Appendix 4
Equality Impact Assessment summary report
Each of the numbered sections below must be completed
1. Title of plan, policy or strategy being assessed.
NHS Lothian Disability Equality Scheme 2009-12: Impact on patients, carers, families
and communities (see separate EQIA report for impacts on staff)
2. What will change as a result of this proposal?
The Disability Equality Scheme aims to address the barriers that disable people and
prevent them from accessing effective health care and information about their health,
and from gaining fulfilling employment with NHS Lothian. It includes a detailed action
plan that sets out the steps that NHS Lothian will take over the next 3 years to
eliminate discrimination, promote equal opportunities for disabled people, tackle
harassment related to disability, and meet the requirements of the Disability Equality
Duty.
The Disability Equality Scheme is built around the UK Equalities Measurement
Framework to make it easier to measure progress towards our commitments. It tries
to focus on end results rather than processes and policies.
This is a report of an assessment of the impact of the Scheme on patients, carers,
family members and communities. A separate impact assessment is available for
impact on staff.
3. Date of RIA
6 November 2009
4. Who was present at the RIA?
Name
Job Title/
representing
Date of
RIA
training
Email
Lesley Boyd
(facilitating)
Health Inequalities
Manager, CHPs
and REAS, NHS
Lothian
Gordon
Mungall
Disability West
Lothian; West
Lothian Disability
Forum
-
Contact equality lead for details
Catherine
Garrod
Lothian Centre for
Integrated Living
-
Contact equality lead for details
John Murdoch
Lothian Centre for
Integrated Living
-
Contact equality lead for details
Wilma Lawrie
Lothian Patient
-
Contact equality lead for details
Lesley.boyd@nhslothian.scot.nhs.
uk
Appendix 4
Public Partnership
Network
Michael
Pisanek
Patient
Information
Centre Manager,
NHS Lothian
Jim Robinson
Health Inclusion
Facilitator, NHS
Lothian
Richard Walter
Complaints
Officer, NHS
Lothian
CHP/REAS Team
michael.f.pisanek@luht.scot.nhs.u
k
james.robinson@luht.scot.nhs.uk
Richard.walter@nhslothian.scot.nh
s.uk
-
Susan
Tennyson
Senior Charge
Nurse, Advanced
Practitioner REAS
Lui Giacomello
Partnership
representative,
NHS Lothian
Lui.giacomello@luht.scot.nhs.uk
James Glover
Head of Equality
& Diversity, NHS
Lothian
James.glover@nhslothian.scot.nhs
.uk
-
Susan.tennyson@nhslothian.scot.
nhs.uk
Nov 08
5. Population groups considered
Potential differential impacts
minority ethnic people (incl.
The Disability Equality Scheme (DES) will
gypsy/travellers, refugees & asylum impact on people from this group, as 1 person
seekers)
in 5 in Scotland is disabled. The issue of
different attitudes to disability in some
communities was discussed. It is possible
that NHS Lothian’s promotion of the social
model of disability might conflict with a more
medical model adopted in some cultures.
women, men and transgender
Yes. As incidence of disability increases with
people
age there may be differential impact on older
women.
people in religious/faith groups
Yes. Some people may have religious beliefs
(or the culture they feel a part of may have
those beliefs) about disability that are
different to others.
disabled people
Yes. The DES will impact on disabled people.
As it is based on the social model of disability,
it will have a wide impact, potentially affecting
all people who are disabled by societal
barriers.
older people, children and young
Yes. It was noted that there would be
Appendix 4
people
lesbian, gay and bisexual people
people of low income
people with mental health problems
homeless people
people involved in criminal justice
system
staff
carers
Other groups (please specify)
potential for differential impact dependent on
whether the person concerned was in their
early years, of school age, in transition
between school age and adulthood, an adult
of working age or an older person.
Yes, for example in terms of mental health
conditions among patients, carers and others
in the community who are gay, lesbian or
bisexual.
Yes. Some types of impairment are more
likely to occur in people living on low incomes
which may lead to some people being at
higher risk.
Yes. People with mental health problems face
particular barriers in accessing and benefiting
from health services.
Yes. Homeless people are likely to face
significant barriers in accessing and
benefiting from health services and face
significant health inequalities.
Yes. This will particularly be the case when
NHS Boards take over responsibility for
health service provision to prisoners during
2010.
Yes (see Staff EQIA for a fuller exploration of
the impacts on NHS staff)
Yes. Carers face well-documented health
inequalities and poor health outcomes, and
are often themselves disabled.
Other groups discussed included:
 Potential staff (i.e. people interested in a
career in NHS Lothian)
 The general public
 Visitors
 Volunteers
 Contractors and agency staff
 Looked-after children and young people
 Personal assistants employed by
disabled people
 Rurally isolated people
6. What positive impacts were identified and which groups will they affect?
Impacts
Impact on discrimination
The Scheme was felt to be likely to have a positive impact
on discrimination, not just against disable people but
against other groups too. This is because the Scheme
communicates strong messages about equality, diversity,
dignity and respect for Human Rights. The Scheme
includes commitments on accessibility of services,
Affected populations
All groups, including
as patients, family
members, personal
assistants, carers and
the wider population.
Appendix 4
involvement of disabled people and other stakeholders,
communication support and staff training and attitudes.
Impact on equality of opportunity
The Scheme promotes equal opportunities for disabled
people and other groups. It takes a Human Rights based
approach to encourage equality of opportunity for all
individuals. Significant commitments are included in the
Scheme to improve employment of disabled people and
access to services.
Impact on relations between different groups
There will be a positive impact on relations between
disabled people and NHS Lothian staff. The Scheme does
not specifically tackle relations between different racial
groups but it does promote a Human Rights-based
approach to ensure that all individuals are treated with
dignity and respect.
Impact on harassment
The Scheme will have a positive impact on harassment of
disabled people. It includes commitments to improve dignity
at work and address workplace harassment and bullying of
disabled staff. It also promotes plans such as those to
protect vulnerable adults from harassment and abuse. The
scheme should hopefully also have a impact on the
harassment of carers and families of disabled adults and
children, which has been reported within Lothian when
carers and families act as advocates for their disabled
family members.
Impact on positive attitudes to disability
The Scheme promotes the social model of disability, and
includes specific actins to promote a positive image of
disability through the Communications Strategy. The
Scheme also includes actions to improve the profile of
disabled people among managers and senior staff in NHS
Lothian. This was felt to be a positive impact.
Impact on taking account of disabled people’s
disabilities
The Scheme will have a positive impact on the way NHS
Lothian takes account of disabled people’s disabilities.
Through improving awareness of disability issues and
promoting a strong person-centred care approach to
delivering health services, the Scheme will result in more
responsive services. Through actions to develop the
support that disabled staff receive in employment –
including in redeployment and recruitment – the Scheme
will have a positive impact on taking into account disabled
staff’s disabilities.
All groups, including
as patients, family
members, personal
assistants, carers and
the wider population.
Disabled people, NHS
Lothian staff
All groups, including
as patients, family
members, personal
assistants, carers and
the wider population.
All groups, including
disabled people as
staff, patients, family
members, personal
assistants, carers and
the wider population.
All groups, including
disabled people as
staff, as patients,
family members,
personal assistants,
carers and the wider
population.
Appendix 4
Impact on encouraging the participation of disabled
people in public life
The Scheme promotes involvement of disabled people in
decision making about health services, and as members of
public participation groups. It also encourages disabled
people to develop in their careers and as high profile
members of staff. In addition, the Scheme supports work to
improve the diversity of Board members. These were felt to
be likely to have a positive impact on encouraging disabled
people to participate in public life.
Other positive impacts
The Scheme will have a positive impact on diet and
nutrition of disabled people through links with the Nutritional
Strategy.
There is likely to be a positive impact on disabled people’s
ability to determine their own health care.
The Scheme was also felt likely to have a positive impact
on the social status of disabled people; on their
employment opportunities; on their income levels; and on
their participation and inclusion in wider society.
All groups of disabled
people, including as
patients, family
members, personal
assistants, carers and
the wider population.
Disabled staff,
disabled people who
wish to become Board
members.
All groups of disabled
people, including as
patients, family
members, personal
assistants, carers and
the wider population.
Disabled staff.
7. What negative impacts were identified and which groups will they affect?
Impacts
Impact on discrimination
The Scheme should include more reference to improving
the standards use din capital projects so that disabled
people are not disadvantaged as a result of planners
following minimum building standards, which may not be
adequate for accessibility, e.g. toilet space requirements.
Failure to address this may have a negative impact on
disabled people.
Impact on harassment
It is possible that an improved awareness of harassment
and disability equality might conflict with attitudes to
disabled people that are held by some cultural groups. The
Scheme promotes a positive attitude to disability as well as
a more Human Rights based approach that encourages
dignity and respect for all individuals.
Impact on positive attitudes towards disabled people
The Scheme promotes positive attitudes to disability that
might conflict with the needs of carers. To mitigate this, the
Scheme should link more closely with the Carer’s Strategy.
Impact on personal choice
The Scheme may negatively impact on the personal
Affected populations
All groups of disabled
people, including as
patients, family
members, personal
assistants, carers and
the wider population.
Disabled staff.
Disabled people from
some ethnic
minorities. Their
carers and families.
Carers of disabled
people.
Some disabled people
Appendix 4
choices of some disabled people, for example in relation to
smoking and tobacco use. However the reason for this
would be to improve overall health and wellbeing.
Impact on carers and family members
The Scheme may result in negative impact on carers and
family members as it encourages disabled people to
participate more in decisions about their own health care.
This may cause tensions with some attitudes to disability
among carers and family members.
Some carers and
family members.
Impact on patients in long stay facilities
It was felt that the Scheme would benefit from more explicit
commitments to improve facilities and specialist equipment
for disabled people who are in longer-term in-patient care.
Disabled people in
longer term care.
Impact on safety of sites and services
The Scheme was felt to be likely to have a positive impact
on the safety of sites and services, but it was agreed that
there should be more reference to ensuring that
redevelopment or building sites are safer for disabled
people and that accessibility is prioritised even for
temporary modifications.
All groups of disabled
people, including as
patients, family
members, personal
assistants, carers and
the wider population.
Disabled staff.
8. Evidence available at the time of the RIA
Evidence
Data on populations in need
Available ?
Yes
Data on service
uptake/access
Data on quality/outcomes
Yes
Research/literature evidence
Patient experience
information
Consultation findings
No
Yes
Good practice guidelines
Other (please specify)
No
No
Yes
Comments
Some data available on incidence of
disability among the wider population.
Data on use of certain NHS Lothian
services
The Scheme includes actions to
develop data of this nature.
From involvement activities with
patients
From involvement and consultation
activities carried out June-November
2009. See separate involvement report
(Appendix 1 of Scheme).
Appendix 4
9. Additional Information and Evidence Required
None for the purposes of this impact assessment. Data availability will be improved
following implementation of actions in Scheme.
10. What communications needs were identified? How will they be addressed?
The Scheme includes a wide range of actions to promote effective communication, in
different formats and languages. The Scheme itself is available in different formats
on request. It will be promoted via the NHS Lothian website and articles in NHS
Lothian publications. It will also be the subject of a press release for external media.
11. Recommendations





The DES should link more explicitly with Lothian Carers’ Strategies to ensure that
the needs of carers are not impacted on negatively by promotion of more positive
attitudes to disability.
The Scheme should include more reference to improving facilities, bathing and
toilet equipment and other specialist provision for disabled people in long term
care environments.
The Scheme should make more explicit reference to prioritising accessibility
when building modifications or redevelopments are being planned and carried
out. Effective EQIA would encourage this to take place.
The Scheme should include actions to develop understanding of financial
implications of equality & diversity commitments.
The Scheme should include actions to encourage planners of capital projects to
go beyond minimum building standards when undertaking building design,
particularly with respect to accessible toilet provision. This should include joint
work with Local Authority building inspectorates to improve standards and
compliance with these.
12. As a result of the EQIA what actions have been, or will be, undertaken and
by when? Please complete:
Specific actions (as a result of Who will take them Deadline for Review date
the RIA)
forward (name and progressing
contact details)
Amendments to the Scheme
as listed in the
recommendations
James Glover,
Head of Equality &
Diversity
9 November
2009
June 2010
13. Who will be consulted about the findings of this impact assessment?
Appendix 4
This impact assessment will be published online for wider consultation. It was also
circulated among members of the Disability Equality Steering Group.
Consultation responses received during the period 17 November – 1 December have
been incorporated into this report.
Manager’s Name: James Glover, Head of Equality & Diversity
Date: 10 November 2009, revised 1 December 2009.