Section 4 Integrated Impact Assessment Summary Report Template Audit Risk level (Risk level will be added by Equalities Officer) Each of the numbered sections below must be completed Interim report Final report (Tick as appropriate) 1. Title of plan, policy or strategy being assessed Leg Ulcer Management Record 2. What will change as a result of this proposal? People with leg ulcers will be able to keep a record of investigation and treatment to assist in the management of their condition. It will also contain self management advice. 3. Briefly describe public involvement in this proposal to date and planned We have some information from the patient experience questionnaire and complaints. Pilot planned 4. Date of IIA 26.02.15 5. Who was present at the IIA? Identify facilitator, Lead Officer, report writer and any partnership representative present and main stakeholder (e.g. NHS, Council) Name Job Title Date of IIA training Email Bridget Nuttall District Team 20.02.15 bridget.nuttall@nhslothian.scot.nhs
Ruth Ropper Karen Stout Jeanette Timmins Manager Lead Tissue Viability District Team Manager Tissue Viability ruth.ropper@nhslothian.scot.nhs.uk karen.stout@nhslothian.scot.nhs.uk Jeanette.timmins@nhslothian.scot.nhs.uk 6. Evidence available at the time of the IIA Evidence Available? Comments: what does the evidence tell you? Data on populations in need Data on service uptake/access Data on equality outcomes Population of Lothian 850,000. Approx 1% of the population (~8,500) will develop leg ulcers Leg ulcer care is provided by a variety of healthcare professionals across primary and secondary care settings. The majority of patients are cared for in the community but will still need their ulcers managed if they are admitted to hospital with other health issues. We kw that patient outcomes are better when they are treated by nurses with specialist training in assessment and management of leg ulcers. Research/literature evidence SIGN 120 Public/patient/client experience information Patient experience questionnaire. Pilot. Verbal reports from nurses on how difficult it is to communicate information about patient care. Complaints
Evidence Available? Comments: what does the evidence tell you? Evidence of inclusive engagement of service users and involvement findings Evidence of unmet need Good practice guidelines Environmental data Risk from cumulative impacts Other (please specify) Additional evidence required Consultation zone. Sent out widely for comments including patient involvement. Comments have been positive. Anecdotal evidence from experienced practitioners report that care can be delayed or omitted as patients with leg ulcers attend different care settings. Good evidence available from SIGN and Best Practice Statements to support the patient advice and prescribed care 7. In summary, what impacts were identified and which groups will they affect? Equality, Health and Wellbeing and Human Rights Affected populations Positive The Leg Ulcer Management Record will improve communication about the patient s current treatment plan allowing nurses to deliver prompt care, reduce staff time in looking for information, stop the repeat of investigations e.g. dopplers, ensure the correct bandages and equipments is ordered and applied therefore improving access and quality of service. This will benefit the 1% of the population who have leg ulcers and the staff and carers who support them. This group is mainly older people but can be any age. It will be particularly helpful to
disabled people, homeless, n English speaking and people living in rural/remote locations in aiding communication. Negative Relies on patient remembering to bring record to appointments and into hospital. These patients will be identified at the initial assessment. Simple wording has been used but additional explanation will be required for some. These patients will be identified at the initial assessment. People with dementia (but may also benefit them) People with low literacy Relies on staff remembering to complete. Guidance for staff will be required. Staff Environment and Sustainability Affected populations Positive Negative Ecomic Affected populations Positive
Negative 8. Is any part of this policy/ service to be carried out wholly or partly by contractors and how will equality, human rights including children s rights, environmental and sustainability issues be addressed? NO 9. Consider how you will communicate information about this policy/ service change to children and young people and those affected by hearing loss, speech impairment, low level literacy or numeracy, learning difficulties or English as a second language? Please provide a summary of the communications plan. The Leg Ulcer Management Record will support good communication by providing a written record for those with hearing loss, speech impairment, learning difficulties, low literacy or English as a second language. It will provide a prompt to nurses when explaining investigations, treatment and promoting self care and healthy lifestyles that will improve healing and quality of life 10. Is the policy a qualifying Policy, Programme or Strategy as defined by The Environmental Impact Assessment (Scotland) Act 2005? (see Section 4) NO 11. Additional Information and Evidence Required If further evidence is required, please te how it will be gathered. If appropriate, mark this report as interim and submit updated final report once further evidence has been gathered. 12. Recommendations (these should be drawn from 6 11 above)
1. There is specialist leg ulcer centre in Lothian so the Leg Ulcer Management Record will provide nurses in general care with some support in treating people with leg ulcers. 2. Review patient experience information such as complaints after one year to see if there is any change. 3. Audit of Leg Ulcer Management Record to be done and repeated in one year. 4. Audit to include nurses views on the Leg Ulcer Management Record 5. Guidance to be given to nurses on the implementation of the Leg Ulcer Management Record to encourage participation and ensure patients are given a clear explanation of what it is about. 6. Patients are becoming more accustomed to having patient held records such as the green diabetic book and the catheter passport. Patients to be reminded to take booklet with them when they go for appointments. 13. Specific to this IIA only, what actions have been, or will be, undertaken and by when? Please complete: Specific actions (as a result of the IIA which may include financial implications, mitigating actions and risks of cumulative impacts) Who will take them forward (name and contact details) Deadline for progressing Review date
14. How will you monitor how this policy, plan or strategy affects different groups, including people with protected characteristics? Feedback from patients and healthcare professionals from audit and patient experience information 15. Sign off by Head of Service Name Ruth Ropper Date 30.7.15 16. Publication Send completed IIA for publication on the relevant website for your organisation. See Section 5 for contacts.