Equality and human rights in health and social care

Ted Baker discusses the inequalities in health and social care which have been highlighted over the past year, and explains how we will be working with the Equality and Human Rights Commission to protect people’s human rights.

Prof Ted Baker, Chief Inspector of Hospitals

Everyone deserves equal access to health and social care. Over the past year, COVID-19 has highlighted the inequalities that already existed — and magnified them. We have seen a disproportionate impact on some people with protected characteristics, such as those from Black and minority ethnic backgrounds, older people, disabled people and people with long-term health conditions. Our approach throughout the pandemic has been focused on keeping people safe from harm and protecting their human rights while supporting providers to focus on delivering care, including the COVID-19 vaccination programme.

The Care Quality Commission has to be a key player in ensuring everyone has good quality care. This includes protecting people’s human rights as well as improving outcomes for people who are more likely to face inequalities. In October last year we published our annual State of Care report in which we highlighted the unequal impact of COVID-19. Last year we also published our third COVID-19 Insight briefing, where we discussed how collaboration has been essential to creating an effective response to the pandemic across the system. This is particularly important to those with some protected characteristics, who can be more severely affected by the health and social care system not working well together.

The Equality and Human Rights Commission (EHRC) is an important partner with whom we work closely to ensure we are addressing inequalities and protecting people’s human rights. We have published a new Memorandum of Understanding (MoU) agreement with the EHRC, which sets out how we will work together to protect the wellbeing and human rights of everyone receiving health and social care in England. The MoU details how we will work together, including in areas of mutual regulatory interest, sharing knowledge and expertise, and cross referral of concerns.

The MoU identifies five key areas for our joint working, which aim to improve quality of care and ensure care is always respectful of people’s human rights. These five areas look to improve collaboration between our organisations, ensuring we are sharing information where necessary and have a coordinated approach when it comes to regulation. As part of this we will continue to work together to respond to the equality and human rights issues that have arisen from the COVID-19 pandemic. This includes the EHRC contributing to our work on use of DNACPR and CQC supporting the dissemination of key findings relating to health and social care from EHRC key reports and briefings.

Our joint work is imperative to reducing restraint, segregation and seclusion. The EHRC will continue to input into our work on closed cultures, following the publication of our thematic review of restraint, segregation and seclusion. Linked to this is the Mental Health Act Review, which recommended that ‘Regulatory bodies such as the CQC should use their powers to support improvement in equality of access and outcomes’. To address this recommendation EHRC will be providing training to our Mental Health Act reviewers and inspectors on the Equality Act, public sector equality and the Human Rights Act, and we will continue to work collaboratively on policy issues relevant to the Independent Mental Health Act review and White Paper.

Effective leadership on equality for the workforce, patients and local populations is key to reducing inequalities and providing high quality care. Together with the EHRC we will consider how joint working on leadership in equality and reducing health inequalities in NHS trusts can help to drive improvements for patients and NHS staff. We will look at how together we can lever improvement in equality and human rights for people using health and social care services. We will also continue to focus on how trusts are implementing the Workforce Race Equality Standard (WRES), which is a requirement for NHS commissioners and NHS healthcare providers including independent organisations, as we have found that organisations that do well in promoting equality for their Black and minority staff are also more likely to provide good quality care for all their patients.

These are some examples of how we will be working with EHRC and the important issues we will be focusing on. Equality and human rights will be at the forefront as we implement our new strategy, which has reducing inequalities as cross-cutting theme. The strategy also emphasises human rights protection in terms of risk of harm, and this will be a key focus following the launch. We look forward to working with providers, the public, and other stakeholders on implementing the strategy over the coming months and will continue to update you on our work with EHRC.