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'Think outside the tick box to ensure equality in your trust'

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The equality delivery system will help your organisation to comply with the law, says Dean Royles

The requirements of the Equality Act 2010 mean that public bodies will need to publish information by 31 January 2012 to show they are complying with the need to eliminate harassment, advance equal opportunities and foster good relations between different groups.

All NHS organisations will also need to set specific equality objectives by 6 April 2012 in order to comply with the public sector duties of the act.

To help in these endeavours, the NHS has designed the new equality delivery system (EDS) to support NHS commissioners and providers to deliver better outcomes for patients and better working environments for staff.

The EDS is a tool to help assess how well embedded equality, diversity and human rights are within NHS organisations’ systems and processes. It is made up of four goals: better health outcomes for all; improved patient access and experience; empowered, engaged and well supported staff; and inclusive leadership at all levels.

“A service cannot be described as a quality service if only some patients achieve good outcomes while others do not”

Legal requirements and the EDS will no doubt require a degree of reporting, form filling and box ticking. The key to real success in respect of both will be the effective engagement and involvement of staff and patients. Organisations that have made equality mainstream understand that strong leadership and positive engagement can increase staff morale and, ultimately, improve patient outcomes. 

Furthermore, the EDS makes it clear that equality is more than box ticking - it’s about improving quality and actions that help reduce gaps in health inequalities.

A good-quality service recognises the needs and circumstances of each patient, carer, community and staff member, and ensures services are accessible, appropriate, safe and effective for all and workplaces are free from discrimination where staff can thrive. A service cannot be described as a quality service if only some patients achieve good outcomes while others do not.

NHS Luton has established a Luton-wide EDS implementation group chaired by NHS Luton with staff from partner organisations: Luton and Dunstable Hospital; East of England Ambulance Service; Cambridge Community Services; Luton GP consortia and Luton borough council. Members of this group are working collaboratively to ensure implementation of the EDS.

The aim is twofold: first, not to reinvent the wheel and ensure resources are used effectively; and, second, to ensure this activity builds upon the ongoing focus of QIPP and the existing community engagement infrastructure in Luton, for example by using a partnership approach to community consultation and involvement.

To further help organisations with staff engagement, we have launched a campaign to build a network of champions committed to creating a personal, fair and diverse NHS.

Our personal, fair and diverse (PFD) champions campaign is an opportunity to engage staff at all levels on equality issues to help them champion fairness for patients and colleagues, and to sustain it over time.

How senior leaders behave is crucial to setting the tone and NHS chief executive Sir David Nicholson and others were first to sign up as champions. More information on the campaign can be found at

While the law and the EDS are levers which require NHS trusts to publish information to be transparent and to map progress, real sustainable change will only happen with strong leadership and a commitment to allow trusts to think and work outside tick boxes and link their work to quality. In this way, the vision and ambition of an NHS that is personal, fair and diverse for both patients and staff may be realised.

Dean Royles is director of NHS Employers

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Readers' comments (1)

  • michael stone

    Tick box requirements do in practice lead to a drift towards 'tick box culture'.

    You need proper training, then 'principles based' behaviour, in an ideal world.

    Every time I see a list of tick box rules, with its author adding 'but you should use your brain as well', I think of those football managers who say 'we need to keep attacking as we are now, but to tighten up defensively'.

    Of course, proper training is more expensive than just pushing out a list of 'rules to follow'.

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