Equality objectives

Public Sector Equality Duty

The public sector Equality Duty (PSED) is made up of a general Equality Duty and specific equality duties (SEDs). The general public sector Equality Duty is set out in primary legislation as section 149(1) of the Equality Act 2010. This general duty is supported by secondary legislation in the form of statutory regulations. These statutory regulations are called the specific equality duties (SEDs). The PSED is supported by non-statutory guidance and technical guidance issued by the Equality and Human Rights Commission (EHRC).

The EHRC encourages organisations to consider how the Public Sector Equality Duty (PSED) informs all of their relevant roles. The duties in relation to health inequalities, the principles and values enshrined in the NHS Constitution and NHS England’s key business priorities. The legal duties, on equalities and health inequalities, are important in their own right but they also are relevant to the achievement of the key principles and the values enshrined in the NHS Constitution and echoes in our objectives as an Integrated Care Board.

The general public sector Equality Duty, section 149 (1) of the Equality Act 2010, is one of ‘due regard’ or proper consideration. The general Duty is supported by specific equality duties (SEDs), secondary legislation or statutory rules, designed to facilitate the better performance of the general Duty.

In exercising our functions, the Mid and South Essex Integrated Care Board (ICB) is required to ‘have due regard to the need to’ address three equality aims set out below:

  • Equality aim 1: eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act’.
  • Equality aim 2: advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it’.
  • Equality aim 3: foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

The general Duty’s three equality aims engage eight of the nine protected characteristics set out in the Equality Act 2010. These protected characteristics are age, disability, gender reassignment, pregnancy and maternity, race (i.e. colour, ethnic or national origins and nationality), religion or belief, sex, and sexual orientation. With respect to one of the nine protected characteristics listed in the 2010 Act (marriage and civil partnership), the PSED partially covers this protected characteristic. In this case, public bodies are required to give due regard to the first equality aim, the elimination of discrimination, harassment, victimisation, and any other conduct prohibited by the Equality Act 2010; but public bodies are not required to advance equality of opportunity or foster good relations in relation to marriage and civil partnership. The general Duty means that NHS England has to properly consider all three equality aims in all the activities that it undertakes – for example, employing staff, commissioning and procurement, planning services and fulfilling our statutory and legal obligations.

The ICB equality objectives have been developed in accordance with the mid and south Essex Integrated Care Strategy, which is furthered by our Joint Forward Plan.  The objectives are set in the context of the legislation and what we set out to achieve in our strategies as well as our role as an Integrated Care Board.

The ICB has established two overarching equality objectives reflective of its dual role as a commissioner of health services and that of an employer, which have been further distilled into objectives linked to the equality aims as follows:

To ensure equitable access, excellent experience, and optimal outcomes for all by addressing unwarranted variations in our services and moving towards an integrated health and care system.

  • We will work with communities as equal partners to develop local solutions and build resilient communities.
  • We will develop the organisational culture and governance arrangements within MSE to support embedding the principles of equality and inclusion.
  • We will monitor and review commissioned services to ensure delivery of an equitable health and care system which seeks to address healthcare disparities and poorer outcomes.

To create an inclusive environment where our staff feel valued and are actively supported to achieve their potential, recognising that our culture values diversity and listens to the voice of our teams.

  • We will ensure all staff (including our managers and senior leaders) understand their duties and required behaviours in the workplace and have mechanisms in place for staff to raise issues safely and confidently.
  • We will ensure our recruitment processes and promotion processes both internally and externally are inclusive and accessible.
  • We will ensure our staff networks are working together to allow for intersectionality and ensure they are fully supported and part of the ICB accountability structures.

The EDIB Strategy links each objective to an equality aim, it sets out what success looks like over the next four years as well as highlighting the key actions the ICB needs to take to achieve each of the objectives.

Due Regard to Equality Aims

The Strategy explains how the three equality aims will be demonstrated through key actions that we are taking to address this Duty. These key actions will include but not limited to:

  • Annual publishing of PSED equality reporting outlining equality objectives, progress made and action plans.
  • Annual publishing completed Equality Delivery System (EDS) reports demonstrating ICB’s response to requirements of the PSED.
  • Annual publishing of Workforce Race Equality Standard (WRES), Workforce Disability Equality Standard (WDES) and Gender Pay Gap.
  • Commitment to delivery of our ICS Equality Diversity & Inclusion framework to which includes actions on anti-racism strategy.
  • Robust undertaking of Equality Impact Assessments – demonstrating how equality and fostering of good relations is embed in all business undertaking.
  • Working together to eliminate health inequalities including using the Core20PLUS5 framework to focus targeted interventions at those groups most likely to experience inequalities and accelerate population health outcomes in core clinical areas.
  • Bring the voices and influence of the community into the conversation so that this helps shape the way we design and deliver services, ensuring we take measures to hear from those with protected characteristics and underserved groups.

Mid and South Essex Integrated Care Board (ICB) Priorities

The ICB recognises and values the diversity of the population we serve, and of our workforce. Having a focus on equality is central to our work, ensuing we commission modern, high quality health services for all.  To do that we need a consistent and well-motivated workforce. 

Many of our NHS staff are part of the wider population of MSE and are therefore subject to the same health inequality challenges.

Our vision, within our longer-term strategies and plans, is for a health and care partnership working for a better quality of life in a thriving mid and south Essex, with every resident enabled to make informed choices in a strengthened health and care system.  This means that:

  • Members of the public have the right to expect the care and treatment they receive to be provided in an environment free from unlawful discrimination or harassment.
  • We will tackle health inequalities and ensure there are no barriers to health and wellbeing.
  • We will actively seek to understand the barriers experienced through the lens of the diverse populations we serve and making access to health services equitable.
  • We will ensure our health providers also meet their legal requirements around equality and human rights.
  • Our staff have the right to work in an environment that is free from discrimination, victimisation, and harassment (policies to safeguard staff are included on our staff intranet).

The ICB delivers its responsibilities against the Equality Act in three ways; as an employer, in its function as an ICB and as part of a wider system alongside its strategic partners.  The Strategy lays out our journey over the next four years to develop our EDIB culture and achieve our objectives.  Below provides some examples of the work undertaken to date.

As an employer

We have signed up to the ICS EDI framework, which the ICB is committed to delivering and this is reported back through the People Board.

There are 4 strategic pillars which form part of this framework:

  • Culture and Leadership
  • Talent Management and Acquisition
  • Retention and Recruitment
  • Data

We have the following staff networks in place:

  • Inclusion and Belonging Steering Group
  • LGBTQ+ network
  • Women’s network
  • Diversity network
  • Positive Ways to Wellness network
  • Staff Engagement Group

In terms of WRES data around BME staff, our WRES action plan shows what the ICB has been doing to shift the lower representation of BME staff in Bands 8a and above in both clinical and non-clinical roles.

As a commissioner and within the Mid and South Essex System

The Mid and South Essex Integrated Care Strategy has been established by the Integrated Care Partnership. The ICB has signed up to the Strategy. The priorities of the ICB are enshrined within the Strategy and feed through into our strategic objectives.

In preparing this Strategy, we have had regard for the regulatory and statutory requirements, particularly the four key aims established for ICS:

  • Improving outcomes in population health and health care.
  • Tackling inequalities in outcomes, experience, and access.
  • Enhancing productivity and value for money.
  • Supporting broader social and economic development.

We have also had regard for the ‘Triple Aim’ established for NHS bodies that plan and commission services, which requires them to consider the effects of decisions on:

  • The health and wellbeing of the people of England (including inequalities in that health and wellbeing).
  • The quality of services provided or arranged by both themselves and other relevant bodies (including inequalities in benefits from those services).
  • The sustainable and efficient use of resources by themselves and other relevant bodies.

At the heart of the Mid and South Essex Integrated Care Strategy is the Common Endeavour of reducing inequalities together. Working together to eliminate avoidable heath and care inequalities by creating a broad and equal partnership of individuals, organisations, and agencies, focusing on prevention, early intervention and providing high-quality, joined-up health and social care services, when and where people need them.

The MSE ICS will lead efforts to identify and reduce health inequalities in our area, alongside broad objectives to improve population health and contribute to social and economic development. We have adopted the NHS England ‘Core20PLUS5’ framework that focuses on reducing inequalities by targeting efforts at the most deprived 20% of the national population. Alongside ‘Plus’ populations who can experience the greatest health inequalities and specific condition where we can accelerate prevention work to improve outcomes.

Population plus groups are identified at a local level. In Mid and South Essex, we have identified Gypsy, Roma and Traveller communities, Black, Asian, and Minoritised Ethnic communities, Carers, Adults with Learning Disabilities and Autism, Homeless People, Veterans, Armed Forces Communities and their families, Care Leavers, and Victims of Domestic Abuse and Domestic Violence. As a Partnership, we will work to better understand the needs of these groups and engage proactively with communities to do so. We will encourage our Partners to work closely with these communities in the planning and delivery of services.

The NHS Core20PLUS5 model for adults can be viewed at the following link: https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalitiesimprovement-programme/core20plus5/

The NHS Core20PLUS5 model for babies, children and young people can be viewed at the following link: https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalitiesimprovement-programme/core20plus5/core20plus5-cyp/