ICBs and NHS England play key roles in addressing equality and health inequalities; as commissioners, as employers and as local and national system leaders, in creating high quality care for all. ICBs and NHS England have two separate key duties, one on equality and one on health inequalities. Both require informed consideration by decision makers, but it is important to appreciate that they are two distinct duties.

Equality Act 2010 – Public Sector Equality Duty (PSED)

As an authorised public sector organisation, NHS Lincolnshire ICB is required by the Equality Act 2010 and Human Rights Act 1998 to work in ways that ensure equality and inclusion is embedded into all of its functions. It is the intention of the ICB to eliminate unfair and unlawful discriminatory practices in line with current equality and Human Rights legislation. There are a number of duties which the ICB must address:

1. In the exercise of its functions NHS Lincolnshire ICB must have due regard to the need to:
   1. Eliminate discrimination, harassment and victimisation and any other conduct that is prohibited by or under the Equality Act 2010;       
   2.  Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it;
   3. Foster good relations between persons who share a relevant protected characteristic and persons who do not share it.

1. The ICB must prepare and publish one or more equality objectives at intervals of not greater than 4 years and each objective must be specific and measurable.
2. The ICB must publish information, not later than 30 March each year, to demonstrate compliance with the PSED. The information published must relate to persons who share a relevant protected characteristic who are:

1. Its employees (only when employing 150 people or more)
2. Other persons affected by its policies and practices.

The characteristics which are protected under the Equality Act 2010 are:

• Age
• Disability
• Gender
• Gender reassignment
• Pregnancy and maternity
• Race
• Religion or belief
• Sexual orientation
• Marriage and civil partnership (but only in regard to the first aim – eliminating discrimination and harassment)

Lincolnshire ICB PSED Compliance Reports

2024

LICB PSED report of EDI outcomes April 23 – March 24 and action plan 24/25 (pdf)

2023

LICB PSED report of EDI outcomes April 22 – March 23 and action plan 23/24 (docx)

2022

Equality summary report of outcomes for April 2021 – March 2022

Health and Social Care Act 2012 – Health Inequalities Duty

The Health and Social Care Act 2012 introduced the first legal duties on addressing health inequalities, with specific duties on NHS England and ICBs. Under the Act, NHS Lincolnshire ICB has duties to:

• Have regard to the need to reduce inequalities between patients in access to health services and the outcomes achieved;
• Exercise its functions with a view to securing that health services are provided in an integrated way that would improve quality, reduce inequalities in access to those services or reduce inequalities in the outcomes achieved;
• Include in an annual commissioning plan an explanation of how they propose to discharge their duty to have regard to the need to reduce inequalities;
• Include in an annual report an assessment of how effectively they discharged their duty to have regard to the need to reduce inequalities

More information about meeting the equality and health inequalities legal duties can be found on the NHS England website.

Objective 1: LICB Leaders to drive the EDI agenda and create a sense of belonging through the delivery of measurable objectives on EDI for Chairs, Chief Executives and Board members, which align to the recently published EDI improvement plan high impact area 1

• Annual Chair/CEO appraisals on EDI objectives via Board Assurance Framework (BAF).

Objective 2: Strive to create a compassionate, diverse and inclusive culture by fostering an ethos across the ICS of wellbeing, inclusion and belonging.

• Driven by senior leaders to ensure there are regular and effective communication exercises to deliver key messages around the ethos.

Objective 3: Proactively address health inequalities in Lincolnshire using EDI and Health inequalities information as an integral part of the organisation and the Board decision making processes.

• Liaise with population health and health inequalities team to regularly collect and analyse data to monitor health access, experience and outcomes with the aim to reduce health inequalities amongst different protected characteristics and health inclusion groups.
• Undertake systemwide targeted health campaigns to improve access, experience and outcomes for patients and public from different protected characteristics and health inclusion groups including those from areas of high deprivation.

Objective 4: To comply with our EDI responsibilities and ensure that there are mechanisms in place to monitor the impact and cultural shift in the way we fulfil our ICB duties.

• Monitor outcomes of results from WRES action plans setting further specific and measurable targets to address disparities within certain WRES indicators.
• Implementation of Workforce disability standard (WDES), Gender pay gap and Ethnicity pay gap, action planning and monitoring outcomes through appropriate governance processes.
• Ongoing implementation of the 3 domains of EDS and monitoring of outcomes of action plans to sustain ‘achieving’ level and set processes in place towards reaching ‘excelling’ level in the next 3 years.

The Equality Delivery System (EDS) 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.  The EDS was developed by the NHS, for the NHS, taking inspiration from existing work and good practice.

Implementation of EDS 2022 is a requirement of both NHS commissioners and NHS provider organisations. EDS 2022 implementation by NHS provider organisations is mandatory in the NHS Standard Contract.

NHS organisations should and produce and publish an annual summary of their findings and implementation using the EDS 2022 reporting template.  Detailed information on how to implement EDS 2022 is contained in the EDS 2022 Technical Guidance.

Equality Delivery System and Annual Equality Reporting

2024

Final Equality Delivery System (EDS) report 2023/24

2023

Final Equality Delivery System (EDS) report 2022/23

Workforce Race Equality Standard

The NHS Workforce Race Equality Standard has been in place for a number of years and places obligations on both Commissioners and Providers of services. ICBs and Provider organisations are required to publish an annual update template showing outcomes for White and BAME staff and develop action plans to address any issues that emerge. NHS Lincolnshire Integrated Care Board is also required to monitor and assure itself that those organisations providing services on its behalf have implemented the standard. The ICB’s reporting template and action plans can be found below:

• Workforce Race Equality (WRES) Report 2023 24 including updated Action Plan 2023 26
  
  
• Workforce Race Equality Standard (WRES) Report 2022-2023 including the WRES Action Plan for 2023-26
  
  
• Workforce Race Equality Standard (WRES) Report 2021-2022 including the WRES Action Plan for 2022-23

The WRES technical guidance documents and all other WRES resources are available via the NHS England equality web page.

Workforce Disability Equality Standard reports

The Workforce Disability Equality Standard (WDES) is a set of ten specific measures (metrics) that will enable NHS organisations to compare the experiences of disabled and non-disabled staff. This information will then be used to develop a local action plan and enable NHS organisations to demonstrate progress against the indicators of disability equality. The WDES came into force across NHS Trusts and Foundation Trusts on 1 April 2019 and is restricted to those organisations for the first two years. In 2024, ICBs will also have to collect and submit data for WDES and produce actions plans address gaps. The implementation of the WDES will enable NHS organisations to better understand the experiences of their disabled staff. It will support positive change for existing employees and enable a more inclusive environment for disabled people working in the NHS. Like WRES on which the WDES is in part modelled, it will also allow NHS Lincolnshire ICB to identify good practice.

LICB WDES data reports and action plans will be published here from October 2024.

Workforce Disability Equality (WDES) Report 2023-24 including Actions to March 2025

The WDES Technical Guidance and other resources are available via the NHS England website.

Our equality and inclusion strategies, policies and information

Our Involvement Annual Report is now published which shows where we have engaged with various equality and health inequality groups to involve them in commissioning and shaping services: People and Communities Involvement report 2022-23 (icb.nhs.uk).

• LICB Equality, Inclusion and Human Rights Policy
  
  
• Modern Day Slavery Statement
  
  
• Dignity at Work Policy

Health and Diversity calendars:

Health and diversity calendar of national campaigns – NHS Employers

Faith and Diversity Calendar – The Inter Faith Network

The Diversity and Inclusion Calendar 2024 | Inclusive Employers

The ‘Accessible Information Standard’ – directs and defines a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents, where those needs relate to a disability, impairment or sensory loss.

The Standard applies to service providers across the NHS and adult social care system. Effective implementation will require such organisations to make changes to policy, procedure, human behaviour and, where applicable, electronic systems. Commissioners of NHS care and publicly funded adult social care must also have regard to this standard, in so much as they must ensure that contracts, frameworks and performance-management arrangements with provider bodies enable and promote the Standard’s requirements.

Successful implementation will lead to improved outcomes and experiences, and the provision of safer and more personalised care and services to those individuals who come within the Standard’s scope. Please find out more in the summary information sheet link below.

Accessible Information Standard (AIS) Summary Information Sheet