EqIA - HSCP Learning Disability Strategy 2024-2029

NHS Greater Glasgow and Clyde Equality Impact Assessment Tool

Equality Impact Assessment is a legal requirement as set out in the Equality Act (2010) and the Equality Act 2010 (Specific Duties) (Scotland) regulations 2012 and may be used as evidence for cases referred for further investigation for compliance issues. Please refer to the EQIA Guidance Document while completing this form. Please note that prior to starting an EQIA all Lead Reviewers are required to attend a Lead Reviewer training session or arrange to meet with a member of the Equality and Human Rights Team to discuss the process. Please contact CITAdminTeam@ggc.scot.nhs.uk for further details or call 0141 2014560.

Jump to section:

Description of the service & rationale for selection for EQIA
Why was this service or policy selected for EQIA? Where does it link to organisational priorities?
Questions

Description of the service & rationale for selection for EQIA

The Learning Disability Strategy follows on from East Dunbartonshire Health and Social Care Partnerships (EDHSCP) previous Learning Disability Strategy launched in 2018. Developing a Learning Disability Strategy is not a statutory requirement, meaning that HSCP’s are not legally required to have one. The Strategy expresses EDHSCP commitment to improve the lives of all people with learning disabilities by setting specific priorities to be delivered during the life of the strategy.

Statistics show that people with learning disabilities do not yet enjoy the same life chances as others. At the heart of this Strategy is a commitment that recognises that people with learning disabilities have the same aspirations and expectations as everyone else. Everyone, including those with complex needs, should be treated with dignity, respect and understanding. They should be able to play a full part in their communities and live independent lives free from bullying, fear and harassment.

In developing the Learning Disability Strategy, we aim to redress inequalities that people with a learning disability experience, particularly those with complex needs and from diverse ethnic backgrounds in accessing personalised care and support that would enable them to exercise choice and control over their own lives.

Throughout the strategy there are references to families and carers; it is acknowledged they are vital to the success of the delivery of this strategy whether it be giving feedback, co-production or supporting their loved one to navigate new ways that services are delivered.

The Learning Disability Strategy 2024-29 will guide the work of East Dunbartonshire Health and Social Care Partnership over the next five years. In partnership with people with learning disabilities, their families and people who provide support and services, we want to develop a strategy that delivers the best possible outcomes for people with a learning disability living in East Dunbartonshire.

The new Learning Disability Strategy is being developed via 3 distinct phases, which reflect the legal requirements for consultation as well as supporting guidance. These are:

The HSCP will carry out initial work by looking at the main drivers for change and improvement, statute guidance, national and local policy and local needs. They will provide a consultative draft report that identifies proposed areas for priority action;
The HSCP will consult on the draft report;
The HSCP will develop a final Learning Disability Strategy based on consultation outcomes for approval by the HSCP Board.

In developing the Learning Disability Strategy we aim to consider;

the main pressures (or “drivers”) for change and improvement
analysis of local population and circumstances to ensure that the Strategy identifies and reflects these local needs in the development of its priorities
recent Learning Disability Strategies elsewhere, to help to inform our early thoughts
the expressed views of people with lived experience over recent years, locally and nationally
the key challenges and the proposed areas for priority action over the next five years

Crucially, when establishing the new strategy, the HSCP Board will engage with stakeholders and partners to ensure that a shared approach is taken to the planning of services to deliver the National Outcomes for Health and Wellbeing and to achieve the core aims of integration, which are:

To improve the quality and consistency of services for patients, carers, service users and their families;
To provide seamless, integrated, quality health and social care services in order to care for people in their homes, or a homely setting, where it is safe to do so; and
To ensure resources are used effectively and efficiently to deliver services that meet the needs of the increasing number of people with long term conditions and complex needs, many of whom are older.

It is essential therefore that the new Strategy is accessible to all people with lived experience of learning disability, including those with protected characteristics and any priorities or services produced as a result of the strategy are equally available and fairly provided at the point of need.

The National Care Service and Neurodiversity Bills are rapidly developing agendas at the time of preparing this strategy. Any new and emerging Policy requirements as a result of these, will be incorporated in the developing EDHSCP Learning Disability Strategy 2024-29.

Why was this service or policy selected for EQIA? Where does it link to organisational priorities?

The strategy itself is aimed at improving the lives of people with the protected characteristic of a disability. However, we are mindful that within this group of people lies many more vulnerabilities and potential barriers to equality. The EQIA has been undertaken to ensure any adverse impact on protected characteristic groups is minimised and 2 prior to the Strategy being implemented, we aim to acknowledge the equalities duties placed upon us by the Equalities Act 2010 and that they are upheld. The Equality Duty is non-delegable. In practice this means that public authorities like EDHSCP need to ask their suppliers and those they commission services from to take certain steps in order to enable the public authority to meet their continuing legal obligation to comply with the Equality Duty.

The relevant protected characteristics covered by the Duty are:

Age
Disability
Gender Reassignment
Marriage and Civil Partnership
Pregnancy and Maternity
Race
Religion or Belief
Sex
Sexual Orientation

Throughout the development of the strategy, reference has been made to the general duties (Equality Act (2010) and to the HSCP Equality and Diversity (2017-2021) Policy document and how any proposed changes in service provision will meet the requirement;

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

The Learning Disability Strategy 2024-29 supports the delivery of EDC Local Outcomes Improvement Plan 2017-2027;

Local Outcomes Improvement Plan: Outcomes 2017-2027
Local Outcome 2	Our people are equipped with knowledge and skills for learning, life and work.
Local Outcome 4	East Dunbartonshire is a safe place in which to live, work and visit.
Local Outcome 5	Our people experience good physical and mental health and well-being with access to a quality built and natural environment in which to healthier and more active lifestyles.
Local Outcome 6	Our older population and more vulnerable citizens are supported to maintain their independence and enjoy a high quality of life, and they, their families and carers benefit from effective care and support services.

Promoting equality and addressing health inequalities are at the heart of East Dunbartonshire Health and Social Care Partnership’s (HSCP) vision and values. Empowering people and communities are key strategic priorities for the HSCP Board established within the Strategic Plan. However, it is important that these commitments are set out in more detail, to emphasise our investment in people with a learning disability. That is why we have developed a dedicated Learning Disability Strategy. The Learning Disability Strategy 2024-29 aims to deliver support and services to people with learning disabilities that is aligned with the HSCP’s vision, values and priorities for health and social care in East Dunbartonshire as set out in East Dunbartonshire HSCP’s Strategic Plan (2022-25).

Vision: ‘Caring together to make a positive difference’.
Values: Honesty, Integrity, Professionalism, Empathy and Compassion, Respect

A lot of what the HSCP needs to do to support people with learning disabilities is already set out in national and local policy. But not all HSCPs are the same. Different HSCPs have different pressures and population needs. It is important that we ensure that our Learning Disability Strategy reflects what all HSCPs need to do but emphasises the priorities that are right for our local needs and aspirations, recognising equality law and the impact on people with protected characteristics.

Since the last Learning Disability Strategy, the Covid-19 pandemic has had an enormous impact on people with a learning disability and their carers, so it is essential to ensure that these impacts are recognised in the new strategy and plans developed to support them through and out of the pandemic.

In addition to understanding and responding to legal responsibilities set out in Equality Act (2010), services must pay due regard to ensure a person's human rights are protected in all aspects of health and social care provision. This may be more obvious in some areas than others. For instance, mental health inpatient care or older people’s residential care may be considered higher risk in terms of potential human rights breach due to potential removal of liberty, seclusion or application of restraint. However, risk may also involve fundamental gaps like not providing access to communication support, not involving patients/service users in decisions relating to their care, making decisions that infringe the rights of carers to participate in society or not respecting someone's right to dignity or privacy.

The Human Rights Act sets out rights in a series of articles – right to Life, right to freedom from torture and inhumane and degrading treatment, freedom from slavery and forced labour, right to liberty and security, right to a fair trial, no punishment without law, right to respect for private and family life, right to freedom of thought, belief and religion, right to freedom of expression, right to freedom of assembly and association, right to marry, right to protection from discrimination.

Who is the lead reviewer and when did they attend Lead reviewer Training?

Name: Gayle Paterson - assisted by Anthony Craig Development Officer and Alan Cairns Planning, Performance & Quality Manager

Date of Lead Reviewer Training: 01/05/2018

Staff involved in carrying out this EQIA:
Anthony Craig (Development Officer)
Gayle Paterson (Learning Disability Strategic Review Project Lead -East Dun HSCP)
David Aitken (Head of Service – East Dun HSCP)

Questions

1. What equalities information is routinely collected from people currently using the service or affected by the policy?

In developing the strategy, we used learning from previous plans and strategies; and also utilised our statutory partner’s demographic knowledge to further develop and increase knowledge of local equality groups as these are fluid.

Data relating to people with a learning disability is also collected by a number of National and Local sources.

The Scottish Government have recently collected data via the 2020 Scottish Health Survey and the 2021 Scottish Government Census. The 2021 Census data is not yet available.

Locally within EDC protected characteristics are covered by data collection in the needs assessment process and is recorded on our Care First Database. The information that is recorded includes protected characteristics and is reviewed with regard to an individual’s changing needs and circumstances.

The information recorded on Care First considers protected characteristics and upon review there is no requirement to undertake more intensive analysis. The system allows information relating to support needs to be recorded in addition to the collection of data relating to age, sex, and social class via postcode related data. In addition, local and national data is analysed and from this information resources and alternative services are put in place to support people with a learning disability as required, to ensure that equality and human rights issues for each individual are considered. No barriers have been identified, however there is some information that is not currently mandatory to provide, such as sexual orientation.

East Dunbartonshire Joint Strategic Needs Assessment (JSNA) was referenced as a key resource document in preparing the Learning Disability Strategy, the JSNA was produced with the support of Public Health Scotland’s LIST Analysts. The JSNA informs the planning and nature of future services and provides an overview of the current and projected population demographic, information relating to life circumstances, health behaviours, and health and social care status across East Dunbartonshire. It includes information on age, gender, ethnic origin, population projections, disabilities (including physical, learning, sensory), mental health and wellbeing. The most up to date, robust data available was used to inform this joint strategic needs assessment, including comparisons to the national Scottish average, and available trend data. In addition, available locality level information was included to aid local planning.

Possible negative impact and Additional Mitigating Action Required

Data relating to the protected characteristics of people with a learning disability is captured via a Single Shared Assessment. This information is then logged on the Care First System.

If data is incomplete or inaccurate there is a risk that supporting Strategies will be omitted or targeted inappropriately or disproportionally.

Whilst some protected characteristic data is requested within the Single Shared Assessment and transferred to Care First, not all are included and the fields themselves are not mandatory.

Data that is not currently collected or logged on Care First includes:

Gender Reassignment
Marriage and Civil Partnership
Pregnancy and Maternity
Sexual Orientation

Failure to identify specific groups e.g. gender reassignment could result in them becoming marginalised.

The Single Shared Assessment and Care First Data Base requires updating to ensure all protected characteristic data is included.

To ensure information is routinely captured for monitoring purposes, a communication to all social work staff will help highlight the need to ensure all appropriate fields are used.

The focus on data collection will primarily be for analysis, rather than clinical purposes.

2. Please provide details of how data captured has been/will be used to inform policy content or service design.

The data captured helps the HSCP understand learning disability population dynamics across the authority and set priorities within the Learning Disability Strategy that will deliver services and support that can best respond flexibly to the changing needs of people with learning disabilities.

Scotland’s population is ageing, with numbers of very old people predicted to continue growing and a proportionately smaller working age population. In East Dunbartonshire, the numbers of older people aged 85+ has increased faster than any other HSCP area in Scotland, with this fastest growth expected to continue for the next 10 years. This is a success story in terms of improved health and wellbeing and longer life expectancy, but it has significant implications for the demands placed on future of care and support in Scotland.

Scotland's Census 2011 reported:

EDC’s population size as 105,026 people. Of that population, 458 people have learning disabilities; that’s 0.4% of all people.

101 children and 357 adults have learning disabilities
101 aged 0-15 years, 305 aged 16-64 years and 52 aged 65 + years
247 males and 211 females have learning disabilities

573 people known to have autism; that's 0.5% of all people.

The prevalence of autism in the 0-15 age group is 1.6%. This reflects availability of diagnostic services for autism, which have improved considerably over the last two decades.

293 children and 280 adults are known to have autism
120 females and 453 males are known to have autism

In addition:

34% of people with learning disabilities live in social rented accommodation, compared with 10% of all people.
17% of people with learning disabilities in East Dunbartonshire rate their health as very good, compared with 56% of all people.
The estimated paid employment rate for people with a learning disability is 12% compared to 58% of all East Dunbartonshire adults.

Our own Care First stats tell us that there were 22 (approx. 5.5%) adults with learning disabilities known to health or social care services enrolled in further education in 2023.

This information is captured in a needs assessment and have contributed to the development of the Learning Disability Strategy 2024-29 and informed the priorities.

HSCP Boards are collaborative at heart; they include membership from Local Authorities and Health Boards, plus representatives of service users, informal carers, professionals and clinicians, trade unions and third and independent sector service providers. When preparing any new strategy, an HSCP Board must ensure that all of these stakeholders and partners are fully engaged in the process and have regard to the Health and Social Care Delivery Principles. This ensures that a shared approach is taken to the planning of services to deliver the National Outcomes for Health and Wellbeing and to achieve the core aims of integration, which are:

To improve the quality and consistency of services for patients, carers, service users and their families

To provide seamless, integrated, quality health and social care services in order to care for people in their homes, or a homely setting, where it is safe to do so; and

To ensure resources are used effectively and efficiently to deliver services that meet the needs of the increasing number of people with long term conditions and often complex needs, many of whom are older

The HSCP has carried out initial work by looking at the main pressures (or “drivers”) for change and improvement. Analysis of learning disability population numbers and circumstances has also been undertaken to ensure that the Learning Disability Strategy identifies and reflects these local needs in the development of its priorities. We have also looked at what has been included in recent Learning Disability Strategies elsewhere, to help to inform our early thoughts.

Crucially important, we have reviewed the expressed views of people with lived experience over recent years, locally and nationally. We found that many of the issues and priorities that have been raised in the past remain really important. We wanted to ensure that we reflected these views and opinions before we re-engaged once again, through consultation.

This initial work will be shared with People with lived experience, Partners, Stakeholders and the general public during a 90 day consultation, via formal and informal engagement sessions, website updates, social media campaigns etc. A survey will be distributed to gather feedback on the Strategy Proposal.

The Consultation Paper and survey have been made available in Easy Read Format in addition to the option to receive them in a different language, the use of the interpreting service and how to access it for those who do not have English as a first language, including BSL users, thus ensuring accessibility to a wide range of groups. In addition, the paper and survey will include an e-mail contact address for those who are keen to engage by an alternative method. This will remain the case for the Final Strategy, ensuring accessibility to people with learning disabilities or for whom English is not their first language.

The Learning Disability Strategy 2024-2029 will respond to a variety of needs of our communities, removing discrimination, promoting equality of opportunity and foster good relations.

The new strategy is co-produced in partnership with people with lived experience and Stakeholders via a robust consultation process. Data captured recently has been used to develop the Learning Disability Strategy and inform the key priorities for the next 5 years. These include the right to suitable, high quality housing, effective transitions, health care and healthy relationships.

Possible negative impact and Additional Mitigating Action Required

The Single Shared Assessment and Care First is used to assess the individual needs of carers and deliver or signpost to appropriate supports.

Collectively, data is used to establish learning disability dynamics and population needs.

If data is incomplete or inaccurate there is a risk that supporting Strategies will be omitted or targeted inappropriately or disproportionally.

Whilst some protected characteristic data is requested within the Single Shared Assessment and transferred to Care First, not all are included and the fields themselves are not mandatory.

Data that is not currently collected or logged on Care First includes:

Gender Reassignment
Marriage and Civil Partnership
Pregnancy and Maternity
Sexual Orientation

Failure to identify specific groups e.g. gender reassignment could result in them becoming marginalised.

The Single Shared Assessment and Care First Data Base requires updating to ensure all protected characteristic data is included.

To ensure information is routinely captured for monitoring purposes, a communication to all social work staff will help highlight the need to ensure all appropriate fields are used.

The focus on data collection will primarily be for analysis, rather than clinical purposes.

3. How have you applied learning from research evidence about the experience of equality groups to the service or Policy?

Scotland's Census 2011 reported:

East Dunbartonshire’s population size is 105,026 people. Of that population, 458 people have learning disabilities; that’s 0.4% of all people.

101 children and 357 adults have learning disabilities
101 aged 0-15 years, 305 aged 16-64 years and 52 aged 65 + years
247 males and 211 females have learning disabilities

573 people known to have autism; that's 0.5% of all people.

The prevalence of autism in the 0-15 age group is 1.6%. This reflects availability of diagnostic services for autism, which have improved considerably over the last two decades.

293 children and 280 adults are known to have autism
120 females and 453 males are known to have autism

In addition:

34% of people with learning disabilities live in social rented accommodation, compared with 10% of all people.
17% of people with learning disabilities in East Dunbartonshire rate their health as very good, compared with 56% of all people.
The estimated paid employment rate for people with a learning disability is 12% compared to 58% of all East Dunbartonshire adults.

Our own Care First stats tell us that there were 22 (approx. 5.5%) adults with learning disabilities known to health or social care services enrolled in further education in 2023.

This information is captured in a needs assessment and have contributed to the development of the Learning Disability Strategy 2024-29 and informed the priorities.

HSCP Boards are collaborative at heart; they include membership from Local Authorities and Health Boards, plus representatives of service users, informal carers, professionals and clinicians, trade unions and third and independent sector service providers. When preparing any new strategy, an HSCP Board must ensure that all of these stakeholders and partners are fully engaged in the process and have regard to the Health and Social Care Delivery Principles [opens in a new window]. This ensures that a shared approach is taken to the planning of services to deliver the National Outcomes for Health and Wellbeing [opens in a new window] and to achieve the core aims of integration, which are:

To improve the quality and consistency of services for patients, carers, service users and their families
To provide seamless, integrated, quality health and social care services in order to care for people in their homes, or a homely setting, where it is safe to do so; and
To ensure resources are used effectively and efficiently to deliver services that meet the needs of the increasing number of people with long term conditions and often complex needs, many of whom are older

The Consultation Paper and survey have been made available in Easy Read Format in addition to the option to receive them in a different language, the use of the interpreting service and how to access it for those who do not have English as a first language, including BSL users, thus ensuring accessibility to a wide range of groups. In addition, the paper and survey will include an email contact address for those who are keen to engage by an alternative method. This will remain the case for the Final Strategy, ensuring accessibility to people with learning disabilities or for whom English is not their first language.

The Learning Disability Strategy 2024-2029 will respond to a variety of needs of our communities, removing discrimination, promoting equality of opportunity and foster good relations.

4. Can you give details of how you have engaged with equality groups with regard to the service review or policy development? What did this engagement tell you about user experience and how was this information used?

HSCP Boards are collaborative at heart; they include membership from Local Authorities and Health Boards, plus representatives of service users, informal carers, professionals and clinicians, trade unions and third and independent sector service providers. When preparing any new strategy, an HSCP Board must ensure that all of these stakeholders and partners are fully engaged in the process and have regard to the Health and Social Care Delivery Principles [opens in a new window]. This ensures that a shared approach is taken to the planning of services to deliver the National Outcomes for Health and Wellbeing [opens in a new window] and to achieve the core aims of integration, which are:

To improve the quality and consistency of services for patients, carers, service users and their families
To provide seamless, integrated, quality health and social care services in order to care for people in their homes, or a homely setting, where it is safe to do so; and
To ensure resources are used effectively and efficiently to deliver services that meet the needs of the increasing number of people with long term conditions and often complex needs, many of whom are older

The HSCP carried out initial work by looking at the main pressures (or “drivers”) for change and improvement. Analysis of the learning disability population and circumstances has also been undertaken to ensure that the Learning Disability Strategy identifies and reflects these local needs in the development of its priorities.

The Learning Disability Strategy 2024-2029 will respond to a variety of needs of our communities, removing discrimination, promoting equality of opportunity and foster good relations.

5. Is your service physically accessible to everyone? If this is a policy that impacts on movement of service users through areas are there potential barriers that need to be addressed?

The Learning Disability Strategy will be executed within a variety of venues across the authority. EDC Community Hubs are accessible to ensure the delivery of services locally. All resources accessed for the purpose of consultation will be fully accessible.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

EDHSCP needs to ask their suppliers and those they commission services from to take certain steps in order to enable the public authority to meet their continuing legal obligation to comply with the Equality Duty. When connecting people with a learning disability with community-based supports, resources will already have been commissioned and screened in line with accessibility requirements and equality.

Social Work and Allied Health Professionals support the assessment of individual needs with regards to access and equipment and appropriate resources are made available to ensure equality of access. Social Work Colleagues work closely with other support services e.g. occupational therapy, sensory impaired services and external day care providers to put in place information and supports to remove any potential barriers. Formal Strategies are also in place to promote positive behaviour and prevent incidences of challenging behaviour.

The new strategy is co-produced in partnership with people with lived experience and Stakeholders via a robust consultation process. Any data that is captured has been used to develop the Learning Disability Strategy and inform the key priorities for the next 5 years. These include the right to suitable, high quality housing, effective transitions, health care and healthy relationships.

Where transport is required to support the delivery of the Learning Disability Strategy, a needs assessment is carried out to ensure appropriate resources are made available such as escort, adapted vehicles etc.

6. How will the service change or policy development ensure it does not discriminate in the way it communicates with service users and staff?

East Dunbartonshire HSCP Communications Strategy (CS) (2020-23) and Participation and Engagement Strategy (PES) (2020-23) and the communications matrix were used to devise a Communication Plan. The strategies detail how the EDHSCP will communicate with different stakeholders and give those with one or more protected characteristics an opportunity to share their views.

Throughout the planning and creation of the Learning Disability Strategy 2024-2029 we have strived to be clear, concise and inclusive (use plain English; accessible and easy Read format, with arrangements in place to adapt styles, formats, layouts, community languages (The British Sign Language (BSL)

(Scotland) Act 2015) and material), and ensure that the Strategy is fluid and can adapt to meet the communication needs and preferences of different audiences including those with protected characteristics (e.g., older service users for example generally prefer print and face-to-face communications over social media).

The consultative paper and survey have been made available in Easy Read Format in addition to the option to receive them in a different language or the use of the interpreting service and how to access it for those who do not have English as a first language, including BSL users, thus ensuring accessibility to a wide range of groups. In addition, the consultation paper and survey included an e-mail contact address for those who were keen to engage by an alternative method. This will remain the case for the Final Strategy, ensuring accessibility to people with learning disabilities or for whom English is not their first language.

By adopting this approach in developing and during the life of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

It is important that as the Learning Disability Strategy develops and progresses, we use learning to understand the experience of people with a learning disability from protected characteristic groups and make a commitment to capture all community perspectives across protected characteristic groups.

Social Work Services will continue to engage with people with learning disabilities in the future and ensure any communication barriers are addressed.

7. Protected Characteristic

(a) Age

Could the service design or policy content have a disproportionate impact on people due to differences in age?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring those from across the protected characteristics are represented.

It is important to be aware of potential impacts associated with age discrimination that leads to inequality in terms of access to services and user experience amongst different age groups, and the need to develop multi-dimensional approach to tackling inequality as a consequence of age discrimination.

The Learning Disability Strategy 2024-29 will take account of the needs of people with a learning disability aged 18 years and older that live in East Dunbartonshire or for whom East Dunbartonshire Council are responsible. There is no upper age limit. The strategy will include people with a learning disability who might also have other conditions such as autism, a mental or physical health condition or who have other needs (sometimes we describe this as having ‘complex needs’ or ‘PMLD’, profound and multiple learning disabilities).

There are many different definitions of a learning disability. Scotland’s learning Disability Strategy ‘The Keys to Life’, describes a learning disability as “significant and lifelong. It starts before adulthood and affects the person’s development. This means that a person with a learning disability will be likely to need help to understand information, learn skills and live a fulfilling life.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

Scotland’s population is ageing, with numbers of very old people predicted to continue growing and a proportionately smaller working age population. In East Dunbartonshire, the numbers of older people aged 85+ has increased faster than any other HSCP area in Scotland, with this fastest growth expected to continue for the next 10 years. This is a success story in terms of improved health and wellbeing and longer life expectancy, but it has significant implications for the future of care and support in Scotland. Increasingly age also has an impact on the likelihood of developing one or more long term conditions and increase the demand for health and social care provision.

The East Dunbartonshire HSCP Joint Strategic Needs Assessment projects a 7.6% increase in the overall population of East Dunbartonshire from 2018 – 2043 due to a significant estimated rise in the population aged over 65 years. (The estimated 2018 East Dunbartonshire population is 107,431). The number of children aged 0-15yrs is projected to increase by 4.4%. National Records of Scotland website [opens in a new window]

Of the 2314 people with dementia that Alzheimer Scotland estimates in East Dunbartonshire in 2017, 825 are male and 1,489 are female. The majority of dementia sufferers are aged 65 or over and female. Scotland wide rates of dementia increase with age from 1.8% of males and 1.4% at age 65-69 rising to 32.4% of males and 48.8% of males in the 95-99 and 100+ age ranges.

People with a learning disability are more likely to get dementia at a younger age. About 1 in 5 people with learning disabilities who are over the age of 65 will develop dementia. People with Down’s syndrome have an even higher risk, with about 2 in 3 people over the age of 60 developing dementia, usually Alzheimer’s disease. The reasons why people with Down’s syndrome are at a higher risk of Alzheimer’s disease are not well-understood. It is thought to be due to chromosome 21, which most people with Down’s syndrome have an extra copy of. This leads to a build-up of a protein, which forms plaques on the brain. These plaques are a feature of Alzheimer’s disease. Learning disabilities and dementia Alzheimer's Society [opens in a new window].

The life expectancy of people with profound, complex and multiple disabilities has increased over the course of the last 70 years. This is despite the fact that people with learning disabilities are 58 times more likely to die before the age of 50 than the rest of the population (Emerson and Baines 2010 [opens in a new window]).

Scotland's Census 2011 reported:

EDC’s population size as 105,026 people. Of that population, 458 people have learning disabilities; that’s 0.4% of all people.

101 children and 357 adults have learning disabilities
101 aged 0-15 years, 305 aged 16-64 years and 52 aged 65 + years
247 males and 211 females have learning disabilities

573 people known to have autism; that's 0.5% of all people.

The prevalence of autism in the 0-15 age group is 1.6%. This reflects availability of diagnostic services for autism, which have improved considerably over the last two decades.

293 children and 280 adults are known to have autism
120 females and 453 males are known to have autism

In addition:

34% of people with learning disabilities live in social rented accommodation, compared with 10% of all people.
17% of people with learning disabilities in East Dunbartonshire rate their health as very good, compared with 56% of all people.
The estimated paid employment rate for people with a learning disability is 12% compared to 58% of all East Dunbartonshire adults.

Our own Care First stats tell us that there were 22 (approx. 5.5%) adults with learning disabilities known to health or social care services enrolled in further education in 2023.

Information on age is gathered through a Care Needs Assessment and stored on the internal computer/ information system (Care first) and is used to inform activities and service delivery.

The new Learning Disability Strategy lists a number of priorities designed to ensure equality of access and opportunity for people with a learning disability across the authority, including, the right to suitable, high quality housing, effective transitions, health care and healthy relationships.

The new strategy includes a priority to develop a Covid Recovery Plan which will ensure there is restorative action for issues caused by the Covid pandemic such as poor mental health and missed health appointments for people with learning disabilities, pending implementation of annual health checks for adults with a learning disability, in line with National Policy. There is no age limit on this priority.

The Single Shared Assessment process is cognisant of age when determining the appropriate allocation of services.

Possible negative impact and Additional Mitigating Action Required

Therefore, the Strategy may not be viewed and commented on by all representatives of communities of East Dunbartonshire, particularly protected characteristics groups.

To mitigate this, as stated in the Strategy, we will continue to be committed to consider for any future communication activity, the specific needs and preferences of the communications audience including protected characteristic groups.

Social Work Services will continue to engage with people with a learning disability in the future and capture local need data.

The HSCP should consider whether there would be benefit in developing a Children’s Learning Disability Strategy.

(b) Disability

Could the service design or policy content have a disproportionate impact on people due to differences in age? (Consider any age cut-offs that exist in the service design or policy content. You will need to objectively justify in the evidence section any segregation on the grounds of age promoted by the policy or included in the service design).

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

The strategy will include people with a learning disability who might also have other conditions such as autism, a mental or physical health condition or who have other needs (sometimes we describe this as having ‘complex needs’ or ‘PMLD’, profound and multiple learning disabilities).

Taking cognisance of guidance stated within ‘A Fairer NHS Greater Glasgow & Clyde [opens in a new window]', the Learning Disability Strategy 2024-29 recognises that identified priority topics are required to identify positive action / initiatives, to meet specific needs of the vulnerable and disadvantaged members of our community.

Evidence suggests that disabled people have more difficulties in accessing health services than non-disabled people. The barriers that have been identified are commonly given as:

Difficulty in reading and understanding letters
Difficulty using telephones to arrange appointments
Transport difficulties including costs
Engagement in health services arising from mental health problems

The National Institute for Health and Care Excellence (NICE) [opens in a new window] reports that compared with the wider population, the average age at death for people with a learning disability is 23 years younger for men, and 27 years younger for women. The new strategy includes a priority to develop a Covid Recovery Plan which will ensure there is restorative action for issues caused by the Covid pandemic such as poor mental health and missed health appointments for people with learning disabilities, pending implementation of annual health checks for adults with a learning disability, in line with National Policy. Partners understand the requirement to make all reasonable adjustments to make all services fully accessible.

EDHSCP need to ask their suppliers and those they commission services from to take certain steps in order to enable the public authority to meet their continuing legal obligation to comply with the Equality Duty. When connecting people with learning disabilities with community-based supports resources will already have been commissioned and screened in line with accessibility requirements and equality such as Respite Units, Day Services etc. All centres from which services are provided must comply with the Equality Act 2010, including the provision of access ramps, accessible toilets and loop systems.

Information on disability is gathered through a Care Needs Assessment and stored on the internal computer/ information system (Care first) and is used to inform activities and service delivery.

The new Learning Disability Strategy lists a number of priorities designed to ensure equality of access and opportunity for people with a learning disability across the authority, including:

to improve access to suitable housing/accommodation close to home;
to ensure existing accommodation based services are fit for purpose, high quality, efficient and sustainable;
to improve planning for young people with learning disabilities transitioning to adulthood;
to improve and develop short break provision;
to ensure there is restorative action for issues caused by the Covid pandemic;
to increase engagement with people with lived experience, that improves outcomes;
to promote the development of healthy relationships for people with learning disabilities.

The new strategy is co-produced in partnership with people with lived experience and Stakeholders via a robust consultation process. Recent data has been used to develop the Learning Disability Strategy and inform the key priorities for the next 5 years. The Single Shared Assessment process is cognisant of disability and level of need when determining the appropriate allocation of services.

The HSCP provide a number of pathways to appropriate supports and continue to streamline these to ensure ease of access to support services and advice for people with a learning disability or their carers. By adopting this approach towards and during the lifetime of the Strategy we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

The Learning Disability Strategy will be widely promoted through HSCP service teams, the local PSUC group, its various networks and also through the local Third Sector interface to their members (charities, community groups, networks). However, it still might not reach all groups / people who have a protected characteristic. Therefore, the Strategy may not be viewed and commented on by all representatives of communities of East Dunbartonshire, particularly protected characteristics groups.

Pathways to support will continue to be developed and streamlined by the HSCP.

Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(c) Gender Reassignment

Could the service change or policy have a disproportionate impact on people with the protected characteristic of Gender Reassignment?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve people with a learning disability in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

Transgender People are one of the most marginalised protected characteristic groups in Great Britain. The Learning Disability Strategy 2024–29 will be fully inclusive to all.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

The term Transgender refers to a number of characteristics. These include transsexual women and men, intersex people, androgyne people and cross-dressing (transvestite) men and women. Tran’s people are likely to experience abuse at various points throughout their lives (Scottish Transgender Alliance - Transgender experiences in Scotland 2008).

Gender reassignment is not currently recorded as part of the needs assessment process. However, there is little evidence to indicate that people from this group fare more poorly than others in terms of access to HSCP Learning Disability Services.

NHS GGC offer guidance on health needs for Tran’s people and how to address discrimination against Tran’s people in their briefing paper on Transgender reassignment and Transgender people as well as offering training for NHS staff on the subject of transgender people (NHS GGC Transgender Briefing).

Partnership working, inclusive of the Third Sector is highlighted in various themes within the Strategy and should also impact positively on Transgender people as major research and policy direction around Tran’s people is largely shaped by the Third Sector.

There is no local population data with regards to Gender Reassignment available within East Dunbartonshire. There is no reliable information on the number of transgender people in Scotland. This information was sought in the 2022 Census for the first time, however the results are yet to be published.

GIRES estimates that in the UK, the number of people aged over 15 presenting for treatment for gender dysphoria is thought to be 3 in 100,000 Gender Identity Research & Education Society [opens in a new window]

The Human Rights Act 1998 also provides rights of privacy and fairness, as well as the right not to suffer discrimination or degrading treatment.

East Dunbartonshire HSCP has policies in place to ensure staff members are aware of the sensitivities around gender reassignment.

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, high quality housing, effective transitions, health care and healthy relationships. By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

Therefore, the Strategy may not be viewed and commented on by all representatives of communities of East Dunbartonshire, particularly protected characteristics groups.

Whilst a field exists within the Carefirst Data Base to determine ‘sex’, it is limited to Male and Female categories. A request has been made to the Care First Steering Group to update this. Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(d) Marriage and Civil Partnership

Could the service change or policy have a disproportionate impact on the people with the protected characteristics of Marriage and Civil Partnership?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

All residents of East Dunbartonshire have the same rights in law as anyone else to marry, enter into a civil partnership or live together. Providing the person is over 16 years and has a general understanding of what it means to get married, he or she has the legal capacity to consent to marriage. No one else's consent is ever required.

The Learning Disability Strategy 2024-29 includes a priority to promote the development of healthy relationships for people with learning disabilities. However, ‘the decision to marry or enter into a civil partnership can only be made by an adult with capacity and cannot be taken by anyone else. Where there are concerns, registrars can make enquiries, such as contacting the social work department. The General Register Office for Scotland decides whether someone is capable of entering into the marriage or civil partnership' Mental Welfare Commission - Consenting adults: capacity, rights and sexual relationship [opens in a new window].

The District Registrar can refuse to authorise a marriage taking place if he or she believes one of the parties does not have the mental capacity to consent, but the level of learning disability has to be very high before the District Registrar will do so. The Scottish Government does not require assessment against this protected characteristic unless the policy or practice relates to work, for example HR policies and practices -refer to Definitions of Protected Characteristics document for details)

Possible negative impact and Additional Mitigating Action Required

To mitigate this, as stated in the Strategy, we will continue to be committed to consider for any future communication, activity the specific needs and preferences of the communications audience including protected characteristic groups.

It is important that as the Learning Disability Strategy develops and progresses, we use learning to understand the experience of people with learning disabilities from protected characteristic groups and make a commitment to capture all community perspectives across protected characteristic groups.

A marriage / civil partnership field does not exist within the Carefirst Data Base. A request has been made to the Care First Steering Group to update this. Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(e) Pregnancy and Maternity

Could the service change or policy have a disproportionate impact on the people with the protected characteristics of Pregnancy and Maternity?

The ability to access quality services is a fundamental aspect in ensuring that people with learning disabilities enjoy a high quality of life. Research has demonstrated the need to involve people with learning disabilities in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

East Dunbartonshire HSCP has in place policies that advise on Pregnancy, Maternity and Paternity, Fostering and Adoption leave. In the non-work context, protection against maternity discrimination is for 26 weeks after giving birth, and this includes treating a woman unfavourably because she is breastfeeding.

The Keys to Life Implementation Framework 2019 -21 made a commitment to Protect the rights of people with learning disabilities to become parents, addressing the need to provide effective, early and on-going support to keep families together, including producing an easy read version of NHS Health Scotland’s Parenting Guide ‘Ready Steady Baby’, commissioning the Scottish Learning Disabilities Observatory to produce better data on women who become mothers and their children who become adopted or looked after, and working collaboratively with health and social care partnerships to address stigma and discrimination associated with the rights of people with a learning disability to have children. Our vision - Keys to life: implementation framework and priorities 2019-2021 [opens in a new window].

The Learning Disability Strategy 2024-29 includes a priority to promote the development of healthy relationships for people with learning disabilities as recognised in Learning/intellectual disability and autism: transformation plan [opens in a new window] - People have a clear vision about what they want from their lives: ‘To choose to have a family of our own’.

However, the right to sexual expression assumes that the individual consents. Consent is not given where the person does not or cannot consent or is coerced. If there are concerns about abuse or exploitation, which includes not only direct physical acts but also non-contact abuse such as being forced or encouraged to look at pornographic materials, obscene phone calls, indecent exposure, indecent photography, serious teasing or innuendo, or other physical, emotional, psychological or sexual abuse, the local authority has a duty to investigate under the Adult Support and Protection (Scotland) Act 2007 – Capacity, consent and the criminal law, Mental Welfare Commission - Consenting adults: capacity, rights and sexual relationship [opens in a new window].

Possible negative impact and Additional Mitigating Action Required

The new Learning Disability Strategy 2024-29 includes a commitment for the HSCP to engage at least annually with people with lived experience. Protected characteristics will be considered as part of this engagement. Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(f) Race

Could the service change or policy have a disproportionate impact on people with the protected characteristics of Race?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

The demographic / area profiles recognise that 4.2% of the population of East Dunbartonshire is from a minority ethnic (BME) background (compared to Glasgow City with 11.6% of the pop). This is made up of mixed or multiple ethnic groups which stated they are from a, Asian, Asian Scottish or Asian British, African, Caribbean or Black and other ethnic groups.

The 2011 Census showed 4.2% of East Dunbartonshire’s population were from a minority ethnic group, an increase of around 2% since the last census in 2001, with the Asian population constituting the largest minority ethnic group. In the 2011 census, 96% of the East Dunbartonshire population stated they are white Scottish, white British, and white Irish or white other. Through in-depth focus groups, many BME disabled people report that access to services can be compromised by poor translation, inconsistent quality of care and weak links between services and communities. Disabled people are more likely to live in poverty, but BME disabled people are disproportionately affected with nearly half living in household poverty. Like all disabled people, many of those from black and minority ethnic backgrounds find themselves socially excluded and pushed to the fringes of society (Trotter R, (2012).

Minority Ethnic people are more likely to experience discrimination:

In 2019 minority ethnic adults were more likely to have experienced discrimination in the previous 12 months (19 percent) compared to white adults (7 per cent).
Minority ethnic adults were also more likely to have experienced harassment (17 per cent) than adults from 'White' ethnic groups (6 per cent).

Source: Scottish Household Survey 2019 (Last updated: September 2020)

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

NHSGG&C has an Accessible Information Policy that the HSCP will utilise to provide written information including appointment letters. Instructions for self-care and health improvement resources are available to patients in appropriate formats to ensure they have access to the information they need.

The HSCP and external providers have policies in place and staff can appropriately identify manage and challenge racism in an appropriate and sensitive manner when required. Staff and volunteers are made aware of this.

The learning Disability Strategy 2024-29 literature is available in other languages and formats as required, recognising that Carers from the BME community are more likely to require communication support to navigate into, through and out of services.

The strategy can be translated and made available in audio and large print through the Sensory Impairment team, who work closely with the service and NHS GGC Interpreters would be made available as necessary for clients.

Information on race is gathered through a Care Needs Assessment and stored on the internal computer/ information system (Care first) and is used to inform activities and service delivery. In developing the Learning Disability Strategy, we aim to redresses inequalities that people with a learning disability experience, particularly those with complex needs and from diverse ethnic backgrounds in accessing personalised care and support that would enable them to exercise choice and control over their own lives.

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(g) Religion and Belief

Could the service change or policy have a disproportionate impact on the people with the protected characteristic of Religion and Belief?

The ability to access quality services is a fundamental aspect in ensuring that people with learning disabilities enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

Scotland's Census 2011 reports that in East Dunbartonshire 62.5% of the population stated they belonged to a Christian denomination, 1% reported that they were Muslim, 1.9% reporting other religions and 6.4% not stating.

In terms of the Christian denominations 35.6% of the population in East Dunbartonshire belonged to the Church of Scotland and 22.3% stated they were Roman Catholic. The ‘Other Christian’ group accounted for 4.6% of the population. A large percentage of residents reported they had no religion (28.2%), though this is lower than the Scottish average of 36.7%.

Information on religion/belief is gathered through a Care Needs Assessment and stored on the internal computer/ information system (Care first) and is used to inform activities and service delivery. We recognise that there are barriers that can, if unaddressed prevent some individuals from some faith backgrounds accessing services, such as:

Some older people may not speak English or their ability to speak English as a second language can decrease or become confused
There may be limited cultural sensitivity amongst professionals

e.g. medication could be taken intravenously during fasting for Ramadan

There may be a lack of written information on disabilities in diverse languages and at times information may need to be delivered verbally due to an inability to read information in English
Stigma and pride (feeling ashamed to ask for help outside the family and close-knit community)

NHSGG&C has a Faith and Belief Communities Manual which sets out its commitment to ensuring that spiritual care, including religious care, is provided in an equal and fair way to those of all faith communities and those of none. The manual is designed to help staff respond to religious care, and to be confident as they meet some of the religious needs of those in their care.

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

It is important that as the learning Disability Strategy develops and progresses, we use learning to understand the experience of people with a learning disability from protected characteristic groups and make a commitment to capture all community perspectives across protected characteristic groups.

Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(h) Sex

Could the service change or policy have a disproportionate impact on the people with the protected characteristic of Sex?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

Scotland's Census 2011 reported:

EDC’s population size as 105,026 people. Of that population,
458 people have learning disabilities; that’s 0.4% of all people.
247 males and 211 females have learning disabilities
573 people known to have autism; that's 0.5% of all people.
120 females and 453 males are known to have autism

In East Dunbartonshire there are inequalities of life expectancy between men and women across East Dunbartonshire. Generally, women live longer than men. The average life expectancy for women in East Dunbartonshire is 83.5 years and for men is 80.5 years. In East Dunbartonshire, the average life expectance at 65years was 19.4yrs for men and 21.4yrs for women.

The links between gender and health are becoming more widely recognised and an example of this can be illustrated by looking at mental illness. Although there do not appear to be sex differences in the overall prevalence of mental and behavioural disorders there are significant differences in the pattern and symptoms of the disorders. These differences vary across age groups. In childhood a higher prevalence of conduct disorders is noted for boys than in girls.

During adolescence girls have a much higher prevalence of depression and eating disorders and engage more in suicidal thoughts and suicide attempts than boys. (A Report on the Health of the Population of NHS GGC 2017 19 ).

Females are more likely to experience gender based violence. This risk increases for females with a learning disability. People with a learning disability can have a 10 to 12 times greater risk of sexual assault. Public heath Scotland-Gender based violence webpage [opens in a new window].

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

Therefore, the Strategy may not be viewed and commented on by all representatives of communities of East Dunbartonshire, particularly protected characteristics groups.

Sex is covered under the gender specific field within the Carefirst Data Base, it is limited to Male and Female categories. A request has been made to the Care First Steering Group to update this.

Social Work Services will continue to engage with people with learning disabilities in the future and capture local need data.

(i) Sexual Orientation

Could the service change or policy have a disproportionate impact on the people with the protected characteristic of Sexual Orientation?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

The Scottish Government have recently collected data on sexual orientation via the 2021 Census, but this is not yet available.

In East Dunbartonshire the HSCP and partners are working to better identify the unmet health and wellbeing needs of lesbian, gay, bisexual and transgender (LGBT) people who live in the area. It is estimated between five and seven per cent of the East Dunbartonshire population is lesbian, gay or bisexual. This equates to one in every fifteen people, or over 7,000.

Evidence shows that, especially the older LGBT population have an increased likelihood of living alone and an increased need to be supported through older adult services, but it also identifies many reasons why people are less likely to access the services they could benefit from.

The HSCP, along with the Community Planning Partners (CPP) previously commissioned LGBT Youth Scotland to carry out a programme of work to find out more about the views and needs of our older LGBT residents. Among the approaches was a survey open to anyone over 50 living in the area and researchers also spoke with carers to try and gain an understanding of what individuals identify as their needs.

Many LGBT people fear potentially experiencing homophobia, biphobia and transphobia from services or have previous experience of discrimination from a service. There is often a lack of visibility of LGBT identities within services (such as staff knowledge of the issues affecting LGBT people, promotion of inclusive posters or websites, and explicitly stating that the service is LGBT-inclusive), which are necessary to counter LGBT people's expectations of discrimination or a lack of confidence that services are able to meet their needs.

The Human Rights Act 1998 also provides rights of privacy and fairness, as well as the right not to suffer discrimination or degrading treatment. East Dunbartonshire HSCP has policies in place and staff members are aware of the sensitivities around sexual orientation. The new Learning Disability Strategy lists a number of priorities designed to ensure equality of access and opportunity for people with a learning disability across the authority, including, the right to suitable, high quality housing, effective transitions, health care and healthy relationships.

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

(j) Socio – Economic Status & Social Class

Could the proposed service change or policy have a disproportionate impact on people because of their social class or experience of poverty and what mitigating action have you taken/planned?

The Fairer Scotland Duty (2018) places a duty on public bodies in Scotland to actively consider how they can reduce inequalities of outcome caused by socioeconomic disadvantage when making strategic decisions. If relevant, you should evidence here what steps have been taken to assess and mitigate risk of exacerbating inequality on the ground of socioeconomic status. Additional information available here: Fairer Scotland Duty: guidance for public bodies [opens in a new window]

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

Th HSCP are acutely aware that we currently face the most severe economic upheaval in a generation with the current cost crisis, which is putting livelihoods, and lives at risk, and as with the pandemic, people with learning disabilities and their carers are likely to be amongst those most affected. The Learning Disability Strategy 2024-29 proposals are based on the premise of quality and sustainability and should be delivered within the current financial envelope, meaning no planned changes or cuts to existing service delivery. East Dun JSNA 2021 indicates only 9% of the East Dunbartonshire population were income deprived (Scotland 16%), but there were wide variations across different areas, for instance in the Hillhead area of Kirkintilloch the population was 30% income deprived, yet just over a mile away in Lenzie south it is 3%.

The East Dunbartonshire Local Housing Strategy (2017/22) shows there has been an overall reduction, demand for homelessness services since 2011/12 in East Dunbartonshire. From a peak of just under 700 applications in 2010/11, homeless applications have fallen to just over 500 in 2015/16.

Unfortunately, there is no available breakdown of demographic information to identify the age ranges of homelessness applications. (see JSNA above). SCVO -SDS Regulations and Statutory Guidance expressed their concern relating to the recent substantial and poverty inducing changes to benefits drive through the intentions behind the SDS legislation. SCVO felt that already, people may have

lost amounts of significant income, without even considering the potential loss of mobility components/support in the transfer to Personal Independence Payment (PIP) and Disability Payment.

The new strategy is co-produced in partnership with people with lived experience and Stakeholders via a robust consultation process. The data captured has been used to develop the Learning Disability Strategy and inform the key priorities for the next 5 years. These include the right to suitable, high quality housing, effective transitions, health care and healthy relationships.

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

(k) Other marginalised groups

How have you considered the specific impact on other groups including homeless people, prisoners and exoffenders, ex-service personnel, people with addictions, people involved in prostitution, asylum seekers & refugees and travellers?

The ability to access quality services is a fundamental aspect in ensuring that people with a learning disability enjoy a high quality of life. Research has demonstrated the need to involve individuals in the decision-making process underpinning service commissioning, service design and service delivery, whilst also ensuring individuals from across the protected characteristics are represented.

to eliminate unlawful discrimination
advance equality of opportunity, and;
promote good relations

In relation to the requirement to show due regard to eliminate unlawful discrimination, harassment and victimisation, the HSCP is aware that people with a learning disability may already be at increased risk of discrimination. The Learning Disability Strategy highlights the risks and makes proposals to overcome them. The strategy itself is aimed at improving the lives of people with the protected characteristic of a disability. However, we are mindful that within this group of people lies many more vulnerabilities and potential barriers to equality.

The Public Sector Equality Duty requires public authorities, in the exercise of their functions, to have due regard to the need to:

eliminate Unlawful Discrimination, harassment and victimisation and other conduct that is prohibited by the Equality Act 2010
advance equality of opportunity between people who share a relevant protected characteristic and those who do not, and;
foster good relations between people who share a relevant characteristic and those who do not

The Equality Duty is non-delegable. In practice this means that public authorities like EDHSCP need to ask their suppliers and those they commission services from to take certain steps in order to enable the public authority to meet their continuing legal obligation to comply with the Equality Duty.

Any changes to services or to service provision must be communicated to ensure that those who may be affected, any East Dunbartonshire resident, service user, patient, carer or family member do not receive a lesser service due to their protected characteristics.

The East Dunbartonshire breakdown is;

In 2014, 62% (65,720/106,730) of the population of East Dunbartonshire was of working age (16–64 years), lower than the national percentage of 65%. Children and young people (aged 0–15 years) made up 17% (18,386/106,730) of the population, similar to the national 17%. Adults aged over 75 years comprised 10% (10,695/106,730) of the population, higher than the national average of 8%.

In 2014, 3.3% of adults claimed incapacity benefit, severe disability allowance or employment and support allowance; this was lower than the Scottish figure of 5.1%. The percentage of those aged 65 years and over with high care needs cared for at home, at 38%, was higher than in Scotland overall (35%). The crude rate for children, who were looked after by the local authority, at 7/1000, was similar to Scotland’s rate of 14/1000. Scottish Public health Observatory [opens in a new window]

The Learning Disability rate per 1,000 in 2011 is 4.4, the Scotland rate, per 1000 is 5 (Scotland's Census 2011 -National Records of Scotland (Table QS304SC -Long-term health conditions). The number of people with learning difficulties 0-15 is 101, 16-64 is 305, 65+ is 52. There is 458 people in East Dunbartonshire local authority have learning disabilities. That’s 0.4% of the population. (Scottish Learning Disabilities Observatory website [opens in a new window]

The United Nations Convention on the Rights of Persons and Optional Protocol requires all service provision to be concerned about the difficult conditions faced by persons with disabilities who are subject to multiple or aggravated forms of discrimination on the basis of race, colour, sex, language, religion, political or other opinion, national, ethnic, indigenous or social origin, property, birth, age or other status.

United Nation Website [opens in a new window]

The Learning Disability Strategy 2024–29 will be fully inclusive to all and promote equality of service provision via a revised set of priorities including:

By adopting this approach towards and during the lifetime of the Strategy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

8. Does the service change or policy development include an element of cost savings? How have you managed this in a way that will not disproportionately impact on protected characteristic groups?

There are no cost savings associated with the strategy. However, the HSCP operates within a very constrained financial environment, so unless new funding is forthcoming, any investment in one area will have to be offset by increased efficiency or disinvestment in another area of the HSCP’s business. In order to make this process as transparent as possible, a Financial Plan will identify any new specific additional funding that has been received (or may be expected) to support new developments.

Over the course of the five year strategy, some additional new funding sources may be introduced that we are not yet aware of, but so too may be reductions in funding or pressures elsewhere.

Developing a Learning Disability Strategy is not a statutory requirement, meaning that HSCP’s are not legally required to have one. However, we believe that this strategy provides an opportunity for the HSCP to express our commitment to people with learning disabilities and to providing them with the support they need to lead their best life.

9. What investment in learning has been made to prevent discrimination, promote equality of opportunity and foster good relations between protected characteristic groups? As a minimum include recorded completion rates of statutory and mandatory learning programmes (or local equivalent) covering equality, diversity and human rights.

East Dunbartonshire HSCP is committed to regularly training and empowering staff on equalities issues in order to prevent discrimination, promote equality of opportunity and foster good relations between protected characteristic groups.

East Dunbartonshire HSCP has policies in place to ensure staff members are aware of Equality and Diversity Rights.

Possible negative impact and Additional Mitigating Action Required

All new health, social work, social care and education staff will require training on equalities issues in order to prevent discrimination, promote equality of opportunity and foster good relations between protected characteristic groups.

10. In addition to understanding and responding to legal responsibilities set out in Equality Act (2010), services must pay due regard to ensure a person's human rights are protected in all aspects of health and social care provision. This may be more obvious in some areas than others. For instance, mental health inpatient care or older people’s residential care may be considered higher risk in terms of potential human rights breach due to potential removal of liberty, seclusion or application of restraint. However, risk may also involve fundamental gaps like not providing access to communication support, not involving patients/service users in decisions relating to their care, making decisions that infringe the rights of carers to participate in society or not respecting someone's right to dignity or privacy.

Please explain below if any risks in relation to the service design or policy were identified which could impact on the human rights of patients, service users or staff.

There are no reported risks in relation to human rights. In developing the Learning Disability Strategy, we aim to redresses inequalities that people with a learning disability experience, particularly those with complex needs and from diverse ethnic backgrounds in accessing personalised care and support that would enable them to exercise choice and control over their own lives. EDHSCP asks their suppliers and those they commission services from to take certain steps in order to enable the public authority to meet their continuing legal obligation to comply with the Equality Duty.

Please explain in the field below any human rights-based approaches undertaken to better understand rights and responsibilities resulting from the service or policy development and what measures have been taken as a result e.g. applying the PANEL Principles to maximise Participation, Accountability, Nondiscrimination and Equality, Empowerment and Legality or FAIR*.

PANEL principles underpin the general approach to all plans developed by the HSCP, particularly in respect of maximising participation, preventing discrimination and promoting equality and empowerment of communities.

Facts: What is the experience of the individuals involved and what are the important facts to understand?
Analyse rights: Develop an analysis of the human rights at stake
Identify responsibilities: Identify what needs to be done and who is responsible for doing it
Review actions: Make recommendations for action and later recall and evaluate what has happened as a result.

Having completed the EQIA template, please tick which option you (Lead Reviewer) perceive best reflects the findings of the assessment. This can be cross-checked via the Quality Assurance process:

Option 2: Adjust (where a potential or actual negative impact or potential for a more positive impact is found, make changes to mitigate risks or make improvements)

11. If you believe your service is doing something that ‘stands out’ as an example of good practice -for instance you are routinely collecting patient data on sexual orientation, faith etc. -please use the box below to describe the activity and the benefits this has brought to the service. This information will help others consider opportunities for developments in their own services.

Not Applicable.

Actions – from the additional mitigating action requirements boxes completed above, please summarise the actions this service will be taking forward.

A review of the Care First Data Base has commenced to include the omitted Protected characteristics and a communication will be issued to all social work staff to highlight the need to ensure all appropriate fields are used.

Date for completion: 30 November 2023
Who is responsible? (initials): GP

A review of the Single Shared Assessment will be required to ensure that it captures the additional protected characteristics at the point of contact, to then be uploaded to the updated Care First Database.

Date for completion: 28 February 2023
Who is responsible? (initials): Joint Learning Disability Team

The HSCP should consider whether there would be merit in developing a Children’s Learning Disability Strategy.

Date for completion: 30 November 2023
Who is responsible? (initials): Children with Disability Team

Ongoing 6 Monthly Review: 28 February 2023

Lead Reviewer:
Name: Gayle Paterson

EQIA Sign Off:
Job Title: Learning Disability Strategic Review Project lead
Signature: Gayle Paterson
Date: 31 August 2023

Quality Assurance Sign Off:
Name: Alastair Low
Job Title: Planning Manager
Signature: Alastair Low
Date: 19/09/2023