Overview

From April 2007 amendments to the Sex Discrimination Act 1975 will require public authorities to comply with a general duty to eliminate discrimination and harassment and to pro-actively promote gender equality.

 

This general duty comes into effect on 6 April 2007 and applies to all functions of NHS organisations, as service providers, policy makers and employers, and to any services and functions which are contracted out.  The general duty also applies to charities, voluntary and private sector organisations which are carrying out public functions on behalf of the NHS, such as GPs under contract to a Primary Care Trust (PCT). 

 

Some key features of the legislation include the need for NHS Trusts to:

·          draw up and publish a scheme identifying specific gender equality goals and showing how it will implement them;

·          develop and publish an equal pay policy statement; and

·          carry out gender impact assessments to establish the impact that new policies and services may have on women and men, and allow any negative effects to be mitigated.

 

Specific duties

Specific duties have been introduced to assist public authorities in planning, delivering and evaluating their activities to meet the general duty, and report on those activities.

 

The specific duties require organisations to:

·          prepare and publish a Gender Equality Scheme (GES) showing how they intend to fulfil the duties and setting out gender equality objectives, no later than 30 April 2007;

·          prepare the GES in consultation with employees, service users, and others including Trade Unions. To take into account any relevant information gathered as to how their policies and practices affect gender equality and within overall objectives, to consider the need for objectives to address the causes of any gender pay gap.

·          ensure the GES sets out the actions the organisation has taken or intends to take to:

-           gather information on the effect of its policies and practices on men and women, in employment, services and performance of its functions

-           use the information to review the implementation of the scheme objectives

-           assess the impact of its current and future policies and practices on gender equality

-           consult relevant employees, service users and others (including trade unions)

-           ensure implementation of the scheme objectives.

·          implement the GES and any actions for gathering and using information within the three year life of the scheme;

·          review and revise the GES at least every three years; and

·          report annually on progress.

Step one – Laying the foundations

Senior Leadership

Ensure that the scheme has commitment from the highest level of the organisation. A good way of demonstrating this is for your Chief Executive to provide an introduction endorsing the action plan and emphasising the commitment and active participation of the Board in making it work. See NHS Board Guide for more details.

 

Steering Group

Appoint a steering group at senior level to oversee the creation and implementation of the Gender Equality Scheme (GES) with ownership at board level. It’s important to make sure that this work is in sync with the mainstream business functions of the organisation.

 

Diversity Teams

Appoint diversity teams at each level and in each section of the organisation with devolved responsibilities for feedback of progress into directorates.

 

Ownership

Ensure that staff are made aware of the duty and what it means to them in their everyday working environment with colleagues and service users. 

 

Expertise

Those working on implementation should have real expertise on the issues involved, this can be built up over time, but you could consider employing experts to impart their knowledge to relevant staff.

Step Two – Gathering Data

Gather robust data on the gender profile of service users and employees.  It may be that existing systems already give that information, but it will need to be disaggregated to include information on service user needs, satisfaction and outcomes by gender.  You should use both qualitative and quantitative data as this will ensure that you have robust evidence on which to base your action plan.

 

Quantitative Research

Quantitative data can be analysed to make comparisons between the experiences of men and women (including transsexual people) and draw precise conclusions.  It can also give a good and quick indication of where problems in service delivery may lie. For example, analysis of customer surveys could give the numbers or percentage of men or women satisfied or dissatisfied with a particular aspect of service. 

         

Qualitative Research

This type of research gives much more detail of people’s experiences, and it can reveal issues that may have otherwise been overlooked. It gives people the chance to be much more actively involved by giving them the opportunity to tell of their experiences in their own words.  Qualitative research includes interviewing people face to face, using written transcripts from focus groups, information from websites and information captured from observation.

 

Some of the areas where the Equal Opportunities Commission suggests information could be gathered includes:

·          Existing national research which indicates the major gender issues in your area of work.

·          The different impact which your core business and service provision has on women and on men.

·          The extent to which women and men use your services, satisfaction rates, and any information you can collect on who is not using your services when they might be expected to do so and why.

·          Differentials in service outcomes.

·          The gender profile of your staff, including data on recruitment, promotion, the distribution of women and men in the workforce by seniority and by types of work, harassment, an analysis of training opportunities, grievance and disciplinary procedures, and redundancy. Remember part-time staff, and those with caring responsibilities.

·          Return rates of women on maternity leave and whether they are returning to jobs at the same level of responsibility and pay.

·          Issues and barriers affecting transsexual staff and potential staff.

·          Information on the size and causes of the gender pay gap in the organisation, including the impact of occupational segregation, of pay discrimination and of women’s disproportionate share of caring responsibilities.

 

Data Protection Act

It’s essential to work within the principles of data protection and human rights. If you collect data on individuals, it must be held securely and confidentially, and will be subject to data protection laws. You should inform individuals:

·          about who will process their personal data and for what purpose

·          whether it is intended to disclose any of this information.

This is particularly important in relation to sexual orientation and transsexual women and men. 

 

You should also consult with representatives of affected groups, such as transgender support groups, or any relevant agencies before embarking on data collection.

Step Three – Consultation

Consult with service users and employees when deciding on priority actions, as these are the people that are going to be affected by the outcomes. This is especially important where one sex is under-represented in the formal decision-making processes of the organisation. Involving staff and service users will also facilitate transparency and awareness of intended actions.

In cases where either women or men have been under-represented or disadvantaged by a function or policy, you should consider arranging a single sex consultation and make an effort to encourage the affected group to participate. This is especially important where a minority group has experienced multiple disadvantages, for example, on the grounds of ethnicity and sexual orientation.  

 

You should also hold a separate consultation with the transsexual community. This can be achieved by consulting with:

·          staff networks

·          transsexual support groups

 

Existing forums and networks can be used to consult on gender equality goals.  Staff opinions can be sought via networks groups, trade unions and staff surveys.  However, to get a truly representative range of opinions you will need to consult with groups who may have experienced specific disadvantages, such as:

·          disabled women

·          men and women from ethnic backgrounds

·          single mothers and fathers

·          men and women with caring responsibilities

·          older employees and service users

Step Four - Impact Assessment

The first stage of an impact assessment is called screening. This is where you identify whether or not any new policies, processes, proposals or functions have a negative impact on gender equality.

 

You should first identify the main aims of the policy, then collect information on how the policy will be implemented, which groups it is likely to affect and what the likely outcomes are, if any.  Some questions to help with the process are:

·          Do you have evidence that women and men have different needs, experiences, concerns or priorities relating to the issues addressed by the policy?

·          What proportions of men and women are affected by the policy?

·          If more people of one sex are likely to be affected by the policy, does that fall in line with the policy objectives?

·          If the policy has a specific outcome, is there evidence that the outcome will be different for men and for women?

·          Where there is a difference in impact on women or on men, or on particular groups, how serious is the disadvantage likely to be?

·          Could the policy unintentionally disadvantage people of one sex?

 

If you identify a negative impact, you could either act to remedy the situation or conduct a full impact assessment to better determine the causes of the impact.  If the impact of the new policy or function is not seen as relevant to gender equality, this should be noted and the evidence to back up the decision recorded. 

 

Assessments must be carried out in an open and transparent way, and in consultation with relevant stakeholders. Systems should be put in place for identifying what information was used and how it influenced any decision.  The results of impact assessments must be published and the process of obtaining the results is open to public scrutiny.  View further advice on carrying out impact assessments.

 

All current policies, processes and functions must be continuously monitored and reviewed for relevance to the duty. The GES needs to include information on how existing policies will be assessed for relevance and how they will be prioritised in order of relevance to gender equality. In addition, your will need to produce a timetable to show when assessments will be completed within the three-year lifetime of the GES.

 

Once organisations have found policies that are relevant to gender equality, they will need to give them a priority rating. This in turn will inform the high priority objectives in the GES action plan.

 

Assessment of outsourced services

Managers who are responsible for procurement need to ensure that the services they are buying are also assessed for any relevance to gender equality, including ensuring that the contractor has measures in place to meet the gender equality duty.

 

If a contractor is not delivering the NHS service directly, but providing services on behalf of an NHS organisation, the NHS organisation is obliged to comply with the Duty. This means that the organisation will need to build gender considerations into the procurement process.

 

Therefore you must review all current contracts to assess any adverse impact on gender equality.

Step Five - The Gender Equality Scheme action plan

The Gender Equality Scheme action plan outlines the steps that your organisation intends to take to meet the general duty over the period of the GES.

 

It is a legal requirement to set and implement clear objectives towards promoting gender equality, outlining steps for achievement and setting a realistic timetable for meeting the objectives.

 

The main reason for having an equality scheme and action plan is to bring about a culture change throughout the whole organisation, therefore the action plan should identify specific, achievable outcomes for staff and service users which will facilitate this change.

 

Any decision on goals or actions should be decided upon in consultation with employees and service users, and details of how and why decisions have been made should be clearly stated in the action plan.

 

When setting your priorities, you will need to take into account national gender equality priorities, set by the Department of Health. Synchronise your annual business planning process with the development of your gender equality action plan. This should ensure that thinking on gender equality priorities takes place across the whole organisation, and that the highest level policy-making in the organisation pays due regard to the gender duty.

 

In deciding priorities for action, consider resource implications – a really significant and deep-seated inequality may take enormous staff and cash resources to correct, but if it is clearly a gender equality issue, then it must be addressed.

 

You may find it useful to divide the action plan into separate sections where different teams within the organisation have discrete areas of responsibility. This will help you to implement and monitor the plan, for example, divide employment and service delivery sections.

 

An effective action plan should include:

·          proposals for collecting information on the effect of the organisation’s policies on men and women, in employment, services and performance of its functions

·          proposals for using this information to review implementation of the scheme’s objectives

·          proposals for addressing issues found to be a high priority during assessment of present functions and policies

·          proposals for addressing disparities in service evident from consultation with staff and service users

·          proposals for monitoring all policies and functions where implications for gender equality have been identified

·          proposals for carrying out impact assessments, with timescales for completion

·          proposals for future consultation with relevant groups, both inside and outside the organisation

·          proposals for training staff on the requirements of the gender equality duty

·          proposals for publishing results of monitoring, impact assessments and progress against objectives

·          proposals for making information available to staff and the public

·          a timetable for taking the work forward, including clear outcomes

·          an indication of resources needed to take actions forward

·          an indication of responsibilities for taking actions forward, and who will be ultimately accountable

·          an outline of proposed objectives to address the causes of any gender pay gap

·          proposals for implementation of the objectives within the three year life of the scheme.

Step Six - Monitoring the action plan

You will need to monitor the Gender Equality Scheme action plan to ensure that it is working.   Arrangements for how progress will be monitored need to be set out in the scheme, as well as a statement of how monitoring information will be used to inform future Gender Equality Schemes.

By monitoring services you will identify gaps in provision and help the organisation to use resources more effectively. 

 

Monitoring is made easier when it is clear where responsibilities for implementing the action plan lie.  A process can be set up for each implementation team to report progress on a quarterly basis.  Another way is to use existing auditing processes, such as disciplinary and grievance management policies for staff, to monitor progress on employment functions.

You should consider how the organisation will measure success.  This could include the setting of gender equality performance objectives for managers, supervisors and clinical leaders.

Step Seven – Publishing your Gender Equality Scheme

The regulations do not specify how the gender equality scheme should be published.  You may consider publishing it as part of your annual business plan; as part of an annual report or diversity strategy; as part of a Single Equality Scheme; or as a stand alone document.

 

The only requirement is that the scheme should specify clear gender equality goals and outcomes, and give details of what actions will be taken to meet the goals and how progress will be monitored.

 

The scheme should be accessible to all employees, service users and stakeholders, and made available in various formats on request.  Consulting with stakeholders will determine how people would prefer to see the scheme published.  It would normally be posted onto a public website, but some users may prefer hard copies.

Step Eight - Reporting progress

Progress on the action plan needs to be reported at least once a year. This can be done through existing reporting methods. In addition the results of impact assessments should be reported as they are carried out.

 

In the case of the workforce, reporting progress may include providing regular updates for staff on the internal website, and through staff notices or newsletters. Information can also be cascaded via staff network groups.

 

When informing service users and the general public of progress and results of impact assessments and monitoring, it is also important to consider the needs of all groups so that the information is readily accessible to everyone.

 

It is good practice to publish progress reports in line with the business planning cycle so that they can inform and be informed by the process.

Step Nine -Implement the scheme and action plan

Within the three-year period of the Gender Equality Scheme, you should implement:

·          the actions for gathering and using information; and

·          the objectives in your scheme.

Unless there are situations where this is unreasonable or impracticable.

Step Ten - Review and revise the scheme

Review the GES every three years in order to set new goals.  This helps to  assess progress and consider whether the desired gender equality outcomes are being achieved, and where efforts should now be concentrated. 

 

As with setting up the initial GES, staff and service users should be involved in the process, and evidence gathered on forthcoming and existing gender issues within the organisation.

 

It is good practice to conduct reviews in line with the business planning process

Addressing the gender pay gap  

Under the general duty there is a need to eliminate discrimination that is unlawful under the Equal Pay Act. You will therefore need to set objectives that address the causes of any differences between the pay of men and women that are related to their sex.

 

Information gathered on gender equality in the workforce and the results of assessments of policies and practices, in consultation with employees and trade unions, should help to determine whether these policies and practices are a contributory factor in any gender pay gap. From this information, you should be able to decide if there is a gender pay gap, whether pay objectives are needed, and if so, the relative significance of the three main causes (below) in setting the pay objectives.

 

The gender pay gap is determined by calculating women’s overall average pay as a percentage of men’s.  The main factors which contribute to this gap are:

·          discrimination, including pay discrimination (which is often inadvertent, but nonetheless unlawful).

·          the impact of women’s disproportionate share of caring responsibilities (which often results in women undertaking part-time work which is often poorly paid and often restricts career continuity and progression).

·          the concentration of women in particular occupations (occupational segregation) usually characterised by lower levels of pay than in those numerically dominated by men.

 

You will need to show that you have considered the need for objectives to address the gender pay gap, and if these objectives are not included, reasons for this must be given to avoid non-compliance action.  It may be that you have determined that no pay gap exists within your workforce, but if so, then hard evidence will have to be provided to back this up.

Further information and guidance

·          The Department of Health have produced a document 'Creating a gender equality scheme - A practical guide for the NHS', which gives practical best practice guidance on how NHS organisations might produce a Gender Equality Scheme.

·          The Equal Opportunities Commission website includes some practical advice and guidance, including the Code of Practice on the Gender Equality Duty.