APPENDIX B
Equality Impact Assessment
Guidance is available on Compass. Completion of this template should be proportional
and relevant to the anticipated impact of the project on equalities. It can be tailored to
your project. For support please email [email protected].
STEP 1: Responsibility and involvement
Project title
Health & Wellbeing Board Constitution
Lead officer
completing the
assessment
Jess Lievesley
Council for
the Future
workstream
N/A
Contact details
01992 588590
[email protected]
Date
completed
07 January
2013
Anna Lawrence
Sharon Robinson
Mark Jordan
Assessment
review date
TBC
Others involved
in preparing
assessment
STEP 2: Identify the project objectives and scope of the assessment
Project objectives:
– Purpose and
need
– Intended
outcomes
Purpose and Need
The Health and Social Care Act 2012 dictates that a Health
and Wellbeing Board (HWbB) be created as a formal
Committee of the Local Authority. As part of this process, a
Constitution has been developed by the Commissioning lead
for the Hertfordshire HWbB which outlines the main
responsibilities of the board when it formally commences in
April 2013.
The Constitution may be subject to change following the
application of secondary legislation regarding the local
government procedure rules. Although any resulting
alterations are expected to be minimal, both the Constitution
and the accompanying EQIA will be reviewed following
publication of the legislation in January 2013.
Intended Outcomes
The HWbB Constitution reflects the ambition of the board to
act as a strategic board of commissioners to inform
commissioning decisions across local services. The
Constitution also outlines the statutory obligation of the HWbB
to promote integrated and joint working in the pursuit of
greater effectiveness and efficiency when providing health or
social care services. This is to directly encourage the
improvement of the health and wellbeing of the population of
Hertfordshire and to ensure that service providers are taking
into consideration local needs.
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Equality Impact Assessment
The Constitution therefore outlines a key role of the Board as
promoting health and wellbeing across the population and
reducing health inequalities for all, to include groups with
protected characteristics and other vulnerable sectors of
society. To fully realise this outcome, it is therefore important
that equality and diversity issues are actively considered
during all future functions of the board.
The approach for this EQIA is to ensure that the members of
the board, and as a result also commissioners, service
providers and other relevant partners, make due regard to
equality issues when translating and carrying out roles and
responsibilities as outlined in the Constitution. For example,
when monitoring and assessing performance targets as stated
for each health priority in the Health and Wellbeing Strategy.
To this end, the EQIA will propose actions to support this
process.
Stakeholders:
– Internal, external,
local Member
The far-reaching implications of the HWbB and its Constitution
for the population of Hertfordshire, as well as its emphasis on
partnership working, mean that everyone is a potential
stakeholder. However, specific examples of stakeholders
include:
Internal:
Commissioning teams
Service leads and teams leading on implementation of
the HWb Strategy priorities
Public Health teams
Legal Team
Equalities team
HWb Board administrative team
External:
- Hertfordshire residents
- Specific service users
- Districts
- NHS including CCGs
- Hertfordshire Police
- Healthwatch
- Community and voluntary organisations including
Healthwatch
Other:
- Hertfordshire HWb Board
- Local members
STEP 3: Available data and monitoring information
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Equality Impact Assessment
Available equality information and what it tells us about equalities
Data and monitoring information
The JSNA



The JSNA produces detailed evidence on current and future health needs in
Hertfordshire, and is obligated to monitor equality and diversity issues as part of
its roles and responsibilities. It works with numerous partners, including the NHS,
local government and the voluntary sector, to produce data profiles on a variety of
topics including specific health issues, lifestyles factors such as levels of smoking
in particular areas and ethnicity information.
The JSNA will be used by the board and partners to inform the strategic direction
of commissioning and commissioning decisions. The JSNA has demonstrated
that factors such as race, education and employment can have a direct effect on
levels of health and wellbeing and that these must be taken into consideration
when implementing initiatives.
Commissioners have been and continue to liaise with the JSNA manager to
ensure that key information on protected groups and relevant inequalities is
incorporated into the JSNA. This includes equalities information relating to
deprivation and the social determinants of health in the different localities of
Hertfordshire. The JSNA in turn helps inform of areas of need and impact of
services. The JSNA will play a central role in assessing the implementation of the
Health and Wellbeing Strategy through the creation of data profiles on each of the
nine Strategy priorities.
Further information on the JSNA can be found by visiting their website
(http://www.hertslis.org/partners/jsna/).
Other Data Sources
Other data sources used to assess health needs (and to develop the Health and
Wellbeing Strategy) include local census information to gather data on ethnicity, age
and other distributions across Hertfordshire. The Public Health team, who officially
transfer to HCC in April 2013 as part of the Health and Social Care Act, are also an
important source of health data.
Complaints/ enquiries
N/A
Audits or inspections
The Board will not perform a scrutiny function but will itself be subject to scrutiny by
HCC’s Health Scrutiny Committee.
Local knowledge consultations/ engagement
Membership of the HWbB includes HCC members and officers, districts, the Clinical
Commissioning Groups (CCGs) and Healthwatch, and will bring together various
other local community and voluntary organisations as it seeks to promote and
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Equality Impact Assessment
Available equality information and what it tells us about equalities
encourage effective partnership working. To achieve this objective as outlined in the
Constitution, the HWbB will need to ensure effective engagement with local partners
and the local population, and has already begun to do so through various
engagement events and consultations. For example, the HWb Strategy engagement
that was held between April and July 2012 was able to gather and incorporate the
views of over 3300 key organisations, groups and residents on the proposed Strategy
priorities.
The continuation of this engagement will be a key part of ensuring commissioning
functions are aware of and respond effectively to local needs, including the complex
and varying needs of protected and other vulnerable groups. This may involve specific
targeting of certain groups to ensure equal levels of engagement.
There are also a number of Hertfordshire equality networks that can assist in the
gathering and provision of specific, local equality data as required.
Equality information from national sources
There is a wealth of national guidance from the Government and other national data
sources that assist commissioners, policy makers and service providers to identify
any equality issues pertinent to their particular service. For example, Stonewall has
recently published a report on older Lesbian Gay Bisexual (LGB) people that
indentified significant numbers of disabled LGB people who did not within the last year
access the health, mental health and social care services that they felt they needed.
Organisations such as Joseph Rowntree foundation, ONS, Age UK, Equality and
Human Rights Commission all publish research and evidence that support service
providers.
Other
N/A

Gaps identified – do
you need to collect
more
data/information or
carry out
consultation?

During previous consultation events, such as the HWb
Strategy engagement, it was difficult to assess whether
all protected groups had had the opportunity to give
their views. The board will need to be mindful of
overcoming these difficulties when carrying out or
recommending future engagement.
Evidence from the JSNA suggests that outcomes
related to health and wellbeing can be directly affected
by protected characteristics such as age or ethnicity.
The full implication of such factors will need to be
considered and explored to ensure effective delivery of
board decisions or advice.
STEP 4: Impact Assessment
August 2011 – [email protected]
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Equality Impact Assessment
Protected
characteristic
Age
Potential for negative impact
Evidence obtained from the JSNA,
the HWb Strategy consultation
exercise and from service providers
shows that a person’s age can affect
health outcomes both positively and
negatively. For example, young
adults in Hertfordshire in particular
are under-engaging in both alcohol
addiction services and learning
disability support services showing
that certain ages can be
disproportionately effected or underengaged by health issues.
The HWbB, as demonstrated by the
HWb Strategy, also recognises that
unhealthy behaviours set in
childhood can impact hugely on
health in later life. For example, it is
estimated that half of all mental
health issues in later life are set at
the age of 13.
Disability
As above, evidence obtained from
the JSNA, the HWb Strategy
consultation exercise and from
service providers shows that
disability, both physical and mental,
can affect health outcomes both
positively and negatively. For
example, evidence from
Hertfordshire Stop Smoking Service
(HSSS) shows people who smoke
are more prone to experiencing
disabilities as a result of their
addiction.
How will you mitigate against
this?
The HWbB must recognise that
age can have an impact on the
effectiveness of health
strategies when carrying out
roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as age into
consideration when delivering
commissioning plans, when
engaging or consulting with
partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with all age
groups where such engagement
is required.
The HWbB must recognise that
disability can have an impact on
the effectiveness of health
strategies when carrying out
roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as disability into
consideration when delivering
commissioning plans, when
engaging or consulting with
partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with all
groups affected by a disability
where such engagement is
required.
August 2011 – [email protected]
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Equality Impact Assessment
Protected
characteristic
Race
Potential for negative impact
As above, evidence obtained from
the JSNA, the HWb Strategy
consultation exercise and from
service providers shows that race
can affect health outcomes both
positively and negatively. For
example nationally, depression in
BME (Black Minority Ethnic) groups
is up to 60% higher than in the white
population. Hertfordshire also has a
much a higher representation of
BME groups in certain wards than
others, for example Watford.
How will you mitigate against
this?
The HWbB must recognise that
race can have an impact on the
effectiveness of health
strategies when carrying out
roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as race into
consideration when delivering
commissioning plans, when
engaging or consulting with
partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with all BME
groups where such engagement
is required.
Gender
reassignment
Gender reassignment could have an
effect on health outcomes although
the issue requires more in-depth
exploration before the potential
impact becomes clear.
The HWbB must recognise that
gender reassignment may have
an impact on the effectiveness
of health strategies when
carrying out roles and
responsibilities as outlined in
the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as gender
reassignments into
consideration when delivering
commissioning plans, when
engaging or consulting with
partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with all
trans groups where such
engagement is required.
August 2011 – [email protected]
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Equality Impact Assessment
Protected
characteristic
Pregnancy and
maternity
Potential for negative impact
As above, evidence obtained from
the JSNA, the HWb Strategy
consultation exercise and from
service providers shows that
pregnancy and maternity can affect
health outcomes both positively and
negatively. For example, a failure to
engage effectively with pregnant or
new mothers in campaigns such as
stop smoking can have strong
implications for the child in terms of
future unhealthy behaviour.
How will you mitigate against
this?
The HWbB must recognise that
pregnancy and maternity can
have an impact on the
effectiveness of health
strategies when carrying out
roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as pregnancy and
maternity into consideration
when delivering commissioning
plans, when engaging or
consulting with partners, and
when implementing health
strategies.
The HWbB must ensure it
engages effectively with
pregnant women and new
mothers where such
engagement is required.
Religion or
belief
As above, evidence obtained from
the JSNA, the HWb Strategy
consultation exercise and from
service providers shows that religion
and belief can affect health
outcomes both positively and
negatively although this requires
some further investigation. Religious
groups are often under represented
and under engaged by
organisations with regards to
equality issues.
The HWbB must recognise that
religion and belief can have an
impact on the effectiveness of
health strategies when carrying
out roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as religion and
belief into consideration when
delivering commissioning plans,
when engaging or consulting
with partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with faith
groups and so on where such
engagement is required.
August 2011 – [email protected]
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Equality Impact Assessment
Protected
characteristic
Sex
Potential for negative impact
As above, evidence obtained from
the JSNA, the HWb Strategy
consultation exercise and from
service providers shows that gender
can affect health outcomes both
positively and negatively. For
example, women in Hertfordshire
are less likely to access alcohol
addiction services and it has been
shown that men and women have
different chances of becoming a
carer in their lifetime.
How will you mitigate against
this?
The HWbB must recognise that
gender can have an impact on
the effectiveness of health
strategies when carrying out
roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as gender into
consideration when delivering
commissioning plans, when
engaging or consulting with
partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with both
sexes where such engagement
is required.
Sexual
orientation
As above, evidence obtained from
the JSNA, the HWb Strategy
consultation exercise and from
service providers shows that gender
can affect health outcomes both
positively and negatively. For
example nationally, LGB (Lesbian,
Gay and Bisexual) groups are at a
much higher risk of mental health
problems. 23% of LGB young
people have at some point tried to
take their own life compared to 7%
of young people in general.
The HWbB must recognise that
sexual orientation can have an
impact on the effectiveness of
health strategies when carrying
out roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as sexual
orientation into consideration
when delivering commissioning
plans, when engaging or
consulting with partners, and
when implementing health
strategies.
The HWbB must ensure it
engages effectively with all LGB
groups where such engagement
is required.
August 2011 – [email protected]
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Equality Impact Assessment
Protected
characteristic
Marriage &
civil
partnership
Potential for negative impact
Marriage and civil partnership could
have an effect on health outcomes
although the issue requires more indepth exploration before the
potential impact becomes clear.
How will you mitigate against
this?
The HWbB must recognise that
marriage and civil partnership
may have an impact on the
effectiveness of health
strategies when carrying out
roles and responsibilities as
outlined in the Constitution.
The HWbB must ensure
commissioners, service
providers and the JSNA are
aware that they need to take
factors such as marriage and
civil partnership into
consideration when delivering
commissioning plans, when
engaging or consulting with
partners, and when
implementing health strategies.
The HWbB must ensure it
engages effectively with
effected groups where such
engagement is required.
Opportunity to advance equality of opportunity and/or foster good relations
(Please refer to the guidance for more information on the public sector duties)
The HWbB Constitution itself is unlikely to have a direct negative impact on inequalities
relating to the protected groups or other vulnerable groups in society. It seeks equal
improvement in health and wellbeing and advocates inclusive approaches such as
developing local, tailored solutions for local needs. However the level of success in
implementing such outcomes will depend on consideration of equality issues during all
functions of the board, including engagement and joint working, and of exploration of the
varying health needs of protected groups during delivery of commissioning decisions
decided by the board and the HWb Strategy.
The HWbB Constitution therefore offers an excellent opportunity to achieve a greater
understanding of complex and varying health needs and of encouraging engagement
with representative organisations and with established local equality networks. The HWb
Strategy also seeks not just to ensure there is no negative impact on protected groups,
but to actively seek out opportunities to improve understanding and relations. It may
focus on nine specific health issues but the Strategy encourages everyone to get
involved and to take responsibility for their own health and wellbeing.



People spanning more than one group could be impacted on differently
Full records should be kept separate from this EqIA report
Follow the link for information on what could amount to unlawful discrimination.
August 2011 – [email protected]
Page 9 of 12
Equality Impact Assessment
The conclusion of
your analysis
Select
one
X
No major change
Give details
In itself the HWbB Constitution has limited potential
for discrimination. Further to analysis therefore,
there is no need for major change.
The evidence shows no
potential for
discrimination and you
have taken appropriate
opportunities to
advance equality and
foster good relations.
Adjust the policy
Take ‘mitigating action’
to remove barriers or
better advance
equality.
Ensure decision
makers understand the
equality impact.
Continue the policy
Adverse impacts have
been identified, but
have been objectively
justified (provided you
do not unlawfully
discriminate).
Ensure decision
makers understand the
equality impact.
Stop and remove the
policy
The adverse effects are
not justified, cannot be
mitigated or show
unlawful discrimination.
Ensure decision
makers understand the
equality impact.
STEP 5: Action plan
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Equality Impact Assessment
Issue or
opportunity
identified
HWbB to ensure
equality and
diversity issues
are formally
considered and
acknowledged
when carrying out
key functions
detailed in
Constitution
Action proposed




To support
continued
development of
the JSNA




August 2011 – [email protected]
HWbB to monitor equality and diversity
issues when assessing performance
targets, for example, for the HWb
Strategy. Equality and diversity issues to
be formally raised as an item at every
fourth HWbB meeting.
HWbB to ensure it engages with local
organisations where appropriate, working
effectively with the consumer organisation
Hertfordshire Healthwatch to pass on key
messages to the community and to take
on board local feedback.
HWbB to emphasise to commissioners,
service providers and partner
organisations the importance of assessing
equality issues during implementation of
board decisions or advice.
HWbB to encourage commissioning
teams/service providers to develop
systems to monitor, assess and follow up
equality issues and EQIAs to be
completed for any major health initiatives
where negative impacts are a possibility.
HWbB to take on board equality and
diversity information provided by JSNA to
inform commissioning decisions and
facilitate appropriate joint working that
responds to local needs.
JSNA to continue current undertaking of
developing profiles for each of the nine
HWb Strategy priorities to include detailed
equality and diversity data.
HWbB to encourage commissioners and
service providers to continue liaising with
JSNA manager to ensure key information
on protected groups and relevant
inequalities passed on.
Evidence of JSNA to be used by
commissioners and service providers to
clarify different health and equality needs
and to inform future health initiatives and
engagement.
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Responsibility
and target
date
April 2013
onwards
April 2013
onwards
Mark Jordan
(JSNA
Manager)
Equality Impact Assessment
Issue or
opportunity
identified
To revisit and
review the EQIA
on a regular basis
to incorporate any
further changes to
the HWbB
constitution
Action proposed


To revisit the EQIA and update where
appropriate following the publication of
the secondary legislation regarding local
government procedure rules and HWbBs.
EQIA to be reviewed and updated on a
half year basis.
Responsibility
and target
date
January/
February 2013
Anna Lawrence
(HWb Project
Officer)
April 2013
onwards
August 2011 – [email protected]
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