Equality, Diversity and Inclusion
Our commitment to addressing health inequalities and promoting equality, diversity and inclusion
At NHS Shropshire, Telford and Wrekin, we are committed to undertaking our system leadership role, including in relation to our public sector and general equality duties, and our duty to have due regard to the need to address health inequalities.
We see the diversity of our communities and workforce as a strength to help inform the way we plan, design and commission health and care services for people living across Shropshire, Telford and Wrekin.
We want to ensure that everyone in Shropshire, Telford and Wrekin has fair access, experience and outcomes when it comes to our services and workplaces.
What we mean by Equality, Diversity and Inclusion
- 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. People may require different things to achieve similar outcomes.
- Diversity is about recognising and valuing individual differences. Everyone is unique - we also have things in common with one another, and each one of us has something valuable to contribute.
- Inclusion is about groups and individuals from different backgrounds being culturally and socially accepted so that everyone feels respected and valued for who they are.
Why it's important
We know health inequalities exist across the county and that some people have different access, experience and outcomes when it comes to our services and workplaces. We want to reduce those differences and remove them entirely where possible.
To make sure everyone can get the best out of our services and workplaces, we need to understand the make up of our population and workforce and their individual needs, so they have the best possible experience.
Not only is this the right thing to do, we have a statutory responsibility for assuring equality, diversity and inclusion in health and care commissioning and provision for Shropshire, Telford and Wrekin.
As a public sector organisation, we must comply with specific equality duties that require us to evidence how we pay due regard to the needs of diverse and vulnerable groups in the exercising our responsibilities. This includes compliance with the Equality Act 2010, Human Rights Act 1998, and relevant sections of the Health and Social Care Act 2012.
Who we mean when we talk about diverse and vulnerable groups
The Equality Act sets out nine characteristics who may be discriminated against because of certain characteristics they share. It provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. The groups protected by the Act include:
- Age – People of different ages including children, young and older people
- Disability – People with a long-term condition, or with mental, physical, sensory, learning disability or impairments, or a combination of these
- Gender Reassignment – People who have changed, or are in the process of changing, their sex
- Marriage and Civil Partnership – People who are married or in a civil partnership
- Race – People characterised by shared ethnicity, language or culture
- Religion or Belief – People with or without a religion or belief
- Sex – Men and women
- Sexual orientation – People who identify as Lesbian, Gay, Bi-sexual or Transgender
- Pregnancy and Maternity – Women who are having or have just had a baby
As well as these nine protected characteristics, there are also groups, known as inclusion groups, within our communities who are often socially excluded. These groups typically experience multiple overlapping risk factors for poor health, such as poverty, violence and complex trauma. This includes people who experience homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system and victims of modern slavery.
Further information
Click on the different tabs below for more information about our population and workforce, health inequalities, our statutory duties and how we assess and make sure we are meeting them.
There are 502,990 people living in Shropshire, Telford and Wrekin, 179,854 of those live in Telford and Wrekin and 323,136 live in Shropshire. Whilst Telford and Wrekin is predominantly an urban area, Shropshire, in contrast, is predominantly rural.
Some key facts about our population:
- 49.5% of our population are male, while 50.5% are female
- 21% of our population are aged over 65 years old.
- More than 1/4 of people in Telford and Wrekin live in the 20% most deprived areas nationally
- Shropshire is relatively affluent which masks pockets of high deprivation, growing food poverty, and rural isolation
- There are on average 4,600 births and 4,920 deaths every year
- Across our county, there are 88,000 people with a long term illness, that equates to 18% of our population
- By 2043, it is estimated that there will be 589,330 living in the county and 30% of the population will be over the age of 65
The NHS workforce is more diverse than at any other point in its history.
The national NHS Workforce Race Equality Standard shows Black and minority ethnic (BME) staff make up almost a quarter of the workforce overall (24.2% or 383,706 staff) – an increase of 27,500 people since 2021 (22.4% of staff).
The analysis shows more than two fifths (42%) of doctors, dentists, and consultants, and almost a third (29.2%) of our nurses, midwives, and health visitors are from Black and minority ethnic backgrounds.
Not all of us have the privilege of living a long and healthy life.
For reasons outside of their control, certain groups and populations are far more likely to die early, or develop debilitating health conditions, as a result of unfair, unjust and avoidable factors.
Good health is a fundamental human right and it is up to us to do our part in changing these outcomes.
Here at NHS Shropshire, Telford and Wrekin, we pledge to tackle the problems of ill-health, health inequalities and access to healthcare. We strive for fairness and equity, so everybody can live a fuller, healthier life.
What are health inequalities?
Health inequalities are unfair, unjust and avoidable differences in health across the population, and between different groups within society. We measure health inequalities by looking at:
- Average life expectancy – how long people are likely to live.
- Healthy life expectancy – the quality of someone’s life and what health conditions they might develop throughout their life.
National data tells us that, for example:
- The median age at death for people with a learning disability is 20 years earlier than someone without a learning disability (data source).
- Double the amount of people from Gypsy, Roma or Traveller (GRT) communities report being in bad or very bad health compared to the general population (data source).
The Equality Act provides protection to groups of people who may be discriminated against because of certain characteristics they share. It provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. The groups protected by the Act include:
- Age – People of different ages including children, young and older people
- Disability – People with a long-term condition, or with mental, physical, sensory, learning disability or impairments, or a combination of these
- Gender Reassignment – People who have changed, or are in the process of changing, their sex
- Marriage and Civil Partnership – People who are married or in a civil partnership
- Race – People characterised by shared ethnicity, language or culture
- Religion or Belief – People with or without a religion or belief
- Sex – Men and women
- Sexual orientation – People who identify as Lesbian, Gay, Bi-sexual or Transgender
- Pregnancy and Maternity – Women who are having or have just had a baby
The Equality Act sets out the Public Sector Equality Duty. This duty requires public bodies to consider all individuals when carrying out their day-to-day work – in shaping policy, in commissioning and delivering services, and in relation to their own employees. It requires us to have due regard to the need to:
- Eliminate unlawful discrimination, harassment and victimisation, and other conduct prohibited by the Act
- Advance equality of opportunity between people who share a protected characteristic and those who do not, for example:
- Remove or minimise disadvantages suffered by people due to their protected characteristics
- Meet the needs of people with protected characteristics
- Encourage people with protected characteristics to participate in public life or in other activities where their participation is low
- Foster good relations between people who share a protected characteristic and those who do not
- Tackle prejudice and promote understanding between people from different groups.
The Equality Act also sets out specific duties to help us better perform the Equality Duty. It does this by requiring us to be transparent about how we respond to the Equality Duty.
We are accountable to our service users and open to public scrutiny. The duties, therefore, provide the public with the information they need to challenge and hold NHS Shropshire, Telford and Wrekin to account for its performance on equality.
The specific duties require us to:
- Publish sufficient information to show that it has considered the three aims of the general duty when making decisions, and the equality data that underpins those decisions
- Publish Information related to persons who share protected characteristics who are employees, or others affected, such as service users
- To publish the information in a manner that is accessible to the public
To comply with the requirements of the Equality Act 2010, we will work to continually:
- Monitor its workforce and analyse any unintended variations
- Assess the health needs of its local communities
- Commission programmes and services to address health inequalities
- Carry out Equality Impact Analysis to inform its decision making
- Involve member practices, communities, staff, patients and the public in its decision-making processes
- Produce an equality strategy and annually measure our performance against it
We have obligations under the Human Rights Act 1998 that, as a public body, we must at all times act in a manner compatible with the rights protected in this Act and safeguard these for patients and staff in our care and employment. Human rights are underpinned by a set of common values and have been adopted by the NHS under the acronym FREDA. The FREDA principles represent:
- Fairness, e.g. fair and transparent grievance and complaints procedures
- Respect, e.g. respect for same-sex couples, teenage parents, older people
- Equality, e.g. not being denied treatment due to age, sex, race etc.
- Dignity e.g. sufficient staff to change soiled sheets, help patients to eat/drink
- Autonomy, e.g. involving people in decisions about their treatment and care.
The Equality and Human Rights Commission states that putting human rights principles into public service practice is in the public interest. Evidence shows that public bodies taking human rights seriously treat people better.
We will work to embed a human rights-based approach in the way that we commission services and in our role as an employer. This approach is not new, and is evident in NHS policy initiatives such as Dignity in Care, Essence of Care, Standards of Better Health, and the Knowledge and Skills Framework.
NHS Shropshire, Telford and Wrekin has a legal duty under the Health and Social Care Act 2012 to reduce inequalities between patients regarding their ability to access health services, and with respect to health outcomes, as well as to ensure that services are provided in an integrated (joined up) way.
The Act also places duties on us to promote the NHS Constitution, to enable choice, and to promote patient, carer and public involvement. To discharge this responsibility effectively, we will need to work with our partners to reduce health inequalities among those in greatest need and embed this requirement into its joint health and wellbeing strategies. We will also need to demonstrate how it will provide culturally sensitive services and ensure all patients can exercise choice and be involved in decision making.
When we think about making changes to our services, policies, or workforce practices, it is important that we fully consider the impact that it may have on all of our population groups, along with how it may positively or negatively affect other environmental factors, such as climate change.
The integrated impact assessment process is our tool to ensure that we fully assess the impact of changes on our local population and communities. It is a holistic framework that is used to ensure that new policies and programmes have been considered through not only an equality lens, but also economic, environmental, and health inequalities.
It seeks to
- Identify the positive and any negative impacts for the local population;
- Identify which (if any) of the protected characteristics groups are more likely to be affected by the proposals and what these impacts will be;
- Identify the impact on staff from equality and protected characteristic groups
- Identify the impact that the proposals may have on a set of societal considerations, including climate change and social inclusion.
- Develop an overall set of integrated conclusions on the comparative advantages and disadvantages of the different options; and
- Provide recommendations on ways in which positive impacts can be maximised for the population and for those with protected characteristics and ways in which to mitigate, or minimise, any adverse effects.
Once an Integrated Impact Assessment is completed, it is reviewed by our Quality Team and Health Inequalities Team.
To read more about our Integrated Impact Assessment and to view the tool we use, click on the following link: Assessing the Impact of Change.
The Equality and Involvement Committee provides assurance to the Board that its strategies, plans, service designs and developments have adequately and appropriately:
- considered and addressed the health and care needs and aspirations of residents in Shropshire, Telford and Wrekin who do, or may, experience inequalities in access to health services and health outcomes
- involved people who do, or may, use the services under consideration.
The EIC is a sounding board for programme leads, providing advice and suggestions on how impact assessments and engagement plans can be developed and strengthened, and people and communities identified and reached.
To read more about the EIC, click on the following link: EIC
The NHS Equality Delivery System is a performance framework enabling organisations to review their performance on equality and diversity, and to identify future priorities and actions. It is designed to help organisations to deliver better outcomes for patients and communities and better working environments for staff.
NHS England have produced a short animation video which explains what EDS2 is and how it should be implemented by local NHS organisations. This video can be used by NHS organisations to help communicate the key EDS2 messages to their workforce and communities.
Central to the EDS is a set of 11 outcomes aligned to four goals. These outcomes focus on the issues of most concern to patients, carers, communities, NHS staff and Boards. The three EDS goals are:
- Commissioned or provided services
- Workforce health and wellbeing
- Inclusive leadership
It is against these domains and the accompanying outcomes that we will assess and grade our performance and determine collectively the action to be taken. The EDS grades are set out below:
- Undeveloped activity
- Developing activity
- Achieving activity
- Excelling activity
NHS EDS2 Report 2022
NHS Shropshire, Telford and Wrekin has not finalised the external scoring of the EDS2 self assessment. However the draft self assessment which outlines the evidence collated can be viewed here.
Further information:
NHS Shropshire, Telford and Wrekin Workforce Race Equality Standard draft reporting data and draft action plan can be found here.
The reports on this page refer to the Shropshire, Telford and Wrekin Clinical Commission Group (or CCG), which was replaced by NHS Shropshire, Telford and Wrekin on 1 July 2022.
NHS SCCG WRES Reporting August 2020
NHS Shropshire CCG WRES Report 2020/21
NHS TWCCG WRES Reporting August 2020
NHS Telford and Wrekin CCG WRES Report 2020/21
STW CCGs WRES Action Plan 2020