Equality, Diversity and Inclusion Annual Report

Our achievements

Since 2020 Kingston Hospital NHS Foundation Trust (KHFT) and Hounslow and Richmond Community Healthcare (HRCH) worked together more closely to improve the way in which healthcare services are delivered, working in a more integrated way that benefits local people.

This programme of work was named Better Together. This brought about key opportunities for both organisations to learn from one another, streamline services provided to both patients and staff, and increase our offering of support to our staff and patients with protected characteristics.

In 2023-2024, we made the following notable achievements:

•Implemented the AccessAble app and website enabling patients to plan the best way to access our facilities.

•Supported a culture of listening and learning within the organisation, with listening events taking place regularly on various topics.

•As at 31 March 2024, the vast majority of our staff in both trusts completed the Oliver McGowan eLearning mandatory training, ensuring our staff have a basic awareness of learning disability and autism and understand the skills they need in order to deliver equitable healthcare for these patients.

•Supported the work of our four staff networks (Ability Staff Network, BADEN Staff Network, MEND Staff Network and Pride Together) by providing a budget to support the achievement of their objectives. 

•Delivered various celebratory and educational EDI events across both Trusts.

•Launched our bi-monthly EDI Newsletter.

Who we are 

Kingston Hospital NHS Foundation Trust (KHFT) and Hounslow and Richmond Community Healthcare Trust (HRCH) were former NHS Trusts working together through the Better Together programme.

A disaggregation of Hounslow community services took place in July 2024 and a merger of HRCH and KHFT then took place in November 2024. The new Trust is Kingston and Richmond NHS Foundation Trust (KRFT).

This report provides an account of patient and workforce EDI activities and objectives for the former Trusts in line with reporting requirements.

Kingston Hospital NHS Foundation Trust (KHFT) was a district general hospital providing services to approximately 350,000 people in the surrounding area including Kingston, Richmond, Elmbridge (Surrey), Merton, Wandsworth and Sutton.

The hospital is located on a single site providing a full range of diagnostic and treatment services and has a national reputation for innovative developments in healthcare, particularly in ‘patient-focused’ care across our services including emergency, day surgery and maternity services.

In late 2018 the Care Quality Commission (CQC), rated their services as “Outstanding” for Overall Quality, Leadership and Care.

KHFT provided services to a diverse population where:

• A third of residents in most of our boroughs are from a Black, Asian and ethnically diverse background with the highest population of Korean residents within the Borough of Kingston.
• The religious make up of residents includes Christianity, Islam, Hinduism, Buddhism, Judaism and agnostic.
• A wide range of languages are spoken including, English, Korean, Spanish, Polish, French, German, Portuguese, Italian, Arabic and Dutch.
• There are approximately 27,000 people with Learning Disabilities living in South West London.

HRCH provided community health services for around 523,000 people registered with GPs in the London boroughs of Hounslow and Richmond but also serves a wider population across South West London for a range of more specialist services.

The Trust supported people to stay well in the community, manage their own health with the right support and avoid stays in hospital.

Around 1,300 people were employed at the Trust, who worked across a wide range of health centres, hospitals, GP surgeries, children’s centres, local council facilities and in community settings – including in people’s homes.

EDI governance

We established a Committee in Common as part of the Better Together programme which is empowered to make key strategic decisions with the benefit of expertise and insight from across the full range of service.

This meant our Chief Executive, Chair and other senior leaders work across KHFT and HRCH, allowing our organisations to share best practice and approach patient pathways more holistically.

Equality Diversity & Inclusion Committee in Common

We established our Equality, Diversity and Inclusion Committee, which provides strategic direction, leadership and support for promoting and maintaining equality, diversity and inclusion and human rights issues within the Trust and the wider community in which it serves.

This year, in line with the partnership working, we established an EDI Committee in Common, bringing our efforts in this important area together across our acute and community services.

The Committee in Common reported directly to the Trust Board providing assurance that the Trust is fulfilling its legislative and regulatory requirements relating to the equality, diversity and inclusion and human rights agenda. The Committee was chaired by an Associate Non-Executive Director for both Trusts. 

Mandatory Reporting

KHFT and HRCH were both compliant with their legal obligations and have reported on the Workforce Race Equality Standard (WRES), Workforce Disability Equality Standard (WDES), Workforce Race Equality Standard for Bank staff (Bank WRES), Workforce Race Equality Standard for Medical Staff (MWRES), Gender Pay Gap Reporting and Equality Delivery System (EDS).

Both KHFT and HRCH carried out its first EDS stakeholder event in April 2023 and had been rated as ‘Developing’. More recently the Trusts aligned their EDI objectives with the NHS Equality, Diversity and Inclusion High Impact Action Plan. 

Our reports can be found here: Equality, Diversity and Inclusion reports :: Kingston and Richmond NHS Foundation Trust

Equality Impact Assessments 

As part of the Public Sector Equality Duty within the Equality Act 2010, we continue to undertake Equality Impact Assessments (EIA) ensuring that policies, processes and services delivered do not result in a significant negative impact on staff and services.

EIAs help us to analyse our policies and practices to make sure they do not discriminate or disadvantage people and allows the Trust to establish excellent outcomes for its diverse communities. 

Engagement with Staff and Trade Unions

We are committed to fostering positive relations and working in partnership with its staff and Trade Unions.

The Trust Partnership Forum (TPF) is a committee comprising of both Trust and Trade Union representatives.

The TPF meets monthly to share and consider Trust updates and agree action on various matters. An EDI update report is presented each month.

Workforce Equality, Diversity & Inclusion

The workforce Equality, Diversity and Inclusion Team continued to support delivery across both organisations.

We have been able to provide support to departments in delivering short and bespoke training and information sessions on Equality, Diversity and Inclusion.

Staff Networks

In line with the Better Together agreement, we amalgamated our staff networks and relaunched across both Trusts. This strengthened our joint workforce, giving staff more opportunities to come together, socialise, share their experiences and raise important issues.

We also secured financial support to enable our staff networks to develop, operating more independently and providing targeted initiatives for our staff.

There are currently four active staff networks supporting our staff from Black, Asian and diverse, ethnic backgrounds, LGBTQ+ staff, our staff with visible and hidden disabilities and our Medical and Dental staff from Black, Asian and diverse ethnic backgrounds.  Our networks are as follows:

• Ability staff network
• BADEN staff network
• PRIDE together
• MEND staff network

Equality, Diversity and Inclusion Champions

This year we have completed a third round of recruitment for our Equality, Diversity and Inclusion Champions Role (EDI Champions) following its successful launch in 2021 and we now have over 45 EDI Champions.

Our EDI Champions work within their various departments/cluster/service areas to support delivery of our Equality Diversity and Inclusion Strategy and help to drive behavioural and cultural change across the organisation. 

The role of our EDI Champions is important because they work at service level helping to create a fair, accepting and inclusive culture which in turn will help to reduce the chances and any occurrence of discrimination allowing employees to feel welcome, cared for, safe and valued.

Freedom to Speak Up Guardian

Our Freedom to Speak Up Guardian and a Deputy Freedom to Speak Up Guardian continued to work across both KHFT and HRCH to ensure there is support for staff to speak up and raise concerns at both organisations.

The role of Freedom to Speak Up Champion was also launched offering additional support and helping to embed a culture of speaking up within the organisations.

The Freedom to Speak Up Guardians and Champions will continue to work with the EDI leads, staff networks and EDI Champions to ensure that staff have available routes where they feel safe and comfortable to speak up and raise concerns.

EDI Initiatives and Training

KHFT and HRCH recognised the importance of having open conversations and raising awareness about all protected characteristics. To foster this, a wide range of learning opportunities have been promoted.

We have developed and delivered inclusive leadership training and active bystander training; promoted core managers’ training on race and microaggressions and disability, and offered compassionate leadership training for all staff.

We have also invested in celebrating and promoting a number of EDI awareness days helping to foster an inclusive environment and more learning about each other amongst the workforce.

In the last year the following initiatives were launched and activities took place across both Trusts.

Launch of our EDI Newsletter

In the last year we developed an EDI Newsletter as an additional way to communicate with staff about the EDI agenda, initiatives and events. This was very much welcomed by staff and also provides a tool for our champions, leads and managers to share information at local team meetings.

The Cox Employment Tribunal Case – Listening and Learning Event

We ran a series of online listening and learning events to raise awareness of discrimination and microaggressions.  

Our staff participated in a discussion about the learnings from the case of Michelle Cox, a senior nurse employed by NHS England and Improvement (NHSE&I) Commissioning in North West England.

Celebratory and Educational Events

Working with our staff networks and other stakeholders we delivered a number of celebratory and educational events across both trusts which helped to foster inclusivity and celebration of diversity amongst the workforce. These included Diwali, Black History month and LGBTQ History month.

Volunteering at KHFT and HRCH

Volunteering at the Trust is all about enhancing the care that we provide and is a fundamental part of the Trust’s improvement culture, with over 400 volunteers. Every day, volunteering provides us with amazing stories of kindness and commitment that change patients’ lives for the better.

KHFT and HRCH had an active and engaged local community which is a notable asset against rising pressure and demand on NHS services. It is by working together: Better Together partners, volunteers, community partners and the voluntary sector that we can tackle larger population health issues and healthcare inequalities, reduce pressure on NHS services, and keep our local residents healthy.

Working together with Your Healthcare, and voluntary sector partners including local charities has necessitated a shift for volunteering beyond the hospital walls with programmes such as the Discharge Support Service and Falls Prevention: Community Exercise Programme taking place in patients’ homes and this potential is inherent across services. Volunteers are helping patients wherever they receive their care, whether that’s hospital, home, or community.

Our volunteers at KHFT and HRCH received a one-hour training session on neurodiversity and protected characteristics. The training allows our volunteers to understand the health inequalities that exist for those who have dementia, autism and learning difficulties.

The training enables our volunteers to understand the barriers as well as the legal imperatives and provides practical steps so they can make reasonable adjustments where possible to help people to receive accessible health and care services as early as possible.

Patient Equality, Diversity and Inclusion

The Trusts continued to work to address inequalities in patient care and develop an inclusive culture. We also aim for a diverse representation of patients on our Boards and governance bodies.

Veterans Bronze Award

We are committed to offering practical support for patients and the families of patients who are veterans or serving in the UK armed forces.

Our Chief Executive Jo Farrar signed the Armed Forces Covenant to ensure that no member of the Armed Forces community should face disadvantages in the provision of services, and that, in some circumstances, special treatment may be appropriate especially for the injured or bereaved. We now hold the Bronze Award and we are working towards becoming fully accredited as a Veteran Aware Accredited organisation. 

Reasonable Adjustments Digital Flag

We continued our work with NHSE on the national training module for reasonable adjustments and in 2024 this became available to all staff on the E-learning for Healthcare platform.

We acted as the lead for design of the reasonable adjustments flag for South West London acute Trusts. During the development phase, we continued to support all staff to meet the reasonable adjustment needs for patients with any disability or impairment.

The Learning Disability Liaison Service provides clinical support for patients with the most complex needs and delivers hands-on training for staff and volunteers.

Learning Disability and Autism Partnership Board

The Board monitors all programmes of work relating to learning disabled or autistic patients via a single action plan.

The Board reports on delivery of training, mortality reviews of people with a learning disability and autistic people (LeDeR), and overseas regular engagement with people with a learning disability and/or autism.

We ran two engagement events, both of which were well attended by people with a learning disability and/or autism and their families or carers. Adults with a learning disability attended two Accessible Information quality priority workshops.

A new Learning Disability and Autism Strategy 2024 to 2028 will be developed this year in conjunction with local adults with a learning disability and/or autism.

AccessAble

During 2023/24, the hospital implemented the AccessAble app and website. Patients can now plan the best way to access our facilities before they visit, for example, looking at the location of disabled toilets, quiet spaces, entrances, and the general layout of the site.

Oliver McGowan training

We continued to have a high compliance rate for Oliver McGowan mandatory training amongst our staff.

Oliver McGowan training is new mandatory national training ensuring all staff have a basic awareness of learning disability and autism and understand the skills they need in order to deliver equitable healthcare for these patients.

Module 2 (tiers 1 and 2), developed by South West London ICS, will start in late 2024.

Accessible Patient Information

The Trust has a dedicated team to develop high quality Patient Information accessible via our website leaflet library.

The team also manages our accessible Inpatient Handbooks. The online library supports screen readers, automatic translation, all online accessibility tools, and printing in a range of font sizes and colours.

The team are experts in meeting accessibility standards such as W3C, creating easy read leaflets, and writing for accuracy of translation. 

Patient Insights

The Trust aims to be responsive to patient insights that we gather from a wide range of sources. We use our feedback to identify potential issues or gaps in care for the less heard groups in our community and those most vulnerable to poor health outcomes. 

Regular feedback: We review National Patient Survey and FFT data to check that whether quality of care and treatment is equitable, for example looking at feedback scores by ethnicity, gender, and disability.

Regular audits: We recruited a wide range of participants for 15 Steps and PLACE (Patient-led Assessments of the Care Environment) audits, such as children with special educational needs or disabilities, adults with hidden disabilities, and people who care for others. The audits involve walking around the site to quality assure our hospital environment and facilities.

Ad hoc feedback: A number of surveys were carried out that relate to patient EDI or that explored the experiences of people with specific characteristics. For example, we interviewed patients who DNA (do not attend) appointments to find out why they seem more likely to be from certain ethnic backgrounds or genders.

Our MacMillan Cancer Support service visited a range of less heard community forums to promote attendance at cancer screening and explore some of the  barriers that lead to poorer health outcomes for these groups.

Pastoral and Spiritual Support 

Our Pastoral and Spiritual Support services continue to offer high quality pastoral and spiritual care to all patients, clients, carers, we also welcome referrals from colleagues and carers alike. 

Progress against our 2020-2023 Equality Objectives

We have made good progress against our objectives as set out in our 2020-2023 Equality, Diversity and Inclusion Strategy and action plan.

Many urgent Equality, Diversity and Inclusion issues emerged from Covid-19. At the time the disproportionate negative effect of the virus on people from Black, Asian and ethnically diverse backgrounds was a particular concern. We also learned more about the challenges of working remotely for people with disabilities.

The Trust has also required great flexibility in the workforce to transform the services provided to meet the recovery needs of those hospitalised as a result of Covid-19, and to provide a safe environment for those receiving care in all services. We have had to move at pace whilst ensuring efficient and continued delivery of high-quality care to our patients.

We have a lot to be proud of given the challenges we have been faced, ensuring alignment of our activities with changing national guidance. Key highlight from our progress against our strategic equality objectives are:

• We have supported our staff networks to grow with four joint staff networks relaunched across both KHFT & HRCH
• We have developed our culture of listening and learning with our staff and have held numerous listening events on topics and issues such as race, disability, and LGBT+.
• We have utilised the capacity in the Patient Experience team to further diversify patient involvement.
• Worked collaboratively with primary care partners to implement the Reasonable Adjustment Flag Early Adopter project.
• Oliver McGowan training is new mandatory national training ensuring all staff have a basic awareness of learning disability and autism and understand the skills they need in order to deliver equitable healthcare for these patients.

We have now moved into the next cycle of EDI objectives and this is described in more detail below. 

Our Focus for 2024/25 and beyond

We are developing new, updated Equality, Diversity and Inclusion objectives for the coming years. For our workforce equality objectives these will be largely shaped by the Six High Impact Actions (HIAs) set out in the NHS Equality, Diversity and Inclusion Improvement Plan which was published in June 2023 and which continues to be an NHSE priority. 

These objectives will also be linked to the vision and values of the newly merged organisation, KRFT and will be approved by the Board in 2024/25.