EQUALITY & DIVERSITY The Patient’s Perspective

Equality & Diversity Objective Providing a Healthcare Service that recognises, respects and responds to the diversity of the local communities we serve

Race Equality Local Population Statistics White Pakistan Indian Black British Caribbean Local Community 641,300 104,000 56,000 48,000 (66%) In Patient Profile Selly Oak 65% 3% 2% 3% Queen Elizabeth 65% 5% 5% 6% Workforce 69% 1% 6% 4%

White Pakistan Indian Black

British Caribbean

Local Community 641,300 104,000 56,000 48,000

(66%)

In Patient Profile

Selly Oak 65% 3% 2% 3%

Queen Elizabeth 65% 5% 5% 6%

Workforce 69% 1% 6% 4%

Race Equality Scheme Issues from Initial Impact Assessments Patient Information Interpreting Service Telephone Communications Communications Barriers Cultural needs/awareness Gap with Primary Care

Patient Information

Interpreting Service

Telephone Communications

Communications Barriers

Cultural needs/awareness

Gap with Primary Care

Disability Equality Scheme Trust Issues Requires for the first time that it takes a pro-active approach Needed to involve a range of people with disabilities in the whole process, including employees and the wider community

Requires for the first time that it takes a pro-active approach

Needed to involve a range of people with disabilities in the whole process, including employees and the wider community

Disability Equality Scheme Patient Issues 9 million deaf and hard of hearing people in the UK or 1 in 7 of the UK population Of these 698,000 are severely or profoundly deaf Another 450,000 of them are severely or profoundly deaf and cannot hear well enough to use a voice telephone even with equipment to make it louder An estimated 500,000 black and ethnic minority people are deaf or hard of hearing Communication difficulties can place them all in danger of misdiagnosis or delay in treatment

9 million deaf and hard of hearing people in the UK or 1 in 7 of the UK population

Of these 698,000 are severely or profoundly deaf

Another 450,000 of them are severely or profoundly deaf and cannot hear well enough to use a voice telephone even with equipment to make it louder

An estimated 500,000 black and ethnic minority people are deaf or hard of hearing

Communication difficulties can place them all in danger of misdiagnosis or delay in treatment

Disability Equality Scheme Key Concerns Research conducted by Sign, found that the key concerns for the needs of deaf people in the NHS were:- To improve access to all health services To prioritise and promote disability equality To improve facilities and services for deaf people

Research conducted by Sign, found that the

key concerns for the needs of deaf people in

the NHS were:-

To improve access to all health services

To prioritise and promote disability equality

To improve facilities and services for deaf people

Disability Equality Scheme Experiences of people who are deaf and their carers Lack of knowledge, awareness and consideration by doctors, health professionals and receptionists shown in poor attitudes and lack of deaf awareness in communication Information on deafness not being transferred between healthcare services, not being acted upon and lack of a system to do so Medical staff with little training in deaf awareness/ communications tactics Service providers being unclear on how to deal with deaf patients, particularly A&E.

Lack of knowledge, awareness and consideration by doctors, health professionals and receptionists shown in poor attitudes and lack of deaf awareness in communication

Information on deafness not being transferred between healthcare services, not being acted upon and lack of a system to do so

Medical staff with little training in deaf awareness/ communications tactics

Service providers being unclear on how to deal with deaf patients, particularly A&E.

Disability Equality Scheme Some solutions to help improve our patient’s experience Allow more time for appointments Ask patients how they prefer to communicate Make sure staff are aware of RNID Talktype Use pictures, Video and DVD. At least one front-line staff member should have basic deaf awareness training Produce a short video of the ward and staff to orientate patient to the ward environment Update the website and ensure it is up-to-date and is a comprehensive source of information

Allow more time for appointments

Ask patients how they prefer to communicate

Make sure staff are aware of RNID Talktype

Use pictures, Video and DVD.

At least one front-line staff member should have basic deaf awareness training

Produce a short video of the ward and staff to orientate patient to the ward environment

Update the website and ensure it is up-to-date and is a comprehensive source of information

GENDER EQUALITY SCHEME Trust Issues Needs to be a central plank of service and strategy Will require the Trust’s entire service remit to be tailored to men or women and in areas that are not as obviously gender sensitive Collecting gender-specific disease data is a crucial first step The Health Service is historically starting from a very low base

Needs to be a central plank of service and strategy

Will require the Trust’s entire service remit to be tailored to men or women and in areas that are not as obviously gender sensitive

Collecting gender-specific disease data is a crucial first step

The Health Service is historically starting from a very low base

Gender Equality Scheme The impact of sex differences on health and illness Men typically develop heart disease ten years earlier than women Women’s immune systems make them more resistant than men to some kinds of infection including tuberculosis Women are around 2.7 times more likely than men to develop an auto-immune disease such as diabetes Male-to-female infection with HIV is more than twice as efficient as female-to-male infection

Men typically develop heart disease ten years earlier than women

Women’s immune systems make them more resistant than men to some kinds of infection including tuberculosis

Women are around 2.7 times more likely than men to develop an auto-immune disease such as diabetes

Male-to-female infection with HIV is more than twice as efficient as female-to-male infection

Gender Equality Scheme Gender differences in health and illness Men are more likely than women to commit suicide Women are 2-3 times more likely than men to be affected by depression or anxiety Men are more likely than women to die of injuries, but women are more likely to die of injuries sustained at home The gap between male and female smoking rates is beginning to narrow as young women are taking up the habit more frequently than young men.

Men are more likely than women to commit suicide

Women are 2-3 times more likely than men to be affected by depression or anxiety

Men are more likely than women to die of injuries, but women are more likely to die of injuries sustained at home

The gap between male and female smoking rates is beginning to narrow as young women are taking up the habit more frequently than young men.

Gender Equality Scheme Gender differences in health care Reporting practical problems in access to services Caring responsibilities or transport problems Admit weakness or accept that they may be ill

Reporting practical problems in access to services

Caring responsibilities or transport problems

Admit weakness or accept that they may be ill

Gender Equality Scheme Gender differences in use of health care services – In-Patients Women - slightly more likely to be admitted as inpatients Men from most ethnic minorities – slightly lower rates of inpatient treatment Indian and Pakistani men - higher rates of in-patient treatment Asian women - more likely to be referred to hospital by their GP but also were more likely not to attend appointments Differences in hospital treatment for mental health problems reveal higher admission rates amongst men in early life and again in old age, while female rates are higher in middle age

Women - slightly more likely to be admitted as inpatients

Men from most ethnic minorities – slightly lower rates of inpatient treatment

Indian and Pakistani men - higher rates of in-patient treatment

Asian women - more likely to be referred to hospital by their GP but also were more likely not to attend appointments

Differences in hospital treatment for mental health problems reveal higher admission rates amongst men in early life and again in old age, while female rates are higher in middle age

Gender Equality Scheme Gender differences in use of health care services – Out-Patients Men are more likely than women to attend A&E Women have higher rates overall of GP referrals for out-patient appointments Higher rates of referral for in-patient treatment for women in general surgery, general medicine and psychiatry in particular Differences vary by ethnic group Chinese women and men were less likely to have attended as out-patients compared with general population Chinese women and men are less likely to report being affected by a number of key health conditions

Men are more likely than women to attend A&E

Women have higher rates overall of GP referrals for out-patient appointments

Higher rates of referral for in-patient treatment for women in general surgery, general medicine and psychiatry in particular

Differences vary by ethnic group

Chinese women and men were less likely to have attended as out-patients compared with general population

Chinese women and men are less likely to report being affected by a number of key health conditions

Gender Equality Scheme Gender Blindness The health of women and men is strongly influenced by their biological sex and their social gender Targets for reduced waiting times are same for both sexes but results would be of greater value if disaggregated for women and men and for different clinical specialties However, targets may be reached at different speeds for different specialties and may also reflect specific difficulties facing women and men in accessing care Without a framework in which gender is identified as a relevant factor, the possibility of gender differences cannot be properly explored.

The health of women and men is strongly influenced by their biological sex and their social gender

Targets for reduced waiting times are same for both sexes but results would be of greater value if disaggregated for women and men and for different clinical specialties

However, targets may be reached at different speeds for different specialties and may also reflect specific difficulties facing women and men in accessing care

Without a framework in which gender is identified as a relevant factor, the possibility of gender differences cannot be properly explored.

Equality & Diversity Conclusions A huge agenda to be completed Collecting gender-specific disease data is a crucial first step Working towards a Single Equality Scheme can help Patients come from a wide range of ethnic groups, with different cultural perceptions of health, illness and healthcare. Being sensitive to these different perceptions can impact positively on a patient’s progress and vice versa – but first you have to be aware of them!

A huge agenda to be completed

Collecting gender-specific disease data is a crucial first step

Working towards a Single Equality Scheme can help

Patients come from a wide range of ethnic groups, with different cultural perceptions of health, illness and healthcare.

Being sensitive to these different perceptions can impact positively on a patient’s progress and vice versa – but first you have to be aware of them!

Equality & Diversity Equality & Diversity in the NHS is all about changing how we work and meeting the real needs of the people who use health services Thank you for your time

Equality & Diversity in the NHS is all

about changing how we work and

meeting the real needs of the people

who use health services

Thank you for your time