Building a competent and appropriately skilled workforce is an essential part of modern, effective health care services. There is increasing recognition that wider societal factors such as where a person lives, or which ethnic group an individual belongs to, can have an impact on general wellbeing. Ensuring that NHS Lothian's workforce is appropriately equipped to understand and recognise these factors is a challenge we are undertaking with vigour.

In 2007, NHS Lothian developed its draft Equality and Diversity Strategy. This Strategy outlines our commitment to ensuring that as a service provider and an employer, we do not inadvertently discriminate against anyone on the grounds of gender, ethnic origin, sexual orientation, faith or belief, age or disability. NHS Lothian will strive to go beyond mere compliance with legislation and seek to create a culture where everyone is respected and provided with a service according to their needs.

We will remain vigilant against creating new inequalities as this Strategy is rolled out and seek at all times to focus on an individual as a person and not as someone who is defined by their difference. This will mean moving away from the 'silo' mentality that has often existed in the past to one where we mainstream as many of our services as possible while still remaining alert to the factors that can have a negative impact on health and wellbeing.

Developing this wider capacity for care involves a range of initiatives that can help professionals take on new roles, or which help support people to be better able to provide informal care. In this chapter, three areas where these types of building capacity for care are explored.