Policy on Working in Uganda

Transcription

1 Policy on Working in Uganda Exec Director lead Authors/Leads Feedback on implementation to Executive Director: Chief Operating Officer/Chief Nurse Planning Manager/ Co-ordinator of the Gulu-Sheffield Partnership Senior Nurse/ Clinical Lead of the Gulu Sheffield Partnership Planning Manager/ Co-ordinator of the Gulu-Sheffield Partnership Senior Nurse/ Clinical Lead of the Gulu Sheffield Partnership Date of issue May 2016 Consultation period February 2014 Ratification date 28 April 2016 Ratified by Executive Directors Group Date for review December 2018 Target audience All SHSC Staff Policy version and advice on availability and storage: Version 1 of the policy This policy is stored and available through the Trust intranet This is the first version of this policy. previous version exists. National Links include: Engaging in Global Health- The Framework for Voluntary Engagement in Global Health by the UK Health Sector, DH and DfID July 2014 Increasing Returns: How Overseas Volunteering from the NHS Benefits Us All: A Report by the All Party Parliamentary Group on Global Health (July 2013) Global Health Partnerships: the UK contribution to health in developing countries (Crisp Report, DH 2007) Health is Global: An outcomes framework for global health (DH 2011) World Health Organisation (WHO) Bidirectional Initiative: African Partnerships for Patient Safety (APPS) 2012 UK Contribution to Health Globally : A report by the All Party Parliamentary Group on Global Health 2015 UN Sustainable Development Goals 2015 Tropical Health Education Trust Principles of Partnership 2015 Dignity in Mental Health: World Federation for Mental Health 2015 Policy on Working in Uganda Version 1 Page 1 of 10

2 Contents Section Page 1 Introduction 3 2 Definitions, Purpose, Duties and Scope 4 3 The Gulu Sheffield Mental Health Partnership Introduction, Principles and Best Practice 4 4 Process of Recruiting and Supporting Staff to work in Uganda 5 5 Social Media and Photographs 7 6 The Application of Trust Policies in Uganda 7 7 Ongoing involvement of Volunteers in the Partnership 7 8 Partnerships and Sustainability 7 Supplementary Section A - Stage One Equality Impact Assessment 8 Supplementary Section B- Human Rights Act Assessment Form and Flowchart 9 Human Rights Assessment Flow Chart 10 Policy on Working in Uganda Version 1 Page 2 of 10

3 1. Introduction 1.1 Working in low income countries Approximately 200 NHS and other UK health organisations now run international partnerships. By 2015 it is expected that NHS staff will have spent over 50,000 days working abroad, training 13,000 health workers in host countries. The Sheffield Health and Social Care NHS Foundation Trust has developed an international health link in northern Uganda- the Gulu Sheffield Mental Health Partnership and is seeking to professionalise the scale, quality and organisation of this work to fully realise the benefits for both partners. The Trust recognises this work as an important investment both for improving health globally and bringing important knowledge and skills back into their own local services. To ensure that they can sustain a high-quality contribution to their partner institutions, the Trust works to improve the support it gives its staff to work in Uganda. This policy outlines its commitment to the work of the Partnership in terms of staff working in Uganda. 1.2 National Context A long list of benefits from overseas working in International Health Partnerships (IHP s) has been reported in reviews. In summary these are: leadership development, innovation, international standing, it changes people forever and health gains for developing countries. What emerges is that, although often under the radar, overseas working with IHP s is already a valuable asset to the NHS, and could be contributing much more still to SHSC. The environment for staff who wish to work with IHP s abroad has improved significantly in recent years, thanks in part to the support of central government and increasing interest of local trusts. There are now more programmes operating from within the NHS and the quality of their work has improved. Recent developments include: A new overseas volunteering section of the NHS Careers website to better inform staff of the possibilities and opportunities available. The recently released five-year mandate for Health Education England includes among its targets a requirement to work with its Local Education and Training Boards and their members to support wider volunteering activity and maximise the learning benefits to organisations and staff. Engaging in Global Health- The Framework for Voluntary Engagement in Global Health by the UK Health Sector, DH and DfID July The Key principles for effective involvement in international development are: Ownership: Led and driven by the needs of developing countries Alignment: In line with the host country s national, district and institution-level health plans Harmonisation: Coordinated with other development partners from UK and elsewhere Evidence-based: Results are properly monitored and projects evaluated Sustainable: Supported by a long-term commitment from all parties Mutually accountable: Responsibility for the project is shared by all partners Policy on Working in Uganda Version 1 Page 3 of 10

4 2. Definitions, Purpose, Duties and Scope 2.1 Definitions. The Trust currently works in Uganda as part of an International Health Link, the Gulu Sheffield Partnership. This work is undertaken by staff who nominate themselves for consideration for recruitment. The Gulu Sheffield Partnership focuses on mental health but addresses other associated areas of work that are relevant to the needs of vulnerable people in northern Uganda and the Trusts expertise. To address areas of identified need the Sheffield Health and Social Care (SHSC) NHS Foundation Trust has formed appropriate partnerships with other NHS Trusts and voluntary groups. 2.2 Purpose The purpose of this policy is to provide guidance and support for staff working on behalf of the Trust in Uganda. Its main aim is to ensure the safety of staff undertaking Gulu Sheffield International Health Partnership work in Uganda and to ensure that appropriate Governance mechanisms are in place. 2.3 Duties The duties of staff working in Uganda are determined by the needs of the Gulu Sheffield International Health Partnership as directed by the SHSC Leadership team and Ugandan partners. 2.4 Scope This policy provides guidance for all SHSC staff undertaking work in Uganda and assures the Trust of governance arrangements. 3. The Gulu Sheffield Mental Health Partnership: Introduction, Principles and Best Practice 3.1 Introduction SHSC is the UK partner of the Gulu Sheffield Mental Health Partnership. It aims to ensure that the Gulu Sheffield Mental Health Partnership achieves sustainable change in mental health in northern Uganda and maximises the learning from this to inform changes within the Trust. It commits the Trust to work to the highest standards of both international development and partnership principles, and undertakes this within its existing commitment to service user involvement. The work of the link is determined by the Partnership s Action Plan, which is updated regularly and will be published on the Internet and Intranet sites. This is produced with Ugandan partners as a joint plan. The Trust recognises this work as an important investment both for improving health globally and bringing important knowledge and skills back into local services. To ensure that they can sustain a high-quality contribution to their partners the Trust supports the staff to work in Uganda in a number of ways. 3.2 Partnership Principles and Best Practice As agreed in the Memorandum of Understanding with Gulu Regional Referral Hospital the Gulu Sheffield Partnership is committed to the principles of: Respect Mutual Empowerment Transparency and Accountability of all the work Sustainability of the Partnership The partnership works to the following standards of best practice: All work will be consistent with the aims, plans and priorities of the Ugandan Ministry of Health and regional and local health authorities and within NHS guidelines Activities in Uganda will be led by Gulu partners and will focus on developing expertise and strengthening mental health services in Gulu Policy on Working in Uganda Version 1 Page 4 of 10

5 Evaluations will be undertaken with lessons learnt applied in both Gulu and Sheffield The work will deliver value for money and funding/ resources will only be used for supporting the Partnership objectives. Accounts will be kept of all financial transactions and receipts given. 3.3 Key Areas of work The work is designed to improve patient safety in Gulu Regional Referral Hospital, and Working with the Gulu Branch of Mental Health Uganda, a service user and carers group, to strengthen support in the community, particularly for the poorest people and rural communities 4. Process of Recruiting and Supporting Staff to work in Uganda 4.1 Recruitment of Staff These principles and best practice guidelines inform the recruitment and selection of staff for work in Gulu. Recruitment for working in Gulu is based upon the needs of the Partnership as identified in the Strategic Action Plan. The skills sought from each staff member will be determined by the Trip Objectives. Each staff trip member will also have their own Objectives. Staff will be recruited via a selection process operated within SHSC recruitment guidelines. Line Managers approval must be gained by staff interested in working in Gulu. A co-ordinating group determines the staffing requirements of each visit and recruit staff. Staff interested in working in Gulu are advised to contact the Partnership Clinical Lead and/ or Partnership Coordinator. 4.2 Preparing staff to work in Gulu Ensuring that staff are properly prepared for the challenges of working in low income contexts is vital to ensure that they contribute proactively to the work and by doing so do not come to harm themselves. Pre-departure training and debriefing on return is essential for SHSC staff and a thorough programme is provided. This involves: Risk assessments carried out prior to departure involving the Foreign and Commonwealth Office website and other UK partners who have recently returned from Uganda Signing a Staff Agreement/ Code of Conduct covering a commitment to adhere to the risk assessment and principles of effective involvement in international development An understanding of the requirements of the Travel and Health Insurance that the Trust provides for this work for all staff A high standard of preparation and support of volunteers A commitment to recognise, measure and use the skills brought back by volunteers, with inclusion of international working in workforce development strategies Use of a common tool to record the experiences of staff returning from overseas placements and monitor what new skills they put into practice six months afterwards. The CPD system is used to record this. 4.3 Working in Gulu Short term visits of workers are used as a way to provide support to the work of the Partnership in Gulu, bolstered further by long-distance communication between professionals between trips. Longer term Volunteers will be used when appropriate staff with experience of at least two trips to Gulu are available and the Partnership identifies a role for them. This will be the subject of a different policy. Opportunities for involvement exist at multiple career stages. This will allow some professionals to make repeat trips over several years and develop valuable international health expertise. This will also allow for a team to be built with an incrementally improving knowledge base and experience and the flexibility to use this flexibility, as the need arises. Policy on Working in Uganda Version 1 Page 5 of 10

6 4.3.1 Hours of Work Each member of the group will work as part of the SHSC team and will ensure that the different work streams are coordinated and delivered within the overall aims of the Sheffield Gulu partnership The working day will be flexible and staff will need to be adaptable to suit the situation in Gulu. They may be expected to work in the evening and/or at weekends as part of the Partnership role. Time off will be planned to most appropriately reflect the nature of the work. There will be no entitlement to carry over any time in lieu, on resumption of your substantive duties. Part-time staff will not receive any additional pay for working full time Code of Conduct Staff participating in the Sheffield - Gulu Partnership are representing SHSC and are therefore required to behave in a manner that reflects the professional standing of the Trust. The Staff Agreement, which is signed by everyone prior to travelling to Gulu, outlines in detail the expectations of behaviour. 4.4 Trip Team Leader Each trip has an identified Trip Team Leader, who has worked in Uganda before on at least two occasions. They operate as the Manager of the visit and the Team Leader has responsibility for ensuring the delivery of the Trip Objectives in a safe and professional manner. SHSC expectations about professional conduct applies at all times on the trip and failure to meet those standards will be dealt with by the Team Leader within Trust guidelines. One to one sessions will be organised for staff whilst in Gulu and will be provided by the Trip Team Leader. The Trip Team Leader will produce a Trip report upon their return and these will inform the Objectives of the next visit. The trip will be discussed with the Executive Lead. The Trip Team Leader will be responsible for ensuring that the budget is appropriately accounted and funds are correctly utilised, within the Governance arrangements of the Trust, the principles of the Partnership, and the objectives of the visit. 4.5 Trip Expenses Sheffield Health and Social Care will not use NHS commsioned income for the work of the Partnership. On the basis that funding is available from external sources the Trust will finance the appropriate expenses associated with the work of travelling to and working in Gulu. This will include: Medical expenses of pre-flight preparation (Immunisations, anti - Malaria Tablets etc); Visa; transport to, within Uganda and return to Sheffield, accommodation and a Subsistence Allowance The Trust will provide Travel and Health Insurance as staff are working on behalf of SHSC. The Trust may fund the expenses of volunteers from other relevant NHS Trusts and Universities who support the delivery of the programme. This is based upon funding being available, a judgement that they add value to the work of the Partnership, and that those skills are not available within this Trust to work in Gulu. Decisions on these issues will be taken on a case by case basis with the Executive Lead. 4.6 Duration of Trips and Study Leave Trips to Gulu are designed to meet the needs of the Partnership work. They will usually be14 days per visit, but this may vary depending upon the objectives of the work. Visits to Gulu are undertaken on the basis of using Study Leave. Study Leave additional to their allocated existing professional arrangements will be used for Medical staff 4.7 The Context of Working in Uganda Staff need to be aware of the differences with the UK in some areas of life in Uganda. Homophobia is common throughout Africa, including Uganda and staff should be aware of this when considering working in the country. Policy on Working in Uganda Version 1 Page 6 of 10

7 In the interests of safety issues of homophobia will not be discussed by staff when working in Uganda as this may inadvertently place local partners in a position of being potentially at risk. Staff could also be placed in a difficult situation by discussing homosexuality and homophobia, and the work may be compromised. Staff safety is paramount whilst working in Gulu. Gender inequality is also a significant issue with female subservience being commonplace. This may present personal and professional challenges for staff. The above issues are addressed in the Briefing and Debriefing sessions undertaken with staff to ensure that everyone is as prepared before travelling and supported upon return. The Risk Assessments that are reviewed and shared before each trip include discussion about both of these issues. 5. Social Media and Photographs As this is a work context pictures from the trip will not be placed upon staff personal Facebook account or any other social media. The Trusts Facebook and Intranet/ Internet sites are the means by which information and pictures will be distributed. This is in line with the Trusts Social Media Policy. Any photographs taken will be with the informed consent of the person being photographed. This will be evidenced by the person signing the Trusts Photo Consent Form. 6. The Application of Trust Policies in Uganda Trust policies will apply whilst working in Uganda. In the event of a lack of clarity the trip Team Leader will make a judgement. However the expectation is that work in Uganda is based on the same professional principles as in Sheffield and is therefore transferrable. 7. Ongoing Involvement of Volunteers in the Partnership Trust staff recruited to work in Gulu are expected to retain an involvement in the Partnership upon their return to Sheffield. This is in order to build a team of experienced staff who can support visiting Commonwealth Fellows and create a body of knowledge which will contribute towards changes in SHSC, using their skills and insights. 8. Partnerships and Sustainability The Partnership has developed appropriate links with other organisations that bring value to the work. SHSC recognises the growing need for International Health Links to involve multi-professional teams of NHS staff rather than a single specialty, as well for adequate training to help deliver these goals. Other Sheffield NHS Trusts and organisations are working with SHSC to provide a range of appropriate services. The Trust supports the development of the Sheffield Health International Partnerships (SHIP) and uses links created by that Registered Charity to enhance its work. This will include links with other voluntary groups working in Uganda and Sheffield, and other relevant n - Governmental Organisations (NGO s) in the UK. The Sheffield Gulu Mental Health Programme focuses on the sustainability of training & development programmes, strengthening state provided health systems and capacity building amongst nongovernmental groups. The aim is that changes will be sustained in the long term. Policy on Working in Uganda Version 1 Page 7 of 10

8 Supplementary Section A Stage One Equality Impact Assessment Equality Impact Assessment Process for Policies Developed Under the Policy on Policies Stage 1 Complete draft policy Stage 2 Relevance - Is the policy potentially relevant to equality i.e. will this policy potentially impact on staff, patients or the public? If NO further action required please sign and date the following statement. If proceed to stage 3 Greg Harrison December 2015 This policy does not impact on staff, patients or the public (insert name and date) Stage 3 Policy Screening - Public authorities are legally required to have due regard to eliminating discrimination, advancing equal opportunity and fostering good relations, in relation to people who share certain protected characteristics and those that do not. The following table should be used to consider this and inform changes to the policy (indicate yes/no/ don t know and note reasons). Please see the SHSC Guidance on equality impact assessment for examples and detailed advice this can be found at AGE DISABILITY GENDER REASSIGNMENT PREGNANCY AND MATERNITY RACE RELIGION OR BELIEF SEX SEXUAL ORIENTATION Does any aspect of this policy actually or potentially discriminate against this group? Can equality of opportunity for this group be improved through this policy or changes to this policy? Can this policy be amended so that it works to enhance relations between people in this group and people not in this group? Stage 4 Policy Revision - Make amendments to the policy or identify any remedial action required (action should be noted in the policy implementation plan section) Please delete as appropriate: Policy Amended / Action Identified / no changes made. Impact Assessment Completed by (insert name and date) Greg Harrison December 2015 Policy on Working in Uganda Version 1 Page 8 of 10

9 Supplementary Section B - Human Rights Act Assessment Form and Flowchart You need to be confident that no aspect of this policy breaches a persons Human Rights. You can assume that if a policy is directly based on a law or national policy it will not therefore breach Human Rights. If the policy or any procedures in the policy, are based on a local decision which impact on individuals, then you will need to make sure their human rights are not breached. To do this, you will need to refer to the more detailed guidance that is available on the SHSC web site (relevant sections numbers are referenced in grey boxes on diagram) and work through the flow chart on the next page. 1. Is your policy based on and in line with the current law (including caselaw) or policy? Yes. further action needed.. Work through the flow diagram over the page and then answer questions 2 and 3 below. 2. On completion of flow diagram is further action needed?, no further action needed. Yes, go to question 3 3. Complete the table below to provide details of the actions required Action required By what date Responsible Person Policy on Working in Uganda Version 1 Page 9 of 10

10 Human Rights Assessment Flow Chart Complete text answers in boxes and highlight your path through the flowchart by filling the /NO boxes red (do this by clicking on the /NO text boxes and then from the Format menu on the toolbar, choose Format Text Box and choose red from the Fill colour option). Once the flowchart is completed, return to the previous page to complete the Human Rights Act Assessment Form. 1.1 What is the policy/decision title? What is the objective of the policy/decision? Who will be affected by the policy/decision?.. 1 Will the policy/decision engage anyone s Convention rights? Will the policy/decision result in the restriction of a right? NO NO Flowchart exit There is no need to continue with this checklist. However, o Be alert to any possibility that your policy may discriminate against anyone in the exercise of a Convention right o Legal advice may still be necessary if in any doubt, contact your lawyer o Things may change, and you may need to reassess the situation Is the right an absolute right? 3.1 NO 4 The right is a qualified right Is the right a limited right? 3.2 Will the right be limited only to the extent set out in the relevant Article of the Convention? 3.3 NO 1) Is there a legal basis for the restriction? AND 2) Does the restriction have a legitimate aim? AND 3) Is the restriction necessary in a democratic society? AND 4) Are you sure you are not using a sledgehammer to crack a nut? NO Policy/decision is likely to be human rights compliant BUT Policy/decision is not likely to be human rights compliant please contact the Head of Patient Experience, Inclusion and Diversity. Get legal advice Regardless of the answers to these questions, once human rights are being interfered with in a restrictive manner you should obtain legal advice. You should always seek legal advice if your policy is likely to discriminate against anyone in the exercise of a convention right. Access to legal advice MUST be authorised by the relevant Executive Director or Associate Director for policies (this will usually be the Chief Nurse). For further advice on access to legal advice, please contact the Complaints and Litigation Lead. Policy on Working in Uganda Version 1 Page 10 of 10