E&D Legislation

The Equality Act 2010 brought together previous and separate pieces of anti-discrimination legislation into one Act of Parliament. The Act covers the following “protected characteristics”:

• age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex and sexual orientation.

It consists of a general duty and specific duties for public sector organisations. The Public Sector Equality Duty came into force in April 2011. It requires GCCG, in the exercise of its functions, to have due regard to the need to:

• Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act.
• Advance equality of opportunity between people who share a protected characteristic and those who do not.
• Foster good relations between people who share a protected characteristic and those who do not.

As a public body GCCG must publish information to demonstrate how we fulfil these requirements.

Find out more via the gov.uk website.

The Equality and Human Rights Commission sets out guidance for employers on all areas of human resource management practice. See here for more information.

The Health and Social Care Act 2012 enshrines in legislation for the first time, explicit duties on the Secretary of State for Health, NHS England and CCGs to have regards to the need to reduce health inequalities in the benefits which can be obtained from health services. The duty on the Secretary of State extends to functions in relation to both the NHS and public health. The duties on NHS England and CCGs incorporate both access to, and benefits from, healthcare services.

Clinically-led commissioning – the Act puts clinicians in charge of shaping services. A number of CCGs’ key responsibilities are directly designed to help reduce health inequalities these include:

• Promoting integration – NHS England and CCGs are responsible for promoting better integration of health services with health, social care and other health-related services, where this would improve service quality or reduce inequalities.
• Quality reward – NHS England is able to reward CCGs for providing high quality services, for improving outcomes and reducing inequalities
• No decision about me, without me – NHS England and CCGs are required to involve the public in the planning of commissioning arrangements and proposals to change those arrangements and decisions affecting them. (adapted from DH factsheet C2 provides details regarding health inequalities and the Health and Social Care Act 2012)
• New innovative services – the act enables providers, including the independent 3rd sector, to develop innovative services to tackle complex problems such as health inequalities

Further information is available here.

Public sector organisations also need to have due regard to the Human Right Act 1998 [HRA]. There are five principles of human rights which are: fairness, respect, equality, dignity and autonomy, called the FREDA principles which also form part of the NHS Constitution.

In commissioning and delivering services which are compatible with the HRA, the CCG commits to undertaking human rights based approach in line with PANEL principles: Participation, Accountability, Non-discrimination, Empowerment and Legality.

Further information is available here.

The United Nations Convention on the Rights of the Child (commonly abbreviated as the CRC, CROC, or UNCRC) is a human rights treaty setting out the civil, political, economic, social, health and cultural rights of children. The Convention defines a child as any human being under the age of eighteen, unless the age of majority is reached earlier under a state’s own domestic legislation.

Article 12 of the convention states that ‘parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child’.

Further information is available here.

The NHS constitution revised in March 2012 contains seven principles that guide the NHS as well as a number of pledges for patients and the public. A number of these demonstrate the commitment of the NHS to the requirements of the Equality Act and the Human Rights Act.

The first of the seven principles requires that the NHS “provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief, gender reassignment, pregnancy and maternity or marital or civil partnership status”.

There are also a number of rights contained in the constitution which underpin the NHS’s commitment to equality and human rights and which include:

• the right not to be unlawfully discriminated against in the provision of NHS services including on grounds of gender, race, disability, age, sexual orientation, religion or belief, gender reassignment, pregnancy and maternity or marital or civil partnership status.
• the right to be treated with dignity and respect, in accordance with your human rights.
• the right to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this
• the right to accept or refuse treatment that is offered to you, and not to be given any physical examination or treatment unless you have given valid consent
• the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.

Further information is available here or via the constitution page of our website here.

The NHS Equality Delivery System 2022 is an accountable improvement tool for NHS Organisations in England. Updated EDS Technical Guidance was published August 2022. This is the third version, commissioned by NHS England and supported by the Equality Diversity Council and is a simplified version of EDS2. The EDS comprises eleven outcomes spread across three Domains:

Outcomes are evaluated, scored, and rated using available evidence and are designed to provide assurance or point to the need for improvement. We have recently assessed our position for 2022/23 against the EDS22 framework. A copy of the outcome of the process and the report that we shared with our ICB is available here.

Further information about the Equality Delivery System is here.

Recent research has demonstrated that the treatment and experience of BME staff within the NHS is very significantly worse, on average, than that of NHS white staff. The publication of “The Snowy White Peaks of the NHS” (2014) demonstrated that BME staff were absent from the leadership of many organisations even where the workforce had substantial numbers of BME staff and where the organisation provided services to communities with large number of BME patients.

The report also summarised research over recent years showing that BME staff were treated less favourably by every measure, including promotion, grading, discipline, bullying, and access to non-mandatory training. It demonstrated that such evidence as exists showed little or no progress in recent years despite the growing number of BME staff employed as doctors, nurses and other staff.

During 2014, the Equality and Diversity Council (EDC) carefully considered the combined impact of available research and concluded that it was in the best interests of patients (as well as staff) that early and decisive steps be taken to remedy this inequity.

The challenge to ensure black and minority ethnic (BME) staff are treated fairly and their talents valued and developed is one that all NHS organisations need to meet because:

• Research shows that unfair treatment of BME staff adversely affects the care and treatment of all patients;
• Talent is being wasted through unfairness in the appointment, treatment and development of a large section of the NHS workforce;
• Precious resources are wasted through the impact of such treatment on the morale, discretionary effort, and other consequences of such treatment;
• Research shows that diverse teams and leaderships are more likely to show the innovation, and increase the organisational effectiveness, the NHS needs;
• Organisations whose leadership composition bears little relationship to that of the communities served will be less likely to deliver the patient focussed care that is needed.

In response to this challenge, the 2015/16 NHS Standard Contract includes a new Workforce Race Equality Standard (“the Standard”) which will require almost all NHS providers of NHS services (other than primary care) to start to address this issue. It states at Service Condition 13:

‘The Provider must implement EDS2; and implement the National Workforce Race Equality Standard and submit an annual report to the Co-ordinating Commissioner on its progress in implementing the Standard’.

The Care Quality Commission will also consider the Workforce Race Equality Standard in their assessments of how “well-led” NHS providers are from April 2016.

Further information is available here.

On 24 June 2015, the new ‘accessible information standard’ was approved by the Standardisation Committee for Care Information (SCCI). The standard is known officially as SCCI1605 Accessible Information.

An Information Standard is a formal guidance document which health and social care organisations must follow by law.

Organisations must follow the standard in full by 31.07.16.

The aim of the accessible information standard is to make sure that people who have a disability, impairment or sensory loss get information that they can access and understand, and any communication support that they need.

The accessible information standard tells organisations how they should make sure that patients and service users, and their carers and parents, can access and understand the information they are given. This includes making sure that people get information in different formats if they need it, for example in large print, braille, easy read or via email.

The accessible information standard also tells organisations how they should make sure that people get any support with communication that they need, for example support from a British Sign Language (BSL) interpreter, deafblind manual interpreter or an advocate.

Further information is available here.