From: "Saved by Windows Internet Explorer 8" Subject: Frontline Service EQIA Date: Thu, 5 Mar 2015 13:30:50 -0000 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=70 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:
Ward 62 - =
Maxillofacial=20
including head and neck services (inpatient services)=20
|
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? = |
Ward 62 has =
28 beds to=20
care for maxillofacial and head and neck patients. The length of =
stay=20
varies from 1 night to several weeks. The majority of patients are =
'Same=20
Day Admissions' which means they are admitted on the day of their =
surgery.=20
Patients will be admitted as a result of trauma; head and neck =
cancers;=20
infection; elective surgery and treatment planning. Referrals are =
from=20
GPs, consultants; MacMillan nurses; dentists and other health =
boards=20
throughout Scotland. There are 2 single rooms available, and 9 =
bays with a=20
varying number of beds. Each room and bay has en-suite facilities. =
|
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 to=20
ensure that there is no discriminatory practices.=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: = |
Shona =
Monaghan=20
|
21/01/2015=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):
Nicole =
McInally, Joanne=20
Findlay, Anne Marie Brown, Flora Muir =
|
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 |
The service =
collects=20
information on age, gender, postcode, faith and ethnicity via =
TrakCare.=20
This information in also documented in the nursing notes. TrakCare =
can=20
also record requirements for interpreters and preferred language.=20
|
|
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. = |
No formal analysis =
of=20
equalities data has been undertaken. From data collected there has =
been a=20
change indentified in the 'patient group' accessing the service. =
For=20
example, head and neck cancer patients are now younger than=20
previously. |
|
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. |
Following on from =
previous=20
work undertaken in the service, through the Enhanced Recovery =
After=20
Surgery (ERAS) programme, patients who are identified as having=20
addictions, now have the opportunity to speak to Addiction =
Services at=20
their pre-operative assessment to discuss any issues. As a pilot, =
The=20
Enhanced Recovery After Surgery Diary allows patients to record=20
information about their journey, feelings and goals. This will be =
rolled=20
out further. part of the planning for surFor patients with =
addictions,=20
|
|
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 Service =
previously=20
undertook the monthly Senior Charge Nurse Questionnaires - no =
equality and=20
diversity issues were identified. The Patient Centred Care Team =
obtain=20
weekly feedback from patients through 'themed conversations'. No =
issues=20
have been identified. The Service also utilises the Family and =
Friends=20
Test (Universal Feedback) to capture patient feedback. =
|
|
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. = |
The Service is =
based on the=20
2nd floor of the Neurosurgery Building at the Southern General =
Hospital.=20
At present due to the on-going building works, the main entrance =
to the=20
building is closed, and access is temporarily via the Neurology =
Building.=20
There is signage to direct patients to the temporary access via =
the=20
Neurology building. There is a drop off point outside the =
Neurology=20
Building. There are lifts available to the 2nd floor. At the =
reception=20
desk, patients can request a wheelchair. There are some disabled =
car=20
parking spaces at the side of Neurology Building. =
|
|
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 are =
aware of how=20
to organise interpreters and other forms of communication support. =
The=20
Service is aware of NHSGGC=E2=80=99s Clear to All Policy =
(previously known as the=20
Accessible Information Policy). The Service is currently reviewing =
their=20
appointment letters to ensure they comply with NHSGGC's Clear To =
All=20
Policy. The Service is currently producing a Neuroscience and=20
Maxillofacial information booklet for inpatients. =
|
|
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. |
Staff will try to =
accomodate=20
requests for same sex health professionals. Otherwise, chaperoning =
will be=20
provided. The bays have same sex patients. Staff are aware of the =
Gender=20
Based Violence Policy and how to signpost to support agencies. =
Same sex=20
interpreters would be booked, as required for individual patient=20
need. |
|
(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. In 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 |
The service is =
for patients=20
aged 13 and over. For younger patients, their parents/carers can =
stay with=20
them overnight. Younger patients would also be accomodated in a =
single=20
room. All staff have undertaken child and adult protection =
training. The=20
service are looking to develop a frailty index' which looks at the =
different aspects of ageing and the impact this can have on =
surgical=20
outcomes; possibility of delirium; and quality of life. =
|
|
(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 |
Staff are aware =
of how to=20
organise interpreters. Information will be provided in other =
languages=20
upon request. Any racist incidents would be recorded via =
DATIX.=20
|
|
(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. Ifa homophobic incident occur, staff would =
challenge the=20
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. |
Staff are aware =
of how to=20
organise British Sign Language interpreters and other forms of=20
communication support. Information would be provided in other =
formats upon=20
request. There are accessible toilets available. The Service can =
access 3=20
Dementia Champions and a link nurse who can offer advice. Patients =
over 65=20
would be given an AMT 4 score to ascertain if there was any =
cognitive=20
impairment. The ward has dementia friendly signs and dementia =
clocks. The=20
ward has access to a loop system. For patients with learning =
disabilites,=20
the service can accomodate carers if required. For patients with =
mental=20
health needs, staff would liaise with the appropriate Community=20
Psychiatric Nurse (CPN) if required. Can access audio books via =
the=20
hospital library for people with visual impairments. The service =
can=20
access 'litewriter' and visual boards for patients with =
communication=20
issues. The service can access Speech and Language Therapists if =
required.=20
Mobility and adaptive aids can be provided by the Physiotherapists =
and=20
Occupational therapists. Patients are encouraged to use apps on =
ipads and=20
iphones. |
Circulate=20
information about text relay service for patients with hearing=20
impairments. |
(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 |
Staff can =
signpost patients=20
to Chaplaincy Services. There is a quiet room available on the =
hospital=20
site. Staff can refer to NHSGGC=E2=80=99s Faith and Belief =
Communites Manual if=20
they have any queries about religions/faith groups. Halal, Kosher =
and=20
vegetarian meals available. Staff could contact Pharmacy if a =
patient had=20
any queries about the ingredients in their medication. =
|
|
(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. = |
Staff would =
liaise with=20
colleagues from obstetrics. Facilities are available for =
breast-feeding.=20
Open visiting allows greater flexibility. |
|
(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 cashiers office. Staff can signpost patients to the =
MacMillan=20
Benefits Service. Staff can refer patients to social work. Staff =
can refer=20
patients to support organisations as required. |
|
(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. |
Staff can liaise =
with the=20
Addictions Team as required. There is a protocol in place for =
people in=20
the criminal justice system. For homeless patients, the staff can =
liaise=20
with the Homeless Team. |
|
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. |
Not =
applicable.=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 up =
to date KSF=20
and PDP's. Staff have undertaken mandatory training programmes. =
Staff can=20
access the e-learning modules. The Senior Charge Nurse had a =
safety brief=20
twice a day and a monthly newsletter which is circulated to the =
staff for=20
information. |
|
As part of the =
Patient=20
Centred Care Agenda, instead of the traditional ward round, there =
is now=20
an allocated room. The patient comes to this room (which =
encourages their=20
mobility and independence) rather than having a conversation =
around their=20
bed. The patient then has the opportunity to see the =
multi-disciplinary=20
team (e.g. consultant, registrars, clinical nurse specialists,=20
physiotherapists and occupational therapists) in a private =
setting. The=20
patient still has the opportunity to have the ward round at their =
bedside.=20
|