EHRIA: One-to-One Support implementation project pilot site [Queen Victoria Hospital NHS FT]
1. Equality and Human Rights Impact Analysis (EHRIA)
Help
1.1 Board Lead: Amanda Parker
Director of Nursing
[email protected]
1.4 Analysis Team Members:
1) Author / Editor: Scott Durairaj, Adam Churcher, Amanda Parker
1.5 If this is a cross agency policy/service
or strategy please indicate partner
agencies and their formal title
Equality, Diversity and Human Rights Team [SP NHS FT]
1.6 Completion Statement
1.2 Analysis Start Date:
December 2011
1.3 Analysis Submission Date:
March 2012 -tbc
2) Frontline Staff: Jane Morris, Queen Victoria NHS Hospital
3) Patient / End-user: Ian Stewart – Chair of Governors, together with a patient representative [to be
identified] from a user group.
4) I/We, being the author(s), Service Managers, acknowledge in good faith that this analysis uses
accurate evidence to support accountable decision-makers with due regard to the National Equality
Duties, and that the analysis has been carried out throughout the design or implementation stage of
the service or policy.
1.7 Policy Aim
Pilot forming part of local care pathway redesign, providing evidence of cost-effectiveness and improved
patient reported outcomes and experience for patients with cancer. Macmillan Bid.
Send draft analysis along with the policy, strategy or service to [email protected] for internal quality control prior to ratification.
1.8 Quality Assessor sign off
Equality and Human Rights Impact Analysis (EHRIA)
Mr. Scott Durairaj
1.9 Reference Number
QVH 0001/2012
2
2. Evidence Pre-Analysis – The type and quality of evidence informing the assessment
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X
2.1 Types of evidence identified as relevant have X marked against them
X
Patient / Employee Monitoring Data
X
Risk Assessments
Please provide detailed evidence for the areas
X
Recent Local Consultations
X
Research Findings
Complaints / PALS / Incidents
X
DH / NICE / National Reports
highlighted , and also any other Evidence that may be
relevant (please state):
Focus Groups / Interviews
X
Good Practice / Model Policies
Service User / Staff Surveys
X
Previous Impact Analysis
Contract / Supplier Monitoring Data
X
Clinical Audits
X
Sussex Demographics / Census
X
Data from other agencies, e.g. Services,
Police, third sector
Serious Untoward Incidents
X
Equality Diversity and Human Rights
Annual Report
Demographic data relating to Kent and Medway –
Office for National Statistics.
Demographic data provided by Kent County Council
prior to the National Census. [Mosaic]
Information on Cancer and Ethnicity: Race for Life,
Afiya Trust and Cancer Equality.
3. AimsAndFreedomsGuidanceImpact and outcome Evaluation – Any impacts or potential outcomes are described below.
HelpEqualityImpactsGuidance
3.1
+
Personalisation of care model, will create opportunity for dialogue with patient and Carers –
creating choice and control.
Sexual
Orientation
Human
Rights
Sex
Religion &
Belief
+ –
Race
Ref
Describe how this policy, strategy or service will lead to positive outcomes for the protected characteristics.
Describe how this policy, strategy or service will lead to negative outcomes for the protected characteristics.
(Please describe in full for each)
Disability &
Carers
Gender
Reassignment
Pregnancy &
Maternity
Mark
one X
Age
People’s Characteristics (Mark with ‘X’):
X
Learning Disability: it is recognised that further work is required on supporting communication
with people with LD, as well as provision of advocacy, which in some cases will be a statutory
requirement.
3.2
+
Patient centred focus, together with emphasis on patient and carer need will provide
opportunity to deliver culturally competent clinical care which takes account of person’s needs
and responds positively to cultural and ethnic difference.
X
Evidence based approach also enables clinical staff to better understand cancer in relation to
higher incidence in certain ethnic groups, as well as difference in progression of cancer and the
© Sussex Partnership NHS Foundation Trust March 2011
3
Sexual
Orientation
Human
Rights
Sex
Religion &
Belief
+ –
Race
Ref
Disability &
Carers
Gender
Reassignment
Pregnancy &
Maternity
Mark
one X
Age
People’s Characteristics (Mark with ‘X’):
Describe how this policy, strategy or service will lead to positive outcomes for the protected characteristics.
Describe how this policy, strategy or service will lead to negative outcomes for the protected characteristics.
(Please describe in full for each)
factor that ethnicity can and does play in prognosis and
3.3
+
Kent and Sussex have historically been home to communities with a higher than average level
of adherence to faith; with Kent being the site of the largest Sikh place of workshop in Europe
and Sussex being home to a number of national HQs of minority faith groups.
X
Whilst the multi-faith dimension of the local areas could be viewed as a challenge, this diversity
continues to provide an opportunity for NHS trusts to explore ways of working in partnership,
to better meet the faith and spiritual needs of patients and Carers when developing new
services. This pilot, which is supporting patients and carers through both life changing and/or
at the end of life, will create greater scope to build on exiting work to support increase
knowledge and awareness of staff around matters relating to faith and belief, as well as
support improvements to practice which take account of patient faith and belief.
3.4
+
Sussex and Kent include geographic areas with proportionally larger Lesbian, Gay and Bi
populations. A pilot based in Sussex and Kent will enable issue relating meeting the distinct
needs of the LGB communities to be properly explored and addressed.
3.5
+
The NHS across Sussex has promoted sound working partnerships with groups working to
support better health outcomes for Trans people. The barriers that exist for trans people to
access cancer screening, treatment and care are well documented and understood locally.
This pilot will afford an opportunity to address the ’invisibility of trans patients and carers.
X
X
Add more rows if necessary with new reference numbers in the left column
4. General Duty – Due Regard
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© Sussex Partnership NHS Foundation Trust June 2011
Sexual
Orientation
Human
Rights
Sex
Religion &
Belief
Race
Age
Describe how this policy, strategy or service will show due regard for the three aims of the general duty across
the protected characteristics listed. Please describe in full. (Please make sure that you address each of the
protected characteristics in your answers)
Disability &
Carers
Gender
Reassignment
Pregnancy &
Maternity
People’s Characteristics (Mark with ‘X’):
4
Sex
4.1 Eliminate unlawful discrimination,
harassment and victimisation and
other conduct prohibited by the
Equality Act 2010; Help
The pilot is supported by a good understanding of our local
communities, which is in turn based on ongoing engagement and
consultation, as well as policy and practice which has been
shaped by the Equality Act 2010 and the new Equality delivery
System [NHS].
Sexual
Orientation
Human
Rights
Religion &
Belief
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Age
Race
Describe how this policy, strategy or service will show due regard for the three aims of the general duty across
the protected characteristics listed. Please describe in full. (Please make sure that you address each of the
protected characteristics in your answers)
Disability &
Carers
Gender
Reassignment
Pregnancy &
Maternity
People’s Characteristics (Mark with ‘X’):
The Pilot through the approach adopted by the team and NHS
partners around eliminating discrimination will provide a fresh
opportunity to support the delivery of an integrated model of
cancer support which helps tackle health inequalities, whilst also
promoting best practice and patient centred care.
The Pilot approach based on a holistic model of care, operating
out of a central hub, may better respond to the needs of patients
with Learning Disability and their carers by promoting improved
access and a clearer pathway.
[NB: Sir Jonathan Michael and the Independent Inquiry into
Access to Healthcare for People with Learning Disabilities]
4.2 Advance equality of opportunity
between people from different
groups; Help
The pilot will enable improvement to access for all, to a central
Macmillan cancer nurse for support with improved links between
primary care and acute. This will provide patients and carers with
greater choice and control, personalised care that takes account
of their characteristics and responds to their needs.
The approach and the Pilot may offer better choice to those at
end of life, who because of faith or belief seek greater autonomy
over their care.
Those involved in the pilot will continue to take a robust
approach to diversity monitoring, which will aid work to advance
© Sussex Partnership NHS Foundation Trust March 2011
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Religion &
Belief
Sex
X
X
X
Sexual
Orientation
Human
Rights
Race
Age
Describe how this policy, strategy or service will show due regard for the three aims of the general duty across
the protected characteristics listed. Please describe in full. (Please make sure that you address each of the
protected characteristics in your answers)
Disability &
Carers
Gender
Reassignment
Pregnancy &
Maternity
People’s Characteristics (Mark with ‘X’):
equality of access and benefit between people from different
groups.
4.3 Foster Good relations between
people from different groups Help
The pilot is based on an inclusive and consultative approach to
service development and design. Through involving patients,
Carers, staff, staff side, service users and other stakeholders at
each stage, the Trust has begun the process of supporting good
and productive relations.
Diversity Monitoring & evaluation will form an important aspects
of ensuring good relations, including people from groups that
have historically been disenfranchised e.g. Older Carers, patients
from some ethnic minority groups –including Gypsy and
Travellers, younger men.
X
X
X
X
X
X
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5. Monitoring Arrangements
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5.1 The arrangements to monitor the effectiveness of the policy,
strategy or service considering relevant characteristics? E.g.
↘ survey results split by age-band reviewed annually by EMB
and Trust Board
↘ Service user Disability reviewed quarterly by Equality and
Diversity Steering Group or annually in the EDHR Annual
Report
© Sussex Partnership NHS Foundation Trust June 2011
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6. Human Rights Pre-Assessment
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The Impacts identified in sections ( ) have their reference numbers (e.g. 4.1) inserted in the appropriate column for each relevant right or freedom
+
A2. Right to life (e.g. Pain relief, DNAR, competency, suicide prevention)
–
4.1/4.2
A3. Prohibition of torture, inhuman or degrading treatment (e.g. Service Users unable to consent)
4.1
A4. Prohibition of slavery and forced labour (e.g. Safeguarding vulnerable patients policies)
A5. Right to liberty and security (e.g. Deprivation of liberty protocols, security policy)
A6&7. Rights to a fair trial; and no punishment without law (e.g. MHA Tribunals)
A8. Right to respect for private and family life, home and correspondence (e.g. Confidentiality, access to family etc)
4.2
A9. Freedom of thought, conscience and religion (e.g. Animal-derived medicines/sacred space)
4.2
A10. Freedom of expression (e.g. Patient information or whistle-blowing policies)
4.3
A11. Freedom of assembly and association (e.g. Trade union recognition)
4.3
A12. Right to marry and found a family (e.g. fertility, pregnancy)
P1.A1. Protection of property (e.g. Service User property and belongings)
P1.A2. Right to education (e.g. accessible information)
P1.A3. Right to free elections (e.g. Foundation Trust governors)
7. Risk Grading
7.1 Consequence of negative
impacts scored (1-5)
Help
2
7.2 Likelihood of negative
impacts scored (1-5):
© Sussex Partnership NHS Foundation Trust March 2011
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7.3 Equality & Human Rights Risk Score
= Consequence x Likelihood scores:
6
7
8. Analysis Outcome– The outcome (A-D) of the analysis is marked below (‘X’) with a summary of the decision
X
X
8.1 The outcome selected (A-D):
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8.2 Summary for the outcome decision (mandatory)
A. Policy, strategy or service addresses quality of outcome and is positive in its language
and terminology. It promote equality and fosters good community relations
B. Improvements made or planned for in section 9 (potential or actual adverse impacts
removed and missed opportunities addressed at point of design)
C. Policy, service or strategy continues with adverse impacts fully and lawfully justified
(justification of adverse impacts should be set out in section 3 above
The proposal is overall very positive, we have
suggested three action that will enhance the
proposal and potentially deliver improvements
in experience.
D. Policy, service or strategy recommended to be stopped. Unlawful discrimination or
abuse identified.
9. Equality & Human Rights Improvement Plan
›
›
›
›
›
Remove negative impacts for people with protected characteristics
Improve opportunities for people with protected characteristics
Improve evidence and fill ‘gaps’ in our knowledge where relevant
Record changes already made as a result of the impact analysis process
Actions resulting from public engagement, should include the name and date of the engagement next to it
Actions should when relevant and proportionate meet the different needs of people.
Impact
Reference(s)
(from assessment)
What directorate
(team) action plan will
Action
Lead Person
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Timescale
Resource Implications
this be built into
Update of demographic data sets to
local ward level.
Share knowledge between partners
on matters relating to faith and end of
life care.
Review information for service users
with Learning Disability and in line
with DH guidance ensure clinical staff
have LD training.
Add more rows if necessary
© Sussex Partnership NHS Foundation Trust June 2011
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Build this plan into relevant parts of your project / business / service plans (reflect in their wording that they are ‘equality objectives’
© Sussex Partnership NHS Foundation Trust March 2011
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© Sussex Partnership NHS Foundation Trust June 2011
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