Equality Analysis Division Service Name Equality Analysis Number (provided by the E&D Team) Directorate Service Lead Responsible for completion of Equality Analysis What is the aim of the service? What are the intended benefits and improved health outcomes to patients? Which, if any, third sector, (charity and voluntary sector), groups does the service work with? Does the service carry out any patient engagement or work with any patient groups? ALW Continence Service ALW26.08.2013 Long Term Conditions Name Job Title Telephone Number Email Address Rose Moran CNS Continence 01942 482497 rose.moran@bridgewater.nhs.uk Provision of a comprehensive advisory service across the Wigan borough. The service provides specialist clinical advice, guidance and support to health and social care professionals, carers and clients with regard to continence care. To offer treatment and advice to resolve, improve of help to appropriately manage bladder and bowel dysfunction. None directly, though we do interact with many groups / services, i.e. with referrals and implementation treatments plans. We also have an open offer of educational sessions to all groups / services None directly How do users access the service? e.g. GP referral, self-referral How long do users tend to stay with the service? Are patient records paper based or computerised, if computerised which system is used? Which of the 9 equality strands does your service monitor? Open referral from clients, families, carers, GPs and other services. Variable, clients receiving face to face clinical consultations are with us an average of five months, other clients who are cared for indirectly by the service i.e. clients in receipt of continence products can be with us for many years. SystmOne and paper based notes. For clients in receipt of continence products we use an IT system supplied by the product suppliers. No Age Disability Gender Reassignment Marriage/Civil Partnership Pregnancy/Maternity Race Religion/Belief Sex (Gender) Sexual Orientation NB: Only if relevant to care and interventions At what stage are any of the 9 equality strands No Page 1 of 9
above noted? At what point are patients discharged? What is the discharge process? What is the process following a Did Not Attend? How does the service ensure a DNA was not because adjustments had not been made to facilitate access? Failure to make adjustments may be a breach of the Equality Act 2010 and can lead to vulnerable patients not receiving timely and appropriate care. Referral Forms *** First Appointment Forms Discharge Forms Other Clients receiving face to face clinical consultations are discharged when their bladder/bowel function has improved or they are happy to manage without direct input, or are referred on for specialist investigations or opinion. Clients in receipt of continence products are discharged when they no longer need the products; are admitted into a nursing care facility or they die. Clients receiving face to face clinical consultations have discharge agreed with them. The GP and relevant others involved in their care are informed e.g. district nurses, LD team. Letters are sent to the referrer informing them of the DNA. We screen all referrals to make sure we offer appointment that meet need, i.e. location and timing. However we always inform the client and their referrer if they DNA, we hope that if access was an issue, it can be identified and we can rectify this. Page 2 of 9
Equality Analysis The next section asks more specific questions based on CQC outcome alignment to the Equality Act 2010 and the Human Rights Act 1998. The questions asked relate to barriers potentially facing patients from the nine protected characteristic groups and also those who are carers, from lower socio economic communities and those with chaotic lifestyles (such as the homeless, sex workers or drug users) all associated with health inequalities and poor health outcomes. The CQC identified barriers are Access, Assistance and Attitude; the questions have broken this down into access to the initial appointment, assistance within and following the appointment and attitude relating to staff training in the different health issues, needs and aspirations of the different groups within our community. Would there be any reason, other than clinical need, for the service to refuse to see a patient? How would a patient be made aware of: alternative clinic venues domiciliary care options or flexible appointment times or days? These alternatives can be very important for carers, those observing particular holy days/festivals or those with work commitments. How would the service identify if a patient should be offered a pre-appointment familiarisation visit to the clinic? This could be important for patients with a learning disability or autistic spectrum disorder. Is there an appointment reminder procedure within the service, for example text messaging? If clients not registered with a Wigan GP We would inform them of the reason Depending on presenting condition may be offered either an appointment at a clinic near their home address or a home visit. If a client or carer contact us we would discuss the above Not at present Page 3 of 9
How does the service know if a patient requires assistance for any of the following? Pre-Appointment/Referral At the appointment Post appointment follow up - information provided (including complaints procedure, privacy notices) Are staff confident in how to access this help and why there may need to be an adjustment made? Translation or interpretation for other languages Communication support for deaf, deafened or hard of hearing Communication support for blind or visual impaired Communication support for difficulties with speech Easy read for learning disabilities, lower literacy, the elderly Contrast of text on paper for learning difficulties Large print Learning Disability Health Passport or Care Passport Telephone contact or text messaging We would contact the translation service to see if an interpreter would be available We would ask client / carer how best we can communicate We would ask client / carer how best we can communicate We would ask client / carer how best we can communicate We would ask client / carer how best we can communicate Not needed for consultation Not needed for consultation Completed accordingly Not needed for consultation Service information not available in alternative languages Copy of clinic consultation letter sent to client Establish at consultation how to communicate post appointment, i.e. address consultation letter to designated other. Copy of clinic consultation letter sent to client Copy of clinic letter sent in large print Undertaken for clinic consultation letter Clinic consultation letter sent in large print Will not be used if inappropriate Religious Discussed at appointment If relevant for follow up Not at appointment Page 4 of 9
observances Requests for same sex clinician Quiet areas Longer appointment times Appointments at particular times, for example early or late when quiet Mental health illness Not achievable within service (all staff female) would refer externally or to other service dependant on clinical need N/A Suitable location would be chosen If relevant for follow up Would be flexible depending on circumstances Would be flexible depending on circumstances Consultation would be adjusted as perceived need Longer appointments would be pre booked Undertaken dependant on identified need Page 5 of 9
If a patient is unable to use the telephone are there other ways for them to contact the service? How does the service ensure that all patients can access the reception and waiting area? How does the service ensure patients who may experience difficulties can access the treatment room? Are bathroom facilities available for patients who may need help from a carer? Has the service experienced patients missing an appointment following arrival at a venue, for example because of the patient calling system excluding deaf or hard of hearing? What does the service do to ensure patients understand the information given to them in the appointment? What does the service do to ensure carers understand the information given to them? For example information about pain relief or medicine administration. Does the service offer appointments to, and see homeless patients or those in temporary accommodation? Would one of the service s patients transition to another service? Does information regarding necessary adjustments for access and care get passed to the relevant agency when a patient transitions between services? Via e mail, letter or fax or via third party Service operates from various clinics/health centres, Estates carry out access assessments Estates carry out access assessments Service operates from various clinics/health centres, Estates carry out access assessments no Written information given DVDs used to explain some interventions. Offer to explain things to designated others Written information given DVDs used to explain some interventions. Offer to explain thing to designated others Open referral to service, specialist triage of client s needs. Appointments offered in venues close to home address. Clients may be referred on for specialist investigations or opinion. Children coming from Paediatric Continence service continue to see same clinician. if applicable Page 6 of 9
Would staff in the service be interested in receiving training or accessing advice in the following areas: Autistic Spectrum Disorders Mental health awareness Sensory impairments Learning disabilities Learning difficulties e.g. dyslexia, dyspraxia Lesbian, gay, bisexual health Gender reassignment awareness Religious and cultural awareness Asylum seeker/refugee awareness Already do E&D signed off: Ruth Besford Date: 10.10.2013 ruth.besford@bridgewater.nhs.uk 01744 457389 Page 7 of 9
Age Disability Gender Reassignment Marriage/Civil Partnership Pregnancy/Ma ternity Race Religion/Belief Sex Sexual Orientation Equality Report EqA Completion Date Potential barriers identified Protected Characteristic Group Affected Other Groups Affected Actions Lead Due 10.10.2013 No concerns Service to look at potential text message service for reminders E&D to produce translation and interpretation SOP and policy and a quick start card for staff use E&D to produce a religion and culture in healthcare document for staff use Staff to access requested training Service Lead and E&D E&D E&D E&D Dec.2013 Dec.2013 Dec.2013 Sept.2014 Training Requested Autistic Spectrum Disorders Mental Health Awareness Sensory Impairments Learning Disabilities Learning Difficulties (e.g. dyslexia, dyspraxia) Lesbian, gay and bisexual health Gender reassignment awareness Religious and cultural awareness Asylum seeker/refugee awareness Report Sign Off Service Lead Name: Rose Moran Date: 20 th November 2013 E&D Lead Name: Ruth Besford Date: 20.11.2013 Page 8 of 9
Action Plan Review Date January 2014 and September 2014 Page 9 of 9