Integrated Business Planning

Incorporating

Equality Delivery System 2 and Workforce

Race Equality Standard

Equality Strategy

2016 - 2018

Foreword As Chair of Lincolnshire Partnership NHS Foundation Trust, I am delighted to introduce the Trust’s Equality Strategy. The Equality Strategy helps us ensure equality and human rights are taken into account when we are providing services to our patients and service users, employing people, developing policies, communicating, consulting or involving people in our work. It also incorporates the NHS Equality Delivery System 2 (EDS2) and Workforce Race Equality Standard (WRES), both of which are important tools in demonstrating how we turn our equalities ambition into meaningful action. I’m pleased that, in the past 12 months, we have made progress in a number of equality areas, including:

Our Board signing up to the Diversity in the Boardroom pledge (August 2015)

Increasing our Stonewall Workplace Equality Index ranking (important, as the only externally assessed measure of equality and diversity for organisations, and a tool which enables us to similarly improve performance across all the protected characteristic strands of the Equality Act)

Holding a race focused Improving Care Through Understanding staff conference in Black History Month (October 2015)

Holding a Lesbian, Gay, Bisexual and Transgender (LGBT) focused Everybody Equal? staff conference in LGBT History Month (February 2016) The Trust Board is committed to further improving our performance against the specific duties of the Equality Act 2010 including through our EDS2 and WRES action plans. I know that workplaces where we feel able to bring all aspects of ourselves – whether as staff, volunteers, or patients and service users – deliver better services. I want LPFT to be a welcoming environment reflecting the very best across all the protected characteristics. This Equality Strategy will help us progress this ambition. Paul Devlin Chair

1. Background & Purpose 1.1 Purpose Lincolnshire Partnership NHS Foundation Trust (LPFT) recognises the importance of ensuring its services are fair and equitable to all. At LPFT the diversity of our staff, service users, partners and any visitors to our services is celebrated. We expect everyone who visits any of our sites, comes into contact with any of our services or works for LPFT to be able to participate fully and achieve their full potential in a safe and supportive environment. We welcome all service users and members of staff inclusive of race, disability, sex, sexual orientation, gender reassignment, marriage and civil partnership, pregnancy and maternity, age, religion or belief. This Equality strategy sets out the Trust’s approach to equality and diversity; both as an employer and as a healthcare organisation providing services. It explains and responds to the Trust’s statutory duties to promote equality amongst groups of people who have specific protected characteristics, as defined by the Equality Act 2010. It supports the legal obligations we have in relation to the Equality Act 2010 and the Equality Duties 2011. We believe that Equality and Human Rights (EHR) are fundamentally important to employment, business plans, service change, service delivery and provision, policies and corporate documents and practices. 1.2 Supporting the Trust’s objectives Lincolnshire Partnerships NHS Foundation Trust’s mission statement- ‘Enable people to live well in their communities’. This Equality & Diversity Strategy is aligned with the wider needs of organisation and strategic direction already established. This strategy contributes towards the following strategies; Clinical strategy 2015- 2020 - Clinical Priority 1 – Working with our stakeholders - Clinical Priority 2 – Lead on service integration - Clinical Priority 3 – Improving access to our services - Clinical Priority 4 – Improving pathways of care - Clinical Priority 5 – Enhancing our clinical environments - Clinical Priority 6 – Developing our people - Clinical Priority 7 – Enhance innovation and research - Clinical Priority 8 – Maximising IM&T for clinical delivery - Clinical Priority 9 – Embed service line management - Clinical Priority 10 – Expand the managed care network (MCN)

Organisational Development and People Strategy 2015-17 Caring and capable

o Services that are proactively planned and reflect the diverse needs of patients with staff equipped with the right skills and competencies. o Workforce planning that identifies and meets the challenges of an aging workforce and skills gap.

Effective o Organisational form and care pathways that centre on need.

High Performing o The recruitment of staff with the right values. o Communicating, engaging and empowering staff to make local decisions for the benefits of patients. o Supporting staff to be healthy at work.

1.3 Audience for this strategy

This strategy has been developed to clarify for all the Trust’s stakeholders – patients, carers, staff, commissioners, providers, suppliers, local voluntary/community groups and members of the public – what they can expect from us in ensuring all people from the nine protected groups and other disadvantaged groups receive the health and care services they need.

2. Where are we now

2.1 Understanding our obligations There are a number of legal requirements and equality-based national guidelines which mandate and guide how the Trust provides services to members of diverse communities. The principal equality drivers include:

Human Rights Act 1998

Equality Act 2010

Public Sector Equality Duty- section 149 Equality Act 2010

The Marmot Review 2010

Health and Social Care Act 2012

Health, public health and social care outcomes frameworks

CQC key inspection questions 2013

The NHS Constitution – revised 2013

Equality Delivery System 2

Workforce Race Equality Standard (WRES)

We have a duty of care to our service users and staff to ensure equality is embedded into everything we do and make changes that improve the lives of those individuals in our care or employed with us. 2.2 Local evidence and insight

Lincolnshire From the census 2011 we know that the recorded population of Lincolnshire is 713,653 people within the county. Lincolnshire has a mix of urban and rural populations and is spread across 2,687 square miles and is made up of seven diverse districts. The population of Lincolnshire is increasing- from the 2014 mid-year estimates the population is estimated at 731,500.

Protected Characteristics Other disadvantaged groups

- Age - Disability - Gender re-assignment - Marriage and civil partnership - Pregnancy and maternity - Race including nationality and ethnic origin - Religion or belief - Sex - Sexual orientation - Carers

- People who are homeless - People who live in poverty - People who are long-term unemployed - People in stigmatised occupations (such as women and men involved

in prostitution) - People who misuse drugs - People with limited family or social networks - People who are geographically isolated - People who are experiencing domestic abuse

Key headline demographics of Lincolnshire from the 2011 Census;

DISABILITY/ HEALTH

94% of Lincolnshire residents rated their health as very good/ good or fair.

Almost 6% of Lincolnshire residents rated their health as bad or very bad.

20% of Lincolnshire residents feel that their health affects their day to day activities with almost 11% reporting a little impact and almost 10% reporting a lot of impact.

MARRIAGE AND CIVIL PARTNERSHIP

Almost 28% of the population of Lincolnshire are single (never married or same sex civil partnership).

51.5% of the population of Lincolnshire are married.

10% of the population are Divorced or dissolved same-sex civil partnership.

8% Widowed or Surviving Partner from a same-sex civil partnership.

AGE

The average age of the population of Lincolnshire is 43.

Almost 21% of the population of Lincolnshire is over the age of 65.

62% of the population are of working age (16-64).

RELIGION

68.50% of the population are Christian.

23.10% report having No religion

7.10% did not state their religion.

ETHNICITY

The largest population in Lincolnshire is White: British/English/Scottish/Northern Irish/Welsh at 93%.

The largest minority population in Lincolnshire is White: other at 4%. Black and minority ethnic population of Lincolnshire is 2.4%.

CARERS

11% of the Lincolnshire population report providing unpaid care with 2.9% reporting this is more than 50 hours per week.

Our Achievements To-Date 2014-2016 The Annual Equality Report provides the update on the progress made around the equality and human rights agenda for the Trust. It is a legal requirement within the Public Sector Equality Duty (PSED) of the Equality Act 2010. Please see the reports for full details. Equality reports and data | Lincolnshire Partnership NHS Foundation Trust Some highlights include;

Procurement of a new interpretation and translation service which includes telephone interpretation, document translation and face to face interpretation all available 24 hours a day, 7 days a week.

Accreditation of training 11 mediators across the Trust.

Achievement of all priority goals set within the EDS2 for 2014/15.

Ranked 123rd out of 397 in the Stonewall Workplace Equality Index 2015. A significant rise of 145 places from 2014.

Ranked 124th out of 415 in the Stonewall Workplace Equality Index 2016. While this is down one place from 2015 we gained seven marks overall and have improved on last year despite the slight decrease in ranking.

Lesbian, Gay, Bisexual and Transgender (LGBT) History month activities- February 2015

Hosted a Film night screening of Pride for staff to celebrate reaching top 150 in the Stonewall workplace Equality Index.

LGBT Quiz- A member of the network devised a quiz to test staffs awareness of LGBT history and current issues.

‘Improving care through understanding’ half day staff conference to improve LGBT awareness.

Staff showed their support to LGBT patients and staff and celebrate the fact that LPFT is an LGBT friendly workplace by taking a photo with a rainbow flag or symbol.

‘Improving care through understanding’ half day staff conference for Black History month focussing on those health issues relevant for the black and minority ethnic communities in Lincolnshire.

Continued implementation of staff network groups

Lesbian, Gay, Bisexual, Transgender and Allies

Disability, Carers and Allies

Lived Experience of Mental Health and Allies

Expansion of Equality Links Network.

NHS Equality and Human Rights Week May 2014 and May 2015- programme of awareness and events during the week.

Co-ordination of a trust wide Anti- bullying week campaign November 2014 and November 2015.

Successful in becoming NHS Employers Equality and Diversity Partners 2015-16. Current ESD2 grading EDS2 is a system for NHS organisations to help improve the services they provide for their local communities and provide better working environments free of discrimination, for NHS staff. EDS2 is mandated in the NHS standard contract from April 2015, and from April 2016 will form part of the CQC’s inspection framework within the well-led section.

The Trust’s EDS2 action plan (see separate action plan) details the Trust’s equality objectives, and is a mechanism to monitor and review these. In line with NHS England’s EDS2 guidance, EDS2 Priority goals were set for 2014/15 and achieved. A review of the achievements of the 2014/15 EDS2 action plan has resulted in a re-assessment of the grades as follows:

Underdeveloped Developing Achieving Excellent

2014-15 1 13 4 0

2015-16 0 8 10 0

Each year progress will be assessed on the delivery of our objectives and formulating new improvements for the future. This will make sure that we are making continuous improvements. Workforce Race Equality Standard (WRES) The WRES is a mandatory part of the 2015/16 NHS Standard Contract requiring all NHS providers to demonstrate progress against a number of indicators of workforce race equality. From the WRES, the Trust is required to submit a specific WRES annual report to the Co-ordinating Commissioner outlining progress on implementing the standard. This will be completed by the Equality and Diversity Lead in conjunction with the main equality annual report that is produced. The WRES has nine metrics, four specifically focussing on workforce data, four from the NHS Staff Survey, and one requiring organisations to ensure that their Boards are broadly representative of the communities they serve.

3. Where we want to be To enable people to live well in their communities, the Trust’s vision for equality is that we have a comprehensive understanding of the needs and expectations of all the people who use our all services, so we are able to ensure people from protected and disadvantaged groups can access, and benefit from, services to the same extent as people overall. The Trust’s strategic goals to achieve this are aligned to those in the national Equality Delivery System 2 and are as follows:

Goals Outcomes Current Grade

April 2015 April 2016 for Consultation

Target 2016/17 Target 2017/18

1. Better health outcomes

1.1 Services are commissioned, procured, designed and delivered to meet the health needs of local communities

Developing

Developing Achieving Achieving

1.2 Individual people’s health needs are assessed and met in appropriate and effective ways

Achieving Achieving Excelling Excelling

1.3 Transitions from one service to another, for people on care pathways, are made smoothly with everyone well-informed

Developing Developing Achieving Achieving

1.4 When people use NHS services their safety is prioritised and they are free from mistakes, mistreatment and abuse

Developing Developing Achieving Achieving

1.5 Screening, vaccination and other health promotion services reach and benefit all local communities

Developing Developing Developing Achieving

2. Improved patient access and experience

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 Developing Achieving Excelling

2.2 People are informed and supported to be as involved as they wish to be in decisions about their care

Achieving Achieving

Achieving Excelling

2.3 People report positive experiences of the NHS Achieving Achieving Excelling Excelling

2.4 People’s complaints about services are handled respectfully and efficiently

Developing Developing Achieving Excelling

3. A representative and supported workforce

3.1 Fair NHS recruitment and selection processes lead to a more representative workforce at all levels

Achieving Achieving Excelling Excelling

3.2 The NHS is committed to equal pay for work of equal value and expects employers to use equal pay audits

Achieving Achieving Excelling Excelling

3.3 Training and development opportunities are taken up and positively evaluated by all staff

Developing Developing Achieving Achieving

3.4 When at work, staff are free from abuse, harassment, Achieving Achieving Achieving Achieving

bullying and violence from any source

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 Achieving Achieving Achieving

3.6 Staff report positive experiences of their membership of the workforce

Achieving Achieving Achieving Excelling

4. Inclusive leadership

4.1 Boards and senior leaders routinely demonstrate their commitment to promoting equality within and beyond their organisations

Developing Achieving Excelling Excelling

4.2 Papers for Board and Board committees identify equality-related impacts including risks, and how these are managed

Developing Achieving Excelling Excelling

4.3 Line managers support their staff to work in culturally competent ways within a work environment free from discrimination

Achieving Achieving Achieving Excelling

TOTALS

0 Undeveloped 9 Developing 9 Achieving 0 Excelling

0 Undeveloped 7 Developing 11 Achieving 0 Excelling

0 Undeveloped 1 Developing 11 Achieving 6 Excelling

0 Undeveloped 0 Developing 7 Achieving 11 Excelling

Gradings are determined by answering the question- How well do people from protected groups fare compared with people overall?

Undeveloped Developing Achieving Excelling If there is no evidence one way or another for any protected group of how people fare or if evidence shows that the majority of people in only two or less protected groups fare well.

If evidence shows that the majority of people in three to five protected groups fare well.

If evidence shows that the majority of people in six to eight protected groups fare well.

If evidence shows that the majority of people in all nine protected groups fare well.

WORKFORCE RACE EQUALITY STANDARD (WRES) The Trust will ensure that our WRES results are compiled and published in line with NHS England’s reporting requirements and that any identified actions to increase workforce race equality across the metrics takes place.

4. Making it happen Full details on how the Trust is implementing these strategic objectives can be found in the Trust’s EDS2 Action Plan and WRES results and action plan which are both annual action plans so that the assessments, grades and plan are current and accurately reflect where work is required and are monitored and reviewed frequently. These are published on the website. Equality reports and data | Lincolnshire Partnership NHS Foundation Trust Meeting the Public Sector Equality Duty (Equality Act 2010) The Trust’s Equality Annual Report is produced for April to March period each year and details the equality activity for each period and the equality objectives for the following year, along with the published data required, meeting the Public Sector Equality Duty (Equality Act 2010). The complete data reports for patients and services users, membership and workforce outline the Trust’s profile against the protected characteristics. The table below details which protected characteristics are collected for which data group.

Clinical Systems (Patients/ Service Users)

Workforce Membership

Age √ all systems √ √

Disability √ all systems √ √

Gender Reassignment Added March 2016

Race √ all systems √ √

Religion and Belief √ all systems √ √

Pregnancy and Maternity √

Marriage and Civil Partnership √ all systems √ Added March 2016

Sex √ all systems √ √

Sexual Orientation √ √

The Trust will continue to analyse the data helping the identification of gaps in provision and ensuring implementation of appropriate actions that encourage equality and diversity. Equality Analysis The Equality Analysis (EA) process is a way of considering the equality effect on different groups protected from discrimination under the Equality Act. This is how the due regard is met from the Public Sector Equality Duty (Equality Act 2010). There are two main reasons;

I. To consider any unintended consequences for the protected groups, and II. To consider whether the change will be fully effective for all target groups.

It involves using equality information and the results of engagement with protected groups, to understand the actual impact or the potential impact of the change. It helps to identify practical steps to tackle any negative risks or discrimination, advance equality and foster good relations. The analysis covers all aspects of the Trust business that involves service delivery or employment practices to service users and staff; it is essential to the Trust, involving everything we do, whether formally written or informal practices, including existing and new projects. For further details please see Equality Analysis Guidance. Building on what we have already achieved Within our achievements to date we plan to build on our success with advancing LGBT (Lesbian, Gay, Bisexual and Transgender) equality (this covers the Gender Reassignment and Sexual Orientation protected characteristics from the Equality Act 2010) for our staff and patients and service users. We are committed to learning from this, and being able to transfer these successes into other areas of equality. This will include;

Senior Visible Leaders who identify within equality area to role model and champion equality for that characteristic.

Multi-agency conferences to raise staff awareness around that equality area.

Board involvement in the staff Networks for designated equality areas.

Staff involvement in staff networks/ equality activities.

2016/17 priority- establish infrastructure for Black Minority Ethnic (BME), Disability and Carer equality. 2017/18 priority- establish infrastructure for different ages and gender equality.

2015/16 2016/17 2017/18

Age √

Disability √ √

Gender Reassignment √ √ √

Race √ √

Religion and Belief

Sex √

Sexual Orientation √ √ √

Marriage and Civil Partnership

Pregnancy and Maternity

Carers √ √

5. Strategy ownership and governance

Board of Directors

Executive Sponsors

of Staff Networks

Operations/Governance

and Quality Group

(Internal)

Equality and Diversity

Lead

NHS Lincolnshire

Equality and

Diversity Council

(External)

Joint

Consultative

Negotiating

Committee

(External)

All Staff (Managers, teams and

individuals)

Staff Networks

(Internal) Equality Links

(Internal)

6. Responsibilities Chief Executive, Chair and Board Members The Chief Executive and Chair have overall responsibility for leading and promoting the equality agenda. Furthermore, the Board will take responsibility for applying, co-ordinating and monitoring the activity. Members of the Board, collectively and individually are responsible for supporting this objective making sure the necessary arrangements are in place to eliminate any unlawful discrimination and to promote equality of opportunity and good relations when carrying out their work. The Board will receive on an annual basis the Equality Annual Report, EDS2 assessment, grades and action plan; and the WRES results and action plan for assurance and approval. As part of the Board’s on-going commitment to equality, and the Diversity in the Boardroom Pledge taken in August 2015, a Director will take lead responsibility for sponsoring a staff network and will commit to attending at least one meeting of that group a year to engage with that group and be able to represent any issues affecting that group at Board level. Senior Management The Associate Director of HR and Leadership, with the support of other executive members will have the responsibility to apply, co-ordinate and monitor all aspects of employment and service delivery in relation to equality. Senior managers will promote and publicise their commitment to equality and role model inclusive leadership and behaviour. Operations Clinical Governance and Quality Group The Equality activity within the Trust will be assured through the monthly operations, governance and quality meetings. This group is a collective of senior managers in the Trust. This group is accountable to the Executive team. This group will monitor all of the equality and diversity for the Trust. Staff Networks The networks are a platform for staff to voice their opinions and support the Trust to improve working practices and services. It is a resource that is invaluable in developing positive outcomes. Staff networks are important as they bring together those working within the organisation to help improve staff engagement within their organisation. Equality Links Equality and Diversity Links help promote inclusiveness within teams. The Equality Links programme is to support the Equality, Diversity and Human Rights agenda for staff and patients/ service users. The purpose of the programme is to promote an understanding of equality and to provide a point of reference for signposting to information and sources of guidance and advice within service areas.

Joint Consultative Negotiating Committee (JCNC) JCNC is the mechanism for consultation and negotiation on all key issues affecting staff employed in the Trust on business plans, management of change and staffing implications of options which face the Trust. JCNC is a joint management and staff side committee. JCNC will monitor and review equality performance of Goals 3 and 4 from EDS2 which are workforce and organisation focused and the WRES. NHS E&D Council for Lincolnshire The NHS Lincolnshire Equality and Diversity Council will oversee and provide a co-ordinated approach to EDS2 implementation within the Lincolnshire region. The group has a responsibility to ensure that NHS organisations have robust strategies in place for implementing EDS2. The Council will undertake a systematic scrutiny and monitoring role of EDS2 assessment, grades and action plans for Goals 1 and 2 which are patient focussed. The mechanisms of this group are currently under review. Equality and Diversity Lead The Equality and Diversity Lead will have responsibility for ensuring the Trust is compliant with its legal obligations and that this strategy is implemented. The Lead will also advise all parties on their roles and responsibilities with regards to equality and diversity. Managers Responsibility Managers and Supervisors will ensure that they and all members of staff in their team are aware of their responsibilities and obligations regarding equality and diversity. This will be managed in line with the Trusts values and behaviour framework. Managers will commit to promoting equality activities within their teams and releasing staff where able to attend events, staff network meetings, conferences etc.

All Staff Responsibility Individuals in particular will ensure that they are aware of their responsibilities and obligations regarding equality and diversity. This will be managed in line with the Trusts values and behaviour framework. Service Delivery We will endeavour to ensure that our services are non-discriminatory, enabling equality of access and provision and meet the requirements under the Equality Act 2010. We will make every effort to prioritise our services and set them according to the health and social care needs of all diverse groups within the Lincolnshire community. We recognise the importance of seeking views from our community and work cohesively to identify and improve our services which work towards improving health inequalities. If any access requirement are identified that prevent someone from accessing the services offered, this should be dealt with in the first instance at a local level and escalated to management if necessary. Workers, Stakeholders, students and volunteers Contractors, agency staff, partners and stakeholders and students on placement within the organisation providing services are required to adhere to the equality principles of the Trust.

Appendix A- definitions What is Equality & Diversity?

Equality of opportunity is about viewing individuals positively and recognising that everyone is different, valuing equally the contribution that an individual’s experience, knowledge and skills can make. Diversity is about appreciating the differences in aspirations, customs and traditions we all have in society.

General Principles The document contains measures under the Equality Act 2010 to ensure as far as possible no one in the organisation discriminates (directly or indirectly) or victimises another person on the grounds of age, disability, gender re-assignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. The legislation covers discrimination on the following grounds: Direct discrimination – occurs when person (A) discriminates against another (B) if, because of a protected characteristic, A treats B less favourably

than A treats or would treat others.

Indirect Discrimination – occurs when: * A applies a provision, criterion of practice (‘PCP’) to B. * A applies, or would apply, the PCP to persons with whom B does not share the relevant protected characteristics. The PCP puts, or would put, persons with whom B shares the protected characteristics at a particular disadvantage when compared with persons with whom B does not share the characteristics. * The PCP puts, or would put B at that disadvantage and * The PCP is not a proportionate means of achieving a legitimate aim.

Associated Discrimination – occurs when person (A) discriminates against another (B) if, because of A’s association with another person who possess a protected characteristic, A treats B less favourably that A treats or would treat others.

Perceptive Discrimination – occurs when person (A) discriminates against another (B) if, because of A perceives that B possess a protected characteristic, A treats B less favourably that A treats or would treat others.

Victimisation – occurs when person (A) victimises another person (B) if A subjects B to a detriment because (i) B does a protected act or (ii) A believes that B has done, or may do, a protected act.