Briefing

All you need to know about…

the DH equalities strategy

This autumn the Department of Health is due to launch its first national, confidential opinion survey of all NHS staff. The survey, which will run on an annual basis will replace all the numerous individual staff surveys that NHS organizations run and will offer a snap shot of staff life, covering topics ranging from jobs to whether people have been bullied, faced racial discrimination or sexual harassment.

Soon the NHS will be able to gain a riveting view of just what staff think of its policies and whether those policies are working. And with issues like discrimination and bullying still featuring strongly in health service culture (see page 4), it’s worth taking a look at just how the DH is attempting to tackle the problems through its ‘equalities framework’ for the NHS.

So what is the ‘equalities framework’?

The NHS Plan introduced a Working Lives Standard which says that every NHS staff member is entitled to work for an organisation that can prove it is improving diversity, tackling discrimination and harassment and developing the skills of its entire staff.

In April 2000, the DH launched an ‘equalities framework’, The Vital Connection, which set standards, monitoring arrangements and national targets on tackling harassment, on disability and on achieving a representative workforce. The targets included increasing minority ethnic representation at board level in NHS organisations to seven percent, and 40 per cent for women, by March 2004.

Yes, but what does the strategy do?

Inequality covers many facets – from age discrimination, bullying and lack of childcare to racial and sexual harassment and homophobia. So the initial equalities framework has mushroomed into a variety of projects. The Improving Working Lives strategy set a national framework and standards for ensuring all NHS employers have effective policies to tackle racial harassment and other equality issues. Meanwhile the Positively Diverse project aims to help NHS employers meet the Improving Working Lives standards. The scheme works with individual employers to ensure they become better equal opportunities employers.

What about racial harassment?

Racial harassment and discrimination has a long history in the NHS. A recent DH opinion survey of black and minority ethnic NHS staff in 52 health trusts started with pilot studies in 1999 and 2000. the survey, Tackling Racial Harassment in the NHS: evaluating Black and Minority Ethnic Staff’s attitudes and Experiences, found that 46 per cent had experienced racial harassment in the previous 12 months, whether by patients, colleagues or managers.

The original Improving Working Lives action plan for tacking racial harassment has led to national targets, booklets on good practice and a network of health organisations who have used the Positively Diverse one-year process to improve their equal opportunities policies. These range from Luton & Dunstable NHS trust to Cardiff & Vale NHS trust. But there is still a long way to go. A Royal College of Nursing survey this summer found nurses recruited from overseas faced racism not only from patients but from colleagues and managers (see opposite). This ranged from crude racism to stereotyping and isolation. Some, however reported good NHS practice.

Are people becoming more aware of age discrimination?

There are around 19 million people aged 50 and over in the UK (40 per cent of the adult population) and the UK government is committed to implementing age equality legislation by 2006. The NHS employs more than 145,000 nurses alone who are aged over 50 while only one in ten nurse is aged under 30, compared to one in four during the early 1990s.

But a recent study¹ showed that the NHS still neglects the needs of older staff. At local level, the researchers found, managers are still admitting they prefer to employ younger staff. The DH tackles age discrimination within Improving Working Lives and works with the Age Positive team at the Department of Work and Pensions.

But can a government department deal with such a wide-ranging problem?

One aspect is to work with a wide range of organisations which aim to promote equality. For instance, on homophobia, the Improving Working Lives project has supported the Gay and Lesbian Association of Doctors and Dentists (GLADD) which in 2002 produced guidelines for NHS trusts general dental and medical practices and medical and dental schools on how to deal with and eradicate homophobia.

With a ‘steady stream’ of doctors and dentists, says the DH says, leaving the UK to work abroad and many examples of patients receiving unequal treatment because of their sexual orientation, the DH wants local health organisations to take the guidelines on board.

But so far the jury is still out on the DH equalities strategy. The only way it will be clear whether the numerous policies are having an impact is via work such as the new annual, confidential NHS staff survey, independent research work and the actions of staff that have experienced harassment and discrimination.