From: "Saved by Windows Internet Explorer 8" Subject: Frontline Service EQIA Date: Thu, 3 Sep 2015 10:11:50 +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=25 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:
Pre-Operative =
Assessment=20
Service |
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? = |
POA is an =
assessment=20
service for assessing patients prior to surgery. Assessment will =
unpack=20
the patients fitness for surgery. Service is delivered Victoria =
and=20
Southern. It includes several tests e.g. bloods, ecg, chest x-ray =
and=20
knowing about any patient medication. Will take 1-2 hours but may =
be=20
longer depending on tests required. Applies to all patients aged =
14+.=20
Cover ENT, Gynae, urology vascular and general surgery.=20
|
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.) = |
EQIA relates to a =
current=20
service that is reviewed prior to moving to the new =
location=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: = |
audrey =
anderson=20
|
23/04/2014=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, =
Donald=20
Campbell, Margaret Donaldson, audrey anderson=20
|
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 |
Service uses the =
available=20
fields on the Trakcare system. This includes - age, sex, post code =
and=20
interpreting support. faith and belief and disability is asked at=20
pre-assessment. |
Any =
data=20
captured that is additional to available fields on Trakcare will =
be=20
itemised on the patient's records/assessment document for loading =
onto=20
Trakcare. |
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. = |
Current patient =
flow has been=20
mapped out to ensure that same day admission works seamlessly. =
This will=20
take into account any additional requirements of the patient=20
pre-admission. A snap shot analysis has been undertaken in =
relation to=20
clinical data e.g. those requiring ECG and bloods =
|
|
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. |
A site visit to =
Portsmouth was=20
undertaken to better understand the self-scanning/check-in process =
and=20
impact on patients with additional communication support needs.=20
|
Pilot in SGH=20
will consider access issues |
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. |
A pre-operative =
assessment=20
questionnaire was complated in 2010. 82 questionnaires were =
completed from=20
a diverse range of patient groups. 49% British 23% no response =
with a mix=20
of Kenyan, Sudanese, Scottish, Pakistani. The questionnaire looked =
at=20
patient knowledge and understanding and options for changing the =
pre-op=20
service to respond better to their needs. |
|
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. |
N/A =
|
|
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. = |
There are disabled =
parking=20
spaces located outside the building. There is a drop off zone =
outside the=20
main entrance. There are automatic doors at the main entrance to =
the=20
hospital. There are lifts available which can accommodate =
wheelchair=20
users. The lifts have tactile buttons for patients with visual=20
impairments. There are stairs and an escalator to the first floor =
clinics.=20
There is suitable colour contrast between the floors and walls. =
There will=20
also be a new fast link transport system to the new hospital to =
ensure=20
better transport links with other parts of the city. There is good =
colour=20
contrast in signage to assist wayfinding There will be two =
barriatric=20
outpatient clinic rooms within the new facility. =
|
|
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 |
Staff are aware of =
NHS Greater=20
Glasgow and Clyde=E2=80=99s Interpreting Policy and how to =
organise interpreters=20
and other forms of communication support. The leaflets regarding =
the=20
accessible information policy are displayed in the waiting area. =
The=20
department can borrow a loop system as and when required. The new =
leaflet=20
for pre-op assessment has been updated to comply with the NHSGGC=20
Accessible Information Policy. Thi sis available in the top 5 =
languages.=20
The survey of August 2010 indicated that 5% of respondents had =
other=20
language requirements including Punjabi, Urdu and Youruba and =
Tamil.=20
Telephone interpreting will be available for all patients =
requiring=20
additional communication support. Staff will follow the assessment =
pathway=20
to ensure that all additional communication needs are identified =
and=20
highlighted on Trakcare - e.g. patient requires an =
interpreter=20
|
Circulate=20
information to staff about the text relay service for patients who =
are=20
deaf. Explore possiblities of a dedicated e-mail address for any=20
queries. |
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. |
2010 survey =
identified 54%=20
female 30% male and 16% no response. All rooms are single rooms. =
Staff are=20
aware of relevant policies and can respond to the disclosure of=20
abuse/GBV |
|
(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 NHS=20
Greater Glasgow and Clyde=E2=80=99s Transgender Policy. Staff =
would ask=20
transgender patients how they wish to 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 |
2010 survey =
showed 20% 41-5-=20
age group, 11% under 30 36% over 50 and 16% no response. Services =
will see=20
all adults over the age of 14. |
|
(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 |
2010 patient =
survey - 76%=20
Scottish, 11% no response - remaining responses included British, =
English,=20
Pakistani and Sri Lankan. Staff are aware of NHS Greater Glasgow =
and=20
Clyde=E2=80=99s Interpreting Policy and how to organise =
interpreters. Staff will=20
request same sex interpreters for patients. Any racist incidents =
would be=20
diffused and recorded in the DATIX system. Patient leaflets have =
been=20
translated into the top 5 languages. Any other languages are =
abvailable on=20
request. |
|
(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=20
importance of using appropriate terminology e.g. partner rather =
than=20
husband and wife. Any homophobic incidents would be recorded in =
the DATIX=20
system |
|
(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. |
2010 survey 6% of =
respondents=20
disclosed a disability Staff are aware of NHS Greater Glasgow and =
Clyde=E2=80=99s=20
Interpreting Policy and how to organise interpreters and other =
forms of=20
communication support. The consultation rooms are wide enough to=20
accommodate a wheelchair user. There are a variety of types of =
chairs=20
available for patients. There are accessible toilets located =
throughout=20
the department. Hearing dogs and assistance dogs can be =
accommodated and=20
staff were aware of how to recognise dogs that are working. Staff =
are=20
aware of the Adults with Incapacity Act and the associated =
requirements=20
regarding consent, etc. There have been requests from patients =
with=20
learning disabilities (or their carers) to come to the department =
before=20
their appointment to familiarise themselves with the clinic and =
this=20
alleviates any fears or concerns. The department can accommodate =
carers=20
and advocacy workers (with the patient=E2=80=99s permission). The =
department can=20
signpost to other organisations e.g. Arthritis Care; Lupus UK; =
British=20
Heart Foundation etc. All patients over 65 will undergo an AMT 4=20
cogntitive assessment tool. This tool can be used for other age =
groups if=20
presenting issues suggest it's required. Hoists are available in=20
outpatients dept. should they be required. Staff would use =
Trakcare alerts=20
to notify other departments of need. |
|
(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 |
2010 survey 18% =
declined top=20
respond 22% declared no religion 21% Catholic 21% Church of =
Scotland and=20
remainder mix of Anglican Baptist, Muslim (5%), Quaker and =
Spiritualist.=20
The staff can access the Faith and Belief Communities Manual if =
they have=20
any queries regarding a particular religion. Staff are aware of =
religious=20
festivals. A sanctuary can be made available for prayer or quiet=20
contemplation upon request. (For Muslim patients, staff can tell =
them=20
which direction to pray in). Staff can contact the Chaplaincy Team =
for=20
advice if required. If a patient required food (this would be rare =
as it=20
is an Out-Patient Department) staff would contact the Catering =
Department=20
for appropriate snacks taking cognisance of religious =
needs.=20
|
Staff need to=20
be aware of any changes to available blood products for Jehovah=20
Wtinesses |
(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. = |
There are no =
issues. Baby=20
changing facilities will be available and mothers can be supported =
to=20
either breast feed in public areas or privately. If privacy is =
required=20
there is a breast feeding room available. |
|
(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 reclaim their travelling expenses (if applicable). This can be=20
accommodated within the same building. Staff can signpost patients =
to=20
support organisations e.g. Social Work Department, Patient =
Information=20
Centres, McMillan etc. |
|
(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. |
If a patient has =
an addiction=20
issue and requires access to a prescription (e.g. methodone) this =
is=20
highlighted to the patient booker to allow for extra time or to =
make more=20
flexible arrangements. Staff are aware that some patients may have =
literacy issues and will take this into account e.g. reading =
information=20
out to the patient, going over information verbally. There are =
protocols=20
in place for dealing with prisoners. There were no issues =
identified with=20
patients who are asylum seekers or patients from the travelling=20
communities. All have attended their appointments and been =
contactable as=20
required. |
|
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. |
There are no =
planned cost=20
savings. |
|
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. Newly appointed staff have to complete an induction =
workbook. All=20
staff have undertaken or will undertake the Acute Services =
Statutory and=20
Mandatory Training which includes a session on equality and =
diversity.=20
Staff have also undertaken the on-line equality and diversity =
module There=20
are monthly Senior Charge Nurse meetings to discuss issues and =
monthly=20
departmental meetings. |
|
Good practice =
will be=20
developed as the service progresses. Pre-assessment ensures the =
patient=20
stay is reduced and avoids cancellations for same day admissions =
to bring=20
benefits to patients and staf. =
|