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The Health and Social Care Act 2012 requires CCGs to;

• reduce inequalities between patients with respect to their ability to access health services, and

• reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

The CCG wants to ensure all parts of our local communities have fair access to NHS information, services and premises when they need to use services.

We know that not all people access or take up services in the same way and we want to try to take reasonable steps to accommodate these different needs, particularly for vulnerable protected groups.

The CCG is working hard to ensure not only that its services are appropriate and accessible for all members of our community, but that no one is disadvantaged or discriminated against by the services we put in place.

Each year, the CCG in partnership with the wider health system in north Cumbria publishes a Report to show what we are doing to routinely collect equality data and use this information to ensure that its services and employment opportunities are fair and accessible to all.

Under the Equality Act 2010 and the Public Sector General Equality Duty, public sector organisations such as CCGs must publish sufficient information to demonstrate that, in the exercise of its functions, it has ‘due regard’ (gives early consideration) to:

• eliminate discrimination, harassment and victimisation;

• advance equality of opportunity between people who share a protected characteristic and those who do not; and to

• foster good relations between people who share a relevant protected characteristic and those who do not.

The Act identifies 9 protected characteristics. Information on each can be found below:

Diagram illustrating the protected characteristics
Age - Where age is referred to, it refers to a person belong to a particular age (eg. 32 year olds) or a range of ages (eg. 18-30 year olds).

Disability - A person has a disability if s/he has a physical or mental impairment which has a substantial and long-tern adverse effect on that person's ability to carry out normal day-to-day activities.

Gender reassignment - The process of transitioning from one gender to another

Marriage and civil partnership - Marriage is defined as a 'union between a man and a woman'. Same-sex couples can have their relationships legally recognised as 'civil partnerships'. Civil partners must be treated the same as married couples on a wide range of legal matters.

Pregnancy and maternity - Pregnancy is the condition of being pregnant or expecting a baby. Maternity refers to the period after the birth, and is linked to maternity leave in the employment context. In the non-work context, protection against maternity discrimination is for 26 weeks after giving birth, and this includes treating a woman unfavourably because she is breastfeeding.

Race - Refers to the protected characteristic of race. It refers to a group of people defined by their race, colour, and nationality (including citizenship) ethnic or national origins.

Religion and belief - Religion has the meaning usually given to it but belief includes religious and philosophical beliefs including lack of belief (eg. Atheism). Generally, a belief should affect your life choices or the way you live for it to be included in the definition.

Sex - A man or a woman.

Sexual orientation - Whether a person's sexual attraction is towards their own sex, the opposite sex or to both sexes.

Equality Impact Assessments

Public bodies have a statutory duty under the Public Sector Equality Duty to analyse the effect of its policies, services and functions on the workforce and service users and to publish the results of the analysis and evidence information used.

Equality Impact Assessment in actionThe purpose of an equality impact assessment is the ensure that our services, policies and practices do not directly, indirectly, intentionally or unintentionally discriminate against the users of our services or our staff. Where a negative impact is found, we will mitigate the impact through the development and implementation of equality improvement plans.

Undertaking an Equality Impact Assessment (EIA) enables us to consider the impact of each current and proposed service, policy, procedure or function, not only with regard to ethnicity, disability, age and gender, but also in relation to religion and belief, sexual orientation, and human rights. It is designed to ensure that ‘due regard’ is given to equality in relation to our service users and the manner in which we recruit, train and develop our staff. Some recent examples are featured below:

Cumberland Infirmary Equality Impact Assessment in actionAs part of developing plans for the new cancer centre at the Cumberland Infirmary we held a session particularly focusing on those with physical and sensory impairments and those who may require extra support to access services.

A small group of people with mobility and sensory challenges as well as representatives of groups supporting service users with additional needs met on 15 November 2018.

The afternoon included a presentation from the architects and some conversations about issues ranging from floor coverings, signage and accessibility. The conversations were rich with information, ideas and suggestions and have influenced how some of the plans will be taken forward.

Cumberland Infirmary Equality Impact Assessment in action

See below links to the Equality Impact Analysis which was completed as part of the Healthcare for the Future consultation work.

-  West, North and East Cumbria Equality Impact Analysis Report (July 2016)

-  West, North and East Cumbria Equality Impact Analysis Report Addendum (Nov 2016)

An Equality Impact Analysis Workshop  was also held on 6 December 2016.

The workshop was organised in partnership with the Action for Health Network with the aim of gathering feedback directly from those with a protected characteristic or those who specifically support those with a protected characteristic, across all of the proposed changes in the Healthcare for the Future Consultation,

There were 28 people who attended the workshop, all of the protected characteristics were represented (other than the LGBT community).

To strengthen the input into the EIA process and to ensure that every effort has been made to cover as many of the protected characteristics and 'hard to reach' groups as possible a further 3 deliberative events were held - One for representatives of the Neurological Alliance and one for the representatives from the deaf community (both in west Cumbria ) and one for the LGBT community (held in Carlisle). Select following link below for full information including feedback from all of these events.

Feedback from the Equality Impact Analysis Workshop 

The consultation document was also made available in other formats (audio or braille) or in other languages, on request during the consultation period.

-  The Easy Read version of consultation document
-  A large text version of the consultation document

A signer (someone who communicates information to deaf people using sign language) was present at all of the public consultation meeting and sound loops were also implemented.

a consultation for all - poster highlighting the importance of cross organisational working when developing Equality Impact Assessments

North Cumbria CCG Organisational Objectives

1.    Support quality improvement within existing services including General Practice

2.    Commission a range of health services appropriate to our populations needs

3.    Develop our system leadership role and our effectiveness as a partner

4.    Improve our organisation and support our staff to excel

1.    Achieve improvements in overall health by clinical effectiveness, patient safety and patient experience for all through quality monitoring of commissioned services.  Acting on information received from engagement activities and patient feedback.

With a view to promoting equality of access to services commissioned by NHS North Cumbria CCG.

2.    Ensure that all staff are aware that equality is everyone’s business and everyone is expected to contribute to the CCGs equality objectives.

With a view to ensuring that staff at all levels of the organisation understands local equality and diversity issues.  Provide mandatory training and access to other training relating to equality issues and legislation.

3.    Provide a working environment that values and respects the individual and challenges discrimination, harassment, bullying and victimisation.

With a view to monitoring staff recruitment and retention and grievances and disciplinary reporting. Providing access to leadership and development programmes for all staff.


All staff within the CCG have a responsibility to ensure compliance with Equality Legislation and to ensure they follow the CCG core values and vision. 

Governance for NHS Cumbria CCG 

The Senior Management Team is accountable for equality, diversity and inclusion related issues and will monitor progress against the strategy and action plan, reporting as appropriate.

The Governing Body ensures that NHS Cumbria Clinical Commissioning Group has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with clearly established principles of good governance.

Equality Delivery System (EDS)

A refreshed Equality Delivery System for the NHS – EDS2

The Equality Delivery System (EDS) was commissioned by the national Equality and Diversity Council in 2010 and launched in July 2011.  It is a system that helps NHS organisations improve the services they provide for their local communities and provide better working environments, free of discrimination, for those who work in the NHS, while meeting the requirements of the Equality Act 2010.

In November 2012, Shared Intelligence published their report ‘Evaluation of the equality delivery system for the NHS’ which looked at how the EDS has been adopted across NHS organisations. Based on this evaluation and subsequent engagement with the NHS and key stakeholders, a refreshed EDS – known as EDS2 – was made available in November 2013.

The main purpose of the EDS2 was, and remains, to help local NHS organisations, in discussion with local partners including local populations, review and improve their performance for people with characteristics protected by the Equality Act 2010. By using the EDS2, NHS organisations can also be helped to deliver on the Public Sector Equality Duty. EDS2 is more streamlined and simpler to use compared with the original EDS and is aligned to NHS England’s commitment to an inclusive NHS that is fair and accessible to all.

• Better health outcomes: The NHS should achieve improvements in patient health, public health and patient safety for all, based on comprehensive evidence of needs and results.

• Improved Patient access and experience: The NHS should improve accessibility and information, and deliver the right services that are targeted, useful, useable and used in order to improve.

• Representative and supported workforce: The NHS should increase the diversity and quality of the working lives of the paid and non-paid workforce, supporting all staff to better respond to patients’ and communities’ needs.

• Inclusive leadership at all levels: NHS organisations should ensure that equality is everyone’s business, and everyone is expected to take an active part, supported by the work of specialist equality leaders and champions.

Performance should be assessed and graded by NHS organisations in discussion with local people and the workforce. ​​​​​​

EDS assessment-grades.png

Equality and Diversity word cloud