Equality Impact Assessment


EQUALITY IMPACT ASSESSMENT

Adults Health and Wellbeing Directorate

2010-13 Service User and Carer Involvement Strategy and Service User and Carer Involvement Payments Policy

EQUALITY IMPACT ASSESSMENT

Name of the policy or function being assessed: 2010-13 Service User and Carer Involvement Strategy and Service User and Carer Involvement Payments Policy

Directorate Adults Health and Wellbeing Directorate

Date Impact Assessment completed 1st draft: 26-Jan-10

2nd draft: 11-Feb-10

Is this a policy or function? Policy x Function 

Is this a new or existing policy or function?New x Existing 

Names and roles of the people carrying out the Impact Assessment:
1.Joanne Starkie – User and Carer Involvement Manager, AHWB Directorate – leading on strategy and policy development in these areas.
2. Hannah Bailey – Strategy and Policy Manager, AHWB Directorate – view from equalities lead for the Directorate
3. John Hoang – Communications and Marketing officer, AHWB Directorate – view from communications lead for the Directorate
4.Christine Sheppard & Nick Maxwell – Involving Older People Project – view from third sector involvement from the perspective of older people and LGBT services
5. Shanara Matin – Interim Head of Participation and Engagement – view from involvement lead for the Partnership
Service Head / Deborah Cohen
Signature
Date

Once you have filled in this document please send a copy to the Diversity and Equalities Team.

If you have any questions regarding this form please call the Diversity and Equalities Team.

SECTION 1

AIMS AND IMPLEMENTATION OF THE POLICY

Identifying the aims of the policy[1]
1.1. What: The 2010-13 Service User and Carer Involvement Strategy (referred to as “the Strategy” from this point onwards). The Strategy lays out how the Directorate will develop and deliver on service user and carer involvement (referred to as “users” from this point onwards).
The Service User and Carer Involvement Payments Policy (referred to as “the policy” from this point onwards) sits alongside the Strategy and lays out how the Directorate’s approach to meeting user out-of-pocket expenses in relation to involvement, and the Directorate approach to recognizing and rewarding this involvement.
1.2 Purpose: The purpose of the strategy and policy is to ensure the Directorate can:
  • Meet CQC key outcome area three “Making a Positive Contribution”
  • Meet the requirements of the transformation agenda
  • Improve the quality of services
  • Support users to make a positive contribution
  • Support community cohesion work
User involvement is an essential requirement to meet the first two outcomes, and a method for achieving the last three outcomes.

Rationale behind the policy and its delivery

1.3 Vision
The Strategy vision is: “To create an environment where the impact of involvement on our services, local communities and the individual user or carer is positive, visible and lasting”.
1.4 Objectives
The strategic objectives to meet this vision are:
i) To create a culture where user involvement and empowerment is embedded and reflected in the work practices of the Directorate and commissioned services
ii) To maintain and develop an involvement structure that is inclusive and meaningful to users and the Directorate
iii) To develop involvement so that user perspectives and experiences are included from the start of service planning and through the design, delivery and monitoring of all processes and in all aspects of the transformation agenda
iv) To develop processes and tools to support staff and users to be involved in a way that is empowering, effective, inclusive and value for money
v) To ensure that the outcomes and impact of user involvement is visible, real and known by users and key stakeholders
vi) To work effectively in partnership with key stakeholders across relevant public services
The policy is included under Objective (4).
1.5 Expected outcomes
The expected outcomes of the strategy and policy are:
i) For all users:
  • Increased satisfaction with services provided and commissioned by the Directorate
  • Increased choice and control in planning support
  • Increased confidence in the Directorate and the complaints procedure
  • Increased understanding of how the Directorate works, what changes are planned, what involvement options there are and what the impact of involvement has been
ii)For users who have been involved:
  • Increased skills and confidence
  • Increased social capital
  • Reduced social isolation
  • Increased understanding of how the Directorate works and how decisions are made
  • Able to user involvement experiences to access employment and training opportunities
iii)For the Directorate and commissioned services:
  • Improved quality of services – recognised by CQC and users
  • Increased accountability
  • Wide range of involvement options
  • Increased understanding of user needs and perspectives
  • Ability to demonstrate that a wide range of views have been heard and acted on
  • Increased staff understanding of involvement principles and the Strategy and how it relates to work practices
  • Increased staff job satisfaction
iv)For other stakeholders:
  • Improved perception of Directorate service user involvement and partnership working
  • Increased awareness of user involvement in the Directorate
1.6 Factors that could contribute to or detract from meeting the outcomes:
i) Financial resources
  • An allocated budget is needed to fund Strategy actions
  • A lack of resources will conversely mean that the actions cannot be completed, including those around making involvement inclusive
  • There is a need to focus on value for money in climate of limited resources
ii)Staff resources, roles and planning
  • There is one central resource (User and Carer Involvement Manager) to support Directorate staff and providers to deliver the Strategy.
  • A lack of understanding over roles (i.e. that all staff need to deliver the Strategy) is a serious risk to the Strategy being successfully delivered.
  • There is a need for resources to plan and deliver involvement fully to ensure it is effective and avoid tokenism.
iii)Systems
  • There is a need to have systems in place to support Directorate-wide involvement initiatives and to ensure they are inclusive. Role of User and Carer Involvement Manager is to develop these systems.
  • Without these, the risk is that involvement will be reliant on individual personalities and will therefore be unsustainable. It will also be at risk of involving the same users and therefore not incorporating a wide range of views and not being to identify hard-to-reach groups.
v)Communication mechanisms and messages
  • The basis for involvement is provision of information – therefore need to ensure information is clear, accessible and easy to understand to enable scrutiny and informed choices (i.e. meaningful involvement). There is a need to ensure we know what the communication needs of users are including literacy, language and health issues, and produce information in this way.
  • There is a need to have consistent internal and external messages around involvement in relation to other key “messages” (e.g. transformation). The risk otherwise is that the message about involvement will not have the intended impact and will get “lost”.
vi)Internal “buy in” from staff
  • There is a need to ensure that staff understand and agree with the principles of involvement. The risk otherwise is that staff will not understand their role in relation to this, and will not deliver the Strategy
vii)Partnership working
  • There is a need to ensure that key stakeholders in the Directorate, other areas of the council, NHS Tower Hamlets are working consistently where needed towards the same goals. The risk otherwise is that involvement becomes fractured, and resources are not being used in the most effective way (i.e. duplication).
viii)Past history / negative experiences
  • Any previous negative experiences of users and staff on involvement risks producing cynicism and a lack of interest in involvement (e.g. feeling that it doesn’t work)
  • There is a need effective communication plan and focus on communicating impact of involvement to overcome this.
ix) Expectations and large organisations
  • Involvement can raise expectations as to what can be delivered and when. Reality is often that in large organisations, change can take time to implement. There is a need for clarity over project and expectations from the start to ensure users do not feel there is no impact as a result of their involvement.
x)Change in government
  • The 2010 general election may result in a change of government and therefore a change in involvement requirements. There is a need to ensure that the Strategy and policy are flexible enough to meet changing demands whilst still maintaining a clear direction.

Who is affected by the policy? Who is intended to benefit from it and how?
1.7 Main stakeholders:
  • Directorate staff
  • Staff in commissioned providers (including ULOs)
  • Service users
  • Carers
  • THINk
  • Partnership Participation and Engagement team
  • Health services: NHS Tower Hamlets, Barts and the London Trust, East London Foundation Trust, Community Health Services
1.8 Outcomes for stakeholders
  • Please see 1.5 “expected outcomes”
  • The Strategy and policy were developed in consultation with the main stakeholders listed above. The key messages were around the need to demonstrate the impact of involvement and to communicate this impact back to people.
1.9 Groups which might be expected to benefit from the intended outcomes but who do not
  • The primary focus of the Strategy is users where the Directorate is the lead commissioner. The focus is therefore on learning disability, physical disability, older people and people in Supporting People services rather than mental health (where the lead commissioner is NHS Tower Hamlets). The policy applies to all users and carers who have been invited to an event, meeting or activity by the Adults Health and Wellbeing Directorate under the scope of the Strategy.
  • The Strategy includes actions to:
  • Monitor diversity in involvement to identify hard-to-reach groups
  • Ensure information on involvement is produced in accessible formats
  • The policy aims to ensure there is no cost to users to get involved (including approach to child care costs, replacement carer costs)
  • There are differing views on the issue of whether to develop user groups that are theme based and cut across traditional client groups (e.g. mental health or learning disabilities). One view is that specialist groups based on traditional client categories are needed in some instances, particularly in services where people have high needs and how information is conveyed has to be carefully considered. Another view is that developing user groups based on theme enables users from different backgrounds to come together, share experiences and learn from one another. The approach that is agreed will have an impact on who will benefit from the intended outcomes.
  • There are differing views on the issue of whether to develop user-led involvement and consultation in hard-to-reach communities (for example, commissioning a specialist Bangladeshi organisation or individual to consult with the Bangladeshi community). One view is that this is an effective way of involving users whose perceptions of the Directorate may discourage them from getting involved. Another view is that the perceptions and barriers need to be broken down so that the principles of working in equal partnership with users are embedded. The approach that is agreed will have an impact on who will benefit from the intended outcomes.

Promotion of good relations between different communities
1.10 How the Strategy contributes to better community cohesion
  • Please see 1.9, point 3. Developing user groups based on theme rather than client group will enable users to share experiences and develop mutual understanding. The Strategy proposes that that specialist existing groups based on traditional groups continue where these groups are functioning well, but that new groups are developed based on theme where possible.
  • The Strategy includes an action to develop an annual calendar of events and meetings for users to attend. This will enable users from all services and client groups to come together.
  • The Strategy includes an action to consider where users can be involved across Directorate services and across Tower Hamlets services. This will enable users from different client groups to have positive cross cultural contact.
  • The Strategy includes an action to develop a programme of training and support for users who are interested or who are involved. This can include diversity training, which in turn will increase understanding of diversity issues.
  • The Strategy includes an action to identify and target hard-to-reach groups, with a view to gaining a wide range of user views. For user groups, this should result in more diverse membership which in turn will increase user understanding and awareness of different communities.
  • Meetings and groups in relation to involvement is a way of reducing social isolation and developing user skills and increasing community cohesion.
  • The focus of the Strategy is ensuring that the impact of involvement is known and visible. In communicating the impact of involvement, this will in turn demonstrate the valuable contribution made by diverse group of users to social care services.
  • The policy is a way of ensuring that the above action can take place, by clarifying our approach to meeting out-of-pocket expenses in relation to involvement and our approach to recognising and rewarding this.

(Specifically identify the relevance of the aims of the policy to the equality target groups and the Council’s duty to eliminate unlawful racial discrimination, promote equality of opportunity and good relations between people of different racial groups).
i)Eliminating discrimination:
  • The Strategy includes actions to put systems in place to identify hard-to-reach groups, and to target these groups so that a wide range of views are heard
  • Strategy includes an action to develop a programme of training and support for users who are interested or who are involved. This can include diversity training, which in turn will increase understanding of diversity issues.
ii)Promoting equality of opportunity
  • The policy user expenses in relation to involvement and our approach to rewarding involvement is intended to ensure that financially there is equality of opportunity in involvement.
  • The Strategy includes actions to develop minimum standards in relation to involvement. This is intended to include using accessible meeting venues, for consideration to be given to meeting times and refreshments (for example, providing halal food), and communication minimum requirements (for example, using “plain English” and offering interpreters).
  • The Strategy includes actions to ensure that information on involvement is produced in accessible formats most needed by users.
iii)Promoting good relations between people of different racial groups
  • Please see 1.10

Policy Priorities:
i)Fitting in with Partnership and Council priorities
  • The 2020 Community Plan states our aspiration of “One Tower Hamlets” and is built around four key themes. The priorities within these themes are around reducing inequalities and poverty, strengthening community cohesion and providing effective services to everyone in Tower Hamlets.
  • The 2006-16 Improving Health and Wellbeing Strategy aims to have health and social care services which are “the best in the country and will be recognised by the people of Tower Hamlets as being so”. The theme of organisations working in partnership with each other and with residents to provide personalised and high quality services runs throughout the strategic principles needed to achieve this.
  • The 2006-11 Council Strategic Priorities lays out twelve key priorities which include “improved outcomes for vulnerable adults and children”, “stronger and more cohesive communities” and “locally focussed services empowering local people”.
  • The 2009/10 – 2010/11 Council Strategic Plan aims to “improve the quality of life for everyone living and working in Tower Hamlets” through a range of objectives that include reducing inequalities, strengthening communities and supporting residents through education, employment and quality public services.
  • The 2009-10 Adults Health and Wellbeing Business Plan lays out specific priorities for Directorate in order to fulfil its role in “supporting people to maintain, or return to, life within the mainstream as active citizens with equal rights, opportunities and contributions to make.”
  • The Tower Hamlets Third Sector Strategy aims to create a thriving environment for the third sector, including user led organisations. The Strategy includes actions to ensure a supportive infrastructure for the third sector exists, and that their voice is heard and acted upon.
ii)Factors and forces that could contribute/detract from the outcomes
  • Unemployment, overcrowding and health problems are some of the issues related with deprivation, with levels vary significantly in different parts of Tower Hamlets. One of the key challenges for Tower Hamlets remains the issue of tackling deprivation and inequalities in the borough.
  • Future regeneration is aimed at tackling this issue (planned in part in relation to the 2012 Olympics and Paralympics) but is also cited as a major contributing factor in the predicted growth in population, which is estimated to rise from around 220,500 to 270,000 in the next ten years. The challenge for public services will therefore also be to meet the needs of an increasing population.
iii)How the outcomes meet or hinder or policies, value and objectives
  • Key messages from these strategy and policy documents are around the need to strengthen community cohesion, provide personalised and high quality services and empowering those who are vulnerable and at-risk. The Strategy lays out plans to involve users as a key mechanism to achieve these outcomes. The policy enables this to happen effectively and in a way that is inclusive.

How the policy is implemented

  • The Strategy and policy have been developed by the AHWB Directorate User and Carer Involvement Manager, in consultation with service users, carers, staff and stakeholders.
  • The Strategy and policy are to be implemented by all Directorate staff, as outlined on Appendix II (1-3 Year Action Plan) of the Strategy and as per the policy document.
  • One of the Strategy objectives is around working effectively in partnership with others. External parties will need to meet the planned minimum requirements for involvement, which will include the Council’s Equal Opportunities policy
  • Interface with relevant external stakeholders will be carried out at a Partnership level through the Participation and Engagement Strategy Steering Group and at a health and social care level through the Health and Social Care Engagement Group.
  • The AHWB Quality Board will monitor the delivery of the strategy through six monthly reports demonstrating performance against the strategy action plan.
  • The Directorate Joint Senior Management Team will monitor user involvement via quarterly updates based on the strategy action plan targets
  • The Directorate Management Team will receive updates on user involvement via internal monthly Self Assessment Survey (SAS) performance reports
  • The delivery of business plans and service improvement plans are monitored through the Directorate governance structure. These plans will include service-level targets on involvement which are consistent with this Strategy.
  • The THINk Steering Group will continue to monitor user involvement via monthly updates based on the strategy action plan targets.
  • The policy will be reviewed on an annual basis as part of the wider review of the strategy.

SECTION 2