EQUALITY IMPACT ASSESSMENT PART 1 INITIAL SCREENING. 1. Name of the policy / function / service development being assessed?

Transcription

1 EQUALITY IMPACT ASSESSMENT PART 1 INITIAL SCREENING 1. Name of the policy / function / service development being assessed? Behavioural Disorders Unit - Provision of Single Sex Accommodation 2. Name of person responsible for carrying out the assessment? Alex Ward/Richard Stiles/Marcia Facey 3. Describe the main aim, objective and intended outcomes of the policy / function / service development? The Department of Health has given a clear public commitment to eliminating mixed-sex accommodation for hospital inpatients. Three objectives were set for the NHS, designed to deliver single-sex accommodation. They apply to all NHS trusts providing inpatient accommodation. The objectives are: 1. to ensure that appropriate organisational arrangements are in place to secure good standards of privacy and dignity for hospital patients; 2. to achieve the Patient's Charter standard for segregated washing and toilet facilities across the NHS; and 3. to provide safe facilities for patients The service must be compliant with the DoH single-sex directives by 1 April Aim: To comply with the Department of Health single sex ward guidelines. Objective: The objective is to ensure continuous provision of single-sex services to as many individuals as practicable whilst maintaining compliance with the Department of Health requirements for provision of inpatient services. The BDU inpatient service shall therefore accept male only admissions to its facilities in accordance with DoH national guidance and CQC regulations. Intended Outcomes: The Department of Health s directive regarding Privacy and Dignity arrangements on the unit in line with recommendations from the Care Quality Commission will be met. Identify services which can meet gaps in relation to assessment and treatment for women. 1

2 4. Is there reason to believe that the policy / function / service development could have a negative impact on a group or groups? YES / NO Which equality groups may be disadvantaged / experience negative impact? Race YES / NO Disability YES / NO Gender YES / NO Age YES / NO Sexual orientation YES / NO Religion / belief YES / NO 5. What evidence do you have and how has this been collected? An audit of the referrals to the BDU shows that whilst the requirement for female admissions is low there is a demand for this service. The demand is consistent with Autism Spectrum Disorder which has 7:1 male: female ratio 6. Have you explained your policy / function / service development to people who might be affected by it? Yes / No If yes please give details of those involved This has been a key national priority. As part of the Trust wide work around Privacy and Dignity the need for service change has been explained to referrers, patients on the ward and some of their carers. 7. If the policy / function / service development positively promotes equality please explain how? 8. From the screening process do you consider the policy / function / service development will have a positive or negative impact on equality groups? Please rate the level of impact and summarise the reason for your decision. Positive: High Medium Low (highly likely to promote (moderately likely to promote (unlikely to promote equality of opportunity equality of opportunity and equality of opportunity and good relations) good relations) and good relations) Negative: High Medium Low (highly likely to have a (moderately likely to have a (probably will not negative impact) negative impact) have a negative impact) 2

3 Neutral: High (highly likely) Reason for your decision: The BDU provides a rapid and robust assessment of referrals and recommendations for inpatient admissions or outpatient therapeutic treatment input as soon as possible where deemed appropriate. It aims to provide a safe therapeutic environment for these groups of individuals adopting an individualized approach to care that preserves dignity, promotes responsibility for self, and works towards independence through a multi-disciplinary care approach. It also provides a comprehensive care and treatment for adults with Autistic Spectrum Disorders (ASDs); Asperger s syndrome/high functioning autism; Obsessive Compulsive Disorders (OCD), patients with forensic mental health background and/or other complex mental health needs. The numbers of female patients needing admission to the BDU are low. This is a specialist service which accepts referrals nationally. Such services are few for people who have challenging behaviour and complex needs with an Autistic Spectrum Disorder. There are a number of services which may be able to meet the needs of women. They may not be considered appropriate as alternatives to admission to the BDU. These services include MIETS In-pt Unit, Attention Deficit Hyperactivity Disorder Service (ADHD), Behavioural Genetics Clinic (BGC) and the Female Hormone Clinic. The impact may be greater for women who do not meet the criteria for admission to MIETS, do not live locally and are therefore not able to travel for regular out-patient treatment. Date completed: Print name: Richard Stiles/Alex Ward If the screening process has shown potential for a negative impact you will need to carry out a full equality impact assessment 3

4 PART 2 FULL EQUALITY IMPACT ASSESSMENT 1. Name of the policy / function / service development? Behavioural Disorders Unit [BDU] Provision of Single Sex Accommodation 2. From the initial screening process, which groups may experience negative impact? Race YES / NO Disability YES / NO Gender YES / NO Age YES / NO Sexual orientation YES / NO Religion/belief YES / NO 3. What evidence do you have? Please give details: (a) Strong evidence The change took place on 1 st April 2010 when the BDU was required to fully comply with national guidance respecting patients Privacy and Dignity. This has meant that the unit is not able to admit female patients to the unit, however there are other service that are able to provide treatment them. 4. Please outline steps taken during the EIA process to raise awareness and consult/involve interested parties and those who may be affected by the policy / function / service development A meeting by the BDU s Multidisciplinary Team was held on 29 th October 2009 to discuss the privacy and dignity issues. A nursing audit of the ward confirmed that the environment did not meet required standards. To comply, the ward would need significant environmental alteration to accommodate both sexes. It was agreed that the ward could admit male patients only. The decision and rationale was communicated to PCTs, referrers, existing patients on the ward and some of their carers. The ward teams held discussions with the PCTs for the two female patients on the ward. Arrangements were made for them to be transferred to other in-patient services outside of the Trust. 5. What does available evidence / results of consultation show? The process undertaken was to raise awareness of the service change. 6. If you have not been able to conduct consultation how do you intend to test out your findings and recommended actions? Referrer and patient feedback. 4

5 7. What changes or practical measures would reduce the negative impact on particular groups? (Think what a successful outcome would look like and what can be done to bring about this outcome) There are a number of specialist services within the Trust that are able to work with women who might previously have been admitted to the BDU. Some of these services include: MIETS In-patient Unit (MIETS) This provides treatment and services for people with learning disabilities and Autistic Spectrum Disorder; but may not be suitable for patient populations who would have been suitable for BDU admission. Attention Deficit Hyperactivity Disorder Service (ADHD), Behavioural Genetics Clinic (BGC) and the Female Hormone Clinic, which are outpatient services. These services are also considering a review of their care pathways and how they can increase the range of their treatment options on offer to meet the needs of female patients who might previously been admitted to the BDU. The BDU is located in an older style of hospital ward. In order to provide good levels of privacy and dignity for male and female patients, substantial structural alterations would need to be made to the building. If changes are required please complete the action plan template overleaf: 8. What are the main conclusions of the assessment? There are other Trust services which will be able to offer alternatives for assessment and treatment which already work closely with the BDU. We will monitor the overall impact of the service change and any gaps in meeting the needs of female patients. 9. Has a monitoring process been established to measure/review the effects of the policy, function or service development? (This may include statistical analysis of monitoring data, satisfaction surveys or use of networks) No (if no, please state why) Not formally established but we will be monitoring the number of women whose needs cannot be met (and could have benefited from admission) as a result of the service change. Date completed: Print name: R. Stiles and Alex ward. Please send an electronic copy of the completed assessment, action plan (if required), any relevant monitoring reports used and a summary of replies received from people you have consulted, to: 1. Kay.harwood@slam.nhs.uk 2. Your Service Equality Lead 5

6 ACTION PLANNING The following action plan should summarise the proposed actions, setting out the timescale, lead individual and include details of any monitoring needed in the future to check that desired outcomes are reached. Not Required Issue / Adverse impact identified No female in patient admissions to the BDU Proposed actions Senior clinicians will signpost patients to appropriate services and monitor the number of female patients whose treatment needs cannot be met through MIETS, ADHD, BGC and the Female Hormone Clinic and who otherwise could have been considered for admission to the BDU. Responsible/ lead person Alex Ward and Richard Stiles Timescale 11/10 Progress No female admissions to the BDU Senior clinicians will continue to review options (locally) for extending the range of treatment option offered for patients with complex needs. R. Stiles & Alex Ward Nov Please send an electronic copy of your completed assessment to: 1. Kay.harwood@slam.nhs.uk 2. Your Service Equality Lead 6