NHS London
Lewisham Primary Care Trust (PCT) is responsible for providing health services to over 265,000 Lewisham residents following the restructuring of PCTs in 2002.
Lewisham PCT provides a full range of primary care services, as well as commissioning hospital, mental health and other specialist services for the Lewisham area.
The PCT also provides services which operate as an arms length Adult, Children and Young People's Health Services Directorate. These are commissioned and performance managed in the same way as the hospital and mental health services, to ensure that all services are monitored in terms of quality and value for money.
As a public body, Lewisham PCT recognised that it has a duty to eliminate discrimination and promote equality across all of its functions, including its health services and employment practices.
Discussions between key local organisations resulted in a borough-wide commitment to develop a single equalities framework. This would support each individual organisation's requirement to develop and publish their own schemes and to enable them to work collectively, with the community, to promote equality and access to services and employment.
Lewisham PCT developed an initial framework that was then used to communicate to staff and to initiate developing its Single Equalities Scheme (SES), ensuring that it included both the new legislative requirements and the agreed priorities of the statutory partners.
The first step was to establish the business case for establishing an SES. The trust identified that the SES would:
- ensure that it is legally compliant primarily on race, disability and gender
- enable the trust to streamline its approach to equality, recognising that activities cut across equality dimensions, and to make links between equalities and other key business areas eg. health inequalities and commissioning
- provide an important lever for change in terms of highlighting inequalities in accessing services or possible discriminatory practices in delivering services
In establishing its framework for agreeing an SES, the trust discussed and agreed the framework's four key areas (outlined below): the overarching aims, priorities, objectives and desired results.
Area one - the trust identified two overarching aims:
- reduce inequality and eliminate unlawful discrimination in aspects of the planning, development, resourcing, commissioning and delivery of local health services
- to promote equality of opportunity whilst valuing diversity, both among employees within the trusts and across communities within Lewisham
Area two - the trust agreed the following priorities:
- target action on health inequalities
- embed equality impact assessments in the organisation
- ensure equity is a key strand when commissioning services
- improve data collection to monitor key diversity areas
- ensure equality in staff recruitment, selection, retention and progression
- build staff awareness and capacity to deliver services equitably
- engage with local communities when developing the SES
Area three - the trust agreed the following objectives:
- jointly deliver a borough-wide health inequalities strategy and action plan with local partners
- incorporate equality impact assessments into the planning, development and review processes
- embed the reduction of health inequalities and the promotion of equity into the annual commissioning strategy, commissioning decisions and commissioning arrangements
in partnership with local healthcare providers, improve the quantity, quality and effective use of equality data in primary care
- ensure equality of opportunity in the recruitment, selection and appointment processes, as well as workforce development and support schemes
- ensure that the PCT's commitment to delivering equality is embedded into individual and organisational training and development plans
- involve and engage equality groups and the wider community in developing the SES
Area four - the trust identified the following key strategic outcomes to ensure that the SES remained outcome based:
- There is a substantial reduction in health inequalities across the borough, both in terms of access to health services and health outcomes
- Equality Impact Assessments are routinely carried out on all new and reviewed polices, strategies, services and functions. Any emerging action plans are appropriately progressed and performance against each action plan is annually reviewed
- Clear demonstration to stakeholders, workforce and residents how health intelligence on inequalities and the needs of local communities has informed service provision and delivery
- Produce accurate data on service users, enabling the trusts to produce robust and timely information on the health, health needs and health outcomes of communities
- The diversity of the workforce reflects the diversity of the local population at all levels
- Trust employees are operating at, or where appropriate above, level 2 of the Knowledge and Skills Framework ( KSF) for equality and diversity
- There is an equally high level of user satisfaction with local health services and no significant difference in the numbers of complaints across all communities
- Business case for adopting an SES is successfully communicated across the organisation
- Successful integration of both workforce and service delivery within the proposed schemes and business planning
- Commitment to identifying fewer but more specific actions under each priority
- One or two health areas successfully identified for each equality dimension and related to existing health inequalities.
- This will focus on access to, and delivery of, primary care services. It will have clear links to how each directorate contributes to reducing inequalities and promoting equality in each health area
- Partnership working in place across the borough
- Key workforce requirements of the SES is embedded within the learning and development of the organisation, through KSF and Equality Impact Assessments
- The structure for the SES is successfully communicated to staff and service users
- Equality and diversity training is mandatory and refresher training is carried out via team meetings
- Recognition of the trust's long term commitment to equality and diversity, evidenced in the three-year action plan, which is reviewed annually
The equality and diversity team to seek the views of the trust's management team on the proposed priority areas and strategic objectives. They will also work with the management team to look at the suggested processes for monitoring and reviewing the SES, and how the trust can best performance manage its progress on equality.
This is being supported by a review of membership of the corporate equalities group and building links with key statutory bodies.
Donna Carr, Public Health Programmes Manager, telephone 020 7206 3266 donna.carr@lewishampct.nhs.uk