The Equality Delivery System (EDS) is an NHS England improvement framework for commissioners and providers to review and develop services, workforce and leadership.

The main purpose of the EDS is to help local NHS systems and organisations, in discussion with local partners and local populations, review and improve their performance for people with characteristics protected by the Equality Act 2010. By using the EDS 2022, NHS organisations can also be helped to deliver on the Public Sector Equality Duty.

The EDS comprises eleven outcomes spread across three domains:

• Domain 1: Commissioned or provided services
• Domain 2: Workforce health and well-being
• Domain 3: Inclusive leadership

NHS Humber and North Yorkshire ICB took undertook its first formal review and rating exercise in 2023/24. To support the process an internal steering group was established made up of representatives from relevant directorates and each domain had an assigned executive lead and several teams contributing to the evidence base. There are four possible ratings:

• Excellent activity
• Achieving activity
• Developing activity
• Undeveloped activity

These are applied to each outcome and then reviewed for the domain overall.

Evidence was recorded within reporting templates, you can read a summary of our performance below. Our overall score was 13, which indicates that we are ‘developing’.

Domain 1: Commissioned or provided services

Our score for commissioned services was 5, which indicates that we are ‘developing’ under this domain. The services reviewed under this domain were:

• Tobacco Dependency Services
• Access to Primary Care
• Maternity Services

The outcomes measured were:

• Patients have required levels of access to the service
• Individual patient’s health needs are met
• When patients use the service, they are free from harm
• Patients (service users) report positive experiences of the service

Evidence overview

Whilst there are impressive statistics for the number of patients offered and who take up stop smoking services within hospitals, access to appropriate data around the protected characteristics of smokers who access hospital services will help to ensure there are no barriers to having appropriate information and to accessing the relevant stop smoking services.

Good practice was identified in primary care in respect of developing and testing integrated neighbourhood teams and some specific pilot projects appear to be yielding good results. However, greater collaboration is needed within primary care to support practices and PCNs in understanding the needs of their patient groups, particularly with respect to communication needs including translation services. Access is clearly an issue that has been identified within previous engagement (NHS@75 and Pride in our Health), and follow-up work is needed to understand how access barriers may relate to any protected characteristics.

Maternity services demonstrated some real patient-centred thinking with a LMNS Equity and Equality Action plan detailing some specific programmes of work to support vulnerable groups through pregnancy, delivery and post-birth. A number of dedicated posts have helped to further this programme of work. The Ask a Midwife project is a particular example of good practice. The implementation of new IT systems provides the opportunity to use data more effectively to identify need and gaps in provision.

It is also evident that reviewing services in isolation is not helpful and whilst this review focussed on three specific services, a wider programme of work taking a more holistic view through the lens of equality, diversity and inclusion should be welcomed.

Domain 2: Workforce health and wellbeing

Our score for workforce health and well-being was 5, which indicates that we are ‘developing’ under this domain. The outcomes measured under this domain of the EDS were:

• When at work, staff are provided with support to manage obesity, diabetes, asthma, COPD and mental health conditions.
• When at work, staff are free from abuse, harassment, bullying and physical violence from any source.
• Staff have access to independent support and advice when suffering from stress, abuse, bullying harassment and physical violence from any source.
• Staff recommend the organisation as a place to work and receive treatment.

Evidence overview

The number of schemes and support mechanisms for staff is commendable and the development of the Inclusion Network and Inclusion Assembly are both very important steps in bringing together colleagues with protected characteristics to influence meaningful change. 

A greater focus on physical health and the promotion of more preventable illnesses has been identified as an area for action and the development of a health and wellbeing framework will be a positive step.

Domain 3: Inclusive leadership

Our score for inclusive leadership was 3, which indicates that we are ‘developing’ under this domain. The outcomes measured under this domain of the EDS were:

• System leaders (Band 9 and Very Senior Managers) and those with line management responsibilities routinely demonstrate their understanding of, and commitment to, equality and health inequalities.
• Board/committee papers (including minutes) identify equality and health inequalities related impacts and risks and how they will be mitigated and managed.
• Board members and system leaders (Band 9 and Very Senior Managers) ensure levers are in place to manage performance and monitor progress with staff and patients.

Evidence overview

The Board receives regular reports on the progress made in respect of staff networks and initiatives to support the wider health and wellbeing of the ICB and wider ICP workforce and a number of internal and external communications mechanisms are utilised to share specific EDI initiatives and good practice.

The absence of specific staff feedback will be addressed with the implementation of a staff survey in 2024, with information received used to develop an EDI Improvement Plan. Leadership skills and competence development, underpinned by a behavioural framework will also be part of the organisational development plan.

External and Peer Review Process

An external process has been undertaken with the following groups reviewing specific domains:

• Local Healthwatch organisations – domain 1
• The Humber and North Yorkshire Inclusion Assembly – overall approach to the assessment
• The Inclusion Network – all domains
• The Social Partnership Forum (Trade Unions) – domain 3
• Staff Health and Wellbeing Group – domain 2 

The completed review templates from Healthwatch, the Inclusion Assembly, the Inclusion Network and the Social Partnership Forum are available to read.

Comments made by the Staff Health and Wellbeing Group have been included in the final template. A peer review was also undertaken by West Yorkshire ICB in respect of domain 3 and their comments were considered as part of the action planning.

Download and read a summary of the review outcomes for each of the EDS2022 domains for NHS Humber and North Yorkshire ICB.

Download and read our full EDS Report and action plan.

These sections will be added to before the end of March as objectives are agreed and WRES and WDES reports are finalised.

The ICB has agreed the following equality objectives for 2024/25:

Objective 1: Enhance Data Quality and Utilisation for Improved Health Outcomes

Action steps:

• Develop systems to gather comprehensive data on the needs and challenges faced by both the population served and the staff we employ.
• Utilise data analytics effectively to identify trends, gaps, and opportunities for targeted interventions to improve health outcomes.

Objective 2: Foster Collaborative Information Sharing with System Partners

Action steps:

• Build on developing mechanisms (Insight Bank) for sharing information and insights with system partners to gain a deeper understanding of the experiences and barriers to access faced by specific protected characteristics.

Objective 3: Promote Learning and Implementation of Best Practice

Action steps:

• Identify successful programmes and initiatives with demonstrable positive outcomes in addressing health disparities and promoting EDI.
• Share findings and lessons learned from these programs with relevant stakeholders, both within the organisation and across partner agencies.

Objective 4: Enhance Engagement with Underrepresented Voices

Action steps:

• Review and revise engagement strategies to ensure they are inclusive, and representative of the diverse communities served.
• Provide accessible platforms and channels for feedback and participation to ensure the voices of all community members are heard and valued.

Objective 5: Promote Workforce Understanding and Support

Action steps:

• Enhance policies and practices to promote diversity, equity, and inclusion in recruitment, retention, and career development opportunities.

Objective 6: Implement EDI Training and Skill Development

Action steps:

• Evaluate the effectiveness of training initiatives through feedback mechanisms and performance assessments and make adjustments as needed to ensure continuous improvement.

The Workforce Race Equality Scheme (WRES) requires NHS organisations to demonstrate progress against nine indicators of workforce equality.

The main purpose of the WRES is:

• To help local, and national, NHS organisations (and other organisations providing NHS services) to review their data against the nine WRES indicators;
• To produce an action plan to close the gaps in workplace experience between white and ethnic minority staff, and;
• To improve ethnic minority representation at the Board level of the organisation.

The WRES will ensure that all healthcare staff are treated fairly and with respect, which will have a positive impact on patient care. Humber and North Yorkshire ICB WRES report will be published by 31 March 2024

The Workforce Disability Equality Standard (WDES) is a set of ten specific measures that supports NHS organisations to compare the experiences of Disabled and non-disabled staff.

The Workforce Disability Equality Standard (WDES) was introduced in April 2019 as a mandated data collection for NHS provider trusts. NHS organisations use the metrics data to develop and publish an action plan. Year-on-year comparison enables NHS organisations to demonstrate progress against the indicators of disability equality to create a culture of belonging and trust that will improve retention, recruit from the widest possible talent pool and provide sustainable careers.

It is not a mandated requirement for ICBs, but NHS Humber and North Yorkshire ICB has chosen to complete and the report will be published by 31 March 2024.

Since 31 March 2017, it has become mandatory for all public sector employers with more than 250 employees to measure and publish their gender pay gap information. Since then, employers have had a responsibility to publish data annually.

Equal pay means that men and women in the same employment who are performing equal work must receive equal pay, as set out in the Equality Act 2010.

The gender pay gap is a measure that shows the difference in average earnings between men and women across an organisation or the labour market.

Public bodies with 250 or more staff are required to publish gender pay gap information each year. This duty to publish will apply to ICBs from 31 March 2024.

We are committed to ensuring and encouraging genuine belonging for people working across health and social care in Humber and North Yorkshire. Read more about how we are working collaboratively within the Partnership pages of our website.

Humber and North Yorkshire Health and Care Partnership – Accessibility Statement