Interim Equality Objectives

March 2023

Statement on Equality Objectives

Background – Public Sector Equality Duty

The public sector Equality Duty (PSED) is made up of a general Equality Duty and specific equality duties (SEDs). The general public sector Equality Duty is set out in primary legislation as section 149(1) of the Equality Act 2010. This general duty is supported by secondary legislation in the form of statutory regulations. These statutory regulations are called the specific equality duties (SEDs). The PSED is supported by non-statutory guidance and technical guidance issued by the Equality and Human Rights Commission (EHRC).

The EHRC encourages organisations to consider how the Public Sector Equality Duty (PSED) informs all of their relevant roles. The duties in relation to health inequalities, the principles and values enshrined in the NHS Constitution and NHS England’s key business priorities. The legal duties, on equalities and health inequalities, are important in their own right but they also are relevant to the achievement of the key principles and the values enshrined in the NHS Constitution and echoes in our objectives as an Integrated Care Board.

The general public sector Equality Duty, section 149 (1) of the Equality Act 2010, is one of ‘due regard’ or proper consideration. The general Duty is supported by specific equality duties (SEDs), secondary legislation or statutory rules, designed to facilitate the better performance of the general Duty.

In exercising our functions, the Mid and South Essex Integrated Care Board (ICB) is required to ‘have due regard to the need to’ address three equality aims set out below:

  • Equality aim 1: ‘a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act’.
  • Equality aim 2: ‘b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it’.
  • Equality aims 3: ‘c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

The general Duty’s three equality aims engage eight of the nine protected characteristics set out in the Equality Act 2010. These protected characteristics are age, disability, gender reassignment, pregnancy and maternity, race (i.e. colour, ethnic or national origins and nationality), religion or belief, sex and sexual orientation. With respect to one of the nine protected characteristics listed in the 2010 Act (marriage and civil partnership), the PSED partially covers this protected characteristic. In this case, public bodies are required to give due regard to the first equality aim, the elimination of discrimination, harassment, victimisation, and any other conduct prohibited by the Equality Act 2010; but public bodies are not required to advance equality of opportunity or foster good relations in relation to marriage and civil partnership. The general Duty means that NHS England has to properly consider all three equality aims in all the activities that it undertakes – for example, employing staff, commissioning and procurement, planning services and fulfilling our statutory and legal obligations.

Due Regard to Equality Aims

This report explains how the three equality aims will be demonstrated through key actions that we are taking to address this Duty. These key actions will include but not limited to:

  • Annual publishing of PSED equality reporting outlining equality objectives, progress made and action plans.
  • Annual publishing completed Equality Delivery System (EDS) reports demonstrating ICB’s response to requirements of the PSED.
  • Annual publishing of Workforce Race Equality Standard (WRES), Workforce Disability Equality Standard (WDES) and Gender Pay Gap.
  • Commitment to delivery of our ICS Equality Diversity & Inclusion framework to which includes actions on anti-racism strategy.
  • Robust undertaking of Equality Impact Assessments – demonstrating how equality and fostering of good relations is embed in all business undertaking.
  • Working together to eliminate health inequalities including using the Core20PLUS5 framework to focus targeted interventions at those groups most likely to experience inequalities and accelerate population health outcomes in core clinical areas.
  • Bring the voices and influence of the community into the conversation so that this helps shape the way we design and deliver services, ensuring we take measures to hear from those with protected characteristics and underserved groups.

The ICB has established two overarching (interim) equality objectives as set out below:

  • Our overall objective as an employer is to create an inclusive environment where our staff feel valued and supported to achieve their potential recognising that our culture values diversity and the voice of our teams.
  • Our overall Equality objective as an organisation is to ensure equitable access, excellent experience and optimal outcomes for all by addressing unwarranted variations in our services and moving towards a joined-up health and care system.

Mid and South Essex Integrated Care Board (ICB) Priorities

The ICB delivers its responsibilities against the Equality Act in three ways; as an employer, in its function as an ICB and as part of a wider system alongside its strategic partners.

As a new organisation, the ICB is developing its Equality Strategy to define the specific objectives more fully in the medium to long term; this statement describes the processes in place currently and the work being undertaken to maintain compliance with the Act, our specific duties and our ambitions to tackle equalities.

As an employer

Our overall objective as an employer is to create an inclusive environment where our staff feel valued and supported to achieve their potential recognising that our culture values diversity and the voice of our teams.

We have signed up to the ICS EDI framework, which the ICB is committed to delivering and this is reported back through the People Board.

There are 4 strategic pillars which form part of this framework:

  • Culture and Leadership
  • Talent Management and Acquisition
  • Retention and Recruitment
  • Data

Within these areas there are objectives for us to deliver for our workforce that will enable us to deliver our overarching objective.

We have the following staff networks in place:

  • LGBTQ+ network
  • Women’s network
  • Peer support group for those with long term conditions
  • A race equality network is in the process of being developed

We have also held an engagement event around the East of England anti-racism strategy and have some actions out of this.

In terms of WRES data around BME staff, our interim WRES plan which was pulled from predecessor clinical commissioning group data does show lower representation of BME staff in Bands 8a and above in both clinical and non-clinical roles. Actions to address this include

  1. Support and promote leadership development opportunities for BME colleagues to progress into more senior roles. For example, the Stepping up Programme available to bands 5- 7 through the leadership Academy and build into career conversations.
  2. Monitor activity for bands 8a & VSM posts and review to determine barriers to access.
  3. Analyse data on ICB secondments and promotions to determine how many BME staff have been recruited and define ICB practice to ensure accountability for these decisions is embedded within recruitment processes.
  4. Train recruiting managers on how to use the De-Bias Recruitment and Selection Toolkit (NHS London Workforce Race Strategy).
  5. Embed the No More Tick Boxes principles and suggestions into recruitment practices to improve each stage of recruitment and career progression.
  6. Relaunch a staff network for BME colleagues with the aim of learning from experience and involvement of BME staff to better understand real or perceived barriers to job applications and internal career development. The network will not be responsible for delivering actions, rather informing the organisation of what those actions should be.
  7. Through BME network create safe spaces for BME individuals to meet and share experiences in a safe and supportive environment.

As part of the Mid and South Essex System

The Mid and South Essex Integrated Care Strategy has been established by the Integrated Care Partnership. The ICB has signed up to the Strategy, which is currently being agreed by the partners within the system. The priorities of the ICB are enshrined within the Strategy and feed through into our strategic objectives.

In preparing this Strategy, we have had regard for the regulatory and statutory requirements, particularly the four key aims established for ICS:

  • Improving outcomes in population health and health care.
  • Tackling inequalities in outcomes, experience, and access.
  • Enhancing productivity and value for money.
  • Supporting broader social and economic development.

We have also had regard for the ‘Triple Aim’ established for NHS bodies that plan and commission services, which requires them to consider the effects of decisions on:

  • The health and wellbeing of the people of England (including inequalities in that health and wellbeing).
  • The quality of services provided or arranged by both themselves and other relevant bodies (including inequalities in benefits from those services).
  • The sustainable and efficient use of resources by themselves and other relevant bodies.

At the heart of the Mid and South Essex Integrated Care Strategy is the Common Endeavour of reducing inequalities together. Working together to eliminate avoidable heath and care inequalities by creating a broad and equal partnership of individuals, organisations, and agencies, focusing on prevention, early intervention and providing high-quality, joined-up health and social care services, when and where people need them.

The MSE ICS will lead efforts to identify and reduce health inequalities in our area, alongside broad objectives to improve population health and contribute to social and economic development. We will adopt the NHS England ‘Core20PLUS5’ framework that focuses on reducing inequalities by targeting efforts at the most deprived 20% of the national population. Alongside ‘Plus’ populations who can experience the greatest health inequalities and specific condition where we can accelerate prevention work to improve outcomes.

Population plus groups are identified at a local level. Populations we would expect to see identified are ethnic minority communities; people with a learning disability and autistic people; people with multiple long-term health conditions; other groups that share protected characteristics as defined by the Equality Act 2010; groups experiencing social exclusion, known as inclusion health groups, coastal communities (where there may be small areas of high deprivation hidden amongst relative affluence). Inclusion health groups include people experiencing homelessness, drug and alcohol dependence, vulnerable migrants including refugees and asylum seekers, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system, victims of modern slavery and other socially excluded groups. In Mid and South Essex, we have identified Gypsy, Roma and Traveller communities, Black, Asian, and Minoritised Ethnic communities, Carers, Adults with Learning Disabilities and Autism, Homeless People, Veterans, Armed Forces Communities and their families, Care Leavers, and Victims of Domestic Abuse and Domestic Violence. As a Partnership, we will work to better understand the needs of these groups and engage proactively with communities to do so. We will encourage our Partners to work closely with these communities in the planning and delivery of services.

Our overall Equality objective as an organisation is to ensure equitable access, excellent experience and optimal outcomes for all by addressing unwarranted variations in our services and moving towards a joined-up health and care system.

The commitments and objectives set out in the MSE Integrated Care strategy are:

  • We will work together across our Partnership to address the priorities identified in the Core20PLUS5 frameworks.
  • We will work together to define our local Core20PLUS5 targets and measures and review progress annually.
  • We will work with our local Alliances to regularly review and update those local characteristics which form our priority PLUS groups.
  • We will identify a specific cohort of c.5,000 households experiencing poor health and care outcomes and develop and deliver a plan to better understand and support their needs.

The NHS Core20PLUS5 model for adults can be viewed at the following link: https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalitiesimprovement-programme/core20plus5/

The NHS Core20PLUS5 model for babies, children and young people can be viewed at the following link: https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalitiesimprovement-programme/core20plus5/core20plus5-cyp/

Please note these objectives will be updated as part of establishing the ICB Equality Strategy.