Equalities in Health

Historically, health services have largely been planned without taking into account patients’ needs relating to inequality and discrimination. In order to properly understand the population we serve and develop better health services, we need to collect and use a wider range of evidence to help us build up a more complete picture.

Currently, NHSGGC is building up a more comprehensive picture through the following:

• Population data analysed in relation to protected characteristics and socio-economic status.
• Patient monitoring by  protected characteristics e.g. ethnicity monitoring and socio-economic status
• Patient profiling to understand the needs of individual patients in relation to their protected characteristics
• Information on patient experience by  protected characteristics and social economic status
• Differences in the health status and health outcomes for people  with different protected characteristics
• Impact on health of discrimination and social inequality
• General information about inequality and discrimination

Evidence of good practice across NHSGGC

The COMPASS service

The COMPASS team is a city–wide mental health service which exists to provide mental health care and treatment for asylum seekers and refugees with moderate to severe mental health problems stemming from trauma.

Data is collected through the referral form or at assessment.  The referral form captures information on: general demographics and family, including dependants; language spoken; need for interpreter; religious affiliation; level of educational attainment; Asylum Status, physical disability and trauma history. Alert systems are used to notify staff of additional needs at appointments.

Further information is then collected at assessment including: nature of financial pressures; importance of faith and religion; family composition and needs in relation to adults and children; history of gender-based violence, sexual orientation and preferred language and interpreter.

The service completed an Equality Impact Assessment and identified a number of actions to further improve collection of equalities data, such as using non-gender-based enquiry in relation to sexual orientation and including questions around socio-economic status, physical disability and sensory impairment.

Equalities data has been used to directly enhance patient care.  For example, information collected on language is used to inform the selection of translated appointment letters and the booking of an appropriate interpreter. Socio-economic status of clients is used to assess eligibility for support with travel to appointments and to guide clients to further support. Information on a client’s religious beliefs is used to inform the timing of appointments and is taken into consideration during psychological therapy.

Collection of equalities data has also informed service planning and review. For example, awareness of the asylum status of clients has lead to the service routinely sending out maps with first appointment letters which include photos of our department. Socio-economic data was used to inform the decision to provide clients with information on services for destitute people. Information on client demographics was used when planning to meet the needs of groups under-represented in the service.

The Sandyford Initiative

The Sandyford Initiative provides NHSGGC’s specialist sexual, reproductive health services. 

At registration, age, postcode, ethnic origin, disability status and gender are collected.  Alert systems are used to notify staff of additional needs at appointments. 

The collection of Ethnic origin has significantly improved in the last few years due to staff training and revision of the registration form.  

Sexual orientation is not asked about at registration.  The service considered this but do not feel that such a sensitive subject should be enquired about by clerical staff or that our patients should be required to label themselves at this initial use of the clinic. It is covered in routine sexual history taking, where sexual preference, experience and desire is enquired about.

Activity at all Sandyford locations is closely monitored and a range of reports have demonstrated good use of equalities monitoring data to ensure access to local services and appropriate targeting of particular groups. 

For example, a report for Sandyford Renfrewshire shows that the local service is:

• used by local people, with 80% of activity by people living in the CHP area
• successfully targeting young people
• increasing the proportion of men seen overall
• increasing the proportion of men who have sex with men seen,
• seeing a more deprived population than the local average, with 38% attendees from the most deprived quintile

Information about ethnicity has been used to plan specific interventions, for example a series of events aimed at involving local African communities. 

In Inverclyde CHP, data analysis drew attention to high sexually transmitted infection rates in young people, sexual health needs in Greenock prison, and unprotected sex amongst men who have sex with men as key local priorities.

 Due to locally identified need, Sandyford South East has some male-only and female-only clinic appointments and a weekly appointment clinic for women staffed by an Urdu and Punjabi speaking female doctor.

Useful Sources of Information

• BME Health and Wellbeing (PDF)
• Ethnic monitoring in relation to SMR00, 01 and 04 data 
• Equality Groups in Glasgow ODS Report (PDF)
• Health & Care in Scotland – Results from the 2009/10 Scottish Household Survey
• How Fair is Britain
• Mental Health in Focus: exploring inequalities in the mental health of those living in Greater Glasgow and Clyde
  • Summary Report (PDF)
  • Full Report 
• Significant inequalities in Scotland – Identifying significant inequalities and priorities for action
• Sinking & Swimming – Understanding Britain’s Unmet Need
• Understanding Glasgow
• Unequal Society – Ethnicity & Mental Health (PDF)
• Variations in the Experiences of Inpatients in Scotland – Analysis of the 2010 Scottish Inpatient Survey 
• What you need to know about Mental Health Inequality (PDF)

The NHS in Scotland aims to work more in partnership with patients. Learning from patient experience and service user engagement initiatives is key to Goal 2. However, initiatives that ignore inequalities issues are discriminatory. Service user engagement should specifically involve people representing the protected characteristics.

People’s experience of inequalities relates to why they develop health problems, do not engage with health services and find it difficult to manage their health problems. Service user engagement and patient experience programmes that recognise inequalities issues will:

• identify barriers to patient attendance
• improve equal access to services
• improve patient experience of services
• improve the experience of taking part in service user engagement activities

In the long term, these inequalities sensitive programmes will lead to a better understanding of:

• which patients access health services and why
• the type of inequalities patients have experienced
• how this affects their health and the way they use health services

In NHS Greater Glasgow and Clyde some areas have carried out Equality Impact Assessments of user engagement activity. In addition, support is being provided for a strategic approach to:

• recognising equalities issues within user engagement induction and development
• equalities monitoring of service user engagement groups

NHS Greater Glasgow and Clyde has also completed inpatient and primary care pilots as part of the national Patient Experience Learning Programme [BROKEN LINK] which includes equalities monitoring.

Evidence of good practice across NHSGGC

Engagement and Mental Health

Glasgow Anti-Stigma Partnership has carried out a range of activities to engage with service users, carers and communities on mental health and equalities related stigma. For example:

• the Mental Health Arts and Film Festival was started by GGC, now Scotland wide. 40,000 participants – interactive events which cover a wide range of equalities, anti-stigma and anti-discrimination issues
• BME and equalities Community Engagement Programme (Mosaics of Meaning) recognised in UK National Mental Improvement Frameworks and internationally as good practice. Wide dissemination of tools
• Mindwaves programme commissioned: service users, carers and local communities working as ‘journalist’ identifying, developing and publishing mental health and wellbeing good news stories

Local areas have engaged with patients and staff as follows:

• Forensics Services stigma research with staff & patients, patient ward atmosphere scale, carers conference of over 50 people, DVD of patient & carers journey
• Asylum seekers and refugees & mental health users group – developed Women’s Charter, user conference of 100 people in March
• Engagement with BME communities and Imams in South East Glasgow – psychological perspectives on race and faith – conference of over 150 people in October; mental health staff involved in setting up of Roma Practitioners and service users Group and participate in Glasgow Homelessness Network user engagement work
• Carers survey piloted in South Glasgow. Renfrewshire Intensive Home Treatment Team patient satisfaction questionnaires for each client

View our Patient Engagement web pages

Useful links

Equality and Human Rights Commission – The Equality Act Codes of Practice post consultation report

Scottish Community Development Centre – National Standards for Community engagement

Scottish Health Council – Participation Standard – Participation Standard

People’s health choices are shaped by their experience of discrimination and feeling excluded and Goal 3 requires health workers to understand this.

How much people adopt a healthy lifestyle is influenced by how valued people feel by society or how much investment they have in their future.

An approach to health improvement based on making choices now which will benefit you in the future is unlikely to benefit people who lack power, who feel their future looks bleak or who are dealing with immediate concerns like debt or unemployment.

Equally Well, the Ministerial Task Force on health inequalities identified the following key health inequalities facing people in Scotland;

In Scotland in 2006, healthy life expectancy at birth was 67.9 years for men and 69 years for women. In the most deprived 15% of areas in Scotland in 2005-2006, healthy life expectancy at birth was considerably lower at 57.3 years for men and 59 years for women.

A higher proportion of babies born to mothers living in the most deprived fifth of the population have a low birth weight than those born to mothers living in the most affluent areas (9% compared to 5% in 2004 – 2005).

In Scotland in 2006, people who had a low household income, or reported finding it difficult to manage on their household income, had poorer mental wellbeing than those with a high household income or who reported finding it easy to manage on their income.

There are large and increasing relative inequalities in deaths amongst young adults due to drugs, alcohol, assault and suicide.

In Scotland in 2006, more than two thirds of the total alcohol-related deaths were in the most deprived two fifths of area.

Those living in the most deprived 10% of areas of Scotland have a suicide risk double that of the Scottish average.

Adult smoking rates increase with increasing deprivation. In Scotland in 2005-2006, smoking rates ranged from 11% in the least deprived 10% of areas to 44% in the most deprived 10%.

Compared with the non-South Asian population, the incidence of heart attacks in Scottish South Asians is 45% higher in men and 80% higher in women.

Lesbian / gay / bisexual and transgender people experience lower self esteem and higher rates of mental health problems and these have an impact on health behaviours, including higher reported rates of smoking, alcohol and drug use.

Just under a quarter (24%) of all individuals in households with at least one disabled adult or disabled child are living in relative low income, compared to 16% of those in households with no disabled adults or disabled children.

Equally Well (2008) Click here to download PDF.

Equalities in Health in Scotland

Evidence of good practice across NHSGGC

Smoking Cessation Needs Assessment of BME population living in South East Glasgow HSCP

This research programme aims to better understand barriers to accessing cessation services for BME people and make appropriate changes to service delivery models.

Thrive Counselling Service for Male Survivors of Childhood Sexual Abuse

Understanding gender and in particular the impact of masculine norms and values helped the counselling service establish itself. Thrive, like many inequality sensitive services, has helped dispel the perception of ‘hard to reach groups’ and replaced it with a more positive understanding of potential preventative barriers in current service designs.

Keepwell Anticipatory Care Programme

At the Heart of the Keepwell model is an understanding that health gain can be achieved if the cause of ill health is treated from an inequalities perspective. Asking people to make health choices as part of a health check without understanding the context of lived experience would fail to make sustained and generational improvements. To this end, Keepwell has included a number of additional, non-clinical elements to support patients make investment in future personal health planning.

Goal 4 describes the need to remove barriers to services for those with protected characteristics. Barriers can be physical, about attitudes or about how we plan services to meet the needs of one group and not another. These barriers to services can cause direct discrimination e.g. not having an interpreter available to meet someone’s language needs or indirect discrimination e.g. always having appointment times at a time when a particular group can’t make it.

There are a range of programmes underway to remove barriers for patients:

Equality Impact Assessment

Goal 4. requires that all services address unlawful discrimination. In order to do this we have developed an Equality Impact Assessment process which can help services identify areas of risk and take action to improve services for people with protected characteristics.

Accessible Information

Effective communication is vital to provide high-quality services and care. Many of those who access services have difficulty understanding the information provided. This may be because they are blind, deaf, have a learning difficulty, or because English is not their first language. It may be because they need support in terms of reading (literacy problems) or they have a condition which limits their ability to communicate (e.g. following a brain injury or a stroke). Children and young people have specific communication requirements.

Goal 4 requires that information for NHS Greater Glasgow and Clyde patients is presented in an accessible way, in a range of languages and formats that are easily used and understood by the intended audience. This does not mean watering down the content or creating a summary.

This means taking information in a form that is not accessible to an individual, and changing, translating or interpreting it into a form the individual can understand.

Disability Access

Goal 4 requires NHS Greater Glasgow and Clyde to ensure that all its building and sites are accessible for disabled people. We have an annual programme of Disability Discrimination Act audits where we work in conjunction with a disabled peoples’ network to assess the accessibility of our buildings and grounds. In addition, NHSGGC invests in innovative solutions to overcome barriers for disabled people using our services.

These include:

• Good practice guidelines for those with sensory impairment.
• a British Sign Language online interpreting pilot, aiming to improve access to interpreting for Deaf people.

Evidence of good practice across NHSGGC

The Sandyford Initiative is an NHSGGC wide sexual and emotional health service.  It provides a comprehensive range of services at a central location in Glasgow and within ‘Hubs’ across NHSGGC.    

The initiative completed an EQIA as part of a redesign of its services.  The EQIA indicated a range of good practice on equalities exists within this services. This included good use of equalities monitoring data, routine enquiry on social issues and  adapting the service to meet the needs of specific communities.  The EQIA allowed reflection on gaps and subsequently areas for improvements were identified such as sensitive enquiry and recording of sexual orientation.

‘Inequalities Sensitive Practice’ is central to Goal 5. This kind of practice involves taking into account underlying issues of social inequality, such as money worries or gender-based violence, in order to improve the health of individual people. Evidence shows that if these issues are not taken into account by the health service, opportunities are missed to improve health and to reduce health inequalities.

An Inequalities Sensitive health practitioner:

• understands the impact that inequality has on a patient’s experience of life and health
• doesn’t judge and understands power within the practitioner/patient relationship
• is sympathetic and has good listening skills which enables the patient to tell their story, thus making it ‘real’
• challenges in a sensitive way, providing alternative options
• takes a person centred approach

From 2006 to 2009, NHS Greater Glasgow and Clyde delivered an Inequalities Sensitive Practice Initiative which produced evidence and resources for staff.

The organisation now has a number of programmes of work aimed at ensuring our services know and understand their responsibilities in identifying and responding to experiences of social inequalities.

Evidence of good practice across NHSGGC

Healthier Wealthier Children

Working in partnership to tackle child poverty and inequality can produce meaningful and far-reaching results. The Scottish Government-funded Healthier, Wealthier Children project has been operating in the NHS Greater Glasgow and Clyde area since October 2010 and has succeeded in embedding financial inclusion referrals into care for pregnant women and families that are experiencing or are at risk of poverty.

Key to the project is the ethos that tackling child poverty is everyone’s business, and that money and debt worries need to be routinely discussed as part of assessments. It brings together maternal and early years health and social care professionals with voluntary sector providers of money advice, debt advice, and income maximisation services which explore benefit and tax credit entitlement. Onward referrals from advice services are also made to address related issues such as fuel poverty, homelessness, addiction, mental health and immigration advice.

At the end of March 2012, 3853 referrals had been made to advice services which resulted in 54% uptake among pregnant women and families. Six out of 10 people accessing the advice services received some type of intervention with a total annual recorded gain of just over £2.7 million (for 644 referrals) and £328,000 in one-off lump sums (for 370 referrals). The majority of referrals – 80% – were made by midwives and health visitors.

The project achieved its aims of increasing access to money advice services for equality groups. Women are more at risk of poverty due to the gender pay gap, occupational segregation, part time working and caring roles. Evidence also shows that women are more likely than men to go without food and clothes in families experiencing poverty with a female and male composition. 94% of referrals in this project were women This is particularly encouraging as pregnancy & childbirth can be risk times for increased financial hardship.

The majority of referrals were single parents. 17% of referrals were from BME communities (83% White Scottish / British / Irish; 6% Pakistani; 3% Polish; with a range of other ethnic groups referred also).

A NHSGGC wide Equality Impact Assessment (EQIA) was carried out early on in the project with some areas carrying out local EQIAs, which supported marketing to equalities groups.

Within the health board area 10 community health (and care) partnerships and 6 local authorities are involved in the delivery of the project, which is being evaluated by the Glasgow Centre for Population Health. A learning network has been established to share information and support emerging good practice across the partnership.

For more information and detailed case studies visit the HWC web site.

Gender based violence

Gender Based Violence (GBV) is recognised as being a major public health issue causing pain, injury and suffering, particularly to women and children and as such is an important contributing factor to poor health outcomes for individuals attending NHSGGC services. It is known that all health staff have a unique and crucial role in identifying and supporting all those affected by it.

GBV and Maternity Services

In NHSGGC, routine enquiry about domestic abuse was introduced at the maternal history taking visit prior to the issuing of CEL_41 (2008). However, it wasn’t a uniform roll-out as it occurred prior to the amalgamation of NHS Argyll & Clyde and Greater Glasgow NHS.

Early on in maternity services, the work to embed routine enquiry about domestic abuse was supported by 3 midwives, who received intensive training around gender based violence (GBV). These staff now co-ordinate a strategic response to GBV in all of the Women’s and Children’s Directorate.

The approaches have been different for Greater Glasgow and Argyll & Clyde areas with a wide range of work carried out over the years including:

• Assessing midwives training needs and what they perceived were the barriers to routine enquiry
• Ensuring that service issues were addressed for all areas (e.g. ensuring that all staff were introducing private time)
• Development of a rolling programme of basic awareness and skills based training (the latter provided by the Women’s Support Project)
• Standards of care were written (based on the All Wales Pathway but following the incremental stages of establishing a pathway for routine enquiry) and a set of competencies
• Mentoring for staff who lacked confidence after initial training in how to ask the question sensitively and responding to disclosures. (e.g. the mentor sits in through two booking visits feeding back after each one so that the midwife is aware of the improvements (if any needed) in her approach, & developed a range of practical case studies to work with mentees on how to deal with disclosures)
• Evaluation and monitoring of routine enquiry and mentoring

GBV and Sexual Health Services

The Sandyford Initiative provides all specialist sexual health services within NHS Greater Glasgow and Clyde. A GBV Policy was developed in January 2011. It sets out procedures for supporting staff to identify and respond appropriately to clients who have experienced gender-based violence, or who are perpetrators of gender-based violence. It also provides up to date information about all forms of GBV and appropriate support services available for referral.

Given the significant levels of gender-based violence within the population and its consequences for health and well-being it is important for staff working in sexual health services to have the competence and confidence to ask about GBV including domestic abuse. Sandyford staff already regularly deal with people who have experienced abuse, whether or not the abuse is a direct or indirect cause of their presenting condition, including self harm or suicide attempts.

In house education sessions have been provided and clinical supervision sessions and appropriate support from line managers provide additional opportunities for staff to discuss their experiences of sensitive routine enquiry and other GBV related issues.

GBV work in Renfrewshire HSCP

Renfrewshire HSCP has led work across NHSGGC to ensure Sensitive Enquiry on GBV becomes part of routine practice.

A GBV lead was identified by the CHP Director to drive delivery of NHSGGC GBV Plan. The GBV lead was able to garner support for this programme at an early stage by having an extended management team session. This resulted in a whole systems approach being taken across primary care services.

Renfrewshire CHP is in the process of extending the national programme to include Health and Community Care Settings and have provided short training sessions for admin staff. They have also utilised local Multi-Agency Partnership relationships and resources to ensure that all key staff access Basic Awareness Domestic Abuse Training.

A programme of support for staff has been agreed, covering Peer Support, Clinical Supervision, Line Manager Support and Complex case discussion/review. The involvement of a specialist local women’s organisation (Women & Children First) has been secured to support complex case discussion. Extensive internal communication and promotion of the GBV plan has included NHSGGC’s team brief system as well as team meetings.

NHS Greater Glasgow and Clyde has an annual budget of 2.6 billion and employs 38,000 staff. Goal 6 requires these resources to be used innovatively to tackle inequality. Work to tackle inequality is part of NHS Greater Glasgow and Clyde’s core business rather than an additional service. This means that financial and service planning needs to have tackling inequality at its centre.

While acknowledging the difficult economic environment in which public authorities are now operating, the Equality and Human Rights Commission is emphasising the compulsory nature of the equality duties, and the importance of public authorities meeting their duties when making significant decisions.

NHS Greater Glasgow and Clyde has carried out rapid impact assessments of cost savings programmes to ensure that there is not an unfair effect on those with protected characteristics.

The Public Sector Duties and Financial Decisions (PDF)

Goal 7 requires NHS Greater Glasgow and Clyde to remove barriers to recruitment for people with protected characteristics.

Discrimination and prejudice can impact on people’s employment opportunities and it is unlawful to discriminate against people when recruiting or in the workplace. A more diverse workforce is important to patients because it means we are representative of the communities we serve. In order to monitor diversity, Human Resources produces Equal Opportunity Reports on applicants and employees.

All Human Resources policies are subject to Equality Impact Assessment to ensure that they support the recruitment and retention of a diverse workforce. NHS Greater Glasgow and Clyde have a range of guidance and policies which support this. Human Resources can support managers to ensure they are delivering best practice and our Recruitment Guidance Manual includes advice on equal opportunities interviewing.

Goal 8 requires that staff have access to a range of learning opportunities to ensure that they are aware of the equalities legislation and have the skills to deliver health services that are fair to all.

The Equality Act 2010 contains nine protected characteristics (areas where we must not discriminate) and by law the NHS must actively promote equality.

We need to ensure that our staff are able to:

• Challenge discrimination,
• Promote equality of opportunity and
• Meet the needs of those with protected characteristics.

Equality is a complex subject area and we have developed a range of short e learning modules to promote better awareness of each protected characteristic. These modules describe the needs of those with protected characteristics and their protection in the law.

Staff training and resources uptake is analysed by protected characteristic which will help ensure that staff have equal opportunities to access training and development opportunities.

A Manager’s Guide to the Equality Act 2010 is available so that senior personnel can support their staff to meet the legislation’s requirements.

Goal 9 requires NHS Greater Glasgow and Clyde to ensure that the procurement of goods and services is not discriminatory. For example, making it clear how smaller organisations who specialise in equalities work can bid for NHS contracts.

‘Social benefits’ clauses can be used to ensure contractors make a positive impact in the local community. For example, the New South Glasgow Hospital which is being built in Govan has provided training places to give people access to construction jobs.

Evidence of good practice across NHSGGC

New South Glasgow Hospitals

The New South Glasgow Hospital campus project will be the largest single NHS hospital build project ever undertaken in Scotland. The campus will include a new children’s hospital, new adult hospital and laboratory development.

NHS Greater Glasgow and Clyde (NHSGGC) recognises the important role the NHS plays in local communities beyond the provision of healthcare facilities and services. The strategy adopted in relation to the campus not only seeks to engage patients in the design of the new hospitals but also engages communities in the broader campus development, maximising the opportunities from NHSGGC’s investment.

The impact of the new South Glasgow Hospitals Campus will only be realised through effective collaboration between partner organisations, building on existing partnership structures in South West Glasgow and Glasgow.

Community Benefit

NHSGGC sought to maximise training and employment opportunities, business start up and business growth through a targeted approach to securing benefit for communities in Greater Glasgow and Clyde in the procurement process for the new hospitals.

In doing so, the board included specific community benefit considerations requiring bidders to demonstrate how they would meet the following objectives:

• Target 10% of total labour required to deliver the project to be delivered by New Entrants
• Assess and develop the capacity of Small/ Medium Enterprises
• Assess and develop the capacity of Social Enterprises

Targeted Training and Recruitment

Brookfield Construction Ltd (BCL) has committed to deliver a target of 10% of total labour required to deliver the project (including those works delivered by specialists, or sub-contractors) to be delivered by New Entrants. In addition, BCL has also committed to deliver additional targets in relation to training and learning (see below).

BCL has entered into a partnership with Glasgow South West Regeneration Agency (GSWRA) to deliver training and recruitment targets. In furthering the traing and recruitment targets, GSWRA working with Brookfield will:

• Devise a Local Labour Action Plan and establish requirements with Sub-Contractor/s to recruit and source supplies locally where these exist.
• Establish an operational team to deliver services including: vacancy promotion, skills assessment and matching, general and vocational training and business development.
• Establish a “Recruitment & Training Centre” in close proximity to the New South Glasgow Hospitals Project.
• Share relevant data and management information to ensure collaborative working.
• Identify and source funding from various agencies, development programmes, charities to ensure that aims and objectives are achieved.
• Engage effectively with the community and other stakeholders on the work of the Partnership.
• Recruit relevant partners to enable effective delivery of these aims.

In addition to the above, BCL has adopted a recruitment protocol were all vacancies resulting from the construction project will be notified to GSWRA to support mainstream recruitment form communities in South West Glasgow.

Developing the Supply Chain

In assessing and developing the capacity of Small Medium Enterprises (SMEs) BCL have entered into partnership with Glasgow City Councils Supplier Development programme (SDP) to support and develop the capacity of Small Medium Enterprises by undertaking:

• Activities to identify Small Medium Enterprises (SME’s) and assess their capacity.
• Actions to assist Small Medium Enterprises (SME’s) to obtain contracts
• Actions to ensure that the sub-contractors make work packages available to Small Medium Enterprises (SME’s)
• Measurement of the social and economic impact of the engagement with the Small Medium Enterprises (SME’s)
• To provide support for the Small Medium Enterprises (SME’s) to assist them to work in Partnership.

In assessing and developing the capacity of social enterprises, BCL have entered into partnership with Community Enterprise in Scotland. Community Enterprise in Scotland under the “Ready for Business” programme will support and develop the capacity of Social Enterprises by undertaking:

• Activities to identify Social Enterprises and assess their capacity.
• Actions to assist Social Enterprises to obtain contracts
• Actions to ensure that the sub-contractors make work packages available to Social Enterprises
• Measurement of the social and economic impact of the engagement with the Social Enterprises
• To provide support for Social Enterprises to assist them to work in Partnership.

BCL will work with Glasgow City Council and Community Enterprise in Scotland to provide training and support to equip SMEs and social enterprises with the relevant expertise and policies to enable them to bid for potential sub-contracting opportunities.

Recognising that the scale of opportunities available may be prohibitive for smaller SMEs and social enterprises, the BCL has committed to identify construction and non-construction related ‘work packages’, which are accessible to SMEs and social enterprises who otherwise would have found it difficult to secure a contract.

BCL have agreed a protocol for SMEs and SEs wishing to engage in the project .This has been supported by the establishment of a portal for individuals and businesses to register for future opportunities.

Reducing the health inequality gap and shifting resources from treatment to prevention requires action from organisations other than the NHS.. This includes education, employment, housing, transport and other public services which impact on the underlying causes of poor health.

Goal 10 requires NHS Greater Glasgow and Clyde to work with other partners to address inequality and discrimination. For example, Glasgow Community Planning Partnership recently carried out research on protected characteristic groups to enable all partners, including NHSGGC, to improve services.

NHS works with partners on a range of projects to tackle health inequality.

Healthier Wealthier Children is an example of partnership working to ensure families with money worries are referred to financial inclusion services to reduce child poverty.

Equality Groups in Glasgow ODS Report

Evidence of good practice across NHSGGC

Working with the Local Authorities and the Voluntary Sector is crucial in addressing the effects of poverty.  Within Glasgow City, NHSGGC is a key partner in the development of an Anti-Poverty Strategy.  As part of that, a strategic plan to address the effects of child poverty has been developed. This includes consolidating our NHS approach to child poverty, which includes ensuring families have appropriate support e.g. through Universal and Vulnerable Care Pathways and ensuring social interventions such as parenting support and money advice are widely available.

It is the responsibility of NHSGGC staff to provide an interpreter for patients attending any of our healthcare services.

Please note that the provision of interpreters is paid for directly by NHSGGC. There will be no cost to your service.

For more information on this service, go to HR Connect/Interpreting

NHSGGC policy states that we must provide formal interpreting support for all out-patient appointments and at least once a day for an in-patient stay.

This support can be provided via our British Sign Language (BSL) Online interpreting Service – using NHSGGC’s communication support iPads – or by booking a Face to Face interpreter.

The BSL Online interpreting service is available 24 hours a day, 7 days a week. This means that in an unplanned or emergency situation, staff can quickly link up to an interpreter at any time and communicate with their Deaf patient. It can also be used during hospital stays, or to enable Deaf patients to communicate with staff if waiting for a face to face interpreter to arrive.

The BSL Online service can be accessed at a wide range of sites across NHSGGC – for a full list of sites, more information and a short instruction video, click here.

To book a face to face BSL Interpreter, contact the NHSGGC Interpreting Service. Patients may have a preferred interpreter that they would like to use for their appointment. This information should be passed on to the Interpreting Service who will make the booking. Wherever possible you should try to book the person or organisation the patient chooses. However, in an emergency situation it may not always be possible to use the patients preferred choice.

Where possible staff should book interpreters in advance of any appointment. In an emergency, or if you require an interpreter within the next 24 hours,  please call the booking centre and explain the circumstances. 

NHSGGC Interpreting Service (8.00am until 6.00pm Monday to Friday, 8.00am until 4.00pm Saturday to Sunday)
E-mail: interpretingservice@ggc.scot.nhs.uk
Telephone: 0141 347 8811

Out of Hours Procedures

Please contact the patient’s preferred agency, if provided, or call 0141 347 8811 to be connected to an appropriate service.

You can also access the BSL Online Interpreting Service which is available 24/7.This service allows staff to communicate with  Deaf BSL patients while waiting for a face to face interpreter to arrive.

Telephone interpreting is available 24/7 and can be accessed by calling or using the app.

Please note that the process for accessing telephone interpreting is changing from 1st April 2023

For more information on this service, go to HR Connect/Interpreting

Patients can now access the telephone interpreting service to contact any NHS Greater Glasgow & Clyde service.

For example, patients can use the telephone interpreting service to call from home and make an appointment with their GP, discuss medications with their Pharmacy or book a Maternity appointment.

An information leaflet is available in multiple languages. It explains how to use the service by calling or by using a mobile app and provides patient codes specific to NHSGGC services.

Contact NHSGGC Interpreting Service (8.00am – 6.00pm Monday to Friday, 8.00am – 4.00pm, Saturday to Sunday)
Email: interpretingservice@ggc.scot.nhs.uk  
Telephone: 0141 347 8811

Out of Hours Procedures

Call 0141 347 8811 to be connected to the appropriate service.

• NHSGGC Interpreting, Communication Support & Translation Policy
• How to Access Interpreting Support Wall Chart
• Language identification poster
• Language identification leaflet

Printed copies of the above are available from equality@ggc.scot.nhs.uk

As a statutory organisation, we are required to provide information in a format which all our service users can understand. This includes providing information in accessible formats such as audio, Braille, large print and community languages.

Every time a new piece of information is produced or an existing one reviewed, it should at the same time be produced in audio CD, words and pictures, Braille, large print, British Sign Language DVD and in our top five spoken languages (review annually).
 
We must also respond to any individual patient request for information in any accessible format or language of their choice. 
 
A statement has been produced that should be placed in all leaflets.  It states the following in English plus the ‘top six’ community languages (currently Polish, Mandarin, Romanian, Arabic, Urdu and Farsi).
 
‘If you require this information in an accessible format, such as large print or braille, or in a community language, please use the contact details on your patient information leaflet or letter.’

Ordering as an insert

This insert should be included with appointment letters and pre-attendance information posted to the patient, and can be given to patients on attendance at clinics or on admission. It is supported by posters displayed within hospitals and GP surgeries and is also offered on Solus Screens.
 
The leaflet is available from stock in packs of 100 and can be ordered via the PECOS system or by any method used to order goods from stock (e.g. paper indent). It is available in 2 formats to suit varying distribution methods – as a single sided A5 sheet or as a one-third A4 sheet (compliments slip format) suitable for DL type envelopes.
 
Order codes are as follows:

• 97106 – Size 1/3 A4 (compliments slip format)
• 97107 – Size A5

Printing the statement within a publication

If you would like to include the statement in your document (as opposed to using an insert), you can use image 1 (portrait) or image 2 (landscape) and adjust to size.

Other formats

This statement is also available in other formats, including words and pictures, audio and British Sign Language.

NHS Greater Glasgow and Clyde (NHSGGC) produces vast amounts of information, through many routes and in many forms. The task of making all our information accessible, i.e. producing it in various formats (such as large print, audio or braille) and languages, is a very significant challenge.

The purpose of our ‘Clear to All’ Accessible Information Policy is to make sure there is a consistent, accurate and clear approach to providing accessible information to patients and members of the public. 

Staff Resources

Step by Step Staff Guide to Producing Accessible Information 

Informing Patients of Right to Alternative Format/Language inserts – see Alternative Formats/Languages section above.

Language Identification Card (PDF)

Patient Information

These resources provide the following statement:
‘If you require this information in an accessible format, such as large print or braille, or in a community language, please use the contact details on your patient information leaflet or letter.’

Multi-language version (PDF)

Audio version (MP3)

Words and pictures version – English (PDF)

Words and pictures version – Arabic (PDF)

Words and pictures version – Simplified Chinese (PDF)

Words and pictures version – Polish (PDF)

Words and pictures version – Punjabi (PDF)

Words and pictures version – Urdu (PDF)