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:

Community Paediatric Speech and Language Therapy

This is a : Service Redesign

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?

Provision of assessment and care for children with speech language and communication impairment and disability within Renfrewshire

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.)

Reconfiguration of service level agreement and funding from Renfrewshire Council. This is likely to involve a period of process mapping and capcity in community settings and support increased self managed care.

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:

Kathleen MacKinnon
01/04/2018

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):

Kathleen MacKinnon (SLT Manager); Gillian McDaid (Service Manager)

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.

Age (0-19yrs) Sex Race Disability
Data recorded on EMIS patient registration. As care group is paediatric,limits to range of data collected

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.

Use of interpreting services for bilingual and bilingual families will continue Children with disabilities will continue to access the service as required and appropriate to their needs Increased waiting times may impact on whole service not specifically groups with protected characteristics

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.

Use of community language interpeters to assess and provide care for children using languages other than English

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 service changes will not impact on quality or access to service for equality groups

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.

Use of NHS and LA accommodation to deliver our service ensures that we are accessible for children with disability. There will be no change of site for delivery of services

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.

Accessed training from interpreting services, use interpreters for reports and phone for appointments if required, advice sheets in most community languages. We will continue to adhere to NHSGGC Clear to All and Interpreting Protocols

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.

Not applicable

(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 being are aware of NHSGGC's gender Reassignment Policy in relation to the provison of clinical care

(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.

0-19 with transfer to adult services if required. Access to our service will not disproportionately impact on any age group within our population

(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.

ask referrers about home language and book interpreter accordingly. Assses in mother tongue and english if required using interpreters. Avoid use of tests standardised in English Translate reports if required, book with interpreters if required Use of epertise and skills in bilingualism from elsewhere within SLT teams within NHSGGC

(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.

No data routinely collected.
Staff development is required given the age range of young people involved in service

(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.


Hearing Impaired Community: use sign interpreters, we use regular deaf awareness sessions including use of radio aids, hearing aids and cochlear implants Use of AAC devices for children and young people who have no verbal language Use of visual (rather than verbal /written signs) A significant percentage of our patients who use our service have learning disability, we use talking mats, alternative communicative communication systems, sign systems to deliver care. We consider adjustments to the delivery of care to meet specific needs e.g. ensuring materials, clinics are accessible for individual needs of children and families

(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.

Bilingual Practice Development Network provides us with support on culturally sensitive practice. Attendance recorded in staff personal files

(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.

Our work with babies on eating and drinking allows us to support mothers who wish to breastfeed. Our clinics have private baby changing and feeding areas.

(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.

Children are seen in settings where their needs are best met e.g. home, clinic or school as appropriate to needs Parents can access our drop in service at a clinic of their choice (4 per month across Renfrewshire) No disproporionate impact of changes in service for users living in conditions of poverty EMIS neighbourhood reports allow us to monitor service access across geographical areas

(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.

EMIS record allows to transfer information across NHSGGC and across teams

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.

Reduction in external funding has an impact across all groups accessing the service not particularly equalities groups
Team are embarking apon a period of process mapping and capcity building in community settings to support increased self managed care in collaboration with local authority Self managed care approaches are a feature of the national AHP transformational plan for children. Delegation of care is only possible where any clincal risk can be be managed safely by the child and family and agreed in individual care plans

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.

Staff are required to undertake Equality and Diversity training on Learnpro and certificates stored in personal files. Specific needs of bilingual and multilingual populations are managed via professional networks Regular Deaf awareness sessions and AAC updates

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

Care plans developed in partnership with patients and families

Everyone has the right to be free from torture, inhumane or degrading treatment or punishment

Regular child protection training Child protection always discussed at team meetings and 1:1 meetings Advice of taste and texture for children with eating and drinking difficulties Support other services to access child's voice in most effective and apprporiate method

Prohibition of slavery and forced labour


Everyone has the right to liberty and security


Right to a fair trial


Right to respect for private and family life, home and correspondence


Right to respect for freedom of thought, conscience and religion


Non-discrimination

Service is accessed and offered based on clinical need not on the basis of disability, ethnicity

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.