RAPID IMPACT ASSESSMENT TOOL – EQUALITY AND DIVERSITY


In this document the terms policy, function, procedure or proposal are used interchangeably.
Please make reference to positive and negative impacts in the narrative part of each section.
1. Policy Title
Highland Sexual Health Strategy
2. Please give a brief description of the
policy, function, procedure or proposal
Strategy to improve the Sexual Health of
groups and individuals throughout the
Highland Population
3. RIA REFERENCE NUMBER
RIA10/04/06MANNPUBLIC HEALTH01
4. Department/Directorate responsible for
policy
5. Responsible Manager
Public Health /Health Promotion
6. Person/s completing RIA
Name
Lorraine Mann
Lorraine Mann
Pip Farman
Natalie Morel
7. Policy attached (if no, then where can it
be found)
8. Date of RIA meeting (s)
9. Total length of time taken to complete
RIA
Title & Tel Number
Health Promotion
Specialist Sexual
Health 01463
704937
Specialist in Public
Heath 01463
704789
Policy Development
Manager 01463
704918
No
Yes
Draft Policy currently
attached, when
recommendations approved
by Highland Sexual Health
Strategy final strategy will be
attached
10th April 2006 & 13th April 2006
4 hrs
10. General Comments about RIA process
NONE
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47. Please use the space below to record any Impact.
Factor (Name and Number
13 Substance Misuse
Group Impacted
Specifically Chaotic drug users (under any other
groups)
Nature of Impact
It is well documented (nationally and internationally) that individuals engaging in chaotic
drug use are at increased risk of developing potentially less stable relationships and may
be at increased risk of potentially contracting infections that can be sexually transmitted.
Although the Sexual Health Strategy makes references to actual and potential
vulnerable groups it is anticipated that more specific reference would be provided at an
action planning level rather than broader strategic level, this may be within sexual health
services and/or drug services.
Action
1.
Ensure that Substance Misuse is given appropriate consideration within Sexual
health Services, either at action planning stages or within service level agreements.
2.
Ensure that Sexual health issues are discussed when undertaking Drug Action
Team specific Equality and Diversity Impact Assessment.
Factor (Name and Number
14 Risk Taking Behaviour
Group Impacted
Potentially all groups
Nature of Impact
The Strategy aims to provide a framework against which services can meet the needs of
their particular client group. This is achieved by providing a broad outline of key themes
and groups and broad guidelines on responses to these themes. In this way the
strategy is seen as having a positive response to potentially all groups. It has been
highlighted that not all groups will have equal access to information in relation to risk
taking behaviour (this further referenced throughout the process) and there is potential
for adverse impact in this instance. In this context there is potentially an impact on staff
in terms of those working specifically with these groups and being able to address
sexual health issues and staff working in sexual health services ensuring that they are
accessing specific groups effectively and appropriately.
Action
3.
Review current practices re distribution of information literature in relation to
meeting the needs of different equality groups
4.
Take a snapshot of actual levels of knowledge re sexual health issues with staff in
services working specifically with equality groups (for example Older People’s Services)
2
Factor
(Name
Number
15
Education
learning
and Group Impacted
ALL (EXCEPT People on low income People involved in the
and criminal justice system and people with specific health
issues). Potential negative impact – People in religious/faith
groups
Nature of Impact
The strategy makes specific reference to the education and learning provision to all
Highland residents in relation to sexual health through information and service provision,
this is seen as a positive impact if delivered by services. In developing the strategy it
has been highlighted that currently some children and young people are withdrawn from
sexual health education in school, on the basis of specific religious beliefs or faiths. It is
noted that staff require further training to ensure they are able to provide appropriate
support to these parents in relation to what if any information might be provided in
another setting or using other methods (see factor 21). Issues re staff education and
learning are addressed in factor 16 and 33
Factor (Name and Number
16 Skills
Group Impacted
Staff
Nature of Impact
(As with section 33) Although the strategy refers throughout indirectly to staff learning
and development, it would appear that there are no specific objectives relating to
learning and to the inclusion of equality and diversity issues in this learning. This RIA
process has highlighted the importance of ensuring that staff have the appropriate
knowledge and skills to support all groups appropriately and therefore prevent any
potential or actual adverse impact.
Action
5.
Carry out RIA in partnership with local authority in relation to schools learning
approaches to providing Sexual Health Education with specific reference to meeting the
needs of different faith groups.
Factor (Name and Number
17. Availability of care and support
Group Impacted
Children and Young People
Staff
Nature of Impact
A review of the strategy content highlighted some possible incongruence in terms of how
Children and Young People may or may not be able to access sensitive services and
having a choice of provision of such services. It would appear that in the case of a
sexual assault any Young Person approaching a service would be required to inform the
police and may be required to travel some distance from home in order to be medically
assessed by the police. This again may impact on the ability to maintain the
confidentiality of the Young Person, in terms of access to transport and access in terms
of distances to be travelled and limited availability of public transport. (see also Factor
23 and 27 )
Action
6.
Take a snapshot of postcodes of Young Persons using services and agree action
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as required to support access to services for those in areas of low use.
Factor (Name and Number
18. Other lifestyle issues
Group Impacted
Nature of Impact
This is seen as an area of equal impact on all groups, sexual health is influenced by
lifestyle issues and specific impacts are discussed throughout this document.
Factor (Name and Number
19. Social status, attitudes
stigma
Group Impacted
and All Equality Groups
Nature of Impact
In terms of the strategy, the importance of addressing any negative impact in relation to
this factor is highlighted throughout. As previously mentioned impact assessing specific
service provision will illustrate how this relates to practice.
Factor (Name and Number
21. Social/Family Support
Group Impacted
People in faith/religious groups
Nature of Impact
As referenced at Factor 15,
Action
7.
Further investigation is required as to how information and support might be
provided to parents in specific faith groups and implementation of learning into practice.
Factor (Name and Number
22. Stress
Group Impacted
All groups
Nature of Impact
This is seen as a potential area of impact for all groups because of the nature of
services and issues related to Sexual health and Services. Issues specific to Equality
groups are highlighted elsewhere in the document.
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Factor (Name and Number
23. Income and Relative Income
Group Impacted
Children and Young People
Nature of Impact
There is an existing national and international evidence base suggesting a positive
correlation between teenage pregnancy and uptake of benefits/decrease in employment.
By reducing teenage pregnancies the strategy can be seen as having a potentially
positive effect on future income.
The availability of emergency hormonal contraception may be unequal in terms of
access for Children and Young People as a cost is incurred. Although this provision
may be available free of charge in a health setting it is particularly relevant to those living
in remote and rural areas where confidentiality and access can be easily comprised or
are limited.
Action
8.
Ensure that availability and uptake of provision are regularly reviewed and an
approach agreed by the strategy group for action locally or lobbying to the centre.
Factor (Name and Number
25. Personal Safety.
Group Impacted
All groups
Nature of Impact
Positive impact in that the strategy aims to maintain and improve the personal safety of
the Highland Population by ensuring good sexual health.
Factor (Name and Number
27. Health Care
Group Impacted
Young People
Nature of Impact
As highlighted in Factor 17 and 23
Factor (Name and Number
28 Transport
Group Impacted
Disabled People, Children and Young People,
Transgender People, People on low income,
People with specific health issues
Nature of Impact
Disabled People may not be able to access all services as public transport services
which are generally limited are even less available to people with a disability, this may
impact on the choice of services available
Children and Young People may similarly have limited choice because of transport links
as previously mentioned, this may also apply to people on low income in terms of
accessibility to services with significant travel distances required for those in remote and
rural areas
Services in relation to care, support or treatment of Transgender specific issues are not
available in Highland, which means individuals are required to travel out with Highland to
access provision, incurring significant cost. This situation is similar for individuals in
relation to sexual dysfunction issues. Issues for all these groups may be exacerbated by
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the limited practice of GPs refusing to provide Sexual Health Services. Although this
should automatically generate a referral to other services, there is no accessible
evidence that supports or challenges this view at this time.
Action
9.
Issues relating to access to health services are being impact assessed within the
local authority as part of a wider EQIA process, feedback from this process should be
provided to clinical networks for local action.
10.
Review patient information gathering in sexual health services and gather
information about use of services by disabled people. This information should then be
used along with data about other equality groups to draw up a baseline of current
provision and review any inequalities arising in relation to transport for example.
11.
Review any existing data about the transgender population in NHS Highland area
and ensure that support to access services is clearly available to this group.
Factor (Name and Number
29. Social Services
Group Impacted
Children and Young People
Nature of Impact
Although there is reference to the role of child protection services within the strategy,
there is a lack of clear reference to the role of such services in relation to the sexual
health of Young People and it is therefore difficult to judge any potential impacts, on the
basis of a lack of information it would be possible to assume a negative impact until
evidenced otherwise.
Action
12.
Include clear reference to the role that Child Protection services have in the
development of the strategy and subsequent practice and provision.
13.
Advise partners of these issues when conducting EQIA with Child Protection
Services.
Factor (Name and Number
33. Employee Training
Group Impacted
Potentially All Groups
Nature of Impact
Although the strategy makes some references to training, how this is filtered into
practice is unclear. As with all other areas of training it is not clear how equality and
diversity is built in to existing Sexual Health training. Although this is being considered
as an issues in the equality and diversity training model, some of the SH training occurs
outside the learning and development services. Potential impacts on equality groups
may be exacerbated if staff working with such groups do not see the relevance of such
training, for example people working for people who are disabled or Older People.
Action
14.
Equality and Diversity Impact assess sexual health training activities
15.
Agree to build equality and diversity into SH training
16.
Review how training is promoted to staff working with equality groups
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Further information required:
Information about sexual health and risk taking behaviour specifically in relation to Older
People, Disabled People, People with mental health problems and Homeless People
Snapshot of knowledge base of staff working with these groups re accessing Sexual
Health Services
Information from various faith groups in relation to the provision of sexual health
information to children
Number of people requiring transgender specific services travelling from Highland
Number GPs not providing sh services and referrals to services generated through this
i) Recommendations and priority status
 Ensure that Sexual health issues are discussed when undertaking Drug Action Team
specific RIA.
 Referenced further in relation to assessment of need, it will be most beneficial to
carry out RIAs with specific sexual health services to review potential positive and
adverse impact in relation to risk taking behaviour, education and learning,
particularly in terms of Disabled People, Older People, People with mental health
problems and Homeless People (see also section c re request for further evidence).
 The strategy should include clear reference to the learning and development needs
of staff in specialist and generic services and an indication of the relevance of
equality and diversity within any learning and training opportunities. It has been
recommended that equality and diversity be included within all NHS training, this
approach could be replicated across partners involved in this strategy.
 Partners involved in the strategy should ensure that training provided to their staff
has been equality and diversity impact assessed and that training specifically on
equality and diversity is available to all staff. Although Public Authorities do have
specific duties to comply with outlined in codes of practice in relation to Race,
Disability (December 2006) and Gender (April 2007) the strategy should recognise
that carrying out such tasks may take time and require a staged approach to
completion.
 Patient information gathered by services should include information about age,
disability, ethnicity and sexual orientation as well as gender to ensure that any
inequalities in service provision can be highlighted and addressed as soon as
possible.
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