Executive Summary The Equalities Report 2016 /17 is the Trust s response to the Public Sector Equality Duty requirement to publish equality monitoring data in relation to our workforce and service users. This document presents a brief summary of the key findings. The Trust has worked hard over the years to ensure that the wellbeing of patients, visitors and staff remains central to all of its functions. We aim to consistently provide high quality healthcare that meets the needs of our local communities, and to ensure that our services are inclusive and welcoming. As an employer, we aim to keep our staff informed, involved and confident in delivering the services we provide. Our Trust Board seeks to provide proactive leadership, supporting and promoting equality and diversity to ensure that our staff can work in environments free from discrimination. Whilst we have been able to demonstrate compliance with a number of requirements, we cannot become complacent. We have a range of projects and future actions to undertake that will help us to make our services more inclusive, supporting us to achieve better health outcomes and to improve the overall experience for both patients and service users, and our staff members. 1. Profile of the Local Population The Trust is situated in the London Borough of Hackney. In February 2017, Hackney s Policy and Partnership Team released a Facts and Figures leaflet. It estimates Hackney s population at 269,009, with this likely to exceed 300,000 people by 2027. Hackney is a relatively young borough, with just under 25% of its population under 20. The proportion of residents between 20-29 years has grown in the last ten years and now stands at just under 20.1%. People aged over 55 make up only 14% of the population. Hackney is a culturally diverse area, with significant Other White, Black and Turkish communities. The Charedi Jewish community is concentrated in the north-east of the borough and is growing. People from Australia, the US and Western European countries like Spain, France and Italy make up the largest groups who have recently come to live in Hackney from abroad. Just over a third of Hackney s residents are Christian. This is a lower percentage than the London and England averages. Hackney s population contains significantly more people of Jewish and Muslim faith, as well as a higher proportion of people with no religion and those who did not state a religion than average in both London and England. In 2011, 14.6% of Hackney residents said they were disabled or had a long-term limiting illness; this remains the same in 2017. Almost nine out of ten Hackney residents say that Hackney is a place where people from different backgrounds get on well together.
The Trust employed 3,783 individuals as of 31st December 2016.This is a decrease of 17 staff since the 2015 report. The Trust workforce profile has remained largely the same since the 2015 report, with the percentages of female and male staff remaining static since 2015. Ethnicity within the workforce remains diverse, with 44.8% of the workforce from a White background, 29.2% Black and 14.8% Asian. The majority of the Hackney population identify themselves as belonging to the White ethnic group (54.7%) The next ethnic group which is represented is Black (23.1%); these figures have not changed significantly across any of the ethnic groups during 2016. 2. Key Findings 2.1 Breakdown of Trust Employees by Disability The 2011 census reports that 14.5% of the Hackney population define themselves as having a long term illness that limited their daily activities in some way. 3.2% of Trust employees (as recorded on the Electronic Staff Record) identify themselves as disabled or have a long standing illness or health problem. This has increased from 2.6% in the previous report. There has been a decrease in the number of staff members who do not disclose their disability status, from 47% in 2014 to 38% in 2015 and 33% in 2016. The 2016 national staff survey identified 287 respondents (16%) who stated that they have a long-standing illness, health problem or disability. This has increased slightly from 14.1% of respondents in the 2015 survey and is the same as the national average of 16%. It is, however, above the figure for Hackney s population. This figure is likely to be a more accurate representation of disability in the workforce due to the guaranteed anonymity of the staff survey, which appears to have generated a higher response. Disability Respondents % Yes 287 16 No 1511 84 Total 1798 100
Within the survey, disabled staff members were more likely to report that they had not had an appraisal, were left feeling their work was not valued, that they had experienced harassment, bullying and discrimination and that the organisation does not act fairly in terms of career progression. The Trust has improved around making adequate reasonable adjustments. Key Actions: to improve and better understand staff demographic data through improved collection o Develop a Disability awareness group and action plan based on findings from Workforce Disability Equality Standard (WDES) o Present WDES at staff forums o Improve staff demographic data collection further through a full staff census o Look at the shortfall from short listing to appointment for disabled staff 2.2 Recruitment by Ethnicity The number of applicants from an Asian ethnic background has risen from 22.5% in 2015 to 24%, which is well above the percentage of Asian staff in the overall workforce. The number of applicants from Black ethnic backgrounds remains overrepresentative of the Trust s workforce at 31.5%, compared to the actual workforce figure of 29.2%. The percentage of White applicants has decreased from 33.9% in 2015 to 31.5% in 2016. In relation to shortlisting, the figure for Black applicants has decreased from 33.2% in 2015 to 18.8% in 2016 and has increased for White applicants from 37.9% to 52.4%. For those appointed, there is a significant increase in White applicants who are appointed when compared to the local population and indeed the percentage of applicants. White candidates account for less than a third of total job applications but almost two thirds of appointments. The converse is true for candidates from Black and Asian backgrounds, where the combined percentage of appointments is less than half the percentage of applicants. In addition, the percentage of Black staff members at appointment is 8% lower than the local populations (15% compared to 23%). The issue with BAME candidates being less likely to be appointed following shortlisting has become significantly worse in 2016 compared to 2015. The Equality and Diversity Group are looking at Good Practice in the NHS for Recruitment and will be considering ways to improve and implement change during 2017-18.
100% 80% 60% 40% 20% 0% 54.7% 44.8% 6.4% 23.1% 3.0% 29.2% 9.1% 14.8% Recruitment by Ethnic Origin 5.3% 3.0% 4.5% 4.3% 4.0% 8.3% 5.1% 1.7% 1.8% 31.0% 4.9% 31.5% 24.2% 52.4% 65.6% 3.0% 18.9% 2.1% 15.1% 15.7% 10.3% Hackney Residents Trust Staff Applicants Shortlisted Appointed Asian Black Chinese Mixed White Any Other Not Declared Key Actions: to improve on the shortfall from interview to appointment for BME staff o Undertake further analysis of the drop off from shortlisting to appointment for BAME candidates o Review the interview process and membership of interview panels for all roles banded 8a and above roles o All staff members who recruit other staff members to attend Unconscious Bias training o All shortlisting to be carried out by two members of staff and monitored o Establish a more consistent process for monitoring interview decisions o Ethnic origin recruitment data to be built into regular workforce performance data 2.3 Career Progression Against a national average of 11%, 14.5% of respondents reported that the Trust does not act fairly with regards to career progression or promotion regardless of ethnic background, gender, religion, sexual orientation, disability or age. The breakdown of the results by protected characteristics would suggest that staff members who are from BAME backgrounds, or who are disabled, gay men, aged 51-65, or who are Christian are more likely to report that the Trust does not act fairly with regards to career progression. In 2016, the Trust rolled out a career development programme specifically targeted at BAME groups, which was well received. The impact of this has not been reflected in the 2016 survey results. The programme will be repeated in 2017, along with a more robust communications plan. Key Actions: to improve staff perception on career progression and encourage fairness and openness.
o Offer Reach career development programme to all staff o Further develop career ladders, so that staff members can clearly identify ways to develop and move up within their careers o Hold secondments / acting up positions centrally to ensure equality of access and opportunity for all staff 2.4 Training and Development Equal access to learning and development opportunities is a key component of the Trust s approach to equality and diversity. In 2016 we are able to report on access to training by key protected characteristics for the first time. The training data does not show significant differences for access between staff from different age groups / ethnic back grounds or religious backgrounds. However, the data does not show how non-mandatory training allocated across teams and professions. Over the coming year, the Trust will seek a more delineated form of this data in order to be able to establish whether any particular groups have more access to particular types of courses. Key Actions: to improve the manager training package, improve on how non mandatory training data is collected and managed o Support managers to ensure that more consistent conversations about training and development occur during Performance and Development Reviews. o Develop a good manager s guide to provide support and clarify expectations with regards to supporting staff development o Improve data collection for non-mandatory training to ensure that we better understand who is accessing training opportunities o Develop career frameworks for clinical roles to make it clearer what training and development is required to support career development and promotion 2.5 Disciplinary issues The chart below shows the spread of Employee Relations cases across all ethnic groups in 2016. The one dismissal was a black member of staff. All five formal disciplinary sanctions were issued to black staff members. The data shows that overall, Black and Minority Ethnic staff are more likely to be involved in formal disciplinary cases than white colleagues BAME staff members make up 50.53% of the workforce but account for 81% of disciplinary cases. Measures were taken throughout 2016 to improve the disparity and these appear to be having a positive impact. There were a total of 25 live disciplinary cases at the end of 2016 and 64% of these were staff from BAME backgrounds.
This data is now reported on a monthly basis in the Workforce Performance Report and to the Joint Staff Consultative Committee. Further analysis has been undertaken on the reasons for the disciplinary action and on whether black staff members are being disciplined disproportionately to other ethnicities; a report was presented to the Trust Board in December 2016, containing recommendations which are being taken forward into 2017. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Employee Relations by Ethnicity 0 0 0 0 3 0 0 1 2 2 12 2 1 3 1 1 4 2 3 42 3 3 1 0 Black Asian White Other Mixed Key Actions: ensuring equitable approaches to disciplinary processes for staff members from BAME backgrounds o Continue to develop approaches to support the assessment of ER cases prior to a formal process starting - such as the introduction of the commissioning managers role o Continue with reporting to the Trust Board, Workforce Performance Meeting and Joint Staff Consultative Committee o Carry out a yearly audit of all ER cases to identify potential bias or inconsistency o Support managers ongoing development of their people management skills through training, and development of advice and guidance documents. o Increase promotion of the mediation service, and ensure all staff are aware that this should be explored before entering into a formal process o Continue to actively seek out best practice and emerging evidence by engaging in regional and national networks and development programmes.
2.6 Discrimination (Including bullying / harassment) Within the 2016 national staff survey, staff members from a Black or Asian background are more likely to report a less favourable experience of working at the Trust than any other ethnic staff group. Key Action: ensuring that all staff members have an experience free from discrimination (bullying / harassment) o All staff members who recruit other staff members to attend Unconscious Bias training o Increase promotion of the Freedom to Speak Up Guardians to help ensure that all staff are aware that they have access to this resource o BAME group to work together with the Equality and Diversity group on the development of a WRES Action plan 2.7 Patient Access The population of Hackney is extremely diverse and this is reflected in attendances at the hospital and the provision of community health services. The Trust prioritises the provision of culturally sensitive services suited to the individual needs of patients. Patient Attendance Hackney 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Asian Black Chinese Mixed White Any Other Not Stated The graph above shows all hospital attendances by ethnicity over the period covered by the report, and demonstrates that access to services is broadly in line with the profile of the local population.
2.7 Patient experience A total of 410 complaints were received in 2016 and we were able to collect ethnic origin and gender data for over 80% of these. The breakdown of complaints by both gender and ethnicity is in line with the Trust's patient profile and shows that all groups are able to access the complaints process. Collecting demographic data from patients making enquiries at the Patient Advice and Liaison Service (PALS) is more difficult due to the short face to face nature of the interactions. The level of level of demographic data collected in 2016 improved Slightly on 2015 but was still not sufficient to enable meaningful analysis. Due to the timing of the release of national survey data we are still in the process of analysing our patent feedback data for 2016 and will include this in an updated report in the autumn. Key Actions: continue to improve the collection of patient data o Ensure completeness of patient data collected with particular reference to data collected relating to complaint and PALS enquiries o Publish a revised report in quarter 3 of 2016 including patient data. o Improve service representation on the Equality and Diversity Group The full Equalities Report 2016 /17 can be found on this page: http://www.homerton.nhs.uk/about-us/corporate-policies/equality-and-diversity