Equality Delivery System domains

Equality Delivery System (EDS) is focused around three ‘domains’:

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

EDS Deep Dives

As part of our work on health inequalities, we undertake EDS deep dives to find out more about our approach to population health management (PHM).

  • Improve access to healthcare services

  • Ensure individual health needs are met

  • Ensure care and treatment provided is free from harm

  • Improve healthcare experience and service user satisfaction

2025/26 deep dives

Awaiting governance approval (NHS Board 15 June 2026)

2024/25 deep dives

2023/24 deep dives

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 team via email: feedback@nhsdorset.nhs.uk or call 01305 568900