STANDARD 2018-2019 Sandra Ovid Equality, Diversity & Inclusion - - PowerPoint PPT Presentation

WORKFORCE RACE EQUALITY STANDARD 2018-2019

Sandra Ovid

Equality, Diversity & Inclusion Manager, NEL Sandra.ovid@nhs.net 0203 6881460

Contents

Merton CCG WRES 2018-19

About Workforce Race Equality Standard (WRES) 3 Foreword 4 Workforce Race Equality Standard (WRES) Indicators 5 Providers and Compliance 6 WRES Indicators 7 WRES Report 2018-19 8-14 Action Plan 15

About the Workforce Race Equality Standard (WRES)

Merton CCG WRES 2018-19

In 2014, NHS England and the NHS Equality and Diversity Council agreed actions to ensure employees from Black and Minority Ethnic (BME) backgrounds have equal access to career opportunities and receive fair treatment in the workplace. It was agreed that a Workforce Race Equality Standard (WRES) should be developed, and in April 2015 it was made available to the NHS. All NHS organisations including CCGs, Trusts and CSUs as well as national organisations are encouraged to implement the WRES in an open and transparent way. This will help to show the national, clinical and commissioning workforce. The Workforce Race Equality Standard is a set of indicators that, for the first time, require all organisations with NHS contracts, to demonstrate progress against a number of areas of race equality, including a specific indicators to address the low levels of BME Board representation. Simon Stevens, Chief Executive of NHS England, said: “The Five Year Forward View sets out a direction of travel for the NHS – much of which depends on the health service embracing innovation, engaging and respecting staff, and drawing on the immense talent in our workforce”. “We know that care is far more likely to meet the needs of all the patients we’re here to serve when NHS leadership is drawn from diverse communities across the country, and when all our frontline staff are themselves free from discrimination. These new mandatory standards will help NHS organisations to achieve these important goals.”

Foreword

Merton CCG - WRES Report 2018-19

Merton CCG is committed to ensuring that diversity and inclusion is at the heart of everything we do in the CCG and to seek assurance from our Providers that they do the same to meet contractual requirements in relation to the Workforce Race Equality Standard (WRES) and Equality Delivery System (EDS2). There is robust evidence for the effectiveness of having an ambition that is based upon commitment to specific goals, monitored by frequent feedback. BME leadership representation across the NHS has shown signs of improvement since the introduction of the WRES, however, there is a clear need for further accelerated improvement. Aspirational goals to increase BME representation at leadership levels and across the workforce pipeline will reinforce the existing WRES programme of work. Many organisations and part of the NHS are already setting aspirational goals for a number of WRES Indicators. Issues of the lack of leadership representation apply as much to the clinical workforce as they do to the non-clinical workforce. Whilst the next part of the WRES strategy focuses upon representation across the Agenda for Change (AfC) bandings, this strategy approach will apply to those NHS staff that do not fall under the Agenda for Change model. This recommended model will align with the timeframe announced by the government on this aspiration for the public sector, it is in line with the timeframe for the NHS Long Term Plan and Interim NHS People Plan and is the basis upon which this strategy is informed for the current WRES programme of work across the NHS. This is our fourth WRES report which sets out the CCG’s performance information against the nine mandatory NHS WRES metrics. Since inception, the CCG has adopted the EDS2 and now we are publishing the WRES report. Publishing reports is one part of ‘Due Regard’. It is about our commitment to ensuring we are inclusive in our service delivery and that our staff reflect the community we serve. The report covers the CCG’s workforce profile, staff survey and board composition by ethnicity. The report also details the calculations and analysis of the results against each metric, with recommendations for improvements where appropriate. The report will be published as an internal document in December 2019 and the new NHSE WRES Strategic Data Collection Service (SDCS) Data submission was submitted to meet the August 2019 timeline. Of note, the CCG is in the process of applying to merge into one South West London (SWL) CCG from April 2020; this will require WRES reporting processes to be updated to reflect this.

*RAG ratings are colour coded: Green represents BME experience equivalent to White experience Amber represents some difference between BME and White experience. Red Large difference between BME and White experience.

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Key highlights

Merton CCG WRES 2018-19

Overall 91% of staff reported their ethnicity as at 31 March 2019. This is an increase of 4% on the previous year where 87% of staff reported their ethnicity. BME staff has increased by 2% on the previous year. The disclosure rate remained relatively the same year on year. Indicator 1: There is an decrease by 5% for BME staff in AfC Bands 1 – 7 compared to the previous year. White and BME staff mirrored with a percentage of 45% for 2018-19. Indicator 2: Shortlisted White candidates are 6.70 times more likely to be appointed to roles than BME candidates. This is an increase with the previous year reporting this as nearly twice as likely. WRES guidance states A figure below “1” would indicate that white candidates are less likely than BME candidates to be appointed from

• shortlisting. In 2018-19 BME staff numbers in the shortlisted category have increased significantly by 46%

compared to the previous year. Indicator 3: 2018-19 data shows that White staff are more likely than BME staff to enter the formal disciplinary process. Indicator 4: The Workforce system now enables the capture of non-mandatory CPD and training across the organisation. 26 members of staff completed the 2018 NHS staff survey. Indicator 5-6: It is hard to carry out a comparison on BME responses because of the low data on the previous year. However, 22% of White staff reported that they experienced harassment, bullying or abuse from patients/relatives or members of the public in the last 12 months. This has increased by 15.3% on the previous year. That said, staff experiencing harassment, bullying or abuse from staff in the last 12 months has also increased by13.3% for White staff and BME staff has increased by 33.3% compared to the previous year. Indicator 7-8: 90.9% of White staff believe that the organisation provides equal opportunities for career progression or

• promotion. The numbers were too low to report on BME staff experience regarding equal opportunities for career

progression or promotion. The National average for BME on this indicator is 59.3%. Indicator 9: Currently Merton CCG Governing Body Members are not reflective of its workforce nor the local population it

• serves. This has remained unchanged from 2017-18.

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Workforce Race Equality Indicators

Merton CCG WRES 2018-19

For each of these four workforce indicators, compare the data for White and BME staff Indicator Description 2017-18 RAG rating 2018-19 RAG rating 1 Percentage of staff in each of the AfC Bands 1-9 and VSM (including executive Board members) compared with the percentage of staff in the overall workforce Note: Organisations should undertake this calculation separately for nonclinical and for clinical staff Developing Developing 2 Relative likelihood of staff being appointed from shortlisting across all posts Developing Under- developed 3 Relative likelihood of staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation Note: This indicator will be based on data from a two year rolling average of the current year and the previous year Developing Achieving 4 Relative likelihood of staff accessing non-mandatory training and CPD National NHS Staff Survey indicators (or equivalent) Under- developed Under developed For each of the four staff survey indicators, compare the outcomes of the responses for White and BME staff 5 KF 25. Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months Under- developed Under developed 6 KF 26. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months Under- developed Under developed 7 KF 21. Percentage believing that trust provides equal

• pportunities for career progression or promotion

Under- developed Under developed 8

• Q217. In the last 12 months have you personally

experienced discrimination at work from any of the following? b) Manager/team leader or other colleagues Under- developed Under developed Board representation indicator. For this indicator, compare the difference for White and BME staff 9 Percentage difference between the organisations’ Board voting membership and its overall workforce Note: Only voting members of the Board should be included when considering this indicator Under developed Under developed

Local NHS Healthcare Providers’ and Compliance

Providers WRES Report 2018 – 19 published as at September 2019* Link / Attachment

Level of Compliance

Epsom and St Helier University Hospitals NHS Trust Yes Workforce Race Equality Report (2018- 19)provides a summary of how we are doing against nine workforce indicators. Workforce Race Equality Standard 2018-19 St Georges Hospital NHS Trust Yes Workforce Race Equality Report (2018- 19)provides a summary of how we are doing against nine workforce indicators. Workforce Race Equality Standard 2018-19 South West London and St George’s Mental Health NHS Trust Central London Community Healthcare NHS Trust Yes Final Workforce Race Equality Report 2018-19 . There is also a document which talk about WRES 3 years action plan Yes Workforce Race Equality Report (2018-19 ) provides a summary of how the Trust are doing against nine workforce indicators Final Workforce Race Equality Standard 2018-19 Workforce Race Equality Standard 2018-19 All NHS Trust Leaders are required to sign up to a strategy designed to support local NHS trusts in their implementation of the Workforce Race Equality Standard (WRES) and to meet the aspirations of increasing black and minority ethnic (BME) representation at senior levels across the NHS. This strategy will support local NHS Trusts to develop and refine their existing WRES Action Plans. This strategic approach will help NHS trusts to meet the workforce race equality commitments set out in the NHS Long Term Plan the Interim NHS People Plan as outlined in the national WRES Model Employer strategy. Merton CCG - WRES Report 2018-19

Merton CCG 1 April 2018 - 31 March 2019

What is the data telling us? 37% of Merton communities are from a BME

• background. That said, Merton CCG workforce reflects

41% BME as at the 31 March 2019.

• Overall 91% of staff reported their ethnicity as at 31

March 2019. This is an increase of 4% on the previous year where 87% of staff reported their ethnicity.

• The disclosure rate has improved year on year.
• BME staff increased by 2% on the previous year.

What have we done over the last year?

• Staff are encouraged to report their ethnicity as part
• f recruitment and selection processes on an ongoing

basis.

• Periodic data cleansing of the Electronic Staff

Records (ESR) was undertaken and information gaps are addressed through communications to staff to update their personal information.

Merton CCG WRES 2018-19

Table 1

Achieving

Merton CCG Workforce Ethnicity

2017-18 2018-19 White

32 48% 38 50%

BME

26 39% 31 41%

Not disclosed

8 12% 7 9%

Total

66 100% 76 100%

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Merton CCG WRES 2018-19 Report

What is the Data telling us?

• Table 2 shows a decrease of 5% of BME staff in

bands 1-7 in 2018-2019 compared to the previous year.

• White and BME staff mirrored on percentage of 45%

for 2018-2019.

• BME staff have increased in Bands 8-9 by 4%

compared to the previous year.

• The cohort who chose not to disclose their ethnicity

decreased by 5% from the previous year. What have we done over the last year?

• Staff were encouraged to report their ethnicity as

part of the recruitment and selection process on an

• ngoing basis.
• Periodic data cleansing of the Electronic Staff

Records (ESR) was undertaken and information gaps were addressed through communications to staff to update their personal information.

Table 1

Indicator 1

Percentage of staff in each of the AfC Bands 1-9 and VSM (including executive Board Members) compared with the percentage of staff in the overall workforce disaggregated by: Non-Clinical staff/Clinical staff Table 2

Developing

44% 45% 53% 54% 50% 45% 37% 41% 6% 10% 10% 5% 0% 10% 20% 30% 40% 50% 60% 2017 - 2018 2018 - 2019 2017 - 2018 2018 - 2019 Band 1-7 Band 8-9

Workforce by Bands 2017-18 – 2018-19 - Merton

White BME Not disclosed

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Indicator 2

Merton CCG WRES Report 2018-19

Relative likelihood of staff being appointed from shortlisting across all posts

WRES guidance states A figure below “1” would indicate that white candidates are less likely than BME candidates to be appointed from shortlisting. What is the data telling us?

• Table 3 shows once shortlisted White candidates are

6.70 times more likely to be appointed to roles than BME candidates in 2018-19. This is an increase on the previous year where White candidates at 1.84 were nearly twice as likely to be appointed than BME candidates.

• Recruitment activities in 2018-19 were relatively low due

to the increased recruitment activity to form the Local Delivery Unit (LDU) in the last year.

• In 2018-19 BME candidate numbers in the shortlisted

category has increased by (46%) compared to the previous year.

• Overall there is an increase of 60% of White staff being

appointed in 2018-19 compared to the previous year.. What have we done over the last year?

• Recruitment and selection training for interview panels,

which included unconscious bias training was implemented from 2017-18.

• Explored positive action initiatives from other areas

including other CCGs’ best practice.

Table 3

2018 - 19 2017 - 18 2018 - 19 2017 - 18 2018 - 19 2017 - 18 A P P LIC A NT S S H ORT LIS T E D A P P OINT E D 27% 27% 36% 16% 80% 20% 67% 67% 61% 15% 20% 11% 6% 6% 3% 14% 0% 14%

Merton CCG Recruitment 2018-19

White BME Not disclosed

Under- developed

Merton CCG

2017 -18 2018-19

White BME White BME

Number of staff in workforce

32 26 38 31

Number short listed applicants

35 83 43 72

Number appointed applicants

7 9 4 1

Ratio shortlisting to appointment

0.2000000000 0.1084337349 0.0930232558 0.0138888889

Relative likelihood of White staff being appointed from short listing compared to BME staff

1.84 6.70

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Indicator 3

11

Merton CCG 2017- 2019

Indicator 3: Disciplinary Process White BME Number of staff in workforce 38 31 Number of staff entering formal disciplinary 1 Likelihood of White staff entering formal disciplinary 0.02 The relative likelihood of BME staff entering formal disciplinary compared to White staff What is the data telling us?

• Due to the small total number of formal

disciplinary processes raised over the two-year rolling period, the data may not be statistically significant.

• Table 4 shows that White staff are more likely

than BME staff to enter the formal disciplinary process. What have we done over the last year?

• Continued to monitor this indicator by ethnicity to

identify any trends over time.

• Introduced mandatory BME representation on

formal disciplinary panels.

• Monitor formal disciplinary investigations,

performance/ capability and mediation data going forward.

Achieving

Merton CCG WRES Report 2018-19

Table 4

Relative likelihood of staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation (This indicator will be based on data from a two-year rolling average of the current year and previous year)

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Merton CCG WRES 2018-19

2017-18 2018-19

White BME White BME Number of staff in workforce

32 26 38 31

Number of staff accessing non mandatory training and CPD Likelihood of White staff accessing non- mandatory training and CPD Likelihood of BME staff accessing non- mandatory training and CPD Relative likelihood of White staff accessing non-mandatory training and CPD compare to BME staff

What is the data telling us?

• Information for non-mandatory and CPD training was not routinely

collected in 2017-18. That said, the CCG has now put mechanisms in place and developed a Workforce System which enables the capture

• f non-mandatory CPD and training across the organisation.

What have we done over the last year?

• Gathered equality data to support the reporting of this metric through

an analysis of PDPs and recording of all formal and informal non- mandatory training that staff benefit from such as secondments, attendance at conferences and workshops, mentoring and shadowing

• Publicised non-mandatory training and CPD programmes to all staff
• Encouraged and motivated all staff through PDP & objective setting
• Ensured that the Workforce System is enabled to capture non-

mandatory training going forward. What are we planning for 2019-20?

• Plan to roll-out reverse mentoring programme as part of the potential

merging of the SWL CCG.

• The Workforce System now enables the capture of non-mandatory

CPD and training across the organisation, so that staff can proactively log additional activities.

Indicator 4 Relative likelihood of staff accessing non-mandatory training and CPD

Table 6

Under- developed

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Summary of 2018-19 Staff Survey outcomes (WRES Indicators 5-8)

Merton CCG 2017 2018 Average Median for CCGs’

5 KF25 – percentage of staff experiencing harassment, bullying

• r abuse from

patients/relatives or members of the public in last 12 months Of the total who responded those who said ‘YES‘: White: 6.7% (15) BME: 0% Of the total who responded those who said ‘YES’: White: 22% (18) BME: 0% White: 9.4% BME: 10% 6 KF26 – percentage of staff experiencing harassment, bullying

• r abuse from staff in

last 12 months Of the total who responded those who said ‘YES’: White: 20% (15) BME: - Of the total who responded those who said ‘YES’: White: 33.3% (18) BME: 33.3% (15) White:18.9 % BME: 29.8 %

Indicators 5-6 National NHS Staff Survey Indicators 2018-19

What is the data telling us? 26 members of staff completed the 2018 NHS staff

• survey. This is less than a quarter of the workforce.

The WRES guidance states if the numbers are below 11 then a dash is used to indicate low levels of

• response. It is difficult to publish data without

identifying individuals, or where the numbers of BME responses to the staff survey are too low to merit publication without potentially identifying individuals.

• Table 7 shows 22% of White staff reported that

they experienced harassment, bullying or abuse from patients/relatives or members of the public in the last 12 months.

• This has increased by 15.3% on the previous year

and is above the national average of 9.4%.

• Staff experiencing harassment, bullying or abuse

from staff in the last 12 months has increased by 13.3% for White staff and BME staff has also increased to 33.3% compared to the previous year where no numbers were recorded due to low response from BME staff. This is above the national average of 29.8%. What have we done over the last year?

• MCCG implemented a best practice approach to

recruitment and selection, included BME staff on senior recruitment panels.

Under- developed

Merton CCG WRES 2018-19

Table 7

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Merton WRES Report 2018-19

Indicators 7-8 National NHS Staff Survey Indicators 2018-19

What is the data telling us? The WRES guidance states if the numbers are below 11 then a dash is used to indicate low level of

• response. It is difficult to publish data without

identifying individuals, or where the numbers of BME responses to the staff survey are too low to merit publication without potentially identifying individuals. .

• Table 8 shows for 2018 that 90.9% of White staff

believe that the organisation provides equal

• pportunities for career progression or promotion.

This is an improvement on the previous year.

• Due to numbers below 11 there were no data on

last year to compare BME and White staff experiences.

• White staff personally experiencing discrimination

at work from manager/ team leader or other colleagues has decreased by 6.7% which is still slightly above the national average of 4.6%.

• However, for BME staff this has increased to

33.3% compared to the previous year. This is well above the national average of 14%. There were no data on last year to compare BME staff experiences. What have we done over the last year?

• MCCG has implemented a best practice

approach to recruitment and selection.

• Promoted ‘Dignity at Work’ Policy through

different initiatives across the CCGs.

Under- developed

Summary of 2017-18 Staff Survey outcomes (WRES Indicators 5-8)

Merton CCG

2017 2018 Average Median for CCGs’

7 KF21 percentage of staff believing that the

• rganisation provides

equal opportunities for career progression or promotion Of the total who responded those who said ‘YES’: White: 6.7% (15) BME: - Of the total who responded those who said ‘YES’: White: 90.9% (11) BME: - White: 88.1% BME:59.3% 8 Q17b in the last 12 months have you personally experienced discrimination at work from manager/team leader or other colleagues Of the total who responded those who said ‘YES’: White: 6.7% (15) BME: - Of the total who responded those who said ‘YES’: White: 0% BME: 33.3% (15) White: 4.6% BME: 14%

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Table 8

Indicator 9:

Merton CCG WRES 2018-19

What is the data telling us? Currently MCCG Governing Body members is not reflective of its workforce and the local population it serves. There are currently no BME GB Members on the Board in 2018-19 The difference (total Board-overall workforce - please see SDCS data) 2017-18

• White: 37.2%
• BME: -39%
• Not disclosed: – 2.2%

2018-19

• White: 20.6%
• BME: -40%
• Not stated: 20.2%

What have we done over the last year?

• Explored positive action initiatives from other areas across the sectors, including other CCGs best practice.

Percentage difference between (i) the organisations’ Board voting membership and its overall workforce and (ii) the organisations’ Board executive membership and its overall workforce

Table 9

Under- developed

Total of GB members 2017-18 2018-19 CCG Workforce Number % Number % Number % White 12 86% 12 71% 38 52% BME 0% 0% 31 42% Not stated 2 14% 5 29% 4 5% Total 14 100% 14 100% 73 100%

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

Voting GB members 2017 -18

2018 -19 CCG Workforce

Number % Number % Number % White 8 80% 7 58% 38 52% BME 0% 0% 31 42% Not stated 2 20% 5 42% 4 5% Total 10 100% 12 100% 73 100% Non-Exec - GB members 2017-18 2018-19 CCG Workforce

Number % Number % Number %

White

6 71% 10 86% 38 52%

BME

0% 0% 31 42%

Not stated

1 29% 4 14% 4 5%

Total

7 100% 14 100% 73 100%

Non -voting GB members 2017-18 2018-19 CCG Workforce Number % Number % Number % White 4 100% 6 86% 38 52% BME 0% 0% 31 42% Not stated 0% 1 14% 4 5% Total 4 100% 7 100% 73 100%

Exec- GB members 2017-18 2018-19 CCG Workforce

Number % Number % Number % White 6 86% 2 67% 38 52% BME 0% 0% 31 42% Not stated 1 14% 1 33% 4 5% Total 7 100% 3 100% 73 100%

16

Indicator Status and Priority level Point for focus Action Owner Planned review date

1 and 9 Senior BME Representation in Bands 8+, VSM, GB

• 2-hour recruitment and selection training for all LDU recruiters / managers and Governing Body Members (to

include unconscious bias awareness avoidance)

• Continue to attract applicants from the local community by publicising jobs locally. More senior jobs are already

advertised in the HSJ but recruiters should be encouraged to promote vacancies through LinkedIn, Daily Comms round-up and other targeted local and national publications i.e. The Voice (BME national publication)

• Recruitment plans for Governing Body vacancies support representation of the workforce and community as aligned to

NHS Long Term Plan the Interim NHS People Plan and A Model Employer: Increasing black and minority ethnic representation at senior levels across the NHS

• Use of Resources Group now in place to consider new/ interim positions

HR/ LDU Executive team March 2020 2 To address the variance in recruitment likelihood between BME and White Staff

• Deep–dive exercise to identify trends with internal recruitment process via staff survey
• Ensure all interview panels have had Recruitment and Selection and Unconscious Bias training
• Ensure there is a BME panel member on the selection panel for positions in Band 8 and above
• Weekly information to be shared via staff briefing / newsletter about new staff, leavers and interims

OD Team / HR Director March 2020 3

To continue to monitor any disciplinary cases

• Continue to monitor this indicator by ethnicity to identify any trends over time.
• Introduce mandatory BME representation on formal disciplinary panels
• Monitor formal disciplinary investigations, performance/ capability and mediation data going forward.

HR March 2020 4 To assess the impact

• f non-mandatory

training on BME career progression

• Develop monitoring through workforce to capture non-mandatory training i.e. staff conference, secondment,

acting-up

• Publicise non-mandatory training and CPD programmes to all staff
• Monitor the PDP process for BME staff to ensure they are being offered and taking up development
• pportunities
• Rollout training for line managers to ensure they are familiar with the appraisal process and are systematically

identifying training needs through PDPs, with any additional needs identified being considered to be funded by the CCG

• Statutory and Mandatory training process to become standard as part of local place induction (all courses to be

completed during the first week of commencing employment) – current staff training is monitored monthly

• Local place induction to include link to PPI and equalities team to ensure all staff are aware of commitment to

involving local people, promoting equality and reducing health inequalities

• Individual application processes for higher level courses for example Masters will be reviewed and triangulated

according to the LDU Learning and Development policy. This is currently under review across SWL

OD/HR March 2020 5 and 6 Reducing incidences

• f bullying and

Harassment within Merton CCG

• Ensure support is provided to CCG staff including service user representatives, to identify prevalence of

harassment bullying or abuse. This will be done through organisation’s commitment to wellbeing

• Implemented a best practice approach to recruitment and selection including BME staff on senior recruitment

panels

HR//OD March 2020 7 and 8 Develop and promote culture of inclusion throughout Merton CCG

• Active monitoring of the ethnic breakdown of those in senior roles and how representative this is compared to

the staff population overall

• Promote ‘Dignity at Work’ policy through different initiatives across south west London

HR/MD/OD March 2020

Action Plan 2019-20

Merton WRES Report 2018-19

RAG status key

BME experience equivalent to white experience Some difference between BME and white experience Large difference between BME and white experience

To know more

If you would like to discuss any element of this report, please contact: Julie Hesketh, Director of Quality & Governance (Merton and Wandsworth CCGs) Email: Julie.Hesketh@swlondon.nhs.uk Mobile:07920 331830