Disability Equality Scheme for the
Royal Devon and ExeterNHS Foundation Trust
Forward by the Chief Executive
I take pleasure in introducing you to the first Disability Equality Scheme for the Royal Devon and Exeter NHS Foundation Trust. As a public body the RD&E has an obligation to produce such a scheme; however our commitment to equality is not just confined to meeting our legal requirement, but to ensuring that we provide the best possible healthcare services to our local population.
As an NHS Foundation Trust we believe in putting service users at the centre of everything we do and involve them, and those that care for them, in developing services to meet individual needs. This philosophy is outlined in the patient and Public Involvement Strategy 2005 and in our Service Development Strategy 2004, both of which emphasise the principle of public accountability and community involvement as a vital expression of our status as a membership organisation.
Publishing this Disability Equality Scheme gives us a good opportunity to show how we aim to address the inequality, disadvantage and discrimination that disabled people may experience during their lives.
We aim to ensure that when we plan and deliver services we think about how we can meet the diverse needs of disabled people. We also want to show how we will support disabled people in their roles as employees of the Trust, and how we will continue to acknowledge the skills and abilities of people who apply for jobs and are employed by the Trust.
The key to implementing a successful scheme and therefore to achieving these aims is to involve disabled people. We want disabled people to tell us what we need to do better or differently. We want to know what you think of our services and this first scheme. We will incorporate your feedback into our scheme each year when it is reviewed, and we will publish this information each year.
If you would like to contribute to the further development of the scheme, comment on the first draft, or give us your views on accessing services at the Trust, you can do so in the following ways:
- Fill out one of our Disability Equality questionnaires, which can be found on our website
- Write to Kath Taylor, Patient Liaison Services Manager, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW
We look forward to working with you.
Angela Pedder
Chief Executive
Contents
1Responsibilities
2Meeting the general duty
2.1 Developing the scheme – involvement of disabled people
2.2 Ongoing involvement / information gathering
2.2.1Our standards for involvement
2.3 Use of information in ongoing review
2.4 Disability equality impact assessments
2.5Improvedaccess to services, information and communication
2.5.1Access to services
2.5.2Access to information / communication
2.6Monitoring
2.7Publishing the results of assessment, involvement and monitoring
3Comments and complaints
4Training
5Equality in employment
5.1Employment monitoring
5.2Creating a culture so disabled people can declare their disability
5.3Disability awareness
5.4Retaining our disabled employees
5.5NHS opportunities
Appendix AAction Plan
Appendix BPeople involved in developing the Disability Equality Scheme
1.Responsibilities
The Chief Executive has overall responsibility for the Disability Equality Scheme.
As joint chairs of the Trust Diversity Steering Group, the Directorof Human Resources and the Director of Nursing and Service Improvement have responsibility for overseeing the success of the Trust in meeting the requirements of the Disability Equality Duty.
The Patient Liaison Services Manager has responsibility for the development, implementation, monitoring and review of the Disability Equality Scheme.
Members of the Trust’s Disability Equality Action Group (DEAG), the Patient and Public Involvement (PPI) Steering Group, and the Diversity Steering Group also contribute their expertise and experiences via the quarterly meetings.
2.Meeting the general duty
The following sections and the Action Plan that follows at Appendix A explain how we are meeting (or how we will meet) the new general duty.
In writing this scheme, we have used the recommendations made by the Disability Rights Commission in their Code of Practice on ‘The Duty to Promote Disability Equality’ and the Department of Health in the document Creating a Disability Equality Scheme: A Practical Guide for the NHS.
2.1 Involvement of disabled people in developing the scheme
In addition to the recent work to gather the views of disabled people (coordinated by Devon and Cornwall Constabulary), the Trust has a history of involving disabled people and their representatives.
Examples of this include:
- Patient task group – With input from Living Options Devon, disabled people and their representatives worked with senior staff from the West of England Eye Unit and the Audiology department with the aim of improving services at the RD&E. The activity was primarily on how best to meet the needs of people with physical and/or sensory disabilities.
- DDA steering group – The initial focus was mainly on accessibility issues and in 2002 a detailed access audit was carried out. Disabled people were involved in assessing the outcomes and contributed to prioritising the recommendations for action.
- Disability Equality Action Group – actions were identified and prioritised as a result of the report produced by Evans Jones Access in December 2004 and the group’s development day held in June 2005. Subsequent activity on developing services and the function of the group itself formed the action plan for 2005/06. More recently two sub-groups of the group have been established to look at:
- Processes for admission and effective care of patients with special requirements
- Raising professional awareness / training
In June 2006, we held a second development day with members of our DEAG and PPI steering groups. The relevant actions agreed by the groups have been added to the DES Action Plan, which can be found at Appendix A.
The first draft scheme will be circulated to a range of people/groups for comment and via our Disability Equality Action Group we will continue to involve disabled people and their representatives in the ongoing development and review of this scheme.
We will invite comments from our service user and carer groups and a list of the individuals / organisations to which the document will be circulated for comment can be found at Appendix B.
We will also consult with our staff via the Joint Staff Forum.
2.2Ongoing Involvement / information gathering
We are committed to involving disabled people and giving disabled people opportunities to comment on how our services and employment practices are provided and developed. We also recognise that it is important disabled people are represented in all of the ways in which we consult and involve people, in accordance with section 11 of the Health and Social Care Act 2001.
We will continue to gather information via:
- Our steering groups
- A disability equality questionnaire for patients, service users and carers (via post or the trust website
- Other questionnaires carried out as part of our overall patient and public involvement (PPI) activity
- Our patient advice and liaison service (PALS) and from formal complaints
- Our Foundation Trust membership.
The Disability Equality Action Group is a key part of how we deliver our PPI strategy, and it is via this group that we aim to involve disabled people by:
- Finding out what barriers disabled people face when accessing our services, and taking steps to remove them
- Asking if disabled people are satisfied with the services we provide e.g. through surveys and focus groups
- Including them in setting priorities and helping us to plan things
- Looking at the impact of existing and proposed policies
- Monitoring and checking how well things are done
- Reviewing and revising the scheme and providing feedback on how disabled people’s views have influenced our decisions.
2.2.1.Our standards for involvement
Our PPI strategy guides our overall approach to consulting and involving the public and people who use our services. In addition to this, we have developed a ‘toolkit’ to assist employees who are or will be undertaking any type of involvement work. This contains information about ensuring the successful involvement of those who are often described as ‘seldom heard’.
It includes advice and information on practical issues such as:
- Using accessible venues and equipment
- Arranging events at reasonable times and dates to make it easier for people to attend
- Consideration of transport arrangements and accessible parking
- Arranginginterpretation and communication support for people who require it to ensure that the needs of people are met through, for example, language interpreters, induction loops, large print, information on audiotape.
2.3Use of information in ongoing review
We will look at the feedback from the sources detailed above on aquarterly basis as part of the regular reviewing/updating of our action plan. We will incorporate the feedback on a yearly basis when publishing our annual update.
2.4Disability equality impact assessments
At the RD&E we want to understand whether our services are meeting everyone’s needs, and ensure that people who need our services have access to them. To help us to do this we carry out Equality Impact Assessments.
Equality impact assessmentsare a way of deciding whether an existing or proposed policy, procedure, practice or service does (or may) affect people differently, and if so, whether it affects them in an adverse way.
We have been carrying out equality impact assessments on a number of policies and services during 2006. Assessments will be carried out on all new policies and services as they are developed. Existing policies and services will be assessed as part of the planned review process. Disability issues will be considered alongside other equality issues such as race and gender.
We have produced guidance for staff and provided training to people who are responsible for undertaking equality impact assessments.A summary of the results of the completed equality impact assessments will be reported via the Trust website.
2.5Improvedaccess to services, information and communication
2.5.1Access to services
As a service provider The Royal Devon and Exeter NHS Foundation Trust is responsible for exercising public functions. This means that under the Disability Discrimination Act 1995 we have a legal duty to ensure that wherever possible disabled people can use or receive the same services to the same standards as non-disabled people, and that disabled people do not experience unlawful discrimination.
As previously highlighted (see section 2.1), two detailed audits were carried out in 2002 and 2004, with outcomes and recommendations reported to the DDA steering group. Group members helped to prioritise the actions needed to improve access.
Work commenced on those actions identified as being the first priority and lots of improvements have been achieved in a variety of areas. These include: ramped approaches, designation of accessible parking, signage, power-assisted doors, and removal of non-essential furniture or other obstructions in circulation routes.
Other items were designated as second priority with agreement that works be completed on a planned replacement basis. This includes: fixed desks and counters, adjustments of door closers to meet British Standard / Part M obligations, road crossings, additional accessible parking, way finding signage, and changes to ramps.
Additional access issues still to address (as identified at away-day) are:
- To improve signage across the Trust
- To investigate a ‘fast-track’ access system in the Emergency Department for individuals with specific requirements. The system will be piloted with people with learning disabilities.
2.5.2 Access to information / communication
The action plan ensures linkage to other pieces of work relevant to disabled people, including the Trust policies on interpretation and translation, the production of patient information, more accessible information for disabled people, partnership working with voluntary and community groups, and involvement with groups who may face additional barriers to access.
The purpose of our interpretation and translation policy is to:
- Describe the essential practices and processes for the proper provision of interpretation and translation services
- Raise awareness of interpretation (including sign language) and translation needs and to encourage staff to proactively plan for these needs
- Ensure staff have knowledge of how to access interpretation and translation services and the confidence to use them.
Our policy for producing patient information also includes guidance to staff on how to provide written information in accessible formats. The guidance follows the good practice ‘toolkit’ issued by the Department of Health in November 2002.
We have also purchased a software package called ‘Widget’ which allows us to translate trust documents into a format that is appropriate for individuals with special requirements. Licences were purchased for areas such as the communications department, the health information centre, photographics, and the access team.
When looking at the documentation process for individuals with special requirements, we scoped nationally to see if we could learn from other organisations. This resulted in us finding a pre-made communication book which has a number of symbols and drawings to assist with the admission and clerking process, as well as general communication needs. The League of Friends kindly supported a request to purchase one of these books for each of the clinical areas and departments within the RD&E and 60 books have now been delivered to all wards and departments.
Working with our Learning Disability Liaison Nurse, we agreed that we would trial a questionnaire to enable us to survey patients who have special requirements. In the first instance we have purchased a survey designed by the Devon Partnership Trust and will be trialling this with 100 patients who have a learning disability.
Specific actions identified still to be completed are:
- The use of symbols to identify those patients with specific requirements. A sub group of the DEAG has worked to identify a number of symbols that can be used to annotate patient’s medical records and/or be placed visibly at the head of the bed so that staff are aware from the outset that individual patients may have special requirements. However we recognise that not all patients will want to be ‘labelled’ in such a way and for this reason we have developed a simple consent form and this, along with the symbols, was formally approved by our Information Governance Committee in September 2006. This work will continue as we are now working with our IT department to identify if we can more efficiently flag patients with special requirements, right from the point of referral.
- To improve communication with the Deaf community
- To further develop the Trust website by considering options to improve accessibility
- To provide more information on the website to outline the further support and advice services available at the Trust.
- To ensure the information about the Care of the Dying Pathway is accessible to patients, carers and relatives
2.6Monitoring
The Trust will monitor its services and employment on disability issues. We will provide the results of monitoring information through service plans, the results of equality impact assessments and where appropriate within the annual report of the Scheme.
2.7Publishing the results of involvement, impactassessment, andmonitoring
Once we have collected the information we will publish the results. The way we do this will vary; we will publish some within reports provided by services to relevant committees, others will be published via the Trust’s website.
Progress will be summarisedin our yearly report on the Disability Equality Scheme, which will include an update on the Action Plan. We will continue to involve disabled people both internally and externally (via our Diversity Steering Group and the Disability Equality Action Group and its sub groups) and provide information on our future disability equality plans and activities. We will also show examples of what has changed as a result of involving disabled people.
We will inform the public about this information through:
- The Diversity section of the Trust’s website:
- Planned distribution to relevant voluntary organisations, community groups and representatives
- ‘RD&Express’ – the Trust newsletter provided to all Foundation Trust members.
We will inform employees about this information through:
- ‘RD&E News - the Trust newsletter for employees
- The Diversity sectionsof ComEx (the trust intranet system).
3Comments and complaints
Patients, carers, relatives and members of the public who feel they have experienced disability discrimination at the RD&E may make a complaint through the Trust’s formal complaints procedure.We take all complaints seriously and will not tolerate any form of discriminatory behaviour.
We will provide information in a variety of formats on the Independent Complaints Advocacy Service (ICAS) to anyone who requires assistance and advice to make a complaint. There is also the option to contact PALS (patient advice and liaison service) to give informal feedback/suggestions on Trust services.
Ongoing monitoring of the themes and trends from complaints and PALS is also another way by which we routinely gather information to see if we are meeting our equality duties.
We have grievance and disciplinary procedures in place and a policy on dealing with complaints of harassment relating to employees.
We also have a ‘whistle blowing’ procedure, which extends the protection for employees who want to report bad practice without fear of being victimised as a result.
4Training
We have training in place to raise awareness of diversity issues, so that our staff are more aware of, and have the skills to take positive action in removing barriers placed in the way of disabled people by society.
A planned approach to Diversity training was approved in June 2006. The purpose of the training is to provide managers and employees with the skills and knowledge they need to ensure that compliance to Diversity legislation and addressing inequalities becomes part of our day to day activities. The plan will also help to support a ‘diversity aware’ culture.