Equality Impact Assessment Tool for Frontline Patient Services
Equality Impact Assessment is a legal requirement and may be used as evidence for cases referred for further investigation for legislative compliance issues. Please refer to the EQIA Guidance Document while completing this form. Please note that prior to starting an EQIA all Lead Reviewers are required to attend a Lead Reviewer training session. Please contact CITAdminTeam@ggc.scot.nhs.uk for further details or call 0141 2014560.
1. Name of Current Service/Service Development/Service Redesign:
Older Peoples Acute Assessment
Unit, Royal Alexandra Hospital |
2. Description of the service & rationale for selection for EQIA: (Please state if this is part of a Board-wide service or is locally determined).
A. What does the service do? |
The Unit provides
specialist assessment of frail elderly patients who are not acutely unwell
but require intensive assessment of rehabilitation needs. It is a short
stay Unit with duration of stay less than 72 hours before discharge or
transfer to appropriate clinical setting. |
B. Why was this service selected for EQIA? Where does it link to Development Plan priorities? (if no link, please provide evidence of proportionality, relevance, potential legal risk etc.) |
It is a relative new service
and is a gateway for a high number of older people admitted to the
hospital. |
3. Who is the lead reviewer and when did they attend Lead reviewer Training? (Please note the lead reviewer must be someone in a position to authorise any actions identified as a result of the EQIA)
Name: |
Date of Lead Reviewer Training: |
Con Gillespie
|
31/03/2012
|
4. Please list the staff involved in carrying out this EQIA (Where non-NHS staff are involved e.g. third sector reps or patients, please record their organisation or reason for inclusion):
Con Gillespie (Lead Nurse
Dermatology) |
Lead Reviewer Questions |
Example of Evidence Required |
Service Evidence Provided |
Additional Requirements | |
1. |
What equalities information is routinely collected from people using the service? Are there any barriers to collecting this data? |
Age, Sex, Race, Sexual Orientation, Disability, Gender Reassignment, Faith, Socio-economic status data collected on service users to. Can be used to analyse DNAs, access issues etc. |
Standard demographic
information captured by Trakcare system on admission, further demographic
and lifestyle, nursing assessment via Nursing Assessment Document. This
includes information regarding gender and faith / beliefs No specific
Equality & Diversity information taken on admission to hospital
|
Review scope to
include more equality information and analyse same |
2. |
Can you provide evidence of how the equalities information you collect is used and give details of any changes that have taken place as a result? |
A Smoke Free service reviewed service user data and realised that there was limited participation of men. Further engagement was undertaken and a gender-focused promotion designed. |
The information captured is
essential primarily used to support advancement in providing
individualised clinical care therefore as stated above there is no
specific focus on capturing and analysing equality and diversity
information at present |
|
3. |
Have you applied any learning from research about the experience of equality groups with regard to removing potential barriers? This may be work previously carried out in the service. |
Cancer services used information from patient experience research and a cancer literature review to improve access and remove potential barriers from the patient pathway. |
The service has been in place
for 3 years, through this time ongoing work has taken place to ensure that
the Team identifying the specific frail elderly patients who benefit from
the service, this has included taking referrals from an increased number
of gateways., initially this was only via Emergency Department but now
includes referral via Medical Assessment Unit and Acute Medical
Receiving |
|
4. |
Can you give details of how you have engaged with equality groups to get a better understanding of needs? |
Patient satisfaction surveys with equality and diversity monitoring forms have been used to make changes to service provision. |
The Unit is engaged in
standard patient experience systems including Universal Feedback, Patient
Opinion. There have been no complaints received regarding the Unit. It is
currently involved project work to improve engagement with carers in
preparation for introduction of the Carers Act next year. |
Implement
learning from Acute Carers work and share with other clinical areas
|
5. |
Question 5 has been removed from the Frontline Service Form. | |||
6. |
Is your service physically accessible to everyone? Are there potential barriers that need to be addressed? |
An outpatient clinic has installed loop systems and trained staff on their use. In addition, a review of signage has been undertaken with clearer directional information now provided. |
The Unit is purpose built and
edsigned to look after frail elderly and disable patients therefore there
are no identified barriers in the Unit. Within the hospital, disabled
parking spaces are located at the top of the car park in close proximity
with the Unit. For patients who do not drive or are not able to access
public transport, patient transport , ambulance service is
accessible. |
|
7. |
How does the service ensure the way it communicates with service users removes any potential barriers? |
A podiatry service has reviewed all written information and included prompts for receiving information in other languages or formats. The service has reviewed its process for booking interpreters and has briefed all staff on NHSGGC’s Interpreting Protocol. |
Communication is recognised as
of vital importance particularly in recognising those with impairments and
people using the service where English is not their first language. The
staff are all fully aware of interpretor service and how to access it both
for foreign language and for deaf people. Dementia Friendly environment
checks have taken place which has ensured that signage is clear, floor
colouring is clear and dementia friendly clocks are on walls in
appropriate locations. |
Sensory
Impairment Training session 28th June RAH - encourage attendance
|
8. |
Equality groups may experience barriers when trying to access services. The Equality Act 2010 places a legal duty on Public bodies to evidence how these barriers are removed. What specifically has happened to ensure the needs of equality groups have been taken into consideration in relation to: | |||
(a) |
Sex |
A sexual health hub reviewed sex disaggregated data and realised very few young men were attending clinics. They have launched a local promotion targeting young men and will be analysing data to test if successful. |
No evidence of discrimination
on basis of gender. Staff group includes males and females. Patient group
includes males and females with not disproportiante bias towards either
gender. Toilet facilities and privacy, dignity requirements fully
met. |
|
(b) |
Gender Reassignment |
An inpatient receiving ward has held briefing sessions with staff using the NHSGGC Transgender Policy. Staff are now aware of legal protection and appropriate approaches to delivering inpatient care including use of language and technical aspects of recording patient information. |
Staff report having had
experience with caring for patients undergoing gender reassignment. They
are able to outline managing sensitively care issues and treating person
as individual according to his / her needs and preferences. Staff able to
are both familiar with and can advise how to access Transgender
Policy. |
|
(c) |
Age |
A urology clinic analysed their sex specific data and realised that young men represented a significant number of DNAs. Text message reminders were used to prompt attendance and appointment letters highlighted potential clinical complications of non-attendance. |
The Unit specialises in
providing exemplary care for older people. It strives to achieve the
highest care standard for older people at all times, the environment,
culture and care is focussed on this. It seeks to provide specialist
assessment and support for frail elderly patients who require
rehabilitation and support towards returning them to home is possible with
care interventions required. All staff have undertaken Adult protection
and Child protection training. There is arrange of ages across the
staffing profile. |
|
(d) |
Race |
An outpatient clinic reviewed its ethnicity data capture and realised that it was not providing information in other languages. It provided a prompt on all information for patients to request copies in other languages. The clinic also realised that it was dependant on friends and family interpreting and reviewed use of interpreting services to ensure this was provided for all appropriate appointments. |
The Unit is committed to
delivering non discriminatory care and treats all people who enter the
Unit with dignity and respect. No race hate crimes reported and a mixture
of races is noted amongst staffing profile. Staff can appropriately
identify management and challenging racism in an appropriate and sensitive
manner when required, |
|
(e) |
Sexual Orientation |
A community service reviewed its information forms and realised that it asked whether someone was single or ‘married’. This was amended to take civil partnerships into account. Staff were briefed on appropriate language and the risk of making assumptions about sexual orientation in service provision. Training was also provided on dealing with homophobic incidents. |
The Unit is committed to
delivering non discriminatory care and treats all people who enter the
Unit with dignity and respect. Staff recognise and embrace diversity and
respect diverse lifestyle choices. No discrimination noted in employment
policy and variances in sexual orientation. Staff recognise changes in
legal framework regarding legal civil partnerships. |
|
(f) |
Disability |
A receptionist reported he wasn’t confident when dealing with deaf people coming into the service. A review was undertaken and a loop system put in place. At the same time a review of interpreting arrangements was made using NHSGGC’s Interpreting Protocol to ensure staff understood how to book BSL interpreters. |
The Unit cares for people
with all manners of disability and is purposely designed to cater for all
person's with physical and sensory disabilities as highlighted in
section6. |
|
(g) |
Religion and Belief |
An inpatient ward was briefed on NHSGGC's Spiritual Care Manual and was able to provide more sensitive care for patients with regard to storage of faith-based items (Qurans etc.) and provision for bathing. A quiet room was made available for prayer. |
Staff have recognised
variances in people's religious and non religious beleifs. The Faith &
Beliefs manual is regularly accessed when there is any uncertainty in
meeting the needs of different spiritual requirements for people who use
the facility |
|
(h) |
Pregnancy and Maternity |
A reception area had made a room available to breast feeding mothers and had directed any mothers to this facility. Breast feeding is now actively promoted in the waiting area, though mothers can opt to use the separate room if preferred. |
The Unit does not routinely
carer for pregnant patients but can provide breast feeding facilities for
carers, staff and visitors who require an areas to breast feed their
child. The area is in close proximity to Maternity services in the
hospital and can access specialist care, advice and support when
required. |
|
(i) |
Socio - Economic Status |
A staff development day identified negative stereotyping of working class patients by some practitioners characterising them as taking up too much time. Training was organised for all staff on social class discrimination and understanding how the impact this can have on health. |
Any financial challenges can
be addressed in conjunction with referral and support form Social Work
Department. While there are no direct questions available in the admission
process there is scope for staff to discuss with patients and carers
financial concerns. The Cashiers Office in the Main Foyer in the hospital
is available for travelling expenses when required |
|
(j) |
Other marginalised groups - Homelessness, prisoners and ex-offenders, ex-service personnel, people with addictions, asylum seekers & refugees, travellers |
A health visiting service adopted a hand-held patient record for travellers to allow continuation of services across various Health Board Areas. |
There are no specific
comments to add regarding these marginalised groups besides good
recognition of their various specific needs. |
|
9. |
Has the service had to make any cost savings or are any planned? What steps have you taken to ensure this doesn’t impact disproportionately on equalities groups? |
Proposed budget savings were analysed using the Equality and Human Rights Budget Fairness Tool. The analysis was recorded and kept on file and potential risk areas raised with senior managers for action. |
While cost saving exercises
are regularly carried out, there is great care taken to avoid any direct
or indirect impact on equality and diversity |
|
10. |
What investment has been made for staff to help prevent discrimination and unfair treatment? |
A review of staff KSFs and PDPs showed a small take up of E-learning modules. Staff were given dedicated time to complete on line learning. |
As a core outline in annual
appraisal , equality and diversity is included with every member of staff
yearly review. All staff are encouraged to complete learn pro module for
equality and Diversity |
Encourage
staff to complete Learn Pro module on Equality and Diversity
|
11. In addition to understanding and responding to our legal responsibilities under the Equality Act (2010), services have a duty to ensure a person's human rights are protected in all aspects of health and social care provision. This may be more obvious in some areas than others. For instance, mental health inpatient care (including dementia care) may be considered higher risk in terms of potential human rights breach due to removal of liberty, seclusion or application of restraint. However risk may also involve fundamental gaps like not providing access to communication support, not involving patients/service users in decisions relating to their care, making decisions that infringe the rights of carers to participate in society or not respecting someone's right to dignity or privacy.
Please give evidence of how you support each article, explaining relevance and any mitigating evidence if there's a perceived risk of breach. If articles are not relevant please return as not applicable and give a brief explanation why this is the case.
Right to Life
A fundamental principle in the
Unit is fully involving patients in their medical and nursing care as far
as possible this includes treatment aimed at preserving life. Protective
legislation regarding Adults with Incapacity is used when required for
patients unable to participate in such discussions.
|
Everyone has the right to be free from torture, inhumane or degrading treatment or punishment
No relevant discriminatory issues
regarding this |
Prohibition of slavery and forced labour
No relevant discriminatory issues
regarding this |
Everyone has the right to liberty and security
No relevant discriminatory issues
regarding this. Strict protocols are used to mange patients who require
support, safely, in accordance with their medical, psychological and
physical needs. |
Right to a fair trial
No relevant discriminatory issues
regarding this. |
Right to respect for private and family life, home and correspondence
Privacy and confidentiality is
protected at all times - staff are sensitive to ensuring that all efforts
are made to protect this particularly in more open aras of the
Unit. |
Right to respect for freedom of thought, conscience and religion
No relevant discriminatory issues
regarding this. |
Non-discrimination
The central ethos is treating all
persons with dignity and respect in accordance with all individual
characteristics including race, gender, belief at all times.
|
12. If you believe your service is doing something that ‘stands out’ as an example of good practice - for instance you are routinely collecting patient data on sexual orientation, faith etc. - please use the box below to describe the activity and the benefits this has brought to the service. This information will help others consider opportunities for developments in their own services.
I think the real strength
of the service lies with the commitment and care of the team in looking
after a very vulnerable population of people with skill, compassion and
fairness. |