This section includes links to equality related research and information.

Much of the information in this section will be based on some form of equality data monitoring. This is information about a person’s age, gender, ethnicity, disability, sexual orientation or faith. When using NHS services, you will most likely be asked to provide this information about yourself, and many people wonder why or what it is used for. This guide developed by Stonewall helps to explain the reasons for being asked to ‘tick those boxes’. At Hull CCG we use this data to help inform our equality impact assessments, to make sure we are commissioning services to meet the needs of the whole population.

Population demographic and health needs information resources:

Hull Joint Strategic Needs Assessment (JSNA) demographic population profile information

Hull’s Adult Health and Lifestyle Survey 2014

Public Health England Health Profile, Kingston upon Hull, 2014

The links below have information about the profile, health needs and useful resources for different population groups.

Age

Refers to all age groups, including children and young people, older people, working age people.

The chart below shows the age profile of the population of Hull compared to England (based on 2011 Census data).

Hull’s population is relatively young compared to England: the number of people in their 20s is higher than England due to Hull being a University city. There are also fewer people aged 50+ in Hull compared to England.

Resources:

Children and Young People’s mental health and wellbeing – information about what support is available in Hull.

Youth Health Movement website – a national hub for young people and youth organisations which aims to provide young people with the skills, knowledge and confidence to act as peer mentors, increasing awareness of healthy lifestyles and encouraging involvement in activities to promote good health. It also provides the opportunity for young people and youth leaders to network and share ideas.

Rise above - This website, for young people aged 11-16, focuses on key topics such as peer pressure, body confidence, relationships, drugs, smoking and alcohol.  The aim is to encourage young people to make positive choices for their health and help with the pressures of growing up.  Created by young people for young people, helping them to Rise above.

Suicide prevention toolkits for health professionals working with young people

New toolkits produced in collaboration between the Royal College of Nursing (RCN) and Public Health England (PHE) primarily for nurses who work with children and young people, whether in community or hospital settings, including:

• School nurses
• Practice nurses
• Accident and emergency nurses

These toolkits aim to develop skills and knowledge and recognise the wider context of mental health in relation to sexual orientation and gender identity. They provide a general outline for health professionals looking to increase their skills and knowledge around suicide prevention strategies with lesbian, gay, bisexual and transgender young people.

Living independently with long-term conditions

The Ipsos Mori Ethnography Centre of Excellence has published an evaluation exploring the lives of older people living with multiple long-term conditions.

Navigating health and care: living independently with long term conditions sets out the views of 36 patients, family members and carers in order to gain an insight into their experiences of living with and managing their long term conditions and the care they receive.

The evaluation finds older people living with multiple long term conditions are generally happy with the NHS but often find the health and care system is not set up for their needs.

Commissioning home care for older people

The Social Care Institute for Excellence has published SCIE guide 54: Commissioning home care for older people. This guide captures the latest research findings on this important and emerging area of social care. It also provides some practice examples of good work in this area. The guide is aimed at health and social care commissioners of home care services for older people with complex needs. Providers of these care services may also find it useful.

Age profile of NHS staff infographic.

Disability

The legal definition of disability is a physical or mental impairment that has a significant and long-term (more than 12 months) impact on a person’s ability to carry out day-to-day tasks. This includes people who are learning disabled, physically disabled, people with mental illness, sensory loss and long-term chronic conditions such as diabetes, HIV, cancer.

The social model of disability defines the environment as being disabling, rather than a person’s impairment or difference. The focus is on removing barriers that prevent disabled people from participating fully and accessing services. More information about the social model for disability

Census 2011: 19.6% of the Hull population stated that their day-to-day activities were limited by disability (10% 'limited a lot'; 9.6% 'limited a little').

The Hull local Health & Lifestyle Survey 2014 reported that 27.7% of respondents identified that they have an illness or disability, which limits daily activities.

Adult disability type by number of people in Hull by age group (Source: Projecting Older People Population Information System and Projecting Adult Needs and Service Information – 2012 estimates)

Learning Disability: Inequalities and Reasonable Adjustments

People with a learning disability experience inequalities in physical and mental health.

On average, the life expectancy of women with a learning disability is 18 years less than for women in the general population; and the life expectancy of men with a learning disability is 14 years less than for men in the general population (NHS Digital 2017).​

(Source: Mencap: https://www.mencap.org.uk/learning-disability-explained/research-and-statistics/health/health-inequalities )

The Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD)​ highlights stark inequalities. (http://www.bristol.ac.uk/media-library/sites/cipold/migrated/documents/fullfinalreport.pdf_).

Public Health England has produced a range of guides to making reasonable adjustments to healthcare services, and how to support people with a learning disability to access healthcare services: https://www.gov.uk/government/collections/reasonable-adjustments-for-people-with-a-learning-disability

Disability in the United Kingdom, Papworth Trust Report, 2014: This report gives an overview of the key facts and figures about disability in the UK.  It covers areas such as employment, health, housing, transport and education.

Learning Disability: Communications Tools

If you have a learning disability, there are a number of tools which you can download for free below to improve your experience of going to your GP or using another health service. You may also find some helpful information on the CHCP Wellbeing Service webpage

Blood test communication board

Things I may see of hear in A&E

Where might the nurse want to look communication board

What happens at the doctors

Annual Health Check GP practice communication board

Race or ethnicity

This category includes people from all ethnic backgrounds, or nationalities. When referring to race equality, people often refer to BME groups or people (Black or Minority Ethnic).

Estimates from the 2011 Census are that black or minority ethnic residents now make up 10.3% of the population, compared to the 2001 Census figure of 3.8%. Many BME people in Hull are students or European migrants with only 2.8% of BME people over 65.

The Black and Minority Ethnic Group communities in Hull: Health and Lifestyle Summary, published in 2013 found that:

• While the number of Hull BME residents has tripled in the last 10 years, Hull still has lower proportions of nearly all BME groups, when compared to the UK average
• The greatest increase in BME numbers was due to increased numbers of white Europeans, mostly from Poland and other East European countries
• Achieving a healthy diet seems to be the area where the BME groups on the whole do worse than the overall adult Hull population
• Gypsy & Traveller group tend to have poor physical health, but enjoy good mental health and high social capital

Commissioning Mental Health Services for black and ethnic minority communities

The Joint Commissioning Panel for Mental Health has published Guidance for Commissioners of Mental Health Services for people from black and minority ethnic communities. This guide describes what ‘good’ mental health services for people from Black and Minority Ethnic communities look like. This guide focuses on services for working age adults. However, it could also be interpreted for commissioning specialist mental health services, such as CAMHS, secure psychiatric care, and services for older adults.

Finding health information in different languages

• Northumberland, Tyne and Wear NHS Foundation Trust have a comprehensive online database of health information in different languages.
• NHS website on how to access information and resources in other languages.
• Hull CCG accessible information & interpreter service

Gender / sex

The 2016 estimates for Hull identify that the male population is 148,103 and the female population is 144,934.

Life expectancy at birth: For 2012-14 life expectancy at birth for Hull men was 76.6 years, and for Hull women it was 80.5 years. For England, life expectancy at birth was 79.5, and 83.2 years for men and women. There is significant difference between life expectancy across Hull. Click here for further information in the JSNA Life Expectancy Toolkit.

More information about specific health differences / issues affecting males and females in Hull can be found on in “Hull’s Adult Health and Lifestyle Survey 2014, Public Health Sciences, Hull City Council.” (Page 51):

www.hullpublichealth.org/assets/PrevalenceSurveyMainReport2014v2.pdf

Gender reassignment

This includes people who have undergone or are currently undergoing gender reassignment, this includes trans men (female to male), trans women (male to female).

There are no official statistics nationally or regionally regarding transgender populations, however, GIRES (Gender Identity Research and Education Society - www.gires.org.uk) estimated that, in 2007, the prevalence of people who had sought medical care for gender variance was 20 per 100,000, i.e. 10,000 people, of whom 6,000 had undergone transition. 80% were assigned as boys at birth (now trans women) and 20% as girls (now trans men). However, there is good reason, based on more recent data from the individual gender identity clinics, to anticipate that the gender balance may eventually become more equal.

Resources

More information about Hull CCG’s Gender Identity Policy Guidelines.

General Medical Council (GMC) guidance

The first report of the House of Commons Women and Equalities Committee highlighted significant concerns about doctors’ lack of awareness and consideration in treating transgender patients.

The General Medical Council (GMC) helps to protect patients and improve medical education and practice in the UK by setting standards for students and doctors. In response to concerns raised in the report, the GMC have published guidance for doctors, advising how the Principles of Good Practice should be applied when treating transgender patients.

Top Tips for Working with Trans People [2013] - this guide by TransBareAll, is designed to give staff a basic understanding of trans people and their needs, as well as tips on how you can best support them in your role and in the workplace. It will also point you to sources of further reading and information.

Sexual orientation

(Refers to a person's sexual identity in relation to the gender to which they are attracted. This includes lesbian, gay and bi-sexual and heterosexual people).

There are no statistics for relating to the sexual orientation of people who live within Hull.  However, the Government estimates that 5% of the national population is lesbian, gay or bisexual.

Resources

Suicide Prevention toolkits for health professionals working with young people - New  toolkits produced in collaboration between the Royal College of Nursing (RCN) and Public Health England (PHE) primarily for nurses who work with children and young people, whether in community or hospital settings, including:
·         school nurses
·         practice nurses
·         accident and emergency nurses

These toolkits aim to: develop skills and knowledge and recognise the wider context of mental health in relation to LGBT sexual orientation and identity. They provide a general outline for health professionals looking to increase their skills and knowledge around suicide prevention strategies with LGBT young people.

Prescription for Change is a report published in 2008 by Stonewall highlighting the findings of health research of lesbian and bisexual women. This is based on a survey of over 6,000 lesbian and bi-sexual women.

Gay and Bi-sexual Men’s Health Survey highlights the findings of a survey of nearly 7,000 gay and bisexual men about their health and their experiences of health services.

Gay in Britain - this report from Stonewall provides some highlights based on the outcomes of poor experiences from the LGBT community when accessing health care.

Sexual Orientation: A guide for NHS Staff was developed by Stonewall as a result the research above about the poor experiences and health inequalities of many lesbian, gay and bi-sexual people.

Religion or belief

The Equality Act defines religion as any religion, or lack of a religion, and belief as any religious or philosophical belief, or lack of such a belief.

According to the 2011 Census, 54.9% of the population of Hull has identified themselves as Christian and 3.1% of the population is made up of other religions. This is made up of the following religions:

Buddhist: 0.30%, Hindu: 0.20%, Jewish: 0.10%, Muslim:  2.10%, Sikh: 0.10%,

Other Religion: 0.30%

34.8% of people stated ‘No religion’

(Not stated: 7.2%)

Resources

A Practical Guide for Religion and Belief in the NHS provides practical advice, illustrated by case studies, for NHS staff. The guide addresses employment and service provision considerations .

Ramadan

Fasting in the month of Ramadan is obligatory on all adult Muslims. Ramadan is from 27 May to 25 June in 2017.  Many patients and staff will be fasting or wanting to fast in Ramadan. It helps if NHS frontline staff are aware of and respect this important religious obligation and how such beliefs may affect the different elements of care.

Click here for information on healthy fasting.

Latest travel health advice for Hajj and Umrah pilgrims published – published July 2016 by Public Health England.

Pregnancy and maternity

The Equality Act includes protection against discrimination if you are pregnant, have recently given birth (within 26 weeks of birth) or are breastfeeding.

Resources

Severe pregnancy sickness

The Pregnancy Support Sickness (PSS) and the British Pregnancy Advisory Service (BPAS) charities have jointly published I could not survive another day, which highlights the impact on women of severe pregnancy sickness. Together the PSS and BPAS have surveyed women who have experienced termination of pregnancy while suffering severe pregnancy sickness over the past 10 years. This report aims to reflect their experiences and examines what more can be done to improve care for women in this situation and better support their choices.

Maternity Action, a charity promoting equality for pregnant women, partners and young children, provide information about pregnancy and maternity rights, including rights to breastfeed in public places.

This section includes links to equality related research and information.

Much of the information in this section will be based on some form of equality data monitoring. This is information about a person’s age, gender, ethnicity, disability, sexual orientation or faith. When using NHS services, you will most likely be asked to provide this information about yourself, and many people wonder why or what it is used for. This guide developed by Stonewall helps to explain the reasons for being asked to ‘tick those boxes’. At Hull CCG we use this data to help inform our equality impact assessments, to make sure we are commissioning services to meet the needs of the whole population.

Population demographic and health needs information resources:

Hull Joint Strategic Needs Assessment (JSNA) demographic population profile information

Hull’s Adult Health and Lifestyle Survey 2014

Public Health England Health Profile, Kingston upon Hull, 2014

The links below have information about the profile, health needs and useful resources for different population groups.

Age

Refers to all age groups, including children and young people, older people, working age people.

The chart below shows the age profile of the population of Hull compared to England (based on 2011 Census data).

Hull’s population is relatively young compared to England: the number of people in their 20s is higher than England due to Hull being a University city. There are also fewer people aged 50+ in Hull compared to England.

Resources:

Children and Young People’s mental health and wellbeing – information about what support is available in Hull.

Youth Health Movement website – a national hub for young people and youth organisations which aims to provide young people with the skills, knowledge and confidence to act as peer mentors, increasing awareness of healthy lifestyles and encouraging involvement in activities to promote good health. It also provides the opportunity for young people and youth leaders to network and share ideas.

Rise above - This website, for young people aged 11-16, focuses on key topics such as peer pressure, body confidence, relationships, drugs, smoking and alcohol.  The aim is to encourage young people to make positive choices for their health and help with the pressures of growing up.  Created by young people for young people, helping them to Rise above.

Suicide prevention toolkits for health professionals working with young people

New toolkits produced in collaboration between the Royal College of Nursing (RCN) and Public Health England (PHE) primarily for nurses who work with children and young people, whether in community or hospital settings, including:

• School nurses
• Practice nurses
• Accident and emergency nurses

These toolkits aim to develop skills and knowledge and recognise the wider context of mental health in relation to sexual orientation and gender identity. They provide a general outline for health professionals looking to increase their skills and knowledge around suicide prevention strategies with lesbian, gay, bisexual and transgender young people.

Living independently with long-term conditions

The Ipsos Mori Ethnography Centre of Excellence has published an evaluation exploring the lives of older people living with multiple long-term conditions.

Navigating health and care: living independently with long term conditions sets out the views of 36 patients, family members and carers in order to gain an insight into their experiences of living with and managing their long term conditions and the care they receive.

The evaluation finds older people living with multiple long term conditions are generally happy with the NHS but often find the health and care system is not set up for their needs.

Commissioning home care for older people

The Social Care Institute for Excellence has published SCIE guide 54: Commissioning home care for older people. This guide captures the latest research findings on this important and emerging area of social care. It also provides some practice examples of good work in this area. The guide is aimed at health and social care commissioners of home care services for older people with complex needs. Providers of these care services may also find it useful.

Age profile of NHS staff infographic.

Disability

The legal definition of disability is a physical or mental impairment that has a significant and long-term (more than 12 months) impact on a person’s ability to carry out day-to-day tasks. This includes people who are learning disabled, physically disabled, people with mental illness, sensory loss and long-term chronic conditions such as diabetes, HIV, cancer.

The social model of disability defines the environment as being disabling, rather than a person’s impairment or difference. The focus is on removing barriers that prevent disabled people from participating fully and accessing services. More information about the social model for disability can be found here.

Census 2011: 19.6% of the Hull population stated that their day-to-day activities were limited by disability (10% 'limited a lot'; 9.6% 'limited a little').

The Hull local Health & Lifestyle Survey 2014 reported that 27.7% of respondents identified that they have an illness or disability, which limits daily activities.

Adult disability type by number of people in Hull by age group (Source: Projecting Older People Population Information System and Projecting Adult Needs and Service Information – 2012 estimates)

Learning Disability: Inequalities and Reasonable Adjustments

People with a learning disability experience inequalities in physical and mental health.

On average, the life expectancy of women with a learning disability is 18 years less than for women in the general population; and the life expectancy of men with a learning disability is 14 years less than for men in the general population (NHS Digital 2017).​

(Source: Mencap: https://www.mencap.org.uk/learning-disability-explained/research-and-statistics/health/health-inequalities )

The Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD)​ highlights stark inequalities. (http://www.bristol.ac.uk/media-library/sites/cipold/migrated/documents/fullfinalreport.pdf_).

Public Health England has produced a range of guides to making reasonable adjustments to healthcare services, and how to support people with a learning disability to access healthcare services: https://www.gov.uk/government/collections/reasonable-adjustments-for-people-with-a-learning-disability

Disability in the United Kingdom, Papworth Trust Report, 2014: This report gives an overview of the key facts and figures about disability in the UK.  It covers areas such as employment, health, housing, transport and education.

Race or ethnicity

This category includes people from all ethnic backgrounds, or nationalities. When referring to race equality, people often refer to BME groups or people (Black or Minority Ethnic).

Estimates from the 2011 Census are that black or minority ethnic residents now make up 10.3% of the population, compared to the 2001 Census figure of 3.8%. Many BME people in Hull are students or European migrants with only 2.8% of BME people over 65.

The Black and Minority Ethnic Group communities in Hull: Health and Lifestyle Summary, published in 2013 found that:

• While the number of Hull BME residents has tripled in the last 10 years, Hull still has lower proportions of nearly all BME groups, when compared to the UK average
• The greatest increase in BME numbers was due to increased numbers of white Europeans, mostly from Poland and other East European countries
• Achieving a healthy diet seems to be the area where the BME groups on the whole do worse than the overall adult Hull population
• Gypsy & Traveller group tend to have poor physical health, but enjoy good mental health and high social capital

Commissioning Mental Health Services for black and ethnic minority communities

The Joint Commissioning Panel for Mental Health has published Guidance for Commissioners of Mental Health Services for people from black and minority ethnic communities. This guide describes what ‘good’ mental health services for people from Black and Minority Ethnic communities look like. This guide focuses on services for working age adults. However, it could also be interpreted for commissioning specialist mental health services, such as CAMHS, secure psychiatric care, and services for older adults.

Finding health information in different languages

• Northumberland, Tyne and Wear NHS Foundation Trust have a comprehensive online database of health information in different languages.
• NHS Choices page with to access information and resources in other languages.
• Hull CCG accessible information & interpreter service

Gender / sex

The 2016 estimates for Hull identify that the male population is 148,103 and the female population is 144,934.

Life expectancy at birth: For 2012-14 life expectancy at birth for Hull men was 76.6 years, and for Hull women it was 80.5 years. For England, life expectancy at birth was 79.5, and 83.2 years for men and women. There is significant difference between life expectancy across Hull. Click here for further information in the JSNA Life Expectancy Toolkit.

More information about specific health differences / issues affecting males and females in Hull can be found on in “Hull’s Adult Health and Lifestyle Survey 2014, Public Health Sciences, Hull City Council.” (Page 51):

www.hullpublichealth.org/assets/PrevalenceSurveyMainReport2014v2.pdf

Gender reassignment

This includes people who have undergone or are currently undergoing gender reassignment, this includes trans men (female to male), trans women (male to female).

There are no official statistics nationally or regionally regarding transgender populations, however, GIRES (Gender Identity Research and Education Society - www.gires.org.uk) estimated that, in 2007, the prevalence of people who had sought medical care for gender variance was 20 per 100,000, i.e. 10,000 people, of whom 6,000 had undergone transition. 80% were assigned as boys at birth (now trans women) and 20% as girls (now trans men). However, there is good reason, based on more recent data from the individual gender identity clinics, to anticipate that the gender balance may eventually become more equal.

Resources

For more information about Hull CCG’s Gender Dysphonia Policy Guidelines, click here.

General Medical Council (GMC) guidance

The first report of the House of Commons Women and Equalities Committee highlighted significant concerns about doctors’ lack of awareness and consideration in treating transgender patients.

The General Medical Council (GMC) helps to protect patients and improve medical education and practice in the UK by setting standards for students and doctors. In response to concerns raised in the report, the GMC have published guidance for doctors, advising how the Principles of Good Practice should be applied when treating transgender patients.

Top Tips for Working with Trans People [2013] - this guide by TransBareAll, is designed to give staff a basic understanding of trans people and their needs, as well as tips on how you can best support them in your role and in the workplace. It will also point you to sources of further reading and information.

Sexual orientation

(Refers to a person's sexual identity in relation to the gender to which they are attracted. This includes lesbian, gay and bi-sexual and heterosexual people).

There are no statistics for relating to the sexual orientation of people who live within Hull.  However, the Government estimates that 5% of the national population is lesbian, gay or bisexual.

Resources

Suicide Prevention toolkits for health professionals working with young people - New  toolkits produced in collaboration between the Royal College of Nursing (RCN) and Public Health England (PHE) primarily for nurses who work with children and young people, whether in community or hospital settings, including:
·         school nurses
·         practice nurses
·         accident and emergency nurses

These toolkits aim to: develop skills and knowledge and recognise the wider context of mental health in relation to LGBT sexual orientation and identity. They provide a general outline for health professionals looking to increase their skills and knowledge around suicide prevention strategies with LGBT young people.

Prescription for Change is a report published in 2008 by Stonewall highlighting the findings of health research of lesbian and bisexual women. This is based on a survey of over 6,000 lesbian and bi-sexual women.

Gay and Bi-sexual Men’s Health Survey highlights the findings of a survey of nearly 7,000 gay and bisexual men about their health and their experiences of health services.

Gay in Britain - this report from Stonewall provides some highlights based on the outcomes of poor experiences from the LGBT community when accessing health care.

Sexual Orientation: A guide for NHS Staff was developed by Stonewall as a result the research above about the poor experiences and health inequalities of many lesbian, gay and bi-sexual people.

Religion or belief

The Equality Act defines religion as any religion, or lack of a religion, and belief as any religious or philosophical belief, or lack of such a belief.

According to the 2011 Census, 54.9% of the population of Hull has identified themselves as Christian and 3.1% of the population is made up of other religions. This is made up of the following religions:

Buddhist: 0.30%, Hindu: 0.20%, Jewish: 0.10%, Muslim:  2.10%, Sikh: 0.10%,

Other Religion: 0.30%

34.8% of people stated ‘No religion’

(Not stated: 7.2%)

Resources

A Practical Guide for Religion and Belief in the NHS provides practical advice, illustrated by case studies, for NHS staff. The guide addresses employment and service provision considerations .

Ramadan

Fasting in the month of Ramadan is obligatory on all adult Muslims. Ramadan is from 27 May to 25 June in 2017.  Many patients and staff will be fasting or wanting to fast in Ramadan. It helps if NHS frontline staff are aware of and respect this important religious obligation and how such beliefs may affect the different elements of care.

Click here for information on healthy fasting.

Latest travel health advice for Hajj and Umrah pilgrims published – published July 2016 by Public Health England.

Pregnancy and maternity

The Equality Act includes protection against discrimination if you are pregnant, have recently given birth (within 26 weeks of birth) or are breastfeeding.

Resources

Severe pregnancy sickness

The Pregnancy Support Sickness (PSS) and the British Pregnancy Advisory Service (BPAS) charities have jointly published I could not survive another day, which highlights the impact on women of severe pregnancy sickness. Together the PSS and BPAS have surveyed women who have experienced termination of pregnancy while suffering severe pregnancy sickness over the past 10 years. This report aims to reflect their experiences and examines what more can be done to improve care for women in this situation and better support their choices.

Maternity Action, a charity promoting equality for pregnant women, partners and young children, provide information about pregnancy and maternity rights, including rights to breastfeed in public places.