NHS LOTHIAN
Disability Equality
Scheme 2009-12
Please contact us if you would like any of the
appendices to this document in larger print. The contacts
section is on page 37.
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 38
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………………………………..7
The social model of disability………………………….9
Equality and Human Rights – an introduction………10
How much progress has been made?......................13
How we involved disabled people……………………18
How we assess the impact of what we
do on disability equality………………………………..21
How we collect information about disability…………25
Employing disabled people in NHS Lothian………...30
Monitoring and developing this Disability
Equality Scheme……………………………………….35
Contacts and finding out more………………………..37
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.
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NHS Lothian Disability Equality Scheme 2009-12
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.
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 2009-2012. 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.
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NHS Lothian Disability Equality Scheme 2009-12
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.
6
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.”
7
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.”
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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
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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.
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NHS Lothian Disability Equality Scheme 2009-12
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
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
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
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NHS Lothian Disability Equality Scheme 2009-12
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
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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.
 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
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NHS Lothian Disability Equality Scheme 2009-12
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.
 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:
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NHS Lothian Disability Equality Scheme 2009-12
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.
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
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NHS Lothian Disability Equality Scheme 2009-12
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).
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NHS Lothian Disability Equality Scheme 2009-12
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.
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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,
4
Disability Equality Duty Code of Practice for Scotland 2006
18
NHS Lothian Disability Equality Scheme 2009-12
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.
3. Learning Disability workshop: a dedicated learning
disability workshop was run on 22 July 2009. A total of
16 disabled 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. 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.
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:
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NHS Lothian Disability Equality Scheme 2009-12
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
20
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
5
Fair for All guidance – reference to be added
21
NHS Lothian Disability Equality Scheme 2009-12
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.
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
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NHS Lothian Disability Equality Scheme 2009-12
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.
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.
23
NHS Lothian Disability Equality Scheme 2009-12
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
24
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).
25
NHS Lothian Disability Equality Scheme 2009-12
 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.
 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:
26
NHS Lothian Disability Equality Scheme 2009-12
Communication support provided via ITS 2005 2009
Units of provision. A unit = 1 hour of interpreting or
100 words of translation
BSL
Braille
Tape
Large
Print
2005-6
1,150
6
2
2006-7
1,101
3
2
2007-8
1,100
3
1
0
0
3
2008-9
1,043
Awaiting
Awaiting
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
27
NHS Lothian Disability Equality Scheme 2009-12
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 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
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NHS Lothian Disability Equality Scheme 2009-12
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
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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 know from the
anonymous bi-annual staff survey that some disabled
employees report bullying and harassment. While work
to address 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).
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NHS Lothian Disability Equality Scheme 2009-12
 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).
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).
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NHS Lothian Disability Equality Scheme 2009-12
“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:
 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.
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NHS Lothian Disability Equality Scheme 2009-12
 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
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NHS Lothian Disability Equality Scheme 2009-12
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
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.
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NHS Lothian Disability Equality Scheme 2009-12
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
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
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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
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NHS Lothian Disability Equality Scheme 2009-12
0131 537 6510
Jim Robinson, Health Improvement Facilitator
james.robinson@luht.scot.nhs.uk
0131 536 0055
Diane Loughlin, Health Promotion Lead
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
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