Health equity, equality, diversity and inclusion

Equality2024-12-03T15:44:18+00:00

Our commitment to addressing health inequalities and promoting equality, diversity and inclusion

At NHS Dorset, we are committed to undertaking our system leadership role, including in relation to our public sector and general equality duties, and our duty to have due regard to the need to address health inequalities. To ensure that everyone in Dorset has fair access, experience and outcomes from our services. This includes through commissioning (designing and buying) health services that respect and respond to the diversity of our local population.

Our Joint Forward Plan sets out our ambition that Dorset is a healthy place where everyone can live their best life – taking care of bodies and minds to stay well.

We know that different people have different needs, and we want to make sure that everyone gets the support they need to be healthy. We think it’s important to treat everyone fairly and recognise that equality isn’t about treating everyone the same, instead it is about ensuring that. good outcomes are available to everyone, from all backgrounds.

We also want to make sure that our workplaces are welcoming and kind places where everyone feels valued, has access to good career opportunities and development and feel that they belong. We work closely with our partner organisations in Dorset to make sure that all our workplaces are inclusive and fair.

These pages provide detailed information on all the things we are doing to ensure our health and care services are meeting the needs of our local communities and are refreshed annual to inform our annual equality, diversity and inclusion report. Our equality, diversity and inclusion work is part of a wider programme to address health inequalities, and ensure equality of access, experience and outcomes from health care services.

Our legal responsibilities are set out in the Equality Act 2010.

Health inequalities are differences in how healthy some groups or communities are, compared with others. They don’t happen by chance, but because of the conditions in which we are born, grow, work and live.

These conditions include:

  • The opportunities we have because of the resources available in the area that we live (for example good jobs and education, housing and access to transport and local services and community support)

  • Individual factors such as our age, ethnicity, gender etc. (protected characteristics); or access to a good diet, physical activity, whether we smoke and can access healthcare early

  • Whether we’re from other vulnerable groups such as having experience of the criminal justice system, are homeless, have experienced racism of trauma, or are from a marginalised group such as Gypsy, Roma or Traveller, or are a migrant

The more negative impacts we experience, the more likely we are to have poor health.

More information on the wider action we are taking, our approach to addressing health inequalities, and how we work with our partners to address differences in access to our services, and our future plans is available in our Health Inequalities Annual Report.

Further supporting resources are also available on our cross-system ‘Our Dorset’ website.

NHS Dorset ICB Health inequalities annual report 2024

Understanding Health Inequalities in Dorset

The Health Inequalities report provides detailed information on variation across 24 domains (areas of work) for a number of population groups – this includes the protected characteristics of age, gender, ethnicity/race and disability within specific service areas.

Service areas looked at in the report include planned hospital stays, outpatients services, and emergency use of healthcare services, waiting times, flu and covid vaccination, mental health services, cardio vascular disease, cancer, diabetes, maternity services, oral health, services for people with learning disability or autistic people.

This is a new report recently requested by NHS England. We will use the information from this years report to help us to improve our ability to understand differences in access and outcomes from health and care services, and further develop improvement plans and focus our efforts where we identify issues.

In future reports, we will look to include further analysis by other protected characteristics or inequalities groups where information is available.

NHS Dorset ICB Annual Equality, Diversity and Inclusion Report 2024

Introduction

Our legal duties

NHS Mandated Equality Standards

Our ICB workforce

Working with local communities

Our equality objectives 2024-2025

Equality Impact Assessments (EIA)

Equality Delivery System 2024

Equality monitoring

Annual Equality, Diversity and Inclusion Report 2024-2025

We are pleased to present our Equality, Diversity and Inclusion Annual update produced for NHS Dorset Integrated Care Board in this accessible format.

Accessible communications

We want to make it as easy as possible for people to get involved in our work and find out more about local health services.

If you need information in an alternative format, such as easy read, large print, Braille, audio or an alternative language, please let us know by contacting the communications and engagement team via feedback@nhsdorset.nhs.uk or call 01305 368900.

This site sets out how NHS Dorset delivers upon its commitment to taking equality, diversity and inclusion into account in all we do, from commissioning (designing and delivering) services, employment, developing policies and engaging with our local communities.

Introduction

Our Equality, Diversity and Inclusion Annual Report sets out how we have performed in meeting our legal duties as set out in the Equality Act (2010) and in meeting our Public Sector Equality Duties. The information presented in this report represents the progress we have made in incorporating equality, diversity and inclusion into all aspects of our work in the last year.

The publication of this report and the information contained within the pages on this site demonstrate compliance with the Public Sector Equality Duty and requirements to publish equality information annually.

The information contained in the pages of this online report set out:

  • NHS Dorset ICBs commitment to equality, diversity and inclusion

  • Evidence of our ‘due regard’ to the Public Sector Equality Duty

  • Progress made against the ICBs equality objectives set in 2023

  • Updated equality information and objectives for 2024-2025

Legal duties for equality and inclusion

This section outlines the various legal requirements and NHS England Mandated Standards relating to Equality, Diversity and Inclusion.

The Equality Act (2010)

The Equality Act was introduced in 2010 to make it easier for people and organisations to understand discrimination law. The Act provides protection to groups of people who may be discriminated against because of certain characteristics they share; and provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. Further information.

The Public Sector Equality Duty

The Equality Act 2010 brought a new Public Sector Equality Duty (PSED) requiring public bodies to declare their compliance with the duty on an annual basis. This means that we must show compliance with both the general and specific duties of the PSED.

For the general duty we need to show how we are having due regard to the need to:

  • Eliminate unlawful discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010

  • Advance equality of opportunity between people who share a protected characteristic and people who do not share it

  • Foster good relations between people who share a protected characteristic and people who do not share it

Protected characteristics – in the context of the PSED – are defined as:

  • Age

  • Disability

  • Gender reassignment

  • Marriage and civil partnership

  • Pregnancy and maternity

  • Race

  • Religion and belief

  • Sex

  • Sexual orientation

Equality Act 2010 - Protective characteristics

Human Rights Act (1998)

The Human Rights Act (1998) came into effect in the United Kingdom in October 2000. The act requires ICBs to ensure that their commissioning decisions safeguard vulnerable people, and do not put people’s lives at risk or expose them to inhumane or degrading treatment.

Health and Social Care Act (2012)

The Health and Social Care Act (2012) states that each ICB must, in the exercise of its functions, have regard to the need to:

  • Reduce inequalities between patients with respect to their ability to access health services

  • Reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services

  • Promote the involvement of patients and their carers, in decisions about provision of health services to them

  • Enable patients to make choices with respect to aspects of health services provided to them

NHS Constitution (2015)

The NHS Constitution (2015) sets out rights for patients, the public and staff. It outlines NHS commitments to patients and staff, and the responsibilities that the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. NHS Constitution targets are monitored via the ICB’s Quality Committee, and further assurances are provided to the Board.

NHS Mandated Equality Standards

In 2022, NHS England launched a new Equality Delivery System 2022 framework. EDS 2022 is designed for both NHS commissioners and NHS providers and places a heavier focus on partnership working between ICS system partners. EDS helps NHS organisations improve the services that they provide for their local communities and provide better working environments, free from discrimination, for those who work in the NHS, whilst meeting the requirements of the Equality Act (2010).

The aim of the Accessible Information Standard is to make sure that people who have a disability, impairment or sensory loss, receive information that they can access and understand, and receive any communication support that they need. Commissioners of NHS services must have a regard to this standard, in so much as they must ensure that they enable and support compliance through their relationships with provider organisations. This standard is in the ICB’s NHS Standard Contract and is monitored by Quality and Performance Key Performance Indicators (KPIs).

The NHS Workforce Race Equality Standard (WRES) is a useful tool to identify and reduce any disparities in experience and outcomes for NHS employees and job applicants of different ethnicities. The Standard is used by organisations to track progress in identifying and helping to eliminate discrimination in the treatment of Black and Minority Ethnic (BAME) employees.

The Workforce Disability Equality Standard (WDES) is a set of specific measures (metrics) that enables NHS organisations to compare the experiences of disabled and non-disabled staff and improve outcomes for NHS employees and job applicants with disabilities. All NHS standard contracts set out that NHS Trusts and NHS Foundation Trusts are required to implement the WRES and the WDES.

All public authorities are required to co-operate with the Police Commissioner under the Modern Slavery Act (2015). This means that police and health care services, together with voluntary organisations, are legally required to work together to support people who have experienced slavery.

The NHS People Plan was published in July 2020. The plan sets out actions to support transformation across the whole NHS now and in the future. It focuses on how we must all continue to look after each other and foster a culture of inclusion and belonging, as well as action to grow our workforce, train people, and work together differently to deliver patient care.

The People Plan sets out what NHS staff can expect from leaders and each other and includes a focus on fostering a culture of inclusion and belonging. The NHS People Plan includes a People Promise, which outlines the actions and behaviours staff should expect from their employers and colleagues, as part of improving the experience of working in the NHS for everyone.

More recently, the NHS Long -Term Workforce Plan was published on 30 June 2023. This plan has been described as ‘once in a generation opportunity to put staffing on a sustainable footing and improve patient care’. The 15-year plan focuses on training, retaining and reforming the workforce and places close attention the way in which the NHS is organised to enable these ambitions. In particular, the plan places emphasis on retaining staff by improving culture and well-being.

Other recent national developments include the NHS Equality, Diversity and Inclusion Improvement Plan published in early June 2023. This improvement plan sets out targeted actions to address bias and discrimination that exists in workplace experiences, policies and practices against specific groups and individuals within the NHS workforce. The EDI Improvement Plan has set out six high impact actions;

  • EDI objectives for chairs, chief executives and board members
  • Overhaul recruitment and embed talent management
  • Review pay gaps for race, disability and gender
  • Address health inequalities within the workforce
  • Reduce inequalities for internationally recruited staff
  • Eliminate experiences of bullying and harassment

Our Dorset ICS People and NHS Dorset’s People Plan sets out a clear ambition to develop cultures of pro equity and inclusion across our system that is the foundation for a great staff experience and delivering on health inequalities. The ICS EDI programme brings together EDI leads across our partners and we have collectively identified actions we will take together.

The Sexual Orientation Monitoring Information Standard (SOM) provides a mechanism for recording the sexual orientation of all patients/service users aged 16 years and over across all health services and local authorities with responsibilities for adult social care in England, and in all service areas where it may be relevant to record this data.

We have incorporated sexual orientation monitoring into our refreshed Equality Impact Assessments to enable us and our providers to identify health risks at a population level that support preventative and early intervention work to address health inequalities for LGB communities.

Our ICB workforce

NHS Dorset ICB is committed to holding up to date information about its workforce, in line with current data protection legislation, to help ensure that strategic decisions affecting the workforce are based on accurate reporting.

We recognise the need for our workforce to be representative of our local communities and that we need to do more to attract and retain a workforce a workforce that is representative and improve the experiences of our diverse staff. Within our existing workforce there are issues with under-reporting of diversity monitoring which means we need to work harder to encourage our employees to share this information with us so that we are able to understand the needs and challenges they may face.

NHS Dorset ICBs workforce equality information update provides an overview of diversity within our existing ICB workforce as of 1 February 2024.

Workforce representation as of 1 September 2024.

It is mandatory for organisations with 250 or more employees to report annually on their gender pay gap. The gender pay gap shows the difference in the average pay between all men and women in a workforce.

Read NHS Dorset gender pay gap report 2024

Read NHS Dorset ethnicity pay group report 2023-24

Read NHS Dorset disability pay gap report 2023-2024

Read Dorset NHS Integrated Care Board workforce equality information 2024

Learning and development opportunities

NHS Dorset has a clear People Development Plan to support delivery of the NHS Dorset People Plan. The mission of the Learning and Development Plan and team is to “Provide equitable opportunities for you and your teams to learn, grow and develop, enabling everyone to be at their best self at work”

Our staff are encouraged to discuss and agree learning and development opportunities with their managers and these include undertaking specific workshops, attending conferences and events and identifying areas for on the job development.

Through the ICS EDI programme, linked to the Dorset ICS People Plan, the ICB is committed to increasing the learning and development opportunities and improving career development for individuals who are from groups who are under-represented within our workforce and for developing cultures of equity and inclusion. Working closely with our partners, specific examples of collaborative EDI development opportunities include:

The programme brings senior leaders from across our system together, supporting them develop as agents of change. It is a significant step in helping us reduce health inequities and embed action on equality in all that we do by empowering leaders to influence and develop cultures of pro-equity and inclusion for our staff and population. The topics of the programme focus on “Seeing, Responding and Leading Differently”.

Feedback so far from participants indicates that the programme is helping to shift their thinking and perspectives and building their confidence to take new and different actions to reduce biases, exclusion, and discrimination across our system, and in turn help reduce health inequalities.

This image is a photograph of 25 course attendees and tutors outside the training venue.

This image is a photograph of 25 course attendees and tutors outside the training venue.

With our partners we have collaboratively co-designed two training sessions that will be launched this spring to staff across our ICS to support and enhance knowledge in key concepts that are vital to foster a culture of inclusion and belonging for our workforce.

Course objectives

Conscious inclusions Leading for inclusion
Explain the concepts of cultural competence, bias, discrimination, racism, microaggressions and privilege Understand the impact of inclusive leadership on team member experience
Demonstrate awareness of the experiences of our staff from underrepresented backgrounds and NHS obligations Identify examples of inclusive leadership within their day-to-day practice
Develop communication skills and self-awareness to have culturally sensitive conversations Review team culture and identify areas to enhance inclusive practice
Recognise your own biases and differences to better support staff Initiate compassionate conversations with team members to enhance inclusive cultures and recognise needs of others
Apply understanding of tools to breakdown cultural barriers To understand leadership best practice when supporting diversity across their team/services

Testimonials

We have three levels of health inequalities and population health training which support staff and teams across the system to use data to review their services and identify where population groups may not be getting fair or equal outcomes, or where there are opportunities for improvement.

Over 500 of our staff, including the ICB Board, have played our innovative board game which enables participants to consider the real life challenges that different population groups might face in getting the best health outcomes.

More than 350 people across the ICB, our hospitals, general practices and the voluntary and community sector have participated in more intensive health inequalities and population health management training. We have trained 64 Ambassadors across the NHS, local authority and voluntary sector. We our currently working with community sector partners across Dorset to review and add to the scenario’s and characters we use in our PHM game to make sure it continues to reflect the lived experience of our diverse population.

Our ambition is that we will have a skills and capability offer targeted to the opportunities they have in their job, for everyone that has a role in improving health, across our system.

This image shows four different kinds of training available through our health inequalities and population health management programme. It includes an interactive board game, a two hour session for people new to the subject area, a one day course for people who might lead at team undertaking a piece of work, and a train the trainer course for people who’s main job is supporting people to improve the quality of services

Alongside the health inequalities and PHM training, colleagues across the system have led the development of specific learning offers.

For example:

  •  Dorset Health Care has developed training for junior doctors
  • Allied Health Professional colleagues are focussing on skills and knowledge that their staff, who tend to have more than one off contact with patients, need to embed action on health inequalities into their job
  • Public Health Dorset supported by the ICB has led on the development of Health Literacy training

Learning from these programmes will form core components of the training offer for everyone with a similar opportunity (e.g. one off contact, extended contact with service users etc.)

We strive to keep staff well informed and involved in key decisions and priorities of the organisation. This has been particularly important in the first few years of the ICBs establishment. The following methods are used to communicate, engage and involve staff:

  • Daily FYI updates sent via email, with links to our staff intranet pages
  • Weekly CEO and chief officer blogs
  • Fortnightly team brief cascade
  • Quarterly FYI Live events
  • Staff intranet – FYI SharePoint – with a wide range of information around EDI, learning and development, health and wellbeing, latest news, policies, documents, events and more
  • Inclusion calendar which outlines a wide range of EDI focused awareness days, celebrations and areas of focus for the month
  • Your Voice Forum for representatives across various directorates to meet for updates and feedback monthly
  • Staff networks, freedom to speak up guardians and wellbeing champions

Our Pro Ability Network raises the profile and awareness of the issues faced by staff living with a disability or long-term condition and also those with responsibilities as a carer. The network plays a key role in shaping and developing an open, positive, and inclusive working culture.

The Pro Ability Network has achieved much since its establishment in July 2023, and has run a number of in-person and online events during the year including:

  • Say hello drop in sessions
  • Meet and greet with the network chief officer sponsor
  • Talk on autism
  • Established a mental wealth group
  • Celebrated an event for Carers Rights Day
  • Established a carer connecting group
  • Developed a reasonable adjustments passport
  • Neurodiversity celebration week campaign

Cultural Diversity Network

Our newly renamed Cultural Diversity Network is a vibrant and welcoming space, open to staff from all ethnic backgrounds. The network is committed to fostering a sense of belonging, offering support, and facilitating meaningful dialogue among colleagues.

Led by a dedicated network chair and supported by a chief officer sponsor, the network continues to grow, offering a platform where all members can connect. We host regular meetings and events aimed at celebrating our diverse workforce and promoting equality for all.

Some of our recent initiatives include:

  • Monthly meetings to share ideas and support one another
  • Safe space sessions for open, honest conversations among members
  • Celebrations such as Black History Month and Race Equalities Week, featuring thought-provoking events and discussions

Everyone is welcome, and we encourage all to participate.

LGBTQ+ is a staff network with an aim of raising awareness and the profile of LGBTQ+ issues and colleagues in the workplace and to ensure that there are visible role models at different levels of the organisation. The network provides a safe space for peer-to-peer support and is a critical friend for the ICB, informing our EDI activities and actions to ensure we are providing a more inclusive working environment for staff.

Activities and events the network have supported during 2023-2024 include:

  • Bourne Free Pride in the Park with our system partners networks
  • Celebrating LGBTQ+ History month including reaching out to the ‘Space Youth Project’ and asking for shared lived experiences of accessing health care services which we shared with our staff
  • Regular blogs and educational updates from our network members sharing their experiences and raising awareness
  • Online Trans awareness talk from a former army offer with over 40 years lived experience of being trans and gender diverse
  • Regular network meetings and listening events with their chief officer sponsor

Following the introduction of the Workforce Race Equality Standard (WRES) in 2015, every NHS organisation has been required to submit individual annual WRES data returns to NHS England on an annual basis. Similarly, since 2018, NHS Trusts have been required to submit Workforce Race Disability Standard (WDES) data returns to NHS England.

In August 2023, NHS Dorset ICB worked with NHS Provider Trusts within the ICS to produce a collated WRES and WDES system report. The aim of the report was to analyse performance and progress against each of the indicators and identify priority areas for improvement and opportunities for targeted and collaborative action in line with our ICS People Plan.

The report demonstrated there are pockets of good performance, however identified some areas where there are opportunities for improvement such as:

  • Ensuring equal representation across all pay bands, including board level
  • Ensuring ethnically diverse and disabled staff feel that they are provided with equal opportunities for career progression
  • Improving the experiences of ethnically diverse and disabled staff in relation to bullying, harassment and abuse

As a result there were a number of recommendations that were made to the ICB Board to be incorporated into the EDI programme of work.

Working with local communities

We are committed to ensuring that we promote equity by keeping the needs of our communities at the heart of our commissioning and system leadership role.

We believe, as is reflected in our planning and ethos, that healthcare provision on an equitable discrimination-free basis is the right of all in Dorset.

NHS Dorset takes seriously the particular needs that members of diverse communities or those groups who share protected characteristics and are more likely to have poorer health have. We believe, as is reflected in our planning and ethos, that healthcare provision on an equitable discrimination-free basis is the right of all in Dorset.

Our Equality, Diversity and Inclusion Strategy has at its heart a commitment to keeping the needs of our diverse communities at the centre of our purpose as an ICB role. This includes tackling as effectively as possible health inequalities by having appropriate actions to take in place.

Our mission, ‘Supporting people in Dorset to lead healthier lives’, means that we need to work with a range of communities and populations to support them in accessing and using local health services. We need to increase knowledge about healthcare needs to enable our communities to lead healthier lives. We work closely with local people, patients, providers, staff and voluntary organisations to help reduce inequalities and eliminate any discrimination within our services and working environments.

NHS Dorset’s strategic approach for working with people and communities underpins how we work with communities to promote equity and address health inequalities. It includes a specific section which provides more details on how we are working with people and communities to reduce health inequalities.
Our Dorset Public Engagement Group created a diagram to illustrate that service provision starts with local people.

Our equality objectives

Progress against our 2023-2024 equality objectives

In 2023 we defined a set of equality objectives designed to set out a range of initial commitments in relation to EDI while the emerging ICB and system continued to develop and firm up its long-term priorities and plans. Our objectives were informed by our 2023 EDS grading exercise, insights from staff and stakeholders, our NHS Dorset People Plan and Dorset ICS People Plan, the South West Regional Leading for Inclusion Strategy, NHSEs High Impact Actions and our WRES and WDES metrics.

Progress against our 2023-2024 objectives includes:

Objective Action taken
Objective 1: our commissioned and provided services will meet the needs of our diverse population.
  • Reviewed and refreshed approach to managing the potential for unequal outcomes from our services launching a new System Quality, Equality, Equity Impact Assessment
  • Embedded equality impact assessment as a core component of our new gateway process for approving all new projects in the ICB
  • Reviewed our population health management workforce development programme and embedded equality impact assessment, to ensure that everyone undertaking a PHM programme routinely considers the potential for their services to impact differently on groups who share a protected characteristic compared with those who don’t (alongside reviewing this for groups more likely to have poorer health outcomes)
  • Agreed a new equity and inclusion health post in the health inequalities team structure
  • Undertaken three equality delivery system reviews
Objective 2: Our workforce will see improvements in health, well-being, and diverse representation.
  • Appointed a dedicated workforce equality, diversity and inclusion business partner
  • Established an ICB Equity, Equality, Diversity and Inclusion Steering Group
  • Established/refreshed three staff networks (ethnic diverse community, pro-ability, and LGBTQ+)
  • Established a system wide EDI programme group delivering joint EDI activity as per ICS People Plan
  • Review and launch of the wellbeing plan and variety of actions delivered
  • New appointment of two staff level freedom to speak up guardians and variety of actions delivered
  • Worked with networks to review a variety of policies including reasonable adjustments policy
  • Health and wellbeing passport to capture long term conditions and adjustments should staff move teams
Objective 3: Our leaders will demonstrate a clear and strong commitment to EDI in all they do.
  • Launched system wide commissioned leading for equality programme to 25 senior leaders to create a pool change leaders for equality and to support reduction in health inequalities
  • System collaboration design of conscious inclusion workshop and inclusive leadership workshop
  • Executive sponsors established and active in supporting staff networks
  • Chief officer specific objectives linked to EDI
  • Chief officer holds specific objective for 2023/24 to implement the regional EDI strategy, prioritising leadership development and revision of key people policies

The ICB has a specific duty under the Public Sector Equality Duty (PSED) to set equality objectives at least every 4 years. We have refreshed our objectives and these have been formally endorsed by our ICB Board in March 2024.

Overarching objective Specific objective Milestone/success metrics
By April 2025 we will publish comprehensive information for the public on progress and plans to improve the experience and representation of our workforce to meet the needs of our diverse population Pay equality

  • By September 2024 analyse data to understand pay gaps by protected characteristic and put in place improvement plans
  • Produce 2024 gender pay gap report
  • Analyse further data for race and disability and produce improvement plans with networks
By April 2025 we will publish comprehensive information for the public on progress and plans to improve the experience and representation of our workforce to meet the needs of our diverse population Diversity of workforce

  • By May 2024 produce a detailed analysis of the representation of existing workforce by protected characteristics and compare to local population
  • Produce the disaggregated report
  • Review with networks to identify priority actions
  • Use this to inform our internal actions including inclusive recruitment and talent management plans
By April 2025 we will publish comprehensive information for the public on progress and plans to improve the experience and representation of our workforce to meet the needs of our diverse population Career progression/talent management

  • By June 2024 create and implement a talent management plan to improve the diversity of executive and senior leadership teams and evidence progress of implementation by June 2025
  • Use diversity of workforce data and staff survey data to inform priority areas
  • Work with system partners to align plans and approach
By April 2025 we will publish comprehensive information for the public on progress and plans to improve the experience and representation of our workforce to meet the needs of our diverse population Inclusive recruitment and selection

  • By September 2024 implement a plan to widen recruitment opportunities within local communities
  • Align with the ICS People Plan approach
  • Including the creation of career pathways into the NHS such as apprenticeship programmes and graduate management training schemes and evidence
By April 2025 we will publish comprehensive information for the public on progress and plans to improve the experience and representation of our workforce to meet the needs of our diverse population5 Workforce health and wellbeing

  • By September 2024 conduct a deep dive analysis and produce a targeted action plan that aims to review and improve the health, wellbeing and a reduction in any health inequalities that exist in our workforce with evidence of progress by May 2025
  • Use EDS Domain 2 as a basis for deep dive and action plan
  • Work with networks to review actions and staff survey insights to develop plan
  • Agree metrics for improvement
  • Contribute to system wide review of workforce health equity review
By April 2025 we will publish comprehensive information for the public on progress and plans to improve the experience and representation of our workforce to meet the needs of our diverse population Discrimination, bullying and harassment reduction

  • By March 2024 review data by protected characteristic on bullying, harassment, discrimination and violence and set reduction targets and develop plans to improve staff experience year on year
  • Ensure safe and effective policies and processes are in place to support staff affected by domestic abuse and sexual violence (DASV). Support should be available for those who need it, and staff should know how to access it (by June 2024)
  • Create an environment where staff feel able to speak up and raise concerns, with steady year on year improvements (by March 2024)
Overarching objective Specific objective Milestone/success metrics
By April 2025 we will publish information to our public on how our leaders demonstrate a clear and strong commitment to equality, diversity and inclusion in all they do and the impact this has on our diverse population Chief executives, chairs, and board members must have specific and measurable EDI objectives to which they will be individually and collectively accountable
  • Every board and executive team member must have EDI objectives that are specific, measurable, achievable, relevant and time bound (SMART) and be assessed against these as part of their annual appraisal process (by April 2024)
By April 2025 we will publish information to our public on how our leaders demonstrate a clear and strong commitment to equality, diversity and inclusion in all they do and the impact this has on our diverse population By December 2024 we will have launched a variety of leadership interventions which aim to develop cultures of pro-equity and inclusion across the system and are able to demonstrate how these are supporting outcomes in tackling health inequalities and improved staff experience
  • Fully evaluate the outcomes of the Leading for Inclusion Health Equity Change Agent Programme
  • Embed the learning and scale and spread the approach
  • Including the Inclusive Leadership Programme across the system
  • This will inform a further system inclusive culture development plan for 2025 across the system
Overarching objective Specific objective Milestone/success metrics
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By March 2025 – we will complete and publish 3 equality delivery system deep dives across three different services
  • Deep dive areas agreed – by June 2024
  • Reviews completed by December 2024
  • Improvement plans (where required) set by March 2025
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By June 2024 equality and health inequality impact assessment fully incorporated into population health management programme and resources (to enable systematic assessment using common process of all organisation population health quality improvement programmes)
  • Map current PHM process and learning objectives by April 24
  • Fully integrate EIA/HEAT tool into PHM process – by September 24
  • Agree with cross system stakeholders – December 24
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By October 2025 a web/app based SQEEIA process in place to enable assurance of systematic monitoring of completion, and a review cycle of agreed actions etc. and SQEEIA assessments are published on our web pages
  • Scope and timeline identified by digital/IT teams – April 24
  • Key metrics agreed and schedule date of delivery – April 24
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By March 2025 – a public view of our DiiS system is made available on our website, including the ability to view performance by protected characteristic where data available
  • Detailed timeline to be developed and agreed by end June 24/25
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By May 25 senior system leaders completed inclusion training and embedding the impact and outcomes to support scale and spread
  • Identify initial outcomes linked to reducing health inequalities
  • Embed outcomes in inclusive leadership and management offer
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By July 2024 system quality, equity, equality impact assessment training and supporting resources updated/developed and updated staff training resources available
  • Patient equality and inclusion health lead in post – June 2024
  • Updated resources published – July 2024
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By March 2025 the ability to systematically review variation in services by protected characteristic through our DiiS integrated intelligence service is further strengthened
  • Review of fields against NHS England health inequalities reporting requirements and equality duties (protected characteristics) by June 24
  • Addition of new fields as required/available by September
By April 2025 we will publish comprehensive information for the public on how our commissioned and provided services meet the needs of our diverse population By March 2025 further refinement of ICB digital communication channels in respect of accessible information standard and wider communications needs (e.g. re equality duty) – fully implemented
  • Detailed timeline and actions to be set out by end June 24/25
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We are working with our staff networks and EDI Steering group to review data and insights and develop an action plan to deliver these objectives and will report back on progress against these objectives with metrics in March 2025.

Equality Impact Assessments (EIA)

NHS Dorset are committed to advancing equality and enabling equitable outcomes for its workforce and the local population.

We do this by checking whether our services or policies might potentially impact differently on some groups who share one or more of the characteristics protected by law under the Equality Act.

Based on relevant data, information, consultation, learning and insights we take steps to:

  • Identify and minimise disadvantages people may encounter due to their protected characteristics

  • Identify and put-in-place positive action measures to meet needs of some people with protected characteristics where these are different from the needs of other people

  • Address any disproportionate impacts identified

We do this in a number of ways including  through a process of Equality Impact Assessment which is integral to service planning, redesign and delivery.

It is one of the ways in which we check whether we are meeting both our legal duties, and our own ambitions to make sure that everyone in Dorset has fair access, experience and outcomes from our services.

We are refreshing our approach to Equality and Health Inequalities (EHIA) to ensure it is:

  • In line with the latest guidance from the equality and health regulators and best practice

  • Fit for purpose and able to develop system capacity to respond to the scale and pace of change required

  • Improves outcomes for people using health services across Dorset

The refreshed approach will better equip and help us to:

  • Undertake a rolling programme of EHIAs to inform improvements

  • Streamline and create a digital version of our forms to make it easier for staff to complete them and the public and other colleagues to understand the work we have undertaken

  • Take account of equality and health inequalities considerations at all stages of service development and delivery

  • Further enhance EHIA training and support offer for staff and system colleagues

  • Improve further our understanding of, and ability to, address gaps in datasets

  • Meet our statutory duty requirements and our ambition to be recognised as an ‘exemplar’ in the South West region and beyond

We anticipate the EHIA refresh to be completed by March 2025 and the EHIA Digital Platform to go live over the next financial year.

Please send any queries or requests for further information on how you can get involved with the Equality and Health Inequalities Impact Assessments (EHIAs), to: phm@nhsdorset.nhs.uk

Equality Delivery System 2024

NHS Dorset ICB are pleased to have completed Domains 1, 2 and 3 of the Equality Delivery System (EDS) and overall have achieved a rating of “Achieving” as at March 2024.

EDS is focused around three ‘Domains’:

  • Domain 1 – Commissioned or provided services

  • Domain 2 – Workforce health and wellbeing

  • Domain 3 – Inclusive leadership

We have undertaken three deep dives into areas of service, using our population health management approach. EDS reviews have been undertaken collaboratively with the main NHS Trusts in Dorset – University Hospitals Dorset, Dorset Health Care and Dorset County Hospital Services areas reviewed in 2024/25 are:

  • End of life care
  • Ear, nose and throat patients who do not attend their appointment (to inform wider learning on variation in patients who do not attend their appointments)
  • Falls risk modelling

Each service review was scored by a stakeholder panel and collated to ratify the final score. Topics included in domain 1 are substantial pieces of work completed over many months, the findings of which will be used to inform strategy, policy and ongoing service improvement, both within the individual service area, and through extrapolating findings for application to other relevant services, This year, we used our domain 1 EDS review to test whether our population health management process routinely considered equality as part of the processes. Our findings will help us to improve that process, and our ability to review our services through a health equity lens e.g. is the right data and analysis available to us, and to consider what we need to do to improve the skills and support for people undertaking EDS reviews.

Domain 1 – Commissioned or provided service DRAFT ICB only ratings
Outcomes 1A Service users have required levels of access to the service 2 – Achieving activity
Outcomes 1B: Individual service users health needs are met 3 – Excelling activity
Outcomes 1C: When service users use the service, they are free from harm 2 – Achieving activity
Outcomes 1D: Service users report positive experiences of the service 2 – Achieving activity
Draft overall rating for domain 1 9/12 (DRAFT)

There is already a significant amount of systematically reviewed information and evidence available for domain 2 (workforce race and disability equality standard, gender pay, staff survey) and several actions are already in placed linked to our NHS Dorset People Plan and Dorset ICS People Plan. The detailed analysis of the outcomes has identified areas we are doing well and activities we can add to our EDI action plan to deliver our EDI objectives.

Domain 2 – Workforce health and wellbeing Ratings
Outcomes 2A: When at work, staff are provided with support to manage obesity, diabetes, asthma, COPD and mental health conditions 2 – Achieving activity
Outcomes 2B: When at work, staff are free from abuse, harassment, bullying and physical violence from any source 2 – Achieving activity
Outcomes 2C: Staff have access to independent support and advice when suffering from stress, abuse, bullying harassment and physical violence from any source 2 – Achieving activity
Outcomes 2D: Staff recommend the organisation as a place to work and receive treatment 1 – Developing activity
Overall rating for domain 2 7/12

There is a recognition that the Board are committed to creating a culture of compassion whereby diversity is encouraged and celebrated, enabling an environment where all staff are empowered and have a positive experience. There has been some great activity already here, but there are areas for improvement to increase to Activity to ‘Exceeds Requirements’ in this Domain for 2025. Specific attention will be paid to Board members supporting our staff networks and cultural celebrations, embedding the new System Quality, Equity and Equality Impact Assessments and developing our inclusive recruitment approaches, specifically focusing on increasing the diversity of our senior leadership.

Domain 3 – Inclusive leadership Rating
Outcomes 3A: Board members, system leaders (band 9 and VSM) and those with line management responsibilities routinely demonstrate their understanding of, and commitment to, equality and health inequalities 2 – Achieving activity
Outcomes 3B: Board/committee papers (including minutes) identify equality and health inequalities related impacts and risks and how they will be mitigated and managed 2 – Achieving activity
Outcomes 3C: Board members and system leaders (band 9 and VSM) ensure levers are in place to manage performance and monitor progress with staff and patients 2 – Achieving activity
Overall rating for domain 3 6/9

Overall draft EDS rating 2024 – 25 – Achieving

We have made a good start in reviewing and updating our approach to the equality delivery system which has given us a good foundation for our planned comprehensive work programme next year.

Equality Delivery System domain 1 review

Equality Delivery System domain 1 action plan

Equality Delivery System domain 2 and 3 review and action plan

Supporting information

Equality Delivery System Service domain 1 service 1 additional information – palliative and end of life care

Equality Delivery System Service domain 1 service 2 additional information – falls risk modelling

Equality monitoring

All NHS providers that NHS Dorset contracts with undertake an annual equality compliance review. The table provides a snapshot of the current position of each of the main NHS providers following a review of their websites.

Commissioned provider Equality objectives Published equality information EDS undertaken in 2024 Published WRES report Published WDES report
University Hospital Dorset NHS Foundation Trust Yes Yes Yes Yes Yes
Dorset HealthCare NHS Foundation Trust Yes Yes Yes Yes Yes
Dorset County Hospital NHS Foundation Trust Yes Yes Yes Yes Yes

Workforce Equality Information

The NHS Equality and Diversity Council announced in July 2014 that it had agreed action to ensure employees from black and ethnic minority (BME) backgrounds have equal access to career opportunities and receive fair treatment in the workplace.

NHS Dorset will continue to publish local equality reports including WRES (Workforce Race Equality Standard) and WDES (Workforce Disability Equality Standard) on an annual basis and previous CCG reports can be accessed on request.

NHS Dorset has incorporated the actions identified from the WRES report into the overarching Equality, Diversity and Inclusion Strategy action plan. Key actions already taken include:

  • To attract and retain a more diverse workforce within NHS Dorset

  • Establish support for BME staff within the organisation and link with local BME Staff Networks as a safe space to raise concerns

  • Ensuring job vacancies are widely publicised within our diverse community groups

  • Collaborating as an integrated care system to develop specific development programmes for our staff from black and minority ethnic backgrounds

More information

The Five Year Forward View sets out a direction of travel for the NHS – much of which depends on the health service embracing innovation, engaging and respecting staff, and drawing on the immense talent in our workforce.

We know that care is far more likely to meet the needs of all the patients we’re here to serve when NHS leadership is drawn from diverse communities across the country, and when all our frontline staff are themselves free from discrimination. These new mandatory standards will help NHS organisations to achieve these important goals.

Simon Stevens, Chief Executive, NHS England

The evidence is clear that treating all healthcare staff fairly and with respect is good for patient care. When black and minority ethnic staff, who make up a large minority of nurses, doctors and other NHS staff, are treated fairly it improves patient experience and patient safety. The Workforce Race Equality Standard encourages, and where necessary requires, all NHS providers to treat all black and minority ethnic staff fairly and ensure their full talents are used. It is good news for patients and for staff that NHS organisations have adopted this ground breaking evidence-based approach.

Roger Kline, Research Fellow, Middlesex University Business School

Contract monitoring

The NHS Standard Contract for Service Conditions SC13 and SC14 includes rules about equality that NHS service providers have to follow. This includes things like following the Public Sector Equality Duty, using EDS2, following the Workforce Race Equality Standard, and implementing the Accessible Information Standard. These requirements apply to all NHS-funded services.

Accessibility

Accessible communications

We want to make it as easy as possible for people to get involved in our work and find out more about local health services.

If you need information in an alternative format, such as easy read, large print, Braille, audio or an alternative language, please let us know by contacting the communications and engagement team via feedback@nhsdorset.nhs.uk or call 01305 368900.

Accessible Information Standard

Since August 1 2016 onwards, all organisations that provide care or adult social care have been legally required to follow the Accessible Information Standard. ICBs are expected to give consideration to the duty and ensure their providers are meeting this standard. NHS Dorset monitors the process through contract monitoring.

The Standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can easily read and understand or have the support needed so they can communicate effectively with health and social care services.

Further information on the Standard can be found on the NHS England website.

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