31st December 2012 Public Sector Equality Duty Equality Act 2010 How Wandsworth Clinical Commissioning Group* is meeting the requirements of the Act. * Wandsworth Clinical Commissioning Group (CCG) was formally authorised on 10th December 2012 1 Introduction and background The Equality Act 2010 brings together all previous equality legislation in England, Scotland and Wales. The Act includes a new public sector equality duty (the equality duty), replacing the separate duties relating to race, disability and gender equality. The equality duty came into force on 5 April 2011. The public sector equality duty requires public authorities, when carrying out their functions, to have due regard to the need to: Eliminate discrimination, harassment and victimisation and any other conduct that is prohibited by or under the Act. Advance equality of opportunity between people who share a relevant protected characteristic and people who do not share it. Foster good relations between people who share a relevant protected characteristic and those who do not share it. Public bodies must be transparent about how they are responding to the Equality Duty, and are required to publish relevant, proportionate information showing compliance with the Equality Duty. This report outlines how Wandsworth CCG is complying with these requirements. About Wandsworth CCG Prior to December 2012, NHS Wandsworth was the primary care trust and Borough team responsible for the health of the people who live in Wandsworth. As part of the recent Government reforms in health it became part of NHS south west London, the transition organisation tasked with delivering the healthcare across five south west London Boroughs. On December 10th Wandsworth Clinical Commissioning Group was formally authorised to be the body responsible for delivering the new healthcare reforms and commissioning functions for health services across Wandsworth. It is co- terminus with the London borough of Wandsworth but also looks after an additional 71,000 patients who are registered with a Wandsworth GP but who live outside the Borough. Other CCGs in South West London include Croydon, Kingston, Merton, Richmond and Sutton CCGs. Wandsworth’s CCG comprises 3 locality commissioning groups (LCGs) Battersea, Wandle and West Wandsworth. These locality commissioning groups are broadly co-terminus with previous local health groups. These commissioning groups will work together to help manage local budgets and commission services for patients. Running alongside CCGs groups are the Health and Wellbeing Boards. The boards will also be fully operational by April 2013. This will remove divisions between the NHS and local authorities and give communities greater say in the services needed to provide care for local people. The boards will bring together those who buy services across the NHS, public health, 2 social care and children’s services, elected representatives and representatives from HealthWatch to plan the right services for their area. They will look at all health and care needs together, rather than creating artificial divisions between services. The core business areas within the organisation are: Commissioning healthcare services on behalf of the population of Wandsworth. Improving the health and wellbeing of the population of Wandsworth and reducing inequalities in health. Coordinating and developing health services provided by primary care contractors GPs, dentists, pharmacists and optometrists. Wandsworth’s project board is working to integrate services, including: • • • • combining health and social care support for dementia suffers to reduce hospital readmissions improved communication between health and social care professionals to enhanced the support package offered to vulnerable members of the community fast-tracking learning by integrated public health teams in local authorities Joint Strategy Needs Assessment as the driver of clinical priorities Health and Wellbeing Strategy with key themes – Integration – Resilience – Prevention Transformation of out-of-hospital care through our Wandsworth Council integration work-stream “Planning All Care Together” Improvement and development of primary care Using the voice of patients to influence our commissioning intentions Our Vision The vision of the CCG is: “Better care and a healthier future for Wandsworth.” We will achieve this by being Patient focused, Outcomes driven, Principled; Collaborative and Progressive & Professional. For further definition of our vision please go to www. Health of Wandsworth As a large inner London borough, Wandsworth has some unique challenges in relation to healthcare provision. Some of these key challenges are: There are higher proportions of younger adults (20 – 44) living in the borough than anywhere else in England. the borough is more ethnically diverse than the national population 3 the population is highly transient, more so than the national population with the patient population changing 30% each year Wandsworth varies widely in its level of deprivation - ranging from the very affluent to the very deprived Further information about our borough and the health of Wandsworth is available here. Our Staff Wandsworth CCG is committed to recruiting, developing and retaining the best workforce to make sure we provide high standards of healthcare. We believe in valuing, developing, communicating and consulting with our staff. Equality and Diversity at Wandsworth CCG Since its inception in 2002 the Wandsworth PCT developed and sustained effective strategies on equality and diversity. More recently we have developed a Thinking Partners Group (TPG) to support us in delivering against goals and challenges in these areas. The group oversees our approach to Equality and Diversity and is made up of representatives from local community groups, LINKs, Expert Patients, third sector, public health, carer groups, and senior, staff from the organisation. We have developed a Community and Seldom Heard Groups Grant Scheme to ensure the needs, views and priorities of hard to reach organisations are considered and fully embraced within NHS services. The TPG, Seldom Heard Group partners, Patient and Public Involvement Groups are now working closely with the CCG to ensure that equality and diversity objectives and priorities inform their plans, processes, systems and decisions. The now developed GP locality leads and locality groups are now taking an active role in equality and diversity issues in Wandsworth. Meeting our Public Sector Equality Duties To ensure Wandsworth CCG meets its statutory equality duties under the Equality Act 2010 we have utilised the Equality Delivery System (EDS)1 to develop a strategic approach which: Identified the Thinking Partners Group as our partner organisation to help us deliver evidence of good practice across the organization Involves Seldom Heard Groups helping us to assess our performance in equality and diversity and define priorities for the localities. 1 Designed for the NHS, the EDS is there to drive up equality performance and embed equality into mainstream NHS business in line with the requirements of the Equality Act. 4 Will help establish gaps or barriers within our services and the impact these may have on the nine protected characteristics and ensure we take remedial steps to address them Will show how we advance equality and diversity across all our core functional activities Will set equalities priorities for the next 3 years and Will ensure Wandsworth CCG makes equality a reality for all, by continuing to mainstream equality and diversity considerations into all core functional activities, and as part of its work under the NHS Equality Delivery System (EDS). As part of our EDS activities, we have: Trained the Thinking Partners Group to enable them to participate fully in the EDS approach Ran an information gathering day with staff and community representatives to identify work that contributes to EDS outcomes and activities Surveyed staff about their views of NHS Wandsworth/Wandsworth CCG as an employer Begun, with staff, patients, carers and users, to identify priorities to promote inclusive leadership 5 Evidence to show how we comply with our Public Sector Equality Duties In 2011, we identified some key development areas for Wandsworth CCG to help us embed equality and diversity into core functional activities, particularly within CCG plans, decisions and activities. Since then, we have continued to train and empower our staff, we involve them in equality development initiatives and activities, such as EDAY (a day where staff, patients, users and communities come together to share what we are doing around equality and diversity, assess our performance, learn from our stakeholders and find out what is important, urgent and needs to be included in decision making, build relationships and agree some equality priorities) In this section, we have outlined how Wandsworth CCG complies with the Public Sector Equality Duties. It also summarises priority issues and development areas for the organisation and these are followed by the actions we will take to advance equality and diversity and ensure an inclusive and accessible service for all. How Wandsworth CCG advances equality and diversity, fosters good relations and address discrimination Activity/policy/project Explanation Customer Relationship Management System We continue to develop and use the CRM to gather up to date and accurate targeting of individuals and organisations around PPI activity. The CRM accommodates and reaches a rich diversity of people in the Wandsworth area, allowing us to engage, involve and consult with a wide group of people on various healths, policy and planning issues. Equality Analysis Working in partnership with colleagues in the South West London area, we have developed our Equality Impact Assessment process into Equality analysis, a process which focuses more closely on meeting the needs of protected characteristics. Succinct, user friendly and responsive, it includes guidance and one to one support (where needed/requested) to ensure everyone actively assesses the impact of all plans, decisions, policies and activities on the different protected groups. We continue to produce regular reports to the Board outlining outcomes from the assessments and changes needed to address identified gaps. The Board has made it a priority for all items presented for decision or agreement to include an equality analysis. 6 ‘E’ Day We held another EDAY event on 29th of November 2012. The event built on the successful one which took place in December 2011. This time round we brought representatives from our Thinking Partner Group and Seldom Heard communities, together with our staff to gather information for publishing as part of our public sector duties, assess our performance for each protected group, to learn from each other and to identify priorities for next year. We also discussed priorities for improving equality in employment activities and achieving an inclusive leadership culture within the Trust. Our patient representatives found the day to be incredibly beneficial, a comment from one of our representatives – ‘I just want to reiterate the words already expressed. I found the afternoon very rewarding. The session brought home to me not only details of the work already being undertaken by the NHS but where the users and representatives of the different communities in Wandsworth can make a real difference for the better’. The following pulls together a range of services and initiatives currently in place to advance equality and diversity Cancer Awareness – piloting increased access to education and information about treatments to different protected groups Commissioned pulmonary rehabilitation classes for communities – getting closer to patient homes New diabetes integrated model GP direct diagnostic treatment Development of self-management delivery plans for long term conditions Helping self-help groups to develop and thrive Maternity birth plans developed and agreed, process supported by WCCG GP Peer support groups, breastfeeding and Chlamydia New diabetes model to ensure patents all receive NICE 9 Keycare processes Maternity WCCG reviews all policies that cover patient involvement Using patient satisfaction in maternity services to improve services Obesity procurement focusing on children and young people Finance support to advance equality 7 BME cancer outreach programme COPD pathway evidence with NICE 13 quality standards Children’s IAPT – better for disadvantaged children to access Maternity services developed base on population census including ethnicity and socio economics Bloodspot failsafe screening at birth, makes sure action taken early Cancer awareness, signs and symptoms – community pharmacists development Localities ensuring that all CRBs done Incident reporting Chlamydia screening Healthy Living Programme (footsteps and health trainers DNA audits Patient satisfaction surveys run by the screening service. Patient electronic survey equipment in process of being purchased which will provide quicker and easier methodology to assure patient satisfaction. In the treatment arm of the programme (Diabetic eye screening – DES) in the ophthalmology service at Moorfields hospital, transport was highlighted as an area of need to improve uptake. Appointment letters have been re-designed to improve the layout and highlight ways to request transport if required. Patients who are not eligible for hospital transport due to selection criteria are now advised to discuss with their GP, as they have designated funds for transport needs. We also focused specifically on issues relating to patients with long term conditions and on the needs of carers. These were some of the services and initiatives identified Self-management support for long term conditions Falls and bone health, EPP reunions, patient report group Integrated falls and bone health pathway, leaflets, satellite falls and bone health clinics We identified specific projects underway focusing on the different protected groups. 8 Last year’s EDAY and EDS activities have helped our staff to have a better understanding of equality issues and have made them more aware of the different protected groups. This is now helping them to target services and plans to their different needs. There is a lot more to be done to address inequalities and discrimination, but the following outlines some of the work going on. Religion or Belief Acknowledgment of individual beliefs in maternity care Understanding perceptions of cancer among different religious groups OC cancer pilot – raising awareness that if you go to your GIP you will not be wasting your time Sexual Orientation Chlamydia screening Age Flu Chlamydia screening Audiology services Cancer awareness, targeting 55 and under to raise awareness of oesophageal and stomach cancer. Cancer is more common in older people Falls – bone health – wider 65 age group and those on 4 or more medications Mental health programme 0 – 15 years and drugs and alcohol programme for the same age group Incident and serious incident reporting Improved online access, health needs of children Work with sheltered housing and charities to improve access for older adults via referral to healthy living services. Access for children via referrals from parents or schools Following a “Did not attend” audit (diabetes) for the screening pathway- young adults (25-40) where seen to DNA more often. Previously, evening and weekend clinics have been trailed with little improvement in uptake. Health promotion work with schools, nurseries and other venues parents may attend have recently been trialled to see if this improves this age group’s 9 uptake. Pregnancy and Maternity Liaison committee for new mums Patient satisfaction survey Working with St Georges maternity to encourage midwives to refer pregnant women and new mothers to healthy living services Development of a more robust and formal relationship with the maternity providers in SWL regarding DES (Diabetic eye screening) in pregnancy as this is required within the first trimester, at 28 weeks and potentially between 16-20 weeks if the first trimester scan is abnormal. Sex Cancer awareness – oesophageal cancer more common in men than women, sometimes 4 times more Planned work – Healthy Living - health trainers will be targeting work with men’s groups. A potential source is pubs but also certain male dominated work environments could be a point of access. Disability Incident and serious incident reporting Purchase of specialist equipment in maternity unit Cancer awareness – pilot raising awareness of signs/symptoms and to go straight to GP/Pharmacy Audiology services Healthy Living, Footsteps and Health trainers All sites/ screening venues are able to see patients in wheelchairs, although anyone who is unable to sit up is not suitable for DES screening. Work has recently started with the learning disability nursing team to highlight the programme (Diabetic eye screening - DES) to this client group and establish better ways to improve uptake in this group. 10 There is ready access to translators and British sign language interpreters as required and once the programme (DES) is aware of this need, they record it on the patient’s notes and arrange as required. Race Cancer awareness – stomach cancer more common in black women, than women from white backgrounds or other ethnic groups Children’s IAPT Diabetes education – booklet and DVS in different languages (booklet 3 languages and DVD 5 languages) Specific health promotion work has occurred within the Asian community and started with the Somali community to increase awareness, need for diabetic eye screening and improve uptake. The delivery of the Expert Patients Programme in Wandsworth The work going on now is in addition to all the other activities identified last year to embed equalities. The Expert Patients Programme is a self management programme for people living with a long term health condition. The programme is delivered by people from different community settings and backgrounds, all living with a long term condition. In doing so we have been able to embed traditional, religious, cultural and diverse considerations into the programme. This programme is developing as part of the Wandsworth Self management Programme ( WSMP) which is part of PACT ( Planning All Care Together) Wandsworth’s Joint Strategic Needs Assessment (JSNA) The JSNA is an assessment of Health and Social Care needs in Wandsworth undertaken jointly by the Council and the Primary Care Trust (PCT).It offers a systematic method of reviewing the health and well being of a population, leading to agreed commissioning priorities that will improve health and wellbeing outcomes and reduce inequalities." Within the JSNA we outline how equality and diversity will be mainstreamed, and how the specific needs of different communities will be addressed. QIPP Equality analyses being carried out on QIPP activities. Wandsworth Health and The establishment of a health and well-being board. The board is made up of councillors, allied health 11 Wellbeing Board professionals, voluntary sector representation and GPs who have designated strategic responsibilities for public health. Clinical Commissioning Groups The Thinking Partner Group (TPG), Seldom Heard Group partners, Patient and Public Involvement Groups are now working closely with the CCG to ensure that equality and diversity objectives and priorities inform their plans, processes, systems and decisions. The now developed GP locality leads and locality groups are now taking an active role in equality and diversity issues in Wandsworth. Wandsworth CCG’s Strategic Plan (CSP) This is our plan to address the health needs of the population as identified in the JSNA Patient and Public Involvement Strategy Our plan to ensure that patient, carers the public and their representatives are involved and engaged in the business of health commissioning by Wandsworth Clinical commissioning Group Pals and complaints The delivery of a system to ensure that patients and the public are able to redress issues of concern to them directly with the PCT, including making formal complaints. Patients unable to communicate in English have access to translation services and we run PALS events in the localities to ensure seldom heard and under-represented groups have access to our services. The development of Patient Pathways The redesign and re-commissioning of local health services to ensure that all patients have access to high quality care services from the onset of illness, and including where appropriate health promotion and disease prevention activities Patient and Public In November 2012, we also developed and successfully launched our revamped and revitalised Involvement Online Resource online PPI Toolkit http://www.ppitoolkit.org.uk/index.php now aptly called the PPI Resource Centre. Interactive, engaging, informative and responsive, it has been designed to support and help Wandsworth CCG and NHS organisations to engage, involve and inform patients, users, carers, communities and staff from different backgrounds. It is a development tool and can be used in learning events and to educate staff on how best to work with stakeholders to meet the needs of 12 different communities. Involvement and Engagement Log This document outlines the extensive range of activities we undertake to support the development and delivery of services by ensuring that they are informed by both the patients experience and also the involvement of patients in local health matters. This is not only required by law, but there is an increasing amount of evidence which suggests patients health outcomes are better achieved if patients are involved in decisions about their health. The log shows the diverse groups we have engaged and involved in local health matters. PPI Consultations on GP Commissioning We continue to organise events for patients, users, carers, local communities and to encourage participation from the different protected characteristics. We are now looking for ways to diversify the populations we engage in GP forums/working groups. Seldom Heard Groups project We continue to work with Seldom Heard Groups – they have taken a keen and active interest in the work of the Clinical Commissioning Group (CCG). LGB and T programme of activities Following a detailed health needs analysis in LGB&T communities (2009), we have continued our strong working relationship with local LGB&T communities. We continue to be involved with Stonewall and Wandsworth LGBT Forum. Direct working with vulnerable people The Healthy Living Programme is an access function of the Public Health Department that facilitates entry to healthy living services, this could be by coordinating referrals from various sources to Healthy Living providers, or providing a Health trainer service for more vulnerable people to help them overcome barriers to access and build resilience. Health promotion and developing the community to increase resilience The Public Health Promotion and Community Development functions communicate health messages through a mixture of written, visual, physical and interactive information, and work with communities to mobilize resources to improve their well being and care. 13 Evidence to support Equality Performance at Wandsworth CCG Activity/policy/project Explanation Link Wandsworth’s Joint Strategic Needs Assessment (JSNA) The JSNA is an assessment of Health and Social Care needs in Wandsworth undertaken jointly by the Council and the Primary Care Trust (PCT).It is a systematic method of reviewing the health and well being of a population, leading to agreed commissioning priorities that will improve health and wellbeing outcomes and reduce inequalities." http://www.wandsworth.gov.uk/jsna Wandsworth CCG’s Strategic Plan (CSP) This is our plan to address the health needs of the population as identified in the JSNA To be included Wandsworth Health and Wellbeing Board The establishment of a health and well-being board. The http://www.wandsworth.gov.uk/ board is made up of councillors, allied health info/100010/health_and_social_care/ professionals, voluntary sector representation and GPs who will have designated strategic responsibilities for 1231/public_health/2 public health. NHS Wandsworth Single Equality Strategy (SES) Our commitment to ensuring that our services and employment practices are fair, accessible and appropriate for the diverse communities we serve and the workforce we employ. January 2011 – December 2014 Patient and Public Involvement Strategy (1) Our plan to ensure that patient, carers the public and their representatives are involved and engaged in the business of health commissioning by Wandsworth 14 SES 2011-2014 version 1-4 FINAL.doc Clinical commissioning Group Evidence from a workshop and conference demonstrating how we engaged with a wide range of service users including with those whose voices are seldom heard Annual PPI Evidence Logs PPI Activity collated from across the PCT demonstrating how the organisation is engaging with patients and the public PPI newsletters Monthly newsletters informing the public of health activities that they can become involved with. These newsletters are circulated electronically and in paper form to around 1200 contacts in Wandsworth including Community and third sector organisations. This is also evidence to support how we use the CRM to engage with patients and the public and their representatives Expert Patients Programme A series of programmes designed to support people with long term conditions by development self management techniques, along with quarterly reunions to ensure that they are offered continued support from the programme and are able to participate in other PPI activity 15 Notes from Tables combined-2.docx shared participants comments.docx Available through PPI Lead Colin.smith@wpct.nhs.uk EDAY flyer Flyer to promote EDAY event on 29th November 2012. The database of all the evidence we gathered and our grading will be published on 6 April 2013. Equality Analysis Template Newly re-designed template Analysis of all Equality Analysis carried out to dates Analysis of equality analysis Ongoing and further information available through PPI lead. Seldom Held Groups Project Discussions and involvement activities, examples of what we have done to date NHS Wandsworth Public Health Report 2011 The Annual report places a very strong focus on tackling cancer in the locality and amongst under-represented groups PPI consultations on GP commissioning A summary of all the feedback we gathered from discussions with patients, users, carers and community groups around GP Commissioning Stonewall Membership of Stonewall and our submission to the workplace equality Index 16 See: Patient and Public Involvement Strategy (1) 2012 stonewall submission in WORD.docx Working with Wandsworth LGBT Forum Information from their website demonstrating our commitment to working with them http://www.wandsworthlgbtforum.co.uk/pages/h ealth.html Wandsworth Youth Health Jury A Wandsworth young people’s projects that meets monthly in Wandsworth CCG and participates in our work Annual Plan for Youth Health Jury.docx Wandsworth Lay User Group Quarterly meetings with experienced patient representatives who meet to receive presentations on Commissioning and health work and provide feedback to project staff Public Health Community Development Team Regular meetings in the community and ad-hoc events and reporting for JSNA 17 Lay user gp meeting Nov 18th notes.docx 07.08.12 CDC 3 month plan.docx Areas for further development and improvement As an organisation, we continue to improve in equality and diversity and strive to meet the needs of the different protected groups. We also know there is more work needed to ensure equality is fully incorporated into everything we do, particularly as our new commissioning structures and new organisations develop. We need a stronger focus on employment equality issues. We have just completed our staff survey for 2012 and this has highlighted some gaps and challenges which need to be addressed. We also acknowledge the commitment from our senior leaders to equality, but from consultations with our staff and stakeholders, recognise there is more to be done to achieve an inclusive leadership culture. Using the Goals from the Equality Delivery System, we have identified the following areas for improvement. The identified needs will be grouped under a three year strategic equalities plan, currently being developed in partnership with the Thinking Partners Group and our Seldom Heard communities. The plan will be published in April 2013. EDS Goals Priorities to address immediately Goal 1: - Better Health Outcomes for All To gain a better understanding of the health needs of the transgender community – a community we seem hard to reach and whose health needs are often overlooked. Work needed to engage with this group and involve them more in seldom heard activities Increase mental health awareness amongst GPs, particularly and give GPs information and better understanding of the protected groups and their specific health needs – e.g. mental health issues amongst LGBT community Urgent need to mainstream equality and diversity into all areas of GP commissioning activities. Tackling perceptions, beliefs and attitudes about cancer in different communities Men between 40 -60 need to be encouraged to engage with healthcare/services Improve health needs of carers, this is often overlooked COPD and carers, attendance at carers groups meetings to raise awareness of COPD and receive feedback for COPD services Young women getting Chlamydia due to lack of information/education 18 Priorities for years 1 - 3 Supporting GPs to deal with patients who do not have close families and want a friend to be included in their health care Diversifying members of locality patient groups COPD – more focus on elderly and young people A lot of LGB&T people do not want friends and family to know about their sexuality, how is this being addressed within health care Sexual health screen – need to get better at improving health needs of protected groups Prostate cancer in black men, awareness racing is really urgent Total involvement of partners regardless of sexual orientation – GPs and health practitioners need training and support to help them understand needs of LGB&T communities, also how to work better and effectively with this community Informing carers’ families of services for the people they care for Transitions pathway not very Not enough awareness in Community health about E&D and protected characteristics. What are the issues and how to help those communities HIV+ amongst Gay men become more invisible , also in BME communities Goal 2: - Improved Patient Access and Experience Poor attitudes and poor communication amongst front line staff. There is the need to work with GPs and with other commissioned services to ensure their services promote dignity, respect and value for all. Training for staff and good customer care values need to be embedded into all activities. Changing locations of clinical reference group meetings to increase access and participation Training for healthcare professionals to help patients manage their conditions Disseminate easy to read Diabetic eye screening information leaflets which have been nationally produced to learning disability team and general practice. Discuss commissioning of a re-trialling screening clinics at different times to improve uptake amongst young adults Goal 3:- Empowered, engaged and well supported staff Equalities training for all staff, particularly new ones and for CCGs and locality managers Review and assess impact of recruitment policies on different protected groups. To analyse workforce data by different protected groups and publish results. Ensure that all staff from whatever background are able to progress and develop within the organisation at all levels. Training for line managers, plus a major push across the organisation to encourage line managers to do appraisals and PDPs for their staff. This will lead to more staff having equal access to development opportunities Encourage more staff to be involved in planning and decision making activities. Ensure any improvement in employment and workforce activities are shared widely and regularly with staff. This will build 19 smooth to adult services and must be improved Increasing cross cultural working with individuals Creating hubs as a point of informal contact for the young Better engagement of wider community in GP activities/commissioning Improving access to PALS services Improve ways in which people are communicated with Advocacy Practical/physical access More education and training for nursing staff around equality and diversity Exercise, mental health and wellbeing programmes, stress management initiative, management training and a real clarity in roles and responsibilities may be needed Focused drive to address inappropriate behaviours and a policy aimed at removing discrimination, bullying and harassment from patients and the public Future surveys to be monitored by protected groups so there is clearer information about how the organisation’s employment and workforce practices impact on different groups. Staff in the screening service is confidence and staff will be able to see how their feedback is being used to improve policies and practices across the organisation. Training on specific matters, especially those that are increasingly becoming part of our role such as ‘an introduction to the council’s finance and procurement systems. Goal 4:- Inclusive leadership at all levels Goal 4: Equality training for senior managers, in particular GPs/CCG Inclusive Engagement and involvement activities leadership with local communities, seldom heard at all groups and protected groups and more levels visibility in the community Senior managers, decision makers, middle managers to have equality priorities and targets managed by a single manager with cross site responsibility. A recent EQA visit indicated that they are satisfied with local management, although accommodation/estates are too small for comfort. This has been shared with St George’s Chief Executive. Succession planning strategies needed to grow and develop talents Regular communication from senior leaders around how they advance equality and diversity Conclusion Wandsworth CCG has made a strong commitment to improve the health and wellbeing of its patients, users, carers and community groups. It has committed itself to using the Equality Delivery System (EDS) to help involve patients, carers, service users and the public in all aspects of our work as well as accessing a much wider range of communities. Part of this entails valuing the rich diversity of our local community and ensuring their voices and needs inform all the work we do. We also need to ensure our staff and leaders fully embrace our equality values and mainstream equality and diversity into their thinking, policies, decision making and strategies. The work we have done to date will enable us to develop carefully scoped three year objectives to ensure that we continue to value our staff and embrace the values of our community partners. Over the coming months we will ensure that the equality gaps we have identified in our services and work, can have actions placed against them, which will strengthen our ability to provide a fairer and more accessible service. This will also facilitate our ability to listen more carefully to what our community stakeholders tell us and act upon it. We will continue to build on the work of our Thinking Partners Group so that they are able to play a full and participating role in our work and, in part, represent the views, needs and aspirations of the communities we serve. 20