Equality and Diversity Strategic Action Plan

Progress Report, April 2013-March2015

Equality and Diversity Strategic Action Plan

About this report

In April 2013, we published our Equality and Diversity Strategic Action Plan, which set out NES’s equality outcomes and mainstreaming priorities for 2013-2017. We produced this progress report to satisfy our statutory duties to report on progress delivering our equality outcomes and mainstreaming the equality duty into our day to day work. This report captures progress as of 31st December 2014.

The report provides an overview of key achievements and case studies to illustrate our work in each of our six priority areas.

The report also provides a high level summary of key employment data and examples illustrating how we use employment data. Our detailed employment metrics are published annually in our Workforce Plan, which supports mainstreaming equality into the workforce planning process. The Workforce Plans for 2013-14 and 2014-15 should thus be read as a supplement to this report. They can be accessed on the Equality Monitoring page of our website[1].

About NES

We are a national special health board working in partnership with our stakeholders to provide education, training and workforce development for those who work in and with NHSScotland.

Our aim is to improve health and care through education and a significant proportion of our work focuses on the clinical workforce, with a large part of our funding used to pay for doctors and dentists in trainingand the training of those who train them. In addition we prepare professionals for practice in clinical psychology, pharmacy, optometry and healthcare science and we provide access to education for the nursing, midwifery and allied health professions and for healthcare support workers and administrative, clerical and support staff. We deliver CPD for each of the four primary care professional contractor groups; GP, dentistry, pharmacy and optometry.

We also support public service reform and current policy priorities through education relating to improving quality, service re-design, leadership and management, mental health, dementia, older people, and children and young people, with a particular emphasis on enabling sustainable quality through the 2020 Vision for integrated health and social care.

More information about NES is available in our Fast Facts publication[2].

Summary of Progress

This section highlights key achievements and case studies in our priority areas.

Reducing Barriers to Education and Workforce Development

This priority outlines actions we will take to improve access to education and training for groups who have experienced barriers to education and career development, which is a particularly relevant issue for the non-registered workforce, especially administrative, clerical and support services (ACS) and health care support workers (HCSW) and for staff working in remote and rural areas. These staff groups include large numbers of women, particularly at lower bands (ACS, HCSW), larger numbers of staff who identify themselves as disabled (ACS), and significant numbers of overseas qualified or immigrant staff (HCSW, remote and rural).

We are also taking forward work to improve access to work in NHSScotland for young people under this priority.

Key achievements:

• We developed educational pathways for estates and facilities staff and are developing similar pathways for clinical and support staff. This will support improved access to learning and career development. Examples and case studies of our work can be found in the ACCESS Newsletter.

• We established a programme of support to improve access to employment in NHSScotland for young people, developing guidance and support for NHS Boards on using programmes such as Modern Apprenticeships and the Certificate of Work Readiness.

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Case Study: Improving employment opportunities for young people through workforce development support for NHS Boards

NES has undertaken a programme of work to support workforce development and succession planning in a range of administrative and support fields in NHSScotland. A significant strand of this programme has focused on enhancing opportunities for young people to develop skills and access career pathways in health and social care.

This has involved:

• Moving Forward with Modern Apprenticeships, which provides guidance on using MAs within NHSScotland
• Establishing the NHSS MA Network
• Supporting the sector skills council to develop a new Modern Apprenticeship in Healthcare Support
• Delivering Modern Apprenticeships in NES in Creative and Digital Media and Business Administration, with agreed pathways from the MA programme into employment opportunities
• Piloting and producing guidance on the Certificate of Work Readiness qualification, supporting NHSS employers to offer high quality placements for young people experiencing difficulty finding work.

Further details, including case studies of individual learner experiences, are available at [link] [/end Box]

Making Education and Training More Inclusive

This priority outlines actions we will take to develop our educational resources and products so that they are more inclusive of the needs of diverse groups of learners, and work we will undertake with partners to develop capacity for delivery of education and training in NHSScotland which is more inclusive. Our evaluation, research and engagement activities suggest that this is particularly relevant for disabled people, staff who have migrated to Scotland from overseas, people who have difficulties with literacy or limited educational experience. Remote and rural staff may have different learning needs or require different modes of educational delivery than staff in other parts of Scotland.

Our work in this area has focused on:

• increasing awareness of and championing inclusive approaches to learning;
• signposting learning and development professionals, trainers, mentors, managers and learners to resources to support learners who experience difficulties with literacy, numeracy and digital literacy;
• embedding inclusive education principles into quality management of practice learning environments and educational governance;
• delivering accessible e-learning, events and courses more consistently, and further developing our approach to inclusive digital learning.

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Case study: Support for Adult Literacies, including Dyslexia, Dyscalculia and English as a Second or Other Language

In June 2014, we launched The Literacies Portal. This new web resource provides links to a wide range of information, guidance and resources to support adult literacies in the NHSScotland workplace. Divided into sections for educators, supervisors and staff, the portal signposts to resources to support reading, writing, numeracy and computer skills. It also includes resources which will help staff to work with patients who have difficulty with reading, writing, numbers or using computers.

NES, working in partnership with the Workers’ Educational Association, is piloting a Professional Development Award (PDA) in Developing Literacies Learning Programmes for the Workplace (Units 1 & 2). The aim of this PDA is to enable NHSScotland educators to:

• deepen their own understanding of adult literacies issues which might affect the workplace
• create a plan to increase awareness and understanding of literacies issues within their own workplace

As part of the project, the participants will also contribute to the evaluation of The Literacies Portal as a tool to support adult literacies in the NHSScotland workplace. [/end Box]

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Case Study: Reducing Differential Outcomes: Educational Support for International Medical Graduates in General Practice

National research on differential performance of International Medical Graduates (IMGs) on the Royal College of General Practitioners’ Clinical Skills Assessment identified a number of areas where IMGs, having had different educational experiences, may have different learning needs than UK graduates or may require additional support. In Scotland, NES’s deaneries (which were amalgamated to become the Scotland Deanery in April 2014) have delivered a number of specific educational programmes relevant to IMGs to support them to prepare for the Clinical Skills Assessment and medical practice in Scotland. These programmes have included:

• Intensive communication skills;
• English language support, with support from a trained linguistic on spoken and written language structure and dealing with colloquial language;
• 1:1 support from Training Programme Directors;
• Enhanced induction.

The North of Scotland Deanery’s intensive communication skills event evolved over time, informed by evaluation and feedback and includes:

• Orientation
• Small group work about culture (medical & general) & language
• Reflective learning exercise
• Provision of an ‘educational prescription’ from the faculty that contributes to early ES formative assessment
• Some follow-up where resources allow focussing on language/ culture/ communication skills

The West of Scotland Deanery developed an enhanced induction programme for trainees who did not complete a UK Foundation Programme. This induction includes working in the NHS, communication skills, the purpose of and response to feedback. The induction was developed with input from IMGs that are now Educational Supervisors and one who is a CSA examiner.

From April 2014 the former regional deaneries were combined into a single Scotland Deanery. The Deanery is reviewing the existing programmes and good practice from throughout the UK to develop a nationally consistent approach to support. [/end Box]

Reducing Occupational Segregation

The health and care workforce is structured by high degrees of horizontal and vertical gender occupational segregation. NES’s strategic role in workforce development provides the opportunity to contribute to a wider agenda of developing the workforce in ways which will incrementally change the structure of the workforce, making it more effective and increasing opportunity for both women and men. This priority sets out the actions we will take to do this, though raising awareness of relevant issues and signposting good practice.

We recognise gender occupational segregation as a complex and long-standing issue in the workforce in Scotland. Our approach has been to develop leadership and management programmes with regard to these issues and to ensure that our support for improving access to development and employment for young people helps to reduce occupational segregation.

Examples of our approach include:

• Proactive use of images in recruitment programmes which reflect diversity.
• Analysis of the demographic makeup of cohorts selected to development programmes.
• Developing monitoring guidance for equalities for use in CPD and fellowship programmes.
• Ensuring that our work to support Modern Apprenticeships highlights issues with occupational segregation and signposts those who will be using MAs to relevant research.
• Supporting development of a high-quality MA in health and social care support.

Education and Development for Cultural Competence and Person-centred Care

This priority sets out specific work we will undertake to ensure that our education and training enhances the cultural competence of the workforce, and that we embed equality and diversity in our broader educational support for person-centred care.

We support a range of educational activity which supports staff development to deliver person-centred care to the diverse people of Scotland. These include core programmes of training (eg, postgraduate training in Medicine, Psychology, Pharmacy and Dentistry) where person-centred approaches are embedded in the curriculum. This is a significant contribution to improving the care experience and quality of care for service users from a range of communities, as person-centred approaches have been highlighted as appropriate educational interventions to support development of the knowledge and skills needed to work with diverse populations.

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Case Study: Enhancing quality by involving service users and carers in Psychology training programmes

In recent years the quality of Psychology training has been further enhanced by the participation of serviceusers and carers in the two Scottish Doctoral and Masters programmes.

The two Doctoral programmes adopted contrasting approaches in the deployment of service users and carers. One started with a clear programme of activities for service users; involving them in learning activities, reviewing trainee report abstracts, advising on curriculum development etc. The other university integrated the service users into the programme in a more organic way, allowing users to lead in determining the impact that they wished to achieve and developing the strategy for integration. Across the two programmes service users and carers have made valued contributions in a range of areas including: curriculum planning; trainee recruitment; design of supervisor training; teaching and trainee evaluation. The groups’ input has ranged from direct work with trainees through to consultation on various programme committees.

The key to providing useful support for service users has been planning and scheduling activities around the capacity, needs and preferences of individuals. This helped the team optimise contributions and minimise the pressure placed on service users.

Feedback indicated that service users find their involvement in the programmes personally rewarding in terms of interest, new skills and improved confidence.Those who attend the groups have reported that the meaningful response of the programmes to their contributions is both rewarding and appreciated. The programmes provide a range of training and support activities for the service user groups. However, while these activities are valued by the group members, it appears that much value derived from their participation isbased on the changes made to training resulting from their input.

The NES Clinical Practice Director for Psychology observes that the utility of user involvement in training development, delivery and quality assurance can often be under-estimated. He comments that their questions and comments have been searching and helpful; enabling the Programme Team to enhance learning in a number important areas.

Serviceusers have been contributing to the development and delivery of Psychology training since 2012. The universities and NES Psychology Team have been reflecting on this aspect of their programmes and are now considering enhancements in several areas as follows:

• New ways of integrating serviceusers, carers and advocates within organisational structures of programme teams,
• More involvement of service users in trainee induction and induction planning,
• Involvement of service users in quality management of the clinical learning environment,
• Improving representation from under-represented psychology service areas such as forensic psychology, CAMHs, older adults and LGBT service users. [/end Box]

We also develop educational frameworks, programmes and learning resources for uniprofessional or multiprofessional continuing professional development (CPD), which supports existing staff to further develop skills, knowledge and practice which will improve care for specific populations. These are increasingly designed within the framework of a human rights-based approach to health and care.

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Case Study: Programmes to reduce specific inequalities: Improving experience for people who use augmentative and alternative communication

The main aim of thisprogramme was to support the national delivery of the vision for Scotland described in “A Right to Speak”: that “individuals who use augmentative and alternative communication (AAC) are included, free from discrimination, and live in an environment that recognises their needs and adapts accordingly.”

People who use AAC experience a wide range of inequalities – and these are often fundamentally related to their communication support needs. A key theme of “A Right to Speak” is about addressing inequity in access to services and equipment across the country.

Our contribution can be described in terms of three themes – supporting multiagency partnership development, supporting learning and development across all agencies involved in providing services to people who use AAC, and research.

The project supported a wide range of initiatives and developments. We provided funding across the health, social care and education sectors to support partnership development projects. In relation to learning and development we have overseen the production of a cross sector framework (Informing and Profiling Augmentative and Alternative Communication Knowledge and Skills (IPAACKS)) for assessing current knowledge/practice and planning development in relation to AAC. We also commissioned research: for example, a project about Quality Indicators for AAC services from the perspective of people who use AAC.

Equality and diversity is central to this project. Throughout the project we have been aware of the importance of reflecting the diversity of people who use AAC in images and resources. As part of the process for applying to us for funding (e.g. for partnership development or learning/development projects) applicants were required to reflect on how their work would support equality and diversity. An individual who uses AAC sits on the project steering group and people who use AAC have had been key partners in the development of resources (e.g. IPAACKS) and a public facing marketing campaign:

We are exploring the impact of a number of our projects. IPAACKS is currently being evaluated and we are collecting information about how it has changed and influenced practice. As part of the marketing campaign a follow up survey will be completed across all agencies to evaluate the impact of the awareness raising efforts of the “Now Hear Me” campaign. Applicants to the learning and development fund have been asked to complete learning outcome feedback details, and this information is being shared via a conference with a newsletter, posters and series of workshops. [/end Box]

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Case Study: Programmes to reduce specific inequalities: Caring for Smiles, better oral health for dependant older people

The main aim of the project is to support the National Oral Health Improvement Strategy for priority groups (2012) by providing care home managers with training resources to champion oral health for older dependant people.

Older dependant people are often unable to communicate that they have pain. Embedding oral health within everyday personal care enables care planning and ongoing risk assessment, so that older people get the oral care they need and are free from dental pain.