Introduction – context

West Yorkshire Health and Care Partnership wants equity, fairness and social justice to weave through all of our work.

In 2024, we set about developing a West Yorkshire Strategy relating to equality, diversity and inclusion (EDI). There are clear connections to our mission, values and behaviours and to support our 10 big ambitions, our Joint Forward Plan and our West Yorkshire Integrated Care Strategy.

In addition, this strategy will help us achieve equity within our programme delivery and help link priorities in our workforce through work such as the West Yorkshire Health and Care Partnership People Plan Workforce Strategy, the Fellowship Programme, System and Leadership Development and the Strategic Race Equality Network.

There are many pressures on our health and care services, including recovery from COVID-19, financial pressures, increased demand, lack of funding in care services and discrimination in the NHS. We must be bold and ambitious despite these challenges.

The differences between equality, equity, justice and inclusion

The image below, courtesy of Kirklees Council, explains what reality, equality, equity, justice and inclusion are and how they look.

It is important to note that there will be other barriers people may experience, for example; visual impairments or health inequalities.

Five views of a football match, representing the ideas of reality, equality, equity, justice and inclusion. A full description of the image is on this web page.

Reality

One gets more than is needed while the other gets less than is needed. A huge disparity is created.

In the first image, person 1 has been given four boxes to stand on. Person 1 was already really tall, and with the aid the the boxes has a great view of the game. Person 2 has been given one box to stand on and with the aid of this box is just tall enough to see the game over the fence. Person three also has one box but is unable to stand on it so cannot see the game at all. One gets more than is needed while the other gets less than is needed. A huge disparity is created.

Equality

The assumption is that everyone benefits from the same support. This is considered to be equal treatment.

In the second image, all three people have been given one box to stand on. Person 1 still has a good view of the game and the view is the same as before for person 2. Person 3 is now standing on the box but is much shorter than person 2 so cannot see the game at all. The assumption is that everyone benefits from the same support. This is considered to be equal treatment.

Equity

Everyone gets the support they need which produces equity.

In the third image, Person 1 has no boxes to stand on because they are tall enough to see the game just standing up. Person 2 still has one box and can see the game. Person 3 has two boxes to stand on and can now see the game. The boxes make all three people the same height. Everyone gets the support they need which produces equity.

Justice

All three can see the game without support or accommodations because the cause of the inequity was addressed. The systemic barrier has been removed.

In the fourth image, the fence has been removed so no-one needs a box to stand on. All three can see the game without support because the cause of the inequity was addressed. The systemic barrier has been removed.

Inclusion

Everyone is included in the game. No one is left on the outside. The barriers have been removed, everyone feels valued and involved.

In the final image, the spectators are now playing the game. Everyone is included in the game. No one is left on the outside. The barriers have been removed, everyone feels valued and involved.

We are acutely aware of health inequalities across our populations, in access, experience and in outcomes. This work must align to priorities already in place to reduce these health inequalities.

Lots of work has taken place to embrace equality, value diversity and promote inclusion.
We want to build on that work and be better at sharing good practice across the health and care system.

It is important for all of us to better understand the power and privilege we each hold.

Sliding scales of power and influence

The table below gives examples of different characteristics. If a person has more characteristics in the second or third columns this means they are more likely to have less power and influence, and more likely to experience health inequalities. If a person has more characteristics in the fourth column, they are more likely to have more power and influence and are unlikely to have experienced health inequalities.

Sliding scales of power and influence
Scales of power and influence	Less power	Some power	More power
Citizenship	Asylum seeker	Refugee	Resident
Skin colour	Dark	Different shade	White
Education	Basic literacy and numeracy	Some qualifications	University
Ability	Significant disability	Some disability	No disability
Sexuality	LGBTQIA+	Gay man	Heterosexual
Neurodiversity	Significant neurodivergence	Neuro-atypical	Neurotypical
Mental health	Serious mental illness	Some mental illness	No mental illness
Body size	Large	Average	Slim
Housing	Homeless	Renting	Property owner
Wealth	Poor	Average	Rich
Language	Speaks no English	English is second language	English
Gender	Trans, non-binary	Woman	Man

Introduction – context

Power of one power of many

Foreword