Public Sector Equality Duty: Annual Equality Data Monitoring Report 2018 Summary Report
1 Background and introduction 1.1 The Equality Act 2010 Specific Duties Regulations 2011 (SDR) requires public bodies with 150 or more employees to publish information on the diversity of their workforce and diversity of people affected by its policies and practices. This report provides data covering the period 1st January 2018 to 31st December 2018. 1.2 The information relates to (a) the Trust s workforce; (b) leavers during 2018; (c) Service Users receiving support and care; and (d) Service Users recommending our services Friends and Family Test). 1.3 The information is disaggregated by protected characteristics, which are: Age; Disability; Gender Reassignment / Transgender; Marriage / Civil Partnership; Pregnancy and Maternity; Race; Religion or Belief; Gender; and Sexual Orientation 1.4 Where possible, the report provides comparison against 2016 and 2017 data. This helps the public and the Trust to assess the organisation s work in relation to the general duties under the Equality Act which are to: Eliminate unlawful discrimination, harassment and victimisation and any other conduct prohibited by the Equality Act Advance equality of opportunity between people who share a protected characteristic and people who do not share it Foster good relations between those who share a protected characteristic and those who don't. 1.5 The information in this Executive Summary report also helps the Trust to understand how it is meeting its equality objectives, which were adopted during 2015 2016 financial year. These objectives mirror the NHS Equality Delivery System2 Goals, which are: Better Health Outcomes Improve Patient Access and Care A representative and supportive workforce Inclusive leadership 1.6 More detailed report is available on request to support the information provided in this Executive Summary. 1.7 During 2018, the Trust achieved the Employers Network for Equality and Inclusion s (ENEI) TIDE Bronze Award 1, and are also in the Inclusive Top 50 UK Employers List 2018/2019 2 1 TIDE = Talent Inclusion & Diversity Evaluation 2 Inclusive Top 50 UK Employers List established through membership of Inclusive Companies Membership. 2
2 Headlines of 2018 workforce composition Overall workforce trend 2.1 Since 2016 the overall workforce has increased by 3.9%. The table below shows the annual increase of 2% per year during 2017 and 2018 respectfully Three year workforce trend 2016 2017 2018 Total Workforce (Headcount) 4126 4205 4293 % Increase from 2016-1.9% 2.0% 2.2 The key reasons for the increase in the workforce are related to winning contracts to deliver services (such as Bournemouth Specialist Drug and Alcohol Service and Daisy Unit) and development of new services (such as Learning Disabilities In-Patient Daisy Unit) Workforce split by pay bands 2.3 The table below shows that 71.3% of staff are in Bands 2 to 6. This is a 3.3% decrease from 2017, and nearly the same percentage as in 2016. These staff carry out the critical support and operational delivery roles, which account for the majority of representation. 2.4 In terms of headcount, the greatest increase has been Band 7 (from 469 staff in 2017 to 501 in 2018). The roles in these bands on the whole carry mid-level management and leadership (clinical and non-clinical) responsibilities. 3
Age 2.5 The table below shows that there has been no significant change in the age profile of the workforce since 2016. Three year workforce trend by age bandings 2016 2017 2018 Total Workforce 4126 4205 4293 % (and headcount) 18-25yrs 5.3% (220) 5.8% (242) 5.8% (250) % (and headcount) 26-35yrs 22.7% (938) 22.7% (955) 23.0% (989) % (and headcount) 36-45yrs 24.1% (994) 23.6% (992) 22.8% (980) % (and headcount) 46-55yrs 30.1% (1,276) 30.6% (1,285) 29.9% (1,283) % (and headcount) 56-65yrs 15.3% (631) 15.7% (661) 16.7% (717) % (and headcount) 65+yrs 1.6% (67) 1.7% (70) 1.7% (74) 2.6 The majority of our staff fall within 46yrs 55yrs age grouping, indicating that the Trust continues to have a significant middle aged workforce. 2.7 The percentage of staff in the 18-25yrs age grouping has not changed significantly since 2016. The Trust is working hard through its recruitment drive to attract applications from educational establishments which will hopefully result in an increased representation of younger employees in the workforce. 2.8 In the age grouping 56yrs-65yrs, within the next 10 years nearly 17% of staff will reach or be nearing the likely retirement age. There may potentially be an increase in the number of staff in this age grouping if individuals choose not to retire because of changes in pension entitlements and regulations. This would be positive as the Trust can retain their skills. Gender 2.9 The gender split of the workforce is at nearly 75% female and 25% male. There has been no significant change in the gender profile of the workforce since 2016. Traditionally, health and care services have attracted a higher proportion of females than many other professions. 4
2.10 The tables below shows that there are more females than males across all pay bands, and that females have consistently been well represented in senior management roles (Band 8a and above). 2.11 Female representation in Clinical and Non-clinical roles is also credible. They represent 73.5% of all Clinical roles and 78.4% of all Non- clinical roles. 2.12 Females are also well represented in Consultant roles (which has been consistent since 2016): Females Males Total Headcount % Headcount % Consultant 130 61 46.9% 69 53.1% Nurse Consultant 5 3 60.0% 2 40.0% 2.13 Trust has continued to maintain a credible gender balance, with 50:50 split in the composition of Board level roles since 2016. This is very positive in terms of females in very senior leadership. Very Senior Non-clinical Roles (Board Level) Females Males Headcount % Headcount % Grand Total Chair 1 100% 0 0.00% 1 Non-Executive Directors* 1* 20.00% 4 80.00% 5 Associate Non-Executive Director 1 100.00% 0 0.00% Chief Executive Officer 1 100.00% 0 0.00% 1 Board Level Directors 3 50.00% 3 50.00% 6 Total 7 50.00% 7 50.00% 14 *1 post at Non-Executive Director level vacant as of December 2017 5
2.14 The tables below show the full-time and part-time split since 2016, and the overall percentage of the part-time workforce. The percentages of female part time workers remain significantly high and there is steady increase in part-time workforce overall. Three year trend of full and part-time split by gender 2016 2017 2018 % F/T females 66.4% 66.5% 66.7% % F/T males 33.6% 33.5% 33.3% % P/T females 86.2% 85.6% 85.9% % P/T males 13.8% 14.40% 14.1% 2016 2017 2018 Total % of P/T Staff 40.4% 41.0% 41.6% 2.15 Further analyses shows that the part-time workforce in the Trust is (a) female dominated; (b) most prevalent in pay Bands 1 4 across both genders; and (c) least prevalent in senior and very senior management positions (pay bands 8a and above). Race / ethnicity 2.16 It should be noted that in terms of race, the definition of White includes White British, Irish and Any Other White ethnicities. Definition of Black and Minority Ethnic (BME) includes all other categories of ethnicities (e.g. Black African, Asian Indian, Mixed, Chinese etc.), except Unknown or Not stated. These definitions are based on the NHS s Workforce Race Equality Standard (WRES). 2.17 The Trust has seen increase of BME staff in comparison to both 2016 and 2017. The overall Black and Minority Ethnic (BME) representation is now at 11.5%. This is 0.5% increase since 2017. 6
2.18 Within the Trust s area of operation, the overall BME population aged between 16-64yrs (likely working age) is 8.2% 3. Therefore, the Trust s BME workforce of 11.5% is a healthy representation. 2.19 Nearly 3% of staff have not stated their ethnicity, which is a slight increase 2016 and 2017 (when it was 2%) 2.20 The table below shows the representation of BME staff across all pay bands. 2.21 Of the total number of BME staff in the workforce (495) 46% are represented in Bands 1 to 4. Whilst this percentage is lower than in 2017, of all White staff in the workforce (3678) 38% are represented in Bands 1 to 4, which show that disproportionality remains for BME staff in lower pay bands. 2.22 Representation of BME staff at Bands 8a and above (including Medical and Other ) has been proportionally in line with the representation of White staff in the same Bands in 2016 and 2017. However, BME staff are proportionally better represented than White staff in 2018 at 15% BME and 14% White respectively 2.23 The table highlights the representation of BME staff in Clinical and Non-clinical roles: Total Clinical Workforce Total Non-Clinical Workforce BME / White staff total Headcount % Headcount % BME 396 12.5% 99 9.9% 495 White 2774 87.5% 904 90.1% 3678 Grand Total 3170 1003 4173 52.24 The 12.5% of BME staff in clinical roles remains similar to their percentage of representation in 2016 and 2017. However, the 9.9% of BME staff in Non-Clinical roles is an increase from 2017 when it was 8.8%, and 8.2% in 2016. This is positive. 3 Office of National Statistic s Working Age Annual Population Survey (Jul 2017 Jun 2018) 7
2.25 There has been some progress made in terms of BME representation across pay bands, however their disproportionality in lower pay bands continues. Disability 2.26 There has been an increase in the percentage of declarations in disability monitoring data from 78% in 2016 and 82% in 2017, to 83.5% in 2018. This includes respondents who have stated No, Yes or Prefer not to answer. 2.27 Overall, 5.3% of the Trust s workforce are disabled staff, or at least they have declared their disability. This is an increase from 3% in 2016 and a slight increase from 5% in 2017. 2.28 The percentage of staff that have Not Declared has dropped from 22% in 2016, 18% in 2017 to 16.4% in 2018. This decrease is a positive move towards encouraging declarations. 2.29 Within the Trust s area of operation, the percentage of economically active or work limiting disabled people aged 16 64rs is 67.4% 4 (151,000) of all disabled people of expected working age in our catchment area (224,100). This means that there is a significant pool from which we can potentially recruit from. 2.30 There has been an increase of Disabled staff in pay bands 1 to 4 (from 73 in 2017 to 79 in 2018), and pay bands 5 to 7 (from 123 in 2017 to 134 in 2018). The number of Disabled staff in pay bands 8a and above (including Medical and Other ) has remained the same (at 15). 4 Office of National Statistics (ONS) dataset on Annual Population Survey (Jul 2017 Jun 2018) 8
Sexual Orientation 2.31 There has been an increase in percentage of sexual orientation monitoring since 2016 from 70.4% to 76.0% in 2018 (74.8% in 2017). This is positive progression to encouraging more declaration 2.32 The number of staff from Lesbian, Gay and Bisexual (LGB) communities has steadily increased from 107 in 2016 and 118 in 2017, to 136 in 2018. This is 3% of the total workforce. 2.33 The percentage of staff who wished not to disclose their sexual orientation has decreased from 29.7% in 2016 to 24.0% in 2018. This seems to indicate that there is a steadily increasing culture of sexual orientation acceptance Marital Status 2.34 There is no significant difference to the 2016 or 2017 data. Nearly 50% of the workforce is married and 39% are single. The rest of the workforce is made up those who are divorced or legally separated or who have not declared their status. Pregnancy / Maternity 2.35 Staff who are on maternity, paternity, shared parental and adoption leave will vary on year to year basis. The Trust adheres to NHS Agenda for Change terms and conditions of pay, which go over and above statutory regulations. For example, the Trust offers occupational maternity pay in addition to statutory payments. Religion / Belief 2.36 Staff who are Buddhists, Hindu, Muslim, Jewish, Sikhs and Jainists form 3.7% of the workforce respectively, which is a 0.5% increase from 2016 and 2017. Otherwise, there are no significant changes in the declaration of religion / belief amongst the workforce. 9
3 Leavers by protected characteristics 3.1 The data in this section refers to staff that left the organisation by Age, Race, Gender and Disability. This is because the volume of statistical information provides more meaningful analyses than that of other protected characteristics. 3.2 Note: (a) Junior Doctors at Foundation Year 1 and 2 are not included in this data as they are on a rotational cycle as part of their training and (b) data includes all Bank Staff and those on Fixed Term Contracts, Total leavers / voluntary resignations / reasons for leaving 3.3 For the Trust increasing retention across all protected characteristics remains one of the key priorities as outlined in the Trust s Recruitment and Retention strategy. The shows that the number of leavers has dropped since 2016 and in particular leavers due to voluntary resignations 2016 2017 2018 Total leavers 1335 1055 966 Voluntary resignations 881 799 698 3.4 Work life balance remains a significant reason for voluntary resignation, although percentage has decreased from 56% (446 staff) in 2017 to the 51% (356) in 2018. Table below highlights the three most common reasons. Reasons for voluntary resignations Total Promotion elsewhere 72 Relocation 88 Work Life Balance 356 3.5 The above most common reasons have been consistent amongst leavers since 2016 3.6 The percentage of voluntary resignations within 1 year of appointment (see table below) has reduced from 37.8% in 2017 to 32.4% in 2018, but is higher than 26.8% in 2016. 10
3.5 Work will continue to reduce voluntary resignations with one year through staff engagement and increased on-boarding activities. This is a crucial part of our approach to increasing retention. Age 3.6 Majority of resignations since 2016 have been in the age banding 26-35. 3.7 However, amongst 16-25 year olds, voluntary resignation has dropped since 2016 when it was 131 resignations, to 93 in 2018 (113 in 2017). This indicates that there is an improving retention rate amongst the younger workforce. Ethnicity 3.8 The percentage of BME leavers during 2018 has reduced from 17% in 2017 to 14.2% in 2018 3.9 The data shows that of the overall number of BME leavers, nearly 77% was voluntary resignations. In comparison, of the total number of White leavers, nearly 71% were voluntary resignations. Therefore, proportionally BME staff are more likely to voluntarily resign than White staff. 11
3.10 The incidence of both BME and White staff voluntarily resigning within one year of service has reduced considerably since 2016 and 2017. There is also a closer parity between BME and White staff leaving within 1 year of service. Gender 3.11 There has been no significant change in the trend between female and male leavers since 2016. The 2018 data shows that of all leavers (966), 74.4% (719) were female and 25.6% (247) were male. These percentages have been nearly consistent in the previous two reporting years. 3.12 The table above shows that of all the female leavers, 74.3% were voluntary resignations. This percentage has been similar to the percentage in 2017 (75%) 3.13 In comparison, of all male leavers 66.4% were voluntary resignations. This percentage is a sharp rise from the 25% in 2017, and 27% in 2016. This shows that there has been a proportional increase in voluntary resignations amongst male staff. 12
3.14 Of all female voluntary resignations, 35.2% were within one year of service. In comparison, 23.2% of all male voluntary resignations were within one year of service. 3.15 The above percentages are lower than in 2017 which is an improvement. Disability 3.16 The data below shows that79% of all disability yes leavers were voluntary resignations, compared to 74.1% of disability no voluntary resignations. 3.17 This shows that proportionally more disabled staff are likely to voluntarily resign that nondisabled staff. This has been a consistent trend since 2016. Despite the overall increase in disabled staff in the workforce since 2016 made little progress in retaining them. 3.18 Our detailed data also shows that of all the disabled staff who voluntarily resigned in 2018, 32.7% (16) resigned within 1 year of service. This percentage is lower than the 42.5% in 2017 and 28% in 2016. This shows that whilst more disabled people are voluntarily resigning at least since 2017, they are less likely to do so within one year of service. 13
4 SERVICE USER DATA (as of 31/10/2018) 4.1 Service user is extracted from RIO system for the snapshot date of 31st October 2018. It should be noted self-declaration personal data related to protected characteristics is an option for Service Users and not a mandatory requirement. 4.2 The following should be noted on the availability of protected characteristics data for Children & Adolescent Mental Health Services (CAMHS) and Improving Access to Psychological Therapy services (IAPT also known as community based well-being therapies ): The CAMHS and IAPT data are on IT different systems than RIO. Consequently, CAMHS and IAPT data has not so far generally been included in reporting of overall completion of protected characteristics data. To include this information would mean relatively complicated data manipulation and processing which risks the accuracy of the data overall. Also, CAMHS and IAPT have different reporting requirements to adult secondary mental health services, and so their systems are configured to meet these. This includes difference in what is recorded and what is not (e.g. Marital Status, Pregnancy and Gender Reassignment is not recorded by CAMHS and IAPT systems), and also differences in reporting categories (e.g. for ethnic group there are some sub group categories missing). Work will need to be done during 2019 to map existing data held on CAMHS and IAPT systems to facilitate ease of migration into RIO system. 4.3 The data is to a total of 17,165 service users on caseload. This is an increase of just over 1,100 since 2017. Age 4.4 Of all Service Users on caseload 42% (7204) are within 65yrs and over age groupings, compared to 37% in 2016. This is an increase of 5%. Age Band Service Users on Caseload Percentage of Total <16 8 0.05% 16-17 27 0.16% 18-24 1360 7.92% 25-34 2393 13.94% 35-44 2256 13.14% 45-54 2293 13.36% 55-64 1624 9.46% 65-74 1737 10.12% 75-84 2862 16.67% 85 plus 2605 15.18% Grand Total 17165 100.00% 14
4.5 A large proportion of those 65yrs and over are accessing the following services: Dementia Memory Complex Intervention Team 4.6 As in 2017, 8% of our service users are of <16-24yrs on our caseload. Of these, majority are accessing the following services: Early Intervention Assessment and Recovery Specialised Community 4.7 The number of 25-44 year old Service Users on our caseload remains the same as in 2017 at 27%. Of these, majority are accessing the following services: Assessment and Recovery Community Mental Health Early Intervention Gender 4.8 Data shows that although there more females are accessing services than males, has been an overall increase by 500 more males accessing our services than in 2017. 4.9 The table below shows the gender split of Service Users Gender Patients On Caseload Percent of Total Female 9386 54.68% Male 7776 45.30% Not Specified 3 0.02% Grand Total 17165 100.00% 4.10 Of total number of females (9386), a large proportion are accessing the following services: Dementia Services (an increase since 2017) Recovery Memory 4.11 Of total number of Males (7291), large proportion are accessing the following services: Assessment and Recovery (an increase since 2017) Dementia (an increase since 2017) Memory (an increase since 2017) 4.12 Since 2017, there has been an increase in male access to some services which is positive in terms of supporting and promoting men s mental health and well-being. However this increase is not reflected in other services types 15
Race / Ethnicity 4.13 The overall percentage of Black and Minority Ethnic (BME) Service Users (which includes all of the above ethnic groups except for White or White British or Irish, Not Known and Not Stated ) remains at 7% for the third consecutive reporting year. 4.14 This percentage is slightly lower than the overall BME normal working age population (16-64yrs) in our area of operation 8.2% 5, which provides an indication of degree to what extent our services are accessible to BME communities. 4.15 The majority of the BME Service Users are receiving services from our delivery units in Bristol and Swindon. This not surprising as demographic information shows that these areas have a larger BME population overall. Service Units BME White Not Known / Not Stated Total BANES 66 1171 59 1296 Bristol 707 4120 307 5134 CAMHS* 1 8 1 10 Medical 3 3 N. Somerset 44 1913 60 2017 S. Gloucestershire 86 1266 129 1481 Secure 44 197 1 242 Specialised 53 1250 483 1786 Swindon 149 2122 94 2365 Wiltshire 61 2617 153 2831 Total 1211 14667 1287 17165 4.16 The top three services that support BME Service Users are: Assessment and Recovery (an increase of BME service users since 2017) Dementia (an increase of BME service users since 2017) Early Intervention 4.17 Since 2017, there has been an increase in BME access to some services which is positive. However, this is not reflected in other service types. Disability 4.18 There has been an increase in the service users responding to the disability monitoring question. Of the total number of Service Users, 12.3% declared either Yes or No to the Disability monitoring question. This is 4% increase from 2017 and 8% increase from 2016. The actual percentage of Disabled service users has increased from 1.97% in 2017 to 3.35% in 2018. 5 Office of National Statistic s Working Age Annual Population Survey (Jul 2017 Jun 2018) 16
4.19 Whilst there has been a positive increase in disability monitoring responses, the percentage of Unknown remains unsatisfactorily high (see table below). There is a need to do more in promoting the benefits of disclosure to help in person centred care: Disability Service Users On Caseload Percent of Total No 1536 8.95% Unknown 15054 87.70% Yes 575 3.35% Grand Total 17165 100.00% 4.20 It is possible that disability may be recorded in a variety of places within RIO rather than where it should be recorded. So the information may be there but not easily extractable. 4.21 Of the total number of Service Users who declared Yes (575), 60% (346) are accessing Dementia Services Sexual Orientation 4.22 Overall, nearly 15% of service users have responded to the sexual orientation monitoring question, compared to 10% in 2017. However, the table below shows that 83% of the data regarding sexual orientation is Unknown, which is a reduction of 5% from 2017. Whilst this is some progress, it remains high Sexual Orientation Patients On Caseload Percent of Total LGB 74 0.43% Unknown 14324 83.45% Heterosexual or Straight 2351 13.70% Not stated (declined to respond) 79 0.46% Not known (not recorded) 324 1.89% Other sexual orientation not listed / Person asked & does not know/is not sure 13 0.08% Grand Total 17165 100.00% 4.23 The challenge for the Trust is to reduce the percentage of Unknown, and since 2016 the Trust has been progressing in this area (the percentage of Unknown in 2016 was 95.6%) 4.24 With the introduction of the Sexual Orientation Monitoring Standard during mid-2017, the Trust has amended data collection fields on RIO to reflect the standard. Work will need to be done to promote (a) the value of declaration and (b) accurate inputting of data onto RIO by staff 4.25 Data on LGB Service Users accessing specific services is not included here as potentially they will be identifiable. 17
Marital Status 4.26 19.7% of Service Users are married, which is an increase of 3.7% from 2017 and 2016. 4.27 The percentage of Not Known and Blank records (i.e. No data has been entered into the fields) in RIO remains high at 36%. Marital Status Patients On Caseload Percent of Total Married 3386 19.73% Divorced 862 5.02% Not Disclosed 110 0.64% Not Known 747 4.35% Separated 260 1.51% Single 4765 27.76% Widowed 1658 9.66% (blank) 5377 31.33% Grand Total 17165 100.00% 4.28 It may be that data is recorded elsewhere within individual case records, if so further work needs to be done to ensure that data is recorded and uploaded on to RIO in the right place. Transgender / Gender Re-assignment 4.29 The number of Service Users on caseload who are in the process of gender reassignment has increased slightly from 2017. Gender reassignment begun Patients On Caseload Percent of Total No 2634 15.35% Yes 20 0.12% (blank) 14511 84.54% Grand Total 17165 100.00% 4.30 Overall, nearly 15% of service users have responded to the Transgender / Gender Reassignment monitoring question, compared to 11% in 2017. This shows steady progress in our data collection under the protected characteristics 4.31 Data on Transgender Service Users accessing specific services is not included here as potentially they will be identifiable 18
5 SERVICE USERS RECOMMENDING THE TRUST (Friends & Family Test) 5.1 Friends and Family Test surveys are help to measure the quality of our services from a Service User point of view. These anonymised surveys, which are voluntary to complete, are offered to Service users at a point of discharge from care, during individual care reviews or transfer of care to another provider. 5.2 The data: Covers the period July 2018 September 2018 6 (financial quarter 2) provides a snap-shot Provides the total number of survey responses covering both Community and Ward based surveys (including their respective Easy Read versions). Provides the total number of positive responses only (which covers Highly Likely, Likely or Yes ) to the question Is disaggregated by positive responses and some of the protected characteristics, where protected characteristic information is available 7. Excludes data where the record of protected characteristic information is either Unknown or Not stated, Prefer not to answer or Blank on our system. 5.3 The table below provides an overall response to one of the key the questions in the survey - How likely are you to recommend our service to friends and family if they needed similar care or treatment? July 2018 September 2018 (Q2) FFT survey respondents Total number of survey responses 2412 Total number of positive responses 2153 Total number of Male positive responses 677 Total number of Female positive responses 837 Total number of White positive responses 1374 Total number of BME positive responses 98 Total number of 16-25yrs positive responses 237 Total number of 26-35yrs positive responses 264 Total number of 36-45yrs positive responses 195 Total number of 46-55yrs positive responses 216 Total number of 56-65yrs positive responses 169 Total number of 65yrs+ positive responses 434 Total number of Disabled Yes positive responses 906 6 The 2017 data reported on quarter 3 September 2017 December 2017, however data for the same time frame has not been available at the time of writing this report) 7 No data is collected on protected characteristics other than Gender, Age, Race and Disability. 19
5.3 89% (2153) of all responses are positive. This is a 1% increase from the previous reporting year. 5.4 There has not been any notable significant change in the percentage of male and female positive responses since 2017 5.5 5% (98) of all positive responses are from BME Service Users, which is increase from previous reporting year 5.6 Those aged 65yrs and over continue to provide a positive response than in other age groupings. 5.7 For majority the age groupings, there has been a slight increase in the number of positive responses since previous reporting year. 5.8 There was a slightly lower number of positive responses from Disabled people who have declared Yes to Disability monitoring questions (906 in 2018 compared to 921 in 2017) when completing the survey. 20