Equality Strategy 2013 – 2016
Review date: June 2016
Page 4
Equality Objective 6
Page 14
Page 5
Equality Objective 7
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The Trust’s Approach to Equality and Diversity
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The Trust’s Strategic View of Equality
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Protected Characteristics and Health Inequality
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Equality Analysis
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Our Continuing Commitment to Equality
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Equality and Diversity Training
Page 17
Working in Partnership with Local Communities
Page 9
Valuing our Diverse Workforce
Page 18
How we Developed our Equality Objectives
Page 10
The Staff Compact and the TEWV Staff Survey
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Equality Objective 1
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TEWV Equality and Diversity Steering Group
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Equality Objective 2
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Reporting and Monitoring Arrangements
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Equality Objective 3
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Glossary and Useful Links
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Equality Objective 4
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Contact Details
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Equality Objective 5
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Equality monitoring enables us to gather information about
who uses our services and how people view them, which is
essential when planning and reviewing services.
Tees, Esk and Wear Valleys NHS
Foundation Trust is delighted to
launch its Equality Strategy 2013 2016.
This three year strategy continues to
develop and improve upon the work
the Trust began back in 2009 and
sets out the Trust’s continuing
commitment to embed Equality,
Diversity and Human Rights into
everything the Trust does.
Chris Stanbury
Director of Nursing
and Governance
The delivery of the strategy’s ideals
and principles will rely on the
significant contributions made each
and every day by Trust staff.
Valuing the hard work, dedication,
diversity and commitment of all our
staff remains of paramount
importance to everyone including the
Trust, its staff, service users, their
carers and our stakeholders.
The objectives in this strategy drive and support positive
organisational change which contributes towards better
patient care, patient experience and better health
outcomes. I am sure you will agree that it is essential
that we all consider the value and importance of having
and sustaining good mental health and wellbeing within
all of our communities.
This can only be achieved by working together to
eliminate inequality wherever it exists and to promote
fairness and inclusion in everything we do. This
• Access to Trust services
• Provision of Trust services
• Delivery of Trust services
• Employment
We will make sure that our strategy is planned and
supported in an effective way so that Trust staff can play
their part. Making sure the Trust achieves the equality
objectives published in this strategy is the responsibility
of everyone who is employed by or has association with
the Trust.
The Equality Act 2010 requires all public sector organisations,
including Tees, Esk and Wear Valleys NHS Foundation Trust, to
publish equality objectives every four years.
The Trust has to publish details of engagement work that has
taken place to develop and evidence the Trust’s Equality
Objectives and also how the Trust will measure its progress
against them.
The purpose of this strategy is to provide an overview and
information on the Trust’s approach to equality and diversity and to
inform you, our staff, about our equality objectives. We will also
provide some background information which will explain how we
formulated our equality objectives.
We believe the Trust’s equality objectives will make a real
difference to some of the most pressing issues facing protected
groups in our society.
What works for one community will not necessarily work for another – the needs of an African Caribbean man who is
afraid to engage with services are different from the needs of an Asian woman who may think that having a mental
health problem is shameful. (Delivering Race Equality in Mental Health Care: A Review 2009)
The Trust’s Approach to Equality and Diversity
Tees, Esk and Wear Valleys NHS Foundation Trust is
committed to actively recognising and promoting Equality
and Diversity. The Trust believes in making every effort to
be a fair and unbiased organisation. Further to this, the
Trust aspires to be an organisation that embraces and
values people, recognising the benefits that diversity brings
to the Trust both as an employer and in the delivery of
The Trust’s
Equal care for
all campaign
launched in
Negative behaviour can have a direct impact on patient
experience. A lack of compassion, poor attitude or bullying
is a destructive element within any team or organisation
where it exists. It also contributes significantly to workplace
As a public body within the NHS the Trust expects a
continuous and exemplary commitment from all of its staff
regardless of pay grade or position, taking a proactive
approach to Equality, Diversity, Human Rights and the
Care Quality Commission’s Essential Standards of Quality
and Safety.
As an employer the Trust is developing an organisational
culture in which diversity is valued and staff are able to
promote equality and challenge unlawful harassment,
discrimination and bullying.
We do this to ensure that staff, service users and their carers
receive fair and equal treatment throughout their employment or
their care.
A white mental health staff worker is no less equipped to
provide a culturally responsive service for BME (black and
minority ethnic) clients than a Black or Asian staff worker.
Competency and commitment will cross all ethnic boundaries.
(Positive Steps – NHS 2007).
Protected Characteristics and Health Inequality
The Equality Act 2010 applies to all organisations that
provide a service to the public or a section of the public
(service providers). It also applies to anyone who sells
goods or provides facilities.
People from protected characteristic groups can
experience a combination of exclusion, alienation,
bullying, and harassment, isolation and may also have
problems accessing public services.
It applies to all Trust staff, whatever their role and
responsibility and to anyone else who carries out a
public function. It applies to services, whether or not a
charge is made for them.
There is mounting evidence that stigma, prejudice, and
discrimination create a hostile and stressful social
environment that can lead or contribute to mental health
The Act protects people from discrimination on the
basis of one or more ‘protected characteristics’ (these
used to be called ‘grounds’).
Health inequalities are avoidable as well as unjust,
unfair and unlawful.
The relevant characteristics for services, public
functions and employment are:
If a patient needs special
equipment or help because
of their disability the
hospital must make
reasonable adjustments to
provide this.
(Government Equalities
gender reassignment
marriage and civil partnership
pregnancy and maternity
religion or belief
sexual orientation
Our Continuing Commitment to Equality
The Trust believes in making a real positive difference in everything it
does. The Trust knows that the vast majority of staff share the Trust’s
core value to be treated with ‘respect’.
So, what will the Trust do?
 The Trust will publish an Equality Strategy every four years
 The Trust will publish equality information that is accurate
and will ensure that this information is updated on a regular
 The Trust will continue to embed equality and diversity into
our organisation and recognises that it is a key element
of the Trust's business, service provision and employment
 The Trust will deliver on our commitment through our
equality objectives
 The Trust will publish and achieve our equality objectives
The Trust will review its equality objectives to ensure that they
remain current and challenging
*If you would like to see our implementation plan in full please see the
section on further information at the back of this document.
“From our experience in tackling race,
gender and disability inequalities, we know
that relying on individuals taking
discrimination cases is not enough.
Tackling entrenched discrimination needs
proactive leadership within institutions to
build effective policies, practices and a
strong internal culture of equality, dignity
and respect”. (Beyond tolerance – Equality
and Human Rights Commission 2009)
Working in Partnership with Local Communities
The Trust is working in partnership with people who have
disabilities and has undertaken disability access audits to
ensure that the Trust can identify any barriers to accessing
Trust services.
The Trust had five listening and involvement events in 2011
that took place in Durham, Stockton, Scarborough,
Northallerton and Harrogate to ask local people about what
matters to them in relation to equality and the provision of
mental health, learning disability, substance misuse and
eating disorder services.
The Trust asked local residents, individuals, voluntary
groups and staff:
The Trust continues to host events on fair and equal access to
Trust services, including a recent event held in Scarborough
which focused on deafness and spirituality and a planned future
event that will look at how the Trust can meet the needs of
LGB&T people.
The Trust believes that it is important for staff to work together
and in partnership with other agencies and with local
communities. It is a significant opportunity to improve access,
tackle stigma, prejudice and remove barriers that can still inhibit
people from protected groups from accessing mental health and
learning disability services.
Feedback from these events has contributed towards the Trust’s
equality objectives.
 why each of the protected characteristics is
 why the Trust needs to take equality seriously
 how equality can make a difference
 what key messages need to be taken on board by
the Trust
There is at least twice the risk of suicide attempts in lesbian, gay
and bisexual people compared to heterosexuals (NIMHE 2007)
How we Developed our Equality Objectives
The Trust considered:
 The diversity of Trust staff and local communities and
their different needs
 Which groups access Trust services and which groups
access less often
 Gaps that were identified in the collection of equality
data (information) and the quality of that data
 Equality issues raised by staff and issues and complaints
raised by service users and their carers
 Areas where the Trust could make a meaningful
improvement which was more than minor or trivial
 The Trust has recognised that some objectives need
more time to complete than others. The Trust has
identified this in its equality objectives
Where English is a second language,
accessing mental health services can be
very difficult. Language is a key
contributing factor to incidences of
misdiagnosis, as well as low referral for
psychotherapy and counselling.
(Positive Steps – NHS 2007).
 Feedback from communities at listening events
held around the Trust
Equality Objective 1
Our Equality objectives are made up of service objectives
and employment objectives.
Background Information
The Trust has identified from consultation with people
from protected groups that its clinical staff need to
develop cultural competency particularly around
ethnicity, sexual orientation and gender reassignment
Service objectives focus on :
 Making sure services are inclusive and accessible to all
protected groups
 Raising awareness around groups that often find it
difficult or hard to access services
 Making sure that services meet people’s needs
 Improving patient experience
Objective 1
By March 2016, the Trust will develop and deliver
cultural competency training to all clinical staff, to
provide assurance that the needs of the Trust's
diverse service users are met and to increase the
proportion of BAME (black, Asian and minority
ethnic) and LGBT (lesbian, gay, bisexual and
transgender) patients reporting satisfaction with
services to the same level as those of white British
and heterosexual patients.
Employment objectives focus on :
 Recruiting and maintaining a diverse and skilled
workforce that is representative of its communities
 Improving the working environment for all its staff
 Making sure that everyone has the opportunity to reach
their full potential.
This will be monitored through the Trust’s patient
experience questionnaire.
Equality Objective 2
Equality Objective 3
Background Information
The Trust has identified through engagement with its
communities that the role of religious and spiritual
needs in relation to mental health must be recognised
and supported. This will be monitored through the
feedback from the Spirituality Pathway Implementation
Background Information
The Trust has identified through engagement with its
staff, communities, third sector and statutory partners
that there is a considerable under representation of the
Gypsy Roma Traveller population amongst the Trust’s
service users. This has been confirmed by a survey of
community teams in North Yorkshire.
Objective 2
By March 2016, the Trust will have put systems in
place to meet service users’ religious and spiritual
needs by ensuring that 100% of patients have their
religious and spiritual needs addressed through
their care plan by the development, pilot and
implementation of a spirituality pathway.
Objective 3
The Trust will implement a focused work plan to
improve the access to Trust services for the Gypsy,
Roma and Traveller communities. The work plan
will be initially piloted on a site in North Yorkshire
and a site in County Durham in 2012/13 and aims to
improve access for this community by 50% by
March 2016 from the access baseline in March 2012.
Equality Objective 4
Background Information
Like all NHS organisations the Trust participates
in the National NHS Staff Survey. This provides
valuable information about how our staff feel and
their opinions about the Trust as an employer.
The staff survey results tell us that staff who
experience long term health conditions are less
satisfied than staff that do not. The Trust
monitors the staff survey and has identified three
indicators that require further improvement.
Objective 4
By March 2016, to decrease by 50% the
number of indicators in the staff survey
where staff who have long term health
conditions have statistically significantly
less favourable scores.
Equality Objective 5
Background Information
The staff survey results tell us that there may be
groups of staff that are less satisfied than
average. It is important to look in detail at the
staff survey results to understand more about why
this might be the case.
Objective 5
By March 2016, to identify indicators in the
staff survey where staff who share protected
characteristics score worse than staff in
general and to develop appropriate actions.
This will be monitored on an annual basis through
the staff survey with the results being reported to
the Trust Board of Directors.
Equality Objective 6
Equality Objective 7
Background Information
It is essential that the Trust monitors the level of pay
staff receive to ensure it is fair and transparent. The
best way of doing this is to undertake an equal pay
audit. This is where the level of pay for staff from
different groups is compared to that of other groups
and the national average. If differences are
identified further analysis will be undertaken to try
and work out why the differences exist.
Background Information
Through consultation with the staff, service users and
carers accessing the Learning Disability (LD) services it
has been recognised there is further improvement
required to enhance the experience of and ease of
access to services.
Objective 6
By March 2013, to undertake a Trust wide equal
pay audit.
This will be monitored by the Trust Board of
Objective 7
By March 2016 the Trust will have monitored and
further developed the planned access through the
Green Light Access to Healthcare plan.
This objective will be monitored by the performance
measures for the Green Light action plan, the patient
experience feedback from LD service users and
complaints/incident reports.
The Trust’s Strategic View of Equality
The Trust looks for different ways to implement its
strategic view on Equality. This includes being committed
to taking part in the NHS Equality Delivery System,
completing Equality Analysis, providing Trust Staff with
Equality and Diversity Training and participating in the
Stonewall Workplace Equality Index.
The Equality Delivery System (EDS) was designed for the
NHS to help organisations improve equality performance
and embed equality into mainstream NHS business.
The EDS is seen as a way for NHS organisations to meet
the requirements of the Equality Act 2010.
The EDS is based on a set of 18 outcomes grouped into
four goals:
These outcomes focus on the major priorities for
patients, carers, the public, local communities, NHS
staff and Boards.
On completion of the EDS and the outcomes the Trust’s
performance is analysed and graded and the final
grades are approved by Health Watch.
The EDS enables the Trust to define equality objectives
which are supported by an action plan which is
implemented by staff across the Trust.
Performance and progress in relation to these
objectives are then assessed on an annual basis.
The EDS was implemented in April 2012 the details of
which can be viewed on the Trust website.
 Better health outcomes for all
 Improved patient access and experience
 Empowered, engaged and included staff
 Inclusive leadership at all levels
Carers of disabled and older people are protected
by law. (The Equality Act 2010)
Equality Analysis
The Trust has an Equality Analysis Toolkit which helps
support the review of Trust polices, procedures,
strategies, functions and services in order to establish
the impact on Equality by the Trust.
The Equality Analysis Toolkit supports the Trust and its
staff to work towards fulfilling the legislative
requirements of the Equality Act 2010. Part of normal
day to day decision-making for all public sector bodies
should involve assessing in so far as is relevant and
proportionate, the impact they have on equality in our
An equality analysis must be completed:
Reviewed as a minimum every three years for all
existing policies, procedures, functions, strategies
and services
Reviewed when significant (more than minor/trivial)
amendments and changes are made
The Trust’s Equality Analysis Toolkit can be found
on the Trust website at: www.tewv.nhs.uk/policies
or by copying and pasting this link below into a web
For all new polices, procedures, functions,
strategies, services and business plans, codes of
practice, projects and guidance
People are also protected from being
discriminated against because of lack
of religion or belief, so they cannot be
treated less favourably because they do
not follow a certain religion or have no
religion or belief at all. (Government
Equalities Office)
Dynamic assessment for all Trust Board decisions
and proposals. The Trust Board of Directors will not
ratify any document or proposal that has not
had an equality analysis
Equality and Diversity Training
Equality and Diversity Training is essential, it supports the
development of empathy, compassion, understanding and
knowledge. It enables staff to put equality and diversity
into practice within their role, regardless of their position in
the organisation and helps to ensure the Trust remains
compliant with the Equality Act.
The Trust uses a variety of different training methods
which include sharing patient stories, face to face training
and e-learning. These different approaches promote good
practice and encourage empathy.
Members of staff with good levels of E&D awareness are
more likely to demonstrate higher levels of emotional
intelligence, tact and professionalism.
Equality and Diversity Training is mandatory for all Trust
staff. Some other examples of where equality and
diversity is embedded within the training are:
People enjoy life more if they are treated fairly.
(Government Equalities Office)
Trust Board of Director Seminars
Corporate Induction
Leadership and Organisational Development Training
Trust Values Training
Recruitment and Selection Training
Hospital Managers Training
Equality Analysis Training
Bullying and Harassment Training
Equality Act and Human Rights Act Seminars
Complaints Investigation and PALS Team Training
The Trust is working in partnership with other organisations to
deliver the following specific awareness raising training
Asylum Seeker Awareness Training
Deaf and Visual Awareness Training
Deaf and Mental Health Awareness Training
Gender Sensitivity Training
LGB Awareness Training
Investing in Equality and Diversity training leads to competent
staff that are able to deliver services that meet peoples needs.
Valuing Our Diverse Workforce
Employees that are treated fairly and with respect
perform better, are more likely to deliver excellent
services and continue working for the Trust.
Diversity in the workplace recognises the different
skills, knowledge, abilities that our staff bring to the
Trust, whatever their position in the organisation.
The Trust has a number of ways of showing staff they are
valued for what they do:
We run an annual staff awards programme (the Making a
Difference awards). There are ten award categories and
staff, service users and their carers can nominate team or
individuals that they feel have made a real different to the
care and/or support they have received.
Our values provide the guiding principles for how we want
our staff to behave and to reflect the importance we place
on these the Chairman presents a bi-monthly Living the
Values Award.
The Executive Management Team also choose a Team of
the Week to recognise those that have gone that extra mile
to achieve great outcomes.
We also recognise staff for their long service to the NHS,
presenting those with over 25 years service with a certificate
and high street vouchers.
Women are more likely to seek help from and disclose
mental health problems to their primary health care
The Staff Compact and the TEWV Staff Survey
The staff compact describes the 'psychological'
contract that exists between staff and the
Within the Equality Strategy, the compact plays
a supporting role in helping staff to provide the
best possible patient experience of safe and
effective care, whilst ensuring that their own
needs for support, development and the
resources to do the job are made available.
An example of how we monitor the Trust ‘s performance in
relation to staff satisfaction is through the national NHS staff
survey. This takes place annually and is used by the Trust
improve the safety, working environment and the
relationship that the Trust has with its staff.
Trust staff are accountable for their behaviour
in the workplace towards their colleagues,
service users and their carers and when they
carry out any public function.
The Trust uses the results from the staff survey to develop
corporate and directorate action plans to ensure
improvements are made. The Trust performs favourably
when compared with other similar NHS organisations (in the
top 20% for 20 out of 28 indicators in 2013)
Non discriminatory practice is a legal requirement
of all public sector employees
In person centred mental health care, culture, ethnicity
and faith should be central to care. They should not be
sideline issues. (Colour Mind)
Depression affects one in five older people.
(Mental Health Foundation)
TEWV Equality and Diversity Steering Group
Develop and performance manage the systems to monitor and
improve Equality, Diversity and Human Rights within the Trust with
particular reference to ensuring the Trust meets its responsibilities
under the Equality Act
The group reports to the Quality and Assurance
Committee and is chaired by a Non Executive Director
supported by the Executive Director who has Board
level responsibility for Equality and Diversity and
Human Rights. The group has representation and
membership from each of the clinical and corporate
directorates, this includes service leads.
Develop an annual work plan to progress the delivery of Equality,
Diversity and Human Rights to ensure the Trust meets its legal
responsibilities under the Equality Act
In order for the Equality and Diversity Steering Group
to achieve its objectives, it works with clinical and
corporate service management teams.
The TEWV Equality and Diversity (E&D) Steering Group meets
quarterly to:
Ensure that systems are in place to provide assurance that
demonstrates compliance with all legislative and quality requirements
Monitor incidents of breach of Equality, Diversity and Human Rights
legislation and monitor and audit the dissemination of learning
lessons and feedback from action
Oversee any procedural and policy development and review
Ensure that systems are in place to provide evidence of the Trust’s
compliance with the expectations of any external regulatory bodies
and their standards
Non Executive
Director, Barbara
Matthews chairs
the Trust’s Equality
and Diversity
Steering Group
Men are more likely to seek specialist
mental health care and are the principal
users of inpatient care.
Reporting and Monitoring Arrangements
The TEWV Equality and Diversity Team reports to the Trust
Board of Directors directly three times a year. In addition to
this there is also an annual publication of information.
The E&D Lead reports to the Quality and Assurance
Committee (QUAC) three times a year and submits an
annual report of progress as part of the reporting cycle. The
Workforce Lead reports to the Workforce and Development
Both the E&D Lead and the Workforce Lead report to the
Executive Management Team (EMT) as necessary and in
accordance with Trust requirements.
Health care discrimination against trans
people has included the refusal of care such
as smear tests, breaches of confidentiality
and the practice of placing trans women on
male wards, and trans men on female wards.
(Trans People’s Health - Department of Health
Older people’s sexuality generally is not
often talked about and this is even truer of
people who are gay, lesbian or bisexual.
(Perspectives on ageing: Lesbians, Gay Men
and Bisexuals - S. Knocker 2012)
Glossary and Useful Links
What it means
Black, Asian and
minority ethnic
Black and minority
Equality and
Equality Delivery
Human Resources
Learning Disability
Lesbian, gay,
bisexual and
TEWV Equality Strategy Implementation Plan 2012 – 2016
TEWV Published Equality Statistics
TEWV Equality Delivery System
If you would like a printed copy of any of the above
information please contact us on 0191 3336542 / 6267 or by
email @ [email protected]
Care quality commission essential standards of quality and safety
Equality and Human Rights Commission
Government Equalities Office – Home Office
NHS Equality Delivery System (EDS)
Contact Details
If you would like to know more about how you can get involved please
contact us by email at [email protected]
Or by telephone
Chris Stanbury – Director of Nursing and Governance
0191 3336533
Lesley Mawson – Associate Director of Nursing and Compliance
0191 3333589
Sarah Jay – Equality and Diversity Lead
0191 3336267
Simon Marshall – HR Manager
Depression during pregnancy can affect
about 15 out of every 100 women (News
England July 2011)
Suicide rates show that British men are three
times as likely to die by suicide than British
women. (Mental Health Foundation)

Equality Strategy - Tees, Esk and Wear Valleys NHS Foundation Trust