The Equality Act: a lever for change

There’s a lot of discussion going around at the moment about how the Equality Act hasn’t quite gone far enough. I don’t disagree with those comments, but for me the Act brings the equalities agenda back to the top table and organisations are again reflecting on how well they manage inclusion.

From my perspective there are two key issues:

1) Equality, Diversity and Inclusion can be seen as an “add-on”.  

In many Trusts, (though more acute than PCTs) this is reflected in how they deliver their equalities agenda. 

Many Trusts are good at delivering interventions to patients and service users.  This includes reviewing their intrepretaton services, producing language cards, putting induction loops into every reception area.

But only the best Trusts are fully embracing public involvement in their approach to redesigning and developing services.  Patient and public views go beyond the equality strands, and it is important to listen to these views when working on service improvements.  

There are pockets of best practice out there, and sexual health is typically one of these, where there is already an embedded culture of inclusion. 

To take that first step towards inclusion is about recognising how powerful and important public involvement is, and then making some minor adjustments about how go about delivering service improvements.   The equality elements can then be drawn out and evidenced in an Equality Impact Assessment (EIA).

At the very least, there needs to be a recognition that there is a wealth of data out there that can be drawn upon to inform decisions from each of the different equality strands.  And there are a range of local community groups that will already be engaged with the Trust through their Public & Patient Involvement Forums.  Trusts needs to get better at using this information to inform their decisions.

2) the Equality Agenda can be compared to a piece of string. 

Each Trust makes their own decision of how long that piece of string will be:  some specialists believe that it should be the length of an entire ball of string.  In-house practioners who listen to managers saying “We don’t have the time for this” cut the string as small as they possibly can.

There is undeniably a fear around the equality agenda, and this could be because the agenda is huge.  This is evidenced through the lack of consistency across a “patch”. 

In the North West, the SHA has done a bespoke piece of work to bring consistency, which started with an in-depth analysis of how their local PCTs were implementing the Equalities Agenda.  A toolkit was produced which all 53 Trusts in the region are working to.  It’s a great piece of work, but it’s not transferable, and particularly not to acute Trusts.

In essence, none of us are sure what “best practice” really looks like, even with a simple process such as EIAs.  There’s little, if any, benchmarking undertaken.   We share information on a local, informal level, but ultimately it is the passion, credibility and priorities of the local Equality and Diversity Lead that will drive up standards within their own Trust.

So the Equality Act doesn’t address everything that we wanted it to.  But what it does do is give us an opporunity to talk to our Execs and Non-Execs about Equality & Diversity and what we need to do next on our journey to become fully inclusive.


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