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EHRC fires equality warning shot at Integrated Care Boards

Updated: Apr 3, 2023

A couple of Integrated Care Board (ICB) Chief Executives have kindly shared with me a helpful letter they were sent on 14 February 2023 by Jackie Killeen the Equality and Human Rights Commission (EHRC) Chief Regulator setting out ICB responsibilities to meet the requirements of the public sector equality duty (PSED).


The letter states

The PSED is designed to support I

Bs and other public bodies to think about equality across your work, to identify the major challenges before you and to take action to tackle them. The PSED consists of a general duty and specific duties. The general duty requires ICBs to actively think about how they can prevent discrimination, advance equality and foster good relations.


The PSED is designed to support ICBs and other public bodies to think about equality across your work, to identify the major challenges before you and to take action to tackle them. The PSED consists of a general duty and specific duties. The general duty requires ICBs to actively think about how they can prevent discrimination, advance equality and foster good relations.


It applies to the services you provide and to your employment of staff. It also applies in most instances to the services you commission others to deliver on your behalf, for example to the sub-contracting of care staff or health services. The PSED requires a thorough consideration of the needs of people with each of the protected characteristics


The specific duties require you, as an integrated care board, to be transparent about your work on equality and how you are meeting the requirements of the general duty. Each year you must publish equality information that sufficiently demonstrates how you are thinking about equality across the services you provide and your employment of staff. ICBs should also have one or more published equality objectives, which should be specific and measurable and cover a period of up to four years. The next deadline for the publication of equality information is 30 March 2023. Our expectation of all ICB’s is that they will have published their equality information and objectives by this date.


In addition to these requirements, the specific duty regulations also contain an obligation for public bodies with 250 or more staff to publish gender pay gap information each year. This duty to publish will apply to ICBs from 30 March 2024, however the published data will cover their workforce profile at 31 March 2023, so this needs to be collected and recorded. Although ICBs are not required to publish this information in 2023, your ICB can voluntarily do so if you are able to. You can read more about the requirements of the PSED and the specific duties in our guidance on the duty.


Later this year we will be monitoring how every ICB is meeting its PSED obligations. This is so that we can better understand how you are considering and prioritising the needs of people with different protected characteristics. We will use the findings from this exercise to help target our support and to share learning about best practice. We intend to work collaboratively with NHS England and the Care Quality Commission.


As part of this monitoring we will particularly look at what steps are being taken to tackle the inappropriate detention[i] of people with a learning disability and autism and also at action to tackle disproportionate rates of detention of ethnic minority people under the Mental Health Act 1983. In both cases, we see the provision of early and preventative community-based services as being of critical importance. We are also likely to look at how ICBs are considering equality within their workforce, including the experience of low paid ethnic minority staff.


The implications of the letter

Crucially the letter from the equality regulator reminds ICBs that the PSED applies to the services the ICB provides, to their employment of staff and also applies in most instances to the services they commission others to deliver on your behalf, for example to the sub-contracting of care staff or health services.


This third requirement requires ICBs to set out, to organisations they commission services from, a requirement to explain how each organisation is meeting their own PSED requirements both in terms of the services they provide and, within those services, how the employment of staff is considered.


Taken alongside expectations from other regulators - NHS England, the CQC and the Health and Safety Executive - this letter is both an opportunity for ICBs to step up their equality focus and a reminder of their statutory duties.


Whether you work in an ICB, or work in an organisation (in health or social care) that provides services commissioned by an ICB, you might want to ask how this obligation is being carried out where you are?

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