EDC HSCP Assistance with Transport Policy 2019

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.

Name of Policy/Service Review/Service Development/Service Redesign/New Service: EDC HSCP Assistance with Transport Policy 2019

This is a: Policy Review

Description of the service & rationale for selection for EQIA

What does the service or policy do/aim to achieve?

East Dunbartonshire Health and Social Care Partnership (HSCP) Annual Business Development Plan (Transformational Change Plan) 2019/20 identified the review of assistance with transport arrangements as a priority. The HSCP Assistance with Transport Policy was first launched on 5 September 2019. Implementation of the policy coincided with the Covid 19 Pandemic, which saw changes to how services were delivered and significant challenges in providing transport for customers, which adhered to Public Health Scotland Guidance. With services now returning to pre pandemic arrangements, the HSCP are seeking to fully implement the Policy.

East Dunbartonshire HSCP Social Work Services provide a range of services to children, young people and adults. In relation to assistance with transport, the Service has reviewed its arrangements with the aims of ensuring that:

its duties are being fulfilled appropriately; and
there is clarity across the Service about the circumstances in which it is appropriate to consider providing assistance with transport

In developing the Assistance with Transport Policy we considered the legal, policy and financial frameworks by which transport is delivered.

The Assistance with Transport Policy aims to formalise East Dunbartonshire Council HSCP’s approach to delivering assistance with transport in accordance with the relevant range of duties and powers and in a manner that is consistent and equitable, meeting the needs of those within the authority who require transport assistance to attend statutory service provision. Procedures and Guidance have been developed to support the implementation of the Policy.

The Service operates within a defined legal and policy framework. As well as defining its duties towards those who reside in the East Dunbartonshire Council area, the legal framework makes provision for a range of powers which may or may not be exercised by the Service. The ways in which the Service exercises those powers, or does not exercise them, are influenced by the policy framework. Implementation of the policy will prevent continued challenges to existing model of provision of transport.

The Assistance with Transport Policy will affect service users who are looking for or are currently in receipt of support with transport, as a way of accessing social work services.

Currently, Social Work Services in East Dunbartonshire Health and Social Care Partnership are divided into services for Children and services for Adults. The two services operate in distinct and separate ways, there are different assessment tools, eligibility criteria and care planning mechanisms.

Whilst there are statutory requirements to assess needs of children and adults at risk and those with a disability, transport is not an entitlement and any provision of such should be means tested. Service users may be required to contribute financially to their care plan, if transport is provided and eligibility criteria met.

The Service operates to a defined allocated budget. The Service is accountable for use of this budget. Ensuring that duties are fulfilled includes spending the money it has in the most effective and efficient ways and ensuring that it does not incur expense unnecessarily. Social Work Services and the Education Department spend significant amounts of money on the provision of transport. Reviewing the Assistance with Transport Policy will achieve greater consistency and best value in regards the provision of transport.

In reviewing this area of service, the legal, policy and financial framework within which the Service is planned, managed and delivered has been taken into account.

In addition, benchmarking was carried out to establish common practice within other HSCPs. There are various approaches to the provision of transport throughout Scotland and there appears to be strengths and weaknesses to each.

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

A policy on the provision of assistance with transport is necessary, not only to support the ongoing achievement of the aims noted above, but also to make clear to service users and others with an interest on this matter, the HSCP’s approach to assistance with transport. Following the Policy will ensure that the Service:

appropriately fulfils its duties; and
provides clarity about the circumstances in which it is appropriate to consider assisting with transport

Principles

The principles which underpin the Assistance with Transport Policy and Procedures reflect the overall objectives of the Service in terms of:

supporting children, young people and adults who are vulnerable or in need to remain at home or in their own communities;
assisting children, young people and adults who are vulnerable or in need to achieve their potential and lead independent lives;
ensuring that those who use the Service receive a high standard of care;
achieving better involvement and support for Carers and other stakeholders; and
promoting the welfare of individuals who are vulnerable or in need

The Assistance with Transport Policy is set in the context of the relevant social work legislation. Principles of policy include:

Service Users are encouraged and supported to –

reach their full potential, in all aspects of their lives;
be safe, healthy, respected, responsible and included members of the community; and
be as independent as their individual circumstances allow

Carers are encouraged and supported to fulfil their Carer role and to work alongside the Service to ensure those they care for have the maximum opportunities to -

reach their full potential, in all aspects of their lives;
be safe, healthy, respected, responsible and included members of the community; and
be as independent as their individual circumstances allow

Carers are encouraged and supported to have their own needs assessed through a Carer’s assessment, where this is appropriate

Previous to the 2019 Policy, where there was an assessment of need and call for services which required transport provision, the HSCP would provide this as part of the overall package of care, regardless of what other supports were available such as mobility benefits, mobility car or the ability of an individual to make their own arrangements for transport.

The Assistance with Transport Policy has been selected for an EQIA to ensure any adverse impact on protected characteristic groups is minimised and prior to the Policy being fully 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 or Civil Partnership
Pregnancy and Maternity
Race
Religion or Belief
Sex
Sexual Orientation

The Assistance with Transport Policy will affect service users who are looking for or are currently in receipt of support with transport to access statutory social work services. The policy will impact predominantly on children and adults with a disability, as the main recipients of support with transport. Access to support with transport will be dependent on a needs assessment / individual service user review to consider circumstances and ability to contribute towards transport requirements. Standard procedures and an assessment form have been developed to ensure consistency in the application of the policy.

The Service will take account of any other income or resources (in kind or in cash) available to the Service User and/or their Parent/Carer which

could reasonably be expected by the Service to be utilised for the purpose of aiding mobility – this will be through a financial assessment which should ensure that individuals do not experience any financial hardship in the application of policy and that any benefits provided for the purpose of supporting access to transport are treated fairly and equally across all those in receipt of assistance with transport.

Throughout the development of the policy, 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 Assistance with Transport Policy 2019 supports the delivery of EDC Local Outcomes Improvement Plan 2017-2027;

ED SOA Outcome 2; ‘Our people are equipped with knowledge and skills for learning, life and work’.
ED SOA Outcome 3; ‘Our children and young people are safe, healthy and ready to learn’
ED SOA Outcome 5; ‘Our people experience good physical and mental health and wellbeing with access to a quality built and natural environment in which to lead healthier and more active lifestyles’
ED SOA Outcome 6; ‘Our older population are supported to enjoy a high quality of life and our more vulnerable citizens, 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 by improving personalisation, information and communication and reducing inequality and inequity of outcomes is a key strategic priority for the HSCP Board established within the Strategic Plan. However, it is important that these commitments are set out in more detail, to meet our obligations and ensure consistency. That is why we have developed a dedicated Assistance with Transport Policy. The Policy aims to deliver support and services to children, young people and adults 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

Relevance to HSCP Strategic Plan; -

Empowering People
Prevention and Early Intervention
Public Protection
Supporting Families and Carers

This plan makes a commitment to support carers with their own needs and in their caring role, and to recognise better the contribution of informal carers and families in keeping people safe and supporting them to continue to care if that is their choice.

In February 2020, the Independent Care Review was published, which aimed to identify and deliver lasting change in Scotland’s ‘care system’ and led to the publication of The Promise. East Dunbartonshire HSCP is committed to ensuring The Promise shapes future planning to strengthen the things we do well and make the fundamental changes required for children and families in East Dunbartonshire.

Since its inception, East Dunbartonshire HSCP has continued to implement and develop Self Directed Support whilst incorporating the values (respect, fairness, independence, freedom and safety) and principles (collaboration, informed choice, involvement, participation, innovation, responsibility and risk enablement) contained within the legislation.

The HSCP has developed a three year Implementation Plan (2021 – 2024) which focuses on achieving specific outcomes to further develop Self Directed Support locally:

All planning for change and measurement across Self Directed Support activities must involve the people, workers and organisations affected;
Senior decision makers and systems create the culture and conditions for choice and control over social care support;
Workers enable and empower people to make informed decisions about their social care support;
Workers across all aspects of social care support exercise the appropriate values, skills, knowledge and confidence; and,
People have choice and control over their social care support.

Reducing Inequalities

Central to the objectives of the HSCP Strategic Plan 2022-25 is to pursue improvement activity that contributes to reducing inequality and inequity of health and social care outcomes. In addition to this being a dedicated action area in support of the Empowering People priority, the plan itself has been fully Equality Impact Assessed in line with the requirements of the Equality Act 2010. The Strategic Plan has also been assessed in support of the Fairer Scotland Duty which requires public bodies to actively consider how they can reduce inequalities of outcome caused by socio-economic disadvantage, when making strategic decisions.

Financial Context

A Medium-Term Financial Strategy (MTFS) has been developed to pull together into one document all the known factors affecting the financial sustainability of the partnership over the medium term. This strategy establishes the estimated level of resources required by the partnership to operate its services over the next five financial years, given the demand pressures and funding constraints that we are likely to experience.

This MTFS for East Dunbartonshire HSCP outlines the financial outlook over the next 5 years (2022 – 2027), which covers the period of the Strategic Plan, and provides a framework which will support the HSCP to remain financially sustainable. It forms an integral part of the HSCP’s Strategic Plan, highlighting how the HSCP medium term financial planning principles will support the delivery of the HSCP’s strategic priorities.

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

Name: Gayle Paterson - assisted by Anthony Craig Development Officer
Date of Lead Reviewer Training: May 2018

Staff involved in carrying out the EqIA:

Anthony Craig (Development Officer), Gayle Paterson (Learning Disability Strategic Review Project Lead - East Dun HSCP), David Aitken (Head of Service – East Dun HSCP), Jean Campbell (Chief Finance & Resources Officer – East Dun HSCP), Claire Carthy (Head of Children & Criminal Justice Services – East Dun HSCP)

Lead Reviewer Questions

1. What equalities information is routinely collected from people currently using the service or affected by the policy? If this is a new service proposal what data do you have on proposed service user groups. Please note any barriers to collecting this data in your submitted evidence and an explanation for any protected characteristic data omitted.

Example
A sexual health service collects service user data covering all 9 protected characteristics to enable them to monitor patterns of use.

Service Evidence Provided

An understanding of the communities and people across the HSCP area population is vital in the planning and provision of health and social care services.

The updated Assistance with Transport Policy may affect Service Users who access Statutory Social Work Services and their Parent/Carers, who are likely to hold Power of Attorney/Legal Guardianship Order for the service user.

Information relating to these groups is gathered via Adult and Children Assessments and Support Plans and logged on EDC internal computer/ information system (Care first) and is used to inform activities and service delivery.

The Scottish Government have recently collected data via the 2020 Scottish Health Survey and the 2021 Scottish Government Census.

Data relating to Carers and Service Users is also collected by a number of National and Local sources, for instance data relating to the population of people with a Learning Disability in Scotland is collated and reported on by The Scottish Learning Disability Observatory (SLDO).

Locally within EDC most 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 Service User and Carers changing needs and circumstances.

Equalities information on young people is also recorded by Education Services via the Pupil Information Management System SEEMIS. This 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.

The information recorded on Care First considers protected characteristics and upon review there is no requirement to undertake more intensive analysis. In addition, local and national data is analysed and from this information resources and alternative services are put in place to support service users and carers as required to ensure that equality and human rights issues for each individual are considered. No barriers have been identified in the collection of data; however, Service Users and Carers can choose not to disclose their personal information.

The HSCP commissions a carer support organisation ‘Carers Link’ to provide carer services throughout East Dunbartonshire. ‘Carers Link’ provides a range of direct services and the provision of individualised advice, guidance and support to both adult and young carers. They collect and share carer demographics data with the HSCP.

East Dunbartonshire Joint Strategic Needs Assessment 2021 (JSNA, opens in new window) was referenced as a key resource document in updating the Assistance with Transport Policy, 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.

In relation to the requirement to show due regard to eliminate unlawful discrimination, harassment and victimisation, the HSCP is aware that Parent/Carers may be at increased risk of discrimination by association and will take all proportionate steps to ensure the burden of care is not exacerbated unfairly through our corporate decision-making processes.

By adopting this consistent approach to the provision of assistance with transport, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

Data relating to the protected characteristics of Service Users and Parent/Carers is gathered via Adult and Children Assessments and Support Plans. 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 protected characteristic data is requested within the Adult and Children Assessments and Support Plans, not all fields are mandatory.

To ensure information is routinely captured for monitoring purposes, a communication to all social work staff and Carers Link 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. Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Example
A physical activity programme for people with long term conditions reviewed service user data and found very low uptake by BME (Black and Minority Ethnic) people. Engagement activity found promotional material for the interventions was not representative. As a result an adapted range of materials were introduced with ongoing monitoring of uptake. (Due regard promoting equality of opportunity).

Service Evidence Provided

Individuals with responsibilities towards a Service User include, for example, a:

parent or other person with parental responsibilities or rights;
Carer;
guardian; or
person having power of attorney.

As noted earlier, the Service operates within a defined legal framework. This framework includes a range of legislation from which it derives duties and powers. In relation to the duties and powers which the Service has regarding assistance with transport, the main source of these duties and powers are the:

Social Work (Scotland) Act 1968 (as amended)
Chronically Sick and Disabled Persons Act 1970 (as amended)
Children (Scotland) Act 1995 (as amended)
Mental Health (Care and Treatment) (Scotland) Act 2003.
Children and Young People (Scotland) Act 2014

In general terms, where there is a duty to provide assistance with transport (e.g. with travelling to allow participation in a service being provided in respect of the Service User need), there is also a power to seek repayment, of some or all, of the costs for this assistance.

Whilst the policy will be applied consistently across all service users, those most likely to be adversely affected are those in the protected characteristic groups of Age, Disabilities and Maternity. As part of the assessment process consideration will be given to any mitigating factors that affect these protected groups.

In relation to Service Users, and those with responsibilities towards them, any consideration of assistance with transport will take into account the availability of other sources of assistance with transport. The Service will take account of any other income or resources (in kind or in cash) available to the Service User and/or their Carer which could reasonably be expected by the Service to be utilised for the purpose of aiding mobility. The expectation is that arrangements would be made (by the Service User and/or their Carer) to utilise these in respect of the transport needs.

Where other assistance with transport is available, and depending on the source and nature of that assistance, the Service will decide whether to:

provide some assistance with transport;
provide no assistance with transport; or
provide some assistance with transport and claim/reclaim the cost or part of the cost of this assistance (from the person who received the assistance or those with responsibilities towards them, where appropriate).

In relation to Criminal Justice Services there is national guidance in relation to assistance with bus fares. This is the only assistance with transport that can be provided under the duties and powers that relate to Criminal Justice Services. The Procedures and Guidance does not therefore need to cover Criminal Justice Services.

The data captured within Adult Carer and Service Users support plans and logged on the Care First Data Base helps the HSCP understand Service User and Carer dynamics across the authority and set priorities within a range of Policies and Strategies that will deliver services and support, which can best respond flexibly to changing needs and circumstances.

In addition, we used learning from previous plans and strategies; and carried out benchmarking across Greater Glasgow and Clyde (GGC) HSCP’s to identify how assistance with transport is provided in other authority areas and the potential impact on protected groups, specifically adults and children with disabilities.

We also utilised our statutory partner’s demographic knowledge to further develop and increase knowledge of local equality groups as these are fluid.

Carers

The Scottish Census 2011 indicates that 10.9% of residents across East Dunbartonshire were reported to be providing unpaid care to relatives, friends or neighbours compared with 9.4% in Scotland.

Of those who provided 50 hours or more of unpaid care the majority were aged 65 and over and were female.

More than half of the carers known to services are over 65 years old, with the gender split almost exactly that of the nation balance at 61% being female.

Age

East Dun JSNA 2021 shows that East Dunbartonshire has an aging population with 22.5% of the total population aged over 65, slightly above the national average (19.1%), 10.8% aged over 75yrs (Scotland 8.5%). The population aged 16-29yrs was 14.6% (Scotland 17.5%). Large increases in population are projected for those aged over 65yrs, and in particular, the number of persons aged 85yrs+ which was predicted to increase by 48% between 2018 and 2030, the largest increase in Scotland and which is the age-group most in receipts of services. The National Records of Scotland (NRS) population projections suggest there will be an increase of 7.6% in the overall population of East Dunbartonshire from 2018 – 2043 due to significant estimated rise in the population aged over 65yrs.

Life expectancy at birth of 80.5 for males in East Dunbartonshire (Scotland 77.1) and 83.7 for females (Scotland 81.1). An ageing population and higher life expectancy are expected in combination to increase demand for health & social care services.

Socio – Economic Status

In public health terms it is crucial to recognise the impact of relative poverty on health and wellbeing. Despite relative prosperity overall in East Dunbartonshire, the known impact of deprivation in affected communities is an issue that the HSCP must prioritise in order to ensure that access to and impact of services is equitably targeted to people and communities who are at risk of poorer health.

The 2011 Census reported that the average gross weekly earnings for full time workers living in East Dunbartonshire in 2020 was 22% higher than the Scottish average, with female full-time workers earning more than male full-time workers.

29% of carers in the most deprived areas care for 35 hours a week or more – more than double the level in the least deprived areas. This highlights that the impact of caring may be exacerbated by existing low incomes and poor health in these areas and the need to ensure such inequalities are addressed within the HSCP plans and strategies.

East Dunbartonshire is, as a whole, relatively less deprived than many other local authorities in Scotland. However, East Dunbartonshire has 8 data zones in the most deprived 25% in Scotland.

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%.

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.

East Dun JSNA 2021 indicates that the number of direct payments in East Dunbartonshire increased from 40 in 2007/08 to 186 in 2020/21.

Disability

East Dun JSNA 2021 indicates that 5.6% of the adult population in East Dunbartonshire reported a disability (Scotland 6.7%). Just under half of reported disabilities (48%) were sensory impairment, while 32% related to a physical disability.

Sensory impairment includes blindness, partially sighted, deafness, hard of hearing or multiple categories and was the main disability reported in the 2011 Census (48% reported disability). Sensory impairment increases significantly with age and the number of people aged over 65yrs registered in East Dunbartonshire with a sensory impairment was more than double the number of adults aged 18-64 years with sensory impairment.

In the 2011 Census 32% of the adult population reported physical disability. Physical disability in East Dunbartonshire increased with older age and there were slightly more females identified. Again, East Dunbartonshire’s ageing population means the number of people with a physical disability can be expected to have increased since 2011 and likely to increase significantly in the future.

Scotland's Census, 2011, reported 26,349 people to have learning disabilities (15,149 males and 11,200 females), which is 0.5% of Scotland's population.

458 people in East Dunbartonshire local authority have learning disabilities. That’s 0.4% of 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
12.3% of adults with learning disabilities have paid employment, compared with 58.3% of all adults
34.8% of people with learning disabilities live in social rented accommodation, compared with 10.0% of all people
Only 17.7% of people with learning disabilities rate their health as very good, compared with 56.6% of all people

East Dun JSNA 2021 states that there were 403 adults (18+) with a learning disability who had some support from the east Dunbartonshire Joint Learning Disability Team during the year 2021. This prevalence is in line with the Scottish average. Most customers with Learning Disability are male: 56.6 % Male and 43.4% Female. The largest prevalence by age is 18-29 with 32% of the total and the lowest for 75+ with 4.5% of the total.

Autism is a lifelong developmental disorder, sometimes referred to as autistic spectrum disorder (ASD). Autism affects the way an individual understands, communicates and relates to other people and the environment and includes Asperger’s Syndrome. The East Dunbartonshire Autism Strategy highlights the challenges in understanding and recording the true prevalence of autism. Previously a prevalence rate of 1.1% of the population was used, but more recent research suggests that the rate is higher, at 1.57 % of population. On this basis, it is estimated that there are 1,027 people across all adult age groups (16+) with autism in East Dunbartonshire in 2012 of which around two thirds are male.

Adults included in the LDSS annual return for the year 2020/21 with a diagnosis of Autism and having some contact with social work during the year was 172 (18+). It is generally recognised though that the recording of Autism is under-represented on health and social care information systems.

Long-term Health Conditions

The Health and Wellbeing survey in 2014 demonstrated the relationship between the prevalence of long-term conditions and increased age.

Another important factor in the prevalence of long-term conditions was deprivation. The Health and Wellbeing Survey 2014 suggested that 49% of those in the 20% most deprived data zones in East Dunbartonshire were more likely to be receiving treatment for at least one long term condition compared to 35% in the remaining data zones.

East Dun JSNA 2021 shows that Cancer is one of the most prevalent LTCs with around 6% of individuals from East Dunbartonshire on GP registers with a diagnosis of cancer in 2018/19. From 2016-2018 there were, on average, 632.6 (per 100,000 pop) people with a new diagnosis of cancer in East Dunbartonshire (Scotland 638.7).

28% of East Dunbartonshire residents identified themselves as having one or more long term conditions (Scotland 30%). Arthritis, cancer and CHD were the most prevalent conditions in East Dunbartonshire, though prevalence was lower than the Scotland figures for all.

Hospital Activity - 52% of patients in East Dunbartonshire who had an emergency admission to hospital in 2018/19 were aged over 65yrs (Scotland 44%). Of those with multiple emergency admissions 49% were aged 65 years or over (Scotland 41%)

East Dunbartonshire had a COPD incidence rate per 100,000 (3-year average) of 104.6 in 2019/20 compared with the Scotland rate of 168 per 100,000. COPD incidence rates in both East Dunbartonshire and Scotland had decreased over the past few years.

The prevalence of asthma in individuals from East Dunbartonshire on GP registers was around 3 per 100 in 2018/19.

Coronary Heart Disease (CHD) - The prevalence of CHD in individuals from East Dunbartonshire on GP registers was around 4.4 per 100 in 2018/19.

Hospital admission and delayed discharge would have an impact on a carers ability to provide transport.

Maternity

The 2011 Census reported that 11.8% of East Dunbartonshire households were one person households and is projected to rise by 10% between 2018 and 2043, with other household sizes remaining the same or reducing.

East Dunbartonshire has an estimated 12.4% of children who live in families with limited resources after housing costs, considerably lower than Scotland as a whole at 20.7%.

The population dependency ratio refers to the proportion of the dependent population (0-16 years and over 65 years or non-working age) in relation to the independent population (16‐64 years or “working age”). The higher the dependency ratio, the lower the working age population compared to the proportion of “dependents”. This can have resource implications on health and social care service provision. The population dependency ratio was calculated using recent NRS population estimates projected to 2043, taking into account changes in the State pension age. As the total number of dependants in East Dunbartonshire was increasing faster than the working age population, the population dependency ratio was projected to increase to 77.9% in 2043 (Scotland 65.9%).

Possible negative impact and Additional Mitigating Action Required

There is a risk of possible negative impact as a result of the implementation of The Assistance with Transport Policy, including:

Financial impact due to transport charges being applied
Service users reducing attendance at statutory services to avoid additional costs, exacerbating pressure on carers

To mitigate the risk of above the Assistance with Transport Policy will be applied carefully, with those affected being assessed on an individual basis, taking into account any exceptional circumstances.

Social Work Services will continue to engage with affected Service Users and Parent/Carers throughout the implementation of the Assistance with Transport Policy using the most effective method of communication.

A robust Assistance with Transport Assessment will be carried out to determine whether assistance with transport is required. Whilst the intention is to apply the Assistance with Transport Policy consistently, there is scope for mitigating or exceptional factors to be considered when making a decision as to whether assistance with transport will be provided. Each individual will be assessed on their unique circumstances and exception will be considered where mitigating factors are present, such as low income, health concerns etc.

In all cases where the Service proceeds to make an assessment on the possible provision of assistance with transport the following considerations will apply: -

Any assessment for assistance with transport will be done separately from the assessment of need
Any assessment for assistance with transport will identify whether the Service has a duty to provide such assistance
The Service will be able to demonstrate that any assessment for assistance with transport or actual assistance provided is done in accordance with the Policy and the Procedures and Guidance.
Where the care plan is supported by benefits such as PIP or other sources of funding, this will be taken into account in coming to a decision about assistance with transport, including in terms of the possible impact on the Independent Living Fund (ILF) of any decision to provide assistance with transport

This assessment and recommendation will be discussed with the Service Manager at the Resource Allocation Group.

Where there is a decision to assist with transport, this decision will be subject to regular review, as follows:

at each subsequent review of the Service User care plan;
at any time where there is information to suggest a significant change of circumstances in the case;
at any time the Service considers it appropriate; or
notwithstanding any of the above, at a minimum on an annual basis

Bearing in mind the relevance of assistance with transport to the achievement of the care plan, examples of where assistance with transport may be assessed as essential are where:

the Service User, or their parent/Carer, has no other access to assistance with transport, e.g. there is no-one who is willing and able to assist with transport and all other options, including the use of public transport, have been taken into account and ruled out for specific reasons. (These details will be evidenced within the assessment form and the evidential information will also be recorded in the Service User case record);
due to specific health and safety issues related to the Service User there are no appropriate transport alternatives. These details will be evidenced within the assessment form and the evidential information will also be recorded in the Service User case record;
a Carer is caring for more than one dependent and because of the competing caring demands they are not in a position to provide assistance with transport; or
there are issues of risk and/or low income exists and the giving of assistance with transport would avoid the Council being caused greater expense through the giving of assistance in another form, or where failure to provide transport would cause greater expense to the Council on a future occasion;

but note too that this does not necessarily mean that the Service will not seek reimbursement of the costs/part of the costs of any assistance provided.

For children, assistance such as is mentioned above may be given unconditionally or subject to conditions as to the repayment, in part, of it or of its value; but before giving it, or imposing such conditions, the local authority shall have regard to the means of the child concerned and of his parents and no condition shall require repayment by a person at any time when in receipt of –

universal credit under Part 1 of the Welfare Reform Act 2012;
income support or working families’ tax credit payable under the Social Security Contributions and Benefits Act 1992;
any element of child tax credit other than the family element or working tax credit
an income-based jobseeker’s allowance payable under Jobseekers Act 1995; or an income-related allowance under Part 1 of the Welfare Reform Act 2007 (employment and support allowance)

Where there is disagreement by a Service User, or an individual with responsibilities towards the Service User, about the decision that has been made with regards assistance with transport an appeal can be raised. The outcome of the appeal will be provided within ten working days of receipt of the appeal.

As is the case with other areas of service, any Service User, or an individual with responsibilities towards that Service User, may use the complaints procedure if they wish to do so. As is usual practice, Service Users, and individuals with responsibilities towards Service Users, should be advised of the complaints procedure.

Hand in hand with the Assistance with Transport Assessment will be the provision of direct support to ensure that service users or those with responsibilities towards them are receiving the financial benefit awards that they are entitled to. An Income Maximisation Form (IMF) will be completed and should be submitted to the Department of Works and Pensions (DWP) for assessment.

By adopting this consistent approach to the provision of assistance with transport, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

3. How have you applied learning from research evidence about the experience of equality groups to the service or Policy? Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination. harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Example
Looked after and accommodated care services reviewed a range of research evidence to help promote a more inclusive care environment. Research suggested that young LGBT+ people had a disproportionately difficult time through exposure to bullying and harassment. As a result staff were trained in LGBT+ issues and were more confident in asking related questions to young people.

(Due regard to removing discrimination, harassment and victimisation and fostering good relations).

Service Evidence Provided

The updated Assistance with Transport Policy may affect Service Users who access Statutory Social Work Services and their Carers, who are likely to hold Power of Attorney/Legal Guardianship Order for the Service User and most often the people responsible for the management of a service user budgets/finance.

Individuals with responsibilities towards a Service User include, for example, a:

parent or other person with parental responsibilities or rights;
Carer;
guardian; or
person having power of attorney

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 Policy, 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 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 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

A lot of what the HSCP needs to do to support carers 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 Carers Strategy reflects what all HSCPs need to do but emphasises the priorities that are right for local needs and aspirations.

The HSCP has carried out initial work by looking at the main pressures (or “drivers”) for change and improvement. Analysis of Parent/Carer and Service User numbers and circumstances has also been undertaken to ensure that any developing Policies identify and reflect local needs in the development of priorities.

Social Work (Scotland) Act 1968 (as amended)
Chronically Sick and Disabled Persons Act 1970 (as amended)
Children (Scotland) Act 1995 (as amended)
Mental Health (Care and Treatment) (Scotland) Act 2003.
Children and Young People (Scotland) Act 2014

In developing the policy, we used learning from previous plans and policies; and also utilised our statutory partner’s demographic knowledge to further develop and increase knowledge of local equality groups. We also took learning from other HSCP area Transport Policies to adopt a best practice model.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with assessed need.

For this reason, a robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the Service User or those responsible for them disagree with the decision.

If assistance with transport is agreed, in accordance with the Policy reimbursement of the costs/part of the costs of any assistance provided will be requested. Again, this is caveated by a robust assessment process and recognition of low income.

The HSCP will work in partnership with Service Users and those responsible for their care to ensure the best possible outcomes are achieved via a robust care plan and that any assistance provided to support the care plan is fair and equitable across all equality groups.

By adopting this consistent approach to the provision of assistance with transport, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

As in question 2.

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? Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Example
A money advice service spoke to lone parents (predominantly women) to better understand barriers to accessing the service. Feedback included concerns about waiting times at the drop in service, made more difficult due to child care issues. As a result the service introduced a home visit and telephone service which significantly increased uptake.

(Due regard to promoting equality of opportunity)

* The Child Poverty (Scotland) Act 2017 requires organisations to take actions to reduce poverty for children in households at risk of low incomes.

Service Evidence Provided

The Assistance with Transport Policy was widely consulted at its inception via formal engagement events. A programme of consultation was developed which identified the key stakeholders and in particular those impacted by the proposed Assistance with Transport Policy. The process of consultation progressed during September – November 2019. A range of approaches were used to reach service users and carers in ways that encouraged views to be expressed including in-person consultation sessions;

Thursday 31st October 1pm – 3pm Kelvinbank Resource Centre

Thursday 31st October 5pm – 7pm Kelvinbank Resource Centre

Friday 1st November 10am – 12pm Bearsden Hub – Large Hall

The East Dunbartonshire Public, Service User and Carer (PSUC) representatives group met on the 25 November 2019 and were asked to provide comment on the proposed policy.

The PSUC members supported having a policy in place but suggested that the guidance and assessment form would benefit from being simplified.

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 Policy, 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 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 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 implementation of the policy is predicated on an individual service review process, which will provide a forum for discussing and understanding the needs of the Service User and Parent/Carer, offering a person centred focus and involvement of the Service User in the development of their support arrangements.

The HSCP has carried out initial work by looking at the main pressures (or “drivers”) for change and improvement. Analysis of carer and service user numbers and circumstances has also been undertaken to ensure that any developing Policies identify and reflect local needs in the development of priorities.

More recently, transport provision was discussed during Q&As at Learning Disability Strategy Engagement Events in May 2022, with Parent/Carers of Service Users with a Learning Disability and or Autism. Responses were reported within the subsequent newsletter (as below) which reaches across the authority via Service Users, Parent/Carers, Schools, Third Sector Organisations, etc.

Q3. Will transport still be provided?

‘Yes, transport will still be provided. The Assistance with Transport Policy was implemented in 2019/20 and we will endeavour to ensure that this is applied consistently across the new service. The Policy meant that people were asked to make their own way to Day Services, where possible. If this is not possible then Council Transport is provided, however there is a charge associated with this. We would encourage Parents/ Carers to complete an Income Maximisation Form (IMF), so that any charges are means tested and the correct charge can be calculated based on their ability to pay’.

For this reason a robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the service user or those responsible for them disagree with the decision.

If assistance with transport is agreed, in accordance with the Policy, reimbursement of the costs/part of the costs of any assistance provided will be requested. Again, this is caveated by a robust assessment process and recognition of low income.

By adopting this consistent approach to the communication of the Assistance with Transport Policy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

As in question 2.

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? Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Example
An access audit of an outpatient physiotherapy department found that users were required to negotiate 2 sets of heavy manual pull doors to access the service. A request was placed to have the doors retained by magnets that could deactivate in the event of a fire. (Due regard to remove discrimination, harassment and victimisation).

Service Evidence Provided

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

EDHSCP need to ask their suppliers of transport 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 Parent/Carers with community-based transport, resources will already have been commissioned and screened in line with accessibility requirements and equality, such as, safeguarding checks, escort, adapted vehicles etc.

Social Work and Allied Health Professionals support the assessment of Service Users and Parent/Carers needs in regard 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 support services to put in place information and supports to remove any potential barriers.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with assessed need.

A robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the service user or those responsible for them disagree with the decision.

In relation to the requirement to show due regard to eliminate unlawful discrimination, harassment and victimisation, the HSCP is aware that Parent/Carers may be at increased risk of

discrimination by association and will take all proportionate steps to ensure the burden of care is not exacerbated unfairly through our corporate decision-making processes.

By adopting this consistent approach to the provision of assistance with transport, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

As in question 2

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

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Example

Following a service review, an information video to explain new procedures was hosted on the organisation’s YouTube site. This was accompanied by a BSL signer to explain service changes to Deaf service users.

Written materials were offered in other languages and formats.

(Due regard to remove discrimination, harassment and victimisation and promote equality of opportunity).

Service

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.

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 carers with community-based transport, resources will already have been commissioned and screened to ensure that all additional communication support needs are met, for example strategies to respond to an individual with Autism who requires a consistent approach, low arousal etc.

We recognise that there are barriers that can, if unaddressed prevent some individuals from Black and Ethnic Minority (BME) communities 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 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)

The Scottish Census 2011 (opens in new window) indicates that 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 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)

Throughout the development of the Policy, 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

In relation to the requirement to show due regard to eliminate unlawful discrimination, harassment and victimisation, the HSCP is aware that carers may be at increased risk of discrimination by association and will take all proportionate steps to ensure the burden of care is not exacerbated unfairly through our corporate decision-making processes.

NHSGG&C has an Accessible Information Policy that the HSCP will utilise to provide written information including letters.

The HSCP 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 Assistance with Transport Policy 2019 is available in other languages and formats as required, recognising that Service User and Parent/Carers from the BME community are more likely to require communication support to navigate into, through and out of services.

The Policy 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 relating to Service User and Parent/Carer race is via a Care Needs Assessment and stored on the internal computer/ information system (Care first) and is used to inform activities and service delivery.

Possible negative impact and Additional Mitigating Action Required

As in question 2

7. Protected Characteristic

(a) Age

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). Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

The ability to access quality services is a fundamental aspect in ensuring that Service Users and Parent/Carers enjoy a high quality of life. Furthermore, 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.

We learned that those most likely to be adversely affected are those in the protected characteristic groups of Age, Disabilities and Maternity. As part of the assessment process consideration will be given to any mitigating factors that affect these protected groups.

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.

As part of the assessment process consideration will be given to any mitigating factors that affect elderly Parent/Carers, such as their ability to provide transport with a mobility car due to declining health/frailty. In all such instances a discussion will take place to review the appropriateness of a mobility car in meeting the Service Users holistic needs and any potential alternatives that could achieve this more effectively.

For this reason, a robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the service user or those responsible for them disagree with the decision.

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

By adopting this consistent approach to the provision of assistance with transport, 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 Assistance with Transport Policy aims to formalise East Dunbartonshire Council HSCPs approach to delivering assistance with transport in accordance with their Statutory Duty and in a manner that is consistent and equitable, meeting the needs of those within the authority who require transport assistance to attend statutory service provision.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(b) Disability

Could the service design or policy content have a disproportionate impact on people due to the protected characteristic of disability? Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Required

The ability to access quality services is a fundamental aspect in ensuring that Service Users and Parent/Carers enjoy a high quality of life. Furthermore, it is important to be aware of potential impacts associated with disability discrimination that leads to inequality in terms of access to services and user experience amongst different groups, and the need to develop multi-dimensional approach to tackling inequality as a consequence of disability discrimination.

Scotland's Census, 2011, reported 26,349 people to have learning disabilities (15,149 males and 11,200 females), which is 0.5% of Scotland's population.

458 people in East Dunbartonshire local authority have learning disabilities. That’s 0.4% of 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
12.3% of adults with learning disabilities have paid employment, compared with 58.3% of all adults
34.8% of people with learning disabilities live in social rented accommodation, compared with 10.0% of all people
Only 17.7% of people with learning disabilities rate their health as very good, compared with 56.6% of all people

The United Nations Convention on the Rights of Persons and Optional Protocol (opens in new window) 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.

Long-term Health Conditions

The Health and Wellbeing survey in 2014 demonstrated the relationship between the prevalence of long-term conditions and increased age.

The prevalence of asthma in individuals from East Dunbartonshire on GP registers was around 3 per 100 in 2018/19.

Coronary Heart Disease (CHD) The prevalence of CHD in individuals from East Dunbartonshire on GP registers was around 4.4 per 100 in 2018/19.

Hospital admission and delayed discharge would have an impact on a carers ability to provide transport.

As part of the assessment process consideration will be given to any mitigating factors that affect Parent/Carers with disabilities or long-term health conditions, such as their ability to provide transport with a mobility car due to declining health.

In all such instances a discussion will take place to review the appropriateness of a mobility car in meeting the Service Users holistic needs and any potential alternatives that could achieve this more effectively.

For this reason, a robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the service user or those responsible for them disagree with the decision.

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

By adopting this consistent approach to the provision of assistance with transport, 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 Assistance with Transport Policy aims to formalise East Dunbartonshire Council HSCP’s approach to delivering assistance with transport in accordance with their Statutory Duty and in a manner that is consistent and equitable, meeting the needs of those within the authority who require transport assistance to attend statutory service provision.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(c) Gender Reassignment

Could the service change or policy have a disproportionate impact on people with the protected characteristic of Gender Reassignment? Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

The ability to access quality services is a fundamental aspect in ensuring that Carers enjoy a high quality of life. Research has demonstrated the need to involve Carers 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 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. Transgender People are one of the most marginalised protected characteristic groups in Great Britain.

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 noted as part of the care 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 Carers 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).

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. GIRES (opens in new window) 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.

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 Policy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

There are no identified implications in the Policy which will specifically have a negative impact on transgender Service Users or Parent/Carers

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(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? Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

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

The Assistance with Transport Policy does not make any specific reference to marriage and civil partnership. 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 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.

Possible negative impact and Additional Mitigating Action Required

There are no identified implications in the Policy which will specifically have a negative impact on Service Users or Parent/Carers that are married or in a civil partnership.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(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?

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

The ability to access quality services is a fundamental aspect in ensuring that Service Users and Parent/Carers enjoy a high quality of life. Furthermore, it is important to be aware of potential impacts associated with pregnancy/maternity discrimination that leads to inequality in terms of access to services and user experience amongst different groups, and the need to develop multi-dimensional approach to tackling inequality as a consequence of pregnancy/maternity discrimination.

East Dunbartonshire has an estimated 12.4% of children who live in families with limited resources after housing costs, considerably lower than Scotland as a whole at 20.7%.

As part of the assessment process consideration will be given to any mitigating factors that affect Parent/Carers with maternal responsibility such as restricted availability to provide transport with a mobility car, due to looking after other siblings or working hours.

For this reason, a robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the service user or those responsible for them disagree with the decision.

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

By adopting this consistent approach to the provision of assistance with transport, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(f) Race

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

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

We recognise that there are barriers that can, if unaddressed prevent some individuals from Black and Ethnic Minority (BME) communities 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 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)

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 (opens in new window) 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.

Minority Ethnic people 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 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 Assistance with Transport Policy 2019 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 policy 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 via a Care Needs Assessment and stored on the internal computer/ information system (Care first) and is used to inform activities and service delivery.

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

Possible negative impact and Additional Mitigating Action Required

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(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?

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

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%.

Religious beliefs of carers are not currently noted as part of the needs assessment process. However, there is little evidence to indicate specific faith groups fare more poorly than others in terms of access to HSCP Carers services.

However, we recognise that there are barriers that can, if unaddressed prevent some individuals from some faith backgrounds accessing services, for example;

• There may be limited cultural sensitivity amongst professionals e.g. Ramadan

• Stigma and pride (feeling ashamed to ask for help outside the family and close-knit community)

• The requirement for same sex care/support

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

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 carers with community-based transport, resources will already have been commissioned and screened to ensure that all additional support needs are met, for example cultural requirements such as same sex care/support.

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.

It will be policy that all staff and volunteers will be made aware of these policies and as we have stated, by adopting this approach towards and during the lifetime of the Policy, we aim to ensure that we remove discrimination, promote equality of opportunity and foster good relations.

Possible negative impact and Additional Mitigating Action Required

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(h) Sex

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

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

The Scottish Census 2011 indicates that more than half of the carers known to services are over 65 years old, with the gender split almost exactly that of the nation balance at 61% being female.

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 (opens in new window).

The Scottish Census 2011 indicates that 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.

Possible negative impact and Additional Mitigating Action Required

There are no identified implications in the Policy which will specifically have a negative impact on Service Users or Parent/Carers of a certain sex.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(i) Sexual Orientation

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

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

Service Evidence Provided

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

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.

Possible negative impact and Additional Mitigating Action Required

There are no identified implications in the Policy which will specifically have a negative impact on Service Users or Parent/Carers due to sexual orientation.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(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 socio-economic status. Additional information available on Fairer Scotland Duty (opens in a new window).

Seven useful questions to consider when seeking to demonstrate ‘due regard’ in relation to the Duty:

1. What evidence has been considered in preparing for the decision, and are there any gaps in the evidence?

2. What are the voices of people and communities telling us, and how has this been determined (particularly those with lived experience of socio-economic disadvantage)?

3. What does the evidence suggest about the actual or likely impacts of different options or measures on inequalities of outcome that are associated with socio-economic disadvantage?

4. Are some communities of interest or communities of place more affected by disadvantage in this case than others?

5. What does our Duty assessment tell us about socio-economic disadvantage experienced disproportionately according to sex, race, disability and other protected characteristics that we may need to factor into our decisions?

6. How has the evidence been weighed up in reaching our final decision?

7. What plans are in place to monitor or evaluate the impact of the proposals on inequalities of outcome that are associated with socio-economic disadvantage? ‘Making Fair Financial Decisions’ (EHRC, 2019)21 provides useful information about the ‘Brown Principles’ which can be used to determine whether due regard has been given. When engaging with communities the National Standards for Community Engagement22 should be followed. Those engaged with should also be advised subsequently on how their contributions were factored into the final decision.

Service Evidence Provided

The ability to access quality services is a fundamental aspect in ensuring that Service Users and Parent/Carers enjoy a high quality of life. Furthermore, it is important to be aware of potential impacts associated with Socio – Economic Status & Social Class discrimination that leads to inequality in terms of access to services and user experience amongst different groups, and the need to develop multi-dimensional approach to tackling inequality as a consequence of Socio – Economic Status & Social Class discrimination.

In public health terms is crucial to recognise the impact of relative poverty on health and wellbeing. Despite relative prosperity overall in East Dunbartonshire, the known impact of deprivation in affected communities is an issue that the HSCP must prioritise in order to ensure that access to and impact of services is equitably targeted to people and communities who are risk of poorer health.

The average gross weekly earnings for full time workers living in East Dunbartonshire in 2020 was 22% higher than the Scottish average, with female full-time workers earning more than male full-time workers.

The 2011 Census reported that 29% of carers in the most deprived areas care for 35 hours a week or more – more than double the level in the least deprived areas. This highlights that the impact of caring may be exacerbated by existing low incomes and poor health in these areas and the need to ensure such inequalities are addressed within the HSCP plans and strategies.

East Dunbartonshire is, as a whole, relatively less deprived than many other local authorities in Scotland. However, East Dunbartonshire has 8 data zones in the most deprived 25% in Scotland.

East Dun JSNA 2021 indicates that The number of direct payments in East Dunbartonshire has increased from 40 in 2007/08 to 186 in 2020/21.

East Dun JSNA 2016 indicated 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)

The 2011 Census reported that 29% of carers in the most deprived areas care for 35 hours a week or more – more than double the level in the least deprived areas. The impact of caring may be exacerbated by existing inequalities of low incomes and poor health in these areas.

Notably 383 carers are under the age of 15, which far exceeds the estimate of the Scottish Government Census. Over 14% come from the most deprived areas. 51% are caring for a sibling.

As part of the assessment process consideration will be given to any mitigating factors that affect Parent/Carers with low income, such as income levels and any additional financial burden.

For this reason, a robust assessment process will be carried out, which will capture any exceptional circumstances that should be considered when making the decision as to whether or not assistance with transport is provided. The decision must also be approved by the Service Manager and discussed at the Resource Allocation Group. Thereafter, an appeal/complaint process can be instigated if the service user or those responsible for them disagree with the decision.

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

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

Possible negative impact and Additional Mitigating Action Required

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

(k) Other marginalised groups

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

Service Evidence Provided

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

In developing the policy, 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.

The Scottish Census 2011 shows that 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.

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.

Possible negative impact and Additional Mitigating Action Required

There are no identified implications in the Policy which will specifically have a negative impact on other marginalised groups that have not been covered in the document.

If applied consistently the policy will deliver equitable assistance with transport across all equality groups, in accordance with Statutory requirements.

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?

Your evidence should show which of the 3 parts of the General Duty have been considered:

Remove discrimination, harassment and victimisation
Promote equality of opportunity
Foster good relations between protected characteristics

There are a number of key opportunities and challenges for the HSCP at a national and local level. The most significant opportunity being the Review of Adult Social Care, elements of which have now been reflected in the new programme for government and will see significant investment across a range of areas including the development of a National Care Services on an equal footing to the National Health Service, expansion of support for lower-level needs and preventive community support, increasing support to unpaid carers and sums paid for free personal care.

The medium-term financial outlook for the IJB provides a number of cost pressures with levels of funding not matching the full extent of these pressures requiring a landscape of identifying cost savings through a programme of transformation and service redesign. The IJB is planning for a range of scenarios ranging from best to poor outcomes in terms of assumptions around cost increases and future funding settlements. This will require the identification of £11.5m to £21.8m of savings with the most likely scenario being a financial gap of £11.5m over the next five years. This will extend to £28.9m over the next 10 years, however this becomes a more uncertain picture as the future environment within which IJBs operate can vary greatly over a longer period of time. Based on the projected income and expenditure figures the IJB will require to achieve savings between £0.5m and £3.0m each year from 2022/23 onwards.

Key areas identified to close the financial gap:

Efficiency Savings

Implementing a range of initiatives which will ensure services are delivered in the most efficient manner.
Demand Management
Implementing a programme focussed on managing demand and eligibility for services which enable demographic pressures to be delivered without increasing capacity. This is an area of focus through the Review of Adult Social Care

The Assistance with Transport Policy aims to realign transport provision to a fair and equitable position for all service users and Parent/Carers.

The Assistance with Transport Policy will be supported by a robust assessment process that is both means tested and flexible to take account of extenuating circumstances

Possible negative impact and Additional Mitigating Action Required

As in question 2

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.

Service Evidence Provided

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.

Training and awareness sessions have been provided to health, social work, social care and education services. Over 60 session per year are provided by Carers link.

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

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.

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.

Please explain in the field 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.

The EQIA highlights that there could be a risk of discrimination for some protected groups such as those in the protected characteristic groups of Age, Disabilities and Maternity, if the policy is not applied robustly, incorporating a full assessment process or for Parents/Carers and/or Service Users from an ethnic minority background or who hold particular religious beliefs, if not communicated appropriately, with attention being paid to cultural sensitivities.

The information recorded on Care First considers protected characteristics and upon review there is no requirement to undertake more intensive analysis. In addition, local and national data is analysed and from this information, resources and alternative services are put in place to support service users and carers as required to ensure that equality and human rights issues for each individual are considered. However, Service Users and Parent/Carers can choose not to disclose information on protected characteristics.

EDHSCP asks their suppliers and those they commission services from such as taxi companies 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, Non-discrimination 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:

No major change (where no impact or potential for improvement is found, no action is required)

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.

To mitigate the risk of above Social Work Services will continue to engage with affected Service Users and Parent/Carers throughout the ongoing implementation of the Assistance with Transport Policy using the most effective method of communication and paying particular attention to any cultural sensitivities.

The Service will be able to demonstrate that any assessment for assistance with transport or actual assistance provided is done in accordance with the Policy and the Procedures and Guidance.

Support will be provided to ensure that Service Users or those with responsibilities towards them are receiving the financial benefit awards that they are entitled to. An Income Maximisation Form (IMF) will be completed and should be submitted to the Department of Works and Pensions (DWP) for assessment.

The Service will monitor attendance by benchmarking current figures and surveying current and former users and their carers of the service to determine any evident reduction in attendance in future or any unforeseen impact on Protected Groups, as a result of the Policy implementation.

Ongoing 6 Monthly Review
6 monthly EQIA Review Date: 31 October 2023

Lead Reviewer

Name: Gayle Paterson
Job Title: Learning Disability Strategic Review Project Lead
Date: 20 March 2023

Quality Assurance Sign Off

Name: Alaistair Low
Job Title: Planning Manager
Date: 04/04/23