Vision

The use of diversity information to support high quality care and promote equality.

Aims

• Collect information describing personal characteristics such as age, gender, disability, ethnicity, religion and sexual orientation
• Promote the use of this information by policy makers, planners, and staff implementing policy and monitoring the health service
• Advise how this information can be used to comply with legislation, regulations, policies and to demonstrate good practice
• Develop new information systems to record and present this information in support the patient journey Tailor health care delivery to meet individual patient needs

Background

At present Scotland lacks detailed information on equality and diversity as data has not been routinely collected. What is required is detailed personal information to understand the problems facing NHS Scotland, to inform the design of solutions, and to support NHS Scotland in promoting equality and diversity in all its business areas.

Implementation

NHS Scotland, along with the National Resource Centre for Ethnic Minority Health (NRCEMH), has developed a business case to implement the routine collection of information on ethnic and other minority and diversity groups.

Work streams

EDIP will deliver these objectives through six work streams.

1. Classification Standards - Define and implement the ethnicity and socio- cultural associated data standards to be used in all NHS Scotland systems for monitoring ethnicity and diversity in health
2. Technical - Provide and implement a specification of requirements for use by NHS Scotland systems to ensure the correct and consistent recording and reporting of equality and diversity in health; to be used to modify computer systems in use across Scotland
3. Patient Focus Public Involvement (PFPI) - Ensure that NHS staff and all ethnic groups across Scotland willingly consent to give more personal information about themselves
4. Training - Train appropriate staff in data collection procedures, analysis and management of Equality and Diversity information.
5. Research and Development - Develop and implement national evidence base for health and ethnicity and other diversity groups
6. Human Resources - The Diversity Task Force (DTF) was established on 16th April 2004 to provide strategic leadership to NHS Scotland Managers and act as an enabler to facilitate culture change at every level. Scottish Workforce Information Standard System (SWISS) To help NHSScotland map out the make-up of the staff employed and identify any issues around meeting the diverse needs of staff, staff have been asked to complete a short Equality Monitoring Survey

Definitions

Equality

Is about creating a fairer society where everyone can participate and has the opportunity to fulfil their potential. It is mostly backed by legislation designed to address unfair discrimination and resulting inequalities based on membership of a particular group.

This approach is about ensuring that groups of people who continue to be disadvantaged or unfairly discriminated against have access to opportunities for full participation in society. It supports legal sanctions that encourage organizations to endorse this approach.

Diversity

Is the recognition and valuing of difference in its broadest sense. It is about creating a culture and practices that recognise, respect, value and harness difference for the benefit of patients, carers, members of the public and members of staff.

This approach is about individuals - it is about recognising difference as a source of strength within organisations and it is about recognising that some differences are also the source of inequality, disadvantage and exclusion. By focusing solely on individual differences we may not recognise collective experiences of institutional discrimination.

Ethnic Monitoring

Equality and Human Rights Commission define ethnic monitoring as the process of collecting, storing and analysing data about people's ethnic backgrounds to: highlight possible inequalities, investigate the underlying causes, and remove any unfairness or disadvantage.

In service delivery monitoring can demonstrate:

• Patient care, e.g. an approach which doesn't treat everyone the same but is tailored to individual needs
• Local NHS organisation, e.g. monitoring uptake of services/ ensuring non discriminatory practice
• National, e.g. describing the risk of schizophrenia by ethnic group/ informing and influencing policy development

Important points about collecting ethnicity information:

• It is based on self-definition something the patient decides
• It is collected with informed consent - collecting appropriate information in appropriate formats
• It is standard information that can be compared with existing sources e.g. the Census
• It is collected once (probably in primary care) and appropriately shared across the NHS in Scotland within the context of patient confidentiality and data protection
• It is collected by fully trained staff
• It includes all the information needed for appropriate care (background, religion, language, gender preference, disability, sexual orientation and other items)

Ethnic Group

Ethnic group is a combination of factors including skin colour and physical features, family origin, language and religion. It is mainly a social construction and its significance is determined to a large extent by society and self ascription¹.

More information is available as part of the Data Dictionary that includes links via Clinical Data sets to the Generic Clinical Data Sets and Scottish Social Data Standards Project.

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¹Lee B, Syed Q and Bellis M (1998) "Improving the health of black and ethnic minority communities: a North West of England perspective"