Download Equality Impact Assessment for Health budgets

EQUALITY ASSESSMENT FORM
Title of procedural
document:
Governance for Personal Health Budgets
What are the intended
outcomes of this work?
Include outline of objectives
and function aims
This policy sets out the process for CCG staff for the
governance of PHBs.
Who will be affected?
e.g. patients, staff, service
users etc.
CCG staff, individuals and their representatives
Evidence
What evidence have you considered? List the main sources of data, research and
other sources of evidence (including full references) reviewed to determine impact
on each equality group (protected characteristic). This can include national research,
surveys, reports, research interviews, focus groups, pilot activity evaluations etc. If
there are gaps in evidence, state what you will do to close them in the Action Plan on
the last page of this template.
The POET (Personal Outcomes Evaluation Tool) Surveys of personal health budget
holders and family carers 2015 have been published. These surveys and analysis of
the results were compiled by In Control and the Centre for Disability Research,
Lancaster University. This includes equality monitoring information on protected
characteristics – gender, age, ethnicity and sexuality.
POET is a self-reported user experience survey tool which is intended to be used at
the time the PHB is reviewed. The POET tool is aimed at two key groups, individuals
who have been allocated a PHB and family member carers.
Disability
Consider and detail (include the source of any evidence) on attitudinal, physical and
social barriers
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
In the POET survey for PHB holders 33.9% had complex health needs and 32.2% a
physical disability.
Generally a PHB has a positive impact in terms of giving the individual more control
over their health outcomes.
Reasonable adjustments are considered in terms of language barriers and
comprehension, for example documents are made available in ‘easy read’ format.
Gender
Consider and details (including the source of any evidence) on men and women
(potential link to carers below)
The Policy does not impact differently on men or women.
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
Race
Consider and detail (including the source of any evidence) on different ethnic groups,
nationalities, Roma gypsies, Irish travellers, language barriers.
There will be no negative impact with the proviso that race issues such as cultural
awareness, unconscious bias are kept in consideration.
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
From the POET survey of PHB holders 89.19% were ‘any white’.
Age
Consider and detail (including the source of any evidence) across age ranges on old
and younger people. This can include safeguarding, consent and child welfare.
Older people could be positively affected as older people are more likely to have
health problems which meet the criteria of ‘primary health need.
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
The POET survey of PHB holders found that 49.81% were over 55.
Gender reassignment (including transgender)
Consider and detail (including the source of any evidence) on transgender and
transsexual people. This can include issues such as privacy of data and harassment.
There will be no negative impact with the proviso that gender reassignment issues
are kept in consideration.
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
Sexual orientation
Consider and detail (including the source of any evidence)on heterosexual people,
as well as lesbian, gay and bi-sexual people.
PHBs deliver an equitable service regardless of sexual orientation. All staff involved
with PHBs are subject to the values in the NHS Constitution.
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
Religion or belief
Consider and detail (including the source of any evidence) on people with different
religions, beliefs or no belief.
There will be no negative impact on the proviso that religious and cultural beliefs are
kept in consideration.
Section 1C of the National Health Service Act 2006 states that, in exercising
functions in relation to the health service, the Secretary of State must have regard to
the need to reduce inequalities between the people of England with respect to the
benefits they can obtain from the health service. (The National Framework
paragraph 20).
In the POET survey of PHB holders 62.45% were Christian and 28.06% of no
religion.
Pregnancy and maternity
Consider and detail (including the source of any evidence) on working arrangements,
part-time working, infant caring responsibilities
Not applicable
Carers
Consider and detail (including the source of any evidence) on part-time working,
shift-patterns, general caring responsibilities.
The Policy will have a positive impact on carers giving them more control on how
care and support is provided.
In the POET survey of carers72.84% were female and 27.16% were male.
Other identified groups
Consider and detail (including the source of any evidence) on different socioeconomic groups, area inequality, income, resident status (migrants) and other
groups experiencing disadvantage and barriers to access
Anyone who is eligible for NHS services may be eligible for a PHB.
Engagement and Involvement
Have you engaged stakeholders in gathering evidence or testing the evidence
available?
If not, what do you intend to do?
There was extensive engagement with stakeholders by the former Dorset PCT
during the pilot in 2009 to 2012.
How have you engaged stakeholders in testing the policy or programme
proposals?
If not, what do you intend to do?
In 2016 the CCG intends to set up a support and information group for PHB holders
and their representatives.
If you have engaged groups, please list below and include who was involved,
how they were involved and the key outputs:
Groups engaged
Date and type of
Outputs from activity
engagement
N/A
N/A
N/A
Summary on analysis
Considering the evidence and engagement activity you listed above, please
summarise the impact of your proposals. Consider whether the evidence shows
potential for differential impact; if so, state whether adverse or positive and for which
groups. How will you mitigate any negative impacts? How will you include certain
protected groups in services or expand their participation in public life?
The purpose of the Policy is to ensure governance of PHBs in terms of patient safety
and financial governance. There is no potential for differential impact as the Policy
will be applied to all PHB holders.
The PHB support and information group will include protected groups and expand
their participation in PHBs.
Equality Act 2012
The CCG is bound by the Public Sector Equality Duty and is required to evidence
how in its decisions is delivering the following. Please outline how your work and the
service will contribute to these:
Eliminate discrimination, harassment and victimisation
Access to assessment should be fair and consistent. There should be no
discrimination on the grounds of race, disability, gender, age, sexual orientation or
belief, or type of health need. The CCG is responsible for ensuring that
discrimination does not occur. This will be monitored through the quarterly report to
the Quality Group.
Advance equality of opportunity
Equality of opportunity will be advanced by the ‘right to have’ a PHB for adults or
children who are CHC eligible.
Promote good relations between groups
The PHB process is person centred and is not dependent on diagnosis or condition.
What is the overall impact of your proposals of decision?
Consider whether there are difference levels of access experienced, needs or
experiences, whether there are barriers to engagement, are there regional variations
and what is the combined impact?
The Policy will have no negative impact against the protected characteristics with
some provisos that issues are kept in consideration.
Addressing the impact on equalities
Please give an outline of what broad action you or any other bodies are taking
address any inequalities identified through the evidence.
The CCG has commissioned Pro-Disability and Enham (voluntary sector support
agencies) to provide support services and advice to PHB holders or their
representatives. This includes, help with recruitment, payroll and HMRC returns.
Action planning for improvement
Please give an outline of the key actions based on any gaps, challenges and
opportunities you have identified. Actions to improve the policy/programmes needs
to be summarised (An action plan is appended for action planning). Include here any
general action to address specific equality issues and data gaps that need to be
addressed through consultation or further research.
A group for PHB holders will be set up with regular meetings. This could address
specific equality issues and data gaps through further consultation.
Please give an outline of your next steps based on the challenges and opportunities
you have identified.
Set up the PHB support and information group in 2016 which will endeavour to be as
inclusive as possible.
Name and job title of person who carried
out this assessment
Date assessment completed
CCP Lead
Date assessment signed
Angie Smith
Senior Continuing Healthcare Support
Services Manager
29/12/2015
Paul Rennie