EOC(3)  MW015

Equality of Opportunity Committee

Inquiry into Migrant Workers

Response from North West Wales NHS Trust

The North West Wales NHS Trust is a dynamic and progressive organisation that provides services of the highest quality for the counties of Gwynedd, Ynys Môn and parts of Conwy. The Trust employs in excess of 5000 staff and with an annual budget of over £200 million serves a population of approximately 225,000 people, in addition to large numbers of holidaymakers who are attracted to the area every year. The Trust is responsible for 2 Acute Hospitals, 9 Community Hospitals, 2 Mental Health Hospitals and 3 support bed units, all of which are supported by an extensive network of community, mental health and learning disability services 1.

As far as the Trust itself is concerned, the vast majority of migrants with whom it has contact are those who work for the Trust as staff members rather than patients - especially within the cleaning agencies - and it is worth noting that the migrant population surrounding a University has specific characteristics.  Many overseas workers in this area are temporary residents in post graduate education supporting themselves during their studies, whose linguistic ability is already at the upper levels of the international standard.  

In keeping with the multi cultural/multi faith character of its service users, the Trust operates a robust race relations scheme tied into spiritual care, working very closely with the North Wales Racial Equality Network and the Commission for Equality & Human Rights, in order to deliver a holistic approach to patient care and staff welfare.  

Although there is limited up to date information on the numbers of migrant workers within this area, according to the WRS and NINo, Wales as a whole accounted for less than 3% of the A8 applications in 2006, two thirds of which were from Polish migrants, with a further 15% sourced from Slovakia 2.

(1) http://www.northwestwales.org/WiSSCMS-en-207.aspx).

(2) http://new.wales.gov.uk/docrepos/40382/40382313/statistics/economy)

Experience of migrant workers and their families

• From our experience, the greatest problem encountered by migrant workers lies in the lack of information about and, understanding of, the procedure which governs access to secondary sector healthcare.  Many migrant workers are not registered with a GP and do not benefit from the usual access provided via GP services. Also, the language of communication with clinicians can prove problematic.

• The Trust has established an Access Liaison Group which looks at ways the Trust can be accessed by all of its service users and works to address the impact of any potential barriers whether physical, sensory, communicative or cultural.

• The Gwynedd, Anglesey and Trust Joint Patient and Public Involvement  Committee are developing 'must have’ key information pamphlets in Polish, Cantonese and Portuguese.

• A new initiative has been developed with the Trust Volunteer Service to provide basic level English tuition and practice for migrant workers who volunteer within the Trust.

• The Trust Multi Faith Centre hosts both Islamic and overseas Christian Weekly Fellowship meetings where migrant workers can access fellowship, not only with those from their own ethnic background but also with those who share their faith within the indigenous community.

• Recently, a joint initiative was funded by all NHS Trusts, LHBs and Local Authorities to hold an All Wales Health and Social Community Consultation Day in order to gain the views of the migrant population.

The impact of economic migration on local communities

• Challenge to understand cultural background of migrants and extend fellowship. Trust policy is to actively promote understanding, currently planning international cookbook with contribution from different national groupings which may give insight to the rainbow spectrum of cultures within the hospital and a little understanding of their origins.

• The regulatory framework

• All relevant legislation is appropriately applied to employees of the North West Wales NHS Trust including residency requirements, eligibility to work in the UK, Equal Opportunities, Equality and Diversity, etc.   All medical staff employed by the Trust are subject to further regulatory checks as part of their employment application which are additional to the standard, due to the sensitive nature of their work involving children and vulnerable adults.  For this reason, medical appointments are dealt with by Medical Personnel rather than the standard application procedure via Human Resources.

• Examples of good practice

• The Chaplaincy Centre / The Multi Faith Multi Cultural Spiritual Centre

The Chaplaincy Centre co-ordinates the pastoral/spiritual care of patients/staff on the basis of individual needs.  Close links are maintained with key members of staff drawn from the world’s major religions to provide a ready source of expert guidance.
The Multi Faith Centre which opened at Ysbyty Gwynedd in October 2005 now enjoys active twenty-four hour use by staff and patients and it is particularly satisfying to note that the Centre is shared simultaneously by those of different faiths and those of alternative spiritual perspectives.

Early in 2008, the Multi Faith Spiritual Centre will be hosting a 'Round the world poetry exhibition’, with a diverse range of contributors involving many languages and faiths.

• The Partnership

Although the Trust has endeavoured to persevere with the use of the language line, the demands of clinical situations invariably require more than it can provide.  Partner institutions such as Bangor University are a useful source of support. The University database contains information regarding the ethnic origin and linguistic proficiency of all its staff/students and the Head of Admissions has been particularly supportive with requests from the Trust in emergency situations - this relationship will continue to be developed.

Suggestions

• Due to the very limited numbers of some migrant groups, the cost implication of providing information can prove to be exorbitant, therefore, one way forward would be through an All Wales initiative for the provision of information in these specific languages.

• Some form of understanding and directive regarding interpreters would prove beneficial, as staff advise the present system of using the language line has simply not been practical within many clinical situations.

• Raising awareness amongst the general population of local communities regarding the character of some of these migrant communities would be helpful, specifically in terms of communities - rather than the individuals - within the countries of origins.

References

(1) http://www.northwestwales.org/WiSSCMS-en-207.aspx).

(2) http://new.wales.gov.uk/docrepos/40382/40382313/statistics/economy).