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Discrimination elimination


17 March 2014

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A revised toolkit from NHS England aims to aid commissioners deliver equality
Improving the health and wellbeing of everyone has been a key driver for the NHS, but evidence suggests that we still have a lot of work to do. We are also fully aware that patients and communities have circumstances and backgrounds that are distinct and that healthcare services need to be able to flex around individual needs. 

A revised toolkit from NHS England aims to aid commissioners deliver equality
Improving the health and wellbeing of everyone has been a key driver for the NHS, but evidence suggests that we still have a lot of work to do. We are also fully aware that patients and communities have circumstances and backgrounds that are distinct and that healthcare services need to be able to flex around individual needs. 
Only by recognising that every patient has different needs and circumstances can we best meet those needs and improve outcomes by delivering a personal form of care, using and supporting the diverse talents and experiences of our workforce. The Equality Delivery System (EDS) for the NHS is a toolkit to help all staff and NHS organisations understand how equality can drive improvements, strengthen the accountability of services to those using them, and bring about workplaces free from discrimination.
The EDS was made available to the NHS in 2011. Following an evaluation of its implementation across England in 2012 a refreshed EDS was launched by Sir David Nicholson, chief executive of NHS England, on 4 November 2013. It is known as EDS2. 
The main purpose of the EDS is to help local NHS organisations, in discussion with local patients, communities and NHS workforce, to review their equality performance for people with characteristics protected by the Equality Act 2010. At the heart of EDS2 are 18 outcomes, against which NHS organisations assess and grade themselves. These outcomes relate to issues that matter most to people who use, and work in, the NHS.
In addition to people with protected characteristics, EDS2 can be applied to people from other disadvantaged groups who have difficulty in accessing, or benefiting from, the NHS. These include people who are homeless, in a stigmatised occupation, long-term unemployed, living in poverty or living in isolated locations, and so on. 
Among other levers, the 18 outcomes of EDS2 support the themes of and deliver on, the NHS Outcomes Framework, the NHS Constitution, the Care Quality Commission’s key inspection questions set out in Raising standards, putting people first – Our strategy for 2013 to 2016. Indeed, by using the EDS, NHS organisations can also be helped to deliver on the public sector Equality Duty.
The EDS is a generic tool for all NHS organisations, including clinical commissioning groups (CCGs). In 2011, the EDS was built into the authorisation process for CCGs and as a result the overwhelming majority of CCGs are implementing the tool at local level. As different NHS organisations apply EDS2 outcomes to their performance, they should do so with regard to their specific roles and responsibilities. 
Moreover, NHS commissioners should also apply EDS2 in light of the performance of the providers they commission services from. NHS commissioners might also ask private providers who provide NHS services for all or some of their patients, working under contracts to them, to use EDS2 as appropriate.
Issues for commissioning support units (CSUs) may arise when CCGs use EDS2. For example, if the EDS reveals shortcomings in the commissioning and procurement process, a CCG might look at how it has worked with its CSU to put appropriate contracts in place, and monitor them.
EDS2 was built by the NHS for the NHS, commissioned and steered by the NHS Equality and Diversity Council (NHS EDC). EDS2 is aligned to NHS England’s commitment to an inclusive NHS that is fair and accessible to all. NHS England and the NHS EDC are committed to supporting and encouraging all NHS organisations to implement EDS2, to make the difference that our patients, the public and the workforce need and deserve.
Further information on the EDS can be found at on the NHS England website

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