FUNCTION OR POLICY | COMMITMENT
Actions we committed to in our Scheme and new commitments | OUTCOMES/ ACTIONS TAKEN
Work undertaken to date | FUTURE ACTION
Work underway or planned to address these challenges | DEADLINE/ TIMING | CONTACT
Lead unit working on this |
High Impact |
Overall health policy development for NHS Boards and staff for improving health and reducing health inequalities | Key policy areas to keep under review as policy developments emerge, the requirements of RR(A)A and racial equality. Key areas include: substance misuse, mental health, women & children, public involvement, health improvement, health protection, NHS workforce, condition specific service developments eg. CHD, diabetes. | There has been senior level leadership on taking forward the race equality agenda. The Fair for All strategy and the National Resource Centre for Ethnic Minority Health are playing a key role. The Department has met with CRE Scotland at a senior level to monitor and assess progress in the equality proofing of health policy, and further guidance is to be issued to staff | Equality assessment tool for the Department is being developed Consult on equality assessment tool Apply assessment tool across Department | Complete by March 2004 Complete by July 2004 Ongoing - from October 2004 | Health Planning and Quality Division
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Patient Focus and Public Involvement | The ongoing development of the NHS towards a patient focused service that is responsive to the needs of patients and involves the public in service development. Ensuring delivery of this policy is key to the Department's commitment to racial equality in health, health care and health services. | The National Resource Centre is working to support NHS Boards in ensuring that services are culturally sensitive and meet minority ethnic needs. The specific requirements which health providers have to meet are set out in Departmental guidance ( HDL (2002) 51 Fair for All: Working Together Towards Culturally Competent Services) | Annual review of progress by NHS Boards towards implementing Fair for All action plans | Publish by September 2004 | Health Planning and Quality Division
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| Health Boards are required to deliver the first phase of their Fair For All action plans in March 2003, but are also required to provide a scheme by the earlier date, November 2002. | Fair Enough? Fair For All Progress Report was published in November 2003. It contains a detailed review of health boards' and trusts' schemes and Fair for All action plans. | | | Health Planning and Quality Division
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Minority ethnic health | Scottish Refugee Integration Forum report, which includes recommendations from a health and social care sub-group, has been issued for consultation. Recommendations for action will be taken into account in developing the work programme of the National Resource Centre for Minority Ethnic Health. | The Annual Report of the National Resource Centre for Ethnic Minority Health 2002-2003 was published in November 2003. It contains further information about the role of the centre and the progress of NHSScotland on race equality. | The National Resource Centre continue to undertake and commission research on minority ethnic health and encourage the development of networks which will promote the involvement of minority ethnic communities and individuals in their health and health services. | | Health Planning and Quality Division
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NHS Human resource issues | Annual staff survey which includes sections on ethnicity and discrimination and use by NHSScotland employers of a Self Assessment Tool (process to be validated by Audit Scotland and external auditors) to be undertaken as integral parts of the Performance Assessment Framework. | - An Annual staff survey and ethnic monitoring is carried out by NHSScotland employers. This includes data on access to training by staff from minority ethnic communities. Findings from the current staff survey will be used to identify areas where action is required.
- Information regarding minority ethnic staff is available on NHSScotland's ISD website.
- The Staff Governance Standard Self Assessment Tool and the staff survey were undertaken as part of the Performance Assessment framework.
| Within the Human Resources Directorate a Diversity Task Force will be established in early 2004. The Task Force will be responsible for driving cultural change within NHS Scotland with a view to increasing the recruitment, retention and progression of staff from under represented communities. This task force will have a direct link to the overarching Equality & Diversity Co-Coordinating Group for health. Strong links have been forged with Health Planning and Quality Division to ensure that the strategy for health is developed jointly with regard for service users and staff. The HR Directorate has strong links with the National Resource Centre for Ethnic Minority Health to ensure race and ethnicity issues are considered for all workforce policy. | June 2003 - annually thereafter | Partnership and Employment Practice Division, Human Resources Directorate
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| Two year rolling review of PIN (Partnership Information Network) Guidance (Key guides Equality, Bullying, Harassment.) | PIN Guidelines on Equal Opportunities and other aspects relating to fair treatment of staff have been issued. The Equal Opportunities and Recruitment and Selection Pin Guidelines are currently being reviewed with a particular focus on Diversity and Equality Issues in view of the new regulations under RR(A)A. | | 2004 | Partnership and Employment Practice Division, Human Resources Directorate
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Leadership of NHS | Chief Executive of NHS signed up to CRE leadership challenge and a commitment to regular meetings with CRE leadership. | The Chief Executive and the Health Minister met with CRE during 2003, and took part in a major conference in November designed to reinforce the commitment of the Department and the NHS to equality and diversity. As a result of this event the decision has been taken to establish a senior level Equality and Diversity Coordinating Group to lead action in the Department and the NHS. | Establish and support new Equality and Diversity Coordinating Group | March 2004 - then ongoing | Health Planning and Quality Division
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Mental Health Programme | Currently developing a programme of work around race and mental health with the National Resource Centre for Ethnic Minority Health. | The work programme is being finalised and will commence in March 2004. A two year work plan is being agreed. | A stock take of Mental Health Services is planned for 2004 to be undertaken by the National Resource Centre for Ethnic Minority Health. Supported by the Mental Health Division of the Scottish Executive. A key challenge of the next year is to ensure that the implementation of the Mental Health (Care and Treatment) (Scotland) Act 2003 and ensure the implementation takes account of race equality issues. The Act is due for implementation in April 2005. | | Mental Health Division
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Medium Impact |
Public Health Protection | There is some evidence of some ethnic groups being especially vulnerable to infectious disease. NHS Boards will need to take account of this developing action and messages on prevention (Action via Fair For All). Haemaglobinopathy study under way and proposals for further studies on eg diabetes, CHD etc being developed. | Greater Glasgow NHS Board employs several community health workers to work with asylum-seekers, in part to raise awareness about HIV testing, treatment and care facilities and HIV prevention. The Executive's universal antenatal HIV testing policy, introduced in 2003, means that all women, regardless of risk and race, are being offered and recommended an HIV test. PHACE Scotland (which is currently receiving a 3-year core grant from the Executive) provides a welfare rights service and a one to one volunteer support scheme that is open, available and accessed by people from black/ethnic groups. | HIV Scotland (also currently receiving core funding from the Executive) is considering in collaboration with other key interests, how to develop issues around HIV and ethnic minorities. This includes the probability of a survey around HIV within the black African Community living in Scotland, extended to other minority ethnic groups eg Eastern European, Chinese and South East Asian communities. | Ongoing | Public Health Division: administrative Group
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Delayed Discharge | To review the capacity of the system (care homes, home care etc) to match care to future needs. This will take account of ethnicity and diverse needs. | Baseline data relating to the Range and Capacity Review of older people's services has now being collected and is currently being examined. | A report will be published in April 2004. | April 2004
(Final Report) | Community Care Division 1, Branch 1
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| Baseline data being collected and includes any data available on ethnicity. | Ethnicity has not been included at this time due to shortage of validated data. Situation is currently being addressed through current questionnaires and discussions with Ethnic interest groups and we hope to include data relating to this area at a later stage. | | Summer 2004 | Community Care Division 1, Branch 1
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| | Upcoming meeting with Black and Minority Ethnic Elders Group (BMEEG), a national body set up initially by Age Concern to look strategically at policy and practice relating to ethnic elders throughout Scotland. BMEEG is now a charity with limited guarantee with the upcoming meeting due to take place on 2 nd February 2004. | | | Community Care Division 1, Branch 1
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Free Personal & Nursing Care: implement policy | Further work being undertaken to consider/assess impact of policy on all sectors of population and how this can be measured. Quarterly monitoring commenced to track impact. | Ethnicity has not been included within the wider quarterly monitoring. Some information will be available for people in care homes through the combined Care Home Census which asks long term residents about their ethnicity and the receipt of free personal or nursing care. This will be published by the Social Work Statistics Unit in 2004. | | | Community Care Division 1, Branch 3
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Clinical Strategies: Cancer | A commissioned report on the 'Measurement of Risk Factors for Cancer in Ethnicity and Health Research: A case study of tobacco and alcohol' was commissioned by the Scottish Cancer Group. The final report shared with SEHD Public Health and Patient Focus & Public Involvement colleagues. | | | Completed | Health Planning, Branch 2
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| The Macmillan Black and Ethnic Minority Information Project's first toolkit " Effective communication with South Asian people affected by cancer" | Copies circulated to Regional Cancer Networks. | | Completed | Health Planning, Branch 2
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| New Opportunities Fund Bids - Scottish Cancer Group is the NOF Advisory Group which has overseen funding of specific projects impacting on minority ethnic issues. | NOF specific funding secured included:- Forth Valley PCT - identifying unmet information and support needs of ethnic minorities affected by cancer Cancer BACUP - outreach cancer information specialist funded to provide cancer information and support services to hard to reach groups across Scotland including minority ethnic groups. | | Completed | Health Planning, Branch 2
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| Officials met with the Commission for Racial Equality in order to examine the Scottish Cancer Strategy in the light of the needs of minority ethnic communities and their carers. | | National Resource Centre for Ethnic Minority Health to follow up | Ongoing | Health Planning, Branch 2
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Low Impact |
Clinical Strategies: Coronary Heart Disease (CHD) and Stroke | Officials met with the Commission for Racial Equality to examine the CHD/Stroke Strategy in the light of the needs of minority ethnic communities and their carers. New Opportunities Fund Bids: National Advisory Committees for CHD and Stroke are NOF Advisory Groups which have overseen the funding of specific projects impacting on minority ethnic issues. | Agreed to work with CRE Scotland and the National Resource Centre for Ethnic Minority Health to ensure the CHD/Stroke Strategy was not inadvertently discriminatory. The Director of the National Resource Centre for Ethnic Minority Health has been invited to attend the next meeting of the cardiac and stroke MCN Group to discuss an assessment template. NOF specific funding secured included. Greater Glasgow NHS Board 1. Black and minority ethnic groups in heart health information resources: This project will design, tailor and disseminate information materials on heart disease to black and minority ethnic groups who have a higher risk of heart disease. 2. Culturally competent Cardiac Rehabilitation Service for Glasgow's Asian Community: The grant will be used to employ a development officer who will work with the Asian population to help them access heart disease information and services as well as developing proposals to train a multidisciplinary team. 3. Group Exercise Consultation: This project will provide a group exercise consultation resource which will increase patient access, particularly those from minority ethnic backgrounds and patients with established CHD. | ISD to run a software programme which CRE has developed that uses people's surnames to identify ethnicity. | Ongoing Completed | Health Planning and Quality
Branch 4
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Branch 4
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Clinical Strategies: DIABETES | The Scottish Diabetes Framework (April 2002) stated that the Scottish Diabetes Group would publish in conjunction with the National Resource Centre for Ethnic Minority Health a report on 'the epidemiology of diabetes among Scotland's ethnic minorities'. To improve data on ethnicity of patients with diabetes. | The report is in late draft Recording of ethnicity added to annual Scottish Diabetes Survey since 2002. | The NRCEMH hope to launch the report at the Diabetes UK conference in Birmingham in mid-March. Action plan for implementation of NRCEMH recommendations to be developed by Scottish Diabetes Group. Continue to extend and improve the collection of data relevant to people with diabetes from minority ethnic groups. The forthcoming NRCEMH report includes recommendations about which data items should be collected by diabetes services. | Report published and circulated by April 2004. The 2003 Diabetes Survey is due to be published by April 2004. | Health Planning & Quality 4
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Primary Care | Action to achieve tangible changes in primary care through policy implementation and service delivery: access to services, services designed around the needs of patients and respect for individuals. Encouraging the recruitment of a more diverse primary care workforce including more minority ethnic staff. Will form an integral part of the primary care modernisation programme. | Partnership for Care, Scotland's Health White Paper was launched in March 2003. This set out a clear direction for delivering a service that meets the needs of local communities, including minority ethnic communities. There are continuing initiatives to improve diversity in the workforce through general NHS Scotland employment policies. | Several initiatives are planned to improve access to services for all users. | Ongoing | Primary Care Division
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Health Improvement Programme | There has been evidence of some disparity of health experience between different ethnic groups as a result of a number of factors, some of which can be addressed through primary and secondary prevention work on the lifestyle and life circumstance determinants of health. Work will continue on the implementation of the health improvement agenda set out in White Paper 'Towards a Healthier Scotland' with its overarching aim of tackling health inequalities, through targeted action on alcohol and smoking, and through the implementation and development of Fair For All (see above) | | Health Improvement and inequalities policy in development aim to produce a policy document for consultation in spring 2004, prior publication of strategy to address the health gap for reasons of ethinicity, gender, location and socio-economic factors. | Autumn 2004 | Health Improvement Strategy Division
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Substance misuse | Additional action to ensure awareness of drug and alcohol action teams. To ensure appropriate access to misuse services for minority ethnic groups and to raise awareness of general duty requirements and Fair For All. (Communications, treatment, harm reduction and accessibility.) | Corporate action plans monitored the availability of services for minority ethnic groups across Scotland. Training courses on black and ethnic minority issues run by STRADA (Scottish Training on Drugs and Alcohol) | Some monitoring to continue. Discussion meeting planned with BEMIS. Review of Alcohol Plan for Action to consider future action for a range of equality groups. | Ongoing | Substance Misuse Division
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Carer Participation in Community Care Planning | An executive study into carer participation in health and community care planning (Joint Futures For Carers project) has been carried out. It is examining participation issues for all carers, including minority ethnic carers. | | The Executive will work with local authorities, Health Boards and carers' organisations to take forward the study's recommendations. Details will be considered in early 2004 when the final report is completed. | Autumn 2004 | Community Care Division 2, Branch 2
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