Step One – What are we Equality and Diversity Impact Assessing?

Please use the prompts in boxes where available to help answer each question fully

a.Name of piece of work:

Condition Management Service
EQIA CONTACT Brian Devlin ()

b.Description of piece of work

What is it? What does it do? Who does it?

Condition Management is a service provided through a contractual arrangement with JobCentre Plus to provide one to one support by health condition management practitioners which is aimed at individuals on incapacity benefit and are referred on through Jobcentre Plus incapacity benefit advisers. The condition management service is managed and overseen by NHS Highland and they employ the condition management practitioners who deliver the service. At the moment this is provided only through one to one support, although in other areas group work is also used. The service is also trialling the use of IT and telemedicine to reach to rural and isolated areas. The service includes the Highland area and also provides a service to Orkney.

c.What will the measurable outcomes of this piece of work be?

What is going to happen because of this piece of work?

The broad targets set by Jobcentre Plus and NHS Highland is to see 505 participants go through initial assessment. The service must see someone within 5 working days from a referral and provide an initial assessment within 10 working days. No specific measures are taken by Jobcentre plus on outcomes from the service. One of the measures that condition management practitioners would use is an increase in confidence. Participants are asked to complete a self-assessment form both prior to starting the programme and on completion. This form consists of four questions that ask the individual to state their own feelings about their confidence, their health, their feelings about work and a space for comments by both the individual and practitioner. An overall target is that individuals are work ready in terms of both their overall health and mental health. The service is aiming to introduce measurement tools (SF36 tool) by March/April 08 which will gauge impact on health and progression through the programme. Data collected will be fed into the larger NHS database (Skye system) and feed into an overall assessment of health improvement within the NHS.

d.Who will benefit from this piece of work?

How does this piece of work make a difference to patients, staff and/or the public in general?
Patients
The assessment process is jointly agreed with the practitioner and individual so achievements are identified by individuals and also progression made is self-reported by individuals. Aim is to help individuals become work ready
Staff
The programme benefits both staff from Jobcentre plus and NHS and provides valuable partnerships. It also offers a different approach and therefore opportunities for staff to engage in different ways of working. This also includes expanding knowledge and experience of working in a person centred approach using cognitive behavioural therapy
Public
Provides an answer for local businesses in meeting recruitment and retention of staff
Other

e. Why is this piece of work being impact assessed now?

Please tick one box

New piece of work / x / Existing piece of work / Annual review / Other

If “Other” Please give reason for impact assessing now

…………………………………………………………………………………......
…………………………………………………………………………………………………….

Step Two - What data and information do we have?

a. At this stage the group should share any information they have gathered about

equality and diversity issues that may help when carrying out step three, looking

at the impacts of this piece of work.

b. Use this table on this page and the following page to record any evidence that the group have gathered prior to the EQIA

Sources of evidence could be in house or from other sources including consultation
activities, surveys, research reports, academic research, complaints, grievances,
legal cases, media reports etc.

NOTE – Jobcente Plus have carried out an impact assessment on the Pathways to Work Service which will have been undertaken nationally. Contact John Reid for further details.

No further research or data evidence at this stage

c. How have people who will be impacted upon by this piece of work been involved in developing it up until now? Use the table below to describe who has been involved so far in setting up this piece of work and who has been consulted on its development or review.

Partnership working with Jobcente plus and NHS. Other links/networks such as employers and supported employment organisations e.g. Shirlie; ex-offenders; TAG. Service can usefully signpost individuals to the help they may need.
NHS/Jobcentre Plus steering group. Have consulted with Patient involvement team about better involvement with user group, but difficult to see how this could be done other than the individual person centred approach they already use. There is opportunity within the forms for customers to give feedback on the programme
The condition management programme is promoted within local areas and linked into local initiatives. There are plans to do some kind of event that will incorporate customers stories.

Step Three – Looking at impacts

Questions were raised about whether some of the policies and programmes that Jobcentre Plus run, that impact upon condition management, have been impact assessed?

There was a feeling that there were geographical differences in the programme and that the very rural and isolated nature of some of the communities served within Highland and Orkney presented challenges about providing the service to these communities. There was some discussion about whether the programme was limited to mainland Orkney at the moment rather than some of the outlying Islands.

There was also some discussion about how the programme might be promoted and whether this might make a difference to whether individuals selected to go onto condition management or not. The information provided about condition management and pathways generally is provided in both leaflet format and DVD, but there was some discussion about whether this was accessible for people who may have difficulties reading or no access to technology such as DVD players.

The use of video linking was also discussed and whether there needed to be a protocol about when it was necessary to close a video link with an individual if it became apparent that they were unable to effectively participate in it for whatever reason. This decision also needs to be made in a face to face meeting, but is sometimes more manageable than through video link. The question about how to manage what might be difficult behaviour due to the use of drugs and/or alcohol was raised and also how to work with individuals around these issues. Need to look at loan working policies and procedures.

The initial assessment is about listening to individuals and looking at a tailored approach, so individual needs can be responded to at this stage.

There was discussion about the screening process for Pathways and whether this had the potential to affect people differently. People who are either very close to the job market or due to health conditions furthest away are normally screened out – although any individual can voluntarily chose to participate in the programme.

The question was asked about finding out about why some people chose not to come onto the condition management programme or failed to attend appointments as this may again be something that is disproportionately affecting some individuals or groups.

Speak to Cameron ref commissioning research into the impact on the programme on equality groups??

1

d. Tables for recording issues that will have an impact

  • Two tables have been provided please copy this page if more tables are required

Please describe the issue that has been highlighted as having an effect on an equality group
Please include a description of the cause of the issue / Accessible Information
Discussion took place about accessing interpreters to help complete e.g. the self-assessment forms or throughout the process if needed. Help is already available to complete the self-assessment form, but quite a lot of the programme uses material in a workbook format and it was discussed as to whether this is accessible for people who may struggle with written communication for whatever reason. Requests have been made to provide this information in other languages and is also available on DVD and computer, although again this may depend on ability to access this equipment. Further action can be taken to ask these questions of people e.g. finding out how they would like to complete the programme and what format would be the most useful for them. Also need to look at what kind of communication support could be provided e.g. could explore availability of audio-books.
This also tied in with discussion about managing issues around individuals who find it difficult to find personal space and storage for items, which can at times contain quite personal details. People need to be able to find both a personal space to complete the workbook exercises and also somewhere safe to store it. This is particularly important for people living in shared accommodation such as a hostel for homeless people or supported accommodation for people with a learning disability for example.
Which group or groups are or could be impacted upon? / People with who struggle with written communication
People who have limited access to computers/DVD players
People who live in open accommodation such as hostels and supported accommodation
Will the effect be positive or negative? / (Please tick one box) PositiveNegative

1

a. Table for recording proposed changes to piece of work

What changes need to be made to lessen any negative effects
Impact assessments undertaken at Jobcentre plus – Underway
Use of tele/videoconferencing in care/support – Investigations underway to examine how this may be developed and delivered in partnership.
Use of alternative approaches to learning using audio/visual techniques other than reading – work underway with literacy highland to gather information about literacy and need.
Follow up provided in relation to DNAs to ensure any accessibility related reasons for non attendance can be addressed – Being undertaken by project staff
Increase awareness of homelessness and substance use issues and how they might impact on delivery of the project – Training session with Substance Use and Homelessness specialists underway
Lone worker policy impacts on staff in terms of increasing potential risk- impact assessment of policy as part of overall guidance review
Please describe what sources of information are being used to inform the changes being proposed / (Please tick all boxes that apply)
Staff Experience
Patient ExperienceResearch
Other  If “other” please describe
…Training from issue specific staff

Step five – Further information to check recommended changes

  • Please use the table below to record extra information needed to check out the changes that are needed or making sure that the group’s suggestions for change fit with current thinking

a. Table for recording details about further information required to inform proposed changes

Do you need to get any further information, in order to either
a) inform any of the proposed changes?
or
b) to verify any impacts or key issues?
Such information might be existing research, data from services, consult with equality groups or other people who use services / (Please tick one box)
YesNo
If “yes” please provide details below including name of person responsible for getting
the information. And the date by which such information will be provided
………………………………………………………….

1

Step six – Asking others what they think

This is the final part of the EQIA that can be completed at the first EQIA meeting.
Please ensure that you have agreed an approach for completing the rest of the EQIA.
This may mean taking some time now to go through sections 7-9 to prepare.
  • This section is for recording who will see and discuss the changes that the group are suggesting. Consulting with others about the EQIA is a legal requirement, as is consulting with others about changes in services.
  1. Please record below;

the different groups you will consult with e.g. NHS Highland, Other Agencies, members of the Public, Equality and Diversity Groups,

the different ways you will consult with these groups e.g. group email,

online forum, letter, telephone, focus group etc.

Initial EQIA document circulated to relevant staff teams

Step seven – Following up

As a result of the consultations and any further information, have any adjustments been made to the changes suggested by the group?

YesNo

Please provide details of what the group above have agreed to do as a result of the EQIA

Undertake changes / YesNo

e. Please complete the following table to describe how the EQIA of the piece of work will be monitored.

Monitoring timescale / Every 2 years  / Every year  / Every 6 months 
Who will monitor
Name of group or Individual / Staff Team

1