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1
Equality Information Report 2017-18
For further information please contact:
Emdad HaqueSenior Equality, Diversity and Inclusion [email protected] 3688 1121
Final
Our vision: to work together with the Barnet
population to improve health and wellbeing
2
Contents
Introduction S3
About Barnet S4
Our equality and health inequality duties S5-6
NHS mandatory standards S7
Equality Delivery System (EDS2) S8-10
Mandatory Standards S10
CCG Equality Objectives S11
Advancing equality through commissioning S12-14
Our workforce S15
Governance and leadership S16
Inclusive engagement S17
Our providers S18
Forward strategy S19
Appendix 1: Workforce and Governing Body Members Equality
Information including the WRES
S20-34
Appendix 2: WRES Indicators S35
Appendix 3: WRES Action Plan (2017-19) Progress Report S36
3
Introduction
We produce our annual Equality Information Report to demonstrate to our stakeholders how Barnet Clinical Commissioning Group
(CCG) is meeting its duty under the Equality Act 2010. The report also shows the improvements we have made through the delivery of
our objectives against the mandatory standards set out by NHS England including the Workforce Race Equality Standard (WRES),
Equality Delivery System (EDS2) and the Accessible Information Standard. In 2017/18, we refreshed our Equality and Diversity
Strategy for 2018-20 by using EDS2 and we now have an action plan in place for 2018/19 which aims to deliver our equality objectives.
We are committed to commissioning services that achieve the best clinical outcomes for patients and a positive patient experience. The
way we achieve this is by engaging patients, community groups, staff and clinicians in the design and procurement of our services and
by applying innovative ideas. We use every opportunity to listen to our patients, whether through local Patients Participation Groups
(PPGs) or voluntary sector engagement events, or planned engagement throughout the business planning process and ensure their
views reflect in our commissioning decisions.
We aim to improve our equality and diversity performance by delivering on our priorities to meet our statutory duties. Some of these
priorities have been addressed through our North Central London Sustainability and Transformation Plan and going forward, we will
work collaboratively with our partners and providers to address health inequalities.
In July 2017, the Governing Bodies of NHS Barnet CCG, NHS Camden CCG, NHS Enfield CCG, NHS Haringey CCG and NHS
Islington CCG established the NCL Joint Commissioning Committee (‘Committee’). The Committee’s role is to jointly commission the
following services as these are most effectively commissioned collaboratively across the five CCGs:
• All acute services including core contracts and other out of sector acute commissioning;
• All learning disability contracting associated with the Transforming Care programme;
• All integrated urgent care (including 111/GP Out-of-Hours services)
• Any specialised services not commissioned by NHS England.
The new arrangements will help to ensure commissioning and future health services across the NCL system are more joined up,
equitable and co-ordinated for local patients.
This report provides a summary of our activities and there is more information in our CCG Annual Report 2017-18 which can be found
on our website www.barnetccg.nhs.uk
4
About Barnet
Barnet is home to 369,887 residents, based on
a 2016 estimate. The Borough has a higher
proportion of its total population who are aged
over 65 when compared to London. The
number of people aged 65 and over is
projected to increase by 34.5% by 2030, over
three times greater than other age groups.
Barnet’s rising population will place pressure
on all health and social care services, with a
number of implications for health and
wellbeing. Key issues include:
• Obesity and the related conditions for adults,
children and young people;
• Mental health and learning disability;
• Long-term conditions;
• Integrated care;
• Primary care development;
• Diabetes mellitus; and
• Conditions attributable to cold weather
Population and diversity
The population of Barnet is projected to become increasingly diverse, with
the Black, Asian and Minority Ethnic (BAME) population projected to increase
from 38.7 to 43.6% of the total Barnet population. One of the key challenges
will be meeting the diverse needs of these different and growing
communities. Colindale, Burnt Oak and West Hendon have populations that
are more than 50% Black, Asian and Minority Ethnic backgrounds. Over 50%
of all 0-4 year olds in Barnet were from a Black, Asian and Minority
background in 2015 and this is forecast to continue to increase.
There are more children from all Black and Minority Ethnic groups in the 0 – 9
age group, than there are White children. Children and young people in the
10 – 19 age groups are predominantly White. This demonstrates a more
diverse population shift in terms of ethnicity.
Health inequalities
There are inequalities in life expectancy in Barnet by gender, locality/ward and the level of deprivation. Life expectancy at birth in
females (85.0 years) is higher than in males (81.9 years) and overall life expectancy for both the male and female population in Barnet
is higher than the average for England (male =79.4 years, female =83.1 years).
The Garden Suburb ward has the highest life expectancy for both males (84.1 years) and females (88.5 years) while the Burnt Oak
ward has the lowest life expectancy for both males (75.8 years) and females (81.6 years). In addition, the life expectancy gap is wider
and mortality is higher in the most deprived areas compared to the least deprived areas in Barnet. It is clear from international studies
and evidence that people from more deprived groups tend to:
• have higher incidence of cancer;
• be diagnosed later;
• have less treatment; and
• have poorer outcomes
5
Our equality and health inequality duties
Barnet CCG came into being in 2013 through an authorisation process by NHS England which included making it
a duty for the CCG to show ‘due regard’ to the Public Sector Equality Duty (PSED) under the Equality Act 2010
and not delegate it to another organisation. Later on, NHS England introduced more guidance for CCGs on how
to demonstrate compliance and continue making continuous improvement in their equality and diversity
performance (see the diagram below).
Statutory duty
Mandatory Standards
CCG Response
Equality Act 2010
Health and Social Care Act 2012
Human Rights Act 1998
Equality Delivery System (EDS2)
Workforce Race Equality Standard (WRES)
Accessible Information Standard (AIS)
• Equality and Diversity Strategy & Annual
Action Plan
• Equality Information
• Equality and Diversity Working Group
• Assurance from providers through Clinical
Quality Review Groups
• Equality Impact Analysis
Enga
gem
ent
6
General Duty under the Equality Act 2010
The general equality duty, under the Equality Act 2010, requires Barnet
CCG, in the exercise of our 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.
These are sometimes referred to as the three aims, or arms of the
general equality duty. The Act explains that having due regard for
advancing equality involves:
• Removing or minimising disadvantages suffered by people due to
their protected characteristics.
• Taking steps to meet the needs of people from protected groups
where these are different from the needs of other people.
• Encouraging people from protected groups to participate in public
life or in other activities where their participation is disproportionately
low.
Protected characteristics are defined as:
Age, Sex, Disability, Gender Reassignment (Transgender)
Race, Religion or Belief, Sexual Orientation, Pregnancy and maternity
Marriage and civil partnership.
We additionally pay due regard to the needs of carers, seldom heard
groups and vulnerable groups when making commissioning decisions.
Specific Duty
The specific duty requires Barnet CCG to publish equality
objectives at least once every four years and to publish
equality information once a year, demonstrating that it has
consciously thought about the three aims of the Equality
Duty as part of its decision-making process.
The Act also requires that employers with a workforce of
over 150 employees publish information relating to
employees who share protected characteristics. Although
Barnet CCG does not have 150 employees, adopting good
practice, we have included our employee and governing
Body profile as part of this report.
Under the Health and Social Care Act 2012, CCGs have a
duty to:
• Have regard to the need to reduce inequalities between
patients in access to health services and the outcomes
achieved (s.14T);
• Exercise their functions with a view to securing that health
services are provided in an integrated way, and are
integrated with health-related and social care services,
where they consider that this would improve quality,
reduce inequalities in access to those services or reduce
inequalities in the outcomes achieved (s.14Z1);
• Include in an annual commissioning plan an explanation of
how they propose to discharge their duty to have regard to
the need to reduce inequalities (s. 14Z11);
• Include in an annual report an assessment of how
effectively they discharged their duty to have regard to the
need to reduce inequalities (s. 14Z15).
Our equality and health inequality duties (cont’d)
7
NHS mandatory standards
NHS Workforce Race Equality Standard (WRES)
The NHS Workforce Race Equality Standard was developed and
introduced in 2015. Organisations are required to review and report
against nine indicators. The indicators are a mix of NHS staff survey
data and workforce data comparing the experience of BAME and
white staff. It also compares the Governing Body data with the
workforce data and local demography to identify how representative
the Governing Body is compared with the CCG workforce and the
local population. Our first WRES report was published in July 2015,
followed by a progress report that was published in July 2016 with an
action plan. This year we have incorporated the WRES into our
workforce and Governing Body Members report (See our Workforce
and Governing Body Equality Information Report 2017-18).
The Accessible Information Standard means that organisations
providing health or social care need to:
1. Ask people if they have any information or communication
support needs and identify how to meet them.
2. Record those needs in a set way on the patients’ records.
3. Highlight or flag in the person’s file or notes, so it is clear that
they have information or communication support needs and
details of how to meet those needs.
4. Share information about a person’s needs with other NHS
and adult social care providers when they have consent to do
so.
5. Make sure that people get information in an accessible way
and communication support if they need it.
CCGs are exempt from meeting the standard. However, we are
committed to the AIS, and we ensure that whenever we
communicate with the public that we consider the requirements
of the standard. In addition, we will work closely with our
member GP Practices to provide the necessary support to
enable them to meet the requirements of the standard and we
will continue to seek assurance from provider organisations
about their compliance with the standard, including evidence of
how they are planning to meet the standard.
Accessible Information Standard (AIS)
The Accessible Information Standard required all organisations that
provide NHS (including GP Practices) or adult social care to meet
the standard by 31 July 2016.
The aim of the standard is to make sure people who have a
disability, impairment or sensory loss receive information in a way
that they can access and understand, and provide any
communication support they might need. This includes making sure
people receive information in different formats, for example, large
print, Braille, easy read and support such as a British Sign
Language interpreter, deafblind manual interpreter or an advocate.
8
The NHS Equality Delivery System was developed as an equality performance
framework to assist NHS organisations to evidence their compliance with the
Public Sector Equality Duty and embed equality and diversity within the
organisation.
At the heart of the EDS2 is a set of eighteen outcomes grouped into four goals:
1. Better health outcomes for all
2. Improved patient access and experience
3. Representative and supported workforce
4. Inclusive leadership
Organisations are required to grade their performance by using a grading system
as follows:
Red- Undeveloped
People from all protected groups fare poorly compared with the demography of
the borough OR evidence is not available, or if evidence shows that the majority
of people in only two or less protected groups fare well
Amber-Developing- People from only some protected groups fare as well as the
people of the borough.
Green-Progressing- People from most protected groups fare as well as the
people of the borough
Purple-Excelling- People from all protected groups fare as well as all people of
the borough.
EDS2 can help CCGs improve the services they provide for
their local communities; improve the experiences of people
using the services; consider reducing health inequalities in
their locality; and provide better working environments, free of
discrimination, for those who work in the NHS.
NHS Equality Delivery System (EDS2) overview
Meeting the Public Sector Equality Duty through NHS Mandatory Standards
9
Equality Delivery System (EDS2)-grading processes
The CCG uses EDS2 for its equality and diversity planning and implementation and service improvement to advance
equality, as mandated by NHS England. As described in slide 8 the CCG has worked with community interest groups
and carried out an EDS2 grading in 2017-18 which will help determine the priorities for 2018-19 (see the slide on
forward strategy for more information).
Our current performance is based on the grading in 2017-18 and the recent analysis of the CCG’s evidence across
the 4 EDS2 goals and 18 outcomes.
Publishing grades
Grading and action planning
Evidence gathering
Project planning
and engaging
10
Equality Delivery System (EDS2) performance update
Outcome Grade Outcome Grade
1.1 Services are commissioned, procured, designed and delivered to
meet the health needs of local communities
Developing 3.1 Fair NHS recruitment and selection processes
lead to a more representative workforce.
Achieving
1.2 Individual peoples’ health needs are assessed and met in
appropriate and effective ways.
Developing 3.2 The NHS is committed to equal pay for work of
equal value and expects employers to use
equal pay audits to help fulfil their legal
obligations.
Developing
1.3 Transitions from one service to another, for people on care
pathways, are made smoothly with everyone well-informed.
Developing 3.3 Training and development opportunities are
taken up and positively evaluated by all staff.
Achieving
1.4 When people use NHS services their safety is prioritised and they
are free from mistreatment and abuse and mistakes are minimised.
Achieving 3.4 When at work, staff are free from abuse,
harassment, bullying and violence from any
source.
Developing
1.5 Screening, vaccination and other health promotion services reach
and benefit all local communities.
Developing 3.5 Flexible working options are available to all
staff consistent with the needs of the service
and the way people lead their lives.
Achieving
2.1 People, carers and communities can readily access hospital,
community health or primary care services and should not be
denied access on unreasonable grounds
Developing 3.6 Staff report positive experiences of their
membership of the workforce.
Developing
2.2 People are informed and supported to be involved in decisions
about them.
Developing 4.1 Boards and senior leaders routinely
demonstrate their commitment to promoting
equality within and beyond their organisations
Developing
2.3 People report positive experiences of the NHS Developing 4.2 Papers that come before the Board and other
major Committees identify equality-related
impacts including risks, and say how these
risks are to be managed.
Achieving
2.4 People’s complaints about services are handled respectfully and
efficiently.
Developing 4.3 All managers and staff support their staff to
work in culturally competent ways within a
work environment free from discrimination
Developing
Our current performance is based on the grading from 2016-17. This helped us shape our equality objectives in the Equality and Diversity
Strategy 2018-20. In 2017/18 we have sustained our grades and a new grading is planned with the local interest groups and the Council
Public Health for 2018/19, starting with Goals 3 and 4 in June 2018, followed by Goals 1 & 2 in October 2018. This will help us inform our
action plan for 2019/20.
11
Our Equality Objectives in the CCG’s Equality and Diversity Strategy 2018-20 have undergone a series of internal engagement events with staff and
Governing Body members. These objectives are aligned with the national best practice tool EDS2. We have ensured the objectives are based on
Barnet priorities and fully aligned with our CCG and NCL strategic plans. An annual action plan for 2018/19 is being developed and is based around
EDS2 outcomes and local intelligence to deliver these objectives.
CCG Equality Objectives
12
Advancing equality through commissioning
As a commissioning organisation, our aim is to discharge our equality and health
inequality duties through our commissioning functions. There are a number of
ways we currently meet these duties.
Our approach to equality analysis uses a ‘three lenses’ approach to ensure robust
compliance with the equality duty and make the process more meaningful and
effective.
In the next few slides, we have highlighted some of the achievements in 2017/18.
These achievements demonstrate how Barnet CCG delivered its equality
objectives 1 and 2. More information about the achievements can be read in
Barnet CCG’s annual report 2017-18.
In 2017/18, Barnet CCG’s equality focus was primarily around commissioning
services, based on local evidence, and improving access to services for protected
and vulnerable people in the community. This included access to existing services
and any service that was redesigned or newly commissioned.
Our Governing Body, and relevant Committees, have played an important role in
ensuring compliance with our statutory duties by scrutinising business cases and
equality analysis completed by the commissioners.
As sector leader and lead commissioner, Barnet CCG seeks assurance from
Providers on a number of equality policies as mandated by NHS England. This
includes gaining assurance that providers are compliant with the equality duty and
also all NHS mandatory standards (See page 18).
Equality
duty
EngagementHealth
inequality
EqualityAnalysis
Commissioning decisions
13
Advancing equality through commissioning
Equality Objective 1: Commissioning services based on evidence to reduce health inequalities amongst protected and
vulnerable groups.
Barnet CCG aims to work effectively to maximise the local NHS’s contribution to local health and wellbeing. We are here to improve
people’s health, reduce health inequalities and promote prevention and early intervention to support local people to maximise their
personal health and wellbeing. In order to deliver this objective, we engage with, and strive to understand, the needs and wants of local
people and communities.
Key achievements 2017-18
• Across NCL, we have developed our Sustainability and Transformation Plan (STP) to deliver the triple aims of improved health and
wellbeing, transformed quality of care delivery, and sustainable finances as set out in the national Five Year Forward View. Locally as
partners, we have a shared vision, a collective agenda and the commitment to work together in new ways to transform the health
and care services of North London.
• The commissioning and launch of the Dementia Hub in May, in partnership with the Alzheimer’s Society, was a real highlight. The
Hub provides accessible, and much-needed support, in the community for our local residents living with dementia and acts as a focal point to support services across the Borough.
• End of life care: Continuing Healthcare commission high quality care provision for eligible service users at the end of their life. We
continue to work closely with local Hospice teams and District Nursing services to ensure that individuals can receive care in their
preferred place. In 2017/2018, 76% of CHC eligible patients were supported in their preferred place of care at the end of their life.
• A “Red Bag” (important information about a care resident’s health) scheme in care homes was successfully introduced.
• Reconfigured adult community services.
• Streaming of appropriate patients from the Emergency Department to GP surgeries.
• Extended Access service – for 2017/2018 the CCG commissioned an extra 38,000 appointments.
• Building on a suite of locally commissioned services in primary care, Barnet CCG commissioned several new local services to help
meet the changing healthcare needs of the local population.
• Investment was committed to continue commissioning the extended access service to local primary care services.
• Barnet CCG has commissioned CommUNITY Barnet to support its patient and community engagement.
• Through targeted resourcing, and a waiting times reduction programme, Barnet CCG reduced the number of young people waiting
for treatment for over 12 weeks from 119 to 65 and average waiting times from 131 days to 90 days (between 30th September 2016
and 30th September 2017).
14
Advancing equality through commissioning (cont’d)
Equality Objectives 2: Improve access to all services by protected and vulnerable groups
In 2017, we have worked with our partners to engage with the public and begin to implement shared plans to deliver improvements to
health and care and spend money wisely. Some highlights of this include:
Key achievements in 2017-18
• Making it possible for residents to access GP services 8am-8pm through extended access in April 2017.
• Following capital investment of £1million by Camden & Islington Foundation NHS Trust, we opened the Women’s Psychiatric Intensive
Care Unit on 13th November 2017. This will ensure that women that require intensive care in NCL are not placed out of area as a first
response to their crisis and need for intensive care.
• One of the first areas nationally to launch the new integrated urgent care model. This includes:
o Mental Health patients can now ring 111, and be transferred directly transfer to crisis team for advice and support.
o Enables clinical staff to get through to a clinical expert for urgent advice and support by dialling the appropriate number.
• Successful bid for enhanced mental health liaison services in A&E at University College Hospital in 2017/2018, and North Middlesex
University Hospital in 2018/2019.
• Launched a specialist Perinatal mental health service for mums across North Central London, following a successful first wave bid for
national funding.
• Made it quicker and safer for patients to get home from hospital by working at agree standard ways of working and working more
effectively with social care.
• We have worked with CommUnity Barnet and others to ensure these are accessible to everyone who has an interest in the issues being
discussed.
• Involving parents/carers of people with learning disabilities, and other conditions, by collaboratively working with the local authority and
the involvement Board.
15
Workforce
Equality Objective 3: Recruit, support and retain staff from protected groups
WRES
EDS2
Recruitment
Training
Support
Retention
Barnet CCG employs 85 staff from diverse backgrounds (as at 31st March
2018). Our workforce report provides a detailed breakdown of our
workforce activities. Our commitment to advancing workforce equality has
been strengthened by our work with other NCL CCGs, providers and NEL
CSU. In 2017/18 we have:
• Continued attracting applicants from diverse backgrounds.
• Ensured our selection process followed the NHS recruitment
and selection policy and good practice (e.g. ACAS code of
practice)
• Ensured our process of supporting staff with non-mandatory
and CPD courses was fair and have monitored the uptake by
ethnicity.
• Followed the NHS change management policy in our team
restructuring and completed equality analyses, where required,
to ensure ‘due regard’ to the equality duty.
16
Governance and leadership
Equality Objective 4: Strengthen the role of
governance and leadership beyond compliance
CCG Assurance
Equality duty
Mandatory standards
Barnet CCG Governing Body is ultimately responsible for
assuring NHS England that the CCG is compliant with the Public
Sector Equality Duty and is meeting the requirements of the
mandatory standards.
• Barnet CCG Governing Body seeks regular assurance that its duties
are being met and that providers, from whom it commissions services,
are complying with this duty.
• The Equality and Diversity Working Group supports and oversees the
implementation of Barnet CCG’s Equality and Diversity Strategy and is
Chaired by a member of the Governing Body. Membership of the
Group includes Human Resource & Organisational Development,
Engagement, Project Management Office, Equality and Diversity and
Commissioning. The Group is a sub-committee of the Patient and
Public Engagement (PPE) Committee.
• The Group also invites Healthwatch and Public health to discuss
EDS2 grading.
• The CQRC provides the necessary scrutiny on all reports before they
go to the Governing Body.
Clinical Quality and Risk Committee (CQRC)
Senior Management Team
17
Inclusive engagement
Our engagement activities are designed to deliver inclusive engagement outcomes that enable Barnet CCG
to deliver our equality objectives 1 and 2
• Barnet CCG works hard to embed engagement across the organisation and to
work closely with our partners and key stakeholders such as Barnet Council,
Healthwatch Barnet, CommUnity Barnet, the other CCGs in NCL and the Health
and Wellbeing Board. Barnet CCG’s Governing Body Lay Member is responsible
for ensuring effective patient and public engagement.
• When we have targeted audiences for public engagement events, we have worked
with CommUnity Barnet and others to ensure these are accessible to everyone
who has an interest in the issues being discussed.
• The aim of our engagement work is, not only to consult people about the services
they need, but to involve them in co-creating them for the future. A good example
of this is the procurement exercise for Children’s Integrated Therapies
(occupational therapy, physiotherapy and speech and language services)
undertaken in January and February 2018. Young people were trained and
supported to be a part of the panels that scored the bids and interviewed the
shortlisted providers to make a final recommendation.
• Throughout the year, the Learning Disabilities Team made regular visits to the
specialist learning disabilities service to speak to patients as part of contract
monitoring activities. Feedback was used to inform the commissioning approach
and provide assurance.
Case study
In June 2017, we hosted an engagement event attended by 85 delegates, including 29 members of the public and 33 representatives from community and
voluntary sector stakeholders. The event was focused on Care Closer to Home, particularly GP extended access, integrated working and digital services.
The views obtained at this event, along with those we heard at the previous Care closer to Home event in February 2017, were used to develop the CCG’s
Personal Medical Services (PMS) contract Commissioning Intentions for GP services. This included improved access, specifically relating to increasing
the number of bookable online appointments and how more integrated services will be delivered in Care Closer to Home Integrated Networks (CHINs).
18
Our providers
We have a duty to ensure that all our providers are complying with their public sector equality duty and that they are
implementing the mandatory standards e.g. the WRES, EDS2 and Accessible Information Standard.
Below we have listed our main providers and have included an overview of their current performance.
• Barnet CCG seeks regular assurance from its providers through contract monitoring and at the Clinical Quality Review Group (CQRG).
• Based on providers information, Barnet CCG seeks assurance on the progress on their implementation of the WRES, EDS2 and Accessible
Information Standard.
Our main providers
Adopted
WRES
Adopted
EDS2
Published
Equality
Objectives
Published Annual
Equality
Information
Accessible
Information
Standard
Barnet, Enfield and Haringey Mental Health
NHS Trust
www.beh-mht.nhs.uk/equal-opportunities-
and-diversity.htm
Royal Free London NHS Foundation Trust
www.royalfree.nhs.uk/about-us/equality-and-
diversity
Central London Community Healthcare NHS
Trust www.clch.nhs.uk/about-us/equality-and-
diversity.aspx
19
Forward strategy for 2018-19
We have a shared vision and a collective commitment to work together in new ways to change and improve health and care services in North London for
the benefit of our residents. Our main focus in 2018/19 is complying with our equality and health inequality duty. We recognise the challenges facing
Barnet CCG, both in terms of demand for services and diminishing funding, which make it challenging for us to advance equality for all groups in the
community, therefore, some prioritising may be necessary. However, we remain strongly committed to meeting our legal duties by working with our staff,
Governing Body members, the voluntary sector, and all our partners and providers.
•Enhance the ways we undertake equality analysis and how we use the outcomes to inform our commissioning decisions
•Train managers and Governing Body Members
• Implement the WRES Action Plan
•Targeted engagement with local protected groups
•Collaborative working with Public Health and the Health and Wellbeing Board
CCG level
•Work with providers around EDS2 and the WRES and hold them to account
•Work towards harmonising strategic equality objectives across NCL
•Develop systems and process to benchmark work and share good practice
•Prepare for the implementation of the Workforce Disability Equality Standard (WDES)
NCL Level
Priorities
20
Workforce and Governing Body Members
Equality Information including the WRES
Equality Information Report 2017-18
Appendix 1
21
Summary
Under the Equality Act 2010, we are required to publish our equality information to show how we are meeting the public sector equality duty
as a commissioning organisation and an employer. This appendix is part of the equality information report and shows how Barnet CCG has
performed in terms of implementing the Workforce Race Equality Standard (WRES) and Equality Delivery System (EDS2) to meet its public
sector equality duty.
Barnet CCG employs 85 staff (as of 31st March 2017) including 15 office holders who are not employees of the CCG but are on the payroll.
We have included them for WRES purpose only. This is not a large number when divided into different protected groups.
Please note, the race equality data in some indicators is too small to draw any meaningful conclusion as a small change in the
number can change the percentage significantly and, therefore, the percentages need to be treated with caution.
• Barnet CCG has made an improvement in the appointment of BAME staff compared to White staff. For example, BAME staff were three
times less likely to be appointed compared with White staff in 2015/16. This has improved to 1.75 times less likely in 2017/18.
• In 2017/18, there were two staff among the new recruits who declared a disability.
• White staff were twice more likely to access non-mandatory training and Continuing Professional Development (CPD) courses than
BAME staff and the ratio was the same as 2015/16
• There has been an increase in the percentage of BAME staff in Barnet CCG since 2016/17
• There were less than five disciplinary cases over the last two years (2016-18).
• The 2017 Staff Survey outcomes show that BAME staff reported more bulling and harassment from staff, and more discrimination from
colleagues/managers than White staff.
22
Introduction Workforce and GB members Recruitment Staff experience
Background
As part of the Equality Information Report, Barnet CCG publishes its workforce information every year. This is to show how
the CCG is meeting its duty under the Equality Act 2010 in relation to workforce. In addition, Barnet CCG has been publishing
the Workforce Race Equality Standard (WRES) report since 2015. This year we have combined the WRES report with the
workforce diversity report so that we can show how Barnet CCG is performing across all protected characteristics. This will
also help us in our readiness to adopt the Workforce Disability Equality Standard (WDES).
As at 31st March 2018, Barnet CCG employed 85 staff, including Office Holders. This report includes information about our
current workforce and Governing Body Members, recruitment, training and staff survey by protected groups. We have not
included information about gender re-assignment as there is no available data to report and currently the Electronic Staff
Records (ESR) system does not have a category for gender-reassignment.
How we have prepared the report
This report shows how Barnet CCG has progressed against the nine indicators for the period 2017/2018 and includes (where
applicable) a comparison to the 2016/2017 WRES data. The report also contains recommended actions for Barnet CCG to
implement in 2018/19 to improve the CCG’s position about race equality.
To demonstrate how Barnet CCG meets each indicator, data has been collated from several sources, including workforce
data from ESR and TRAC; local demographic data from the 2011 Census as recommended in the WRES guidelines. The
data on recruitment and non-mandatory training and CPD has been gathered from the April 2017 – March 2018 records.
The Staff Survey 2017 WRES questions outcomes have been used for the WRES indicators (5-8)
23
The roles of CCGs in implementing the WRES
Clinical Commissioning Groups (CCGs) have two roles in relation to the WRES; as commissioners of NHS
services and as employers. In both roles, their work is shaped by key statutory requirements and policy drivers
including those arising from:
The NHS Constitution
The Equality Act 2010 and the public sector Equality Duty
The NHS standard contract and associated documents
The CCG Improvement and Assessment Framework
In addition to the NHS standard contract, the CCG Improvement and Assessment Framework also requires
CCGs to give assurance to NHS England that their providers are implementing and using the WRES.
Implementing the WRES, and working on its results and subsequent action plans, should be a part of contract
monitoring and negotiation between CCGs and their respective providers. If there is something amiss with the
providers’ implementation, or use of the WRES and what the results of WRES actually show, CCGs should have
meaningful dialogue with those providers. However, the credibility of the CCG’s relationship with its providers
can only be meaningful if the CCG itself is taking serious action to improve its performance against the WRES
indicators.
CCGs should commit to the principles of the WRES and apply as much of it as possible to their workforce. In
this way, CCGs can demonstrate good leadership, identify concerns within their workforce, and set an example
for their providers. Formally, CCGs are not required by the NHS standard contract to fully apply the WRES to
themselves, as some CCG workforces may be too small for the WRES indicators to either work properly or to
comply with the Data Protection Act. However, neighbouring or similar (comparator) CCGs may wish to submit a
jointly co-ordinated WRES report and action plan; this can counter any potential risk of small workforce
numbers.
Introduction Workforce and GB members Recruitment Staff experience
24
WRES Indicator 1: Percentage of staff in each of the Agenda for Change (AfC) Bands 1-9 or Medical
and Dental subgroups and Very Senior Managers (VSM), including executive Board members,
compared with the percentage of staff in the overall workforce disaggregated by:
• Non-Clinical staff
• Clinical staff - of which
- Non-Medical staff
- Medical and Dental staff
• As mentioned on page five and appendix 2, the WRES indicator has been changed since 2016 and now includes all
clinical and non-clinical staff. Barnet CCG reports its staff data by including permanent staff and those who are on
the payroll but not employed by the CCG (e.g. Office Holders).
• For comparison purposes, Barnet CCG has kept the grouping of the data to Band 1-7, and from 8 to 9 and VSM and
has used a separate category for Office Holders who do not fit under either of the first two categories and are not
staff of the CCG (e.g. Governing Body members who are clinical leads and are on payroll).
• Numbers have been included next to the percentages to show statistical significance.
Race
Introduction Workforce and GB members Recruitment Staff experience
25
2015/16 2016/17 2017/18Performance
compared
with 2016/17
Population(2011 Census)
White58% 59% 56% 3% 64%
BAME29% 32% 27% 5% 36%
Not
disclosed 13% 10% 16% 6% n/a
Workforce by ethnicity compared with local population
The table includes staff and office holders to show the overall commissioning workforce.
16% of the total staff have not disclosed their ethnicity and this is percentage is made up of Office Holders’ number of
non-disclosures (67%). Barnet CCG needs to update this data to ensure greater transparency and clarity.
There has been a small change in the make up of White staff since 2016/17 (-3%), and they appear to be slightly
underrepresented compared with the local white population (64%). The percentage of BAME staff has also decreased
marginally (5%), and appear to be underrepresented compared with the local BAME population (36%).
The disclosure of ethnicity has decreased by 6% since 2016/17 but is greater than the NCL average of 22%.7.
Introduction Workforce and GB members Recruitment Staff experience
WRES Indicator 1: cont’d
Note: Change less than 2% is not shown
26
WRES Indicator 1: cont’d
Bands 1-7Change in %
representationBands 8a -VSM
Change in %
representationOffice Holders
Change in %
representation
Number % Number % Number %
White 13 57% = 30 64% = 5 33% -22%
BAME 9 39% 2% 14 30% = 0% -18%
Not disclosed 1 4% -3% 3 6% = 10 67% 40%
Staff as at 31 March 2018 and percentage changes from 2016/17
The above table shows the percentage changes in
staffing in Barnet CCG and includes Office Holders. The
changes in percentage need to treated with caution as
they may indicate a small, or no, change in the numbers
of staff. Also, it should be noted that a large number of
Office Holders have not disclosed their ethnicity.
Progress summary
White staff in Bands 1-7 – no significant change
White staff in Bands 8a- VSM - no significant change
BAME staff in Bands 1-7 - increased by 2%
BAME staff in Bands 8a-VSM - no significant change.
The number of Office Holders that do not disclose their
ethnicity has increased by 40%. Currently the data is
showing that there are no BAME Office Holders, however,
we know this is not the case.
Introduction Workforce and GB members Recruitment Staff experience
Note: Change less than 2% is not shown
27
Introduction Workforce and GB members Recruitment Staff experience
Breakdown of workforce by protected group as at 31st March 2018 and comparison with NCL CCGs average
Age group BCCG NCL CCGs
Under 31 4% 10%
31 - 40 23% 31%
41 - 50 25% 30%
51 and above 47% 29%
Sexual Orientation BCCG NCL CCGs
Gay 1% 4%
Lesbian 0% 1%
Bi-sexual 0% 0%
Heterosexual 74% 72%
Do not wish to disclose 24% 23%
Marital Status BCCG NCL CCGs
Divorced 1% 5%
Married 66% 46%
Single 29% 41%
Legally Separated 0% 1%
Civil Partnership 0% 1%
Widowed 0% <1%
Unknown 4% 7%
Do not wish to disclose 0% 5%
Disability BCCG NCL CCGs
Yes 6% 3%
No 66% 72%
Do not wish to disclose 29% 25%
Gender BCCG NCL CCGs
Female 80% 70%
Male 20% 30%
Religion/Belief BCCG NCL CCGs
Atheism 11% 15%
Buddism 0% <1%
Christianity 33% 37%
Hinduism 11% 7%Do not wish to disclose my
religion/belief 27% 26%
Islam 6% 5%
Jainism 1% 1%
Judaism 6% 2%
Sikhism 0% <1%
Other 4% 7%
Key highlights• The CCG employs more disabled staff (6%) compared with the NCL average.• Nearly 50% of all staff are over the age of 50 years old.• Female staff represent 80% of the total workforce, compared to 70% across NCL• LGBT staff represent only 1%, compared to 5% in NCL.
28
Introduction Workforce and GB members Recruitment Staff experience
WRES Indicator 9: Percentage difference between the organisations’ Board membership and its overall workforce
2016-17 2017-18 DemographyComparison with local
demography
Comparison with
CCG workforce
GB
Members
CCG
Staff
GB
Members
CCG
Staff
White 55% 60% 67% 61% 64% 3% 6%
BAME 18% 34% 7% 33% 36% -29% -26%
Not
disclosed 27% 6% 27% 6% N/A N/A
Key highlights
• The above information is based on Barnet CCG’s voting
members and staff that are employed by Barnet CCG (excluding
office holders).
• There is an underrepresentation of BAME members on the
Governing Body reported compared with the local BAME
population and the CCG workforce and the NCL CCGs’
average.
Note: Change less than 2% is not shown
Governing Body Members ethnicity data as at 31 March 2018 compared with the local population and the CCG
workforce
29
Introduction Workforce and GB members Recruitment Staff experience
Training WRES Indicator 4: Compare the data for White and BAME staff: Relative likelihood of staff accessing
non-mandatory training and CPD
Note: Change less than 2% is not shown
63%
35%
2%
Non-mandatory training and CPD in NCL CCGs by ethnicity
White BME Do not wish to disclose
Both White and BAME staff have accessed non-mandatory training and CPD in 2017/18. However, as the number of staff accessing non-mandatory training and CPD is very small in Barnet CCG we have aggregated the figures of all NCL CCGs which look more meaningful.
BAME staff in NCL CCGs are almost half as likely to access non-mandatory training and CPD compared with White staff
Introduction Workforce and GB members Recruitment Staff experience
Barnet CCG monitored the diversity information of all new recruits in 2017/18 and the following are some key findings:
Disability: 6% of our total new recruits had a disability
Age: 35% of all new recruits were aged 50 and above
Gender: Female new recruits represent 67% of the total staff recruited in the year.
Sexual orientation: Heterosexual new recruits represent 82% and gay 6%.
Marital status: 47% are married and 35% single
Religion/belief: Most staff were recruited from Christian (26%), Atheist (26%) and Hindu backgrounds (12%)
Race: See the next slide
Barnet CCG follows the NHS Recruitment and Selection Policy and the terms and conditions set out in Agenda for Change. We monitor
diversity data of all applicants who apply for jobs and those who are shortlisted and appointed. However, we do not monitor equality
information of temporary or agency staff. The following data, therefore, is not necessarily indicative of any trend in recruitment but
merely reflects the data of protected groups from 1 April 2017 to 31 March 2018. When recruiting staff we ensure:
• We monitor the diversity data of all applicants
• Our panels are fully trained and are aware of our equality commitments
• We follow the best practice e.g. Two Ticks symbol (positive about disabled people)
31
Recruitment from 1 April 2017 - 31 March 2018 by ethnicity
Ethnicity Applicants Shortlists Appointments NCL CCGs
average
White 354 36% 77 22% 21 27% 19%
BAME 570 57% 86 15% 10 12% 14%
Not disclosed 72 7% 9 13% 3 33%
Introduction Workforce and GB members Recruitment Staff experience
As shown in the above table, we have analysed the
recruitment data on White and BAME staff and
those who did not declare their ethnicity by
comparing the with the BAME applicant data and
the BAME appointment data with the BAME
shortlist data. The same has been applied to
applicant, shortlisting and appointments information
for White staff.
WRES Indicator 2: Compare the data for White and BAME staff: Relative likelihood of staff being appointed from
shortlisting across all posts
In 2017/18 Barnet
CCG employed 44
staff BAME staff were
2.25 times less likely
to be appointed
compared with White
staff. This has
improved from 3
times less likely in
2016/17.
In NCL CCGs, White staff were 1.36 times more likely to be appointed compared with BAME staff
Introduction Workforce and GB members Recruitment Staff experience
Recruitment of staff by protected characteristic (from 1 April 2017 to 31 March 2018
67%
33%
Recruitment by gender
Female Male
6%
82%
12%
Recruitment by sexual orientation
Gay Heterosexual Do not wish to disclose
6%
88%
6%
Recruitment by disability
Yes No Do not wish to disclose
6%
32%
27%
35%
Recruitment by age
Under 31 31 - 40 41 - 50 51 - 60
6%
47%35%
12%
Recruitment by marital status
Divorced
Married
Single
Civil Partnership
Widowed
Do not wish todisclose
26%
26%12%
9%
6%
3%
18%
Recruitment by religion/beliefAtheism
Christianity
Hinduism
Do not wish to disclosemy religion/belief
Islam
Jainism
Other
33
Introduction Workforce and GB members Recruitment Staff experience
WRES Indicator 3: Compare the data for White and BAME staff: Relative likelihood of staff entering the formal
disciplinary process, as measured by entry into a formal disciplinary investigation (This indicator will be based on
data from the most recent two-year rolling average).
50%
40%
10%
Disciplinary cases in NCL CCGs by ethnicity
White BME Do not wish to disclose
Barnet CCG monitors all disciplinary cases based on protected characteristics. Where the number is less than 5, the CCG will not declare the number in this report to maintain the anonymity of the individual/s concerned.
The number of disciplinary cases across NCL is small and this can make a significant difference in the percentage, therefore, the figures provided need to be treated with caution. The 2017/18 data shows that BAME staff were less likely to enter formal disciplinary investigations than White staff. However, when compared with the percentage of staff across the NCL CCGs it appears disproportionate. For example across NCL CCGs BAME staff represent 27% of the total workforce but they represent 40% of the staff that entered into a formal disciplinary.
34
Staff Survey (WRES Indicators 5-8: Compare the outcomes of the responses for White and BAME staff)
Introduction Workforce and GB members Recruitment Staff experience
Staff Survey indicator (WRES) Ethnic Group Barnet NCL CCGs average
Indicator 5- KF 25. Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months
White 29% 13%
BME 10% 13%
Indicator 6- KF 26. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months
White 33% 30%
BME 55% 41%
Indicator 7- KF 21. Percentage believing that trust provides equal opportunities for career progression or promotion
White 67% 74%
BME 33% 27%
Indicator 8- Q17- In the last 12 months have you personally experienced discrimination at work from any of the following? Manager, Colleagues
White 10% 11%
BME 32% 23%
Percentage of CCG staff that said ‘YES’ to the WRES questions in the 2017 staff survey
Figures show staff experience of the CCG compared with their counterparts (e.g. White/BAME).
• More White staff reported that they had experienced bulling, harassment and abuse from relatives than BAME staff.
• More BAME staff reported that they had experienced bulling and harassment from staff compared to White staff.
• More BAME staff reported that they had experienced discrimination from colleagues and managers than White staff.
35
Appendix 2: WRES Indicators
2017 updated WRES include:
Indicators: 1-4- Workforce indicators,
5-8: Staff survey indicators, 9: GB
(Board) Members indicator
The aim of the WRES is to help NHS organisations improve their race equality performance.
The standard is mandatory and CCGs are required to implement them in their own organisations and hold their providers to account.
WRES Indicators
36
Appendix 3: WRES Action Plan (2017-19) Progress Report
Indicator Action Outcome Lead Progress so far1. Percentage of staff in each of the AfC Bands 1-9 and
VSM (including executive Board members) compared
with the percentage of staff in the overall workforce.
(clinical and non-clinical)
Attract applicants from the local
community by publicising jobs
locally.
CCG jobs publicised through
local partners and community
organisations.
Workforce
Lead/Communi
cation &
Engagement
Lead
Action to be taken:
Vacancies are publicised through the communication and engagement team to
local community groups such as Patient newsletters, voluntary action groups,
disability group.
2. Relative likelihood of BME staff being appointed from
shortlisting compared to that of White staff being
appointed from shortlisting across all post (internal and
external)
Provide training to Governing Body
Members and staff on unconscious
bias and recruitment and selection
training.
Ensure, where possible, there is a
BME panel member on the selection
panel for positions in Band 8a and
above.
Likelihood of BME staff being
shortlisted and appointed
increased across all Bands to
a comparable level with White
staff.
Workforce
Lead/OD Lead
• Recruiting staff from BAME backgrounds to sit on interview panels for
certain posts in Band 8A+
• Advice, information and training provided to panel members to ensure
quality and equality of recruitment process.
• Monitoring the data annually which we publish in our WRES progress
report
Further action to be taken:
• Planning on delivering further unconscious bias training/Recruitment and
Selection training to all staff including GB members.
3. Relative likelihood of BME staff entering the formal
disciplinary process, compared to that of White staff
entering the formal disciplinary process, as measured by
entry into formal disciplinary investigations.
Continue monitoring all disciplinary
cases.
Disciplinary cases are dealt
with in a fair and consistent
manner.
Workforce
Lead
All policies including the disciplinary policy are Equality Impact assessed. HR
meet on a weekly basis to monitor/review all ER cases across NCL, Case
numbers are shared with key HR data on a monthly basis with EMT boards. In
addition we work in Partnership with our Union colleagues to map against
protected characteristics and provide data for action planning purposes.
4. Relative likelihood of BME staff accessing non-
mandatory training and CPD as compared to White staff.
Publicise non-mandatory training
and CPD programmes.
Encourage and motivate BME staff
through PDP & objective setting
Take up of non-mandatory
training and CPD increased.
OD Lead • Each PDP is being monitored and a Training Needs Analysis will be
created to produce an organisation OD plan. We will be monitoring training
requests for 18/19 and matching this against who can access and parity of
ability to access
Further Action to be taken:
• All training is advertised in Staff Comms, and Newsletters and the Intranet
• Monitor attendance lists against E&D data
5. Percentage of staff experiencing harassment, bullying
or abuse from patients, relatives or the public in last 12
months.
Continue offering equality and
diversity training
Promote dignity at work policy
through Board Development
Sessions and staff meetings
Celebrate diversity in the CCG to
raise awareness
Monitor all external and internal
recruitment activities
Reduced incidents bullying
and harassment in the
organisation.
More staff should feel that the
CCG is a fair employer
OD Lead • Corporate message about equality, diversity and inclusion highlighting the
CCG’s position and commitment to race equality.
• Staff Involvement Group is set up to take forward actions from the staff
survey results.
• Staff away day has taken place.
• OD leads have been appointed to take forward a OD plan, which include
an organisational training plan.
• WAP process to ensure all post are signed off and advertised
appropriately in NCL.
Further action to be taken:
• Training being rolled out across NCL for managers and staff re B&H
6. Percentage of staff experiencing harassment, bullying
or abuse from staff in last 12 months
7. Percentage believing that CCG provides equal
opportunities for career progression or promotion.
8. In the last 12 months have you personally
experienced discrimination at work from any of the
following: Manager, Team Leader, Other Colleagues
9. Percentage difference between the organisation’s
voting membership and executive membership of the
Board
Continuously review the makeup of
Governing Body voting members to
ensure race equality.
Update GB members ethnicity data
GB voting members reflective
of the staff and local
community.
Workforce/CC
G EMT
• The CCG is working to ensure the GB members reflect the community we
serve, and we are updating the ethnicity data across NCL every year to
monitor that.
• We will look to review Board composition and action plan against %
difference