Our progress meeting our equality objectives for 2019-21.
Equality objective 1: Confident with difference – person centred care and equality
We wanted to find out where and how our colleagues, especially inspection teams, need more support to be confident with difference, so that they can engage more with providers on equality issues.
- carried out a survey of our inspection teams, which showed variable degrees of knowledge, confidence and action on including equality and human rights in inspections.
- used these findings to develop a programme of learning, formal and informal support for CQC colleagues. This included core learning on equality, human rights, diversity and inclusion, regular, specific learning sessions and resources on equality and human rights themes.
- improved equality and human rights in our assessment frameworks and methods. This programme is still in progress and covers all types of services that we regulate and all equality characteristics.
- significantly expanded learning and confidence building on equality during the pandemic.
Equality objective 2: Accessible information and communication
Building on our previous equality objective and to understand where improvement was still needed on meeting the Accessible Information Standard (AIS), we:
- interviewed people from advocacy organisations on how providers were meeting the Accessible Information Standard. We also held two workshops with NHS trusts in the north east. We found that compliance with the standard varied and progress was slow. We had hoped to feed this research into a CQC publication on accessible information and communication but this was curtailed because of the COVID-19 pandemic.
- hosted a workshop with key stakeholders and we are drawing together learning and an action plan on how to achieve better progress nationally on how providers meet the Accessible Information Standard.
- took action during the pandemic to ensure that providers improve communication with D/deaf people using their services.
- continued to highlight accessible information and communication in our regulatory frameworks, in our communications with providers and recently, by checking accessibility in vaccination centres.
- worked to make sure that our communication with people who use services is more accessible for them, for example, when people contact us by phone and in programmes to improve our digital communications. Improvements to our contact centre are in progress. We are looking at how we support people with information and communication needs to give feedback on care and we are improving our website in line with the government digital accessibility standard.
- delivered internal training to improve knowledge and confidence on accessible communication.
Equality objective 3: Equality and the well-led provider
- fulfilled our commitment to evaluating our work on the Workforce Race Equality Standard (WRES) in hospitals. Due to the pandemic, we have had to pause acting on the findings of the review because we paused inspections of the well-led key question. We are now publishing the review with updated actions to align with our new strategy. We will resume our work to act on the findings, including appointing an external advisor to provide oversight and are working jointly with other bodies to develop this work. Our approach will align with our ambitions to take a more flexible and targeted approach to our regulation, with activity taking place throughout the year, not just on inspections.
- improved how we regulate leadership on equality issues for patients and workforce in hospitals. We have produced briefings for hospital staff on the expectations on inequality in the NHS ‘Reset’ letter and embedded the expectations into our regulatory monitoring frameworks. We have worked with the Equality and Human Rights Commission to take enforcement action on sexual safety and workforce in relation to an ambulance trust. Our maternity equity thematic work is underway, where we are looking at leadership on equity for Black and minority ethnic women in maternity services. To support this, we have undertaken learning for hospital staff with Five X More and National Maternity Voices.
- supported work to embed nationally recognised equality tools for hospital trusts such as the new version of the NHS Equality Delivery System and the Workforce Disability Equality Standard into our regulation, although the pandemic has had an impact on this work. We recently ran a learning session for colleagues on the forthcoming Workforce Race Equality Standard in adult social care, led by the team in the Department for Health and Social Care who are developing the standard.
- held workshops for adult social care and GP inspection teams on equality and the well-led provider, and shared good practice examples. In May 2021, we published a resource on culturally competent care in adult social care, including the role of leaders in achieving this.
- continued to support our adult social care and primary medical services inspection teams through the inclusion of issues about equality in leadership in our new methods of monitoring during the pandemic. For example, to help providers consider how they protect staff from Black and minority ethnic communities.
- We also started regular learning and update calls with equality and diversity leads in NHS trusts to share our work on equality and to enable sharing of good practice.
- Our commitment to better data and monitoring on equality and the well-led provider is set out in CQC's strategy from 2021 and our equality objectives 2021-24.
Equality objective 4: Equal access to care and equity in outcomes in local areas
Over the previous three years, we started to look more at local systems including developing work with integrated care systems and carrying some local system reviews. Our 2019-21 equality objectives included expanding our local systems work to better consider equality issues in access and care outcomes.
- developed our approach in our provider collaboration reviews by including equality in our methodology, intelligence, co-production, engagement and listening to people’s voices. We have asked providers about their strategy, collaboration and action on addressing health inequalities, access and care outcomes. Topics have included urgent and emergency care, cancer services, services for people with a learning disability and autistic people, and mental health for children and young people.
- set an expectation that providers cooperate and work in partnership to meet the needs of their local population, including those in equality groups. Through the provider collaboration reviews, we have explored how providers are meeting expectations on tackling inequalities set out in the NHS Reset letter and in the NHS Long Term Plan.
- had a focus in each review on reducing inequalities for people from Black and minority ethnic communities. There is a specific line of enquiry on the experiences of people from Black and minority ethnic communities during the pandemic and how providers are responding to meet their needs in their local areas.
- included new data on ethnicity and the deaths of people with a learning disability in our insight reports, published since the early pandemic.
Equality objective 5: Continue to improve equality of opportunity for our colleagues and those seeking to join CQC
- published our new three-year strategy on diversity and inclusion for our workforce in 2020. The strategy has four high level ambitions: inclusive leadership and accountability, inclusive culture, inclusive engagement and inclusive policies and practices.
To support our leaders, managers and teams to create a culture of safe, open dialogue and ‘respectful enquiry’, we have:
- established and delivered a reverse mentoring and cultural intelligence programme for our senior leadership team.
- held a series of ‘curious conversation’ events for colleagues to share their lived experiences ina safe space and to encourage discussion.
To create equal and inclusive opportunities for all in our recruitment processes and approach, we have:
- reviewed our internal expression of interest process to ensure it is fair, open and transparent.
- introduced independent panel members when recruiting to all vacancies at grade A and above and internal posts.
We are committed to improving the quality of our data on diversity in CQC’s workforce, to build a stronger evidence base for change. We have:
- run equality monitoring campaigns to encourage colleagues to update their protected characteristic details on our workforce system, to help meet our 95% declaration performance measure.