NHS National Services Scotland. Equality Impact Assessment Initial Screening Tool

Transcription

1 Equality Impact Assessment Initial Screening Tool Key Considerations: The Equality Act 2010 means public authorities (including health boards) have a legal duty to have due regard to the need to: eliminate discrimination, harassment and victimisation promote equality of opportunity promote good relations Please consider the following questions in relation to the Policy/Project/Review and the potential impact on the Equality Act 2010 Protected Characteristics: Age Disability Faith/Religion/Belief Race Sex (men and women) Transgender Pregnancy Maternity Marriage Civil Partnerships Please refer to Appendix 1 for a summary of the demographics to help inform the initial assessment 1

2 Summary The main issue in terms of issues to be identified for this proposal is the additional travel required for a relatively small number of patients from the Lothian, Borders and Fife areas. This is acknowledgement and whilst that cannot be avoided ensuring that requirement to travel to the Glasgow Hospitals should only be absolutely necessary and wherever possible care that can be provided locally will be provided locally. Also a high standard of accommodation will be provided for a parent to stay with a child during in-patient stays and those who qualify for travel expenses re-imbursement will continue to receive these as currently the case. Consideration What is the aim of the Proposal Response The aim of this proposed change is create a safe single cleft surgical service for NHS Scotland that is resilient and sustainable and that can provide high quality service for all patients with a cleft of lip and/or palate wherever they live in Scotland. It aims to support a surgical team to work with others in the provision of cleft care across Scotland to provide a continually improving quality of service to all patients with a cleft of the lip and/or palate. Who are the current service users At the present there are two surgical centres in Scotland performing primary cleft surgery. There are three surgeons in total. The services cover for between 90 and 100 new births each year for patients born with a cleft and manages them up until discharge. Until last year this had only been until age 16 but has now been increased to include adulthood. The distribution of new births is shown in the annex 1. Paediatric patients living in Lanarkshire, Forth Valley, Ayrshire & Arran, Dumfries and Galloway, Western Isles and the Argyll & Bute part of NHS Highland as well as Greater Glasgow & Clyde are currently covered by the West of Scotland Service. 2

3 Paediatric patients living in Borders, Lothian, Fife, Tayside, Grampian, Highland, Orkney and Shetland are currently covered by the East of Scotland Service. In Glasgow the paediatric cleft surgical service has recently been relocated from Yorkhill Hospital to the Royal Hospital for Children in Glasgow within the new Queen Elizabeth University Hospital Campus along with all other paediatric services. A maxillofacial surgeon and a plastic surgeon specialising in Cleft Care perform the surgery. In Edinburgh the service is located at the Royal Hospital for Sick Children and the surgery is performed by a plastic surgeon working wholly on cleft surgery. RHSC Edinburgh and RHC Glasgow both being tertiary paediatric facilities, have access to all other clinical disciplines (staff) and equipment for the comprehensive investigation and treatment of these patients, and to Paediatric Intensive Care should this be required. Both hospitals provide a facility to allow a parent/guardian to stay beside the child on the ward when necessary. In Glasgow, where the majority of the adult specialist cleft surgical procedures are performed, the adult service is now co-located with the paediatric service within the Queen Elizabeth University Hospital Glasgow, the work is undertaken by the same surgical team with the Institute of Neurological Sciences. In Edinburgh the procedures on adults would be undertaken at St John s Hospital or Royal Infirmary of Edinburgh some of which would be undertaken by the cleft surgeon and others by the wider maxillofacial and plastic surgery team. All other aspects of cleft care are delivered as locally as possible to the child s home by clinicians employed by their NHS Boards to provide services in their particular field to cleft patients such as paediatric dentistry, speech and language therapy and orthodontics. They are supported in this as part of a Managed Clinical Network now called Cleft Care Scotland. 3

4 Consideration Considering the aim of the proposal and the potential outcome of the review are you aware of any potential impact on the following protected characteristics: Age Response It is envisaged that the proposal will have a positive impact on age characteristics. Previously only the paediatric element of cleft patients was covered by the national service but from last year this included adult care. Therefore returners to the service from procedures carried out in the 80s, 90s and early 2000 s will be able to be referred for a specialist cleft surgical assessment. Having a single surgical service for this will best assure that patients are not lost to follow up and that there is a clear referral into the service. All paediatric patients will still have access to the service and access to a whole team of surgeons to ensure good management of their care. There is a negative impact on those patients from around Edinburgh, East Lothian, Fife and the Borders who will have to travel significantly further for their planned surgical interventions. This is a small sub set to the whole cleft population and the need to travel to the surgical centre will be kept to the minimum with the majority of cleft care still being provided locally. There is a new family accommodation with adequate capacity to ensure that one parent can stay with their child whilst in hospital. Also all patients/parents entitled to reimbursement of travel expenses will have these reimbursed as per the current arrangements. 4

5 Disability There is no intended negative impact on patients due to disability. All patients with a cleft of lip and /or palate will have access to the service. There is a negative impact on those patients from around Edinburgh, East Lothian, Fife and the Borders who will have to travel significantly further for their planned surgical interventions. This is a small sub set to the whole cleft population and the need to travel to the surgical centre will be kept to the minimum with the majority of cleft care still being provided locally. There is a new family accommodation with adequate capacity to ensure that one parent can stay with their child whilst in hospital where necessary. Also all patients/parents entitled to reimbursement of travel expenses will have these reimbursed as per the current arrangements. Faith/Religion/Belief Race There is no intended negative impact on patients on the grounds of Faith/Religion/Belief. The transference of all specialist cleft surgery to Glasgow will not impact on the service being open to all patients with a cleft of the lip and/or palate. Patients will also have access to individual rooms which will allow greater privacy for individuals and their families. There is no intended negative impact from the proposed change on the grounds of race. The Service would ensure as now that all materials would be available in appropriate languages or a translation service will be offered. Sex There is no negative impact on the grounds of sex. If the proposal is accepted the service will remain open to all on grounds of sex. Patients will also have access to individual patient rooms for increased privacy. 5

6 Transgender Considerations Pregnancy Maternity Response There is no intended negative impact on grounds of transgender. The proposed change will ensure that the service is open to all with a cleft of the lip and/or palate. There may be a positive impact on the basis that patients will have access to individual rooms which will improve privacy for the patients and families. There is no obvious negative impact for pregnancy maternity. A family during pregnancy with a diagnosed baby through screening will still be visited and given advice locally as per current arrangements. A diagnosis following birth will still be handled as per the current arrangements. Parents and patients will be visited within 24 hours to provide advice and support as per the current arrangements and this will be delivered by the same staff as currently the position. Marriage Civil Partnerships There is no negative impact from the proposed change on the basis of marriage/civil partnerships. Further Commentary and supporting evidence: We have consulted on the proposal with patients, parents and other interested parties from February until May and the comments we received were considered to identify other mitigating actions required to lessen any negative impacts as far as practical in finalising the proposal. Document approved: National Services Division Senior Management Team Signed off by: Deirdre Evans, Director, NSD Published date and location: 1 August published on NSD website at 6

7 Average Number of Cleft New Births/Registrations per Annum (Source: a 3 year cohort from the Cleft Clinical Audit system April 2012 to March 2015) 7