Equality, Diversity and Inclusion Strategy 2025-2029

Foreward

The Trust serves a population of 5.6m people covering an area of more than 5,000 square miles made up of Shropshire, Herefordshire, Worcestershire, Staffordshire, Warwickshire, Coventry, Birmingham, and Black Country conurbation.

The West Midlands is full of contrasts and diversity. It includes the second largest urban area in the country (Birmingham, Solihull, and the Black Country) yet over 80% of the area is rural. We are the second most ethnically diverse region in the country after London which makes it vital that we work closely with the many different communities we serve. Ensuring we listen and respond to their suggestions and comments ensures that our service meets the needs of everyone in the region.

We are determined to value difference and promote equality, and ensure that all individuals, whether staff or patients, have a high-quality caring experience of NHS services. We are keen to commission the right health care services, by having well-trained staff who can ensure that our Providers meet the equality duties set out in the Equality Act 2010.

West Midlands Ambulance Service is highly committed to equality and inclusion, and this strategy demonstrates our vision for achieving equality and Inclusion. We are dedicated to developing an organisational culture that promotes inclusion and embraces diversity, ensuring that the focus on equality and inclusion is maintained across the Trust.

Building and valuing a diverse and inclusive workforce takes purpose and dedicated action, but the benefits are substantial, both to ourselves and those we serve. The Trust continues to progress and embed, Equality, Diversity and Inclus/tabion into everything we do.

Carla Beechey – Director of People

Anthony Marsh – Chief Executive

Mohammed Ramzan – Equality Lead

Introduction

As the region’s emergency ambulance service, we respond to around 4,200 ‘999’ calls each day. To manage that level of demand, we employ approximately 7200 staff and operate from 15 fleet preparation hubs across the region, and two 999 Emergency Operations Centres. We also provide non-emergency patient transport services across the region for those patients who require non-emergency transport to and from hospital and who are unable to travel unaided because of their medical condition or clinical need. Our staff complete just under 1 million non-emergency patient journeys each year.

We have developed this strategy, not only to comply with our legal obligations under the Equality Act 2010, but because we believe wholeheartedly that it is the right thing to do. Diversity and inclusion must be integral to our culture and values, and we must strive to make them visible in everything we do. They are an intrinsic part of helping us to improve the patient experience, our workplace culture and to highlight the additional needs of those with a protected characteristic.

Our approach to diversity and inclusion goes beyond legal compliance – it is central to our core business. The strategy builds on our long-term commitment to achieving this ambition and how it will enable us to meet the needs of the communities and our workforce. Our Equality Strategy embraces the Equality Act 2010 and NHS mandated requirements and therefore we will be delivering on the following as part of the strategy:

• The Equality Act 2010 – Setting Equality Objectives and publication or workforce information

• NHS Equality Delivery System

• Gender Pay Gap, Ethnicity Pay Gap

• Workforce Race Equality Standard (WRES)

• Workforce Disability Equality Standard (WDES)

Each year, we will assess the progress we have made on delivering our objectives and action plans which will be reported through the Trust Board. Our equality objectives have been agreed through consultation.

Our Strategy

This strategy sets out our commitment to taking equality and inclusion into account in everything we do. We recognise the importance of embedding equality principles and practices within the organisations business activities that will support us as a dynamic ambulance Trust which provides appropriate and timely services for our local population.

We believe integrating equality and inclusion within our mainstream activities makes good business sense which will help to ensure equality of access and better health outcomes for patients and service users whilst having a well-supported and motivated workforce which understands and reflects the diverse communities we serve.

The four-year strategy determines our strategic equality objectives and sets out core areas of work and the actions we will take to fulfil our ambitions. It applies to everyone who visits or works in any of our sites, uses our services, patients and communities, regardless of race or ethnicity, sex, gender reassignment, disability, sexual orientation, age, religion or belief, pregnancy and maternity, socio-economic background and any other distinction.

The strategy is underpinned by our Equality Objectives which are embedded within this strategy.

About us

Many people still think ambulance services only take patients to hospital. In fact, only just over 50% of our patients end up going to an emergency department with the rest either being treated at the scene or in their home, given advice over the phone or taken to another service such as a GP or minor injuries unit. We have achieved that by investing heavily in the skills that our staff have. We are the first Trust in the country to have a paramedic on every vehicle and continue to operate this delivery model.

Our Diversity and Inclusion vision is centred around three pillars:

1. Build a diverse pipeline of people into WMAS as well as valuing diversity of thought and experience of our existing staff.
2. Create an inclusive workplace for all.
3. Reflect diversity in the delivery of our service to the diverse communities we serve.

Legal Duties

The Equality Act 2010 imposes general and specific duties on all public bodies.

The General Equality Duty

The general equality duty applies to public authorities. In summary, those subject to the general equality duty must, in the exercise of their functions, have due regard to the need to:

• Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act.
• Advance equality of opportunity between people who share a protected characteristic and those who do not.
• Foster good relations between people who share a protected characteristic and those who do not.

The Equality Act explains that the second aim (advancing equality of opportunity) involves having due regard to the need to:

• Remove or minimise disadvantages suffered by people due to their protected characteristics.
• Take steps to meet the needs of people with certain protected characteristics where these are different from the needs of other people.
• Encourage people with certain protected characteristics to participate in public life or in other activities where their participation is disproportionately low.

The Act states that meeting different needs includes (among other things) taking steps to take account of disabled people’s disabilities. It describes fostering good relations as tackling prejudice and promoting understanding between people from different groups. It explains that compliance with the general equality duty may involve treating some people more favourably than others. To comply with the general equality duty, a public authority needs to have due regard to all three of its aims.

The Specific Public Sector Equality Duty

The specific duties were created by secondary legislation in the form of regulations. This guide relates to the specific duties for England (and non-devolved public authorities in Scotland and Wales). In summary, each listed authority is required to:

1. Publish annual information to demonstrate its compliance with the general equality duty. This information must include information relating to people who share a protected characteristic who are:

• The Trust employees

• People affected by its policies and practices.

• Each listed public authority must prepare and publish one or more objectives that it thinks it needs to achieve to further any of the aims of the general equality duty. This must be done every four years. The objectives must be specific and measurable. The Trust, through involvement, engagement and consultation have established the Equality Objectives which are detailed in this Strategy.

Both the equality information and the equality objectives must be published in a manner that is accessible to the public. The Trust will ensure that organisational equality information and an update report on the equality objectives is published annually on the respective web pages.

Our Core Values

We have established three core values:

1) We will attract, select and retain a diverse range of talented people to work at the Trust and will value the contribution made by everyone.

2) We will embrace the diversity of all our staff, patients, service-users, visitors and everyone associated with the Trust to create an environment where people are comfortable to be themselves and realize their full potential.

3) We will challenge inequity in all its forms and will promote dignity, respect and understanding within the Trust and the wider community

We believe in fairness and equity, and value diversity in our role as both a provider of services and as an employer. WMAS aims to provide accessible services that respect the needs of each individual and exclude no-one. We are committed to eliminating discrimination in the workplace and ensuring we understand and enact our responsibilities under The Equality Act 2010.

We recognise that discrimination can be direct or indirect and takes place within organisations and at a personal level. Such discrimination is unacceptable and unlawful. We have a zero-tolerance approach towards behaviour that amounts to harassment or the exclusion of any individual.

We expect all WMAS employees to fulfil their responsibilities and to challenge behaviour or practice that excludes or is offensive to service users, suppliers, or colleagues. WMAS continues to develop a healthcare workforce that is diverse, non-discriminatory, and appropriately skilled to deliver modern healthcare services to all

Equality Protected Groups

To comply with the general duty, a public authority needs to have due regard in relation to the following nine equality protected characteristics:

Our Vision for Equality and Inclusion – Practical Steps

Equality Delivery System 3

The Trust has adopted the Equality Delivery System (EDS3) as its performance toolkit to support the organisation in demonstrating its compliance with the three aims of the Public Sector General Equality Duty.

The EDS3 grading process provides the Trust’s Governing Body with an assurance mechanism for compliance with the Equality Act 2010 and enables stakeholders to co-design the equality objectives to ensure improvements in the experiences of patients, service users and employees.

The main purpose of the EDS3 is to help local NHS organisations, in discussion with local partners including local people, review and improve their performance for people with characteristics protected by the Equality Act 2010. By using EDS3, NHS organisations can also be helped to deliver on the Public Sector Equality Duty. Utilisation of the EDS3 framework provides a way for the Trust to show how it is doing against the three Domains: NHS England » Equality Delivery System 2022

Essentially, there is just one factor for NHS organisations to focus on with the grading process. For most outcomes the key question is: how well do people from protected groups fare compared to people overall? There are four grades – undeveloped, developing, achieving and excelling.

Plans will be put in place to identify appropriate Outcomes from EDS3 framework. The grading will then be published annually as part of the organisation annual report and published on the respective Trust website.

Workforce Equality Standards: Race and Disability

NHS Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) are a useful tool to identify and reduce any disparities in experience and outcomes for NHS employees and job applicants. The Standards will be used to track progress to identify and help eliminate discrimination in the treatment of Black and Minority Ethnic (BME) employees and employees with a Disability.

The Governing Body of the Trust will ensure, through overview and reporting processes, that the Trust is evidencing due regard by using the WRES and WDES 12 indicators to help improve workplace experiences, and representation at all levels within the workforce.

The Trust will be collating and analysing WRES and WDES data with the aim of improving the quality of data whilst ensuring that action plans are put in place to address any disparities. The Trust is committed to analysing and putting into action, plans to address issues and concerns throughout the duration of this Strategy with all progress and findings presented to the Diversity and Steering Action Group (DISAG) and the People Committee.

Gender Pay Gap, Ethnicity Pay Gap and Disability Pay Gap

The Trust has a statutory responsibility to deliver on the Gender Pay Gap. We have actively put measures in place in the past few years to reduce the Gender Pay Gap which have proved successful. This work will continue throughout the duration of the Equality Strategy. Although not a statutory requirement at present, the Trust has been collecting the Ethnicity Pay Gap data in 2023 and 2024 because we believe that this is the right thing to do. Any findings will be linked to the WRES action plan and measures put in place to reduce the ethnicity pay gap. The Trust has been working closely with The Black Country Integrated Care System (ICS)and the Trust Chief Executive has pledged to Improve data collection and analysis for Gender Pay Gap, Ethnicity Pay Gap, and the Disability Pay Gap. The Trust will be looking to work closely with the ICS in the Development and implementation of action plans related to Ethnicity, Gender and Disability action plans.

Accessible Information Standard, Interpreting and Translation

The aim of the Accessible Information Standard is to make sure that people who have a disability, impairment or sensory loss receive information that they can access and understand and any communication support that they need. The Trust has introduced a brand-new website. It is partially compliant with the Web Content Accessibility Guidelines version 2.2 AA standard (WCAG 2.2 AA). For example, that means you should be able to:

• change colours, contrast levels and fonts
• zoom in up to 400% without the text spilling off the screen
• navigate most of the website using just a keyboard
• navigate most of the website using speech recognition software
• listen to most of the website using a screen reader (including the most recent versions of JAWS, NVDA and Voiceover)
• We’ve also made the website text as simple as possible to understand.

We have held two accessibility Audits in December 2024 and June 2025 and continue to make upgrades to make it more accessible. For more information see the Trust website: you can find more details here.

West Midlands Ambulance Service will ensure that the service is accessible through the utilisation of appropriate interpreting and translation services when communicating with patients. Our organisation is expected to use the appropriate interpreting, translating or preferred method of communication for those who have language and/or other communication needs. Practitioners will need to assess that the service is fair and equitable for all groups covered under the Equality Act 2010. The Trust will be using the Tender process, which has equality embedded within, to procure the most appropriate and effective interpreting and translation service.

Equality Objectives 2025-2029

We have a legal obligation to publish our equality objectives under the Public Sector Equality Duty. These must be reviewed every four years and should be based on our consultation and involvement with stakeholders. The following high level Equality Objectives are based on findings from workforce data that has been collated from but not limited to Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) data.

Objective 1: Equality Standards

Our commitment to meeting the Equality Standards set by NHS England will be demonstrated by the implementation and monitoring of the following standards:

• Workforce Race Equality Standard
• Workforce Disability Equality Standard
• Gender Pay Gap Reporting
• Ethnicity Pay Gap Reporting
• Commitment to Disability Pay Gap reporting when the national reporting tool is available through ESR
• Equality Delivery System 3

We will do this by:

• Implementing and strengthening our approach to the NHS Equality Delivery System 2 (EDS3) (are you ok with how we will demonstrate this strengthening and improvement?)
• Continue to develop our response to the Workforce Race and Disability Equality Standards (WRES) (WDES)
• Collating Gender and Ethnicity Pay Gap data and identifying actions to address the gap.
• Keep invigorating and supporting the staff equality networks to ensure they are aligned with our strategic equality objectives.
• Working collaboratively with the local Integrated Care System/Board (subject to the new reconfiguration)

Objective 2: Reflective and diverse workforce

We will enhance our approach to recruitment, selection and promotion to positively attract, retain and support the progression of diverse staff across the Trust. We will do this by:

• Target local and diverse communities in recruitment campaigns
• Through the utilisation of the Workforce Race Equality Standard action plan
• which will detail specific actions that will be monitored at DISAG and People
• Committee
• Support managers and teams to be inclusive
• Work closely with external partners and providers (e.g., university paramedic
• programmes) to ensure diversity among the student group, and appropriate
• course content
• Ensure the recruitment and selection training programme informs recruiting
• staff and managers of their legal duties under the Equality Act 2010

Objective 3: Ensure our leadership is committed to creating an environment that promotes and values equality and diversity and this is embedded in all we do

We will do this by:

• Delivering diversity and inclusion training to all members of the Board of Directors and Council of Governor’s
• Ensuring all our leaders have specific diversity & inclusion objectives in their annual objectives with performance discussed during their appraisals
• Board and Committee reports include due consideration to Diversity and Equality and have an equality impact analysis where appropriate or required.

Objective 4: A healthy, fair and more resilient workforce

To create a healthy, fair and more resilient workforce by systematically tackling the root causes of health inequalities within the Trust – ensuring all staff, regardless of role, background, or personal circumstances, have equal opportunities to thrive in work and wellbeing.

We will do this by:

• Prioritising preventative approaches, including health screening, lifestyle support and early intervention services
• Equipping leaders and managers with the knowledge and tools to identify and reduce health inequalities within their teams
• Promoting an organisational culture that champions reducing health inequalities
• Ensuring all patients receive accessible and culturally sensitive care – patient experience will need capture relevant data to achieve this outcome.

These Equality Objectives will sit with the equality action plans and be monitored at the Diversity, and Inclusion Steering Action Group (DISAG) and People Committee.

Health Inequalities

The Trust has a health inequalities strategy that focuses on reducing disparities in health outcomes by addressing socio-economic factors, access to care, and other determinants.

As part of the health inequalities strategy, the Trust produced its health inequalities workforce plan and has been working on reducing health inequalities for staff by establishing a number of key outcomes as follows:

1) Reducing health inequalities through ensuring the workforce reflects the community it serves involves creating a diverse, inclusive, and culturally competent workforce that understands and addresses the unique needs and preferences of the community. A diverse workforce can provide better care, improve communication, and build trust with community members, leading to more equitable health outcomes.

2) Reducing health inequalities through inclusive recruitment involves creating a diverse and inclusive workforce that reflects the community it serves. Inclusive recruitment practices can help address health disparities by ensuring that healthcare providers are culturally competent, understand the needs of diverse populations, and can effectively communicate and connect with patients from various backgrounds.

3) Reducing health inequalities through creating a workplace environment that promotes health and well-being for all employees, regardless of their socioeconomic status, age, gender, or other demographic factors.

4) Reducing health inequalities through job satisfaction involves creating a positive and supportive work environment where all employees feel valued, engaged, and motivated. Job satisfaction can significantly impact an individual’s physical and mental health, so focusing on improving job satisfaction can help reduce health inequalities among employees

5) Reducing physical impacts also reduces inevitable health problems for our workforce due to the nature of our work.

6) New and/or existing health conditions refer to disparities or differences experienced in health outcomes, access to healthcare, and work-related opportunities among employees who have pre-existing health conditions. Addressing these inequalities is essential for creating a fair and supportive work environment.

Working with the Local Integrated Care System

NHS England produced the NHS equality, diversity and inclusion (EDI) improvement plan in 2023 which the Trust has been working on. The plan aims to enhance the sense of belonging for NHS staff to improve their experience and builds on the NHS England People Promise and the People Plan, using data and evidence it sets out six High Impact Actions (HIA):

• HIA 1: Measurable objectives on EDI for Chairs, Chief Executives and Board members
• HIA 2: Overhaul recruitment processes and embed talent management processes
• HIA 3: Eliminate total pay gaps with respect to race, disability and gender
• HIA 4: Address Health Inequalities within the workforce
• HIA 5: Comprehensive induction and on-boarding programmes for international recruited staff
• HIA 6: Eliminate conditions and environment in which bullying, harassment and physical violence occurs.

Work is underway by the Trust in delivering on the EDI improvement plan and the six HIAs, in collaboration with the local Integrated Care System and the Chief Executive of WMAS has pledged to take leadership on HIA3 – Eliminate pay gaps in respect of Race, Disability and Gender.

Equality and Diversity Improvement Plan for the Ambulance Sector

The Equality, Diversity and Inclusion (EDI) agenda is becoming increasingly important for the Ambulance Sector. Data and evidence suggest that many forms of discrimination and poor behaviours continue to exist in the sector and there is an urgent need for these to be addressed. The Trust aims to support the recommendations as identified on EDI indicators by the Association of Ambulance Chief Executives (AACE), which are to; reduce disparities in recruitment, disciplinary actions and improve the experience of staff from under-represented groups.

Building on the existing EDI Improvement Plan actions that all NHS organisations are asked to deliver against, the following section makes recommendations for consideration specifically for the ambulance sector and in relation to the national Ambulance Culture Review. These actions build upon the existing EDI High Impact Actions and EDS requirements, which all Ambulance Trusts are already working on.

These are:

1. Demonstrating Trust Board commitment (Maps to HIA 1)
2. Demonstrating sector wide leadership commitment (Model Employer and maps to HIA
3. Improve the diversity of the ambulance leadership community (Maps to HIA 2 Maps to HIA 3)
4. Each service should aim to reflect the diversity of their local population (Maps to HIA 2 & HIA 5)
5. Provide support for the wider needs of staff (Maps to HIA 4)
6. Continue to develop vibrant and proactive staff networks (Maps to HIA 6 & HIA 4)
7. Leadership training for all front-line leaders on how to address discrimination, bullying and harassment (Maps to HIA 4)

Throughout the duration of this strategy, the Trust will integrate the High Impact Actions and the recommendations by the national Association of Ambulance Chief Executives and deliver at a local level through appropriate action plans. These action plans will be monitored by the DISAG and the People Committee for assurance.

Equality Impact and Risk Assessments

The Equality Impact Assessment process (EIAS) provides a framework for undertaking EIAs. This enables the Trust to show ‘due regard’ to the three aims of the general equality duty by ensuring that all requirements around equality, human rights and privacy are given advanced consideration prior to any policy decisions that the Trust’s Governing Body or senior managers make, that may be affected by these issues.

Due Regard means thinking about the aims of the PSED in the decision-making process. This means that consideration must be given to equality issues such as:

• How the Trust acts as an employer
• How the Trust develops, evaluates, and reviews policy
• How the Trust designs, delivers and evaluates services
• How the Trust commissions and procures from others

Training on how to utilise the EIA framework will be delivered to appropriate staff as well as being promoted in the weekly brief and will be available on the intranet for staff to download. Further advice and guidance will be delivered on the EIA process by the equality when needed. The Trust will continue to ensure that the EIA process is integral to the decision-making processes.

Key Performance Indicators

The following Key Performance Indicators will help us to monitor the effectiveness of the Equality Strategy and Objectives and will include analysis and reporting of the following:

1. Target local and diverse communities in recruitment campaigns and through social media leading to an increased percentage of staff from under[1]represented groups.

• Support our staff to better understand each other through raising awareness around different cultures and practices by organizing and promoting events leading to a decrease in harassment and bullying incidences and improved staff survey results for all groups.

• Work closely with external partners and providers – Capture good practice from our partners and peers to improve our diversity and inclusion performance, e.g., working collaboratively with NHS Commissioning, Black Country ICS/ICB, National Ambulance Diversity Forum and Association of Ambulance Chief Executives.

• Delivery on the Equality Act 2010 requirements and NHS mandated standards going above and beyond of what is required of us statutorily leading to the Trust showing year on year improvements in retention and promotion of staff for all groups.

• Continue to collate WRES, WDES, Gender Pay Gap, Ethnicity Pay Gap and Disability Pay Gap data and put in place transformational action plans which lead to service improvements within the Trust which would be bench marked regionally and nationally.

• Provide regular employment data reports to relevant forums including Trust Executive Management Board, Trust Board and equality resource networks.

• Update and deliver appropriate development for colleagues in respect to diversity and inclusion including the production of new resources and CPD leading to increase in promotional roles for under-represented staff cohorts.

• Implement and strengthen our approach to the NHS Equality Delivery System 3 (EDS3) leading to an increase in positive performance for all domains.

• Investigate the experiences/satisfaction of staff through surveys and pulse groups leading to better staff survey results.

1. Support the staff equality networks to ensure they are aligned with our strategic equality objectives leading to increased membership of the respective networks.

1. Support our Chaplains within the Trust leading to greater support for our staff from different or no faiths.

Annual Report and Strategy Review

The Trust People Committee and Diversity and Inclusion Steering Action Group (DISAG) will monitor associated action plans which under-pin this strategy. The Equality Lead will produce an annual equality report, which will provide evidence on progress on our equality objectives and will lead on a review of our strategy every four years.

Further information

Further information about this strategy and other equality and Inclusion work can be obtained from West Midlands Ambulance Service E-mail: [email protected]

The Trust is committed to ensuring that its communication is clear, plain and available to everyone. This strategy can be made available in other languages or formats on request.

Please contact the Communications team on:

Phone (office hours): 01384 215560

Email: [email protected]