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 with HIV / AIDS
Directorate: Community, Health and Social Care Directorate
Date of assessment: 16th 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 New
o Existing
Being reviewed
o Being reviewed as a result of budget constraints
Describe the area you are impact assessing and, where appropriate, the changes
you are proposing?
1
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 affected by HIV / AIDS.
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:
2
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
This means that the City Council will not be directly commissioning a specific
contract for HIV/AIDS support services. However NHS Salford will continue to
fund services so people will still have access to HIV/AIDS specific services.
In addition, any areas of current service provision not covered by the new
contracts e.g. alternative therapies will need to be purchased by individuals using
their own resources, including personal budgets.
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.
4
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
List of information
What does this information tell you?
Age
Mid-Year Census data The majority of people affected by HIV/AIDS
are aged 25 – 44. However advances in
Service User data
health care mean people are living longer so
from providers
this is likely to broaden the age band.
There are approximately 71,000 people age
Service Provider
50+ in Salford (32.4% of the population). In
Review Forms
2008 there were 501 confirmed cases of
HIV/AIDS in Salford and 8.5% of diagnoses
Stakeholder
are age 50+.
consultation
The current provider organisations engage
with 513 Salford residents – but is should be
noted that individuals can use the services
of more than one provider). 77% of current
service users are aged 25 – 49 and 11% are
50+
It is also known that, nationally, around 25%
of people with HIV are not aware of their
diagnosis. This means there could be a
further 167 people in Salford with HIV.
The information tells us that people are
accessing the current services in line with
5
How will gaps be
addressed? (This should
also be detailed in the
action plan at section E)
There are no gaps in
information.
the age demographics of people affected by
HIV/AIDS.
Disability
Census data
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Gender (including Census data
pregnancy and
maternity)
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Gender
Reassignment
No data available
HIV/AIDS is considered a disability.
The 501 confirmed cases of HIV/AIDS in
Salford equates to 228 per 100,000
population. This is much higher than the
national average of 127 per 100,000
population.
The premises of the current provider
organisations are all physically accessible.
This information tells us that individuals
affected by HIV/AIDS are accessing the
services they need.
There are no gaps in
information.
The majority of people affected by HIV/AIDS
are men. Across the North West 72.39% of
people with HIV/AIDS are men and 27.61%
are women.
In Salford 81.4% of HIV cases presenting to
Social Services are men and 18.6% are
women.
Of those receiving services from the current
Third Sector providers 74.1% are men and
14.4% are women (gender has not been
recorded in all cases).
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
There are no gaps in
information.
6
Data on gender
reassignment is not
Race
Census data
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
Religion and/or
belief
Census data
Sexual Identity
Government data
prevalence of gender dysphoria is 20 per
100,000 population. This would equate to
43 in Salford. This is an area of growing
demand for medical treatment (doubles
every 5 years).
According to the 2007 ONS population
estimate 7.98% of the population in Salford
is from a BME community.
In the North West 65% of people with
HIV/AIDS are White and 35% are from BME
communities of which 28% are Black Africa.
It should also be noted that 10.4% of people
with HIV/AIDS in the North West are asylum
seekers.
Of the individuals accessing current services
21% are from BME communities and of
these 76% are Black African. In Salford
11.9% of HIV/AIDS cases are asylum
seekers.
This information tells us that, given the
demographics of the HIV/AIDS population
and that of Salford as a whole, people are
accessing services in line with expectation.
collected by the providers.
This will be required of
providers in future
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%.
Although there are heterosexual men and
Data on religion is not
collected by the providers.
This will be required of
providers in future
7
There are no gaps in
information.
There are no gaps in
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
People on a low
income
Service Provider
Review Forms
Other (please
state) (For
example carers,
ex offenders)
Service User data
from providers
Service Provider
Review Forms
Stakeholder
consultation
women with HIV/AIDS the majority of people information
affected by HIV/AIDS are gay men.
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.
In Salford approximately 70% of HIV/AIDS
cases are gay men. Of those receiving
services, whose sexual identity has been
recorded, 63% are gay men and 15% are
heterosexual.
This information indicates that heterosexual
men and women and gay men are
accessing services as expected.
Whilst the employment status / income level
of people using HIV/AIDS services is not
recorded all have access to welfare benefits
checks and hardship payments through the
providers. 10.4% of service users are
asylum seekers.
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. Whilst around
13% of people accessing HIV/AIDS services
are ‘significant others’ this could include
non-carers as well as carers. Some of those
accessing the services are HIV+ as well as
being a carer of a partner / child.
This indicates that carers are accessing
8
Data on income level /
employment status is not
collected by the providers.
This will be required of
providers in future
There are no gaps in
information
services appropriately
Section D – Potential impact and how this will be addressed
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
people affected by HIV/AIDS.
 Advocacy
 Dementia Support
As the HIV/AIDS population
 Carers Services
9
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
increases in size and
becomes older services will
need to ensure they reflect
the needs of a wider age
range of service users. It
should also be noted that
older people may experience
greater internalised stigma,
isolation and lack of
confidence.
Disability
Disabled people are
accessing the current
services appropriately.
Service providers will need to
ensure that their services are
accessible to people with
physical and/or sensory
impairments.
Services also need to take
action to combat attitudinal
 Delivering Direct
payments
Will have service
specifications that include
provision for people of all
ages affected by HIV/AIDS.
At present this is mainly in the
25 – 44 age group but will
change as medical advances
mean that people live longer
with better treatment.
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
The new contracts for:
 General Advice,
Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct
payments
Will have service
specifications that include
10
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
adults as possible
barriers.
Gender (including
pregnancy and
maternity)
provision for people affected
by HIV/AIDS. People with
HIV/AIDS are regarded as
disabled. As medical
advances mean that people
live longer with better
treatment it is likely that the
severity of disability will
increase with age. Services
should provide information in
formats other than English.
Providers will be expected to
demonstrate that their service
is appropriate for physically
and sensory impaired people.
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 people affected by
 Advocacy
HIV/AIDS.
 Dementia Support
Providers need to ensure that
 Carers Services
their services are child Delivering Direct
friendly and appropriate for
payments
pregnant women.
Will have service
specifications that include
11
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
Reassignment
No data available to indicate
whether or not people who
have changed gender are
accessing current services
provision for people affected
by HIV/AIDS. Services
should be child-friendly and
appropriate for pregnant
women. 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
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 affected
by HIV/AIDS. 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
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
Race
People from different BME
communities are accessing
the services as expected
according to the
demographics of the
HIV/AIDS population.
Given the incidence of
HIV/AIDS in BME
communities (particularly the
asylum seeking community)
services need to pay
particular attention to tackling
double discrimination.
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
payments
Will have service
specifications that include
provision for people affected
by HIV/AIDS. 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
13
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
Religion and/or
belief
Sexual Identity
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
Current providers do not
The new contracts for:
record the religion of service
 General Advice,
users. People living with
Information and Support
HIV/AIDS can face
 Advocacy
discrimination from the
 Dementia Support
religious communities they
 Carers Services
belong to.
 Delivering Direct
Service providers will need to
payments
ensure data on religion / belief Will have service
is captured and provide
specifications that include
appropriate spiritual welfare
provision for people affected
services
by HIV/AIDS. 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
Heterosexual men and
The new contracts for:
women and gay men are
 General Advice,
14
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
accessing the current
services as expected
according to the
demographics of the
HIV/AIDS population.
As the majority of people
accessing services are gay
men providers need to ensure
that the environment and
information is appropriate for
communities of all sexual
identities
People on a low
income
Current providers do not
record income level or
employment status of people
using their services. Health
inequalities are closely linked
with levels of deprivation. It is
known that people living with
HIV/AIDS experience high
Information and Support
 Advocacy
 Dementia Support
 Carers Services
 Delivering Direct
payments
Will have service
specifications that include
provision for people affected
by HIV/AIDS. Services
should be sensitive to
individuals with different
sexual identities.
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
15
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
work in partnership to provide
services that are appropriate
to different equality groups
and reach as many vulnerable
adults as possible
Other (please state)
(For example
carers, ex
offenders)
levels of worklessness.
Service providers will need to
ensure data on employment
status is recorded and that
people are supported to
maximise their income
Will have service
specifications that include
provision for people affected
by HIV/AIDS. 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
purchase a range of services
from providers of their choice
using their own resources,
including personal budgets
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 for people affected
by HIV/AIDS. Services
should support people in their
caring role.
16
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
Providers will be expected to
demonstrate how their service
has benefitted carers with
HIV/AIDS and carers of
people with HIV/AIDS.
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
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 .
17
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
Person(s)
responsible
Integrated
Commissioning
Managers
Design services with Integrated
Lack of specific
specifications in the
Commissioning
contract for HIV/AIDS each of the following Managers
Support services
areas:
 General Advice,
Information and
Support
 Advocacy
 Dementia
Support
 Carers Services
 Delivering
Direct
payments
that
 incorporate
appropriate
18
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 all
equality groups
affected by
HIV/AIDS
 require
evidence that
services are
accessible to
people affected
by HIV/AIDS
Encourage Third
Lack of specific
Sector organisations
contract for HIV/AIDS to diversify and work
Support services
in partnership to
provide services that
are appropriate to
different equality
groups and reach as
many vulnerable
adults 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
personal budget
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
19
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.
20
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
affected by HIV/AIDS from June 2012.
The information indicates that people affected by HIV/AIDS are accessing current
services as expected, according to the demographics of the HIV/AIDS population in
Salford, in relation to age, disability, gender, race, sexual identity and carers.
There is a lack of data in relation to level of income / employment status, religion /
belief 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 all equality groups affected by HIV/AIDS
 require evidence that services are accessible to people affected by HIV/AIDS
Some areas of current service provision may not be covered by the new contracts
e.g. alternative therapies. These will need to be purchased by individuals using their
21
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
22
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.
23