Community Impact Assessment Form
For a summary of this Community Impact Assessment, click here
Note: A Community Impact Assessment must be undertaken before and at
the time that a decision is being considered
Title of Community Impact Assessment: Commissioning Review of Services for
people
within mental health.
Directorate: Community, Health and Social Care Directorate
Date of assessment: 26th September 2011
Names and roles of people carrying out the community impact assessment.
(Please identify Lead Officer): Lead Officer: Jennifer McGovern – Assistant
Director, Joint Commissioning; Deborah Siddique – Principal Officer,
Commissioning
Section A – What are you impact assessing?
What are you impact assessing? (please tick which applies):o A decision to review or change a service
o A strategy
o A policy or procedure
A function or service
Are you impact assessing something that is?:o
o


New
Existing
Being reviewed
Being reviewed as a result of budget constraints
Describe the area you are impact assessing and, where appropriate, the changes
you are proposing?
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CHSC commission a range of services for vulnerable adults from Third Sector
providers, including advocacy; advice and information; day care; and support for:older people, disabled people, people with HIV/AIDS, people who experience
mental ill-health, cares and people with conditions and / or diseases such as
stroke and cancer. These services help people to live in the community and
maintain their independence, preventing or delaying their need for specialist
interventions.
The health and social care services provided by these Third Sector organisations
were reviewed in 2010/11 in response to the Comprehensive Spending Review,
which necessitated efficiency savings equivalent to 8%. Whilst this meant that
most organisations had to make adjustments to the way they carried out their
services the actual level of services received by vulnerable adults was largely
unaffected in 2011/12.
However the continuing requirement for efficiencies means that the level of
service provision is likely to be affected in 2012/13. This impact assessment is
considering services commissioned for people experiencing mental ill-health.
The Commissioning cycle involves a continuous activity of assessing need,
identifying provision, identifying gaps, specifying service requirements, identifying
a budget, agreeing the contract, monitoring performance and reviewing the
service. As all the contracts with Third Sector organisations were coming to an
end on 31st March 2011 it was agreed that a strategic review of services was
necessary. In order to facilitate this all contracts were extended to 31 st March
2012.
The review involved:
 Individual meetings with providers
 Analysing review forms completed by providers to establish strategic relevance
and identify the full scope of their activity
 Stakeholders contacted for their views to input into the review and recommissioning process
 Questionnaire and focus group with service users
In addition the review has been informed by the:
 Joint Strategic Needs Assessment
 Client group specific commissioning strategies
 Commissioning Strategy for Personalisation
 Gap analysis based on the Adult Social Care / NHS Outcome Frameworks
 Analysis of policy, commissioning guidance and legislation
The outcome of the review is that three priorities have been highlighted for
commissioning services. These are:
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Personalisation
Services delivering advice, information and support; services providing advocacy;
services which can be purchased by individuals with their own resources,
including personal budgets
Rehabilitation and Prevention
Services delivering specialist rehabilitation and preventative support designed to
maintain independent living and prevent the need for admission to secondary care
or intensive social care
Infrastructure Support
Services which contribute to the infrastructure required to deliver effective
partnership working
It has been determined that there will be 5 single contracts commissioned from 1st
June 2012:
 General Information, Advice and Support
 Advocacy Services
 Dementia Support
 Carers Services
 Delivering Direct Payments
Hospital Discharge and Stroke Services will continue to be provided by the
existing providers. This means that the City Council will not directly commission a
specific contract for support services for people experiencing mental ill-health.
In addition some services currently provided through a block contract will have to
be purchased by individuals using their own resources, including personal budgets
by April 2014. This includes: carers breaks, day care.
Section B – Is a Community Impact Assessment required?
Consider what you are impact assessing and mark “x” for all the statement(s)
below which apply
Service or policy that people use or which apply to people (this
could include staff)
Discretion is exercised or there is potential for people to
experience different outcomes
Concerns at local, regional or national level of
discrimination/inequalities
Major change, such as closure, removal or transfer
3
X
X
X
X
Community and regeneration strategies, organisational or
directorate partnership strategies/plans
Employment policy – where discretion is not exercised
Employment policy – where discretion is exercised, e.g.,
recruitment or disciplinary process
X
If none of the areas above apply, you will not be required to undertake a community
impact assessment. Please summarise why a CIA is not required and send this form
to your directorate equality lead officer
Equality Areas
Indicate with an “x” which equality areas are likely to be affected by the proposals
Age
X
Religion and/or belief
X
Disability
X
Race
X
Gender (including pregnancy
and maternity)
Gender reassignment
X
Sexual Identity
X
X
People on a low income
X
Race
X
Other (please state) (For
example carers, ex offenders) Carers
If any of the areas above apply, you will be required to undertake a CIA. You will
need only to consider those areas which you have indicated are likely to be affected
by the proposals.
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Section C – Information
Please provide a list of the information (monitoring and consultation) used to inform your CIA and what this
information tells you. If there are any gaps in information, explain how you will address this.
Equality area
Age
List of information
What does this information tell you?
How will gaps be
addressed? (This should
also be detailed in the
action plan at section E)
Mid-Year Census data There are approximately 33,200 people over There are no gaps in
the age of 65 in Salford (15.4% of the
information
Service User data
population. This is expected to rise to
from providers
17.2% by 2025. It is predicted that 35.8%
(11,893) of people over 65 live alone, 10.7%
Service Provider
(3,581 are carers and 32.4% (10,780) are
Review Forms
unable to manage at least one self-care
activity on their own.
Stakeholder
1 in 5 older people experience depression –
consultation
that is around 6,640.
The nature of existing services (Advocacy,
Carer Support, Drop-in Centre, Relationship
Advice and Guidance, Employment
Development) means that a broad age
range of people access the services e.g.
employment development and relationship
guidance largely accessed by age 25 – 55
age group and a large number of people
accessing the drop-in are over 65.
The information tells us that older people are
accessing the current services in line with
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Disability
Census data
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Gender (including Census data
pregnancy and
expectations
Many older people become frail and unable
to carry out daily tasks due to the natural
aging process and / or conditions such as
stroke.
There are approximately 33,200 people age
65+ in Salford (15.4% of the population). It
is predicted that 32.4% (10,780) are unable
to manage at least one self-care activity on
their own.
An average of 99 people receive day care
services from current providers; 142 carers
are supported; 100 individuals are
supported to gain training or employment,
128 use the advocacy service and 340
receive counselling. It is not known how
many of these individuals have a physical or
sensory disability but all are affected by
mental health issues which, using the social
model of disability, is regarded as a
disability.
Where services are provided in premises /
location of the service provider the facilities
are all physically accessible and each
provider produces a range of information in
accessible formats.
This information tells us that people with a
disability, including mental ill-health, are
accessing the services they need
1 in 4 people experience some kind of
mental ill-health in the course of a year and
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There are no gaps in
information
There are no gaps in
information
maternity)
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Gender
Reassignment
No data available
1 in 5 older people experience depression.
Women are more likely to be affected by
mental ill-health than men – for example
women are twice as likely to experience
anxiety and 60% of people with Obsessive
Compulsive Disorder or phobias are women.
However men are more likely to have drug
and / or alcohol problems – for example 67%
of people consuming hazardous levels of
alcohol are men.
Therefore, more women access the services
provided.
In 2008 there were 68,400 (38.6%) men and
108,985 (61.4%) women aged18 – 64 and
14,400 (43.2%) men and 18,900 (56.8%)
women over the age of 65 in Salford.
We would therefore expect 17,100 men and
27,246 women aged 18 -64 and 2,875 men
and 4,010 women aged 65+ to experience
mental ill-health.
Of those receiving services from the current
Third Sector providers 32.25% are men and
67.75% are women.
This information tells us that men and
women are accessing the services in the
proportions expected
It is estimated (by the Gender Identity
Research and Education Society) that the
prevalence of gender dysphoria is 20 per
100,000 population. This would equate to
43 in Salford. This is an area of growing
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Data on gender
reassignment is not
collected by the providers.
This will be required of
providers in future
Race
Census data
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Religion and/or
belief
Census data
Sexual Identity
Government data
Service User data
from providers
demand for medical treatment (doubles
every 5 years)
It is known that the BME population has
grown since 2001 and according to the 2007
ONS population estimate 7.98% of the
population in Salford is from a BME
community.
Of the individuals accessing current, not
BME specific, services approximately 6%
are from BME communities.
This information tells us that people from
BME communities are accessing services in
line with expectation
The 2001 census indicated that 76.46% of
the population in Salford was Christian,
2.4% Jewish, 1.22% Muslim. It is known
that these figures have changed – for
example it is believed that the Jewish
population is now 5.5%.
The people accessing the services of the
current BME specific provider are doing so
because they are sensitive to their religious
needs. Only one other provider collects data
on religion – this showed that 12.5% of
service users were Muslim, 3.1% Jewish
and 71.9% Christian. This indicates that
people are accessing services as expected
Information on sexual identity was not
collected in the 2001 census but the
Government figure is that 5.7% of the
population is lesbian, gay or bisexual.
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There are no gaps in
information
Data on religion is not
collected by all providers.
This will be required of
providers in future
Data on sexual identity is
not collected by the
providers. This will be
required of providers in
Service Provider
Review Forms
People on a low
income
Other (please
state) (For
example carers,
ex offenders)
Stakeholder
consultation
Service Provider
Review Forms
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Most services for older people are targeted
at heterosexuals. Information on sexual
identity is not collected by the current
service providers
future
Whilst the employment status / income level
of those using services for people
experiencing mental ill-health is not recorded
all have access to welfare benefits checks
through the providers.
People experiencing mental ill-health,
particularly those living on benefits or a state
pension, experience higher levels of
deprivation. Health inequalities are also
closely linked with levels of deprivation
It is estimated that there are 20,000+ carers
in Salford of whom approximately 3,500
receive a service from Community, Health
and Social Care Directorate. A significant
number of carers will be looking after a
partner or family member who is has mental
health issues and some will also experience
mental ill-health themselves. There is a
carer specific element within the current
service provision.
This indicates that carers are accessing
services appropriately
Data on income level /
employment status is not
collected by the providers.
This will be required of
providers in future
Section D – Potential impact and how this will be addressed
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There are no gaps in
information
The Equality Act 2010 requires public bodies to have “due regard” or to consciously think about the three aims of the
Equality Duty as part of the process of decision-making, in the following areas: Eliminate unlawful discrimination, harassment and victimisation
 Advance equality of opportunity between people who share a protected characteristic (link) and those who do
not
 Foster good relations between people who share a protected characteristic and those who do not
Indicate below how you will meet the Equality Duty.
Eliminate discrimination
Equality area
Age
Advance equality of
opportunity
Based on information
What changes will you
detailed in Section C above, make to the function to
who is not, or may not be
maximise positive
getting the outcome they
outcomes for all groups?
need from the function?
Explain why.
People are accessing current The new contracts for:
services as expected in terms
 General Advice,
of the age demographics of
Information and Support
the population
 Advocacy
 Dementia Support
As the older population
 Carers Services
increases in size and
 Delivering Direct
becomes more frail services
payments
will need to ensure they
Will have service
reflect the needs of a wider
specifications that include
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Foster good relations
Is there potential to foster
good relations between
different equality groups?
Explain how you will do
this.
Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
age range of service users
Disability
provision for people
experiencing mental ill-health.
Providers will be expected to
demonstrate that their service
is appropriate to people in
different age groups.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
Disabled people are
The new contracts for:
accessing the current
 General Advice,
services appropriately.
Information and Support
Service providers will need to
 Advocacy
ensure that their services are
 Dementia Support
accessible to people
 Carers Services
experiencing mental ill-health.
 Delivering Direct
Services also need to take
payments
action to combat attitudinal
Will have service
barriers
specifications that include
provision for disabled people,
including people experiencing
mental ill-health. Services
should provide information in
formats other than English.
Providers will be expected to
demonstrate that their service
is appropriate for people
experiencing mental ill-health.
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Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
Gender (including
pregnancy and
maternity)
Gender
Reassignment
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
People are accessing current The new contracts for:
services as expected in terms
 General Advice,
of the gender demographics
Information and Support
of the population and the
 Advocacy
incidence of mental ill-health.
 Dementia Support
As the demographics of the
 Carers Services
population experiencing
 Delivering Direct
mental ill-health changes
payments
providers will need to ensure Will have service
that services are appropriate specifications that include
to the needs of men and
provision for men and women
women
experiencing mental ill-health.
Providers will be expected to
demonstrate that their service
is appropriate for men and
women.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
No data available to indicate
The new contracts for:
whether or not people who
 General Advice,
have changed gender are
Information and Support
12
Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
Third Sector provider
organisations are being
encouraged to diversify and
accessing current services
Race
People from different BME
communities are accessing
the services as expected
according to the
demographics of the
population.
Given the size of the BME




Advocacy
Dementia Support
Carers Services
Delivering Direct
payments
Will have service
specifications that include
provision for transgender
people experiencing mental
ill-health. Services should be
also be sensitive to people
who are in the process of
gender reassignment or have
changed gender. Providers
will be expected to
demonstrate that their service
is appropriate for people who
have changed gender.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
The new contracts for:
 General Advice,
Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct
13
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
population and the incidence
of mental ill-health providers
need to ensure that their
services are inclusive and can
adapt as the population
increases
Religion and/or
belief
Not all current providers
record the religion of service
users. People access the
BME specific providers
services because they are
religiously and culturally
sensitive to their mental
health needs.
All service providers will need
to ensure data on religion /
belief is captured and that
payments
Will have service
specifications that include
provision for people from
BME communities
experiencing mental ill-health.
Services should be culturally
sensitive and provide
information and support in
languages other than English.
Providers will be expected to
demonstrate that their service
is appropriate for people from
all BME communities.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
The new contracts for:
 General Advice,
Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct
payments
Will have service
specifications that include
provision for people from
14
adults as possible
Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
they provide appropriate
spiritual welfare services
Sexual Identity
different faiths and beliefs.
Services should be sensitive
to people’s religion / beliefs
and support their spiritual
welfare.
Providers will be expected to
demonstrate that their service
is appropriate for different
religious / belief communities.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
No data available to indicate
The new contracts for:
whether or not people of
 General Advice,
different sexual identities
Information and Support
access services. Providers
 Advocacy
need to collect this data and
 Dementia Support
ensure that the environment
 Carers Services
and information is appropriate
 Delivering Direct
for communities of all sexual
payments
identities
Will have service
specifications that include
provision for people of
different sexual identities
experiencing mental ill-health.
Services should be sensitive
to individuals of different
sexual identities.
15
Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
People on a low
income
Current providers do not
record income level or
employment status of people
using their services. People
experiencing mental ill-health
and living on benefits
experience higher levels of
deprivation and therefore
health inequalities.
Service providers will need to
ensure data on income level /
benefit status is recorded and
that people are supported to
maximise their income
Providers will be expected to
demonstrate that their service
is appropriate for different
sexual identities.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
The new contracts for:
 General Advice,
Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct
payments
Will have service
specifications that include
provision for people
experiencing mental ill-health.
Services should help
individuals to maximise their
income.
Providers will be expected to
demonstrate that their service
helps to reduce socioeconomic inequality.
In addition it is expected that
people will also be able to
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Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
Other (please state)
(For example
carers, ex
offenders)
Carers are accessing the
services as expected.
Service providers need to
ensure that their services are
carer friendly.
The new contracts for:
 General Advice,
Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct
payments
Will have service
specifications that include
provision carer experiencing
mental ill-health and / or
caring for someone
experiencing mental ill-health.
Services should support
people in their caring role.
Providers will be expected to
demonstrate how their service
has benefitted carers affected
by mental ill-health.
In addition it is expected that
people will also be able to
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
17
Third Sector provider
organisations are being
encouraged to diversify and
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
Cross cutting
themes
(If your responses
cover all equality
areas, state here)
Could making the changes in any of the above areas have a negative effect on other groups? Explain why and what
you will do about this.
None of the above should have an impact on other groups. The service specifications are intended to make
services inclusive to all communities / groups .
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Section E – Action Plan and review
Detail in the plan below, actions that you have identified in your community impact assessment, which will eliminate
discrimination, advance equality of opportunity and/or foster good relations.
Impact (positive or
negative) identified
Proposed action
Collection of data to
Lack of data on:
be included in new
Gender reassignment service specifications
Religion / belief
Employment status
Lack of specific
contract for support
services for people
experiencing mental
ill-health
Person(s)
responsible
Integrated
Commissioning
Managers
Design services with Integrated
specifications in the
Commissioning
each of the following Managers
areas:
 General Advice,
Information and
Support
 Advocacy
 Dementia
Support
 Carers Services
 Delivering
Direct
payments
that
 incorporate
appropriate
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Target date
Required outcome
Inclusion in
Specifications:
October 2011
Collection: from July
2012
Data will be available
from April 2013
Inclusion in
Specifications:
October 2011
Contracts in
operation: from July
2012
Redesigned, inclusive
services available
from July 2012
services for
people
experiencing
mental ill-health
within all
equality groups
 require
evidence that
services are
accessible to
people
experiencing
mental ill-health
Encourage Third
Lack of specific
Sector organisations
contract for support
to diversify and work
services for people
in partnership to
experiencing mental
provide services that
ill-health
are appropriate to
different equality
groups and reach as
many people affected
by mental ill-health as
possible
Enable Third Sector
Services not covered organisations to
by the 5 contracts will make the transition
have to be purchased from block contracts
by individuals using
to providing services
their own resources
that individuals
purchase with their
Commissioning Team December 2011 then
(in partnership with
on-going
Salford CVS)
Redesigned, inclusive
services available
from July 2012
Commissioning Team March 2014
(in partnership with
Salford CVS)
Wide choice of
services available for
people to purchase
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personal budget
Review
Your CIA must be reviewed at least every three years, less if it has a significant impact on people.
Please enter the date your CIA will be reviewed: September 2014. You should review progress on your CIA action
plan annually.
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Section F – Summary of your CIA
As your CIA will be published on the council’s website and accessible to the general
public, a summary of your CIA is required. Please provide a summary of your CIA in
the box below.
Summary of Community Impact Assessment
How did you approach the CIA and what did you find?
This CIA has been based on information gathered during individual meetings with
provider organisations, review forms completed by the provider organisations,
stakeholder questionnaires, current service user questionnaires and focus groups.
The CIA also takes into account the JSNA, appropriate commissioning strategies, a
gap analysis based on the Adult Social Care / NHS Outcome Frameworks.
The three priority areas identified: Personalisation; Prevention and Rehabilitation;
Infrastructure Support mean there will not be a contract specifically for people
experiencing mental ill-health from June 2012.
The information indicates that people experiencing mental ill-health are accessing
current services as expected, according to the demographics of the population in
Salford, in relation to age, disability, gender, race and carers.
There is a lack of data in relation to level of income / employment status, religion /
belief, sexual identity and gender reassignment.
What are the main areas requiring further attention?
The redesigned services will form five new contracts which organisations, including
existing providers, can tender for as sole provider or as a partnership arrangement.
These are:
 General Advice, Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct Payments
Each of the new contracts will have service specifications that:
 incorporate appropriate services for people experiencing mental ill-health in all
equality groups
 require evidence that services are accessible to people experiencing mental illhealth
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Some areas of current service provision may not be covered by the new contracts
e.g. day care, carers breaks, counselling. These will need to be purchased by
individuals using their own resources, including personal budgets. Organisations will
be worked with to ensure they are able to make the transition to this new purchasing
model.
The new contracts will require providers to collect data on employment status,
religion / belief and gender reassignment.
Summary of recommendations for improvement
Services will be redesigned under 5 new contracts incorporating all equality groups
Organisations will be supported to operate successfully in the new Personalisation
model
Data on all equality groups will be collected by providers
Section G – Next Steps
Quality Assurance
When you have completed your CIA, you should send it to your directorate Equality
Lead Officer who will arrange for it to be quality assured. It is important that your CIA
is robust and of good quality as it may be challenged
“Sign off” within your directorate
Your directorate Equality Link Officer will then arrange for your CIA to be “signed off”
within your directorate (see below). Your directorate Equality Lead Officer or other
senior manager within your directorate should “sign off” your CIA (below).
Name
Senior Manager
Signature
Keith Darragh
Date
14 November 2011
Lead CIA Officer
Anne Roberts
14 November 2011
Other Officers conducting
the CIA
Deborah Siddique
21st September 2011
Jennifer McGovern
21st September 2011
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Publishing
When your CIA has been signed off within your directorate, your directorate Equality
Link Officer will send it to the Equalities and Cohesion Team for publishing on the
council’s website.
Monitoring
Your directorate Equality Link Officer will also send your CIA to your directorate
Performance Officer where the actions identified within your CIA will be entered into
Covalent, the council’s performance management monitoring software so that
progress can be monitored as part of your directorate Business Plan.
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