Equality, Diversity & Inclusion (EDI).
The Covid-19 pandemic fundamentally changed our approach to equality, diversity, and inclusion (EDI) in Devon and working in partnership with our staff and communities is at the heart of our vision of building an inclusive health and care system where everyone in Devon feels they belong.
These pages outline some of our EDI programmes of work and our journey so far, if you would like to talk to someone about our work or request the information in alternative formats, please contact:
via email: d-icb.involve@nhs.net or call 01392 205 205
Our Vision for Equality, Diversity and Inclusion
NHS Devon will be a great place to work where staff will feel valued and have a strong sense of belonging. As an organisation we will champion diversity as our route to innovation and improved performance.
We will tackle health inequalities by working hand in hand with local populations and our partners to understand barriers to care and designing services that have the needs of everyone at their core.
The NHS Devon Equality and Diversity Strategy
At NHS Devon, we want Equality, Diversity and Inclusion to be embedded in everything we do and we are proud of our journey so far.
The Equality and Diversity Strategy sets out how we plan to achieve this vision and identifies
- What we have learnt about our communities through the pandemic
- The benefits of equality and diversity
- The Devon picture and case for change
- The journey so far
- The NHS Devon Equality and Diversity objectives
- The NHS Devon and One Devon approach to meeting the NHS England six high impact actions identified in their EDI Improvement Plan
- The partnerships involved with delivering the strategy.
The Equality and Diversity strategy has received approval through a number of committees but is still subject to final approval. The initial feedback has been very positive from colleagues in both the Integrated Care Board and Integrated Care System.
NHS Devon Equality Objectives
We are driven by making NHS Devon a more inclusive organisation and providing better access to health and care services for our diverse and vulnerable communities. The nine equality objectives in the NHS Devon Equality and Diversity strategy are aligned with the NHS England EDI improvement plan and will guide this work over the next 12 months.
We have specific objectives that we will work to achieve with organisations in the Integrated Care System in Devon. As we make progress on these objectives we will seek further opportunity for alignment on the remaining objectives.
Objective 1
Develop inclusive approaches to recruitment that encourage diverse populations to work for NHS Devon so that we can build a more diverse workforce that is reflective of Devon’s local population with an initial focus on race and ethnicity (4% to 8%) LGBTQ+ (1% – 3%) and people with a disability (5% – 20%). This will build a culture where our people feel valued, heard and able to be their best selves at work.
Measurable:
Workforce data – Improvements of 10% each year.
Timeline for delivery:
March 2024
Objective 2
Continue to support our leaders to champion the benefits of equality and diversity and represent EDI at a Board, Executive and Senior Leadership level.
Measurable:
Annual Report and Equality Delivery System submission – 10% increase in evidence provided.
NHS Devon staff survey – An increase in positive responses to leadership questions.
Timeline for delivery:
March 2024
Objective 3
Work with HR to further develop an NHS Devon Staff Network that is representative of our communities with a focus on;
Providing peer support for our colleagues
Creating a reference point when undertaking inclusion initiatives
Seeking support and resourcing with campaigns
Measurable:
Improvement in experience from diverse colleagues; Staff Survey, Workforce Race Equality Standards, Workforce Disability Equality Standards and Medical Workforce Race Equality Standards and Appraisals
Timeline for delivery:
Ongoing
Objective 4
Identify opportunities through the NHS Devon governance review to embed EDI to ensure we are learning and developing through an EDI lens through the Organisation Change process.
Measurable: EDI programmes of work being clearly sighted through appropriate governance channels so can be considered when reviewing wider programmes of work.
Timeline for delivery:
March 2024
Objective 5
The EDI programme will celebrate diversity, raise awareness of discrimination, and involve our staff and communities on the EDI priorities that develop through our work. We will do this through targeted and effective integrated communications opportunities.
Measurable:
When creating communication and involvement plans – have a knowledge bank of information to avoid asking the same questions twice of our diverse communities.
Timeline for delivery:
March 2024
Objective 6
Through an involvement campaign, ensure staff recruited via the International Recruitment Hub, are well supported in their roles and deliver a campaign that celebrates our diverse workforce, tackles racism and builds cohesion in the community.
Measurable:
The learning and best practice from the Devon Alliance approach to international recruitment to be shared system wider with a set of recommendation.
Improved staff experiences measure through; Workforce Race Equality Standards, Medical Workforce Race Equality Standards, Staff surveys and NHS England Chief Nursing Officer and Race Equality action plans
Timeline for delivery:
February 2024
Objective 7
Deliver inclusive involvement in collaboration with the People and Communities Strategy to support the ICB and ICS key aim of tackling inequalities in outcomes, experience and access.
Measurable:
The responses we receive to involvement is representative of our communities in Devon.
Timeline:
Ongoing
Objective 8
As part of the Organisation Change Programme deliver inclusive Recruitment training to Executives, Senior Leadership Team and recruiting managers to ensure people are aware of their biases when recruiting to their teams.
Measurable:
An increased diversity in the workforce that is more representative of our population in Devon.
Timeline:
November 2023
Objective 9
As a system work collaboratively to agree shared EDI priorities and work collectively on achieving a shared vision, with an initial focus on the six high impact actions in the NHS England EDI Improvement Plan.
Measurable:
An increase in system based events and resource when celebrating EDI.
An increase in evidence on system working as part of the EDI reporting processes:
Annual Report
Equality Delivery System
Public Sector Equality Duty
Timeline:
May 2024
The Covid-19 pandemic placed a spotlight on the health inequalities experienced by our diverse communities in Devon and sparked a radical rethink on our approach to delivering EDI in Devon and the below graphic demonstrates the journey we have been on since 2021.
Equality, Diversity and Inclusion in Devon – our achievements
Parliamentary Award-winning vaccination outreach programme
As rollout of the vaccination programme began, it became clear that across the country uptake was lower and vaccine hesitancy was higher among diverse and vulnerable groups. We quickly developed a Covid-19 vaccination outreach programme and worked with local communities to help tackle hesitancy and increase vaccine uptake.
The programme was underpinned by involvement with local communities and together, we co-designed vaccination services that saw us delivering clinics in mosques, community centres, people seeking asylum and refugee hotels, and Gypsy, Roma and Traveller sites, to name but a few.
Information was provided in more than 30 languages and in different formats, such as easy read. British Sign Language translators were also available for vaccination appointments if needed.
Video’s on how we have supported people with learning disabilities to have their Covid and Flu Vaccinations can be found here. More information on the project is listed in our News section.
The result was highly successful and, to date, over 100,000 vaccinations have been delivered on this programme. The programme has demonstrated that to deliver inclusive and accessible services we must involve communities to understand their needs and respond appropriately.
In March 2022, we were invited to present our approach to the Cabinet Office and regional counterparts from other parts of the country, while in July, the NHS Devon EDI team won the national Parliamentary Award for Health Equity for work on this programme and the Nous review, after being nominated by two of Devon’s MPs.
(image of some of the NHS Devon Team accepting the award on stage
at the parliamentary awards)
‘Vaccination Ambassadors’ from diverse backgrounds were recruited from across health and social care, local authorities, and charities to act as trusted voices, promoting the Devon vaccine programme to their communities. For example, Vaccine Ambassadors represented Polish, Romanian, Chinese, Japanese, and Muslim communities in Devon.
Videos about our work with Vaccine Ambassadors:
As part of tackling health inequalities and increasing vaccine confidence within our diverse communities we have allocated funding to allow organisations from the Voluntary, Community and Social Enterprise Sector (VCSE) to run innovative engagement activities to support the vaccine outreach model during the Autumn of 2023. This is following success of a similar approach in both 2021 and 2022. As trusted voices, within our diverse communities, the VCSE organisations are best placed to be the trusted source of information, in collaboration with NHS Devon.
Understanding staff and population experiences
Nous Review
As part of engagement to develop an Ethical Framework for Devon during the height of the pandemic, feedback from ethnically diverse communities described experiences of racism, discrimination and unconscious bias across health services. In response, a Devon-wide review was commissioned to greater understand these issues, namely: Understanding the experiences of health and care in Devon for BAME communities and staff report colloquially known as the Nous review.
The report produced 29 recommendations, all of which were supported by health partners across Devon and most of which are either in progress of have been delivered.
The review has acted as a springboard for a more outward and community development approach to EDI. This review has formed the basis of our Equality and Diversity strategy, not just through the recommendations, but the wider learning around the importance of co-production and joint system working.
NHS England praise – ICB Annual Engagement Assessment 2022/2023
As an ICB we are required to provide information to NHS England on how we are meeting our legal and statutory duties in relation to Involvement and Equality, Diversity and Inclusion. As part of this process, we need to demonstrate how we are delivering the 10 principles of good engagement.
- Ensure people and communities have an active role in decision-making and governance
- Involve people and communities at every stage and feed back to them about how it has influenced activities and decisions
- Understand your community’s needs, experiences, ideas and aspirations for health and care, using engagement to find out if change is working
- Build relationships based on trust, especially with marginalised groups and those affected by inequalities
- Work with Healthwatch and the voluntary, community and social enterprise sector as key partners
- Provide clear and accessible public information
- Use community-centred approaches that empower people and communities, making connections to what works already
- Have a range of ways for people and communities to take part in health and care services
- Tackle system priorities and service reconfiguration in partnership with people and communities
- Learn from what works and build on the assets of all health and care partners – networks, relationships and activity in local places.
In completing the submission, we received a letter of recognition from the Director of Strategic Transformation at NHS England, praising the work we are doing to promote Equality, Diversity and Inclusion and addressing health inequalities.
“We were impressed by your work to promote Equality, Diversity, and Inclusion (EDI) through engagement with LGBTQ+ and ethnically diverse communities to inform the ICB’s EDI strategy and begin developing an anti-racism statement for One Devon.”
“We would like to recognise the work your System is doing to address health inequalities, such as by holding a ‘Cost of Living Summit’ to engage with people and the VCSE sector about how they are being supported to live with significant rises in the cost of living, and support the targeting of a Cost of Living Community Fund.”
International Nurse Involvement
The Devon Alliance for International Recruitment represents six NHS Trusts in Devon and is leading the way on the international recruitment campaign in Devon. As part of this work, we have been working with the Devon Alliance to design a piece of involvement to explore the experiences of international clinical staff that have been recruited in Devon. This involvement is being led by an independent research agency to support participants to be open and honest in their responses.
The international recruitment of healthcare professionals is a widespread practice. However, integrating and retaining international staff can be challenging due to cultural, social, and organisational differences. As part of this involvement, we will explore how international colleagues have integrated within their local communities and workplaces, addressing the anecdotal evidence which suggests that this has a significant impact on overall integration. We will seek to identify the challenges and what could assist in mitigating them in the future. The results will provide valuable insights into the experiences of international clinical staff in the NHS and contribute to developing effective strategies for their integration and retention moving forward.
We are on track to launch this involvement in January 2024 once the NHS Staff survey participation period is closed. The high level findings from this involvement will be shared on completion.
Quality and Equality, Impact Assessments (QEIA) – Involvement 2023
NHS Devon is reviewing its Quality and Equality Impact Assessment process to ensure new services and service changes meet the needs of our most vulnerable communities. We want to understand from our diverse and vulnerable communities what the biggest barriers are to accessing health and care services so that our QEIA process can help tackle these and ensure everyone is able to access the care they need.
Through a series of 20 targeted focus groups, we have commissioned Voluntary Community Social Enterprise partners to gather insights from people who experience health inequalities and those with protected characteristics to achieve two things:
- Gain a better understanding of the barriers that people face in accessing health and care services.
- Understand how health and care services could be more accessible for diverse communities.
The communities we will be speaking to as part of this involvement are;
1. Rural Deprivation (including Coastal)
2. Urban deprivation
3. Children and Young People
4. Poor mental health (Adult)
5. Poor mental health (Children)
6. Learning disability
7. Neurodiversity
8. Sensory disabilities
9. Physical disabilities
10. People for who English is a second language
11. Refugees and people seeking asylum
12. Gypsy, Roma and Traveller community
13. Women from Ethnically Diverse Backgrounds
14. Chinese Community
15. LGBTQ+
16. Looked after children
17. Carers
18. Young carers
Where appropriate, we will be holding more than one focus group to capture the voice of each community.
Once the findings report from this work has been reviewed and approved, the insights gained will be included in the QEIA document to be considered as part of any service change process.
Inclusive recruitment training
NHS Devon is currently going through a period of organisational change and as part of this process – we wanted to ensure recruiting managers were aware of their biases and how this could impact on their decision making through a recruitment process.
We have delivered two virtual training sessions specifically for the Board, Executives and Senior Leadership Team and six additional sessions for managers with recruitment responsibilities.
The session covers;
- Overview of a selection process
- How we all see the world differently
- Unconscious bias
- Examples of bias in practice
- Legal duties – Equality act and the protected characteristics
- Importance of preparation and structure
- Effective questions and answers in interviews
Celebrating diversity
This is a celebration and awareness campaign marking significant cultural events throughout the year. Guests from the local community are invited to talk about their experiences/needs from healthcare at events across the system, raising awareness of different ethnicities, religions, faith groups, LGBTQ+ experiences and disabilities.
NHS Devon attended Exeter and Plymouth Pride and Exeter and Plymouth Respect which was supported by executives from both NHS Devon and from other NHS organisations across Devon. At these events we ran an involvement campaign.
“What do you want Health and Care Services to know about you?”
This provided valuable insights which formed part of our Involvement audit 2018-present day. This provides a record of all the involvement that has taken place over the last five years with key findings and recommendations. This is used as a foundation when planning involvement and inclusion activity to avoid asking our communities the same questions.
Equality Delivery System (EDS)
The Equality Delivery System is a reporting process that all NHS organisations are required to complete to evidence how we are meeting the requirements of the Equality Act 2010 and the Public Sector Equality Duty. EDS looks at three areas;
- Commissioned services – Vaccine Outreach Programme
- Workforce
- Leadership
Under these three areas, there are eleven outcomes we need to gather evidence and score ourself against using defined scoring criteria. As part of this process, we are required to undertake a peer review process for the three outcomes under the leadership section.
NHS Devon scored 25 out of 33 overall – with an overall outcome of “Achieving”
EDS Organisation Rating (overall rating): 25 – Achieving
Below is a key to support understanding of organisation rating:
Those who score under 8, adding outcome scores across domains, are rated: Undeveloped
Those who score between 8 and 21, adding outcome scores across domains, are rated: Developing
Those who score between 22 and 30, adding outcome scores across domains, are rated: Achieving
Those who score 31 and above, adding outcome scores across domains, are rated: Excelling
Like any organisation, NHS Devon know there are some improvements that need to be made and these will be driven through the objectives and priorities in the Equality and Diversity strategy.
This was classed as a transition year by NHS England and we have taken learning from the completion of the process to inform our approach to completion for 2023/2024.
The scoring of the outcomes under the Leadership section are still subject to peer review. Once this has been completed, an updated document will be published.
Get involved in our EDI programmes
Devon-wide Ethnic Equality Network
In July 2022, in line with the Nous recommendations we re-launched our Devon-wide Ethnic Equality Network, which is now been better resourced with administrative support provided by NHS Devon.
If you would like to join this Network, have any question or want to get involved with the work we are doing – we would love to hear from you! Please contact d-icb.involve@nhs.net
