Hereford Hospitals NHS Trust Race Equality Scheme 2008/9 2011/12

Hereford Hospitals NHS Trust Race Equality Scheme 2008 2011 Agenda Item No. 9 (a) Hereford Hospitals NHS Trust Race Equality Scheme 2008/9 2011/12 Hereford Hospitals NHS Trust Race Equality Scheme 2008-2011

1.0 FOREWORD This latest Race Equality Scheme sets out how the Trust will meet its obligations under the General and Specific Duties of the Act. It describes the policies, procedures and mechanisms already in place, as well as our 3 year plan for further development. The Trust will work to eliminate all kinds of discrimination against staff, patients or visitors. I wish to offer an assurance that any instances of direct discrimination will be acted upon immediately and taken seriously using the appropriate measures. Indirect discrimination may be more difficult to identify as it is likely to be implicit, not explicit, but steps will be taken to eliminate any discrimination that cannot be justified on nonracial grounds. To ensure that equality is meaningful and sustainable, it needs to be actively and explicitly built into policy-making. This should ensure that policies, programmes and actions specifically seek to achieve equality, and do not put any group of people at a disadvantage. The Trust recognises that staff need to be involved in the process, and have ease of access to its content. The Race Equality Scheme needs to be the tool that ensures race equality becomes mainstreamed throughout the organisation. Patients and others who use the hospital will be able to access and comment on the Race Equality Scheme. All employees will be expected and required to contribute to tackling any race discrimination, promote equality and good race relations. This Race Equality Scheme will explain why and how this will be made possible. Martin Woodford Chief Executive Mark Curtis Chairman

2.0 INTRODUCTION 2.1 This Race Equality Scheme (RES) is a review of the 2005 RES. The purpose the review is to ensure that we continue to work to an agenda that is relevant, modern and able to deliver our legal obligation to promote race equality within our sphere of influence in Herefordshire and the communities we serve. This sphere has grown with the advent of the new joint working relationship between Hereford Hospitals NHS Trust, Herefordshire Primary Care Trust (PCT) and Herefordshire Council. This joint working initiative brings a greater level of influence to the scheme. 2.2 At Hereford Hospitals NHS Trust we are working towards our moral and statutory duty for promoting race equality and equality of opportunity but we continue to be faced with new challenges. Freedom of movement within the expanded European Union has resulted in the traditionally static communities of this county becoming diverse, very quickly. The inward move of people has changed our expectations of who our neighbours are and we need to put into practice the tools that facilitate and encourage an atmosphere of acceptance, trust and understanding within Herefordshire and the communities we serve. 2.3 The new Race Equality Scheme is an integral part of Hereford Hospitals NHS Trust s overall approach to equality and diversity, which embraces race, disability, gender, age, sexual orientation and religion/faith. Our aim is to promote equality of opportunity for all, both in the services we provide and within Hereford Hospitals NHS Trust.

3.0 WHAT IS A RACE EQUALITY SCHEME (RES)? A RES is a document which contains the specific duties of an organisation under race equality legislation into a coherent strategy and action plan. A RES shows how a statutory organisation plans to meet both its general and specific duties. It is a public document and authorities will be answerable to the public for delivering the programme set out in the scheme s action plan. This 2008-2011 RES reflects future race equality work and carries with it a three-year action plan for promoting race equality in Hereford Hospitals NHS Trust. It sets out the internal and external objectives, with a growing community focus. The scheme outlines how Hereford Hospitals NHS Trust will: Monitor actions for adverse impact on race equality Consult for the potential or actual disproportional impact of actions on race equality and social and community cohesion Publish results of consultation and feedback from monitoring Ensure all employees have access to race equality training Deal with complaints regarding race equality issues 3.1 RACE EQUALITY LEGISLATION 3.3.1 Summary of the Race Relations (Amendment) Act 2000 In April 2001 the Race Relations (Amendment) Act 2000 (RRAA) came into force. It placed both general and specific duties on local authorities to promote race equality and prevent unlawful racial discrimination. The Act requires Hereford Hospitals NHS Trust to publish a Race Equality Scheme, illustrating how it intends to meet the RRAA obligations under the general and specific duty. The General Duty requires: Eliminate unlawful discrimination Promote equality of opportunity Promote good relations between people of different racial groups The Specific Duty requires: Publication of a Race Equality Scheme Publication of a statement of the functions of policies, or proposed policies, which Hereford Hospitals NHS Trust has assessed as relevant to delivering the objectives of the RRAA. This assessment must be reviewed at least every three years. Additional specific duties including monitoring: The number of BME employees Applications for employment, training and promotion by racial group Employees receiving training Employees who benefit, or not, as a result of Hereford Hospitals performance assessment procedure (eg, SPDR appraisal) Employees involved in grievance procedures

Employees who cease employment with Hereford Hospitals NHS Trust 3.3.2 Other Legislative Drivers Human Rights Act 1988 The Human Rights Act (1988) came into force in October 2000, bringing into effect in UK Law, the European Convention on Human Rights. The implementation of this piece of legislation increases the accountability for NHS Trusts such as Hereford Hospitals, to local people with regard to social justice and social exclusion issues. Article 13 (Treaty of Amsterdam) This Treaty provides a legal framework of minimum protection against racial discrimination across all the member states of the EU. It makes it unlawful to discriminate on the grounds of racial or ethnic origin. The directive requires member states to protect against discrimination in employment, training, education, health, social security, cultural benefits and goods/services. The Equality Act (2006) This Act established the Equality and Human Rights Commission (EHRC) and prohibits discrimination on the grounds of religion/belief and religious discrimination in the exercise of public functions.

4.0 POPULATION AND ORGANISATIONAL PROFILE 4.1 Hereford County Hospital is a PFI acute hospital, serving a population of approximately 225,000 from Herefordshire and neighbouring counties including Powys, Gwent, Worcester and Gloucester. All the major DGH specialties are provided on the one site and Herefordshire Primary Care Trust is the main commissioner of Hereford Hospitals acute services. 4.2 The Trust s statutory duty is to provide acute hospital based healthcare services to the local population. In delivering these objectives we aim to adhere to a strong value base, which includes the key principles of valuing diversity, ensuring equality of access, and dignity and respect for others, irrespective of race or religion, age, gender or sexuality. 4.3 In order to deliver appropriate services to the local populations we serve, the Trust needs to be conscious of the local demographics. In respect of ethnic origin of Herefordshire, the demographics are: Group Hereford County Total all ages = 174,871 Herefordshire * England Adults 20 604 = 99,670 and Wales White British 97.54% (c. 97,218 adults) 87.49% (99.1% or c. 173,297 all Irish 0.45% (c. 449 adults) 1.23% ages) Other White 1.11% (c. 1,106 adults) 2.59% Mixed White and Black 0.11% (c. 110 adults) 0.46% (0.4% or c. 700 all ages) Caribbean White and Black 0.05% (c. 50 adults) 0.15% African White and Asian 0.15% (c. 150 adults) 0.36% Other Mixed 0.09% (c. 90 adults) 0.30% Asian or Asian British Indian 0.10% (c. 100 adults) 1.99% (0.2% or c. 35 all ages) Pakistani 0.03% (c. 30 adults) 1.37% Bangladeshi 0.02% (c. 20 adults) 0.54% Black or Black British (0.1% or c. 175 all ages) Other Asian 0.05% (c. 50 adults) 0.46% Caribbean 0.04% (c. 40 adults) 1.08% African 0.05% (c. 50 adults) 0.92% Other Black 0.01% (c. 10 adults) 0.18% Other Chinese 0.12% (c. 120 adults) 0.44% (0.21% or c. 367 all ages) Other Ethnic Group 0.09% (c. 90 adults) 0.42% * NB These figures refer to residents of Herefordshire 4.4 Religion information from 2001 Census Herefordshire England and Wales Christian 79.01% 71.75% Buddhist 0.20 % (c. 200 adults) 0.27% Jewish 0.07% (c. 70 adults). 0.50% Muslim 0.10% (c. 100 adults) 2.97% Sikh 0.04% (c. 40 adults) 0.63% Other Religions 0.26% (c. 260 adults) 0.29% No Religion 12.55% 14.81% Religion not stated 7.71% 7.72%

NB There are no mosques or synagogues in Herefordshire. There is a small prayer meeting for Muslims in Hereford City. The number of Jewish people in the county is possibly 130; about 50 people act as a community and meet regularly, using a Catholic Hall. 4.5 Although not counted in the Census as an ethnic minority, travellers represent the largest single minority ethnic group within Herefordshire. This is true of both the adult and the school populations. Romany Travellers are regarded as an ethnic group under the Race Relations Act. Estimates of the size of the community vary and the numbers obviously fluctuate, but there are possibly 1,000-1,300 travellers in Herefordshire. They comprise three main groups within the community: Traditional or Roma Travellers (about 750 people, most of who are in permanent housing). Irish Travellers (c.100) most of whom are moving through the county. New Travellers (although these are not regarded as an ethnic minority group) mostly moving through. Travellers live in a variety of settings within the county. Most sites, however, appear to be concentrated in the north. 4.6 During the fruit-picking season Herefordshire attracts about 3000 seasonal workers, mainly from European countries, particularly the Ukraine. Most are university students from the Seasonal Agricultural Workers Scheme. 4.7 There are also temporary industrial workers from other European countries in the county, who stay for longer periods (around a year) and include an older age group than the seasonal students.

4.8 Languages Spoken In September 2004, a study commissioned by Herefordshire Council looked at Minority Ethnic People s Experiences in Herefordshire. That report summarized the spoken languages identified in the county, generally in combination with English. Group Roots/Origin Nos. First Language Functional English? Temporary agricultural workers Eastern European 3000 Great variety Variable, Russian main common language Temporary Portugal, Slovakia, Poland 150 Portuguese, Not usually industrial workers Other white minorities Travellers South Asian Mainly South East Asian Slovak, Polish Irish 700 English All other (Welsh, French, 2000 English and US, mixed) several EU languages Jewish 130 English Irish Travellers 100 English (some counted above) Romany Travellers 750 English Indian 168 Punjabi, Hindi, Gujerati, Malayalam, Tamil, Telegu Majority effective in English even if second language Yes Pakistani 46 Urdu, Punjabi, Yes Pushto Bangladeshi 37 Bengali Usually Asian other 84 Burmese, Nepali, No clear data Sinhalese Mixed white/asian 260 English Chinese 210 Cantonese, Very varied Mandarin Non-Chinese other 163 Arabic, Malay, Thai No clear data African 88 Ndebele, Yoruba, Usually Shona, Afrikaans, and others Mixed white/african 80 English Mixed white/caribbean 195 English Other black 17 No clear data No clear date

5.0 PROGRESS AGAINST THE 2005 2008 RACE EQUALITY SCHEME 5.1 Progress against the RES has been made and reported, but it is acknowledged that there new challenges and opportunities for development and improvement. The General and Specific Duties remain pertinent to the Trust RES for 2005 2008. 5.2 Details of Hereford Hospitals NHS Trust s infrastructure which supports this work can be found in Hereford Hospitals NHS Trust s Equality and Diversity Policy, which has been updated and amended since the 2005 RES was published. 5.3 An exciting development is the introduction of partnership working with Herefordshire Council and Herefordshire PCT. It builds on the existing relationships between the organisations which brought about joint training on Impact Assessments for PCT and Hospital staff in 2006, and the introduction of a joint Equality and Diversity Group for the PCT and Hereford Hospitals in 2007. In addition, the PCT and Hereford Hospitals set up a BME Group in 2006, supported by the expertise of Herefordshire Council s Diversity Team. 5.4 Through consultation work undertaken, it is recognised that patients and service users often do not make a distinction between the services of Hereford Hospitals, the PCT and the Council. Partnership working will build closer links between the three organisations, maximise resources and expertise and seek to provide an improved, joined-up approach to race equality in Herefordshire and for the communities we serve. 5.5 Actions to be taken to ensure the Trust meets those duties are described in the next section, and the actions will be regularly reviewed and an update provided to the Trust Board.

HEREFORD HOSPITALS RACE EQUALITY SCHEME ACTION PLAN 2008 2011 Commitments Outcome Measures Lead Target/Date 1. Leadership and Corporate Commitment 1.1 Demonstrate Board level responsibility for taking forward the Race Equality Scheme (RES) 1.2 Ensure staff are aware of the RES 1.3 Empowerment of BME groups to influence change and facilitate challenge 1.4 Support the release of staff to attend BME Staff Network 1.5 Implement and take forward other opportunities to promote cultural awareness and diversity 1.6 Working closer with the media Commitment from Board and senior management recognised by staff Publish on intranet and internet; hard copies available Staff survey, BME group involvement, positive feedback in the community Staff feel valued and the knowledge, skills and experience they contribute are recognised Promotion of guidelines for care for different faiths, promotion of special events within the community Hereford Hospitals develops a beneficial working relationship to dispel myths. Available to comment on events HR Director on behalf of the Chief Executive HR Manager BME leaders, HR managers All managers HR Manager Communication Officer On-going Promotion following RES revision Year on year feedback On-going September 2009 On-going 2. Consultation, Community Development and Scrutiny Consult on the content of the RES to further inform its development and subsequent work Develop closer working relationships with Herefordshire Council and Herefordshire Primary Care Trust to maximise resources and provide an optimum service Evolution of the RES to include current views of staff and local population. Liaise with PCT and Council to agree most effective routes Increased collaboration with Herefordshire Council and Primary Care Trust HR Manager HR Manager On-going Year on year review 3. Service Delivery

Review and develop the Impact Assessment Process Impact Assessment reflects the challenges and positive steps taken towards achieving race equality, and outcomes are published in a meaningful format HR Manager October 2009 4. Employment and Training 4.1 Evaluate the effectiveness of existing procedures for the ethnic monitoring of staffing practice and take action to address any areas of weakness: Staff in post Applicants for employment Applicants for training Those who receive training Those subject to disciplinary procedure Those involved in grievance procedures Publication of detailed outcomes Head of Education and Training, HR Resourcing Manager, HR Managers On-going