Mental Health Nurse Chris explores how the law protects diversity, equity and inclusion within the workplace, and what nurses can do ensure their workplace is in line with current legislation, as well as what can they do to improve this and raise concerns.
What Is Diversity, Equity, And Inclusion?
Diversity is defined as "the practice or quality of including or involving people from a range of different social and ethnic backgrounds and of different genders and sexual orientations". It is a core value within the nursing profession, as having a diverse and representative workforce contributes towards improving quality and promotes equitable healthcare.
Furthermore, patients using healthcare services come from a broad range of backgrounds and the Nursing and Midwifery Council's 2022-2025 Equality, Diversity, and Inclusion Plan states that "everyone deserves safe, effective and kind nursing and midwifery care."
Equality and equity are also two important issues that underpin nursing practice. The terms are often used interchangeably, however there is an inherent difference between the two.
Equality means that each person or group of people is treated equally and provided with the same opportunities and resources. However, equity takes into account the specific needs or circumstances of that individual or group to help achieve an equal outcome.
The concept of equality is about promoting equal rights, status, and opportunities, while equity looks at fairness and impartiality. For this reason, granting equality does not always necessarily address inequality.
Alongside these concepts, inclusion also seeks to promote equitable opportunities. Inclusion is where a workplace culture seeks to welcome everyone, regardless of race, gender identity, sex, ethnicity, ability, religion and age. Inclusive language is used to acknowledge diversity, promote equitable opportunity and is sensitive to difference.
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What Is The Law Relating To Diversity, Equity & Inclusion?
Diverse, equitable and inclusive practice should be at the foundation of all healthcare, and the Equality Act 2010 seeks to promote these issues and protect individuals from experiencing discrimination. Discrimination is defined as being treated unfairly due to having a protected characteristic. The Equality Act provides nine protected characteristics, and if a person experiences discrimination because of one of these characteristics, it is unlawful.
The characteristics defined under the Equality Act are: Age, disability, gender reassignment, marriage or civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.
Furthermore, if someone is treated differently because a friend or family member has a protected characteristic, this is also unlawful as it is considered discrimination by association.
The Public Sector Equality Duty
Healthcare services also have a further statutory duty to fulfil through the Public Sector Equality Duty (PSED). Under section 149 of the Equality Act 2010, a PSED is imposed upon public bodies that are listed within Schedule 19 of the Act. Healthcare organisations are detailed within Schedule 19 as a relevant public body for the purpose of the Act, and they are therefore subject to its provisions by law.
S.149 of the Act states that when carrying out their functions, public authorities, such as healthcare organisations, are required to give due regard towards the Act objectives to:
(a) Eliminate discrimination, harassment, victimisation, and any other conduct that is prohibited by or under the Equality Act 2010.
(b) Advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it.
(c) Foster good relations between persons who share a relevant protected characteristic and persons who do not share it.
The term "due regard" means that organisations must consider and reflect upon the three aims during decision-making processes, policy design and delivery of services.
Nurses can ensure that their practice and workplace adheres to the law through actively promoting diversity within the workforce and when providing care.
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The Duty To Advance Equality
The organisation's policies must also be kept under regular review to ensure they continue to give due regard to the three aims.
The duty to advance equality is defined under s.149 (3) of the Equality Act 2010 as a need to:
(a) Remove or minimise disadvantages suffered by people who share a relevant protected characteristic.
(b) Meet the needs of people who share a relevant protected characteristic where these are different from the needs of people who do not share it.
(c) Encourage people who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low.
S.149 (5) of the Act also sets out the need for organisations to tackle prejudice and promote understanding. There are further specific duties for organisations to publish their equality information.
The PSED is central to ensuring fairness is promoted within the practice of healthcare organisations and that services are meeting the needs of different groups. If consideration is not given towards how a particular function can affect different groups in different ways, it is unlikely to have the intended affect. As a result, inequality can increase and there will be poorer outcomes.
Consideration can also be given towards the protection afforded through the Human Rights Act 1998 (HRA 1998), in particular Article 14, which requires that all the rights and freedoms set out in the HRA 1998 must be protected and applied without discrimination.
To rely on Article 14, an individual must show that discrimination has affected their enjoyment of another right provided under the HRA 1998, for example the right to freedom of expression or the right to privacy.
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How Can Diversity, Equity & Inclusion Be Improved In The Workplace?
Nurses can ensure that their practice and workplace adheres to the law through actively promoting diversity within the workforce and when providing care. Familiarity with equality policies will ensure that nurses day-to-day activity remains in line with both the expectations of the organisation and in compliance with existing legislation.
Healthcare organisations will also usually need to undertake an Equality Impact Analysis when a need for a new practice or service change is identified, or when existing ones are renewed.
Consideration should also be given towards intersectionality and the existence of different experiences when multiple levels of oppression or disadvantage interact. Intersecting social identities, such as disability, race, age, gender, ethnicity, class, physical appearance, and weight may offer both empowerment or oppression depending upon the individual and situation.
Nurses should seek to recognise the diverse experiences within the workplace, and foster a culture of inclusion, and develop practices and policies that value and celebrate diversity.
It is in the interests of employers to maintain diversity, equity, and inclusion within the workplace, as nurses are more likely to stay in their role and have increased motivation when their working environment is welcoming and diverse.
Furthermore, a breach of the Equality Act 2010 could result in a fine for the organisation, and compensation awarded within employment tribunals currently has no limits.