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Joan Jamieson Equality and Diversity Information Programme Manager, Information Service Division

ISD Equality & Diversity Information Programme (EDIP ). Joan Jamieson Equality and Diversity Information Programme Manager, Information Service Division. Men’s Health Forum Scotland 19 th October 2007. What will I talk about this morning.

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Joan Jamieson Equality and Diversity Information Programme Manager, Information Service Division

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  1. ISD Equality & Diversity Information Programme (EDIP) Joan Jamieson Equality and Diversity Information Programme Manager, Information Service Division Men’s Health Forum Scotland 19th October 2007

  2. What will I talk about this morning • Brief overview of Information Services Division (ISD) • Current information about men in relation to ethnicity and health – how easy and with what cost? • Heart of the problem in Scotland • What is the NHS doing : EDIP • Consulting & Engaging with service users

  3. Information Services Division(ISD) Orkney • A national organisation • Part of NHS National Services Scotland • Supporting the collection of health information - (pre-) cradle to the grave • Providing health statistics, information technology & related services for NHS Scotland Shetland Western Isles Grampian Highland Tayside Forth Valley Fife Greater Glasgow & Clyde Lothian Lanarkshire Borders Ayrshire & Arran Dumfries & Galloway

  4. Ethnic Groups in Scotland Census 2001

  5. Age by ethnic group Scotland Census 2001

  6. National Insurance Number Allocations to Overseas Nationals Entering the UK ( abbreviated) http://www.dwp.gov.uk/asd/asd1/niall/registration_tables.xls

  7. Massive prevalence (%) of glucose intolerance (diabetes & IGT) (NHP, 25-74 years)

  8. CHD mortality among those aged 25 years and older, compared to people living in England and Wales Lives in Scotland Source: Fischbacher et al 2007

  9. Ethnic Groups- what is routinely known?

  10. Scottish Diabetes Survey 2005: completeness of recording of ethnicity by NHS Board

  11. Heart of the Problem in Scotland Discrimination Structural -The law of itself is not capable of eliminating discrimination and change does not comes easily to institutions like the NHS. Cultural - stereotyping e.g asylum seekers as all having HIV /people with learning difficulties finding speaking in groups very stressful Institutional -e.g lack of detailed information on ethnicity- “statistical invisibility can lead to political invisibility which in turn prevents an appropriate agenda being developed” (Bhrolchain 1990) Personal - being Black & HIV positive could be less favourably treated due to beliefs and attitudes of some who deem HIV as a punishment for their sexual/ drug practices. Johnson, A ( 2006), Structural, Cultural, Institutional and Personal Discrimination,

  12. Equality & Diversity Programme Remit • designed to help NHS Scotland identify and meet the needs of minority ethnic and diverse groups • promote social inclusion and narrow health inequalities • comply with new laws, regulations and good practice; and • develop information systems that record necessary details with minimum additional fuss and bother.

  13. Context of the Equality & Diversity Programme • Legal and Policy drivers: • Anti Discrimination Laws e.g RRAA2000, DDA • Fair for All health service care and delivery • Patient Centred Care – Involving people • Partnership working • Priority for NHSScotland: • Current lack of relevant data means that the NHS is Scotland is unable to demonstrate non discriminatory practice or any inequalities in the health of the Scottish population by : • Ethnic group/relgion/transgender/disability/sexual orientation/or other determinants of inequality

  14. Public Consultation Meetings • To hear and understand what people across Scotland have to say about providing more personal information to support their healthcare through: • Presentation • Discussion • Questionnaire Consultation Definition : Inviting participants opinions, informing them, reporting their voices and using results to inform recommendations for collecting equality and diversity data.

  15. General Issues Raised by Participants related to their use of the NHS Concerns about the ethnic categories Why NHS wants to know your religion Dietary & suitability of hospital food Languagebarriers Transport & mobility problems Reading & understanding NHS letters/information. Unsuitable hospital Appointment times Medication worries Being asked the same questions repeatedly Lack of time with GP Perception of lack of NHS staff knowledge Translation and interpretation services Problems describing their symptoms NHS 24

  16. Data Collection Design • Self classification/self completion difficult: • Literacy • Language • Understanding of terminology • Who can help • Many dependent on relatives • Poor sight • Shaky hands • Too many questions at one time • GP registration • Practice Nurse • Community Nurse • First referral consultation Personal Approach preferred

  17. What participants want 1 • Although willing to give more personal information a number of requirements were mentioned by participants: • Forms/questionnaires - easy to understand & complete • Clear explanation about the reasons for the data collection • Stakeholders should be involved in preparation & planning • Staff trainedin equality & diversity should ask these questions • Interpreters should be available to support service users

  18. What participants want 2 • Clear & concise information with regard to confidentiality & security of this personal information • Assurance that the information will be used to support culturally competent health care and to improve services • To be asked before this information is shared outside the healthcare sector • Informed about how to change this information • More consideration as to who, where and when this personal information is collected • Further consultation on the religious & sexual orientation questions

  19. Conclusion • Overall participants agreed they would support the NHS in terms of the collecting and providing more personal information. • Ingredients for success include: • Communication at National, Local, individual level with appropriate information and in preferred format. • Local stakeholder involvement of people at the preparation, planning and design. • Benefits clear and unambiguous – be honest. • NHS make use of the information to improve individual care and service delivery balanced with confidentiality & security reassurance. • GP practice level where people know the start of the collection. • Questions, Language, Definitions,Terminology require refinement and user involvement. • Further consultation around capture of ‘spiritual care’/relgion, sexual orientation, disability.

  20. Closing thought Mr Malik has arrived at the hospital to be admitted to hospital for heart surgery. The GP referral includes the following: •Mr Malik uses a wheel chair, •He manages to look after himself apart from assistance with bathing and showering •He would prefer a male practitioner to assist with personal care •He would like his local Imam to pray with him before surgery. Outcome – Mr Malik feels that having his particular needs met made all the difference in his recovery. QuestionCan the NHS make this happen?

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