DISABILITY EQUALITY SCHEME
NHS LOTHIAN
(2007-2010)
Annual Report 2008
December 2008
1
CONTENTS
1.
Background – Our Approach
3
2.
Action to fulfil the Disability Equality Duty
5
2.1
2.2
2.3
2.4
2.5
Action to eliminate discrimination or
harassment
Action to promote equality
Action to take account of people’s disabilities
Action to promote positive attitudes
towards disabled people
Action to encourage disabled people’s participation
in public life
5
5
6
7
8
3.
Information gathering update
10
4.
Priorities for action in 2009 and updated action plan
11
5.
Future Reporting
28
This document is available on our website at:
www.nhslothian.scot.nhs.uk
It can also be made available in other formats and languages. Please contact
James Glover at:
Lothian NHS Board
Deaconess House
148 Pleasance
EDINBURGH, EH8 9RS
Tel: 0131 537 9000
2
1.
BACKGROUND – OUR APPROACH
The NHS in Lothian is committed to stopping all forms of discrimination
against disabled people.
To achieve this NHS Lothian has an overarching Equality and Diversity
Strategy, which identifies disability as one of its key strands, and brings
together actions which are required of NHS Lothian to create a culture which
celebrates diversity, challenges harassment on the grounds of disability and
promotes opportunities for those at risk of discrimination.
Specifically in relation to disability, the Disability Equality Duty (DED) requires
NHS Lothian to publish a Disability Equality Scheme (DES) that sets out the
actions that we are taking to meet the general duties placed on NHS Lothian
as a public authority by the Disability Discrimination Act (1995 and 2005).
This means that we must:
 promote equality of opportunity between disabled persons and other
persons;
 eliminate discrimination that is unlawful under the DDA;
 eliminate harassment of disabled persons that is related to their
disabilities;
 promote positive attitudes towards disabled persons;
 encourage participation by disabled persons in public life; and
 take steps to take account of disabled persons’ disabilities, even where
that involves treating disabled persons more favourably than other
persons.
This scheme was initially published in December 2006 and an updated
version in September 2007.
As an organisation, NHS Lothian has developed its Disability Equality
Scheme (DES) within the context of appropriate Scottish Government
guidelines and the appropriate codes of practice produced to support these
areas. Overall, the NHS Lothian Scheme is written in the context of Fair for
All – The Wider Challenge, the ministerial commitment to tackle health
inequalities in Scotland.
The actions set out in the DES are structured around the following five
categories.
3
o Energising the Organisation – actions in this category is to ensure that
there is ‘buy-in’ from all NHS Lothian staff to changing our organisational
culture and making it more conducive to realising equity for people whose
everyday lives are affected by disability.
o Demographics – action under this category has the aim of capturing the
application of local, Lothian data to support service planning of all the
services that care for disabled people as well as those specialist disability
services we provide.
o Access and Service Delivery – we are taking action to ensure that access
to services, and the quality of service provided, is equitable.
o Human Resources – as an employer, NHS Lothian must meet the legal
requirements placed on all public authorities. We are required to monitor
our workforce data and address any areas where there are inequalities.
We must provide training for our staff to promote understanding of
disability equality issues. We need to work to increase the number of
disabled people in the workforce at all levels. We will continue to use
volunteering as a step in to employment.
o Community Development – these actions seek to ensure that local
communities of people with disability are involved in the planning and
delivery of services in order to ensure that services provided meet their
needs.
NHS Lothian is committed to making real and lasting changes to meet the
Disability Equality Duty. However, we have to acknowledge that it will be a
learning process for all of us. Like most public sector organisations, the
challenge for us in 2008 has been to take excellent and ground-breaking
initiatives in individual parts of NHS Lothian and roll them out across the
organisation. Given the size of NHS Lothian (28,000 employees) and its
complexity, this is a major undertaking and our priorities for the coming year
will continue to reflect this.
This annual summary seeks to capture the main progress that has been
made in the year to December 2008 in meeting the duties placed on us.
4
2.
Action to fulfil the Disability Equality Duty
While the NHS Lothian Disability Equality Scheme (DES) is structured around
the Checking for Change categories, this summary of actions undertaken is
set out against the key themes of the Disability Equality Duty. This section of
the annual summary therefore considers action taken by NHS Lothian to:





2.1
eliminate discrimination or harassment;
promote equality;
take account of people’s disabilities;
promote positive attitudes towards disabled people;
encourage the participation of disabled people in public life; and
Actions to eliminate discrimination or harassment
In the year to December 2008, actions taken by NHS Lothian included:
 Launching the Lothian Deaf Community Mental Health Service in
partnership with Deaf Action, a voluntary sector organisation. It is
staffed by a Community Psychiatric Nurse and a Senior Occupational
Therapist, both fluent in British Sign Language and Sign Supported
English and is the first of its kind in Scotland. Patients will be referred
by GPs and seen at a venue of their choice. The team will work closely
with mental health teams across Lothian to provide specialist advice,
support and information. They are based at Deaf Action, a voluntary
sector project, working with the social work team funded by the four
local authorities.
 Continued impact assessment of policies and strategies to ensure that
the potential for discrimination and harassment is eliminated at the
planning stage.
 NHS Lothian has a system of Confidential Contacts to enable staff to
receive support if they think they are being discriminated or harassed to
enable them to have their allegation investigated. The Chaplains also
provide a support service to staff.
 Continued rollout of NHS Lothian’s range of disability awareness
training programmes (see later in this report for details).
2.2
Actions to promote equality
In the year to December 2008 actions taken by NHS Lothian included:

Ensured the involvement of disabled people in the strategy development
work that has been undertaken during the year. This has included the
5
following major areas of work: Physical Disability and Complex Needs
strategy, development of the DES, Patients Council, Royal Edinburgh
Hospital continued mental health service user involvement in mental health
issues, Learning Disability Strategy, Carers Council, Advocacy
Stakeholders meeting, Public Partnership Forums in Community Health
Partnerships and the Community Health & Care Partnership in West
Lothian.

Developed steering groups with disabled people for specific projects such
as for the St John’s Hospital outpatients children’s resources project,
which involves Disability West Lothian and Signpost; new Fauldhouse
health centre; developments at the Royal Hospital for Sick Children.
 Continued its 5-year programme of auditing and upgrading premises to
ensure that services are accessible or when not, that alternative
arrangements can be made. Most major sites have now been assessed
and programmes of improvement are either completed or underway for
those sites. Priorities for 2009 are the remaining major sites at: Royal
Edinburgh Hospital, Corstorphine and Roodlands; for Acute services
signage, entrances, lift compliance, accessible toilets and showers, access
routes and paths; and for primary care car parking. These priorities were
set with the involvement of disabled people when the plan was developed
in 2006. The full plan is available from NHS Lothian at the address on the
front of this report.
2.3
Actions to take account of people’s disabilities
In the year to December 2008 actions taken by NHS Lothian included:

Development of the Disability Equality Forums into the Edinburgh
Partnership for Equality, integrating disability involvement with
representatives from other strands. This new structure allows us to identify
cross-cutting issues that affect more than one group of individuals while
still ensuring that the opinions of disabled people influence the NHS and
other public services across Lothian.

We involved disabled people in day to day planning of services. For
example, all discussions around the reprovisioning of the Royal Edinburgh
Hospital; Dignity and Respect; Strategic Planning on Mental Health. Our
mainstream structures for involving patients and public include a number
of disabled people, such as the Patient Focus Public Involvement (PFPI)
management group; Public Partnership Forums; patient forums; nutrition
6
groups; and reprovisioning groups overseeing development of services
such as endoscopy and day surgery.

A communications strategy was developed for NHS Lothian in autumn
2008. This is supported by a new policy on interpreting and translation
which includes the needs of users of British Sign Language.

A series of training sessions were delivered throughout 2008 on
communication training for NHS staff. These covered effective
communication with people who are Deaf/Deafblind in health care settings
and with people suffering Dementia and their carers in acute hospital. This
is in addition to our Deaf Awareness training which is in progress and has
been for some time (see later in this report for numbers of people
undertaking training).

We provided a programme of training courses on Deaf Awareness and are
seeking confirmation of additional training for 2009 provided by disabled
people on disability issues, to include further training by Deaf people on
deaf awareness, plus training on working with people with dementia in
acute care settings and on working with interpreters.

Continued to provide ongoing support for NHS Lothian staff who are
disabled through assessments and advice provided by the Occupational
Health Service. Disabled staff and those becoming disabled have had
reasonable adjustments made to enable them to remain in employment
and reduce unnecessary stress in their work areas. NHS Lothian’s
counselling service for staff who are Deaf, deafened or hard of hearing
continued to operate throughout the year and has funding for at least
another 12 months.

Our monitoring indicates that 18% of our volunteers consider themselves
to be disabled. We have taken action to take account of our volunteers’
disabilities in a number of ways including making our information centre
fully accessible for wheelchair-using volunteers and promoting the use of
assistance dogs among our volunteers.
2.4
Actions to promote positive attitudes towards disabled people
In the year to December 2008 actions taken by NHS Lothian included:

Developed and implemented an introductory disability equality awareness
module as part of our formal induction training programme for all NHS
7
staff. In 2008 2,635 staff received this training; since April 2007 when the
training was introduced, 4435 staff in NHS Lothian have completed the
course.

Developed a range of training courses examining disability equality issues
to a greater depth, including a 2-day dementia awareness course (90
attendees in 2008); Do Not Attempt to Resuscitate course (196 attendees
in 2008); Equal Opportunities in recruitment and staff management, which
includes substantial content on disability awareness for managers (144
attendees in 2008).

Developed content for further disability awareness training in the following
areas: learning disability; mental health; deaf awareness. We are currently
exploring use of trainers with personal experience of these impairments or
who are Deaf to deliver these courses, which will be offered to staff from
early 2009.
2.5
Actions to encourage participation of disabled people in public life
In the year to December 2008 actions taken by NHS Lothian included:

Continued to publish our comprehensive workforce report which includes
a wide range of data, including disability-related data, on our 28,000 staff.
A summary of the employment monitoring for the years April 2006 –
March 2007 and April 2007 – March 2008, together with data for the
current financial year so far, is shown in the table below:
Year
2006/07
2007/08
2008/09 to end
September
Current Employees
recorded as disabled*
130
126
140
(*All numbers based on those who have
decided to disclose their disability)
As this figure represents around 0.5% of our workforce we are concerned
that this does not provide an accurate picture of the extent of disability
among our workforce. See section 3. and the updated action plan below
for information about how we plan to improve this situation.
8
 Developed our mainstream public involvement approaches to include
disabled patients and members of the public (see sections above on
involvement in mainstream service developments).
 Developed our long-term strategy for coaching and mentoring to include
specific actions related to developing the leadership skills of disabled
employees of NHS Lothian (NHS Lothian Human Resources and
Organisational Development Strategy 2008).
 Continued to improve the opportunities available for disabled people who
may have difficulties obtaining or retaining employment, by including
specific actions in our Human Resources and Organisational
Development Strategy.
9
3.
Information gathering update
NHS Lothian has now completed its review of existing datasets, with local
needs assessment work updated in relation to:
 learning disability;
 mental health; and
 physical and complex disability.
More generalised analyses of the 2001 Census data, Scottish Health Survey
data – as health and social care provision data were also analysed in relation
to self-reported disability and limiting long-term illness.
NHS Lothian continues to work to develop a system to capture information on
"reasonable adjustments" made for disabled employees. At present this
information is held on a case-by-case basis between Employee Relations and
the Occupational Health Service. Collation of this information will give us a
good picture of the employment-related needs of our disabled staff.
Meanwhile in late 2008 NHS Lothian is starting to pilot new arrangements to
gather patient information in primary care, with two GP practices. This will
help identify some of the obstacles to effective collation and use of patient
data, including disability-related information. The pilot will also identify
opportunities for developing the contractual arrangements with all primary
care providers.
With regard to longer term monitoring, NHS Lothian continues to work with
NHS National Services Information and Statistics Division to improve
guidance on the approach to recording disability. Development of initiatives
such as Happy to Ask, Happy to Tell is progressing and we are currently
planning how we will train NHS Lothian staff to implement these new
information recording systems.
10
4.
Priorities for 2009
In addition to progressing action through our action plan, the main priorities
for work in 2009 in meeting the Disability Equality Duty include:

Developing our existing involvement arrangements including:
- Completing the set up of the new Edinburgh Partnership
Equality Network, and ensuring that it includes appropriate
representation from disabled people to meet their needs.
- Ensuring that the likely new arrangements for Public Focus
Patient Involvement and the Patient’s Bill of Rights incorporate
ways of involving disabled people across NHS Lothian.
- Improving the involvement of disabled people in impact
assessments on policies and strategies.

Rolling 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 will also establish more structured
ways of involving external stakeholders, such as disabled people, in our
assessments.

Improving the ways in which we collect information about disabled people
in the communities we serve, the people we employ and the patients we
help, by:
- Contributing to national NHS Scotland programmes to make
evidence gathering more detailed, such as changes to
nationally-managed data collection systems for NHS Scotland
service provision.
- Piloting work in primary care with two GP practices to improve
data collection across equality strands including disability. This
work is in partnership with the Scottish Government’s
Information & Statistics Division (ISD) as the national lead on
data gathering. The issue is complex and will need a national
approach to enable the collation of meaningful data to improve
patient access to services and health outcomes.
- Improving current levels of workforce data gathering on
disability (and race), working in partnership with trade unions.
11
4.1
Energising the Organisation
This section shows the actions needed to ensure there is ‘buy-in’ from all staff to changing organisational culture
and making it more supportive of the work needed to achieve disability equality outcomes.
Activity
Strategic
Co-ordination
Establish senior
level coordination of
disability
equality activity
Actions Agreed
Progress
Responsibility and
deadline for completion
of action
1. Appoint Board level Director to
lead on disability equity issues.
1. Director of Human Resources
and Organisational
Development.
1. Completed.
2. Integrate disability into equality
and diversity strands.
2. NHS Lothian Equality and
Diversity Strategy developed,
first annual report published
November 2008. Impact
assessment includes disability.
2. Head of Equality &
Diversity (review
November 09).
3. Lead managers identified to
lead, monitor and report on
progress.
3. Equality and Diversity Leads
identified in main operating
divisions. Membership of
Equality & Diversity Steering
Group covers all divisions and
CHPs/CHCP.
3. Executive
Management Team
(Completed, review by
December 2009).
4. Develop performance
4. Costed action plans are
milestones for the
required as part of any formal
implementation of costed
NHS Lothian strategy.
action plans to meet needs and
Examples: Physical & Complex
4. Strategic
Development
Managers for relevant
strategies covering
12
priorities set out in agreed
disability strategies.
Needs Strategy; Learning
Disability Strategy.
5. Establish CHP and Divisional
Implementation groups to
ensure ongoing discussion,
support Equality Impact
Assessments and support
performance monitoring of
strategy implementation.
5. Physical & Complex Needs
strategy now in place, this
action to be taken forward in
2009
disabled people.
(Completed, review by
December 2009).
5. Equality and Diversity
Leads. (December
2009).
6. Ensure involvement of service 6. NHS Lothian is represented in
6. Equality & Diversity
users, carers and voluntary
the Edinburgh Partnership
Leads (review by
organisations in discussion and
Equality Network alongside
December 2009).
development plans and
other public sector
PFPI action Head of
services in relation to disability
organisations. This is currently
Equality & Diversity
issues through the work of the
in development and includes
(July 2009)
Equality and Diversity Lead
disability representatives.
Managers and the Patient
Members also contribute to
Focus Public Involvement
Equality Impact Assessment.
(PFPI) Leads.
Similar joint groups in West
Lothian and East/Midlothian.
Examples in 2008: Independent
Advocacy Plan; carers’
strategy. Priority for 2009:
disability representation in PFPI
restructuring.
7. Ensure continued integration of 7. Health Inequalities reduction
disability issues within strategic
and impact alleviation is a
7. Executive
Management Team
13
objectives of NHS Lothian
Impact
Assessment
Assessment of
functions and
policies to
assess each for
its relevance to
the duty to
promote
disability
equality and to
make
appropriate
adjustment to
policies to
remove/minimis
e adverse
impact
formal requirement on all
strategic plans of NHS Lothian.
Priority for 2009: see next
section on impact assessment.
(Completed, review by
December 2009).
1. Identify all relevant new or
revised functions and policies
and undertake equality impact
assessment (EQIA) for
disability equality.
1. Function and policy assessment 1. Equality and Diversity
is already underway as a part of
leads (underway,
the NHS Lothian Equality and
review by December
Diversity Strategy development
2009).
2. Provide training for EQIA.
Ensure continued availability of
trained staff to support Rapid
Impact Assessment (RIA) and
full EQIA.
2. Training is already in place and
offered to key staff (117
managers and policy
developers trained in impact
assessment during 2008).
2. Lothian NHS Board
and Divisional and
CHP management
teams. (October 2007
onwards).
3. Use outcome of EQIA to inform 3. Impact Assessment Steering
3. IA Steering Group
the revision of policies and
Group set up in 2008 to quality
(Ongoing)
implementation.
proof and monitor practice,
improve the impact assessment
tools available, and oversee the
NHS Lothian-wide training
programme.
4. Ensure all new policies and
4. Vast majority of new policies
4. Lothian NHS Board
strategies have been subject to
and strategies subjected to
and Divisional and
EQIA to promote disability
impact assessment. Priority for
CHP management
equality at Board level.
2009: more consistent
teams. (December
application of impact
2008 onwards, review
assessment process to new
by December 2009).
14
policies, better quality findings.
5. Build an evidence base to
facilitate impact assessment
and promote good practice in
service provision and
employment
5. Priority for 2009: see 4. above
6. Collate and review functions
6. List of functions, strategies and
and policies at least every
policies updated November
three years with interim reviews
2008. Priority for 2009:
as policies are updated.
completion of impact
Publish the outcomes.
assessment of existing policies
and strategies.
7. Produce an annual report of
activity to be made available to
the relevant monitoring
organisations
Establish and
maintain
monitoring
function
7. DES annual report published
December 2007.
1. Establish a Lothian Disability
1. This action superseded by
Equality and Health Forum with
establishment of the Edinburgh
a specific monitoring function
Partnership Equality Network in
2008. Local arrangements in
place in West, Mid and East
Lothian (latter two in
partnership with local
authorities and other public
sector organisations).
5. IA Steering Group;
Lothian NHS Board
and Divisional and
CHP management
teams. (December
2009)
6. Head of Equality &
Diversity (December
2009)
7. Head of Equality &
Diversity (this report
published by 4
December 2008)
1. Equality and Diversity
leads. (Superseded
2008).
15
2. Establish regular monitoring
2. Superseded – see 1. above.
and annual reporting
mechanisms with the relevant
Lothian Disability Forums using
Checking for Change.
2. See 1. above.
3. Regular sharing of good
3. See 1. above. Arrangements to
practice and outcomes from the
be reviewed as EPEN develops
review of the action plan
further throughout 2009.
delivery to ensure it informs
Examples from 2008: Learning
appropriate quality
Disability Strategy
improvement mechanisms.
development; Physical &
Complex Needs strategy.
3. Equality and Diversity
leads (review by
December 2009)
4. Regular reporting to the clinical 4. Equality & diversity a standing
governance arrangements will
item on agenda of Clinical
be carried out.
Governance and Risk
Management Committee from
2008 onwards.
4. Head of Equality &
Diversity (completed;
review by December
2009)
16
4.2
Demographics
This section shows how NHS Lothian has made progress in piloting disability monitoring and where NHS Lothian
has used, or plans to use, Census data to inform future work.
Activity
Profiling
Establish
baseline data
for disability
profiling
Actions Agreed
Progress
Responsibility and
deadline for completion
of action
1. Establish database of existing
needs assessment work and
data sources.
1. Review of existing datasets
completed. Needs assessment
work completed for:
 learning disability;
 mental health; and
 physical and complex
disability.
1. Directorate of Public
Health and Health
Policy (completed;
review December
2009).
2. Establish – in line with
guidance – monitoring data set
and performance indicators
identified in the Checking for
Change performance
monitoring system.
2. This work now being
undertaken by the Edinburgh
Partnership Equality Network
and NHS Health Scotland’s
Equalities & Planning
Directorate.
2. Head of Equality &
Diversity, Equality and
Diversity Leads
(December 2009).
17
4.3
Access and Service Delivery
In this section NHS Lothian has outlined activity that will be undertaken to mainstream disability equality and
improve customer satisfaction and confidence.
Activity
Actions Agreed
Progress
Ensure public
1. Work with NHS Scotland and
1. Significant work completed on
access to
other bodies to develop a
this; NHS Lothian now actively
information and
national programme of health
participating in NHS Scotland
services and
information materials
work led by NHS 24.
agree standards
of practice
2. Review plans for signposting at 2. Already within Divisional action
NHS Lothian facilities and
plans and being implemented.
identify models of best practice.
Responsibility and
deadline for completion
of action
1. Equality and Diversity
leads, Head of
Equality & Diversity
(review by December
2009)
2. Equality & Diversity
leads, Head of
Equality & Diversity
(review by December
2009)
3. Use and learn from complaints,
comments and suggestions.
3. Complaints are reviewed
quarterly across NHS Lothian.
Comments and suggestions are
reviewed at local level and are 3. Head of Equality &
routed through the Equality &
Diversity (review by
Diversity Steering Group.
December 2009).
4. Through patient experiences
identify areas of good practice
and areas for improvement
4. Patient stories, comments,
observation audits, recovery
work in mental health, regional
perinatal unit at St John’s
hospital all good examples of
4. Nurse and Associate
Nurse Directors, via
Patient Experience
Programme (from
January 2008).
18
identification of good practice in
2008.
Ensure that all
NHS Lothian
facilities are
compliant with
DDA physical
access
requirements
1. Ensure implementation of
recommendations from access
audits and develop funding
proposals in response to
identified priorities.
1. Existing CHP and Divisional
groups are used to implement
priorities from existing audits
(see section 2.3 in report
above).
1. CHP and Divisional
Management Teams.
Director of Facilities
and local Estates
Managers. (From
October 2007).
2. Ensure compliance with
building control regulations
relating to disability for all new
NHS Lothian facilities.
3. The results of audits to be used
to prioritise actions in
partnership with users on local
forums
3. 2008 example: Lothian
Community Mental Health Service
developments for deaf people in
conjunction with Deaf Action.
Ensure that
1. Identify issues through
patients have a
reporting systems and develop
choice of
appropriate actions
gender of health
professional
1. Existing quality systems are in
place to allow this to be
implemented.
1. CHP and Divisional
Management Teams
(Achieved, review by
December 2009)
Promote
effective use of
advocacy
1. Ensure equity and diversity
issues are fully reflected in the
Independent Advocacy Plan
1. Directorate of
Strategic Planning and
Modernisation (March
1. Ensure that information about
health and healthcare needs
from advocacy work influences
19
services to NHS
staff through
training and
information
dissemination
2.
Ensure access
to interpreters
and translated
information
planning and promote
awareness of advocacy
services to disability groups.
under development throughout
2008.
2009).
Ensure mapping of advocacy
2. Funding is already in place for
2. Equality and Diversity
services for equality and
advocacy services for people
Leads (review by
diversity issues and link to the
with mental health problems
December 2009).
implementation of the
and learning disabilities.
Independent Advocacy Plan for
Funding for people with
potential further development of
physical disabilities is being
disability advocacy services
considered. At present children
and young people can access
mental health and learning
disability advocacy. Older
people can access advocacy
for mental health problems and
dementia. Impact assessment
of new Advocacy Plan
completed and relevant
changes made.
1. Produce an NHS Lothian policy
on provision of patient
information in alternative
communication systems .
1. Communication strategy
developed during 2008.
1. Communication
Strategy in place.
2. Ensure “easy read”
documentation produced for all
relevant documentation
2. The range of “easy read”
documents is being expanded.
2. NHS Lothian
Communications
Team and Equality
and Diversity Leads
20
3. Establish systems for
3. Monitoring use of I&T for deaf
monitoring existing use and
service users. Reporting
unmet need for interpreting and
system in place to monitor
translation for health and
usage of interpreting and
healthcare issues.
translating services. Snap shot
survey of induction loop
availability and usage in
progress.
Promote
disability
equality in all
service
(Ongoing).
3. Associated Director
Nursing (Strategic
Planning) and Equality
and Diversity Lead
University Hospitals.
4. Update and disseminate code
of good practice, information
and training on working with an
interpreter and in providing
translated information.
4. New programme led by NHS
4 National language and
Greater Glasgow and Clyde in
communication
progress. Working group has
support group.
met three times. Implementing a
language and communication
plan originally developed for
NHS Greater Glasgow and
Clyde. Awaiting outcome of
Scottish Government led
TICSIG group.
5. Implement Happy to Translate
(HTT) logo across Lothian
following pilot in UHD.
5. Ongoing roll out in NHS Lothian 5 Associated Director
There is renewed discussion
Nursing (Strategic
about how NHS Lothian will
Planning) and Equality
progress HTT.
and Diversity Lead
University Hospitals.
1. Develop best practice in service 1. Service Level Agreement for
1. Head of Equality &
procurement.
procured services now includes
Diversity (December
disability equality requirements.
2009).
Effectiveness of these will be
21
providers and
those under
contract to NHS
Lothian
Provide an
environment
and facilities
that meet the
needs of those
using NHS
services
subject to review during 2009.
The mapping of SLAs will
continue during 2009 within
NHS Lothian and will
compliment similar work in local
authorities.
1. Implement actions from
environmental and access
audits
1. Already underway. See report
section 2.2 for details of
progress and 2009 priorities.
1. CHP and Divisional
Groups (review by
Dec 2009).
2. Monitor patient surveys and
complaints
2. Achieved – ongoing as part of
NHS Lothian complaints
process.
2. Complaints Manager
(review by Dec 2009).
3. Implement ‘reasonable
adjustments’ (where indicated /
required).
Establish
systems for
reporting and
collating of
reports of
discrimination
both directed
against staff
and those
reported to staff
3. As 1. above.
3. See report section 2.2 and 2.3
for examples.
1. Procedures are in place for the
management of incidents and
there are systems to monitor
and review.
1. Completed. The DATEX IT
system allows publication of
reports.
1. CHP, Divisional and
Lothian NHS Board
Complaints
Managers (Review
date – December
2009).
2. ‘Adverse incident’ monitoring
form used to record incidents.
2. Form collated by Risk
Management. Work in 2009 will
focus on reviewing and
2. Head of Equality &
Diversity (December
2009).
22
by patients,
carers, or
others.
improving use of these forms,
to enable analysis of the range
and number of incidents.
3. Support system established for
staff affected.
4.4
3. Completed. Staff support
systems include counselling;
peer support contacts and the
chaplaincy service. NHS
Lothian also provides a
counselling service exclusively
for Deaf and staff with a
hearing impairment.
Human Resources
This section shows how NHS Lothian has improved workforce policies relating to disabled people and increased
knowledge of disability equality issues among NHS Lothian staff.
Activity
Duties as an
employer
Actions Agreed
1. Review existing employment
policies for DDA compliance.
Fulfil the
Employment
Duties set out in 2. Review existing employment
the DDA and
practices for DDA compliance
other legislation.
Progress
1. Completed and ongoing. (All
employment policies are
subject to regular review)
2. Completed and ongoing.
Responsibility and
deadline for completion
of action
1. Directorate of Human
Resources and
Organisational
Development. CHP
and Divisional
Management Teams.
23
Staff training
3. Produce required workforce
monitoring reports and identify
any areas of inequality.
Consider appropriate action to
address identified inequalities.
3. Completed. Quarterly workforce
reports now provide all required
equality data.
4. Ensure staff forums are
competent to deal specifically
with issues relating to disabled
NHS employees.
4. Training programme planned
for 2009 for Partnership
Forums and staff-side
organisations.
1. Amend existing mandatory
training to include the general
duty to promote disability
equity.
1. Completed.
Ensure NHS
staff have
equality and
diversity training 2. Amend induction training to
2. Completed.
in which
include the general duty to
disability issues
promote disability equality.
have been
appropriately
3. Raise awareness of the right to 3. Incorporated in training for
covered
take positive action to treat
managers on Equal
person with a disability more
Opportunities in Recruitment
Ensure all staff
favourably to achieve equality.
and Selection.
are trained to
provide services 4. Develop and implement training 4. Range of focused training
that are
programmes for front-line NHS
courses developed for disability
sensitive to the
staff in disability equality and
equality – see section 2.3 in the
needs of
appropriate workplace
report above. Continued
4. Directorate of Human
Resources and
Organisational
Development.
4. Directorate of Human
Resources and
Organisational
Development (Dec 2009)
24
disabled people
Ensure staff
involved in
service
management
and planning
have access to
a training
programme on
mainstreaming
disability issues
behaviours.
development and review
necessary during 2009.
5. Develop and implement training 5. Impact assessment training
programmes for NHS
programme developed,
management and planning in
provided to managers and
reducing barriers for disabled
policy developers (see p13 of
people and appropriate
action plan above).
approaches to mainstreaming
care of disabled people
6. Ensure effective monitoring of
training.
6. Completed. Centralised training
monitoring function now
collates data on all face to face
and e-training.
25
4.5 Community Development
This section shows how NHS Lothian is making sure disabled people are involved and how we will work together
with disabled people, their organisations and other partners to build community capacity.
Activity
Impact
Assessment
Assess and
consult on the
likely impact of
strategies and
policies in
relation to
disability issues
Actions Agreed
Progress
Responsibility and
deadline for completion
of action
1. Involve service users with
disabilities in the Rapid Impact
Assessment process used for
all existing and new policies.
1. Already underway where
appropriate as part of strategic
consultations but further work
necessary during 2009.
1. Directorate of Public
Health and Health
Policy (December
2009).
2. Establish Lothian Disability and
Health Forum.
2. See section above re:
Edinburgh Partnership Equality
Network.
2. Head of Equality &
Diversity & Equality
and Diversity Leads
(December 2009).
3. Develop joint consultation
3. Joint consultations on the
arrangements with local partner
reprovisioning of the Royal
agencies and stakeholders
Edinburgh Hospital, Joint
Health Implementation Plan,
development of the EPEN and
previously through the
Edinburgh Disability Equality
Network
3. Equality and Diversity
Leads and CHP
Management Teams
(Ongoing).
26
Identify leads,
1. Maintain effective partnerships
links with
with Joint Disability Equality
partner
Forums in Edinburgh and
agencies, agree
Midlothian to support multistrategy for
agency approach to tackle
advocacy
disability discrimination with
against
local partner agencies
disability
discrimination
1. See Edinburgh Partnership
Equality Network above. 2008:
Independent Advocacy Plan
developed.
1. Head of Equality &
Diversity and Equality
and Diversity Leads
and CHP
Management Teams.
(Review Date –
October 2008).
Community
Planning
1. NHS Lothian planning
mechanisms to be reviewed to
ensure continued development
of engagement mechanisms.
1. Members of the joint Edinburgh
Disability Equality Forum and
Patient Public Forums
participated in EQIA and other
consultations, e.g. mental
health service users’
involvement in reprovisioning
services at Royal Edinburgh
Hospital in 2008. See above
for 2009 arrangements.
1. Directorate of
Strategic Planning and
Service Modernisation
and CHP and
Divisional
Management Teams;
Head of Equality &
Diversity (review by
December 2009).
2. Ensure disabled people and
disability stakeholder groups
are engaged in the Patient
Focus Public Involvement
activity and involved in future
NHS Lothian service
developments or redesign
processes.
2. Patient Focus and Public
2. Head of Equality &
Involvement groups are already
Diversity (July 2009)
in operation. Priority for 2009:
ensure that planned
developments in PFPI structure
include effective disability
representation.
Ensure that
community
planning
processes
incorporate the
needs of
disability groups
Establish
support and
resource needs
for individuals
and
communities to
take part in
involvement
27
5.
Future Reporting
This annual report provides an update on the work to meet the Disability
Equality Duty by NHS Lothian, both as an employer and as a provider of
services, in 2008. Under existing legislation, we are due to revise our
Disability Equality Scheme and publish a new one by 4 December 2009. This
new Scheme will also include information about our performance during
2009.
During 2009, however, we expect the Westminster Government to publish its
new Equality Act. This is likely to introduce significant changes to the equality
and diversity responsibilities of public sector organisations like NHS Lothian.
Regardless of the specifics of the new Act, we will ensure that we meet any
new equality duties in full and that we continue to develop our capacity and
improve our performance in respect of disability equality.
If you would like to help us by getting involved in our disability equality
work, or simply just to give us feedback, please get in touch with us at
the address on the front of this report.
December 2008
28