Equality, Good Relations and Human Rights Screening Template. Title: BCH Direct

Transcription

1 Equality, Good Relations and Human Rights Screening Template Title: BCH Direct ***Completed Screening Templates are public documents and will be posted on the Trust s website*** See Guidance Notes for further background information on the relevant legislation and for help in answering the questions on this template (follow the links).

2 (1) Information about the Policy/Proposal (1.1) Name of the policy/proposal BCH Direct (1.2) Is this a new, existing or revised policy/proposal? New (1.3) What is it trying to achieve (intended aims/outcomes)? Implement proposals outlined in the RQIA Independent Review of Arrangements for Management and coordination of Unscheduled Care in the Belfast HSC Trust and Related Regional Considerations July BCH Direct is designed to enable frail elderly patients to directly access services in BCH, reducing pressure on the ED and AMU at the RVH. This will also reduce the number of transfers across the hospital sites, will provide more timely and patient centred care and ensure quality and safety is at the cornerstone of our service delivery. In future, the model could support links with community services as envisaged in Belfast Trust Urgent Care Model and in Transforming Your Care. (1.4) How will the proposal be implemented? BCH-Direct is a new service based on ward 1 South in the Belfast City Hospital which is designed and envisaged to improve services for Frail Older People from the Belfast Trust area who require assessment and treatment by a Geriatrician and Care of the Elderly Team. The primary goal of BCH-Direct is to facilitate rapid access to Older People s Services and quick access to evidence based comprehensive geriatric assessment. BCH-Direct builds on and replaces the directorate s previous model for direct access for older persons via OPTIMAL7. Links with primary care teams will remain by facilitating direct assessment and admission after telephone 2

3 referral from primary care practitioners. Protocols have been developed in conjunction with NIAS to identify frail older persons referred to hospital via a non-999 ambulance who could be appropriately assessed directly on the BCH site via BCH Direct. A pilot transport service is also provided to support discharge for clinically stable patients to their own home or nursing home or between sites. For the duration of the pilot a health care assistant will accompany the patient. If a patient in ED requires this transport the consultant will have deemed them fit for transfer to BCH direct. Development of BCH-Direct will be phased in line with recruitment of adequate staffing numbers and performance on the BCH site. This service will be available 24 hours / day and 7 days a week. It is planned that the service will be available to increasing numbers of frail older persons in phased steps. It is anticipated that referral pathways will be developed for the transfer of appropriate frail older persons presenting to ED after senior review by the ED team. It is planned that BCH-Direct may merge with other site admission and assessment services in the future. (1.5) Are there any Section 75 categories (see list in 2.1) which might be expected to benefit from the intended policy/proposal? Age over 75s. (1.6) Who owns and who implements the policy/proposal? Maria O Kane Associate Medical Director, Adult Social and Primary Care Marie Heaney Co-Director, Older People and Physical / Sensory Disability (1.7) Are there any factors that could contribute to/detract from the intended aim/outcome of the policy/proposal/decision? (Financial, legislative or other constraints?) 3

4 As the project is a direct result of the recent RQIA recommendations this has contributed to its rapid implementation. The project has not been given additional funding however and is currently being implemented under existing resource. (1.8) Who are the internal and external stakeholders (actual or potential) that the policy/proposal/decision could impact upon? (staff, service users, other public sector organisations, trade unions, professional bodies, independent sector, voluntary and community groups etc). Internal stakeholders medical staff, nursing staff, pharmacy staff, social work staff, AHP staff. External stakeholders patients over the age of 75 with frailty conditions currently being assessed/admitted via RVH ED. (1.9) Other policies/strategies/information with a bearing on this policy/proposal (for example internal or regional policies) - what are they and who owns them? RQIA Report. Ongoing regional work under DHSSPS Unscheduled Care Task Group Workstreams. 4

5 (2) Available Evidence / Needs, Experiences and Priorities (2.1) Taking into account the information above what are the different needs, experiences and priorities of each of the Section 75 categories for both service users and staff. Please note there are separate tables for Service Users and staff. Service Users Category Details of evidence/information Service users Belfast/Castler eagh population as a whole Service users affected This service will be provided to all future patients aged over 75. Needs, Experiences & Priorities A proxy indication of the possible numbers that may use the service is taken from Trust data on service users from August service users, over the age of 75 in triage category 3 were admitted from ED under the care of the elderly speciality in August

6 Gender Female Male 51% 49% *2011 census It would be anticipated that in accordance with census statistics, there may slightly more women than men that will attend the service. The service is, however, provided on an individual basis with the needs of each patient accommodated. There is no indication of adverse impact in terms of gender. Age % 11% 12% 14% 14% 12% 15% *2011 census Over 75s The service is designed to enable frail elderly patients to directly access services in BCH, reducing pressure on the ED and AMU at the RVH. This will also reduce the number of transfers across the hospital sites, will provide more timely and patient centred care and ensure quality and safety is at the cornerstone of our service delivery. The service is targeted at 75+ frail and elderly, there is no evidence that the proposal would have an 6

7 adverse impact in terms of age. Religion Protestant Roman Catholic No Religion or No Religion Stated 42% 41% 17% *2011 census Using census statistics on religion as a proxy indicator, a slightly higher number of service users from the Protestant religion may be impacted by the proposal. As the proposal is aimed at improving quality of care to all frail and elderly patients, it is not anticipated it would have an adverse impact regarding religion. Political Opinion Broadly Unionist Broadly Nationalist Other Do not wish to answer/unknown 48.3% 45.4% 2.3% 4% * 2011 Assembly election Using census statistics on the 2011 Assembly election results as a proxy indicator, a slightly higher number of people from the broadly Unionist perspective may be affected by the proposal. There is no indication that the proposal would have an adverse impact in terms of political opinion. 7

8 Marital Status Single Married Other/Not known 36% 47% 17% *2011 census Using census statistics as a proxy indicator of the marital status of future service users would indicate that the majority affected would be married. The service is provided on an individual basis and would not have an adverse impact in terms of marital status. Dependent Status Caring for a child dependant older person/ person with a disability 12% of usually resident population provide unpaid care Due to the age of the patients and the nature of the service, it is probable that a majority of patients may be dependent on or have part time carers. Not known * 2011 census The service is designed to meet the needs of this client group and should not have an adverse impact regarding dependent status. Disability Yes No Not known 21% 69% n/a *2011 census Due to the age of the patients and the nature of the service, it is probable that the service users may 8

9 have a disability. The service is designed to meet the specific needs of each patient. Transport for each patient will be provided if required. The primary goal of BCH- Direct is to facilitate rapid access to Older People s Services and quick access to evidence based comprehensive geriatric assessment. The Belfast Trust is committed to adhering to the DDA. All Trust staff attends Mandatory, diversity, equality and human rights training as well as Disability Awareness training to ensure that the needs of patients with a disability are respected and accommodated. There is no evidence to 9

10 suggest the proposal would have an adverse impact in terms of disability Ethnicity White Black/Minority Ethnic Not known 98.21% 1.8% n/a *2011 census Interpreting statistics can be used as a proxy indicator of those patients that attend BHSCT that do not speak English as a first or second language, Polish 30.58% Slovak 0.83% Romanian Portuguese 3.31% 9.09% Tetum 0.83% Arabic 2.48% Bengali 0.83% Chinese - Cantonese 16.53% Chinese - Mandarin 7.44% Latvian 0.83% Chinese - Hakka 1.65% Using census and Interpreting statistics as a proxy indicator, it would appear that the majority of service users affected will be white. The Trust is committed to ensuring that the religious, spiritual and cultural needs of all service users are accommodated. This is assisted by the policy that all staff attend mandatory equality, good relations and human rights training. Lithuanian 25.62% Staff are also aware of the NIRHSC interpreting service and the BIG Word 24 hour telephone interpreting service. Trust staff is required to provide an interpreter if a patient does not speak English as a first language. 10

11 Training on how to access an interpreter is available to all staff. The BHSCT is also committed to the promotion of good relations in the areas of race, religion and has a Good Relations strategy which incorporates a number of initiatives to promote good relations for service users. It is not anticipated that the proposal would have an adverse impact in terms of ethnicity. Sexual Orientation Opposite sex Same sex/same and Opposite sex Do not wish to answer/not known The general view in NI is that an estimated 6-10% identify as lesbian, gay, bisexual *2012 report by Disability Action & Rainbow Project The service is provided according to the needs of each individual. All Trust staff are required to attend mandatory equality, diversity and good relations and human rights training which incorporates sexual orientation. It is not anticipated that there would be an adverse 11

12 impact in terms of sexual orientation. (2.2) Provide details of how you have involved stakeholders, views of colleagues, service users and staff etc when screening this policy/proposal. In line with the organisational change framework and the support of HR colleagues, staff and trade unions have been engaged with throughout the process. It is planned that service user feedback will be collected on the BCH Direct patient experience once fully operational. 12

13 (3) Screening Questions You now have to assess whether the impact of the policy/proposal is major, minor or none. You will need to make an informed judgement based on the information you have gathered. Staff This covers 57 Staff from Medical & Dental, Professional Technical & AHP, Nursing & Midwifery, Social Service and Admin & Clerical Staff. Details of evidence/information Category Staff Trust Workforce January 2014 Staff affected Needs, Experiences & Priorities Gender Female Male 78% 22% Higher Proportion of Female Employees. No indication of different needs in relation to Gender Age % 24% 26% 29% 15% 2% Higher proportion of staff aged between No indication of different needs in relation to age Religion Protestant Roman Catholic 44% 50% Broadly in Line with overall Workforce 13

14 Not known/other 6% Composition No indication of different needs in relation to religion Political Opinion Broadly Unionist Broadly Nationalist Other No answer Unknown 7% 6% 7% 26% 54% Broadly in Line with overall Workforce Composition No indication of different needs in relation to political opinion. Marital Status Single Married Other Not known 38% 56% 2% 4% Broadly in Line with overall Workforce Composition No indication of different needs in relation to marital status Caring Responsibilities Yes No Not Known/Other 21% 20% 59% The Trust has in place a range of flexible working opportunities for staff to support staff to balance work and caring responsibilities 14

15 Disability Yes No Not known 2% 67% 31% Disability: The Trust is committed to ensuring that reasonable adjustments will be facilitated according to any individual needs identified in accordance with the Trust s Framework on the Employment of People with Disabilities. Ethnicity White Black/Minority Ethnic Not known 79% 3% 18% Broadly in Line with overall workforce composition. No indication of different needs in relation to ethnicity Sexual Orientation (towards people of the) Opposite sex Same sex/same and Opposite sex Do not wish to answer/not known 37% 1% 62% Broadly in Line with overall workforce composition. No indication of different needs in relation to sexual orientation 15

16 (3.1)What is the likely impact of equality of opportunity for those affected by this policy/proposal, for each of the Section 75 equality categories? Section 75 Category Details of policy/proposal impact Level of impact? Minor/major/none Gender BCH Direct Service NO Age BCH Direct Service NO Religion BCH Direct Service NO Political Opinion BCH Direct Service NO Marital Status BCH Direct Service NO Dependent Status BCH Direct Service NO Disability BCH Direct Service NO Ethnicity BCH Direct Service NO Sexual Orientation BCH Direct Service NO (3.2) Are there opportunities to better promote equality of opportunity for people within Section 75 equality categories? If yes, provide details. If no, provide reasons. 16

17 Service Users (3.1) What is the likely impact of equality of opportunity for those affected by this policy/proposal, for each of the Section 75 equality categories? Category Details of policy/proposal impact The service is designed and envisaged to improve services for Frail Older People from the Belfast Trust area who require assessment and treatment by a Geriatrician and Care of the Elderly Team. Level of impact? Minor/major/none (3.2) Are there opportunities to better promote equality of opportunity for people within Section 75 equality categories? If yes, provide details. If no, provide reasons. Gender No, section 2.1 details information and steps the Trust implement to ensure equality of opportunity for all Section 75 categories. Age Religion Political Opinion Marital Status 17

18 Dependent Status Disability If assistance is required regarding alternative forms of communication for patients with a disability, this will be provided Ethnicity If an interpreter or translation is required for patients that do not speak English as a first or second language, this will be provided. Sexual Orientation (3.3) To what extent is the policy/proposal likely to impact on good relations between people of different religious belief, political opinion or racial group? Minor/major/none Good relations category Details of policy/proposal impact Level of impact Minor/major/none Religious belief Please see sections, 2.1 and 3.1 Political opinion Racial group 18

19 (3.4) Are there opportunities to better promote good relations between people of different religious belief, political opinion or racial group? Good relations category Please provide details Religious belief Political opinion Racial group (4) Is there an opportunity to better address the health and social inequalities of groups/areas in greatest social, economic or educational need by altering the policy/decision? Suggestions Statistics indicate that there are higher numbers of people from areas of greatest social and economic need that access A&E services, this would also include people over 75 years. The proposal, is however, aimed at ensuring equality of opportunity to services and a higher quality of service to this client group, The primary goal of BCH-Direct is to facilitate rapid access to Older People s Services and quick access to evidence based comprehensive geriatric assessment. 19

20 (5) Consideration of Disability Duties How does the policy/proposal or decision currently encourage disabled people to participate in public life and promote positive attitudes towards disabled people? Consider what other measures you could take. Due to the nature of the service it promotes positive attitudes towards people with disabilities and is designed to enhance the experience of those service users The Belfast HSC Trust is committed to the promotion of the DDA and Section 75 disability duties. Disability awareness training is available to all staff. In line with the above duties the Trust developed a 5 year Disability Action Plan which went out for public consultation and was endorsed by Trust Board. The actions in the Disability Acton Plan are monitored by the Trust Disability Steering Group. For example, have your staff received disability equality training or training on the Trust s Patient and Client Experience Standards? 20

21 (6) Consideration of Human Rights (6.1) Does the policy/proposal affect anyone s human rights in a positive, negative or neutral way? Complete for each of the articles Article Article 2 Right to life Positive impact Negative impact = human right interfered with or restricted Neutral impact Article 3 Right to freedom from torture, inhuman or degrading treatment or punishment Article 4 Right to freedom from slavery, servitude & forced or compulsory labour Article 5 Right to liberty & security of person Article 6 Right to a fair & public trial within a reasonable time Article 7 Right to freedom from retrospective criminal law & no punishment without law Article 8 Right to respect for private & family life, home and correspondence. Article 9 Right to freedom of thought, conscience & religion Article 10 Right to freedom of expression 21

22 Article 11 Right to freedom of assembly & association Article 12 Right to marry & found a family Article 14 Prohibition of discrimination in the enjoyment of the convention rights 1 st protocol Article 1 Right to a peaceful enjoyment of possessions & protection of property 1 st protocol Article 2 Right of access to education Please note: If you have identified potential negative impact in relation to any of the Articles in the table above, speak to your line manager and/or a representative from the Equality Team. It may also be necessary to seek legal advice. 6.2) Please outline any actions you will take to promote awareness of human rights and evidence that human rights have been taken into consideration in decision making processes. The Belfast HSC Trust is committed to the promotion of Human Rights for all staff and service users. All staff must attend mandatory equality, diversity, good relations and human rights training to ensure the human rights of all patients are respected. 22

23 (7) Screening Decision (7.1) Given the answers in Section 4, how would you categorise the impacts of this policy/proposal? Major impact Minor impact No impact (7.2) Do you consider the policy/proposal needs to be subjected to ongoing screening? Yes No A full Equality Impact Assessment (EQIA) is usually confined to those policies or decisions considered to have major implications for equality of opportunity. (7.3) Do you think the policy/proposal should be subject to an Equality Impact Assessment (EQIA)? Yes No 23

24 (7.4) Please give reasons for your decision. The proposal is aimed at ensuring person centred care for frail and elderly patients. Direct is designed to enable frail elderly patients to directly access services in BCH, reducing pressure on the ED and AMU at the RVH. This will also reduce the number of transfers across the hospital sites, will provide more timely and patient centred care and ensure quality and safety is at the cornerstone of our service delivery. The primary goal of BCH-Direct is to facilitate rapid access to Older People s Services and quick access to evidence based comprehensive geriatric assessment. It is not envisaged that the proposal would have an adverse impact for any of the Section 75 categories. (7.5) If you have identified any impact, what mitigation have you considered to address this? The Trust has in place a range of flexible working opportunities to support staff to balance work and caring responsibilities Disability: The Trust is committed to ensuring that reasonable adjustments will be facilitated according to any individual needs identified in accordance with the Trust s Framework on the Employment of People with Disabilities. 24

25 (8) Monitoring. In line with the guidance, you will be obliged to monitor this policy every 2 years. Please detail how you will monitor the effect of the policy/proposal for equality of opportunity and good relations, disability duties and human rights? The Trust monitoring framework developed in relation to the monitoring of service change impact in relation to of Section 75 groups will be followed. It is planned that service user feedback will be collected on the BCH Direct patient experience once fully operational. Approved Lead Officer: Catherine Collins Position: Date: 15/12/2014 Policy/proposal screened by Martin McGrath Equality Manager: Veronica McEneaney Employment Equality Manager: Michelle Morris Please forward completed schedule to lesley.jamieson@belfasttrust.hscni.net 25