The challenges

The main challenges faced by the group and lessons learned were tested at workshops, focus groups and seminars to ensure that they were robust and relevant to others in the forthcoming round of re-organisation.

These are outlined as follows:

• The perception of equality and diversity as a low priority
  The opportunity over the past three or four years to embed equality and diversity into the culture of the organisation has at times been missed, as a result of so many different pressures.
• Mainstreaming equality and diversity
  Equality and diversity are often regarded as the responsibility of the Human Resources department and allocated to relatively junior staff.
• The need for objective evidence that action on equality and diversity can make a difference
  Some PCTs, have been able to reconstruct existing data to match the configuration of the new organisation, but most started from scratch.
• Recruitment and retention challenges
  Some of these were associated with low awareness among prospective employees of these new organisations. In particular, our group of PCTs reported that recruitment of young people is often difficult.
  In addition, in order to attract recruits into primary care, PCTs offer flexible working, particularly part-time working to many staff. However, part-time employees are often not given access to the training and continuing professional development available to their full-time colleagues.
• A dispersed and disparate workforce
  In a PCT where people from ethnic minorities are few, equality and diversity are often not regarded as a priority. This is of particular relevance to PCTs where the workforce is dispersed, with many working in small teams. In practice, the small numbers make equality and diversity greater issues - differences in ability, gender, age, religion and sexual orientation are as important as visible aspects of ethnic diversity.
• Securing meaningful community involvement
  This is essential to determine the profile of services to be provided.
• Violence in and from the community
  PCTs have a legal responsibility to provide a safe and secure working environment. This is more difficult where staff are working remotely, either on their own or with a partner. Physical and verbal abuse of staff is on the increase. Some NHS Trusts have even been forced to withdraw treatment from some patients.
• Using influence and resources
  PCTs have responsibilities to ensure that equality and diversity are embraced by those from whom they procure services. This role will increase with the move towards commissioning services.
• Partnership working and shared services
  Many PCTs have benefited from establishing partnerships. Typical advantages include pooling resources to recruit an equality and diversity specialist to provide advice and support to a number of PCTs; economies of scale in shared recruitment exercises; benefiting from the greater experience of another organisation.