Our Duties and Responsibilities
Since April 2013, The CCG has had responsibility for the commissioning of health services for all its local populations. The breadth of its responsibility is narrower than its PCT predecessors, with NHS England and the local authorities holding some commissioning responsibility.
As a public sector organisation, the CCG will be required to comply with specific equality duties that require it to evidence how it pays due regard to the needs of diverse and vulnerable groups in the exercising of its responsibilities. For the purposes of this strategy, this includes compliance with the Equality Act 2010, Human Rights Act 1998, and relevant sections of the Health and Social Care Act 2012.
Equality Act 2010
The Equality Act was introduced to harmonise the raft of existing equality legislations, making it easier for people and organisations to understand discrimination law. The Act provides protection to groups of people who may be discriminated against because of certain characteristics they share. It provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. The groups protected by the Act include:
- Age - People of different ages including children, young and older people
- Disability - People with a long-term condition, or with mental, physical, sensory, learning disability or impairments, or a combination of these
- Gender Reassignment - People who have changed, or are in the process of changing, their sex
- Marriage and Civil Partnership - People who are married or in a civil partnership
- Race - People characterised by shared ethnicity, language or culture
- Religion or Belief - People with or without a religion or belief
- Sex - Men and women
- Sexual orientation - a person's sexual orientation towards:persons of the same sex, persons of the opposite sex, or persons of either sex.
- Pregnancy and Maternity - Women who are having or have just had a baby.
The Equality Act sets out the responsibilities of public bodies, in the Public Sector Equality Duty. This duty requires public bodies to consider all individuals when carrying out their day-to-day work – in shaping policy, in commissioning and delivering services, and in relation to their own employees. It requires the CCG, when carrying out its duties, to have due regard to the need to:
- Eliminate unlawful discrimination, harassment and victimisation, and other conduct prohibited by the Act
- Advance equality of opportunity between people who share a protected characteristic and those who do not, ie:
- Remove or minimise disadvantages suffered by people due to their protected characteristics
- Meet the needs of people with protected characteristics; and
- Encourage people with protected characteristics to participate in public life or in other activities where their participation is low
- Foster good relations between people who share a protected characteristic and those who do not
- Tackle prejudice and promote understanding between people from different groups.
The Equality Duty supports good decision making. It encourages the CCG to understand how different people will be affected by its activities, so that its policies and services are appropriate and accessible to all, and meet different people’s needs. By understanding the effect of the CCG’s activities on different people, and how inclusive public services can support and open up people’s opportunities, the CCG can be more efficient and effective.
The Equality Act 2010 (Specific Duties) Regulations 2011
The Equality Act also sets out specific duties to help the CCG better perform the Equality Duty. It does this by requiring the CCG to be transparent about how it responds to the Equality Duty. The Government believes that the CCG should be accountable to its service users and be open to public scrutiny. The duties, therefore, provide the public with the information they need to challenge and hold the CCG to account for its performance on equality.
The specific duties require the CCG to:
- Publish sufficient information to show that it has considered the three aims of the general duty when making decisions, and the equality data that underpins those decisions
- Publish Information related to persons who share protected characteristics who are employees, or others affected, such as service users
- To publish the information in a manner that is accessible to the public.
To comply with the requirements of the Equality Act 2010, the CCG will work to continually:
- Monitor its workforce and analyse any unintended variations
- Assess the health needs of its local communities, and to
- Commission programmes and services to address health inequalities
- Carry out Equality Impact Analysis to inform its decision making
- Involve member practices, communities, staff, patients and the public in its decision-making processes
- Produce an equality strategy and annually measure the CCG’s performance against it
Publish information to comply with the requirements of the Act.
Human Rights Act 1998
The CCG has obligations under the Human Rights Act 1998 that, as a public body, it must at all times act in a manner compatible with the rights protected in this Act and safeguard these for patients and staff in its care and employment. Human rights are underpinned by a set of common values and have been adopted by the NHS under the acronym FREDA. The FREDA principles represent:
- Fairness, eg fair and transparent grievance and complaints procedures
- Respect, eg respect for same-sex couples, teenage parents, older people
- Equality, eg not being denied treatment due to age, sex, race etc
- Dignit, eg sufficient staff to change soiled sheets, help patients to eat/drink
- Autonomy, eg involving people in decisions about their treatment and care.
The Equality and Human Rights Commission states that putting human rights principles into public service practice is in the public interest. Evidence shows that public bodies taking human rights seriously treat people better. The CCG will endeavour to embed a human rights-based approach in the way that it commissions services and in its role as an employer. This approach is not new, and is evident in NHS policy initiatives such as Dignity in Care, Essence of Care, Standards of Better Health, and the Knowledge and Skills Framework.
Health and Social Care Act 2012
The CCG has a legal duty under the Health and Social Care Act 2012 to reduce inequalities between patients regarding their ability to access health services, and with respect to health outcomes, as well as to ensure that services are provided in an integrated (joined up) way. The Act also places duties on the CCG to promote the NHS Constitution, to enable choice, and to promote patient, carer and public involvement. To discharge this responsibility effectively, the CCG will need to work with its partners to reduce health inequalities among those in greatest need and embed this requirement into its joint health and wellbeing strategies. The CCG will also need to demonstrate how it will provide culturally sensitive services and ensure all patients can exercise choice and be involved in decision making.
The Act also requires the CCG to work with its local Healthwatch organisations, to provide information to the CQC and Health and Wellbeing Board about essential levels of safety and quality of its providers. The CCG engagement strategy sets out in greater detail how we will work with Healthwatch and its predecessor bodies to achieve this aim.