NHS LOTHIAN
Disability Equality
Scheme 2009-12
Unique ID: NHSL.
Category/Level/Type: LEVEL 1 POLICY
Status: FINAL VERSION
Date of Authorisation: 25 November 2009
Date added to Internet: 2 December 2009
Key Words: policy, disability, equality, scheme
duty, human, rights
Page 1 of 29
Author (s): JG
Version: 4
Authorised by: NHS Lothian Board
Review Date: June 2010
Comments: Final version to be published on NHS
Lothian website by 4 December 2009
NHS Lothian Disability Equality Scheme 2009-12
Contents
Glossary of words and phrases………………………………………….3
Executive summary……………………………………………………….5
Introductory statements…………………………………………………..6
The social model of disability…………………………………………….8
Equality and Human Rights – an introduction………………………….9
How much progress has been made?...............................................11
How we involved disabled people………………………………………14
How we assess the impact of what we do on disability equality…….16
How we collect information about disability……………………………19
Employing disabled people in NHS Lothian…………………………...22
Monitoring and developing this Disability Equality Scheme………….26
Contacts and finding out more…………………………………………..28
Appendix 1 – How we involved disabled people in the development of
our Disability Equality Scheme
Appendix 2 – NHS Lothian’s Impact Assessment Guidance and Toolkit
Appendix 3 – Equality Impact Assessment report for the Disability
Equality Scheme’s impact on NHS Lothian staff
Appendix 4 – Equality Impact Assessment report for the Disability
Equality Scheme’s impact on patients and communities
across Lothian
Appendix 5 – Disability equality action plan 2009-12
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NHS Lothian Disability Equality Scheme 2009-12
Glossary of words and phrases used in this
document
Anticipatory care: this is when a person receives health services to
reduce the risk of them developing a health problem, or to
make it less severe if it happens.
Attitudinal: this means to do with people’s attitudes.
Baseline: this means the starting point for a measurement.
Disabled person: this includes people who are covered by the Disability
Discrimination Act. It also includes disabled children and
young people, as well as other people who are disabled due
to society’s barriers.
Framework: this is like a strategy or a plan.
Impact assessment: this is a way of working out what impact a policy or
a plan will have on different people so that any adverse
effects can be dealt with before they happen. Adverse means
something that is not good.
Indicators: these are ways of measuring how well something is working.
ITS: City of Edinburgh Council’s Interpreting & Translation Service,
jointly funded by NHS Lothian. It is used to arrange British
Sign Language Interpreters and Braille or large print
documents.
Mentoring scheme: this is a way of supporting people so that they gain
confidence and skills.
Optometry: this is a health service for people’s eyes, for example giving
sight tests and providing glasses.
Outcomes: these are end results.
Participation: this means taking part. For disabled people it can mean
being more visible in public or having your voice heard.
Peer support network: this is a group of people supporting each other.
Primary care: these are the health services you receive in your
community, such as your family doctor or GP, or a District
Nurse.
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NHS Lothian Disability Equality Scheme 2009-12
Public sector: this is the Government, the National Health Service,
councils, the police, schools, universities and other
organisations that deliver public services.
Staff side organisations: for example, trade unions.
Workforce: people employed by an organisation.
This Disability Equality Scheme was prepared by:
James Glover, Head of Equality & Diversity
Lesley Boyd, Health Inequalities Manager
Jim Robinson, Health Inclusion Facilitator
Rona Laskowski, Strategic Programme Manager
Sarah Sinclair, Head of Patient Focus and Public Involvement
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NHS Lothian Disability Equality Scheme 2009-12
Executive Summary
This is NHS Lothian’s Disability Equality Scheme for the period 20092012. The law says we must publish a Disability Equality Scheme. It sets
out the steps we will take to make our services more accessible for
disabled people. It also sets out how we will promote disability equality,
stop disability harassment and be a better employer of disabled people.
This Disability Equality Scheme follows on from our last one. In the last 3
years, we have made some progress towards the things we said we
would do. But we still have a long way to go.
The law says we must involve people in developing this Disability
Equality Scheme. We did this during the summer and autumn of 2009.
The priorities that disabled people said we should deal with are:
1. All staff have positive attitudes to disability, through effective
leadership and training in disability equality.
2. All barriers to access have been tackled, including
communication.
3. NHS Lothian has become an employer where disabled people
are treated equally.
4. NHS Lothian is able to work with service users and partner
organisations to support independent living and anticipatory
care for disabled people.
We have published a separate action plan that shows what we will do to
meet these priorities.
The law says we must show how we gather information about disability.
This is important because we need to know how many disabled people
use our services and are employed by us. Then we can make
improvements. This is included in the Disability Equality Scheme.
We are also required to show how we work out the impact of what we do
on disabled people. This is called impact assessment. Our Disability
Equality Scheme says how we do this.
This Disability Equality Scheme will be replaced by a Single Equality &
Human Rights Scheme in 2010.
5
NHS Lothian Disability Equality Scheme 2009-12
Introductory statements
Statement from members of the NHS Lothian Disability Equality
Steering Group
“From the start of the process, we all recognised the huge challenge that
the Disability Equality Steering Group faced in trying to change and
influence the culture of a large public institution like NHS Lothian. It
became evident early on from our discussions within the steering group
that the experience of disabled people as NHS patients has been at
times poor.
“As the group continued to meet together over several months to discuss
and provide input into the NHS Lothian Disability Equality Scheme, we
began to see how by setting specific standards and measurable
outcomes we could begin to build a scheme that would encourage NHS
Lothian to promote disability equality in all of its work practices and
service delivery.
“Institutional disability discrimination still exists in many public bodies and
the government has introduced the Disability Equality Duty specifically to
tackle disability discrimination in the public sector. By involving disabled
people in the development of disability schemes, there is a new
opportunity for us to work in partnership with public authorities to remove
the attitudinal, physical, social and political barriers that remain within
society. The NHS Lothian Disability Equality Scheme seeks to introduce
new priorities for NHS Lothian to tackle institutional discrimination in a
fundamental and meaningful way.”
6
NHS Lothian Disability Equality Scheme 2009-12
Statement from Professor James Barbour, Chief Executive of NHS
Lothian
“NHS Lothian is a large, complex organisation with tremendous ability to
do good. With such a wide range of health services, and such a large
number of staff, NHS Lothian inevitably touches upon the lives of very
many people, within Lothian and beyond. This includes disabled people
as patients, carers, family members and as employees.
“While we are absolutely committed to tackling inequality, we do not
always get it right. This Disability Equality Scheme aims to help us
address this, and achieve the highest possible level of disability equality.
I am delighted that we have been able to benefit from the commitment
and knowledge of disabled people themselves in developing the
Scheme. The document will, I hope, reflect the time and effort they have
given so freely.
“The Board is determined that NHS Lothian will be the best-performing
NHS Board in Scotland, and among the top 25 healthcare providers in
the world. To achieve this, we must reach and surpass the highest
standards in equality and diversity. This Disability Equality Scheme is a
confident step in that direction.”
7
NHS Lothian Disability Equality Scheme 2009-12
The social model of disability
“People are disabled by society’s reaction to impairment
which prevents their participation as equal citizens”
(Inclusion Scotland, 2004).
A model is a way of understanding a situation. The social model of
disability says that people with impairments are disabled by the fact that
barriers exist in mainstream society. These barriers can be physical,
environmental or attitudinal, and prevent people from gaining access to
education, employment, health, information, housing, transport and so
on.
The social model of disability is generally accepted as being in
opposition to the medical model of disability. The medical model says
that the difficulties that people with impairments face are caused by the
ways that their bodies are shaped or experienced.1
This Disability Equality Scheme is built on the social model of disability. It
aims to address the barriers that disable people and prevent them from
accessing effective health care and information about their health, and
from gaining fulfilling employment with NHS Lothian.
1
Lothian Centre for Integrated Living factsheet 5 2008
8
NHS Lothian Disability Equality Scheme 2009-12
Equality and Human Rights – an introduction
Disability equality
The Disability Equality Duty (2006) is a law requiring the public sector to
take pro-active steps to make disability equality happen in public
services, functions and in the way people are employed and trained.
The Duty requires organisations such as NHS Lothian to publish a
Disability Equality Scheme. This is a plan setting out how NHS Lothian
will meet the different responsibilities set out in the Duty. The document
has to have certain parts, such as an action plan and a description of
how disabled people were involved in developing the Scheme.
The legal definition of disability is a broad one. It has changed through
amendments to the law and through action in the courts. It includes long
term health conditions, and about one person in five in Scotland is
disabled. This includes disabled children.
For more information about disability, as well as about the Disability
Equality Duty and what organisations must do to meet it, contact the
Equality & Human Rights Commission:
Scotland helpline: 0845 604 5510
Website: www.equalityhumanrights.com
You can also read about the Disability Equality Duty in our previous
Disability Equality Scheme.
Human Rights
Human Rights are the basic rights and freedoms that belong to every
person in the world2. The Human Rights Act 1998 made some of these
rights3 more easy to enforce in the UK. NHS Lothian must respect these
rights for all people who use its services, people who it employs, and
people who otherwise come into contact with NHS Lothian.
For more information about Human Rights in Scotland, contact the
Scottish Commissioner for Human Rights:
Telephone: 0141 243 2721
Website: www.scottishhumanrights.com
2
Equality & Human Rights Commission 2009
The Human Rights Act 1998 made the rights included in the European Convention of Human Rights
directly enforceable in courts in the UK.
3
9
NHS Lothian Disability Equality Scheme 2009-12
A Scheme based on results
This is NHS Lothian’s Disability Equality Scheme for the period from
2009 to 2012. It has been written with the help of disabled people, and
we have tried to make it as clear and helpful as possible, while making
sure that it meets the requirements of the law. We have also linked the
Scheme to Human Rights as much as we can.
We have used the UK Equalities Measurement Framework to set out our
Scheme and the actions we intend to take. The Framework is a way of
setting out what we intend to do in a way that makes it easier to see
what difference our actions have made. This is called focusing on
outcomes.
To be able to show that we are making progress towards disability
equality, we have to know how to measure our work. For many actions
we want to carry out there are currently no measures. Much of the first
year will be spent working out what these measures are.
For more information about the UK Equalities Measurement Framework,
contact the Equality & Human Rights Commission as above.
“My wife is disabled and can’t walk very far. When she
came for a check up the staff were very good and got her a
wheelchair and took her to the places she needed to go” –
participant in involvement event 5 August 2009
10
NHS Lothian Disability Equality Scheme 2009-12
How much progress has been made?
NHS Lothian’s first Disability Equality Scheme was published in
December 2006. Since then much progress has been made. For
example:
 Services specifically for disabled people have been developed, like
the Lothian Deaf Community Mental Health Service set up in 2008
and a community optometry service for people with a vision
impairment.
 NHS Lothian is recruiting more people with a learning disability
through its Human Resources strategy.
 NHS Lothian is involving disabled people more in new
developments, such as the primary care centre in East Lothian and
the Maternity Strategy.
 NHS Lothian has developed
an effective way of assessing
the impact of what it does on
disability equality, and uses
this to address potential
negative impact in plans and
policies across the board.
“Training for the receptionist
at my practice has improved
the service” – participant at
involvement event, 5 August
2009
 Over 3000 staff have been trained in disability awareness.
 A number of comments were received during the involvement
events, saying that GP surgeries were more helpful and courteous
to disabled people.
 Access to NHS Lothian buildings has improved, after £1million was
spent during the 3 years covered by the last Disability Equality
Scheme. Disabled people also felt that the accessibility of services
generally had improved.
 The Healthcare Academy and work placement training and skills
programmes have targeted disabled people throughout the period
covered by the last Scheme. Both have been expanded and there
are specific commitments towards people with a learning disability
from 2009 onwards.
 Disabled people reported that NHS Lothian seemed to be involving
people more in decisions and planning.
11
NHS Lothian Disability Equality Scheme 2009-12
 NHS Lothian is working with a voluntary organisation called
Minority Ethnic Carers of Older People Project, to identify Black &
Minority Ethnic people who need help to access health services if a
family member is disabled.
 NHS Lothian works with Deaf Blind Scotland, providing guide
communicators to support deafblind people in accessing
healthcare appointments and services.
“I have always found my GP services to be a very good
personal service. If some of this personalisation could be
carried over into the hospital setting I would feel more
human” – participant at involvement event, 5 August 2009
In terms of the priorities listed in the previous Disability Equality Scheme,
there has been positive progress. These are the priorities listed in the
most recent annual report for the last Disability Equality Scheme:
What we said we would do:
1. Develop our existing involvement arrangements including:
(a) the new joint Edinburgh Equality Network, ensuring that it includes
appropriate representation from disabled people. This is now
established and includes disabled representatives.
(b) ensuring that the new arrangements for Patient Focus Public
Involvement and the Patient’s Bill of Rights incorporate ways of
involving disabled people across NHS Lothian. These are still
being developed but will be subject to impact assessment to make
sure that they take disability equality into account. They form part
of actions in this Scheme (see Outcomes 3.5, 4.1 and 8.1).
(c) improving the involvement of disabled people in impact
assessments on policies and strategies. We involve disabled
people in impact assessments, such as for the Carer’s
Assessment Tool, but it is not yet routine and will be developed
during the period of this Scheme (see Outcome 3.6).
2. Roll out impact assessment training across the organisation and
improving the quality and consistency of impact assessments, so that
there is more effective consideration of disability when services,
policies and strategies are taken forward.
12
NHS Lothian Disability Equality Scheme 2009-12
We analysed the take-up of impact assessment training to find out the
parts of NHS Lothian that weren’t applying for the training. We are
targeting those areas to make sure that they supply more people to
do the training and become better at carrying out impact
assessments. You can get a copy of the plan from one of the equality
leads.
3. Make progress with the action plans of both the Joint Lothian
Learning Disability Strategy and the Joint Lothian Physical and
Complex Disability Strategy in partnership with our colleagues across
the four Lothian Local Authorities. These major strategies are well
under way. Contact NHS Lothian for more information about how they
are progressing.
4. Improve the ways in which we collect information about disability by:
(a) Contributing to national NHS Scotland programmes to make
evidence gathering more detailed. NHS Lothian staff sit on
steering groups of key national projects (such as Better Together)
to ensure that they are set up to gather the right information (see
Outcomes 3.5 and 4.1).
(b) Piloting work in primary care with two GP practices to improve
data collection across equality strands including disability. These
pilots are now underway (see Outcome 3.5).
(c) Improving current levels of workforce data gathering on disability
(and race), working in partnership with trade unions. This is
included in the action plan for this Scheme (see Outcome 6.2).
However significant challenges remain. These include raising awareness
about disability equality, staff attitudes to disabled people, and access to
services.
These issues were identified by disabled people who we have involved
in developing this Scheme. You can see these priorities on page 14.
Challenges that we know about ourselves include making impact
assessment more consistent across the organisation, and improving
monitoring of disability.
This Scheme attempts to address these so that NHS Lothian can
continue to work towards disability equality in its services and as an
employer.
13
NHS Lothian Disability Equality Scheme 2009-12
How we involved disabled people
What we had to do
The Disability Equality Duty requires organisations to involve disabled
people in the development of the Scheme. This involvement must be
more than just consultation, and it must have a significant influence on
the contents of the Scheme4. Involvement must be with disabled people
rather than organisations, and should include a range of impairments.
“I was impressed by how quickly we came together as a group and at
the depth of the discussions. It seemed that there was a real
consensus around the table about the issues which the NHS needs to
tackle in achieving disability equality” – member of Disability Equality
Steering Group, 10 July 2009
What we did
NHS Lothian carried out a range of involvement activities to develop the
Disability Equality Scheme. A summary of these can be found in
appendix 1. The activities included:
1. Disability Equality Steering Group: this group met throughout the
summer and autumn and oversaw the development of this Disability
Equality Scheme. Details of the members of the group are included in
appendix 1.
2. Involvement event: over 40 people attended this event held on 5
August 2009. The report from the day, together with monitoring
information and a detailed evaluation report (showing that participants
rated the discussions on the day highly) is available from the equality
contacts listed in the Contacts section of
this Scheme.
“When staff take time to
listen to you it is better”
3. Learning Disability workshop: a
– participant in learning
dedicated learning disability workshop was
disability workshop 22
run on 22 July 2009. A total of 16 disabled
July 2009
people attended. The notes from the day
and an evaluation report are available from
the equality contacts listed in the Contacts section of this Scheme.
4. Staff workshop: a dedicated workshop for staff took place in October
2009. A total of 12 staff from different parts of NHS Lothian took part.
4
Disability Equality Duty Code of Practice for Scotland 2006
14
NHS Lothian Disability Equality Scheme 2009-12
They reported a wide range of impairments. See Appendix 1 for more
details.
These involvement activities were delivered at a total cost of
approximately £2000. This included the cost of British Sign Language
interpreters, accessible transport for participants, and venue and
catering costs.
Some other involvement activities took place that were not directly
organised by NHS Lothian, including a workshop at an Edinburgh
Equalities Network event and a workshop at a Midlothian involvement
event. Feedback on a wide range of issues including employment and
barriers to health was obtained.
“GPs are more accepting of people. They see me, not my disability” –
member of Edinburgh Equalities Network, seminar 16 June 2009
Priorities identified by disabled people
The Disability Equality Steering Group considered the feedback from all
these events and agreed that the most important outcomes to aim for
were as follows:
1. All staff have positive attitudes to disability through effective
leadership and training in disability equality.
2. All barriers to access have been tackled, including communication.
3. NHS Lothian has become an employer where disabled people are
treated equally.
4. NHS Lothian is able to work with service users and partner
organisations to support independent living and anticipatory care
for disabled people.
These priorities are very long term and it may not be possible to achieve
them in the 3 year period of this Scheme. However, disabled people felt
they were important enough to aim for and they have been used to set
out the action plan in this Scheme. There were many other comments
and suggestions made by disabled people and a significant number of
these are also represented in the plan.
“When my family left at the end of visiting time, there was no-one
around who I could communicate with. I was really scared I would die”
– participant in learning disability workshop 22 July 2009, symbols user
15
NHS Lothian Disability Equality Scheme 2009-12
How we assess the impact of what we do on
disability equality
What is impact assessment?
NHS Lothian must assess what the impacts of its services are on
disabled people. It must work out what a service or plan is likely to result
in for disabled people who use that service. NHS Lothian must also work
out how its employment policies affect disabled staff, or disabled people
who might want to become employed by the organisation.
This is called impact assessment. The impact on disability equality can
be positive, negative or neutral. You can find out more about impact
assessment from the Equality & Human Rights Commission, or by
speaking to one of the equality contacts in NHS Lothian.
How NHS Lothian carries out impact assessment
As well as for disability, the law says NHS Lothian must also assess the
impact of what it does on race and gender equality. There is also a great
deal of guidance from the Government and the NHS5 that says that
Health Boards like NHS Lothian should look at issues such as age,
religious belief and sexual orientation when they are assessing the
impact of their activities.
In addition, NHS Lothian works with many groups of people who are
disadvantaged, such as homeless people, people on low incomes,
carers or people in the criminal justice system. These people often have
health needs that are different to others or they may find it hard to
access the services they need.
As a result we have developed a way of doing impact assessment that
looks at a much wider range of issues than just disability. This is called
Rapid Impact Assessment, and you can find guidance and a copy of the
table we use for this on the internet at:
www.nhslothian.scot.nhs.uk
You can also get a copy from one of the equality contacts listed in the
Contacts section of this Scheme.
5
Fair for All guidance – reference to be added
16
NHS Lothian Disability Equality Scheme 2009-12
NHS Lothian’s impact assessment toolkit looks at what the
impact of a plan, service or policy might be on:

Age

Disability

Gender

Race

Religion or Belief

Sexual Orientation

People on low incomes

People with mental health problems

Carers

Homeless people

People involved in the criminal justice system

Staff
All NHS Lothian policies, plans and services must be subjected to impact
assessment. We make sure this happens in the following ways.
1. All plans and policies must have an impact assessment before they
go to the Board or one of its committees. A section on the standard
template used for all Board papers asks for evidence of this.
2. We put a date for impact assessment into our major plans from the
outset so that it is carried out as part of the main work in the plan.
3. We have rolling programmes to review key policies such as our
employment policies. The group responsible for reviewing the
policy must do an impact assessment as part of that reviewing and
updating process.
4. We have a training programme to give managers and other people
who write plans and policies the knowledge and skills to carry out
impact assessment. This has been running since 2007 and over
300 people have been trained.
17
NHS Lothian Disability Equality Scheme 2009-12
Plans for improvement
Much progress has been made since we reported our approach to
impact assessment in the first Disability Equality Scheme in 2006.
However there is still a lot further to go as some parts of the organisation
do not yet carry out impact assessment as frequently as they should.
We have looked at the number of people who have come forward for the
impact assessment training from each part of the organisation. NHS
Lothian now has plans in place to target training at those departments
who have not yet had many people trained.
In addition, we check impact assessment reports to make sure that they
are of a high quality. We also have a plan to improve awareness of
impact assessment across NHS Lothian. You can get copies of these
plans or find out more by getting in touch with one of the equality
contacts.
You can see copies of completed impact assessments on the NHS
Lothian website at:
www.nhslothian.scot.nhs.uk
If you are interested in helping NHS Lothian carry out impact
assessments by being a panel member, please get in touch with one of
the equality contacts.
“I used to get regular physio when I was younger and at school.
Now I have left school I only get short bursts of physio, or not at
all. If it was more it could prevent problems leading to hospital
admissions” – participant in involvement event 5 August 2009
18
NHS Lothian Disability Equality Scheme 2009-12
How we collect information about disability
What kind of information do we collect?
NHS Lothian needs to know as much as possible about disability to
make sure that it can develop its services and policies effectively.
The information we collect about disability includes:
 Information about disability in the wider community across Lothian.
If we know about the needs people have, we can shape our
services to meet them. For example, we needed to know how
many Deaf people lived in Lothian before we could set up a
Community Mental Health Service for them.
 Information about disabled people who use our services. This
information is very important as it tells us whether or not our
services are meeting the needs of everyone who should be using
them.
 Information about disability in our workforce. This helps us
understand the needs of our staff, so that we can be as effective
an employer as possible and make sure that we can give our staff
the support that they need. For example, we are setting up a staff
support network because we know from staff surveys that some
disabled employees are not confident about disclosing their
impairment at work.
We get our data from a range of sources:
 Census data, although this is now very out of date (the next census
will be in 2011).
 Data from the Disability Rights Commission and now the Equality &
Human Rights Commission.
 Information from partner organisations: we share anonymous
information about our communities with local Councils, the police
and other organisations to get a clearer picture of disability in
Lothian.
 We carry out studies of particular groups of people to get a clearer
idea of their health needs. For example, we have carried out
studies of the needs of South Asian people with diabetes across
Lothian.
19
NHS Lothian Disability Equality Scheme 2009-12
 We monitor the number of disabled people who use our services.
We do not currently do this uniformly, so this will form one of the
actions in this Scheme (see Outcome 3.5).
 We monitor the amount of communications support we provide, for
example the number of hours of British Sign Language interpreting
provided for Deaf patients and their families. We use the City of
Edinburgh Council’s Interpreting & Translation Service to arrange
our communications support. This shows that demand for this kind
of communications support is not significantly changing year on
year:
Communication support provided via ITS 2005 - 2009
Units of provision. A unit = 1 hour of interpreting or 100 words of
translation
2005-6
2006-7
2007-8
2008-9
BSL
1,150
1,101
1,100
1,043
Braille
6
3
3 Awaiting
Tape
2
2
1 Awaiting
Large Print
0
0
3 Awaiting
 We use monitoring information from primary care, such as that
collected by GPs. This is also not consistent and we will continue
to work with GPs to improve the way they gather information about
disability among their patients (see Outcome 3.5).
 We carry out a staff survey every two years, in which we ask
employees to record if they are disabled. This information is
anonymous. Return rates are under 30% and work is planned to
improve the return rate next time (in 2010). See Outcome 6.2.
 We ask all applicants to NHS Lothian jobs whether or not they are
disabled. We also monitor people who are promoted internally.
This means that we have a gradually increasing amount of
information on NHS Lothian staff as more and more people change
or start jobs with us. From March 2008 to March 2009 the number
of disabled employees increased from 126 to 154. This is an
increase of 22% in one year. However this still only represents
0.5% of the total NHS Lothian workforce of 29,000. The current
figure is 155 (September 2009). We believe that there are many
20
NHS Lothian Disability Equality Scheme 2009-12
more disabled staff who do not feel confident about disclosing their
disability. Please see the workforce section of this Disability
Equality Scheme and the action plan (Outcome 6.2) for more
details about what we intend to do to address this.
 We monitor disabled people who are not successful at obtaining
employment with NHS Lothian [awaiting figures].
 The work placement and Healthcare Academy programmes that
we run monitor the number of disabled people who pass through
them. This is included in the action plan (see Outcome 6.2).
 We plan to monitor the results of impact assessments by including
the actions from these in Quality Improvement Programmes. These
programmes cover every service in NHS Lothian and are a useful
way to collect information about how changes are happening in a
particular service or department. This is included in the action plan
for this Disability Equality Scheme (see Outcome 3.6).
Actions to improve information gathering and the provision of information
in more accessible ways are included in the action plan (e.g. Outcomes
3.2 and 3.5). The plan lists a number of NHS Lothian strategies that
show how the information we gather about disability will be used. Please
get in touch with an equality contact for more information about any of
these.
“When doing consultation events, NHS should use bigger
pictures and symbols that people can see better.” – participant
in learning disability workshop 22 July 2009, symbols user
21
NHS Lothian Disability Equality Scheme 2009-12
Employing disabled people in NHS Lothian
A major employer
NHS Lothian is a major employer in the region, with 29,000 staff across
a huge variety of roles and professions. However the rate of disclosure
among disabled staff is low at just 0.5%. It is believed that there are
many disabled staff who do not feel confident about informing the
organisation that they are disabled.
This is a matter of concern as we
“The organisation’s positive,
know from the anonymous bi-annual
caring ethos is blocked by
staff survey that some disabled
middle management” –
employees report bullying and
participant in workshop for
harassment. While work to address
disabled staff 20 October 2009
Dignity at Work for disabled staff
does not need to be held back by
low levels of disclosure, it is helpful if we know how many disabled
people work in NHS Lothian, the nature of their impairments, and what
areas and roles they work in.
Improving workforce information
NHS Lothian will gather more information about disability in its workforce
in the following ways:
 Improving response rates to the anonymous staff survey carried
out every two years, by running a promotional campaign in 2010
(see Outcome 6.1).
 Raising the profile of disability in the workforce by establishing a
peer support network for disabled staff and promoting positive
images of disability in internal and external communications about
employment in NHS Lothian (see Outcome 6.1).
 Developing the way we record the reasonable adjustments we
make for staff through our Occupational Health Service (see
Outcome 6.2).
 Working with staff side organisations to improve confidence in
diversity monitoring across the workforce (see Outcome 6.2).
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NHS Lothian Disability Equality Scheme 2009-12
Making changes
The information we gather will be put to good use and will allow us to
develop targeted action plans to address disability equality in the
workforce. The NHS Lothian Human Resources & Organisational
Development Strategy 2008-11 includes commitments to:
 Improve dignity at work and reduce bullying and harassment of
disabled (and other) staff. Disabled staff would like this to include
attitudes to staff from line managers and from colleagues.
 Increase the number of disabled people employed by NHS Lothian,
with clear targets (e.g. work and training placements for 50 people
with a learning disability).
 Increase the number of disabled people in middle and senior
management positions by developing the existing Black & Minority
Ethnic mentoring scheme to include disabled staff.
You can find out more about the strategy from the equality contacts. It is
included as a commitment in the action plan (see Outcomes 6.1, 6.2 and
6.3).
“Colleagues and line managers don’t know how to cope when
you disclose your disability” – participant in workshop for
disabled staff 20 October 2009
Support for disabled staff
At the staff workshop held in October 2009, disabled staff said that they
were concerned about how they were supported in the workplace. They
wanted more effective support from services like Occupational Health
and Employee Relations. This was felt to be particularly important when
considering staff performance, capability proceedings, retirement on
health grounds or redeployment. The action plan includes commitments
to address this (see Outcome 6.3).
Training
Training of staff is an important way to improve knowledge about and
attitudes to disability. Staff training is one of the priorities identified by
disabled people involved in developing this Scheme.
A wide range of training programmes addressing disability equality
already exist. These include:
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NHS Lothian Disability Equality Scheme 2009-12
 Disability awareness training delivered to approximately 2,500 new
employees every year as part of the corporate induction
programme.
 A new disability equality training course has been developed which
focuses on promotion of the social model of disability.
 Training in specific disability issues for certain groups of staff, e.g.
mental health, dementia.
 Training in equal opportunities in recruitment and selection for
managers, including recruiting disabled staff.
 Refresher training in disability equality as part of the Knowledge &
Skills Framework that all staff, with the exception of doctors and
some managers, must complete.
Disabled people suggested that NHS Lothian develop its approach to
training on disability and other equality issues. The training courses that
NHS Lothian already delivers should contain more references to
disability equality. Where necessary new courses should be developed
specifically relating to disability issues. This should be called an equality
training framework.
The equality training framework will include actions to develop existing
disability equality training, while also developing mainstream training
programmes so that they include disability equality elements. This is one
of the actions in the action plan in this Scheme (see Outcome 3.1).
“Sometimes disabled staff feel that the focus is on their sick leave rather
than the fact that promises [of support and adjustments] have not been
implemented.” – participant in workshop for disabled staff 20 October
2009
Partnership
NHS Lothian is fortunate to have excellent relationships with trade
unions. The Lothian Partnership Forum, and the local Forums that
support it, oversees and provides help with workforce-related
developments.
The Partnership also oversees work to improve equality and diversity in
the workforce. This Scheme includes actions to support the development
taking place within unions so that they can continue to provide support to
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NHS Lothian Disability Equality Scheme 2009-12
disabled employees and act as advocates for equality in the workplace.
See Outcome 6.1 for more details.
“NHS Lothian has made an effort to make adjustments for me” –
participant in workshop for disabled staff 20 October 2009
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NHS Lothian Disability Equality Scheme 2009-12
Monitoring and developing this Disability Equality
Scheme
How we will monitor progress
Disabled people told us that we needed to show that we are making
progress against the commitments listed in this Scheme.
The Equality & Diversity Steering Group is made up of staff from all parts
of NHS Lothian. Many people who attend are senior managers or
members of the Board. This group has the main responsibility for making
sure that NHS Lothian does what the Scheme sets out. You can ask for
copies of the minutes of this committee.
In addition to this, NHS Lothian has a number of other committees that
will look at different aspects of this Scheme. For example the Human
Resources Equality & Diversity Sub Group looks at the employment
parts of the Scheme. The Impact Assessment Steering Group oversees
how NHS Lothian is improving its impact assessment practice.
Each year we will produce a report showing what progress has been
made. We will also say what issues still need work. We have agreed with
disabled people that we will run an annual involvement event at which
disabled people will be asked to scrutinise our progress and hold NHS
Lothian to account.
We will then publish the final version of this annual report including
comments from disabled people.
A Single Equality Scheme
This Scheme considers only disability equality, and aims to meet the
Disability Equality Duty. NHS Lothian also has to meet the Race and
Gender Equality Duties, and has published separate Schemes for each
of those duties. The law is going to change again in 2010 with a new
Equality Act that will bring together many separate equality laws. For
more information about the new Equality Act, see the UK Government
Equalities Office website at:
www.equalities.gov.uk/equality_bill.aspx
You can also contact the Equality & Human Rights Commission:
Scotland helpline: 0845 604 5510
Website: www.equalityhumanrights.com
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NHS Lothian Disability Equality Scheme 2009-12
As a result of these changes in the law and the recommendations in the
UK Equalities Review, NHS Lothian plans to develop a Single Equality &
Human Rights Scheme in 2010 in preparation for the new Single
Equality Duty.
The new document will be based on this Scheme. Disabled people have
told us that they support this change, as long as the disability elements
of the Single Equality & Human Rights Scheme remain significant and
can be clearly identified.
“There are not enough audio systems in hospitals for
people who are blind” – participant in involvement event
5 August 2009
27
NHS Lothian Disability Equality Scheme 2009-12
Contacts and finding out more
Information about NHS Lothian
To find out more about NHS Lothian, including information about what
we do and volunteering and employment opportunities, contact:
NHS Lothian
148 Pleasance
Edinburgh
EH8 9SG
0131 536 9000
www.nhslothian.scot.nhs.uk
Email: lothian.communications@nhs.net
You should also contact NHS Lothian at this address if you would like
this Scheme or any other document in an alternative format.
Information about this Scheme
If you have any enquiries about the contents of this Scheme, please
contact one of the following people:
James Glover, Head of Equality & Diversity
james.glover@nhslothian.scot.nhs.uk
0131 536 9037
Lesley Boyd, Health Inequalities Manager
lesley.boyd@nhslothian.scot.nhs.uk
0131 537 6510
Jim Robinson, Health Improvement Facilitator
james.robinson@luht.scot.nhs.uk
0131 536 0055
Diane Loughlin, Health Promotion Lead
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NHS Lothian Disability Equality Scheme 2009-12
diane.loughlin@wlt.scot.nhs.uk
01506 523000
Information about equality and Human Rights
For more information about disability equality, such as the Disability
Discrimination Act or the Disability Equality Duty, contact the Equality &
Human Rights Commission:
Scotland helpline: 0845 604 5510
Website: www.equalityhumanrights.com
For more information about Human Rights in Scotland, contact the
Scottish Commissioner for Human Rights:
Telephone: 0141 243 2721
Website: www.scottishhumanrights.com
“Where a patient’s notes clearly state that the patient is Deaf
and needs an interpreter, it has happened on more than one
occasion that appointments have had to be cancelled because
it was not noticed that a BSL interpreter had to be booked” –
participant in involvement event 5 August 2009
29