitoring arrangementsData is analysed and published on a quarterly basis and positive action publicized
Ongoing
All employees are aware of NHS Highland’s commitment to Equality and Diversity and know how this affects them as employees.
Employment rights and responsibilities are embedded in our Equality and Diversity work.
Employees are aware of the importance of gathering data and can see how positive change can impact on them as a result of data analysis.
For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum)
TBC – awaiting national guidance
Ongoing
Ongoing
16
Action Status Expected outcome Responsibility Achieved by
3.10 Governance arrangementsClear governance arrangements are already in place for reporting through the Highland Partnership Forum network. These will be maintained and improved to ensure adequate publicity for action
Ongoing All employees are well informed and involved in decisions affecting them
For all actions 3.1 – 3.13)
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum)
Ongoing
3.11 Recruitment and selection
To achieve this targeted advertising will be explored, following the example set by Diversity Champions model with support from Stonewall.
To achieve an inclusive interview process, managers will be trained in interview skills and equality and diversity
Diversity of the workforce reflects the ethnic diversity of our community
17
Action Status Expected outcome Responsibility Achieved by
3.12 PIN policies
PIN policies are being reviewed and impact assessed nationally. Locally NHS Highland will follow up this process to ensure that they meet the requirements of local impact assessment procedures and thus can deliver our employment duties adequately.
Ongoing PIN policies will support all staff adequately and awareness of PIN policies will be raised for all staff.
Anne Gent, Director of HR
Workforce E&D subgroup (Highland Partnership forum)
TBC – awaiting national guidance
3.13 Other HR policies
All new policies and policies for review that reach the HR sub group are being impact assessed. All existing employment policies and practices have been impact assessed and are race sensitive. Monitoring is in place to ensure all policies are applied equitably.
All of our employee policies are equipped to support all members of staff. Monitoring shows that there is equitable uptake of HR policies.
Ongoing
18
Action 4: Procure goods and services equitably
This action involves ensuring that the organisations (including commercial companies and voluntary organisations) that we procure services from can assure us that they manage their business in a fair and sensitive way.
Linked to previous action 4 (appendix 4)
Mapped to: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsPolicy and Service Delivery
Our roles: Planning and providing health carePublic sector organisation and partner
Action Status Expected outcome Responsibility Achieved by 4.1 TrainingAll key staff involved in procurement receive E&D training
Ongoing Staff are able to incorporate appropriate specifications in tender and contract documents
Esther Dickinson Gordon Tait
June 2009
4.2 Contracts
Procurement, contracting and commissioning processes are impact assessed.
Ongoing All contracts in NHS Highland conform with our Race Equality duties.
Specifications covering duties are included in all contracts
Gordon Tait June 2009
19
Action Status Expected outcome Responsibility Achieved by Guidance is developed that ensures specifications with regards to E&D are included in all tenders and subsequent contracts for both commercial companies and voluntary organisations.
4.3 Monitoring Procurement staff develop a framework to monitor contracts and ensure that they are compliant with our duties.
All contracted work is awarded to companies who are committed to eliminating unlawful discrimination, promote equality of opportunity and promoting good relations between people of different racial groups,
Evidenced by monitoring as laid out in 5.3
We are able to assess quality of a contractor in relation to meeting our duties.
Gordon Tait Dec 2009
20
Action 5: Sharing good practice among staff
This action is designed to ensure that staff have a way of sharing information between themselves, Equality and Diversity leads in the organisation are able to update staff with new developments and best practice can be replicated throughout the organisation.
Linked to previous actions 2 (appendix 4)
Mapped to: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsPolicy and Service Delivery Employment
Our roles: Improving healthPlanning and providing health careEmployer rolePublic sector organisation and partner
Action Status Expected outcome Responsibility Achieved by 5.1 Publications
Regular articles in staff magazines and on staff intranet
Ongoing NHS Highland staff feel that they work for an organisation that openly supports and encourages good relations between people of different racial groups.
Evidenced by anecdotal feedback during any staff event indicating that there is interest in the information published.
Direct contact from staff who wish to follow up on information contained in articles.
Joanna Taylor Ongoing
21
Action Status Expected outcome Responsibility Achieved by 5.2 Road show Visits across NHSH are planned to deliver updated resources and information to staff working in more remote and rural areas. Update will include:
Fair for all Documents Interpretation and translation
guidance NHSH resource
New action Staff feel supported and encouraged to deliver a service that is accessible to the BME community it serves and promotes equality of opportunity among the staff it employs.
Esther DickinsonAll PDMs
Dec 2009
5.3 Webpages
Create an up to date staff webpage holding resources such as:
New information GuidanceEquality SchemesBest practiceEtc
Ongoing Staff can access material online to support their practice evidenced by feedback from staff giving information about best practice they are involved in.
Change in practice is shared between staff on the Equality and Diversity website.
Esther DickinsonMarie Gilbert
Ongoing
22
Action 6: Specific projects and initiatives
The individual projects in this action are either ongoing projects with a finite time frame that are currently in progress and their progress requires monitoring for this scheme or they are new projects to take forward this year. It is expected that over the three years of the scheme, as projects and initiatives are completed, new ones will be identified.
Supports: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsPolicy and Service Delivery
Our roles: Improving healthPlanning and providing health carePublic sector organisation and partner
23
Action Status Expected outcome Responsibility Achieved by 6.1 Mental Health Including Suicide
NHS Highland has been successful in a funding bid to the Scottish Government Equalities Unit. Funding has been granted to carry out an investigation of the support that people who have mild mental health problems might receive. We want to make sure basic support through reading and talking that we currently use is actually helpful for people who come from Eastern Europe and also for Gypsy Travellers.
Develop and deliver Race and Mental Health Project The project will see if the approaches we have for helping people with mild mental health issues are equally helpful for people from Eastern Europe and for Gypsy Travellers.
Agree process for impact assessment as part of development of mental health integrated care pathways (MH ICP)
2 year project
Culturally appropriate resources and information available to people from BME communities experiencing mild mental health issues
(When we use the term “mild mental health problems” it means issues such as everyday stresses and bereavement, phobias and anxiety disorders. ) Specific training for primary care staff
to support people from BME communities experiencing mild mental health issues
Provide training specifically to MH ICP development groups
Facilitate EQIA process for MH ICPs
Provide feedback for individual MH ICP impact assessments
Natalie Morel Cameron Stark
Natalie Morel
2008 – 2010
2009
24
Action Status Expected outcome Responsibility Achieved by 6.2 GP practices
GP services are approached to highlight their key role in gathering patient profiles leading to a robust system of monitoring at the point of service entry.
GP services gather patient profile data sensitively from their patients.
A system is developed to process this data to inform practice highland wide.
Ongoing
The profile of patients can be produced and used to identify any areas where the patient profile does not represent that of the community, leading to positive actions being taken.
Natalie Morel 2010
6.3 Work with Gypsy/Travellers
A network of staff are identified to ensure that any Gypsy /Travellers, either in permanent sites or “on the move” receives the support they require (from NHSH staff and partners)
To support the work of the network:
A training and planning day for all staff in the network will be arranged
Ongoing The health needs of Gypsy /Travellers are met. Evidenced by:
Increased numbers of Gypsy /Travellers accessing dental services GP practices. screening programmes Immunisation Antenatal care health Improvement work (eg well
man services, smoking cessation advice)
Co-ordination Esther Dickinson
Leads:SE CHPJo SmithNorth CHPSusan BellMid CHPSusan Russel A&B CHPAnn Campbell
Dec 2009
25
Action Status Expected outcome Responsibility Achieved by Resources to support work
with Gypsy /Travellers will be made accessible, or developed if necessary for all network members
Hand held records are used across NHS Highland
Once established this will become an ongoing aspect of NHSH service delivery
Health Care professionals are aware of the health care history of the GT they work with resulting in improved health care.
Dec 2009(Ongoing thereafter)
6.4 Service redesign
A review of the tools used in service redesign is carried out to identify areas where barriers to services, and possible discrimination can be identified and addressed. And to identify where public consultation can be carried out.
As service redesign work is carried out issues relating to removing barriers, tackling discrimination and involving patients and the public in service design is integrated into the process.
New action Documentation related to service redesign shows how issues relating to BME needs are highlighted and addressed.
Stuart Caldwell June 2009
Ongoing thereafter
26
Action Status Expected outcome Responsibility Achieved by 6.5 Hate incident reporting
In partnership launch a hate incident reporting campaign and website.
Ongoing The Highland area is made aware of hate incidents occurring in the community and take action to reduce this.
Moira Paton March 2009
6.6 Supporting the development of an Inter-Faith Council for Inverness and District
Ongoing Better dialogue and understanding between the various faith communities; which, in turn, will be of benefit in the work of spiritual care in NHS Highland.
Michael Hickford Autumn 2008
27
Action 7: Fostering sound leadership and management
Support from high level managers is vital to the work of this action plan. This action has been identified to ensure that all decisions made by the Board reflect the commitment to this RES.
Linked to previous action 1,8 & 9 (appendix 4)
Mapped to: Duties: Eliminate unlawful discriminationPromote equality of opportunity Promote good relations between people of different racial groupsPolicy and Service Delivery Employment
Our roles: Improving healthPlanning and providing health careEmployer rolePublic sector organisation and partner
Action Status Expected outcome Responsibility Achieved by
7.1 E&D governance The board create a sub group to oversee the governance of E&D.
New action The organisation develops a framework for the governance of Equality and Diversity actions throughout the organisation.
The framework is implemented and used to monitor how E&D is becoming embedded throughout the organisation
Roger Gibbins/Garry Coutts
28
Action Status Expected outcome Responsibility Achieved by
7.2 EQIA All staff submitting papers to the board are accompanied by a signed off EQIA ready for publishing.
Ongoing The EQIA process is integrated into the development of new policies/guidelines and new pieces of work.
Evidenced by 80% of papers that are identified as requiring an EQIA are submitted accompanied by a signed off EQIA ready for publishing.
Chris Meecham Natalie Morel
2011
7.3 Levels of awareness
All board members attend E&D training yearly
Ongoing Board members more fully aware of Equality accountabilities and more likely to question this during Board discussions
Lorraine Powers Yearly
7.4 Financial commitment
The organisation will continue to buy interpreting to support need
There is a dedicated £10,000 budget to support all Equality and Diversity Activities.
Ongoing
Ongoing
Patients and staff can access an interpreting service to ensure that all conversations are understood.
The actions within equality schemes are well managed and shown to be achieved at each review.
Roger Gibbins
Roger Gibbins
Ongoing
Ongoing
29
Appendix 2Background information: The Population of the NHS area
NHS Highland demographic contextThe context for race equality has altered significantly in recent years with the increase in arrival of migrant workers brought about by the expansion of the European Union impacting on communities and services across the country. There is evidence that this social and economic phenomena has resulted in considerable numbers of new people from white minority ethnic groups arriving in the NHS Highland area.
The available data to illuminate changes in both national and local demography is limited and there is also a continued deficit in our understanding of the population health needs and health and social care requirements of resident minority ethnic groups. There remains a paucity of data relating to patterns of health and access and use of health services across Scotland. Information about mortality, morbidity, health related lifestyles and service use remains inadequately collected in terms of ethnic coding. The 2001 Census therefore remains the most comprehensive source to understand in particular our Black Minority Ethnic (BME) Groups and still provides key information on age structures, gender and socio-economic status. Routinely collected administrative data provides little evidence to what extent more recent flows of people represent a transient phenomenon or whether such trends will be longer-term. Equally it is difficult to quantify these changes or establish what proportions of economically driven migrants are committed to permanent residency in the area.
Population structure Map 1: NHS Highland
NHS Highland in 2008 serves a population of over 308 thousand people, six percent of the national population in an area that is over 40 percent of the landmass of Scotland.
The expanded NHS Highland encompasses the local authority areas of Highland and Argyll and Bute. Four Community Health Partnerships (CHPs) serve local populations in North Highland, Mid Highland, South East Highland and Argyll and Bute.
The geographical area covered is diverse; including the expanding population of Inverness and the Inner Moray Firth, part of the commuter zone of Glasgow in the Helensburgh and Lomond area, as well as the most remote and fragile communities in both island and mainland locations
29
Figures from the Census 2001 showed that the NHS Highland population is predominantly white Scottish with a relatively low proportion of minority ethnic groups (Table 1). 97.1% of the population identified themselves as white Scottish (83.3%) or white British (13.8%). This is higher than the total figure of 95.5% for Scotland. Minority ethnic groups included white other (1.5%) and white Irish (0.5%). Black Minority Ethnic Groups accounted for 0.8 percent of residents. Although small in absolute numbers this population is diverse in terms of place of birth, ethnic identities, language and culture.
NHS Highland’s white minority groups will now include newly arrived communities of European nationals, mainly, Polish, Latvian, Czech, Lithuanian and Slovakian nationals, as well as the Gypsy and Traveller community.
Table 1: Ethnicity in Scotland and NHS Highland at Census 2001NHS Highland Scotland
Percentage of total population
Percentage of black minority ethnic group Base
Percentage of total population
Percentage of black minority ethnic group Base
ALL PEOPLE 100 - 300220 100 - 5062011
White Scottish 83.27 - 249985 88.09 - 4459071
Other White British 13.84 - 41559 7.38 - 373685
White Irish 0.64 - 1908 0.98 - 49428
Other White 1.46 - 4372 1.54 - 78150
Indian 0.07 9.3 224 0.30 14.8 15037
Pakistani 0.07 8.7 209 0.63 31.3 31793
Bangladeshi 0.05 5.9 142 0.04 1.9 1981
Other South Asian 0.05 6.6 158 0.12 6.1 6196
Chinese 0.13 16.6 398 0.32 16.0 16310
Caribbean 0.04 5.0 119 0.04 1.7 1778
African 0.04 4.7 112 0.10 5.0 5118
Black Scottish or Other Black 0.02 2.3 55 0.02 1.1 1129
Any Mixed Background 0.23 28.2 676 0.25 12.6 12764
Other Ethnic Group 0.10 12.6 303 0.19 9.4 9571
All black minority ethnic groups 0.80 2396 2396 2.01 101677 101677
Data Source Census 2001 © Crown Copyright (Table UV10)
Black minority ethnic groups made up less than one percent of the population in all CHP areas at the last Census. (table 2).
Table 2: Ethnicity in NHS Highland CHPs at Census 2001Argyll & Bute Mid Highland North Highland South East Highland
30
ALL PEOPLE 91306 87215 38462 83237
White Scottish 80.36 82.71 85.43 86.04
Other White British 16.52 14.30 12.57 11.02
White Irish 0.80 0.61 0.41 0.59
Other White 1.53 1.66 1.00 1.37
White 99.21 99.28 99.41 99.02
Indian 0.06 0.06 0.05 0.11
Pakistani 0.08 0.06 0.06 0.07
Bangladeshi 0.02 0.08 0.00 0.07
Other South Asian 0.03 0.04 0.06 0.09
Chinese 0.14 0.11 0.07 0.17
Caribbean 0.03 0.06 0.02 0.04
African 0.04 0.03 0.03 0.06
Black Scottish or Other Black 0.02 0.01 0.01 0.02
Any Mixed Background 0.27 0.19 0.19 0.23
Other Ethnic Group 0.10 0.08 0.09 0.13
All Black Minority Ethnic Groups 0.79 0.72 0.59 0.98
Data Source Census 2001 © Crown Copyright (Table UV10)
The small NHS Highland BME population is widely spatially distributed. (table 3) There are no co-ethnic localised communities as found more typically in large urban environments and many people are living as individuals or nuclear families in remote areas.
Table 3: NHS Highland NHS Highland All black minority ethnic groups
Other Urban Areas 20.5 32.6Accessible Small Towns 2.6 3.6Remote Small Towns 26.6 27.7Accessible Rural 9.9 9.0Remote Rural 40.4 27.2Total 300220 2396
Data Source Census 2001 © Crown Copyright (Table UV10) and Scottish Government 6-Fold Urban Rural Classification (2008)
There is little evidence that minority ethnic communities live in what would be recognised as our deprived communities as defined by the Scottish Index of Multiple Deprivation (SIMD 06). Considering areas defined as in the most deprived 15 percent of national deprivation 8 percent of the BME population lived in one of the 27 deprived datazones compared with 7 percent of the population of NHS Highland overall. This difference is not statistically significant. It should be recognised that SIMD was not designed to identify deprivation at an individual or household level.
A conclusion from the Census settlement pattern would be that many have been attracted to the area for individual or family reasons rather than as the result of any communal pull. The pattern of more recent settlement resulting from the arrival of accession state white ethnic minorities cannot be documented with any accuracy and beyond the simple pull of economic opportunity is
31
not understood. The influence of any communal factor in encouraging particular groups from the enlarged European Union to locate in the NHS Highland area would be of particular interest
Ethnicity and age structureNHS Highland population structure has an ageing profile and it is now well recognised that the population will continue to age as the number of older individuals make up proportionately larger shares of the total population over time. The black minority ethnic population has a younger age distribution that the rest of the population. 76 percent of the BME population in NHS Highland is under the age of 45 years compared with 56 percent of the population as a whole.
Figure 1: Sex and age by ethnic group in NHS Highland
0 20 40 60 80 100
White Scottish
Other white British
White Irish
Other White
Indian
Pakistani
Bangladeshi
Other South Asian
Chinese
Caribbean
African
Black Scottish or other Black
Any Mixed Background
Other Ethnic Group
All Persons
00-15 16-24 25-44 45-64 65-74 75+
Data Source Census 2001 © Crown Copyright (Table S235)
Table 4: Sex and age by ethnic group in NHS Highland
All people White IndianPakistani and other South Asian Chinese Other
Male population 147174 146025 117 282 183 567
Percentage in age group
32
00-15 20.4 20.3 17.9 31.9 24.0 40.016-24 10.0 10.0 12.0 10.6 16.9 16.925-44 27.5 27.5 34.2 34.4 25.7 26.545-64 27.4 27.5 26.5 16.7 25.7 10.965-74 9.0 9.1 6.0 5.7 4.4 2.575+ 5.6 5.6 3.4 0.7 3.3 3.2
Female population 153046 151799 107 227 215 698
Percentage in age group00-15 18.4 18.3 20.6 31.7 24.7 34.016-24 8.3 8.3 3.7 11.0 12.6 7.625-44 27.0 26.9 43.0 36.1 39.1 30.845-64 26.8 26.9 26.2 15.0 18.6 19.965-74 10.0 10.0 5.6 3.5 1.9 4.4
75+ 9.6 9.6 0.9 2.6 3.3 3.3
Male to Female ratio
1.0 1.0 1.1 1.2 0.9 0.8
Data Source Census 2001 © Crown Copyright (Table S235) Figure 2: Population pyramid – percentage of population by age and sex
Data Source Census 2001 © Crown Copyright (Table S235)
33
12 9 6 3 0 3 6 9 12
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-89
90+
Percentage of population
male femaleNHS Highland
BME groups
Ethnicity and healthThe health status and health needs of different minority ethnic communities vary due to the interaction of a number of factors - with some of these groups experiencing better health and some poorer health than the general population. These factors include: a genetic predisposition to particular illnesses, the impact of culture on individual behaviour, greater exposure to risk factors from their country of origin, differences in educational attainment and in socio-economic status. Social exclusion and low socio-economic status has by far the greatest adverse impact on population health and discrimination can affect the health of minority ethnic communities indirectly through lack of employment opportunities, lack of career progression and poor living and working conditions. Racial discrimination also can have a directly adverse impact on both physical and mental health.
The Census provided information on perceived levels of morbidity in the population in terms of limiting illness and general health. Limiting long-tem illness (LLTI) is a self assessed measure of the limitation of carrying out normal daily activities. Compared to Scotland, the proportion of the NHS Highland population at Census with a LLTI was smaller (table 5). The proportions of minority ethnic populations with an LLTI were generally lower than the overall level in NHS Highland. However, interpretation is confounded by both the direct influence of age and by indirect cultural perceptions of health. As in the general population LLTI is age dependent (figure 3). The average age of most minority ethnic groups is younger than the general population and therefore the proportion of the population reporting a LLTI would be expected to be lower as a direct result. The 2001 Census also introduced a general health question that asked respondents to assess their own health as ‘good’, ‘fairly good’ or ‘not good’ over the twelve months prior to Census day. The question is again obviously open to the respondent’s interpretation and people with the same health experience may assess their health differently. Equally age is again a factor in any interpretation but the evidence suggests that minority groups are relatively healthy.
Table 5: Self reported health status in NHS Highland from the Census by ethnic group Scotland NHS Highland
All people All people White Indian
Pakistani and other South Asian Chinese Other
BME Groups
Percentage of population LLTI 20.3 18.9 18.9 14.7 12.4 11.1 13.7 13.2
Good/fairly good health 89.8 91.8 91.8 91.1 93.9 95.0 92.6 93.0
Data Source Census 2001 © Crown Copyright (Table S238)
34
Figure 3: Limiting long-term illness by age band and ethnicity
0 10 20 30 40 50 60
00-15
16-24
25-34
35-59
60-64
65+
Total
Age
Gro
up
Percentage with a LLTI
White Indian Pakistani and other South Asian Chinese Other
Data Source Census 2001 © Crown Copyright (Table S238)
35
Ethnicity and religionThe 2001 Census collected information about ethnicity and religious identity. Combining these results shows that the population is more culturally diverse than ever before. Just over two-thirds (69%) of the NHS Highland population reported having a religion. White Christians remain the largest single group. The Indian group was religiously diverse; 27 per cent of Indians were Hindu, 10 per cent Sikh, a further 9 per cent Muslim and 15 percent Christian. By contrast the Pakistani and Southern Asian grouping were more homogenous, Muslims accounting for 64 per cent. Overall, 26 per cent of the NHS Highland population reported having no religion although variation by ethnicity was marked. Nearly 60 percent of all Chinese people stated they had no religion. Pakistani and the South Asian grouping were least likely to have no religious affiliation
Figure 4: Ethnicity by current religion in NHS Highland
0 10 20 30 40 50 60 70 80 90 100
White
Indian
Pakistani and otherSouthern Asian
Chinese
Other
Percentage
None Church of Scotland Roman Catholic Other ChristianBuddhist Hindu Jewish MuslimSikh Another religion Not answered
Data Source Census 2001 © Crown Copyright (Table T25)
36
Developments since the 2001 CensusThe pattern of migration resulting from enlargement of the European Union has been the most obvious demographic change in the post Census period (table 6). Contacts between overseas nationals and government agencies regulating access to the labour market provide the limited quantitative evidence for the numbers who may have arrived in the NHS Highland area. The principal source of information on all overseas nationals who want to work in the UK is through National Insurance Number Registrations (NINOs). These records collect date of registration, country of origin, gender, age and address of first residence in the UK. The tracing of subsequent movement within the UK is unknown and there is no requirement to de-register prior to returning home or leaving the country. Management systems primarily for regulating employment are unable to provide any substantial details about family or other dependents of registered workers.
The distribution of post-enlargement migrants around the UK differs significantly from that of previous large scale immigration and the NHS Highland area has attracted considerable numbers of new people from the white ethnic minorities of the Accession States (A8)1. In common with the rest of the country the majority of these migrants come from Poland. In 2007-2008, 53 percent of all National Insurance Registrations in NHS Highland were made by people from Poland. The employment rate amongst these migrants is high and many have taken lower skilled/paid jobs that have been difficult to fill with indigenous labour. In contrast to historic cohorts of migrants it is financially and logistically possible for EU migrants to come to the UK on a temporary basis and regularly or permanently return home. It is simply unknown how many people have chosen to settle within any area. Collectively little is known about the health of these groups and the most significant barrier to accessing care and improving job prospects for these groups is the linguistic barrier.
Table 6: National Insurance Registrations by world region in NHS Highland*
TotalEuropean Union
EU Accession States
Other European Africa
Asia and Middle East
The Americas
Australasia and Oceania
2002-03 800 310 50 30 70 100 90 1402003-04 980 320 110 50 100 140 110 1402004-05 2000 280 1130 70 100 180 110 1302005-06 3310 300 2260 80 170 200 130 1602006-07 3440 280 2550 30 140 200 120 1302007-08 3440 250 2590 60 100 150 130 160Total 13970 1740 8690 320 680 970 690 860
Data Source: National Insurance Number Registrations, Department of Work and Pensions
Male registrations have exceeded female over this period – for every one hundred female workers there were 112 male registrations. 80 percent of all registrations were made by workers between the ages of 18 and 34 years of age (figure 5).
1On 1 May 2004, ten countries – Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland,Slovakia and Slovenia – joined the European Union (EU). From that date, nationals of Malta and Cyprus have had full free movement rights and rights to work throughout the EU. The A2 countries are Bulgaria and Romania who joined the EU on the 1st January 2007
37
Figure 5: Age of workers from National Insurance Registrations in NHS Highland*
0.6%
43.5%
36.7%
11.0%6.8%
1.1%
0.4%
Less than 18 18-24 25-34 35-44
45-54 55-59 60 and over
Data Source: National Insurance Number Registrations, Department of Work and Pensions * Based on cumulative registrations in NHS Highland local authorities from January 2002 – April 2008
The Workers Registration Scheme (WRS) provides some additional demographic data specifically about workers from the A8 when they first start employment and for any subsequent changes during the first 12 months of residency. Access to and publication of this data is restricted but it is known from this source that the majority of these workers are employed in hospitality and catering; administration business and managerial services; and SBS sectors (agricultural processing). The types of job attracting these workers over time have been consistent and the majority continue to be employed in low skill jobs such as processing of food, kitchen and catering assistants, waiting staff, cleaning and labouring.
The Institute for Public Policy Research paper of April 2008 Floodgates or Turnstiles2
used data from the WRS to estimate the ‘current stock’ of A8 workers who had registered and remained within local authority areas across the UK between May 2004 and the end of 20073 The numbers can only be considered indicative but would suggest that Highland in particular has attracted and maintained many workers from the A8 (table 7). Only Perth and Kinross (29) and Angus (21) authorities have a higher rate of A8 ‘stock’ than Highland.
Table 7: WRS registrations and IPPR estimate of A8 worker ‘stock’ in Argyll & Bute and Highland
Approved Numbe Rank of
2 3 This estimate of the current A8 stock is based on the assumptions that the WRS underestimates the actual level of worker registration by 33 per cent; and that 50 per cent of A8 migrants who have arrived since May 2004 are no longer in the UK
38
WRS applications May 2004-December 2007
r of A8 workers per 1,000 residents based on IPPR estimate of current A8 stock
Local Authority area in UK (N=434)
Highland 5290 16 39Argyll & Bute 1140 8 133
Data Source: IPPR
Additional indirect evidence suggests that considerable numbers of workers from the Accession States may be committing to a long-term future in the NHS Highland area. Evidence from Highland drawn from WRS shows that the number of dependents declared at first worker registration in the area expanded significantly during 2007-2008 and the numbers of children in local schools whose first language is not English has again increased.
Evidence also shows that the percentage of births to women from outside the UK has increased in NHS Highland (table 8). This general pattern is evident in Scotland and the rest of the UK There will also be differences in fertility patterns between ethnic groups but analysis is limited to country of birth because ethnicity is not collected at birth registration.
Table 8: Live births, by country of birth of mother in NHS Highland2007 2005 2002
All countries of birth 3073 3006 2732UK, Isle of Man, Channel Islands 2759 2791 2567Irish Republic 21 14 12Other EU (Poland in brackets) 150(117) 68(35) 45(1)Commonwealth total 78 84 66
Australia, Canada, New Zealand 28 32 27India, Bangladesh, Sri Lanka and Pakistan 19 19 7West Indies, Belize, Guyana 1 3 0Africa 25 19 16Other Commonwealth 5 11 16
Other countries 65 49 42Not stated 0 0 0
Data Source: GRO(S) Annual Vital Event Tables
In Scotland in 2007 1 in 9 births were to non-UK born mothers and in NHS Highland this figure was 1 in 10. However, in England this figure is about 1 in 5. The relatively small size of Asian communities in both Scotland and Highland will partly explain the difference in the proportion of births to mothers from non-UK countries from that in England and WalesInternational migration patterns and evidence from worker registration shows that recently arrived groups include many women of child bearing age. Women born outside the UK are a diverse group and fertility will vary across a range, but it is
39
known that migrant fertility may be particularly high in the years following arrival in a new country. There are obviously many different reasons for migration, and family building as a process will be inter-related to that experience. Some individuals will stay for only a short period; others arrive with families, or form such relationships and stay. There is currently little information available to understand this complex picture and it is only possible to tentatively suggest that the recent pattern of births to overseas mothers may indicate some degree of longer term commitment from recent migrants to remaining in the area.
Ian DouglasHealth Intelligence Specialist NHS Highland October 2008
40
Appendix 3
Race Equality in the Highlands
Survey Results
1 October 2008
Introduction
Each of the public bodies listed below is obliged to produce a Race Equality Scheme which sets out how it tackles racial discrimination, promotes equality of opportunity and promotes good relations between racial groups. The Race Equality survey was designed to feed into this process.
The partners involved in the survey were:
The Highland Council; NHS Highland; Northern Constabulary; Highlands & Islands Fire & Rescue Service; Highlands & Islands Enterprise; Scottish Natural Heritage; University of the Highlands and Islands
Survey Response
There was a total response of 145 to the survey, 44 of which were from the online version of the questionnaire. 101 provided responses via a paper questionnaire.
The survey ran over a six-week period during August and September 2008.
41
Profile of Respondents
Gender
69% of respondents were female, 31% male.
Disability
9% of respondents described themselves as having a disability.
Age
%Under 16 -16-25 1226-39 1840-60 5161-74 1575+ 4Total 100
Sexual Orientation
All of the 113 respondents to the question apart from one individual were heterosexual.
Faith / Religion
Number of Responses
Christian (undefined) 23None 20
Church of Scotland 15
Church of England 7
Roman Catholic 9
Protestant 5
Muslim 2
Other* 8
Total 89
* Others included Atheist, Buddhist, Spiritual, Jewish, Episcopal, Humanist, Presbyterian and Jehovah’s Witness
42
Ethnic Group
93% of the survey respondents described themselves as white. A full breakdown is provided in the table below.
Number of Responses
White 113Asian 2
Black 1
Mixed 1
Other* 5
Total 122
* Others included (four respondents provided details): Hispanic (2), Scandinavian (1) and “Gaelic speaking community of the Highlands and Islands” (1).
43
Main Survey Findings
Responses to each of the survey questions is reported below. Totals may not sum to 100% because percentages are rounded to the nearest whole percentage point.
Question 1
Since you have been living in the Highlands do you think the levels of racism or racial discrimination have:
%Increased 20
Decreased 11
Stayed the same 36
Can’t say 34
Total 100
Base: 124 respondents
The large majority of respondents (70%) were either unsure, or thought that the levels of racism or racial discrimination had remained the same.
Among those who thought that levels had changed, almost twice as many respondents thought the levels of racism or racial discrimination had increased compared with those who thought levels had decreased.
Young people (aged 16-25) were more likely than average to think the level of racism or racial discrimination had increased (47%).
There were no further notable differences in the pattern of response by gender, disability or ethnic group.
Question 2
Have any of the following organisations treated you, or your family, less fairly because of your ethnic group?
Number %No response 133 92
Local school 7 5
Police 5 3
Council Housing Service or Housing 4 3
44
AssociationLocal college or university 3 2
Business advice agencies 3 2
Local GP 2 1
Local hospital 1 1
Other Emergency Services 1 1Base: 145 respondents
Note: respondents could tick more than one option.
92% of respondents chose none of the options. Among the organisations listed, local schools were most likely to be identified (by 5% of respondents) as having treated the respondent or their family less fairly because of their ethnic group.
Owing to the small numbers involved, no further analysis by ethnic group, age or gender is tenable.
Seven other responses to the question were received:
Local people (2 mentions) Council (2 mentions) Job Centre Sheriff Court Amenities Association
Question 3
Have you been treated less fairly when applying for a job because of your ethnic group?
%All the time 1
Sometimes 11
Never 44
Does not apply to me 45
Total 100Base: 121 respondents
There were no notable differences in the pattern of response by age, gender, disability or ethnic group for Questions 3-7.
45
Question 4
Have you been treated less fairly when applying for promotion or training because of your ethnic group?
%All the time 3Sometimes 3Never 47
Does not apply to me 48Total 100
Base: 118 respondents
Question 5
If you need an interpreter do you get offered one by the public services you use?
%All the time -
Sometimes 2
Never 5
Does not apply to me 93
Total 100Base: 117 respondentsQuestion 6
Do you agree that people from different backgrounds get on well in your local community?
%All the time 29
Sometimes 65
Never 7
Total 100Base: 122 respondents
46
Question 7
Do you feel your community is welcoming of people coming to live here from outside the Highlands?
%All the time 30
Sometimes 68
Never 2
Total 100Base: 124 respondents
Question 8
Do you think the following service providers meet the needs of people from all ethnic groups?
Yes%
No%
Other Emergency Services 95 5
Local GP 88 12
Local hospital 88 12
Local college or university 81 19
Local school 78 22
Police 78 22
Business advice agencies 78 22Council Housing Service or Housing Association 76 24
Base: respondents range from 51 to 77
Overall, the response level to the question was lower than most other questions.
Respondents were most likely to regard “other emergency services” as most likely to meet the needs of people from all ethnic minorities (95%), whereas Council Housing Service or Housing Association were regarded as least likely to do so (76%).
Only one other response was stated, namely “other council services”, which received a “yes” response.
47
Question 9
If you would like to give any examples to support your answers, or make any comments, please use the space below.
Nineteen comments were received which are presented below.
A little annoying to find that people from ethnic groups have equal priority on our housing lists. They quickly learn how our system works and before you know it you'll have a new breed of home owners.
This survey does not seem to be well put together. All those 'Does not apply to me' options; we all HAVE an ethnic group, so the question must apply to everyone, but it seems you are using 'ethnic group' as a -say it without saying it- shorthand for 'minority ethnic group'. Also, what really is the point of asking how you think services are provided to all ethnic groups? Surely most people can only answer that with confidence for their own grouping.
There is always likely to be one bad apple in the box!
Many people still seem to react with caution if they deal with someone with a foreign name or a non-white face. I would apportion some of what I/my family have experienced down to lack of training or awareness, not malice.
With an American/Swiss passport fluent in German and paying uk taxes it seems impossible to find a house to live in therefore staying in a tent.
I think that the attitude of some Highland Councillors towards the Gaelic community is discriminatory and inflammatory. The Council has a duty under the Gaelic Language Act to provide for the Gaelic community and its members should adhere to this.
This survey is a good example. Your question about needing an interpreter - if people did how would they be reading an English survey! You should have supplied the survey in a number of languages. It is limited to English speaking respondents.
Communication in other languages
Lack of language skills
I know of a housing situation in Lochaber where Travellers are treated less fairly, in my opinion
If you were truly anti-discriminatory, you would not ask for ethnic/racial/religious/sexual background.
48
There is sometimes anti-English feeling and sometimes poor understanding of non-Christian religions.
As a white British full-time worker with no family, I have no rating for housing.
Working in education I have found children from other ethnic groups have been welcomed and adapt well, but more resources should be available to help in initial stages. Parents sometimes feel isolated if English is not their first language.
Travelling people bring themselves into conflict with the resident population by illegal camping in lay-byes and other places and creating health hazards by their behaviour. Failure of the appropriate authorities to move these people to approved sites inevitably leads to friction and discrimination.
Many Scots are still backward thinking with regard to the English (taking our jobs, houses etc). We have welcomed the influx of Poles, who have relieved us of some of this racism.
Ongoing anti-English comments in the workplace.
There is still a strong sense of "outsiders" coming to the Highlands and local people not coping with this. Scottish people seem to be entrenched in history and can't let go of the past. They are very personal and feel directly affected by history.
People in the Highlands, especially in villages, do not want anyone apart from Scots. I receive various racist remarks being English even married to a local. God help anyone coming here with a different colour skin.
Further Involvement
Respondents were asked if they would like to come to a meeting to discuss the issues in the questionnaire before the race equality schemes are finalised. Only two people provided contact details for this to be done.
Fewer than 10 people indicated that they would like to receive a draft copy of a Race Equality Scheme before it is finalised, only four of whom provided contact details.
Respondents were asked if they would like to give their opinions about any other similar work in the future. Three respondents provided contact details for this to be done.
49
Appendix 4NHS Highland’s Progress against previous action plan Action 1
Ensure regular review of Action Plan
Action Achievements - examples of good practice Further actions needed
a) Exception reporting at Equality and diversity group meetings
Comments √ Green
The NHS Board have received annual detailed progress reports on Equality & Diversity, including race equality, supplemented by regular brief written updates
Training in Equality & Diversity, patient sensitive services and Equality Impact Assessment has been provided to the Board
A policy has been put in place to require all Board and Committee papers to reflect evidence of equality impact assessment
The need to undertake Equality Impact Assessment has been written in to the Management of Policies Guidance and the Clinical Policies ratification group guidelines
There has been an annual increase in the spend on interpretation & translation
An Equality & diversity Steering Group has met every 6 weeks to progress the agenda and a workforce subgroup has been established
Two new posts to support the Equalities agenda have been established
An Equalities Impact Assessment of the way the Board operates
See objective 7 in the new action plan for actions carried forward
E&D meetings continue
Ensuring sound governance of the E&D agenda could still be further strengthened at board level.
A new governance ‘committee’ has been formally agreed. This will be carried forward
b) Bi- annual (twice yearly) reporting to corporate team.
50
Action 2
Provide regular updates to staff and Public about Fair for All activity nationally and in NHS Highland
Action Achievements - examples of good practice Further actions needed
a) 1 Staff Policy Briefing Comments: √ Green
This action has evolved beyond simply developing a policy briefing. Policy briefings were developed in the first year and have been superseded by informing staff in the following varied formats:
Fair for All activity is included in training resources; Numbers of staff trained : 700
Resources distributed to all GP practices and all hospital wards and services
An equality and Diversity webpage has been designed Relevant staff are regularly forwarded relevant
information Articles appear in staff magazines
See objective 1, 2 & 5 in the new action plan for actions carried forward
Continue to incorporate national work throughout the work of the organisation such as training,
b) 2 Articles in local Unison Magazine
Comments: √ Green
Articles were published as agreed
Productions of articles for a range of publications is ongoing
51
Action Achievements - examples of good practice Further actions needed
c) 2 Team Update articles Comments: √ Green
Tangible outcomes: Articles published included Staff experience of Ramadan, How to use the Interpreting service and coverage of the Staff ESOL lessons.
Productions of articles for a range of publications is ongoing
d) 2 Organised Press Eventse)4 Community Open Events
Comments: √ Green
This work has expanded and includes a variety of community engagement activities.
Tangible outcomes:Such events include:
Show racism the red card football event Health education event with an international women’s
walking group Discussions in the Chinese association regarding
interpreting Health Checks with the Gypsy Traveller community Participation in Council for Ethnic Minority Voluntary
organisations (CEMVO) events to encourage participation in the decision making process.
Publications include:Community Planning partnership newsletter: E&D Highland A section within the “Multicultural Inverness” calendarAn article in the local Polish newspaper Gazeta Highland about the interpreting service
Continue to promote and become involved in community events.
f) 2 Community publications
52
Action 3Raise Awareness with Practice Staff (staff working at GP surgeries) about Equality and Diversity Issues and the Race Relations Amendment Act (RRAA) as services procured on behalf of NHS Highland
Action Achievements - examples of good practice Further actions needed
a) Attend clinical area forum to discuss role of equality anddiversity in practice and agree approach to awarenessraising
Comments O Amber
This has evolved from the initial actions stated here. Awareness raising and training for practice staff has included a variety of actions as follows.
Tangible outcomesRepresentatives attended area medical committees in 2007
NHS Highland now has a rolling programme of Equality and Diversity training
See objective 2 in the new action plan for actions carried forward
Continue to develop and deliver a variety of Equality and Diversity training across Highland.
Identify way to further engage GPs and practice staff.
b) Pilot and evaluate sessions in CHP area
53
Action Achievements - examples of good practice Further actions needed
c) Agree action required to expand training takinglessons learned from pilot
Community Health Partnership (CHP)specific work
All practice managers and a number of staff across North Community Health Partnership (CHP) have attended Equality and Diversity sessions.
Equality and Diversity training is a standing event at Protected Learning Time for all GP practices in Mid and South East CHP
Argyll and Bute CHP have an action plan to roll out training to all staff.
Examples of outcomes from training: Increased usage of the interpreting service EQIAs carried out on various areas of practice Gained ongoing funding for ESOL lessons for NHSH staff Supported the development of E&D guidelines for staff
delivering any training in NHSH
Further work to fully engage practice staff is needed.
54
Action 4Agree protocol for ensuring equality and diversity issues are addressed within procurement arrangements
Action Achievements - examples of good practice Further actions needed
a)Set up one off meeting with all relevant staff toagree manageable and achievable actions
Comments: O Amber
Tangible outcomes Equality and Diversity Terms and conditions of contract along with guidance have been agreed. Staff have been informed that this must now be included in all contracts
Equality and Diversity training (specific to procurement issues) has been delivered.
See objective 4 in the new action plan for actions carried forward
A working group will develop a framework to specifically monitor the Equality and Diversity elements of any contracts awarded.
b) Progress agreed actions
55
Action 5 Set up process for ensuring that Rapid Impact Assessment (RIA) recommendations are implemented (before review dates)
Action Achievements - examples of good practice Further actions needed
a) Include clearer recording of responsibility against actions within RIA
Comments: √ Green
RIA and full EQIA tools have been merged into one process supported by one document and set of guidance. This was done to minimise duplication and encourage more effective completion and follow up of EQIA
Tangible outcomes: New EQIA process available to all staff including electronic
guidance and forms. EQIA training available for all NHSH staff 61 EQIAs have been undertaken
See objective 2 in the new action plan for actions carried forward
Put in place systems to ensure continued review and monitoring of recommendations from EQIA and the embedding EQIA in organisation’s functions.
b) Review all completed RIAS and agree with leadstimetables for implementation.Include in exception reporting with E&D Group.
c) Use process of implementation of recommendationsre Spiritual Care, Advocacy and Food, Fluid &NutritionFunctions as focus for Staff Policy Briefing
56
Action 6
Develop and Action RIA Delivery Timetable according to prioritisation
Action Achievements - examples of good practice Further actions needed
a) Review Prioritisation exercise in light of limitations ofthe tool and draw up timetable according to existingprioritisation exercise
Comments: √ Green
In light of review of the EQIA process and developments in the system for carrying out an EQIA actions a and c have been superseded.
Tangible outcomes Clear guidance for NHSH staff submitting papers to the
Board about carrying out EQIA. All Board papers must now include a statement about EQIA
status in order to be accepted. All NHSH policy and guidance passed to the Clinical policy
ratification group can only be ratified when an EQIA has been undertaken.
Corporate Team and Board have been provided with EQIA awareness raising sessions and as a result continue to develop approaches to embedding E and D in delivery of Board functions
See objective 4 in the new action plan for actions carried forward
No further actions in relation to now defunct RIA will be included in the EQIA future actions.
b) Seek Corporate Team Support to lead on prioritisingRIA / Appoint Non Exec Lead
c) Deliver on RIA Timetable including communityconsultation
57
Action 7
Develop Champions Network
Action Achievements - examples of good practice Further actions needed
a) Recruit 12 more Champions in 2006-2007
Comments: √ GreenThis objective has been revised and outcome has been reached via alternative approaches.
During the course of the training staff that were particularly interested and skilled in E&D issues were identified. Although the aim had been to develop champions in this area the staff fed back that they would prefer not to be identified as this. However such staff have now become key contacts across various departments some of which include: Facilities, HR, Raigmore, each CHP area. These contacts are working towards taking various E&D issues forward thus embedding the agenda across the organisation. Race is a key area of work for this and is embedded into the Equality and Diversity training delivered
Tangible outcomesStaff have supported among other things:
A focus group among Polish women using the maternity service
Providing English for speakers of Other languages (ESOL) classes to facilities staff
The production of multilingual health improvement information Increased usage of the interpreting service
See objective 2 and 5 in the new action plan for actions carried forward
Continue to make links onto NHSH departments.
Identify pieces of work across the organisation that can be supported.
b) Provide 3 follow up training sessions
c) Develop support resource for Champions
58
Action 8 Develop and embed policy and function monitoring, including key outcomes as agreed from Checking for Change national performance monitoring toolkit.
Action Achievements - examples of good practice Further actions needed
a)Review risk assessment tool and make recommendations to Planning and PrioritisationProcess (PPP) Group
Comments: √ Green
The purpose and content of the Checking for Change tool is being reviewed nationally in light of new drivers to build links across equality strands. NHSH had therefore used the tool as a guide but has not followed it precisely.
Tangible outcomes: EQIA of PPP carried out and recommendations proposed. The policy for the management of Policies has had an EQIA All NHSH policy and guidance passed to the Clinical policy
ratification group can only be ratified when an EQIA has been undertaken.
If a recommendation within an EQIA is not taken forward this is recorded and published.
See objective 2 & 7 in the new action plan for actions carried forward
Include EQIA in future review of risk assessment procedures
Ensure EQIA is embedded within broader performance management and monitoring systems in NHSH
Review Argyll and Bute action plan April 09 as several risks associated with E&D are identified
b) Include EQIA process and Equality and Diversity Stamp within Management of PoliciesPolicy
c) Include EQIA in clinical policy review
59
Action 9
Ensure that all elements of FFA/RES are appropriately resourced
Action Achievements - examples of good practice Further actions needed
a) Quarterly budget/resource reporting to E&DGroup
Comments: √ Green
Tangible outcomesDuring 07/08, £28K was allocated to support roll out of training, £3000 for ESOL training of NHSH staff.
In addition, a bid to Scottish Government for £35k to support the development of a Hate Incidents Reporting System across the Highland Partnership was successful. Work on that continues and it will be launched in late 2008.
Partnership monies used to support community engagement activities.
Investment in interpretation support has grown from around £10kpa in 2004/05 to over £80k pa in 07/08
See objective 7 in the new action plan for actions carried forward
Continued support at board level is required.
b) Provide costings/risk assessment at Corporate Team Meetings
Progress reports highlight financial issues and risks
60
Action 10 Launch Health Needs Assessment and Plan for implementing recommendations
Action Achievements - examples of good practice Further actions needed
a) Recommendations and actions approved byCorporate Team and Board
Comments: √ Green
Tangible outcomes: Board approved actions within the plan. Ongoing work with community groups have ensured discussion of findings, along with other emerging research, has been carried out across Highland.
Health inequalities and specific health needs have been incorporated into other organisational performance management systems thus embedding such work across the organisation and removing the need to produce a separate document.
Recommendations made have been merged into the new Race Equality scheme so that the organisation is working from one document.
See objective 2 in the new action plan for actions carried forward
Continue to incorporate specific health needs monitoring and assessment in organisational performance management systems.
b) 3 Community led events to be held promoting anddiscussing findings of HNA and proposed actions
c) As part of action agree ongoing review andassessments required over each 12 month period.
61
Action 11
Develop response to Gaelic Culture issues within Fair For All
Action Achievements - examples of good practice Further actions needed
a) Set up appropriate meetings with local authorityrepresentatives developing Gaelic Culture Strategies
Comments: √ Green
An NHS Gaelic Language Plan implementation group has been set up and met several times to date. This group are taking forward actions to meet our duties under the Gaelic Language Act (2005) which requires us to produce a plan outlining how we intend to promote and provide equal status to the Gaelic Language.
Tangible outcomes: Funding gained from Gaelic Implementation Fund from Bord Na Gaidhlig allowing us to:
Equip a new Health Centre in Kyle with fully bilingual signage Produce a promotional NHS Highland promotional banner in both English and Gaelic Develop health promoting school information to all pupils attending Gaelic Medium education in Gaelic and English.
This has been incorporated into other work in the organisation. No further actions required in the RES.
b) Agree NHS specific response to support andmaintain Gaelic Culture appropriately within the context of equality and diversity
s
62
Action 12
Implement Patient Held Records System for Gypsy/Travellers within Highland
Action Achievements - examples of good practice Further actions needed
a) Agree group membership and set up implementation group
Comment: O AmberThe actions have altered since the publication of this scheme Nationally the hand held records were not rolled out.
Tangible outcomes: A Joint Gypsy/Travellers action plan has been agreed and a network of staff have been brought together to implement this.
Links between the Gypsy/Travellers and health workers on the permanent site in Inverness are strong. Hand held records are used here. However, work is patchy across Highland and this needs to be strengthened.
Initial meetings to identify key health staff across Highland has commenced.
See objective 6 in the new action plan for actions carried forward
A group will be set up across Highland to ensure the health needs of Gypsy Travellers are met across the whole Highland area.
This group will co-ordinate the roll out of the hand held records
b) Group to report to E&D Group and WBA onprogress. Implementation by December 2006
63
Action 13
Improve Pan Highland Recording of Ethnicity (patients)
Action Achievements - examples of good practice Further actions needed
a) Present business case to all CHPs and SSU and include requirement for local monitoring of progress
Comments O AmberPolicy Development Managers are aligned to CHPs to support embedding of Equality and Diversity. This includes improved monitoring data. Tangible Outcomes Training provided to NHSH staff on asking equalities
monitoring questions Monitoring awareness raising sessions made available to all
staff Process mapping approach highlighted to Board and
referenced in staff training
Systems still need much development to ensure that Pan Highland reporting is achieved.
See objective 2 in the new action plan for actions carried forward
Work with eHealth, Medical Records and SCi Implementation teams through the Information Governance Team to continue to develop equality monitoring tools and electronic systems
b) Host one day event on whole system approach and process map patient journey to highlight benefits of recording ethnicity (and other E&D strands andhighlight purpose of EQIA)
64
Action 14
Develop recording and monitoring of data on new Sexual Health Services System
Action Achievements - examples of good practice Further actions needed
a) Include Equality and Diversity issues within system training
Comments: O AmberThis Sexual Health project was not progressed past the pilot stage and so the data was not gathered. This we has been picked up by more generally data recording and monitoring work both locally and nationally.
Tangible Outcomes Ethnicity monitoring awareness raising sessions carried out
in service. System in place to receive local data from Information and
Statistics Division (ISD) through Equality and Diversity Information programme (EDIP) project and Diversity Information and Implementation network (DIIN)
No specific actions to take forward in relation to Sexual Health Services
b) Set up process with Information and Statistics Division (ISD) to ensure local data re ethnicity is made available
c) Meet quarterly with Sexual Health Services Team to review progress
65
Action 15Implement and Monitor Short Term Interpretation Service
Action Achievements - examples of good practice Further actions needed
a) Produce literature explaining how to access service for staff. Also to be available electronically
Comments: O Amber
Tangible outcomes These outcomes reflect the work of North Highland. Interpretation services need to be made widely available in Argyll and Bute and we working towards this as a priority.
A partnership (with Highland Council) interpretation contract has been signed ensuring that standardised interpretation is available across Highland. This has been in operation for 3 years.
Guidance for staff was produced and circulated among staff.
An audit has been carried out on the service.
The usage of the service is monitored
In partnership with agencies across highland this contract is being re-tendered.
Although not in the 2005 RES, we have also set up English for speakers of other languages lessons for staff working in NHS Highland. This now received main stream funding form our facilities department.
See objective 2 in the new action plan for actions carried forward
Complete new tender and award contract.
Continue to work in partnership to manage the contract
Ensure service provided for Argyll and Bute area
b) Produce literature explaining how to access service for public in a range of languages. Also to be available electronically
c) Monthly multi agency meetings to review service use and compare with use of telephone service
d) Produce report of activity andlearning present to Corporate Team
66
Action 16 Oversee Feasibility Study re options for long term Interpretation Services
Action Achievements - examples of good practice Further actions needed
a) Set up multi agency steering group
Comments: O Amber
The performance interpreting service is managed reviewed and In partnership with the Highland Council. Multi agency meetings are held monthly where issues surrounding interpretation are discussed. The new contract has been drawn up following multi agency consultation and in partnership with community planning partners.
Tangible outcomes An increased number of partners have joined the
contract. This means that the BME community will received a
standardised service across these partners.
See objective 2 in the new action plan for actions carried forward
As above b) Report on findings
c) Agree plan for implementation ofagreed service mode
67
Action 17
Agree Process for Translations of NHS literature
Action Achievements - examples of good practice Further actions needed
a) Agree key health information to be translatedb) Agree process for one offtranslations of material and promote process to organisation
Comments: O Amber
Guidance on translation was produced and circulated to staff.
Known translated information has been made available on our website
See objective 2 in the new action plan for actions carried forward
Complete tender process and award contract to a translation agency.
c) Present clear picture of use and potential cost risks to corporate team
68
Action 18
Carry out a staff led staff data gathering exercise(see appendix 5 for staff data to date)
Action Achievements - examples of good practice Further actions needed
a) Set up Project group by advertising in house for interested staff and including HR, Union/Partnership Forum, Health Intelligence Team Representation in group
Comments: O AmberScottish Workforce Information Standard System (SWISS) data monitoring has superseded this action.
Tangible outcomes Over 72% of staff have filed returns for SWISS. On
three occasions target follow up letters have been sent out to encourage returns. Further action is ongoing to contribute to achieving 100% returns.
Findings are being promoted through the Highland Partnership Forum arrangements.
The Workforce Equality and Diversity Action Plan details the responsibilities for all staff monitoring, for example in terms of learning and development and promotion.
Publicity and information related to Dignity at Work is being disseminated through a series of road shows, within which Equality and Diversity is a core component.
See objective 3 in the new action plan for actions carried forward
Continue to build upon this work in the coming years.
b) Agree format of delivery of information request and promote exercise and its purpose including equal opportunities policy and dignity at work policy.
c) Deliver exercise
d) Gather data and promote findings
69
Action 19
Set up manageable staff data monitoring process(see appendix 5 for staff data to date)
Action Achievements - examples of good practice Further actions needed
a) Quarterly meetings with Human Resourcesto ensure data is gathered and accessible and toundertake action required by specific patternsand trends
Comments: O Amber
These actions have been superseded by the establishment of the Workforce Equality and Diversity sub group of the Highland Partnership Forum. This group is overseeing actions in place to address adequate staff data monitoring. The monitoring data collected will be used to identify patterns and trends. Actions put in place are informed by the data findings.
See objective 3 in the new action plan for actions carried forward
Continue to build upon this work in the coming years.
b) Set up and agree pan organisation development of a Positive Action Programme
70
Action 20
Take forward results of training model consultation
Action Achievements - examples of good practice Further actions needed
a) Finalise date for close of consultationperiod
Comments: √ Green
These actions have not been worked through systematically however the outcomes achieved have led to a full programme of training in NHS Highland
Tangible outcomes £28 000 was awarded to develop a sustainable programme of training.
Ongoing training is now available for all staff across all areas of NHS Highland.
Equality and Diversity training is an integral part of NHS Highland learning plan
An online training package is available called the Same Difference.
See objective 2 in the new action plan for actions carried forward
Continue to offer training for all staff.
Develop a range of training opportunities including , face to face, distance learning and team learning
b) Include specific reference to equality anddiversity in NHS Highland training plan
c) Produce project outline and costings for corporate team
d) Agree resource for setting up cross organisation ad hoc and timetabled training
71
Action 21
Develop a Communication Gateway between BME Communities and NHS Highland
Action Achievements - examples of good practice Further actions needed
a) Review complaints procedures with Victim Support and EQIA tool andimplement recommendations
Victim Support Project with BME communities ended. This has been superseded by work on hate crime
No further actions needed.
b) Set up meetings with community leaders and Senior NHS Staff
Comments: √ Green
These actions have been achieved in various ways and in some cases alternative routes have been taken to achieve the same end.
Tangible outcomes
In partnership with organisations across Highland we have: Carried out a formal consultation with all known equalities
groups Remained in constant (yet not formalised) contact with
groups in the community representing BME individuals, and have responded to specific needs (eg offering the Chinese community Health Checks, producing interpreting cards so support the use of interpreters in the community, highlighted the need for the Chaplaincy to support staff to plan care for a Muslim who is expected to die )
See objective 1 in the new action plan for actions carried forward
c) Agree with community leaders clear process for participation includingfeedback and commitment to action from NHS Highlandd) Agree programme of activity to propose to community groups re ad hoc discussion and community led projects and formalised consultations onNHS led agendas including EQIA prioritisation.
e) Agree range of single and multi community meetings
72
Action Achievements - examples of good practice Further actions needed
f) Work with PFPI to increase awareness of BME communities inHighland, the benefits of diversity and importance of equality.
Community consultation was carried with all equality groups to identify common areas of work.
Developed a network of known groups and individuals that we can communicate with regarding heath related matters.
We work closely with the PFPI team to deliver E&D training, work with our patient forum representatives and ensure that public consolations invite individuals from BME communities.
Continue to develop our relationship with BME communities across Highland.
g) Work with other public sector partners to co-ordinate delivery as far as possible to prevent duplication
h) Engage staff through promotion of activities and involvement incommunity led information requests and activities
i) Set up NHS Highland BME Communities staff network
73
Appendix 5
List of all Equality and Diversity Impact Assessments (EQIAs) carried out up to and including September 2008. All EQIAs listed below will be available on line by January 2009
1. Bedrail Protocol
2. Bowel Cancer Screening Programme
3. Breastfeeding Guidelines
4. Business Case For Older People’s Services – Migdale Hospital.
5. Cambusavie Unit Patient Information Leaflet
6. Camhs Framework Proposal
7. Camhs Framework Update
8. Commissioning Sexual Health Services In Argyll And Bute – Terrence Higgins Trust Proposal
9. Communications Action Plans
10. Communications And Engagement Plan
11. Condition Management Service
12. Delayed Discharge Procedures
13. Diabetes Strategy
14. Directorate Of Public Health Annual Report 2007-2008
15. Fixed Term Contract Pin Policy
16. Food, Fluid & Nutrition In Hospital Care Policy
17. Function Of Board Meetings
18. Gender Based Violence Employee Policy
19. Guided Self Help Programme
20. Hate Crime Campaign
21. Healthy Weight Strategy
22. Heart Failure Service
23. Highland Sexual Health Strategy
24. Incident Policy And Procedural Guidance
25. Induction Policy
26. Infant Feeding Strategy
74
27. Infection Control Policy
28. Integrated Care Pathways (Mental Health Communications Stakeholder Involvement Strategy
29. Learning And Development Strategy
30. Learning Gateway Policy
31. Leased car scheme
32. Occupational Therapy Guidance
33. Older People Service Change Proposal
34. Patient Access Policy
35. Patient information Leaflets Dental Services
36. Patient Information Policy
37. Patient Partnership Forum Proposal Argyll And Bute
38. Peg Feeding Guidelines
39. Planning And Prioritisation
40. Policy And Practice Guidance On People With Learning Disabilities
41. Policy and Protocol for Verification of Patient Death in Hospital and Community by an RGN
42. Policy On Management Of Policies And Procedures
43. Practitioners With Specialist Interest Proposals
44. Prevention Of Excessive Weight Loss In The Breastfed Neonate Policy And Guidelines
45. Procedures For Developing Service Level Agreements On Patient Care
46. Promoting Attendance Pin Policy
47. Property Strategy
48. Proposal for Self Referral Pathway to Physiotherapy Services
49. Protocol for management of sex offenders on admission to hospital
50. Redeployment Pin Policy
51. Relationships And Sexuality
52. Review Of Nursing In The Community Public Information Leaflets
53. Safer pre & post employment checks PIN
54. Secondment Pin Policy
55. Smoking Cessation Action Plan
56. Tobacco Policy
75
57. Tobacco Policy – Managers’ Guidance
58. Transferring Skills Across NHS Highland For Nurses, Midwives And Allied Health Professionals Policy
59. Violence Against Women Strategy
60. Volunteering Policy
61. Workforce Strategy
76
Appendix 6
1. All Staff in Post
The pie chart below shows the ethnicity data for the whole of NHS Highland workforce at July 2008. Although the return rate has steadily been increasing, there remains over 20% of staff for whom data is not held. Targeted mail shots and promotional activities over the coming months will address these staff groups.
Compared to the data held for the local population, it can be seen that NHS Highland employ a higher percentage of BME individuals compared to the known demographics of the population. As the data for staff becomes complete, this situation will be monitored.
2. Senior managers
The pie chart below shows the monitoring data that is held for senior managers (the group subject to performance assessment procedures).
The figures for the senior managers are to some extent in line with the figures returned for all staff. Asian and Black groups however, are not represented in this group. This group of staff are so small though that a single new member of staff or a newly completed monitoring form could bring the statistics in line with all staff.
77
ETHNICITY
Any Other0.11%
Black (inc British)0.33%
Blank20.88%
Asian (inc British)1.55%
Prefer Not To Answer3.11%
Mixed0.26%
White73.76%
The next round of publicity and mail outs will facilitate increased returns for this group and so allow a more complete analysis.
Other British 2329%
Prefer Not To Answer 7
9%
White Scottish 3950%
Blank 79%
Irish <51%
Any Other White <51%
Mixed <51%
3. Applications for Learning and Development
The pie chart below shows the reported ethnic group of those employees who have applied for study leave through the learning and development team from 1st April to 31st July 2008. The chart provides a snap shot of ethnicity data for this period and is indicative of those applying for study leave through the year.
Compared to the data held for the whole workforce, this chart shows a much higher completion rate of the submission of ethnicity data. The data provided for most ethnic groups seems to be broadly in line with the data for all staff (notwithstanding the difficulty of using <5 figures).
The figures for white ethnic groups are higher in this chart, which could mean that some people who left the standard monitoring forms blank are identifying themselves as white for the Learning and Development forms. When the data is complete in the whole workforce figures, these figures will be compared again and appropriate action taken if needed.
The new AT Learning system will improve this information by monitoring ethnicity of all participants in and applicants for registered
78
courses. This system is currently in development and should be able to provide us with data from 2009-2010.
Ethnic Group
Declined3%
White British24%
White Scottish62%
White Irish<5
Any mixed background<5
African<5
Indian1%
Other Asian<5
Other White3%
No Response7%
No ResponseAfricanAny mixed backgroundDeclinedIndianOther AsianOther WhiteWhite BritishWhite IrishWhite Scottish
4. Disciplinaries and Grievances
The table below shows disciplinaries against and grievances raised by NHS Highland employees from 31st August 2007 to 31st August 2008.
We have not had monitoring data supplied by most of those who have faced disciplinary action and those who have raised grievances. As the <5 figures represent at least one, then no data is held for over half of those involved in disciplinaries.
A possible explanation of this is that those people who are involved in disciplinary procedures are less likely to complete monitoring data, because they have less confidence in the organisation. Activities to promote monitoring and the reputation of the organisation as a diversity champion are underway to support increased returns. Increased returns will allow more meaningful comparison.
Qualitative data is needed to understand whether there is any significance to the cases in the <5 groups.
Disciplinaries & Employee Concerns12 months to 31 August 2008
Disciplinary Employee ConcernsEthnic Background
Raised Closed Raised Closed
Blank 15 13 18 11
79
Declined <5 <5 <5
African <5
Any Mixed <5 <5 <5
White British <5 <5 10 7
White Irish <5 <5
White Scottish 11 8 30 23
5. Staff applying for and leaving NHS Highland employment
Monitoring of applications was taking place and being entered on a local database up to 2007, and some beyond. This was put on hold because a national online application system (Marje) was then introduced. It was hoped that this new system would allow data collection at the time of application. Due to ‘functionality issues’ this system has very recently been withdrawn. NHS Highland will be putting in place alternative arrangements to ensure future reporting of this data.
A new exit interview process is being developed, which will link to workforce monitoring data. This will ensure up to date returns on those leaving NHS Highland employment.
80