Guidelines for Evaluating Information on Cultural Norms adapted from Mares, Henley & Baxter (1985) Challenging racism and racial stereotypes - when using material which gives cultural information the following questions should first be asked: • Who has been involved in compiling the information? Is it written by • someone from the community being addressed? • Is the material dealing with the culture of: • an entire society? • a particular social class or group? • a particular area of the country? • a small localised group? • Is it clear what sections of the population the information refers to? • Does the material simply describe patterns of behaviour? • are the patterns described in a way that makes them seem absurd or bizarre?

Guidelines for Evaluating Information on Cultural Norms • does it suggest possible explanations? • does it discuss the underlying reasons for unfamiliar patterns of behaviour? • is it clear whether the patterns described are ideal or actual norms? • Does the author make value judgements about the cultural patterns • described? eg: does the author’s attitude strike you as positive, neutral or • negative? • Is culture seen as a fixed state or a dynamic phenomenon? Is this aspect • discussed or ignored? • Does the information analyse the situation of minority cultural groups in • Britain purely in terms of culture and cultural differences? Does it make any • reference to important economic and social factors (eg: unemployment and • racial discrimination)? • What specific new insight have you gained from the information? Has it • increased your understanding of the culture described, or created further • questions in your mind about aspects you were not previously aware of?

Adapted from Ricky Sherouer-Marcuse, Unlearning Racism Workshops, 6501 Dana, Oakland CA 94609, USA Racism Systematic mistreatment of people of colour and third world people which become the justification for further mistreatment which generates misinformation and ignorance about these groups of people Racism hurts all of us, whether or not we are members of the targeted group Racism is one consequence of a self-perpetuating imbalance in economic, political and social power which become socially sanctioned attitudes, beliefs, feelings and assumptions

Basic Premise and Principles of Racism Awareness Training • Racism is part of the culture within British society and individuals within it • have been socialised from childhood into this • Racism encompasses not only our prejudice but also the power held by • white society to translate its prejudices into practices that initiate and • perpetuate injustice • Both black and white people are hurt by racism but in different ways. In the • process of becoming aware of our own racism the pain of that hurt must be • made conscious • Racism Awareness training is concerned with enabling individuals to • explore how racism is part of themselves, the organisations in which they • work and in society as a whole • Individuals are required by the teacher to take responsibility for their own • learning. • The teacher thus acts primarily as a facilitator who helps to build a • group sense of trust; has an understanding that guilt can block change; and • is willing to confront racism and help individuals to make choices about • future assumptions and behaviours.

Basic Premise and Principles of Racism Awareness Training • The teacher therefore requires a deep knowledge and understanding of how • racism operates, as well as skills as a groups facilitator and sensitivity to • group process and individual emotions • Racism Awareness does not take place in one-off short workshops. It is part • of a broader programme of organisational development towards equality of • opportunities in which the overall aim is to confront and change institutional • structures and procedures • The ultimate value of Racism Awareness training lies in its generation of • both individual and group commitment to action for changing racist practices • and achieving justice. This is achieved by overcoming emotional blocks that • can undermine other initiatives such as Equal Opportunity Programmes or • antiracist confrontations

“Multiracial” vs “Multicultural”? 2 PERSPECTIVES:

From Margins to Mainstream

Building Cultural Competence Within the Organisation Competency: “The behaviours that employees must have, or must acquire, to input into a situation in order to achieve high levels of performance” - CIPD

Understanding Organisational Competence • “Cultural Competence”: • Cultural Awareness: • Cultural Knowledge: • Cultural Sensitivity: Recognition that others might be different from you Understanding of specific cultural needs Knowing that cultural differences as well as similarities, exist, without assigning values eg. better or worse, right or wrong etc

Cultural Competence - Assumptions • There is such an entity as cultural competence – • which can be acquired • It is possible to describe and to provide training to • improve the cultural competence of healthcare • professionals which will improve the competence of • the organisation • The employment of ethnic minority healthcare staff • (particularly nurses) will improve organisational • competence

Race Equality in Healthcare and Education, Baxter, 1997 Building Cultural Competence Within the Organisation • Attitudes / Values: • Stereotypes • Prejudice • Personal racism • Institutional racism • Knowledge: • Demographic and • population issues • Inequalities in health • Specific illnesses • Concepts of health • and illness

Race Equality in Healthcare and Education, Baxter, 1997 Building Cultural Competence Within the Organisation • Skills: • Communication across • cultural and language • barriers • Practical hospital care • – physical and spiritual • Care in the community • Specific clientgroups • Approaches: • Change management • Policies and strategies • Building networks • Sharing experiences, • good practice and ideas

The Emergence of a Policy Agenda • Sex • Ethnicity • Disability • Age • Sexual Orientation • Religion and Belief • Human Rights

employment goods, facilities, services both Equality Legislation: Quickening Pace 1980s 1990s 2000s 1970s Sex / Gender Race / Ethnicity Disability Age Sexual Orientation Religion and Belief Human Rights EPA SDA EA GRA RRA RR(A)A DDA DDA EE(A)R EE(SO)R EA(SO)R EE(RB)R EA(RB)R HRA

Equality Legislation: Equality Duties EMPL SERV GENERAL DUTY: SPECIFIC DUTIES: Gender Race Disability Age Sexual Orientation Religion and Belief Human Rights Gender Equality Duty Gender Equality Scheme Equality Impact Assmts etc √ √ Equality Impact Assmts etc √ √ Race Equality Duty Race Equality Scheme Equality Impact Assmts etc √ √ Disability Equality Duty Disability Equality Scheme √ 2009? √ √ √ √ √ √

From Goodwill to Competence NHS KNOWLEDGE AND SKILLS FRAMEWORK CORE DIMENSION 6 Equality & Diversity = This is a key aspect of all jobs that everyone does. It underpins all dimensions in the NHS KSF Core LEVELS: 1 Act in ways that support equality and value diversity 2 Support equality and value diversity 3 Promote equality and value diversity 4 Develop a culture that promotes equality & diversity

KSF CORE DIMENSION 6 Equality & Diversity 1 Act in ways that support equality and value diversity Indicators: The worker: a) acts in accordance with legislation, policies, procedures and good practice b) treats everyone with whom s/he comes into contact with dignity and respect c) acknowledges others’ different perspectives d) recognises that people are different and makes sure they do not discriminate against other people e) recognises and reports behaviour that undermines equality and diversity • Examples of application: • a) around: age, racial group, disability , gender, human rights, mental health etc • b) – e) may include: • what they do or say • what they do not do or say • when interacting with colleagues • when interacting with service users • when working with the public • when working with visitors to the • organisation

KSF CORE DIMENSION 6 Equality & Diversity 2 Support equality and value diversity • Indicators: • The worker: • a) recognises the importance of people’s rights and acts in accordance with legislation, policies and procedures • b) Acts in ways that: • acknowledge and recognise people’s • expressed beliefs, preferences and choices • respect diversity • value people as individuals • c) takes account of own behaviour and its effect on others • d) identifies and takes action when our own or others’ behaviour undermines equality and diversity • Examples of application: • a) around: age, racial group, disability, gender, human rights, mental health etc • b) might relate to: • food and drink • how they like to be addressed and spoken to • personal care • privacy and dignity • the information they are given • the support they would like • their faith or belief • d) would include: • recognising when equality and diversity is not being promoted and doing something about it • recognising when someone is being discriminated against and doing something about it

KSF CORE DIMENSION 6 Equality & Diversity 3 Promote equality and value diversity Indicators: The worker: a) interprets equality, diversity and rights in accordance with legislation, policies and procedures and relevant standards b) evaluates the extent to which legislation is applied in the culture and environment of own sphere of activity c) identifies patterns of discrimination and takes action to overcome discrimination and promote diversity and equality of opportunity d) enables others to promote equality and diversity and a non-discriminatory culture e) supports people who need assistance in exercising their rights • Examples of application: • a) around: age, racial group, disability, gender, human rights, mental health etc • b) might relate to: • communication with different people • health, safety and security / risk management • quality systems standards and guidelines • the allocation of resources • the availability of services • the development of services • c) might relate to: • the learning and development offered to different people • the recruitment, selection and promotion of staff

KSF CORE DIMENSION 6 Equality & Diversity 3 Promote equality and value diversity Indicators: The worker: d) enables others to promote equality and diversity and a non-discriminatory culture e) supports people who need assistance in exercising their rights • Examples of application: • d) might include: • acting as a role model • being aware of the wellbeing of all members of the work team and supporting them appropriately • enabling others to reflect on their behaviour • identifying training and development needs • e) might relate to: • advocacy • enabling people to make the best use of their abilities • intervening when someone else is discriminating against someone on a one-off basis or routinely • making arrangements for support • representing people’s views

KSF CORE DIMENSION 6 Equality & Diversity 4 Develop a culture that promotes equality and diversity Indicators: The worker: a) interprets legislation to inform individuals’ rights and responsibilities b) actively promotes equality and diversity c) identifies and highlights methods and processes to resolve complaints as a consequence of unfair and discriminatory practice d) supports those whose rights have been compromised consistent with legislation policies and procedures and good and best practice • Examples of application: • a)and d) around: age, racial group, disability, gender, human rights, mental health etc • b) would include: • acting as a mentor to people from diverse groups • acting as a role model • actively working in partnership with diverse groups • developing and supporting own team in relation to equality and diversity • ensuring that development opportunities are available to all staff • ensuring the fair recruitment and selection of staff

KSF CORE DIMENSION 6 Equality & Diversity 4 Develop a culture that promotes equality and diversity Indicators: The worker: e) actively challenges individual and organisational discrimination f) evaluates the effectiveness of equality and diversity policies and procedures within the service / agency and contributes to the development of good and best practice • Examples of application: • b) would include: • focusing resources to deliver equitable outcomes • involving the local population in the development of services • listening to the experiences and views of different groups and acting on them • modelling good practice • promoting an open and fair culture throughout the organisation • promoting equality and diversity during partnership working

NHS Leadership Qualities Framework

Joining up the Agenda Vision for the NHS “An environment where all staff feel valued and enjoy a fair and equitable quality of working life, and where different backgrounds, perspectives, knowledge and experiences are welcomed and the benefits that this diversity can bring are actively sought and embraced.” “A service which continuously seeks to improve the quality of healthcare provided to an increasing diversity of patients and clients, through nurturing, supporting and developing its staff.”

Quality Of Service Making cultural competence effective STRATEGY Cultural Awareness POLICIES & PROCEDURES CULTURE Policies Procedures Standards Behaviours Cultural Knowledge CLIMATE SYSTEMS Cultural Sensitivity STRUCTURE BY / OF INDIVIDUALS SYSTEMATIZED WITHIN AN ORGANISATION

The Regulators: UK NHS Healthcare Commission – Draft Strategic Cultural Competence Framework

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Glossary EA - Equality Act, 2006 EA(RB)R - Equality Act (Religion or Belief) Regulations, 2007 EA(SO)R - Equality Act (Sexual Orientation) Regulations, 2007 DDA - Disability Discrimination Act, 1995 - Disability Discrimination Act, 2005 DED - Disability Equality Duty DES - Disability Equality Scheme EE(A)R - Equality in Employment (Age) Regulations, 2006 EE(RB)R - Equality in Employment (Religion and Belief) Regulations, 2003 EE(SO)R - Equality in Employment (Sexual Orientation) Regulations, 2003 EPA - Equal Pay Act, 1970 GED - Gender Equality Duty GES - Gender Equality Scheme GRA - Gender Recognition Act, 2004 HRA - Human Rights Act, 1998 RED - Race Equality Duty RES - Race Equality Scheme RRA - Race Relations Act, 1976 RR(A)A - Race Relations (Amendment) Act, 2000 SDA - Sex Discrimination Act, 1975 SES - Single Equality Scheme

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