1. Barbara Hankins MSc (07802 654249) - 20Mar071
EQUALITY & DIVERSITY
The Patient’s Perspective

2. Barbara Hankins MSc (07802 654249) - 20Mar072
Equality & Diversity
Objective
Providing a Healthcare Service that
recognises, respects and responds to
the diversity of the local communities
we serve

3. Barbara Hankins MSc (07802 654249) - 20Mar073
Race Equality
Local Population Statistics
White Pakistan Indian Black
British Caribbean
Local Community 641,300 104,000 56,000 48,000
(66%)
In Patient Profile
Selly Oak 65% 3% 2% 3%
Queen Elizabeth 65% 5% 5% 6%
Workforce 69% 1% 6% 4%

4. Barbara Hankins MSc (07802 654249) - 20Mar074
Race Equality Scheme
Issues from Initial Impact Assessments
• Patient Information
• Interpreting Service
• Telephone Communications
• Communications Barriers
• Cultural needs/awareness
• Gap with Primary Care

5. Barbara Hankins MSc (07802 654249) - 20Mar075
Disability Equality Scheme
Trust Issues
• Requires for the first time that it takes a
pro-active approach
• Needed to involve a range of people with
disabilities in the whole process, including
employees and the wider community

6. Barbara Hankins MSc (07802 654249) - 20Mar076
Disability Equality Scheme
Patient Issues
• 9 million deaf and hard of hearing people in the UK or
1 in 7 of the UK population
• Of these 698,000 are severely or profoundly deaf
• Another 450,000 of them are severely or profoundly deaf
and cannot hear well enough to use a voice telephone
even with equipment to make it louder
• An estimated 500,000 black and ethnic minority people
are deaf or hard of hearing
• Communication difficulties can place them all in danger
of misdiagnosis or delay in treatment

7. Barbara Hankins MSc (07802 654249) - 20Mar077
Disability Equality Scheme
Key Concerns
Research conducted by Sign, found that the
key concerns for the needs of deaf people in
the NHS were:-
• To improve access to all health services
• To prioritise and promote disability
equality
• To improve facilities and services for deaf
people

8. Barbara Hankins MSc (07802 654249) - 20Mar078
Disability Equality Scheme
Experiences of people who are
deaf and their carers
• Lack of knowledge, awareness and consideration by
doctors, health professionals and receptionists shown in
poor attitudes and lack of deaf awareness in
communication
• Information on deafness not being transferred between
healthcare services, not being acted upon and lack of a
system to do so
• Medical staff with little training in deaf awareness/
communications tactics
• Service providers being unclear on how to deal with deaf
patients, particularly A&E.

9. Barbara Hankins MSc (07802 654249) - 20Mar079
Disability Equality Scheme
Some solutions to help improve our
patient’s experience
• Allow more time for appointments
• Ask patients how they prefer to communicate
• Make sure staff are aware of RNID Talktype
• Use pictures, Video and DVD.
• At least one front-line staff member should have basic
deaf awareness training
• Produce a short video of the ward and staff to orientate
patient to the ward environment
• Update the website and ensure it is up-to-date and is a
comprehensive source of information

10. Barbara Hankins MSc (07802 654249) - 20Mar0710
GENDER EQUALITY SCHEME
Trust Issues
• Needs to be a central plank of service and
strategy
• Will require the Trust’s entire service remit to be
tailored to men or women and in areas that are
not as obviously gender sensitive
• Collecting gender-specific disease data is a
crucial first step
• The Health Service is historically starting from a
very low base

11. Barbara Hankins MSc (07802 654249) - 20Mar0711
Gender Equality Scheme
The impact of sex differences on
health and illness
• Men typically develop heart disease ten years
earlier than women
• Women’s immune systems make them more
resistant than men to some kinds of infection
including tuberculosis
• Women are around 2.7 times more likely than
men to develop an auto-immune disease such
as diabetes
• Male-to-female infection with HIV is more than
twice as efficient as female-to-male infection

12. Barbara Hankins MSc (07802 654249) - 20Mar0712
Gender Equality Scheme
Gender differences in health and illness
• Men are more likely than women to commit
suicide
• Women are 2-3 times more likely than men to be
affected by depression or anxiety
• Men are more likely than women to die of
injuries, but women are more likely to die of
injuries sustained at home
• The gap between male and female smoking
rates is beginning to narrow as young women
are taking up the habit more frequently than
young men.

13. Barbara Hankins MSc (07802 654249) - 20Mar0713
Gender Equality Scheme
Gender differences in health care
• Reporting practical problems in access to
services
• Caring responsibilities or transport
problems
• Admit weakness or accept that they may
be ill

14. Barbara Hankins MSc (07802 654249) - 20Mar0714
Gender Equality Scheme
Gender differences in use of
health care services – In-Patients
• Women - slightly more likely to be admitted as inpatients
• Men from most ethnic minorities – slightly lower rates of
inpatient treatment
• Indian and Pakistani men - higher rates of in-patient
treatment
• Asian women - more likely to be referred to hospital by
their GP but also were more likely not to attend
appointments
• Differences in hospital treatment for mental health
problems reveal higher admission rates amongst men in
early life and again in old age, while female rates are
higher in middle age

15. Barbara Hankins MSc (07802 654249) - 20Mar0715
Gender Equality Scheme
Gender differences in use of
health care services – Out-Patients
• Men are more likely than women to attend A&E
• Women have higher rates overall of GP referrals for
out-patient appointments
• Higher rates of referral for in-patient treatment for
women in general surgery, general medicine and
psychiatry in particular
• Differences vary by ethnic group
• Chinese women and men were less likely to have
attended as out-patients compared with general
population
• Chinese women and men are less likely to report being
affected by a number of key health conditions

16. Barbara Hankins MSc (07802 654249) - 20Mar0716
Gender Equality Scheme
Gender Blindness
• The health of women and men is strongly influenced by
their biological sex and their social gender
• Targets for reduced waiting times are same for both
sexes but results would be of greater value if
disaggregated for women and men and for different
clinical specialties
• However, targets may be reached at different speeds for
different specialties and may also reflect specific
difficulties facing women and men in accessing care
• Without a framework in which gender is identified as a
relevant factor, the possibility of gender differences
cannot be properly explored.

17. Barbara Hankins MSc (07802 654249) - 20Mar0717
Equality & Diversity
Conclusions
• A huge agenda to be completed
• Collecting gender-specific disease data is a crucial
first step
• Working towards a Single Equality Scheme can
help
• Patients come from a wide range of ethnic groups,
with different cultural perceptions of health, illness
and healthcare.
• Being sensitive to these different perceptions can
impact positively on a patient’s progress and vice
versa – but first you have to be aware of them!

18. Barbara Hankins MSc (07802 654249) - 20Mar0718
Equality & Diversity
Equality & Diversity in the NHS is all
about changing how we work and
meeting the real needs of the people
who use health services
Thank you for your time