We all use the NHS, whether going to see the GP or a nurse, getting advice from a pharmacist or seeing a dentist. To make sure everyone is able to get the best out of NHS services we need to understand who our patients are and what their individual needs are so when they need to access treatment they get the right care and have the best possible experience.
We know that health inequalities exist in North Kirklees and that some patients have different access, experience and outcomes when they use the NHS. We want to reduce those differences and remove them entirely where possible.
North Kirklees and Health inequalities
The patient population of North Kirklees Clinical Commissioning Group (CCG) is more than 185,000 people and this is predicted to rise by 12% by 2030 especially in those aged over 65 years, where 1 in 5 will be in this age group. The South Asian population is increasing, especially in Batley and Dewsbury where 38% of those aged under 18 are now South Asian.
Smoking remains at the heart of many of the diseases most common in North Kirklees such as cardiovascular disease (CVD), respiratory disease and cancers, especially lung cancer and infant and children’s health. 1 in 5 (20%) adults smoke and 1 in 10 (10%) 14-year olds smoke.
Obesity is rising in adults, though static in children (aged 10-11 years) at present, and affecting 1 in 5 of both groups.
More women of childbearing age are smoking (almost 1 in 4 (23%)), binge drinking (over 1 in 4 (28%)), and are not concerned about their levels of drinking. Only 1 in 3 (35%) of women of childbearing age meet the recommended level of physical activity.
1 in 5 (19%) of the adult population in Kirklees are carers. This will increase as the population live longer and changes are made to social care provision for those with higher care needs. Adult carers are more likely to have poorer health, especially pain and depression, than non-carers.
In 2010 Dewsbury and Batley had the highest proportion of people living in areas ranked as the worst deprived 20%. In Spen, the proportion of people living in areas ranked as the worst deprived 20% doubled from 2004 to 2010.
In Kirklees, Dewsbury residents can expect to live 3.6 to 4.9 years fewer than Holme Valley residents.
There are children living in poverty in every community in Kirklees at ward level, the percentage ranges from 1 in 14 (7%) in Kirkburton to 1 in 3 (35%) in Newsome and Dewsbury West. The Income Deprivation Affecting Children Index, covering children 0-15 living in income deprived households, showed that:
- Dewsbury and Batley had the highest proportions of children living in income deprived households.
- North Kirklees had a greater proportion of children who were income deprived than South Kirklees.
The Income Deprivation Affecting Older People Index covers the proportion of adults aged 60 or over receiving income support or income based job seekers’ allowance or pension credit. It showed that:
- Dewsbury and Batley had the highest proportion of older people who were income deprived.
- North Kirklees had a greater proportion of older people than South Kirklees who were income deprived.
Dewsbury had the highest proportion of all people living in areas ranked as the worst deprived 20%. This has been the case since 2004.
In Spen, the proportion of all people living in areas ranked as the worst deprived 20% doubled from 2004 to 2010.
For more information on the local population, inequalities and health please visit:
Equality and Diversity
Equality is about making sure everyone is treated fairly and given an equal chance to access opportunities. It is not about treating everyone the same way, as people may require different things to achieve similar outcomes. Diversity means ‘difference’. When it is used in the same context as ‘equality’, it is about recognising and valuing individual as well as group differences. It also means treating people as individuals and placing positive value on the diversity they bring as a result of them belonging to a certain personal protected characteristic or their cultural background.
Equality Act 2010 and the Public Sector Equality Duty
The Equality Act 2010 protects people against discrimination, harassment and victimisation in relation to housing, education, clubs, the provision of services and work. It unifies and extends previous equality legislation.
Equality is a legal principle to eliminate discrimination and promote equality of opportunity to people and groups.
- Eliminate discrimination, harassment and victimisation
- Advance equality of opportunity
- Foster good relations.
The Public Sector Equality Duty (PSED) is made up of a general duty and specific duties. The general duty forms the main part of the legislation, and is supported by specific duties which support public bodies to demonstrate performance and compliance.
The public sector equality duty is described in Section 149 of the Equality Act and requires public bodies, including CCGs, to pay due regard to the need to:
- Eliminate unlawful discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010.
- Advance equality of opportunitybetween people who share a protected characteristic and people who do not share it.
- Foster good relationsbetween people who share a protected characteristic and people who do not share it.
The Act explains that having due regard for advancing equality involves:
- Removing or minimising disadvantage associated with a protected characteristic;
- Taking steps to meet the needs of individuals who share a protected characteristic (where these are different from others); and
- Encouraging persons who share a protected characteristic to participate in public life or in any other activity where participation by that group of people is disproportionately low.
Protected characteristics are defined as:
- Pregnancy and maternity
- Marriage and civil partnership
- Religion or belief
- Sexual orientation
- Gender reassignment
Under the specific duties of the PSED we are required to:
- Publish information to demonstrate compliance with the general duty annually, including data on those with a protected characteristic who are affected by our policies and practices
- Publish one or more equality objectives covering a four-year period
To evidence ‘due regard’ as required by the Equality Act 2010 and to be sure that the decisions we take make a real, positive difference to the lives of people in North Kirklees, where a decision is being made about a potential change to a service, policy or activity an equality impact assessment (EIA) will be completed. We have developed an integrated impact assessment process which includes quality, equality and privacy, amongst others, to ensure that these are considered within CCG commissioning processes.
North Kirklees CCG Public Sector Equality Duty annual reports
Our equality objectives were developed based on the outcome of the previous EDS implementation in 2013. The aim of having objectives is to be able to make service improvements with a focus on particular equality groups.
The objectives are:
- Improved access to psychological therapies (IAPT) for Black and Minority Ethnic people (BME).
- Improve the access, experience and outcomes for South Asian patients with Diabetes
- Improving the access, experience and outcomes of older women with Chronic Obstructive Pulmonary Disease (COPD)
Progress on the equality objectives is monitored by the Senior Management Team.
Equality delivery system (EDS2)
The Equality Delivery System (EDS2) is a toolkit designed by the Department of Health to help NHS organisations to improve the services they provide for their local communities, consider health inequalities in their locality and provide better working environments that are free of discrimination.
The EDS has four goals, with 18 specific outcomes. NHS organisations need to listen to and engage with patients, carers, voluntary organisations and people who work in the NHS in order to grade their equality performance, identify where improvements can be made and act on their findings. The EDS goals are:
- Better health outcomes for all
- Improved patient access and experience
- Empowered, engaged and included workforce
- Inclusive leadership at all levels
They are rated on a scale as follows:
- Purple – excelling
- Green – achieving
- Amber – developing
- Red – undeveloped
This year the CCG is working in partnership with other NHS organisations including
MYHT, YAS and SWYPFT to deliver a joint approach to engaging with local
stakeholders. A Kirklees Equality Panel has been created with membership drawn from a range of community and voluntary sector organisations representing each of the protected characteristics. The panel will grade the CCG and participating NHS organisations against a set of EDS2 outcomes. We will use the data from the grading panel to inform the development of a new set of Equality Objectives.
Workforce Race Equality Scheme
The WRES requires NHS organisations to demonstrate progress against 9 indicators of workforce equality. A Workforce Disability Equality Standard will be introduced in 2018. Our WRES return for 2016 can be found here. An action plan can be found here. Find here an animation for NHS England on the WRES.
Accessible Information Standard for health and social care
The ‘Accessible Information Standard’ establishes a framework so patients and service users (carers and parents) who have information or communication needs relating to a disability, impairment or sensory loss, receive accessible information and communication support when accessing NHS or adult social services.
To prepare for the AIS in 2016 the CCG has;
- developed briefings for providers, CCG staff and GP practices and briefing sessions undertaken.
- undertaken surveys with GP practices to understand the support they need to implement the standard and used the feedback to shape and develop bespoke resources
- provided advice and guidance to health care organisations and their staff to implement the Standard and made contact to ensure they are making progress against the Standard
- promoted and raised awareness of the Standard with healthcare organisations and CCG staff
Equality is delivered as part of the quality portfolio. There is a governing body lay member with responsibility for Equality and Engagement. Progress is monitored through the Quality and Safety Committee oversees progress, reporting to the Governing Body.