How equality and diversity can help create better care for all – Mario Medina

You might think equality and diversity has little to do with health and social care, and that complying with the Equality Act is just a tick box exercise that we all feel duty-bound to comply with. Yet I believe that these two factors are crucial in ensuring Healthcare Improvement Scotland’s work has impact, and that it truly improves health and social care for everyone in Scotland.

Assuming that a programme of work will lead to improvements for all, without trying to really understand the diverse needs of those we want to benefit from the work, can lead to us discriminating against individuals, as well as widening Scotland’s health inequalities gap. Moreover, it can be a sure-fire way to ensure that the aims of the project fall short of our intentions.

As a health body, the Equality Act requires us to eliminate discrimination, advance equality, tackle prejudice and promote understanding across nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. It’s a responsibility that we all share, particularly as each of us has at least five of the nine characteristics. That’s why it’s important to consider the potential impact of our work at the beginning of each project to ensure that it is set up in order to improve care for as many people as possible. To achieve this, a tick box exercise will fail all of us. To really bring about improvements for all of us, equality and diversity have to be factors that we wholeheartedly commit to.

But how exactly do we ensure that a genuine commitment to equality and diversity is built into our work? Let me give you some examples of strategies that have worked for us.

Our Standards and Indicators team considered how the new cervical screening standards might be received fairly by everyone. Potential issues were identified and action taken to engage with different groups who might be impacted, improving our understanding of how to address these issues. Engagement with minority ethnic people identified potential cultural barriers to accessing cervical screening. The standards therefore included a stipulation about the provision of good quality information and strategies that NHS boards can adopt to identify those most unlikely to attend. We also identified issues from the trans community and built that perspective into the standards to ensure assumptions would not be made based on gender when identifying those eligible for screening.

Due to this type of engagement with people whose views are often under-represented in decision-making processes, we were able to design and develop standards with equality and diversity at their heart.

But to ensure we’re factoring equality and diversity into everything we do, we also need to recruit and retain a diverse workforce. We’ve taken a number of steps to improve in this area. We’re part of the Disability Confident scheme, which helps employers recruit and retain disabled people. Each year we complete Stonewall’s Workplace Equality Index (WEI), a tool for employers to measure their progress on lesbian, gay, bi and trans (LGBT) inclusion. During Mental Health Awareness Week, our staff took part in See Me’s Pass the Badge campaign, which encourages people to talk about mental health. We’ve also successfully recruited Modern Apprentices to Trainee Administrative Assistant roles. These actions and initiatives have improved career opportunities for people from a broad range of backgrounds.

The real evidence of our commitment to equality and diversity came with the creation of the Margaret McAlees Award in collaboration with Unison’s Scottish Health Care Branch. Established in honour of our late colleague Margaret McAlees, a Unison steward renowned for helping advance equality and promoting diversity, the nominations highlighted some of the great work our staff are doing. Our SIGN guidelines development team promoted the rights of young people to be involved in decisions which affect them, and worked to ensure patient versions of guidelines were accessible for them. The team behind our Scottish Patient Safety Programme for Mental Health were nominated as early adopters of a human rights-based approach to their work and for their efforts to tackle mental health stigma and discrimination. The award winners, our Focus on Dementia team, demonstrated a commitment to improving the lives of people living with dementia over and above what could be expected of them, undertaking voluntary work and participating in fundraising events in their own time. This work has improved the wider public’s understanding of dementia and how it affects people’s lives.

As an improvement organisation, we’re always looking to do things better. That’s no different when it comes to equality and diversity. We don’t want to simply meet our duties, we want to exceed them. I’m delighted to be in a position where I can look back on excellent work that is making equality and diversity a key part of what we do, and also to support its further development.

Mario Medina is Equality and Diversity Advisor for Healthcare Improvement Scotland.

More information

Healthcare Improvement Scotland website