Monday, 28 May 2012


This afternoon I’m at the headquarters of Leicestershire Partnership NHS Trust. I’ve been asked to attend a briefing with Christina Marriott, Manager of the Integrated Equalities Unit at Leicestershire Partnership NHS Trust, on potential impacts of the closure of the Children's Congenital Heart Unit at Glenfield Hospital. No such decision has been made yet and consultations on the impacts of closure have to be discussed before the decision can be taken.

Christian is having meetings with representatives from organisations standing for each of the relevant Protected Characteristics as defined in the Equality Act 2010, asking for their responses and collating their contributions.

This consultation is not on the subject of whether or not the Children's Congenital Heart Unit at Glenfield Hospital should be closed or should remain open. A long-running consultation on that topic has been held and is now closed. That decision will be made at national level and it is not possible now for us to make any contribution to the process.

What is going on now is the gathering of information about potential impacts of closing the unit at Glenfield - from our perspective, if this is done, how will it affect communities of religion or belief in the city (and in the county and Rutland)?

There are four options on the table and the final decision will favour one of them. In Option A, Glenfield stays open. In the other three options, Glenfield is closed and the nearest site for treatment is Birmingham Children's Hospital. Nothing more can be done at this stage to influence the eventual decision. Christina is very interested in seeing what we have to say in terms of foreseeable impacts of the closure - and, just as importantly, ways of mitigating those impacts.

The response from Leicester Council of Faiths to this part of the consultation process is shown below. This was circulated around our Board of Directors and their comments solicited before it was submitted.
"Safe and Sustainable – A New Vision for Children’s Congenital Heart Services"
Response from Leicester Council of Faiths, drafted following a meeting with Christina Marriott, Manager of the Integrated Equality Service at Leicestershire Partnership NHS Trust HQ, Lakeside House, 4 Smith Way, Grove Park, Enderby, Leics LE19 1SX, Monday 28 May 2012.
This response has been made as promptly as possible, but it should be noted that it is still a provisional one. There is a clear need to keep talking and keep thinking about the possible impacts of rationalising Children’s Congenital Heart Services nationally. If, as a result of decisions made at national level, Glenfield Hospital does not retain its surgical unit, then deeper consultation will be required, perhaps including direct engagement with representatives of different communities of Religion or Belief in the city, county and Rutland.
We appreciate the fact that the Joint Committee of the Primary Care Trust (JCPCT) is showing due regard to the groups it serves in Leicester, Leicestershire and Rutland. We are aware that the conversation with Leicester Council of Faiths is part of a wider ongoing process of consultation, in which JCPCT is talking with other organisations representing people and groups identifying with Protected Characteristics as enumerated in the Equality Act 2010. We know that that these groups include, for example: Leicester Lesbian, Gay, Bisexual and Transgender (LGBT) Centre; Leicestershire Centre for Integrated Living (LCIL); and The Race Equality Centre (TREC). In the context of this knowledge, we hope that nothing in this response will come across as special pleading on behalf of those people and groups who identify with the Protected Characteristic of Religion or Belief. We welcome and support the involvement of a wide range of stakeholders and expertise in the consultation.
JCPCT has to demonstrate awareness of possible or likely impacts on families, groups and / or communities who identify with the Protected Characteristic of Religion or Belief – and to show that proportionate actions that may be taken in mitigation of those impacts have been discussed, recorded and forwarded to those involved in deciding the outcome of this review.
Given the nature of the Protected Characteristics enumerated in the Equality Act 2010, we are aware that many of them overlap, meaning that individuals, families and communities identifying with any Religion or Belief will most likely also identify with one or more of the other Protected Characteristics (i.e. age, disability, marriage and civil partnership, pregnancy and maternity, race, sex, sexual orientation, transgender). In keeping with the current understanding of equality, it is clear that communities, families and individuals no longer align themselves with just one characteristic, but tend more to see themselves as bundles of characteristics. Sometimes these bundles work in harmony with each other within the same community, family or individual, at other times they may compete with each other. At times, one of these Protected Characteristics may come to the fore and be of greater importance, or it may fade into the background and be superseded in importance by others. For example, it may be the case that sometimes individuals, families or groups who identify with the Protected Characteristic of Religion or Belief may speak out more strongly on an issue related to age or disability.
Anyone who identifies with any particular Religion or Belief wants to obtain the same level of service in hospital as any other person: adaptable, competent, sensitive and well-trained staff at all levels; clean and well-kept wards, free from risk of infection; speedy responses by staff members and by NHS institutions to changing needs and situations; the willingness and ability to treat patients, family and visitors as whole people.
People of Religion or Belief are, in the end, people after all. They do not necessarily bring special problems associated with Religion or Belief with them. However, there are particular needs associated with the Protected Characteristic of Religion or Belief, which we hope can be clarified here.
One issue that will surely be raised by all respondents is increased travel time between a unit in Birmingham and home in Leicester, Leicestershire or Rutland. Given that the patient is a child, it’s normal to have an adult family member with the patient at all times, if possible. Family members tend to work in shifts by the patient’s bedside (assuming that a sufficient number of family members are available to do this). This will normally bring about considerable disruption to the family’s routine – which is of special significance if that routine involves playing an active part in the community life of their place of worship. We would want to be assured of decent facilities for parents and/or other family members  to sleep when staying with the patient, and not be subjected to the ordeal of travelling longer distances (especially if they have to drive).
It’s fairly easy to come up with a wish-list that would appear to cover the bases in terms of the Protected Characteristic of Religion or Belief (e.g. family and visitors have access to a well-maintained prayer room or quiet room; appropriate washing facilities for ritual ablutions; a range of sacred scriptures and other appropriate texts in a variety of languages; a display of artifacts and/or symbols for devotional use; food and drink that fits in with Halal, Kosher and vegetarian and vegan dietary regimes). Such a list is important, of course – but in this day and age, these things may be said to be the minimum that would be expected under any circumstances. In relation to these requirements, we would be concerned that, if the unit at Glenfield were to be closed, one impact would be a squeeze on existing facilities, an increase in demand, that could not be coped with comfortably. To mitigate this impact, there would need to be, at the very least, an expansion of such facilities existing at Birmingham Children’s Hospital, in close proximity to the site of Congenital Heart Services.
Over and above all this, however, there is another kind or level of response from the perspective of the Protected characteristic of Religion or Belief, a more nuanced and subtle one, which we would like to see taken into account.
The city of Leicester is known for its distinctive religious profile. If the surgical unit at Glenfield Hospital is to close as a result of this national review, then the religious profile of potential service users from Leicester has to be taken into account for effective functioning of the site to which Leicester-based patients will be referred.
In terms of this religious profile, can we be sure that appropriate training has been or will be given to staff on those other sites, that suitable resources have been or will be made available (to service users and staff), that a relevant multi-faith chaplaincy service is currently or will be accessible (to all who may need it)?
What is the religious infrastructure locally? Even if another city is known for diversity in its own right (e.g. Birmingham) it should not be assumed that this will match up with the sort of diversity found in Leicester. While it is important to be able to demonstrate that Religion or Belief has been taken as seriously as the other Protected Characteristics, it is also important to be able to show that the issue of diversity has been considered to the same degree. There is no generic, universal, “one size fits all” solution to issues that arise in relation to Religion or Belief. There will be variation, perhaps tension (if not actual conflict) between the needs or wishes of different communities of Religion or Belief. There may be competing demands on resources, space or funding that means if one thing is done, another cannot. This may be the case not only between distinct communities, but also within those communities themselves.  When it comes down to it, it may be said that no two families who identify with a particular Religion or Belief may be expected to respond in the same way.
In the midst of all this discussion of equality and diversity, care should be taken not to make it look as though nominal affiliation to the Church of England is “normal”, even for families with no particular religious affiliation.
Issues related to end of life care assume the greatest importance for families who identify with a particular Religion or Belief. Under such circumstances, the stakes are obviously raised. A religious person will probably want to pray more, preferably at their chosen place of worship, for the recovery and well-being of the child. If they are unable to attend their normal religious services or observances, this will put an extra strain on family members.
This potential impact would be mitigated if relevant staff know the location of places of worship (with proper awareness of differences between denominations, sects, etc.). This kind of knowledge can be captured in a multi-lingual resource, but should also be part of the family and patient’s initial care plan. This sort of conversation should be triggered when a child is scheduled for surgery. It would mitigate all kinds of impacts to be able to “front-load” the service in this way, rather than end up trying to take remedial action.
This response submitted by George M Ballentyne, Equality & Diversity Officer, Leicester Council of Faiths, 28 May 2012

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