From: "Saved by Windows Internet Explorer 8" Subject: Frontline Service EQIA Date: Tue, 31 Mar 2015 15:57:42 +0100 MIME-Version: 1.0 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.staffnet.ggc.scot.nhs.uk/EQIA/Pages/FrontlineService.aspx?eqiaID=66 X-MimeOLE: Produced By Microsoft MimeOLE V6.1.7601.17609 =EF=BB=BF
Equality Impact Assessment = Tool for=20 Frontline Patient Services
Equality Impact Assessment is a legal requirement and = may be=20 used as evidence for cases referred for further investigation for = legislative=20 compliance issues. Please refer to the EQIA Guidance Document while = completing=20 this form. Please note that prior to starting an EQIA all Lead Reviewers = are=20 required to attend a Lead Reviewer training session. Please contact CITAdminTeam@ggc.scot.nhs.uk= for=20 further details or call 0141 2014560.
1. Name of Current Service/Service = Development/Service=20 Redesign:
Bone Marrow =
Transplant=20
In-patient Service, Regional Services Directorate (On the Move=20
Programme) |
2. Description of the service & rationale for = selection for=20 EQIA: (Please state if this is part of a Board-wide service or is = locally=20 determined).
A. What does the service do? = |
A bone marrow =
transplant=20
involves taking healthy stem cells from the bone marrow of one =
person and=20
transferring them to the bone marrow of another person. A bone =
marrow=20
transplant has five stages. These are: 1.physical examination =
=E2=80=93 to assess=20
your general level of health 2.harvesting =E2=80=93 the process of =
obtainin the=20
stem cells to be used in the transplant 3.conditioning =E2=80=93 =
preparing your=20
body for the transplant 4.transplanting the stem cells 5.recovery =
period=20
=E2=80=93during which you'll be monitored for any complications or =
side effects.=20
Patients can be in the hospital for approximately 6-8 weeks, on =
occasions=20
longer. Patients are kept in isolation during this period to =
minimise risk=20
of infection. This is a national service for all donor transplants =
(siblings and volunteer unrelated donors). |
B. Why was this service selected for EQIA? = Where=20 does it link to Development Plan priorities? (if no link, please = provide=20 evidence of proportionality, relevance, potential legal risk etc.) = |
This Service was =
selected as=20
part of the =E2=80=98On the Move Programme=E2=80=99 as the =
in-patient service will be=20
moving to the New South Glasgow University Hospital.=20
|
3. Who is the lead reviewer and when did they attend = Lead=20 reviewer Training? (Please note the lead reviewer must be someone in a = position=20 to authorise any actions identified as a result of the EQIA)
Name: |
Date of Lead Reviewer Training: = |
Marie =
McLaughlin=20
|
28/01/2015=20
|
4. Please list the staff involved in carrying out = this EQIA=20 (Where non-NHS staff are involved e.g. third sector reps or patients, = please=20 record their organisation or reason for inclusion):
Flora Muir, =
Laura Meehan,=20
Nicole McInally |
Lead Reviewer Questions = |
Example of Evidence = Required=20 |
Service Evidence Provided = |
Additional Requirements = | |
1. |
What equalities information is routinely = collected=20 from people using the service? Are there any barriers to = collecting this=20 data? |
Age, Sex, Race, Sexual Orientation, = Disability,=20 Gender Reassignment, Faith, Socio-economic status data collected = on=20 service users to. Can be used to analyse DNAs, access issues etc.=20 |
As part of tissue =
typing, the=20
service collects information on age, gender, disabilities and =
ethnicity.=20
TrakCare can also record requirements for interpreters and =
preferred=20
language. There are no know barriers to collecting this =
information as it=20
is a requirement for the transplant. |
|
2. |
Can you provide evidence of how the = equalities=20 information you collect is used and give details of any changes = that have=20 taken place as a result? |
A Smoke Free service reviewed service = user data=20 and realised that there was limited participation of men. Further=20 engagement was undertaken and a gender-focused promotion designed. = |
Collecting =
information on=20
ethnicity and language requirements identified the need for =
patient=20
information leaflets to be translated into Polish and Simplified=20
Chinese. |
|
3. |
Have you applied any learning from = research about=20 the experience of equality groups with regard to removing = potential=20 barriers? This may be work previously carried out in the service. = |
Cancer services used information from = patient=20 experience research and a cancer literature review to improve = access and=20 remove potential barriers from the patient pathway. |
As a national =
development,=20
cord blood transplant is now available to patients who previously =
would=20
not have had a suitable matched donor, and therefore would have =
been=20
unable to have a transplant. Reduced Intensity Transplantation now =
allows=20
older patients to have a transplant, whereas age was barrier to =
treatment=20
based on treatment outcomes. |
|
4. |
Can you give details of how you have = engaged with=20 equality groups to get a better understanding of needs? |
Patient satisfaction surveys with = equality and=20 diversity monitoring forms have been used to make changes to = service=20 provision. |
The ward routinely =
undertakes=20
the Better Together inpatient survey on a monthly basis. The =
Transplant=20
Service also has a patient statisfaction survey which is given to =
patients=20
on discharge. The Service then deal with any issues that arise.=20
|
The =
Transplant=20
Service Survey will be amended to include an equalities monitoring =
form. |
5. |
If your service has a specific Health = Improvement=20 role, how have you made changes to ensure services take account of = experience of inequality? |
A parenting service includes referral = options to=20 smoking cessation clinics. The service provides cr=C3=A8che = facilities and=20 advice on employability and income maximisation. |
Not =
applicable=20
|
|
6. |
Is your service physically accessible to = everyone?=20 Are there potential barriers that need to be addressed? |
An outpatient clinic has installed loop = systems=20 and trained staff on their use. In addition, a review of signage = has been=20 undertaken with clearer directional information now provided. = |
As mentioned =
earlier, the=20
inpatient service is moving to the New South Glasgow University =
Hospital.=20
There will be buses which will drop patients off near the main =
entrance=20
(i.e. Arrivals Square). There are multi-storey car parks, which =
have=20
disabled parking on the ground floor. There is a drop off point at =
the=20
main entrance to the hospital. There are automatic doors to the =
entrance=20
of the hospital. The service will be located on the 4th floor, and =
there=20
are lifts available. The reception desk has a lowered section for =
patients=20
who have a wheelchair. At this stage we cannot fully comment on =
this new=20
area, as staff have not yet had their induction. =
|
|
7. |
How does the service ensure the way it = communicates=20 with service users removes any potential barriers? |
A podiatry service has reviewed all = written=20 information and included prompts for receiving information in = other=20 languages or formats. The service has reviewed its process for = booking=20 interpreters and has briefed all staff on NHSGGC=E2=80=99s = Interpreting Protocol.=20 |
The Service is =
available of=20
NHSGGC=E2=80=99s Clear to All Policy (previously known as the =
Accessible=20
Information Policy). To date there have been specific requests for =
information to be translated into Polish and Chinese (the Bone =
Marrow=20
Transplant - What Now and Autologous Bone Marrow Peripheral Stem =
Cell=20
leaflets). The Service are aware of how to organise interpreters =
and other=20
forms of communication support. They are also aware that the =
Interpreting=20
Policy is available on NHSGGC Intranet. The Beatson has its own =
external=20
website www.beatson.scot.nhs.uk which includes useful information=20
including patient services; support and information services etc.=20
|
The =
Service is=20
examining the possibility of giving patients an audio version of =
their=20
consultation to enhance their understanding prior to their=20
transplant. |
8. |
Equality groups may experience barriers = when trying=20 to access services. The Equality Act 2010 places a legal duty on = Public=20 bodies to evidence how these barriers are removed. What = specifically has=20 happened to ensure the needs of equality groups have been taken = into=20 consideration in relation to: |
|||
(a) |
Sex |
A sexual health hub reviewed sex = disaggregated=20 data and realised very few young men were attending clinics. They = have=20 launched a local promotion targeting young men and will be = analysing data=20 to test if successful. |
There will be =
approximately=20
15 individual rooms for transplant patients within a larger unit.=20
Transplant patients all have single rooms as they need to be =
isolated to=20
prevent infection. Staff are aware of the NHSGGC Gender Based =
Violence=20
Policy. Staff will try to accommodate requests for same sex health =
professionals. If this wasn=E2=80=99t possible, chaperoning would =
be offered. Same=20
sex interpreters would be booked, as required for individual =
patient need.=20
|
|
(b) |
Gender Reassignment |
An inpatient receiving ward has held = briefing=20 sessions with staff using the NHSGGC Transgender Policy. Staff are = now=20 aware of legal protection and appropriate approaches to delivering = inpatient care including use of language and technical aspects of=20 recording patient information. |
Staff are aware =
of NHSGGC=E2=80=99s=20
Transgender Policy. Staff ensure that patients are treated as =
their chosen=20
gender. If this situation arose, they would ask patients how they =
wish to=20
be addressed. |
|
(c) |
Age |
A urology clinic analysed their sex = specific data=20 and realised that young men represented a significant number of = DNAs. Text=20 message reminders were used to prompt attendance and appointment = letters=20 highlighted potential clinical complications of non-attendance.=20 |
There are links =
to the=20
Teenage Cancer Unit that provides specialist care and provision =
for this=20
age group. Child Protection Training and Adult Protection Training =
has=20
been completed as part of NHSGGC Core training programme. Nursing =
staff=20
have completed LearnPro module in Dementia Awareness. Patients can =
be=20
accompanied by carers if preferred. For younger patients, parents =
can stay=20
with them overnight. Staff would explain treatments and procedures =
in an=20
age appropriate manner. |
|
(d) |
Race |
An outpatient clinic reviewed its = ethnicity data=20 capture and realised that it was not providing information in = other=20 languages. It provided a prompt on all information for patients to = request=20 copies in other languages. The clinic also realised that it was = dependant=20 on friends and family interpreting and reviewed use of = interpreting=20 services to ensure this was provided for all appropriate = appointments.=20 |
Interpreting =
services are=20
available and staff are aware of how to arrange interpreters for =
patients.=20
If an interpreter is used, this is documented in the case notes. =
The=20
interpreter is timed to come regulary at the wards rounds but can =
also be=20
arranged for other times. The length of time can be adjusted e.g.=20
encorporate discussions about going home. The interpreter is =
guided by the=20
ward staff around issues related to infection control and is =
allowed to=20
enter the room with the medical team even when the patient is in=20
isolation. Should a racist incident occur,staff would challenge =
the=20
behaviour and document this via Datix |
|
(e) |
Sexual Orientation |
A community service reviewed its = information=20 forms and realised that it asked whether someone was single or = =E2=80=98married=E2=80=99.=20 This was amended to take civil partnerships into account. Staff = were=20 briefed on appropriate language and the risk of making assumptions = about=20 sexual orientation in service provision. Training was also = provided on=20 dealing with homophobic incidents. |
Staff are aware =
of the Civil=20
Partnership Act. Should a homophobic incident occur, staff would =
challenge=20
the behaviour and document this via Datix |
|
(f) |
Disability |
A receptionist reported he = wasn=E2=80=99t confident when=20 dealing with deaf people coming into the service. A review was = undertaken=20 and a loop system put in place. At the same time a review of = interpreting=20 arrangements was made using NHSGGC=E2=80=99s Interpreting Protocol = to ensure staff=20 understood how to book BSL interpreters. |
Disabled parking =
and drop off=20
point outside the hospital entrance Lifts have an audio voice =
announcing=20
floors and Braille buttons Staff are aware of how to arrange =
British Sign=20
Language interpreters and other forms of communication support. =
The unit=20
will ensure any information requests for materials in alternative =
language=20
or other formats will be met in line with NHSGGC=E2=80=99s Clear =
to All Policy=20
(previously known as the Accessible Information Policy). Loop =
system is=20
available at the reception desk All toilets are suitable for =
disabled=20
access Moving and handling equipment is available to facilitate =
safe=20
transfer of those with mobility difficulties. Service users can be =
accompanied by carers if preferred. The Service can accommodate =
patients=20
in wheelchairs or with walking aids, as the corridors and doorways =
are=20
appropriately wide. For patients with learning disabilities, staff =
could=20
contact the Learning Disability Consultant nurse for advice if =
required,=20
staff would also ask their carers for advice. For patients with =
mental=20
health needs, staff would liaise with the appropriate Community=20
Psychiatric Nurse (CPN) if required. There is a dedicated Clinical =
Psychologist for the Service. |
|
(g) |
Religion and Belief |
An inpatient ward was briefed on = NHSGGC's=20 Spiritual Care Manual and was able to provide more sensitive care = for=20 patients with regard to storage of faith-based items (Qurans etc.) = and=20 provision for bathing. A quiet room was made available for = prayer.=20 |
There will a =
Sanctuary=20
available. Staff can tell patients about how to contact the =
Chaplaincy=20
Service. Staff can refer to NHSGGC=E2=80=99s Faith and Belief =
Communities Manual=20
if they have any queries about religions/faith groups. Halal, =
Kosher and=20
vegetarian meals available for inpatients as and when required. =
Pharmacy=20
can suggest alternative medication if there are specific religious =
restrictions on certain medications. Staff are aware that some =
Jehovah=20
witnesses will refuse to have a transplant on religious =
grounds.=20
|
|
(h) |
Pregnancy and Maternity |
A reception area had made a room = available to=20 breast feeding mothers and had directed any mothers to this = facility.=20 Breast feeding is now actively promoted in the waiting area, = though=20 mothers can opt to use the separate room if preferred. = |
Baby feeding and =
changing=20
facilities are available. Pregnant women would not be eligable to =
have a=20
transplant due to the risks involved to the baby. =
|
|
(i) |
Socio - Economic Status |
A staff development day identified = negative=20 stereotyping of working class patients by some practitioners=20 characterising them as taking up too much time. Training was = organised for=20 all staff on social class discrimination and understanding how the = impact=20 this can have on health. |
Staff can =
signpost patients=20
to The McMillan Benefits Service. This Service can assess the =
patient=E2=80=99s=20
circumstances and advise what benefits they may be able to claim. =
The=20
Service use a holistic needs assessment which can identify if a =
patient is=20
having any financial difficulties. Staff can then signpost to =
appropriate=20
services. The patient information leaflets includes a list of =
support=20
agencies and organisations. For patients from other Health Boards, =
there=20
are volunteer drivers who can assist patients in getting to and =
from the=20
hospital. |
|
(j) |
Other marginalised groups - Homelessness, = prisoners=20 and ex-offenders, ex-service personnel, people with addictions, = asylum=20 seekers & refugees, travellers |
A health visiting service adopted a = hand-held=20 patient record for travellers to allow continuation of services = across=20 various Health Board Areas. |
The Service use a =
holistic=20
needs assessment which can identify if a patient is having any =
worries or=20
concerns. Staff can then signpost to appropriate services. For =
patients=20
who are homeless, the service would liaise with the Acute Homeless =
Liaison=20
Service (AHLS). For patients with addictions =E2=80=93 the Service =
would liaise=20
with the Addiction Service. For patients in the Criminal Justice =
System=20
the Service would work with the relevant authorities. =
|
|
9. |
Has the service had to make any cost = savings or are=20 any planned? What steps have you taken to ensure this = doesn=E2=80=99t impact=20 disproportionately on equalities groups? |
Proposed budget savings were analysed = using the=20 Equality and Human Rights Budget Fairness Tool. The analysis was = recorded=20 and kept on file and potential risk areas raised with senior = managers for=20 action. |
As with all =
departments and=20
services, cost savings will be taken into account going forward. =
However=20
it is anticipated that this will not impact on equality groups.=20
|
|
10. |
What investment has been made for staff to = help=20 prevent discrimination and unfair treatment? |
A review of staff KSFs and PDPs showed = a small=20 take up of E-learning modules. Staff were given dedicated time to = complete=20 on line learning. |
All staff have =
KSF=E2=80=99s and=20
PDP=E2=80=99s. All staff have undertaken the Acute Services =
Statutory and=20
Mandatory Training which includes a session on equality and =
diversity. As=20
part of the move to the new hospital, all staff will attend an =
induction=20
programme. |
|
The Service is =
supported=20
by the Beatson Charity(formerly known as Friends of the Beatson) =
which=20
enhances the patient journey e.g. they can offer complementary =
therapies=20
such as massage, reiki. As mentioned above, the Service use a =
holistic=20
needs assessment which can identify if a patient is having any =
worries or=20
concerns. This utilises the social model of care rather than the =
medical=20
model of care. Staff can then signpost to appropriate services.=20
|