Equallity, Diversity and Inclusion Annual Accounts 2022 - 2023 (web version)
Contents
- Introduction
- Our Trust and our values
- Staff profile and our communities
- Staff networks
- Workforce Race Equality Standard (WRES)
- Workforce Disability Equality Standard (WDES)
- Gender pay gap
- Patient Advisory and Liaison Service (PALS)
- Complaints
- Equalities and service provision.
- Achieving Equality and Inclusion plan
1. Introduction
Our strategic aims
In line with its equality duties, Homerton Healthcare NHS Foundation Trust has set out to achieve equality and inclusion for all our people as part of Our Homerton People Plan, which is our plan to make Homerton the best place to work in the NHS, and supports our strategic aims of developing happy, healthy and heard staff and delivering outstanding, equitable care.
Full details of our plan and strategy is available on our website:
https://www.homerton.nhs.uk/equality-and-diversity
https://www.homerton.nhs.uk/trust-strategy/
We are committed to achieving equality and inclusion for all our people at Homerton Healthcare NHS Foundation Trust and we respect and value the diversity and differences of our patients and our people, ensuring everyone is enabled to thrive, feels a sense of belonging, and is able to be their authentic self.
We are proud to be in one of the most diverse locations in the country, with nearly 90 different languages spoken as a main language, and we champion equality, diversity and inclusion in all aspects of our employment practices and service delivery. Every member of our staff is expected to understand, commit to, and champion equality, diversity and inclusion throughout their work.
The Equality Act 2010
The Equality Act 2010 applies to all organisations that provide a service to the public.
The Act protects people from being discriminated against because of a certain characteristic. These are known as Protected Characteristics. They are:
- age
- disability
- gender reassignment (where a person has undergone, or is proposing to undergo, a process (or part of a process) for the purpose of reassigning their sex by changing physiological or other attributes of sex)
- pregnancy and maternity
- race (this includes ethnic or natural origin, colour, and nationality)
- religion or belief
- sex
- sexual orientation
- marriage or civil partnership
As an organisation, we aim to extend our policies, practices, and procedures to cover other characteristics and encompass all gender identities including trans, non-binary and gender non-conforming.
Public Sector Equality Duty (PSED)
The Equality Duty 2010 consists of a General Duty with three main aims. It requires the Trust to have due regard to the need to:
- Eliminate unlawful discrimination, harassment and victimisation and any other conduct which is unlawful under the Act 2010
- Advance equality of opportunity between people who share a protected characteristic and those who do not; and
- Foster good relations between people who share a protected characteristic and those who do not.
In addition, there are two specific duties that the Trust is required to meet:
- publish equality information at least once a year to show how they’ve complied with the equality duty
- prepare and publish equality objectives at least every 4 years
Regulatory context
The Trust is required to implement the Workforce Race Equality Standard (WRES), to ensure it undertakes its Public Sector Equality Duties. In 2015, this became a requirement within all provider NHS Standard Contracts.
The Trust submitted data for the first time in August 2019 for the Workforce Disability Equality Standard (WDES) and completed the submission of this data for 2022 in August 2023. The Trust will submit its Gender Pay Gap data for 31 March 2023 by 20 March 2024 in line with reporting deadlines.
This report summarises the equality monitoring data for patients and staff for the period 1 January 2022 to 31 December 2022, and the WRES and WDES data for the reporting period 1 April 2022-31 March 2023. For staffing numbers, records were drawn as of staff employed on 31 December 2022 and the Gender Pay Gap data is from 31 March 2023.
Achieving Equality and Inclusion for Our People objectives for 2022-25
We have set ourselves ambitious objectives to achieve equality and inclusion for our people as part of Our Homerton People Plan, which feeds into our strategic objective of ‘Developing happy, healthy and heard staff’ within Our Future Together strategy 2023-28.
Our equality objectives are set out below:
- EO1: Work as part of the Integrated Care System (ICS) to design, implement and embed an anti-racist approach in the organisation
- EO2: Empower our Staff networks to ensure all staff feel psychologically safe to bring their whole self to work
- EO3: Review Trust processes in line with just culture principles and are fair and equitable. These will include HR processes (including recruitment, conduct etc.) and organisational change (including Equality Impact Assessments)
- EO4: Reduce the experiences of discrimination, harassment, bullying or abuse
- EO5: Increase the self-declaration rates of staff for: ethnicity, gender, disability, sexual orientation, religion, and belief
- EO6: Continue to ensure education, development and career progression opportunities are inclusive and accessible to all
Progress
In 2022, we developed a set of actions to improve our WDES and WRES metrics and make progress against our equality objectives. An update of these actions may be found below:
| Number |
Action |
Progress |
Equality Objective |
|---|---|---|---|
| A1 |
Leadership from the top The executive team and other very senior leaders will be taking active steps to describe and explain their individual and collective commitment to achieve inclusion for all our people. This is intended to demonstrate the full commitment of key senior leaders and, in time, earn the confidence and trust of our people by delivering on these steps. |
Senior leaders have engaged in first cohort of reverse mentoring and have demonstrated commitment to achieving inclusion through clear communications, engagement with network events and EDI awareness dates, as well as an anti-racist statement published in October 2022 from CEO and Chairman.
|
EO1, EO3 |
| A2 |
Anti-racism Statement and action plan |
An anti-racist approach has been developed in collaboration with Together We Rise staff network and Achieving Inclusion working group and taken to Trust Leadership Team on 4 August, with plans to take through the organisation from October 2023.
|
EO1, EO2, EO3, EO4, EO6 |
|
A3
|
#InclusiveHR |
Currently on step 4 of 5 step challenge for change; the data has been shared with People division and a survey took place in February 2023. |
EO1, EO3, EO4 |
| A4 |
Development of networks |
EDI Lead has continued to work with networks, membership has grown for each network and a Women’s network is in development. Consistent communications and events to raise awareness and heighten their profile. Work is ongoing to support the development of the networks and is included in Appendix 1
|
EO2 |
| A5 |
Debiasing our processes |
Just and Learning Culture Lead has worked with the People division to review cases and provide development sessions to ensure approach is in line with just and learning culture principles and is fair and equitable. |
EO3, EO6 |
| A6 |
Improve reporting of bullying, harassment, abuse, hate crime and discrimination |
Violence and aggression committee has been reinstated in September 2023 to tackle these issues, Freedom to Speak Up has been included in Datix. |
EO1, EO4 |
| A7 |
EDI training |
EDI training package available across the Trust, including EDI overview, automatic bias, bystander intervention, sexual harassment, anti-racism, ‘Working While Black,’ disability awareness, and planned LGBTQIA+ awareness sessions from Autumn 2023.
|
EO1, EO3, EO6 |
| A8 |
Improve our data |
EDI Lead has presented at Trust Welcome to encourage new starters to update their information on ESR – seen a 1.1% increase in disability declaration. |
EO5 |
We have built upon these actions to develop an anti-racism approach, which will help us meet our equality objectives and strategic aims. These are referenced within this report, with the full plan available in the appendix.
Equality Governance
The current equality diversity and inclusion related work and governance infrastructure across the Trust is as follows:
- Board of Directors
The Trust Board has ultimate overall responsibility for ensuring that the organisation is progressing against equality and diversity priorities and is compliant with all relevant legislation.
- People and Culture Committee
The People and Culture Committee is a sub-group of the Trust Board and is responsible for discharging all requirements relating to people and culture including equality, diversity, and inclusion.
- Achieving Inclusion Group
The Achieving Inclusion Working Group monitors delivery of Equality Diversity and Inclusion objectives as part of our Homerton People Plan, creating a space to consult on key projects, reviewing Key Performance Indicators in relation to EDI and explore other areas of work and plans to achieve equality and inclusion for our people. The group is responsible to People and Culture Committee, providing updates and assurance.
- People and Culture Forum
The People and Culture Forum is a space for our people to network, exchange ideas and suggest ways to enhance people experience at the Trust, to help realise the ambition of making the Trust the best place to work in the NHS. It's a space for our people to voice their concerns as individuals or through feedback from our staff groups and networks. This group is made up of representatives from Executive Directors, the People team, Staff networks and staff-side colleagues.
Individual responsibilities
- Chief People Officer
Executive Director responsible for delivering Equality, diversity, and inclusion in the organisation - Head of Organisational Development and Culture
Responsible for the strategic development and operational delivery of ‘Our Homerton People’ plan including health and wellbeing and equality, diversity, and inclusion - Equality Diversity and Inclusion Lead
Provides knowledge, experience, and expertise to ensure the organisation fulfils its responsibilities under the Equality Act 2010
2. Our Trust and our values
Homerton Healthcare NHS Foundation Trust is an integrated care trust which provides hospital and community health services for Hackney, the City and surrounding communities. The Trust provides a full range of adult, older people’s and children’s services across medical and surgical specialties.
The trust operates acute services from a single site: Homerton University Hospital, which opened in 1986. Based on an aggregation of ratings across all of the core services provided from the hospital, the hospital has been rated by Care Quality Commission as ‘Outstanding’. The hospital has almost 500 beds spread across 11 wards, a ten bed intensive care unit and maternity, paediatric and neonatal wards. Community services are provided by staff working out of 75 partner sites in Hackney and the City of London. The trust has a separate registration to provide continuing health care at the Mary Seacole Nursing Home.
Given our staff profile, where Black, Asian and other ethnic background staff make up the majority of our staff, and White staff are the minority, the Trust uses the following terminology:
- Black Asian and other ethnic background
- Black Asian and ethnically diverse
- Black and Global Majority
- Black Asian and Racial Heritage
Language continues to evolve, and we work closely with partners and our Together We Rise staff network to ensure we use terminology that is relevant and appropriate for our staff and the communities we serve, whilst also recognising the limitations of umbrella terms. We avoid using acronyms and aim to specify ethnicity wherever possible.
Our values and behaviours shape everything that we do as individuals and as an organisation, they are the foundation of every interaction we have with each other, our patients, their families and carers, our community, and our partners.
We originally developed our four core values with our people and patients eight years ago, they formed the framework for how we deliver services and treat one another. We’ve now refreshed our values alongside the development of our five-year strategy, and are pleased to now have ‘inclusive’ as one of our five core values.
The ‘Living Our Values’ leaflet sets out our values and the behaviours that underpin them, they set a clear standard of what you can expect while you are cared for or work at Homerton Healthcare.
- Safe
We will do everything we can to make our services as safe as possible and constantly seek to learn and improve. - Personal
We will give compassionate care that addresses individual needs and is responsive to our patients, service users, their families and carers, and our people. - Responsibility
We will take responsibility for our actions and any problems that we come across – we lead by example. - Respectful
We will treat others as we would expect ourselves or our families to be treated and cared for. - Inclusive
We will respect and value the diversity of our patients and people so everyone can thrive, feel a sense of belonging and can be their authentic self.
3. Staff profile and our communities
The Trust is situated in the London Borough of Hackney. Hackney’s population is 259,200 as recorded in the 2021 Census. Hackney is a relatively young borough, with approximately 24% of its population under 20. People aged over 55 make up only 12% of the population.
Hackney is a culturally diverse area, with significant ‘Other White’, Black and Turkish/Kurdish communities. The Charedi Jewish community is concentrated in the north-east of the borough and is growing. People from Australia, the US and Western European countries like Spain, France and Italy have all moved to Hackney in recent years. Just over a third of Hackney’s residents are Christian. This is a lower percentage than the London and England averages. Hackney’s population contains significantly more people of Jewish and Muslim faith, as well as a higher proportion of people with no religion and those who did not state a religion than average in both London and England.
As of 31 December 2022 the Trust employed 4133 staff; a slight decrease from 4200 in the 2021 report.
Breakdown of Employees by Ethnicity
Approximately 40% of Hackney’s population come from Black, Asian, and other ethnic backgrounds with approximately 36% of the population identifying as White British and 16% as ‘other White’[1].
As of 31 December 2022, 56% of our staff are Black Asian or another ethnic background, and 42% are White. 2% are not stated or unknown. The table below provides a detailed breakdown of our employees by ethnicity; Black staff make up 28% of our population, and Asian staff make up 18% of our population.
|
Ethnicity |
Percentage % |
|---|---|
|
Asian |
17.57% |
|
Asian or Asian British - Indian |
7.96% |
|
Asian or Asian British - Pakistani |
2.18% |
|
Asian or Asian British - Bangladeshi |
3.87% |
|
Asian or Asian British - Any other Asian background |
3.05% |
|
Asian Mixed |
0.05% |
|
Asian Punjabi |
0.02% |
|
Asian East African |
0.02% |
|
Asian Sri Lankan |
0.10% |
|
Asian British |
0.12% |
|
Asian Caribbean |
0.07% |
|
Asian Unspecified |
0.12% |
|
Black |
28.43% |
|
Black or Black British - Caribbean |
7.55% |
|
Black or Black British - African |
16.48% |
|
Black or Black British - Any other Black background |
1.89% |
|
Black Somali |
0.15% |
|
Black Nigerian |
0.46% |
|
Black British |
1.89% |
|
Black Unspecified |
0.02% |
|
Southeast Asian |
2.52% |
|
Chinese |
1.26% |
|
Vietnamese |
0.07% |
|
Filipino |
1.16% |
|
Malaysian |
0.02% |
|
Mixed ethnic background |
3.75% |
|
Mixed - White & Black Caribbean |
0.99% |
|
Mixed - White & Black African |
0.56% |
|
Mixed - Any other mixed background |
1.16% |
|
Mixed - Black & Asian |
0.05% |
|
Mixed - Chinese & White |
0.02% |
|
Mixed - Other/Unspecified |
0.05% |
|
Mixed - White & Asian |
0.92% |
|
Other ethnic background |
3.75% |
|
Any Other Ethnic Group |
3.63% |
|
Other Specified |
0.12% |
|
White |
41.93% |
|
White - British |
28.57% |
|
White - Irish |
2.64% |
|
White - Any other White background |
8.73% |
|
White Northern Irish |
0.02% |
|
White English |
0.29% |
|
White Scottish |
0.10% |
|
White Welsh |
0.07% |
|
White Greek |
0.15% |
|
White Greek Cypriot |
0.02% |
|
White Turkish |
0.17% |
|
White Turkish Cypriot |
0.02% |
|
White Italian |
0.15% |
|
White Gypsy/Romany |
0.02% |
|
White Polish |
0.12% |
|
White Mixed |
0.05% |
|
White Other European |
0.80% |
|
Not Stated |
2.06% |
[1]https://hced.co.uk/download/Hackney-Profile_2020.pdf
Gender
In the 2021 Census, 52% of Hackney’s population are female and 48% are male. Our staff profile is 79% female and 21% male, which is representative of the NHS nationally[1] (77% female, 23% male).
There is a lack of borough level data beyond the binary of male and female, so it is difficult to identify the population of transgender, non-binary and gender non-conforming people. The Gender Identity Research and Education Society GIRES, currently estimate there are 650,000 (1% of the population) whose gender identity is incongruent with their assigned gender at birth[2], which would equate to around 2592 people in Hackney.
The Practical Androgyny website estimates approximately 0.4% of the UK population is non-binary[3], equating to around 1,200 people in Hackney.
As data is not collected at either borough level or within the Trust, it is difficult to ascertain numbers of trans, non-binary and gender non-conforming people, and we will continue to feed into national conversations about data collection to improve this in our systems so that necessary support may be provided, although we can estimate based on the national data that at least 1.4% of our staff are trans or non-binary. This would equate to 58 members of staff.
[3]https://practicalandrogyny.com/
Age
In the 2021 Census, 43% of the borough’s population is under 29 years old, and our staff population is 21% of those who are under 30 years old.
We employ a higher proportion of staff who are 31-35 years old (15.4%) compared to Hackney’s population of those who are 30-34 years old (12.3%).
Our staff profile in terms of age has remained stable, however the population of staff over 66 has decreased from 2020 by 4% (6% in 2020 compared to 2% in 2022). This could indicate that more staff have retired.
Religion and belief
40.4% of our staff are Christian, and 29.6% are atheist, unspecified or do not wish to declare. 11.4% of our staff are Muslim and 0.8% are Jewish, which is lower than that of Hackney: 13.1% Muslim and 10.1% Jewish. Since this reporting cycle, ‘Jewish’ has now been added to ESR as an ethnicity and will be included in subsequent reports.
Sexual orientation
There is little information pertaining to sexuality and sexual orientation collected centrally for Hackney, but the Stonewall Rainbow Britain report[1] found that 84% of the population tells us they are straight. The most common identity after straight is bi (5%), and an additional 1% of the population identify as pansexual.
In total, 7% identify as having a sexual orientation that involves being attracted to people of more than one gender.
By comparison identifying as being gay (3%) or lesbian (1%) is much less common, and the report also indicates that 2% of the population identify as asexual or ace. Asexual people experience little or no sexual attraction.
The chart below shows the profile of our staff by sexual orientation.
[1]https://www.stonewall.org.uk/resources/rainbow-britain-report-2022
A lower percentage of our staff are straight (73.5%) in comparison to the overall population and 19.8% of our staff do not wish to declare, are undecided, unspecified or another sexual orientation not listed, which has improved since 2021 (22.4%). This does mean, however, that up to 24.5% of our staff could be of another sexual orientation other than straight, which indicates further work needs to be undertaken to support our LGBTQIA+ communities.
Disability
In the 2011 Census, 14.6% of Hackney respondents said they had a long-term illness that limited their daily activities in some way, compared with 13.6% for London and 17.9% for England and Wales. Hackney’s lower than average rates of disability and long-term illness are likely to be due to its relatively younger population, as disability rates tend to increase with age.
Our data from 31 December 2022 indicates that 5.6% of staff have a disability, 79.7% do not consider themselves to have a disability and 14.7% are undeclared or unknown. The WDES metrics set out the experience of our disabled staff in more detail.
4. Staff networks
Our staff networks are vital in creating an inclusive environment at Homerton, providing spaces for our people to come together and share their experiences, build community, provide a platform for their members, and drive change.
Enable
Enable’s aim is to play a vital role in ensuring Homerton is an inclusive workplace where disabled employees, those with long-term health conditions or neurodiversity feel empowered, and managers feel equipped to support a diverse workforce.
Homerton Rainbow
Homerton Rainbow is Homerton Healthcare's staff LGBTQIA+ Network. They welcome all members of the LGBTQIA+ community and allies to join the Network and support us in creating a more diverse and inclusive organisation.
Together We Rise
Together We Rise is for Black, Asian and racial heritage staff or anyone in support of the Network. The Network has the potential to add value and be the vanguard in helping improve outcomes for Black, Asian, and racial heritage staff within the Trust, and lead the way in giving people opportunities to be heard in a safe environment.
Women’s
Our Women’s Network aim is to build a community that champions the voices, issues, and successes of all female-identifying colleagues.
5. Workforce Race Equality Standard (WRES)
Implementing the Workforce Race Equality Standard (WRES) is a requirement for NHS commissioners and NHS healthcare providers to take steps to ensure employees from Black Asian and other ethnic backgrounds have equal access to career opportunities and receive fair treatment in the workplace.
The WRES comprises 9 metrics and is reported on annually. The data below is for the reporting period 1 April 2022-31 March 2023.
| No. | Metrics |
|---|---|
|
1 |
Percentage of staff in each of the AfC Bands 1-9 and VSM (including executive Board members) compared with the percentage of staff in the overall workforce |
|
2 |
Relative likelihood of White compared to Black Asian and other ethnic background staff being appointed from shortlisting across all posts |
|
3 |
Relative likelihood of Black Asian and other ethnic background staff entering the formal disciplinary process compared to that of White staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation |
|
4 |
Relative likelihood of Black Asian and other ethnic background staff accessing non-mandatory training and CPD as compared to White staff |
|
5 |
Percentage of staff experiencing harassment, bullying or abuse from patients, relatives, or the public in the last 12 months |
|
6 |
Percentage of staff experiencing harassment, bullying or abuse from staff in the last 12 months |
|
7 |
Percentage believing that the Trust provides equal opportunities for career progression or promotion |
|
8 |
Percentage of staff experiencing discrimination at work from manager/team leader or other colleagues |
|
9 |
Percentage difference between the organisations’ Board membership and its overall workforce disaggregated by voting membership of the Board and executive membership of the Board |
Model Employer Goal
NHS England and Improvement have introduced the Model Employer goal to increase representation of Black Asian and other ethnic background people at leadership levels and across the workforce pipeline by 2028, in line with the NHS Long Term Plan.
The overall Black Asian and other ethnic background workforce in the NHS is increasing, however this is not reflected at senior positions where there is an acute under-representation of Black Asian and other ethnic background staff.
Our workforce as of 31 March 2023 is 56.5% Black Asian and other ethnic background (an increase of 2% compared to last year), and the proportion of Black Asian or another ethnic background people at Band 6 and above is 46.3%, compared to 42.7% as of 31 March 2022.
A bespoke report for 2021/22 produced by the National WRES team highlighted three high priority areas for improvement, in line with our Model Employer Goals:
WRES 9: Board representation (overall, voting members, and executive members)
WRES 1: Career progression in non-clinical roles (lower to upper levels)
WRES 1: Career progression in clinical roles (lower to upper levels)
WRES Metrics 1-9
Overall breakdown of ethnicity of staff on ESR (31 March 2023)
Metric 1: Percentage of staff in each of the AfC Bands 1-9 or Medical and Dental subgroups and VSM (including executive Board members) compared with the percentage of staff in the overall workforce
Non-clinical %
Clinical %
Representation of Black Asian and other ethnic background staff from band 7 and above for both clinical and non-clinical groups is not in line with our overall workforce, although at non-clinical band 8a we have seen an increase from 40.4% Black Asian and other ethnic background staff to 45%, and a 3% increase in clinical roles at band 8a. This has potentially led to the increase in the proportion of Black Asian and other ethnic background staff at band 6 and above to 46.3%, compared to 42.7% in 2022. There is still much more work to be taken forward, as White people are overrepresented from band 8b and above, and there is a particular issue at band 9 and VSM level, although the current data does not represent our existing Very Senior Managers.
As the progress update in section 1 shows, work has been undertaken across the Trust to highlight this issue, and the anti-racism approach (Appendix 1) has been formulated to address the issue of representation overall, although there are key actions that will help drive this forward, most notably the 5 step challenge to change, de-biasing our recruitment processes, and ensuring that divisions map out the profile of their staff and are aware of their key issues in terms of representation of staff, and develop action plans to address the specific challenges, drawing on internal support and expertise where relevant, but also looking to best EDI practice within their specialist field.
|
Year |
WRES 2: Relative likelihood of White compared to Black Asian and other ethnic background staff being appointed from shortlisting across all posts |
|---|---|
|
2016-17 |
1.87 |
|
2017-18 |
1.73 |
|
2018-19 |
1.61 |
|
2019-20 |
1.73 |
|
2020-21 |
1.42 |
|
2021-22 |
1.48 |
|
2022-23 |
1.55 |
There have been enormous pressures on our Resourcing team over the past year, and so the work to de-bias our recruitment processes and practice has not progressed. This may be reflected in the increase of White staff being appointed compared to Black Asian and other ethnic background staff, and so efforts must be invested in both our Resourcing team and our Recruiting managers and divisions to help equip them with the knowledge, skills, and tools to de-bias their recruitment practices, whilst ensuring we continue to recruit staff at a rapid pace. This will not only hinge on work centrally within the People team, but across divisions, as this will need to be implemented locally to be effective. An in-depth review of our current recruitment processes and time to hire is being undertaken and the equality action will be incorporated.
| No. | Actions |
|---|---|
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
|
Year |
WRES 3: Relative likelihood of staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation |
|---|---|
|
2016-17 |
3.29 |
|
2017-18 |
1.84 |
|
2018-19 |
1.45 |
|
2019-20 |
1.26 |
|
2020-21 |
1.29 |
|
2021-22 |
2.78 |
|
2022-23 |
0.75 |
This indicator was raised as a significant area of concern in 2022, as Black Asian and other ethnic background staff are 2.78 times more likely to enter the formal disciplinary process than White staff. As stated in last year’s report, work to address this was to be supported by the newly appointed Just and Learning Culture Lead. Over the past year, they worked with the People services team in collaboration with Freedom to Speak Up Guardian, staff networks, and EDI Lead, to enable them to reflect on the way in which they respond and manage cases, helping move towards implementing a restorative and just culture approach.
This metric has now decreased to 0.75, meaning that White staff are more likely to enter the formal disciplinary process.
Although the formal wellbeing and resolution policies are in development, the People services team are on a journey to embed a just and learning culture approach, taking more time to reflect on decisions and being compassionate in their conversations with staff, both verbally and in writing.
They have been asking managers more questions and negotiating with them the best way to manage each case, without immediately beginning a formal process. Although this has been met with some resistance from managers, the team has been supported through the Chief People Officer and Deputy Director to implement a kind and compassionate approach.
This approach shifts the work to the beginning of the case, asking probing questions of the managers to help them analyse the context before taking any procedural steps. This has led to a reduction of formal investigations and disciplinary cases.
The next stage, as set out in the actions below, will be to formalise the proposed policies to embed a restorative and just culture approach; they will provide a clear structure and standard to help operationalise the just and learning culture approach across the whole organisation.
Managers will be key in taking this forward and being part of the wider culture change, and so the policy and approach will be threaded through the Leadership behaviours framework as well as in trainings and communications.
| No. | Actions |
|---|---|
|
3B |
We will review our disciplinary, grievance and bullying and harassment processes in line with our just and learning culture principles, with a focus on early resolution and empowering our people to speak up |
|
3C |
We will work towards assessing mistakes at a systemic level and implement learning and education measures, avoiding an individual blame culture |
|
Year |
WRES 4: Relative likelihood of Black Asian and other ethnic background staff accessing non-mandatory training and CPD as compared to White staff |
|---|---|
|
2016-17 |
2.00 |
|
2017-18 |
0.78 |
|
2018-19 |
0.69 |
|
2019-20 |
0.74 |
|
2020-21 |
0.77 |
|
2021-22 |
0.90 |
|
2022-23 |
0.87 |
Black Asian and other ethnic background staff continue to access more non-mandatory training and CPD than White staff, although this is not yet translating to better outcomes in terms of representation at band 6 and above. It is anticipated that divisional action plans and work to de-bias recruitment will help to address the key issues that are preventing Black Asian and other ethnic background staff from progressing. It must also be noted that it is challenging at an organisational level to capture which staff are applying to access training and the nature of their requests, yet are not given permission by their manager, and this is being explored within the People development team.
| No. | Actions |
|---|---|
|
6B |
Our divisions will use staff survey responses and workforce data to develop plans to tackle racism and inequity |
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
|
Year |
Black Asian and other ethnic background |
White |
|---|---|---|
|
2017 |
28.3% |
33.7% |
|
2018 |
29.4% |
30.0% |
|
2019 |
33.5% |
33.6% |
|
2020 |
30.8% |
31.4% |
|
2021 |
30.2% |
31.8% |
|
2022 |
32.9% |
31.3% |
|
Year |
Black Asian and other ethnic background |
White |
|---|---|---|
|
2017 |
28.0% |
21.7% |
|
2018 |
30.7% |
24.4% |
|
2019 |
27.9% |
22.6% |
|
2020 |
29.1% |
23.2% |
|
2021 |
26.4% |
19.1% |
|
2022 |
29.0% |
20.0% |
Despite a decrease in the percentage of Black Asian and other ethnic background staff experiencing harassment, bullying in 2021, this has increased again in 2022, and so a key feature of our anti-racism approach will be to ensure our staff know where to access support and report incidents, and work to strengthen our bullying and harassment procedures must continue. The Violence and Aggression committee also restarted in September 2023, which will support the work to tackle bullying and harassment across the Trust.
| No. | Actions |
|---|---|
|
3B |
We will review our disciplinary, grievance and bullying and harassment processes in line with our just and learning culture principles, with a focus on early resolution and empowering our people to speak up |
|
4A |
We will promote and support: |
|
4B |
We will continue to encourage our people to report incidents via Datix to our Freedom to Speak Up Guardian |
|
Year |
Black Asian and other ethnic background |
White |
|---|---|---|
|
2017 |
44.1% |
66.7% |
|
2018 |
40.5% |
61.2% |
|
2019 |
41.7% |
61.5% |
|
2020 |
38.2% |
60.6% |
|
2021 |
41.5% |
55.8% |
|
2022 |
40.6% |
58.8% |
Black Asian and other ethnic background staff continue to report that they do not believe the Trust provides equal opportunities for career progression or promotion, despite a slight decrease of 0.9%. This mirrors the representation of Black Asian and other ethnic background staff from band 6 and above, as well as indicates a lack of trust in the work that is being undertaken, which will be addressed through the publication of the anti-racism approach, and the clear communications and ownership of this approach at a senior level.
| No. | Actions |
|---|---|
|
1C |
Our Executive team will make public pledges to the organisation |
|
6A |
Our People team will complete the #Inclusive HR 5 step challenge to change and share interventions across the Trust to support anti-racist initiatives |
|
6B |
Our divisions will use staff survey responses and workforce data to develop plans to tackle racism and inequity |
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
|
Year |
Black Asian and other ethnic background |
White |
|---|---|---|
|
2017 |
17.1% |
7.4% |
|
2018 |
17.6% |
9.1% |
|
2019 |
16.0% |
8.3% |
|
2020 |
16.8% |
7.5% |
|
2021 |
16.9% |
6.7% |
|
2022 |
16.9% |
7.4% |
The percentage of Black Asian and other ethnic background staff experiencing discrimination from managers or other colleagues remains unacceptably high at 16.9%. This has also been indicated in qualitative feedback from the staff survey, and the anti-racism approach aims to address this through the review of our bullying and harassment processes and ensuring staff feel supported to come forward and have spaces to share their experience. It is also imperative that leaders and managers are provided with the resources and training to develop their own anti-racist skills and capability, to ensure they are leading in a compassionate and inclusive way, which will be supported through the leadership behaviours framework.
| No. | Actions |
|---|---|
|
3B |
We will review our disciplinary, grievance and bullying and harassment processes in line with our just and learning culture principles, with a focus on early resolution and empowering our people to speak up |
|
4A |
We will promote and support: |
|
4B |
We will continue to encourage our people to report incidents via Datix to our Freedom to Speak Up Guardian |
|
5B |
We will offer resources and development opportunities, including online resources, training from brap, and local learning interventions |
WRES 9: Percentage difference between the organisations’ Board membership and its overall workforce disaggregated by voting membership of the Board and executive membership of the Board
This metric was highlighted as a high priority in the bespoke report prepared by the National WRES team, and we have seen a slight increase in the proportion of Black Asian and other ethnic background representation at Executive level. This is still not representative of the organisation, and work to ensure that our leaders own and understand anti-racism and are driving and delivering this will be pivotal in helping to tackle this issue on a longer-term basis, underpinned by the bespoke programme, for which we have received funding to deliver by NHS England.
| No. | Actions |
|---|---|
|
1A |
All our Executive team will complete a bespoke programme delivered by brap to support their skills and capability in anti-racist leadership |
|
1B |
Our first cohort of reverse mentees will continue to lead the organization in having difficult and challenging conversations about race, racism, and white privilege |
|
1C |
Our Executive team will make public pledges to the organisation |
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
6. Workforce Disability Equality Standard (WDES)
Implementing the Workforce Disability Equality Standard (WDES) is a requirement for NHS commissioners and NHS healthcare providers to take steps to ensure disabled employees have equal access to career opportunities and receive fair treatment in the workplace.
The WDES comprises 10 metrics and is reported on annually. The data below is for the reporting period 1 April 2022-31 March 2023.
| No. | Metric |
|---|---|
|
1 |
Percentage of staff in AfC (Agenda for Change) paybands or medical and dental subgroups and very senior managers (including Executive Board members) compared with the percentage of staff in the overall workforce |
|
2 |
Relative likelihood of non-disabled staff compared to Disabled staff being appointed from shortlisting across all posts. |
|
3 |
Relative likelihood of Disabled staff compared to non-disabled staff entering the formal capability process, as measured by entry into the formal capability procedure |
|
4a |
Percentage of Disabled staff compared to non-disabled staff experiencing harassment, bullying or abuse from:
|
|
4b |
Percentage of Disabled staff compared to non-disabled staff saying that the last time they experienced harassment, bullying or abuse at work, they or a colleague reported it |
|
5 |
Percentage of Disabled staff compared to non-disabled staff believing that the Trust provides equal opportunities for career progression or promotion |
|
6 |
Percentage of Disabled staff compared to non-disabled staff saying that they have felt pressure from their manager to come to work, despite not feeling well enough to perform their duties |
|
7 |
Percentage of Disabled staff compared to non-disabled staff saying that they are satisfied with the extent to which their organisation values their work |
|
8 |
Percentage of Disabled staff saying that their employer has made adequate adjustment(s) to enable them to carry out their work |
|
9a |
The staff engagement score for Disabled staff, compared to non- disabled staff |
|
9b |
Have you taken action to facilitate the voices of Disabled staff in your organisation to be heard? |
|
10 |
Percentage difference between the organisation’s Board voting membership and its organisation’s overall workforce, disaggregated |
WDES Metrics 1-10
Overall breakdown of staff declaring a disability on ESR (31 March 2022 and 2023)
Metric 1: Percentage of staff in AfC (Agenda for Change) paybands or medical and dental subgroups and very senior managers (including Executive Board members) compared with the percentage of staff in the overall workforce
Non-clinical %
Clinical %
Clinical – Medical and Dental %
We have seen a 1.1% increase in declaration rates of disability, for which we were commended by the national WDES team. This is still lower than the number of respondents in our staff survey who indicate they have a long-term health condition or illness (20.4%), but there are many barriers to declaring disability, including the stigma that persists, as well as lack of understanding about reasonable adjustments and what constitutes disability under the Equality Act. There has been some progress in terms of training to better equip staff and managers with this understanding, but this work must continue, as well as continuing to promote the NHS Health passport, and exploring whether workplace adjustments can be provided through a central budget.
Additionally, the actions set out in the anti-racism approach will help to support disabled staff, particularly our new overarching health and wellbeing policy that is in development, which will focus on equity, prevention and compassion, and workplace adjustments.
| No. | Actions |
|---|---|
|
3A |
We will strengthen our approach to health and wellbeing with an overarching policy that focuses on equity, prevention, and compassion, including a focus on flexible working and workplace adjustments (centralised budget and NHS Health passport) |
|
4A |
We will promote and support: |
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
|
Year |
WDES 2: Relative likelihood of non-disabled staff compared to Disabled staff being appointed from shortlisting across all posts |
|---|---|
|
2018-19 |
1.37 |
|
2019-20 |
1.26 |
|
2020-21 |
1.06 |
|
2021-22 |
1.12 |
|
2022-23 |
0.98 |
Although the metric indicates that disabled staff are just as likely to be appointed as non-disabled staff, we know from feedback from staff that there are still barriers to disabled people applying for roles, and to declaring their disability during the application process. This will be addressed through the de-biasing recruitment work, and recruitment process review and we hope to see an increase of disabled staff applying and declaring.
| No. | Actions |
|---|---|
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures. |
|
Disabled |
Non-disabled |
Disability Unknown |
|
|---|---|---|---|
|
Number of staff in workforce |
248 |
3426 |
597 |
|
Average number of staff entering the formal capability process for any reason |
0 |
0 |
0 |
|
Of these, how many are on the grounds of ill health only? |
0 |
0 |
0 |
|
Likelihood of staff entering the formal capability process |
0 |
0 |
0 |
This procedure has not been used in 2022-23, however discussions with our Enable staff disability network suggested that some staff may not reach the formal stage in these proceedings, and work must continue to ensure that earlier informal stages are managed in a kind, compassionate and inclusive way in line with our aspirations to have a just and learning culture.
| No. | Actions |
|---|---|
|
3A |
We will strengthen our approach to health and wellbeing with an overarching policy that focuses on equity, prevention, and compassion, including a focus on flexible working and workplace adjustments (centralised budget and NHS Health passport) |
|
2018 |
2019 |
2020 |
2021 |
2022 |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
|
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
||
|
Patients/ |
32.7% |
30.0% |
35.8% |
33.3% |
31.0% |
31.2% |
30.8% |
30.8% |
40.4% |
30.0% |
|
|
Managers |
22.1% |
11.9% |
24.0% |
11.0% |
21.7% |
13.4% |
17.8% |
11.9% |
16.9% |
10.9% |
|
|
Other colleagues |
31.9% |
19.3% |
26.1% |
18.1% |
22.5% |
17.9% |
19.4% |
16.4% |
25.6% |
18.2% |
|
|
2018 |
2019 |
2020 |
2021 |
2022 |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
|
|
50.0% |
50.5% |
54.4% |
50.5% |
47.0% |
50.3% |
48.4% |
54.4% |
46.9% |
48.9% |
|
There has been an increase of disabled staff reporting experiencing harassment, bullying and abuse from the public, which indicates further efforts are required to raise awareness of reporting mechanisms and communicate to our service users that this behaviour is unacceptable, which will be supported by the work of the Violence and Aggression Committee.
Disabled staff are more likely to experience harassment from managers and colleagues compared to non-disabled staff and are less likely than non-disabled staff to report an incident of bullying, although this is now at similar levels compared to the 2021 survey. This will be addressed through our anti-racism approach, strengthening our policies around bullying and harassment, and supporting and promoting spaces for people to come forward and feel supported to report these incidents.
| No. | Actions |
|---|---|
|
3B |
We will review our disciplinary, grievance and bullying and harassment processes in line with our just and learning culture principles, with a focus on early resolution and empowering our people to speak up |
|
4A |
We will promote and support: |
|
4B |
We will continue to encourage our people to report incidents via Datix to our Freedom to Speak Up Guardian |
|
2018 |
2019 |
2020 |
2021 |
2022 |
|||||
|---|---|---|---|---|---|---|---|---|---|
|
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
|
43.2% |
52.5% |
39.6% |
53.5% |
45.3% |
50.2% |
44.9% |
49.7% |
44.2% |
51.0% |
Fewer disabled staff believe that the Trust provides equal opportunities for career progression or promotion. We will continue to promote and support our Enable staff disability network to ensure staff feel empowered to bring their whole selves to work and connect with others, as well as divisions understanding the profile of their staff and taking action to address any challenges to progression that disabled staff are experiencing. This will also be supported by the continued promotion of the NHS Health passport.
| No. | Actions |
|---|---|
|
3A |
We will strengthen our approach to health and wellbeing with an overarching policy that focuses on equity, prevention, and compassion, including a focus on flexible working and workplace adjustments (centralised budget and NHS Health passport) |
|
4A |
We will promote and support: |
|
6A |
Our People team will complete the #Inclusive HR 5 step challenge to change and share interventions across the Trust to support anti-racist initiatives |
|
6B |
Our divisions will use staff survey responses and workforce data to develop plans to tackle racism and inequity |
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
|
2018 |
2019 |
2020 |
2021 |
2022 |
|||||
|---|---|---|---|---|---|---|---|---|---|
|
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
|
29.7% |
23.8% |
40.5% |
23.8% |
38.7% |
26.9% |
32.4% |
23.1% |
33.3% |
21.4% |
The percentage of disabled staff reporting that they have felt pressure to come into work despite not feeling well enough has increased slightly since 2021 by 0.9%, despite the pressures of the COVID-19 pandemic lessening, workload remains high, and feedback suggests that staff are under a tremendous amount of pressure. Our new holistic approach to health and wellbeing as part of our just and learning culture approach aims to address this and ensure that people keep well and look after themselves.
| No. | Actions |
|---|---|
|
3A |
We will strengthen our approach to health and wellbeing with an overarching policy that focuses on equity, prevention, and compassion, including a focus on flexible working and workplace adjustments (centralised budget and NHS Health passport) |
|
2018 |
2019 |
2020 |
2021 |
2022 |
|||||
|---|---|---|---|---|---|---|---|---|---|
|
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
LTC or illness |
Without LTC or illness |
|
41.7% |
57.0% |
40.9% |
55.9% |
43.0% |
55.2% |
42.9% |
50.3% |
38.9% |
48.8% |
The percentage of disabled staff who say they are satisfied with the extent to which their organisation values their work has decreased by 4%, despite communications to promote awareness days and events and to raise the profile of Enable staff disability network. This could relate to not having declared their disability or long-term health condition on ESR and receiving appropriate support, and promoting the NHS Health passport as well as our new health and wellbeing policy will be imperative in tackling this issue, as well as divisions having specific plans to support the progression and experience of all staff, including disabled staff.
| No. | Actions |
|---|---|
|
3A |
We will strengthen our approach to health and wellbeing with an overarching policy that focuses on equity, prevention, and compassion, including a focus on flexible working and workplace adjustments (centralised budget and NHS Health passport) |
|
6B |
Our divisions will use staff survey responses and workforce data to develop plans to tackle racism and inequity |
|
7C |
We will promote awareness days and events as part of Our Homerton People calendar of events, including (but not limited to) Windrush Day, Black History Month, International Day for the Elimination of Racial discrimination, and the anniversary of the murder of George Floyd |
|
2018 |
2019 |
2020 |
2021 |
2022 |
|||||
|---|---|---|---|---|---|---|---|---|---|
|
Homerton Healthcare |
Average |
Homerton Healthcare |
Average |
Homerton Healthcare |
Average |
Homerton Healthcare |
Average |
Homerton Healthcare |
Average |
|
74.0% |
73.1% |
65.0% |
73.3% |
72.9% |
75.5% |
69.3% |
70.9% |
66.5% |
71.8% |
The percentage of disabled staff saying that the Trust has made adequate adjustments has fallen by 7.5% since 2018. Feedback from Enable Staff disability network suggests that reasonable adjustments are implemented inconsistently across the Trust. This will be addressed by providing adjustments through a central budget, equipping line managers with the appropriate knowledge and skills to implement them, and continued promotion of the NHS Health passport.
| No. | Actions |
|---|---|
|
3A |
We will strengthen our approach to health and wellbeing with an overarching policy that focuses on equity, prevention, and compassion, including a focus on flexible working and workplace adjustments (centralised budget and NHS Health passport) |
|
6B |
Our divisions will use staff survey responses and workforce data to develop plans to tackle racism and inequity |
|
Year |
LTC or illness |
Without LTC or illness |
Trust Score |
|---|---|---|---|
|
2018 |
6.9 |
7.3 |
7.3 |
|
2019 |
6.7 |
7.3 |
7.2 |
|
2020 |
6.9 |
7.3 |
7.2 |
|
2021 |
6.8 |
7.2 |
7.1 |
|
2022 |
6.6 |
7.1 |
7.0 |
The engagement score for disabled staff remains slightly lower than the overall Trust score, and further work to engage disabled staff remains a priority.
| No. | Actions |
|---|---|
|
4A |
We will promote and support:
|
|
7C |
We will promote awareness days and events as part of Our Homerton People calendar of events, including (but not limited to):
|
WDES 9b: Have you taken action to facilitate the voices of Disabled staff in your organisation to be heard?
The Enable staff network leads are active members of the monthly People and Culture Forum, which feeds directly into our People and Culture Committee.
They are also members of the strategic Achieving Inclusion Group and provide feedback and insight on strategic work across the organisation.
The Equality Diversity and Inclusion Lead meets with the network leads monthly to ensure their voices are heard and included in the organisation.
WDES 10: Percentage difference between the organisation’s Board voting membership and its organisation’s overall workforce, disaggregated
There are currently no disabled staff at Executive level, an area that has been raised as a concern by the national WDES team. This is not to say that there are not any disabled staff, but that stigma persists around disability, and the following actions may help to tackle representation at this level.
| No. | Actions |
|---|---|
|
1A |
All our Executive team will complete a bespoke programme delivered by brap to support their skills and capability in anti-racist leadership |
|
6C |
We will de-bias every stage of our recruitment process and all divisions will be responsible for implementing these procedures |
From March 2018 a new statutory requirement was introduced in relation to gender pay gap reporting. Information about the Trust’s gender pay gap can be found on the government website.
The indicators on which the Trust are required to report are:
- The hourly rate of ordinary pay
- The difference between the mean hourly rate of ordinary pay of male and female employees
- The proportions of male and female employees in the lower, lower middle, upper middle and upper quartile pay bands by number of employees rather than rate of pay
- The difference between the mean (and median) bonus pay paid to male and female employees
All data below is from 31 March from each reporting year.
|
|
2017 |
2018 |
2019 |
2020 |
2021 |
2022 |
2023 |
|---|---|---|---|---|---|---|---|
|
Male |
23.72 |
23.44 |
25.79 |
26.91 |
26.36 |
28.32 |
30.15 |
|
Female |
19.23 |
19.57 |
20.42 |
21.12 |
21.55 |
22.96 |
24.18 |
|
Difference |
4.50 |
3.87 |
5.37 |
5.79 |
4.81 |
5.36 |
5.97 |
|
Pay Gap % |
18.96 |
16.52 |
20.82 |
21.53 |
18.23 |
18.92 |
19.81 |
|
|
2017 |
2018 |
2019 |
2020 |
2021 |
2022 |
2023 |
|---|---|---|---|---|---|---|---|
|
Male |
19.26 |
19.74 |
20.39 |
22.68 |
22.90 |
23.89 |
24.95 |
|
Female |
17.48 |
17.67 |
18.23 |
19.46 |
20.24 |
20.97 |
21.50 |
|
Difference |
1.78 |
2.07 |
2.16 |
3.22 |
2.67 |
2.92 |
3.45 |
|
Pay Gap % |
9.25 |
10.47 |
10.57 |
14.20 |
11.64 |
12.23 |
13.83 |
|
Quartiles |
2023 |
|||
|
Female |
Male |
Female % |
Male % |
|
|---|---|---|---|---|
|
1 - Lower (£4.50-£15.50 Hourly Rate) |
865 |
234 |
78.71% |
21.29% |
|
2 - Lower Middle (£15.51-£21.09 Hourly Rate) |
924 |
170 |
84.46% |
15.54% |
|
3 - Upper Middle (£21.10-£27.07 Hourly Rate) |
838 |
175 |
82.72% |
17.28% |
|
4- Upper (£27.07 Plus Hourly Rate) |
802 |
390 |
67.28% |
32.72% |
|
Total |
3429 |
969 |
77.97% |
22.03% |
|
|
||
|---|---|---|
|
Average Pay |
Median Pay |
|
|
Male |
£8,601.07 |
£6,032.04 |
|
Female |
£8952.13 |
£7,781.28 |
|
Difference |
-£351.06 |
-£1,749.24 |
|
Pay Gap % |
-4.08 |
-29.00 |
|
|
||
|
Employees |
Percentage |
|
|---|---|---|
|
Male |
26 |
2.24% |
|
Female |
28 |
0.69% |
Our mean and median gender pay gap has fluctuated since 2017, peaking in 2020 at 21.53% (mean) and 14.20% (median). Our lowest mean pay gap was in 2018, at 16.52%, and the lowest median pay gap was in 2017, at 9.25%.
Our mean gender pay gap has increased by 1.58% since 2021, now at 19.81% and our median pay gap has also increased to 13.83%, compared to 12.23% in 2022.
Despite women comprising 79% of the staff population, men are overrepresented in the upper quartile, meaning there is a higher concentration of men in the upper end of our pay scales in comparison to the overall population of men in the Trust; 33% of men are in the upper quartile, whereas there are 21% of men overall in the Trust.
Initiatives to support the career development of women, including raising awareness of menopause, have been in place in the Trust, and the new Homerton Women’s network is providing space for all women at Homerton to raise issues affecting them in the workplace. The Trust is beginning work on tackling sexual violence and misconduct following the publication of the Royal College of Surgeon’s report on sexual misconduct in Surgery and sexual harassment in the workplace training was rolled out from June 2023. Our job advertisements also now include a clear statement about flexible working options.
Additionally, our leadership behaviours framework will help to equip managers and staff with the skills and knowledge to champion our values, creating an inclusive culture that promotes compassion.
8. Patient Advisory and Liaison Service (PALS)
The Patient Advice and Liaison Service (PALS) helps to resolve problems and concerns of patients, relatives, and carers, and provides confidential, on- the-spot advice, support and information, and can provide guidance about the different services available within the NHS, as well as other organisations, such as voluntary organisations, community groups or independent advocacy.
Between 1 January 2022 and 31 December 2022 the Patient Advice and Liaison Service (PALS) received 1766 enquiries in total from our patients, a decrease of 411 enquiries compared to the previous year’s reporting period (2177).
From April 2021, the PALS team moved from using the PALS module to the Patient Experience module to record enquiries, which has a wider dataset of characteristics that can be recorded. This data has not been recorded consistently for the reporting period, however this is now being taken forward within the team, so future reports will have a more comprehensive profile of the patients making enquiries to the service.
|
Female |
430 |
|---|---|
|
Male |
189 |
|
Not stated |
1147 |
|
TOTAL |
1766 |
|
ASIAN or ASIAN BRITISH - Any other Asian background |
5 |
|---|---|
|
ASIAN or ASIAN BRITISH - Bangladeshi |
2 |
|
ASIAN or ASIAN BRITISH - Indian |
3 |
|
ASIAN or ASIAN BRITISH - Pakistani |
4 |
|
BLACK or BLACK BRITISH - African |
12 |
|
BLACK or BLACK BRITISH - Any other black background |
5 |
|
BLACK or BLACK BRITISH - Caribbean |
13 |
|
MIXED - Any other mixed background |
6 |
|
MIXED - White & Asian |
1 |
|
MIXED - White & Black African |
2 |
|
OTHER ETHNIC GROUP - Any other ethnic group |
10 |
|
OTHER ETHNIC GROUP - Chinese |
4 |
|
WHITE - Any other white background |
39 |
|
WHITE - British |
40 |
|
WHITE - Irish |
3 |
|
Not stated |
1617 |
|
TOTAL |
1766 |
|
Blind or a serious visual impairment |
1 |
|---|---|
|
Deaf or serious hearing impairment |
1 |
|
Dementia |
1 |
|
General learning disability |
1 |
|
Language advocate required |
7 |
|
Mental health condition |
2 |
|
None |
7 |
|
Other disability |
5 |
|
Social/communication impairment |
1 |
|
Not stated |
1740 |
|
TOTAL |
1766 |
From the limited data available, more than double women than men contacted PALS (430 women compared to 119 men). Where ethnicity was recorded, there was an even distribution of enquiries from Black Asian and ethnically diverse people and White people.
Only 26 enquiries were recorded in terms of disability, compared to 189 the previous year, therefore no meaningful conclusions can be drawn.
9. Complaints
From 1 January 2022 to 31 December 2022, 594 complaints were received; an increase of 44 compared to 2021 (550 complaints). Complaints are received from patients, relatives, advocates, or friends.
As with PALS, the Complaints Department has not consistently recorded information on protected characteristics, so the data is limited for this reporting period. Data is now being collected more consistently, so future reports will have a more comprehensive profile of those making complaints.
|
Female |
401 |
|---|---|
|
Male |
137 |
|
Not stated |
56 |
|
TOTAL |
594 |
|
ASIAN or ASIAN BRITISH - Any other Asian background |
17 |
|---|---|
|
ASIAN or ASIAN BRITISH - Bangladeshi |
7 |
|
ASIAN or ASIAN BRITISH – Indian |
12 |
|
ASIAN or ASIAN BRITISH – Pakistani |
8 |
|
BLACK or BLACK BRITISH – African |
27 |
|
BLACK or BLACK BRITISH - Any other black background |
8 |
|
BLACK or BLACK BRITISH - Caribbean |
30 |
|
MIXED - Any other mixed background |
5 |
|
MIXED - White & Asian |
4 |
|
MIXED - White & Black Caribbean |
4 |
|
OTHER ETHNIC GROUP - Any other ethnic group |
41 |
|
WHITE - Any other white background |
95 |
|
WHITE – British |
80 |
|
WHITE – Irish |
4 |
|
Not stated |
252 |
|
TOTAL |
594 |
|
Blind or a serious visual impairment |
1 |
|---|---|
|
Deaf or serious hearing impairment |
3 |
|
General learning disability |
5 |
|
Language advocate required |
1 |
|
Literary assistance |
1 |
|
Mental health condition |
5 |
|
None |
1 |
|
Other |
10 |
|
Not stated |
567 |
|
TOTAL |
594 |
There remained a high proportion of instances where ethnicity and disability were not recorded, however this was not the case for gender, where only 9.4% of enquiries were not recorded. For ethnicity, this was not recorded in 42% of enquiries, and 95% for disability, highlighting the need to record this data more consistently, as no conclusions can be drawn from the lack of data, however it is clear that more women make complaints than men, although the data also shows in the following section that more women attend our services in comparison to men.
10. Equalities and service provision
The Trust serves the highly diverse population of Hackney, and it is vital that the Trust works hard to meet its duty to provide a high quality of care and service regardless of any characteristic.
|
Gender |
A&E |
Inpatient |
Maternity |
Outpatient |
Total |
|---|---|---|---|---|---|
|
Female |
64708 |
49929 |
72215 |
211755 |
398607 |
|
Indeterminate |
12 |
4 |
0 |
8 |
24 |
|
Male |
59651 |
28693 |
1 |
140180 |
228525 |
|
Not Known |
4 |
1 |
1 |
41 |
47 |
|
Unspecified |
11 |
3 |
2 |
24 |
40 |
|
Total |
124386 |
78630 |
72219 |
352008 |
627243 |
Disregarding maternity attendance, women are more likely to attend as patients than men (97867 more women than men overall).
|
Religion |
A&E |
Inpatient |
Maternity |
Outpatient |
Total |
|---|---|---|---|---|---|
|
Baptist |
124 |
98 |
2 |
542 |
766 |
|
Buddhist |
82 |
64 |
31 |
427 |
604 |
|
Christadelphian |
109 |
111 |
47 |
301 |
568 |
|
Church of England |
3933 |
3561 |
340 |
16436 |
24270 |
|
Free Church |
30 |
37 |
19 |
96 |
182 |
|
Hindu |
207 |
229 |
87 |
1518 |
2041 |
|
Jehovah Witness |
165 |
95 |
15 |
661 |
936 |
|
Jewish |
930 |
964 |
1502 |
3212 |
6608 |
|
Methodist |
259 |
186 |
4 |
956 |
1405 |
|
Mormon |
8 |
6 |
|
25 |
39 |
|
Muslim |
7029 |
4181 |
1974 |
20366 |
33550 |
|
None |
4422 |
2772 |
1030 |
13895 |
22119 |
|
Not Available |
125 |
73 |
17 |
474 |
689 |
|
Not Known |
12768 |
9271 |
4509 |
44725 |
71273 |
|
NULL |
84782 |
50336 |
60433 |
219913 |
415464 |
|
Orthodox |
882 |
532 |
621 |
1314 |
3349 |
|
Other Christians |
3384 |
2459 |
597 |
9259 |
15699 |
|
Other Sects/Religions |
1037 |
578 |
329 |
3377 |
5321 |
|
Roman Catholic |
3429 |
2693 |
540 |
12434 |
19096 |
|
Salvation Army |
17 |
20 |
|
65 |
102 |
|
Seventh Day Adventist |
141 |
91 |
21 |
489 |
742 |
|
Sikh |
523 |
273 |
101 |
1523 |
2420 |
|
Total |
124386 |
78630 |
72219 |
352008 |
627243 |
The Trust serves a number of patients from different religions and beliefs, in line with the overall population of Hackney.
|
Ethnicity |
A&E |
Inpatient |
Maternity |
Outpatient |
Total |
|---|---|---|---|---|---|
|
African (except Somali) |
129 |
1 |
|
9 |
139 |
|
Any Other Group |
83 |
4 |
1 |
15 |
103 |
|
Arab or Middle Eastern |
5 |
|
|
|
5 |
|
Asian inc Asian British - Bangladeshi |
3029 |
2197 |
2766 |
12136 |
20128 |
|
Asian inc Asian British - Indian |
3801 |
2726 |
3224 |
12690 |
22441 |
|
Asian inc Asian British - Pakistani |
1893 |
1607 |
2256 |
7743 |
13499 |
|
Asian inc British-Other Asian Background |
4804 |
2625 |
2914 |
13075 |
23418 |
|
Bangladeshi (inc British) |
40 |
2 |
|
16 |
58 |
|
Black British |
104 |
9 |
|
15 |
128 |
|
Black inc Black British - African |
14851 |
9325 |
6454 |
35362 |
65992 |
|
Black inc Black British - Caribbean |
10633 |
6764 |
3176 |
29091 |
49664 |
|
Black inc British-Other Black Background |
5528 |
2869 |
1783 |
14213 |
24393 |
|
Caribbean |
43 |
6 |
|
2 |
51 |
|
Chinese |
10 |
1 |
|
2 |
13 |
|
Eastern European |
26 |
|
|
5 |
31 |
|
English |
196 |
9 |
1 |
35 |
241 |
|
Greek (inc Greek Cypriot) |
2 |
|
|
3 |
5 |
|
Indian (inc British) |
64 |
2 |
|
17 |
83 |
|
Irish |
8 |
1 |
1 |
5 |
15 |
|
Jewish |
13 |
|
|
2 |
15 |
|
Kurdish |
8 |
|
|
|
8 |
|
Mixed - Any Other Mixed Background |
3736 |
2316 |
1876 |
9577 |
17505 |
|
Mixed - White and Asian |
733 |
507 |
520 |
1914 |
3674 |
|
Mixed - White and Black African |
891 |
514 |
511 |
2253 |
4169 |
|
Mixed - White and Black Caribbean |
1603 |
835 |
649 |
3865 |
6952 |
|
Not Recorded |
99 |
2 |
5 |
468 |
574 |
|
Orthodox Jew |
15 |
|
|
|
15 |
|
Other Asian |
26 |
|
|
8 |
34 |
|
Other Black |
17 |
|
|
3 |
20 |
|
Other Ethnic Groups - Any Other Group |
10774 |
5508 |
5530 |
23755 |
45567 |
|
Other Ethnic Groups - Chinese |
907 |
404 |
579 |
2399 |
4289 |
|
Other Mixed |
25 |
2 |
|
1 |
28 |
|
Other Not Known |
689 |
149 |
83 |
6298 |
7219 |
|
Other Not Stated |
174 |
10 |
1 |
28 |
213 |
|
Other White |
100 |
3 |
1 |
16 |
120 |
|
Other White British |
54 |
5 |
|
16 |
75 |
|
Other White/Mixed White |
6 |
1 |
|
1 |
8 |
|
Pakistani (inc. British) |
27 |
3 |
|
16 |
46 |
|
Patient Refused |
1005 |
1018 |
440 |
4515 |
6978 |
|
Scottish |
2 |
|
|
1 |
3 |
|
Somali |
20 |
3 |
|
1 |
24 |
|
Turkish (inc Turkish Cypriot) |
73 |
3 |
1 |
5 |
82 |
|
Vietnamese |
6 |
|
|
|
6 |
|
Welsh |
2 |
|
|
1 |
3 |
|
White - Any Other White Background |
31740 |
17842 |
21109 |
76272 |
146963 |
|
White - British |
24844 |
20191 |
17434 |
91336 |
153805 |
|
White - Irish |
1529 |
1165 |
904 |
4822 |
8420 |
|
White and Asian |
1 |
|
|
1 |
2 |
|
White and Black African |
9 |
1 |
|
|
10 |
|
White and Black Caribbean |
9 |
|
|
|
9 |
|
Grand Total |
124386 |
78630 |
72219 |
352008 |
627243 |
Approximately 50% of attending patients were White, 18% were Black or Black British and 13% were Asian; this is in line with the overall profile of Hackney residents, from the 2021 Census.
|
Age |
AE |
Inpatient |
Maternity |
Outpatient |
Total |
|---|---|---|---|---|---|
|
20 and under |
33456 |
10665 |
1603 |
36727 |
82451 |
|
21-25 |
10453 |
4542 |
7444 |
15968 |
38407 |
|
26-30 |
13101 |
7729 |
13731 |
31409 |
65970 |
|
31-35 |
11905 |
10946 |
26265 |
37015 |
86131 |
|
36-40 |
9779 |
8913 |
18869 |
33421 |
70982 |
|
41-45 |
7879 |
5253 |
4017 |
29483 |
46632 |
|
46-50 |
6739 |
4329 |
242 |
27827 |
39137 |
|
51-55 |
6695 |
4615 |
25 |
29023 |
40358 |
|
56-60 |
6213 |
4700 |
18 |
29425 |
40356 |
|
61-65 |
4786 |
4208 |
3 |
24903 |
33900 |
|
66-70 |
3697 |
3382 |
0 |
19035 |
26114 |
|
71 and over |
9683 |
9348 |
2 |
37772 |
56805 |
|
Total |
124386 |
78630 |
72219 |
352008 |
627243 |
Patient attendance by age group shows Accident and Emergency has more patients 20 and under; Outpatient services are accessed the most by those 31-35 and 71 and over, and the least by those aged 21-25.
11. Achieving Equality and Inclusion plan - Anti-racism approach and Inclusion actions