Joint Forward Plan Appendix 5

Appendix 5: SNEE ICB Equality, Diversity, and Inclusion

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The NHS People Promise (2020) stated “We are compassionate and inclusive”, and “We each have a voice that counts”. Our mission will therefore be to embrace EDI across the ICB and as a partner within the wider ICS.

Our objectives will be reviewed over Q1/Q2 2023, and new EDI objectives and a strategic plan will then be devised by the end of June 2023 for the next five years. We shall provide safe environments for learning and encourage a system-wide understanding, discourse and reduction of bullying, harassment, or any other form of victimisation of people from protected characteristics. To date, our system-based work has focussed on race, including a commitment to deliver the regional anti-racism strategy. However, our body of work will expand to drive improvement in the following areas across the ICS.

We will fully own our individual and collective responsibility to take immediate action because that is the right thing to do – recognising the fundamental importance EDI in the health and care workforce to: our patients/public – through equality of access to co-produced services and recognising EDI is the only way that we can provide truly personalised care.

• our staff – our workforce should reflect the uniqueness of our local population. We need to recognise bias in practice and in how we manage complaints, provide opportunities for diverse leadership and be active bystanders
• our organisations – diverse leadership improves outcomes for all service users, their families, and their carers, and creates more valuable services with better outreach to under engaged communities.

We will have a collective vision that in the future we should not even need to speak about EDI in health and care because we will all be accepting of diversity and difference,
recognising that:

• this involves both acting immediately to get the basics right and thinking longer term about the innovative and imaginative solutions that will take us further forward
• we need to recognise the barriers to EDI to help us effectively overcome them
• as different partners within the ICS we are all in various places on this journey, we all need to be radical and share our learning to improve all our practice
• we will only achieve equality by enabling equity, doing more to enable all our staff to have an equal opportunity.
• we will use and share our data about EDI both as individual organisations and collectively across the ICS
• we will use commissioning and contracting processes to encourage EDI by incorporating diversity into contracts, and ensuring that requirements or targets are not just token numbers, but meaningful measures

Diversity of thinking

We will encourage diversity of thinking because we recognise that:

• we need diversity of thought, and we will encourage challenge on why we think, do, and talk as we do  it is only our collective workforce that can help us really meet our collective ambitions going forwards. If we treat people more fairly then they will feel valued and contribute their lived experience both at an operational and strategic level
• we should be able to have healthy disagreements and discussions that lead to a collective agreement at the end. In this way people who feel they are less welcome can be more confident that they can join in
• we need to ensure that we listen to the hidden voices which will mean putting in place more effective mechanisms to hear from them
• we need to move beyond protected characteristics and consider wider groups
• we will recognise that recruitment, training, supervision, and career progression should enable ways for people to speak out

We will empower our staff in health and care

We will empower our staff in health and care and in doing so we will:

• recognise the differences between all the different sectors in health and the care and the different challenges that they face e.g., the key role of social care, primary care, and volunteers
• offer valuable training, for example:
  – Active bystander – to give confidence to people to challenge bias and discrimination when they see it
  – Equity in Mind Pride in Practice – insight into the importance of inclusive language and accessibility
  – Unconscious Bias
• ensure that opportunities of promotion are the same in every grade and act where jobs do not attract diverse applicants to ensure that people feel valued and are inspired to apply for roles
• include people who use services on interview panels bringing their different perspectives on the qualities needed for a successful candidate, ensuring that this is not just tokenism
• learn from exit interviews, ensuring we carry them out every time so we can better understand all the reasons for moving between, and out of the health and care workforce. To uncover negative experiences, we will create psychologically safe environments so that people feel able to disclose.

In addition, internally within the ICB a lot of the desired improvement will come from nurturing and empowering our staff and patient/public networks (currently with varying levels of maturity), as well as utilising a co-production methodology to amplify the voices of minorities.

The ICB is currently in the process of developing and recruiting a dedicated EDI team, with executive sponsorship of the relevant programmes and workstreams. The ICB currently has five EDI objectives, which were set out in the interim EDI plan, as follows:

• holding leaders to account by developing EDI objectives, providing line managers with the knowledge, skills and confidence in the inclusion agenda, EDI standards for inclusive leadership, and promote inclusive recruitment
• EDI development programmes for staff ensuring staff are culturally competent in meeting the needs of the service and the community they serve
• promoting positive behaviours and tackle bullying, harassment, and discrimination. Eliminate discrimination, victimisation, and harassment. Advance equality of opportunity between groups of people of diverse backgrounds and with diverse needs. Foster and promote good relations between such groups of people
• become a Disability Confident Leader and an-Anti Racist Employer
• work in partnership with health and social care alliances on the public health and inequalities agenda

These objectives will inform our work and strategy development over the next 12 months with plans in place to develop five key EDI priorities as a system. These priorities will be agreed as part of a wider system (multi-agency) EDI community of practice, alongside the ICP.

The ICP working with the ICB has also scheduled an EDI Summit towards the end of Q4 of 2023/4. This work will then be synthesized and evaluated before presentation to the ICB Board and wider staff and the public.

EDI development training programmes

Underpinning this work, the ICB will look to scale up existing activities to promote equality, and deliver EDI development training programmes for staff, managers, and senior leaders. As well as the delivery of the specialist training, we will address the needs of the local population that the ICB serves, to increase the cultural competencies of the staff by addressing these needs, these include:

• Cultural Competency training
• Inclusivity
• Unconscious biased and conscious biased training
• Managing difficult conversations with diverse population (including race/ethnicity, gender identity/expression)
• Dealing with microaggressions
• Safeguarding in LGBTQ+ community (particularly with domestic violence)
• Gender Dysphoria and challenges in Transgender healthcare
• TextHelp Read&Write Assistive Software Champion training
• Dragon Assistive Software Champion training
• Neurodiversity and Managing Reasonable Adjustments training
• Mental Health & Wellbeing training for Managers
• Period Poverty
• Menopause
• Health Inequalities Awareness training

Equality Impact Assessments

Equality Impact Assessments (EIA) will be completed for all the policies/procedures rolled out and EIAs will also to be carried out for all service changes and restructures, to assess the impact, risks and mitigations on both service delivery and for staff and service users.

The ICB will also ensure:

Inclusive recruitment including:

• reviewing the demographic data identify gaps
• reviewing the recruitment policy/ procedure and process
• reviewing the job descriptions and adverts for plain simple English and user-friendly formatting to avoid discrimination
• usage of Inclusive language
• reviewing the advertising process and the platforms
• fair shortlisting process and assessment process
• diverse interview panels – ethnic minority representation on senior post interview panels
• EDI interview questions
• cultural / Inclusive Ambassadors
• ensuring the recruiting managers are fully trained to implement a fair and transparent recruitment process, and support inclusive recruitment
• providing Inclusive Recruitment training package for recruiting managers
• reviewing and publishing WRES Data / WDES Data and monitor progress

Inclusive Leadership including:

• launching Developmental training programmes for staff from ethnic minority backgrounds to support with career progression
• creating internal opportunities for staff to develop into senior roles
• regular supportive conversations with staff regarding development and career progression
• training managers and leaders to support Inclusive Leadership
• providing NHS Leadership Academy – Stepping up Programmes for ethnically diverse staff

Reverse Mentoring provided, including:

• raising awareness
• sharing stories
• putting people together who would not usually get together
• identifying good potential partners
• setting clear goals and expectations
• working on Your Communication Skills
• being tactful, patient and open-minded
• measuring progress

Focusing upon Staff Retention, including:

• career coaching
• reviewing the annual staff survey results
• reviewing Pulse Survey results
• encouraging staff to complete an exit questionnaire and managers to conduct an exit interview
• collating and analysing data from the surveys / exit interview/ exit questionnaire
• monitoring progress
• providing a confidential helpline for ethnically diverse staff

Reviewing all policies and conduct equality impact assessment, including:

• anti-racist blend in policies especially recruitment and selection policy / procedure
• Anti-Racist Policy
• EoE Anti-Racism strategy
• Anti-Racism Charter Unison
• disability confident employer

Monitoring ICB data, including:

• annual staff survey
• Pulse staff survey
• exit questionnaire
• WRES and Workforce Disability Equality Standard
• Equality Delivery System Two (EDS2)
• Electronic Staff Record (ESR)
• recruitment and selection
• undertake ethnicity pay gap review