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Equality, Good Relations and Human Rights
Screening Template
Title: The Relocation of the consultant and nurse led Glaucoma service from the Royal Hospitals to the Shankill Health and Wellbeing Centre.
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***Completed Screening Templates are public documents and will be posted on the Trust’s website*** See Guidance Notes for further background information on the relevant legislation and for help in answering the questions on this template (follow the links).
(1) Information about the Policy/Proposal
(1.1) Name of the policy/proposal
The Relocation of the consultant and nurse led Glaucoma service from the Royal Hospitals to the Shankill Health and Wellbeing Centre.
(1.2) Is this a new, existing or revised policy/proposal? New
(1.3) What is it trying to achieve (intended aims/outcomes)? This policy aims to develop an appropriate pathway for patient assessment, diagnosis, treatment and on-going monitoring of patients with glaucoma or at risk of developing glaucoma to ensure consistent clinical standards, the targeting of low uptake, inequalities and improved outcomes for patients and carers.
It will involve the relocation of the consultant and nurse led Glaucoma service from the Royal Hospitals to the
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Shankill Health and Wellbeing Centre. This will enable the provision of a more holistic service. It is anticipated that the service will ensure that patients receive the right care and treatment in the right place at the right time by the right staff. Clinical staff delivering the service will be led by medical staff specialising in glaucoma who will be supported by a range of clinical staff. The new location is designed to facilitate easy access for all service users. Car-parking is free and is located directly beside the building with no barriers for service users. It is a new modern building with the Glaucoma service provided in one location on a main transport service route.
(1.4) How will the proposal be implemented?
It will be a phased approach with clinics moving over a period of four months.
(1.5) Are there any Section 75 categories (see list in 2.1) which might be expected to benefit from the intended policy/proposal?
People with sight impairment will benefit from a service that will be provided by a multidisciplinary team in a fully DDA compliant building in a much more enhanced and user friendly accessible environment.
(1.6) Who owns and who implements the policy/proposal?
BHSCT
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(1.7) Are there any factors that could contribute to/detract from the intended aim/outcome of the policy/proposal/decision? (Financial, legislative or other constraints?)
No
(1.8) Who are the internal and external stakeholders (actual or potential) that the policy/proposal/decision could impact upon? (staff, service users, other public sector organisations, trade unions, professional bodies, independent sector, voluntary and community groups etc).
The NI population ( prevalence of glaucoma – 2% of 40-75 age pop and 10% of 75+age pop ; 12% of blind registrations are for glaucoma; approximately 50% of people with glaucoma remain undiagnosed);
Patients with glaucoma, their families and carers
People in families with a history of glaucoma
Voluntary sector organisations (eg Royal National Institute for Blind People, Guide dogs for the Blind Assoc.)
Hospital and community based staff across a range of relevant professions including ophthalmology,
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optometry, orthoptics, nursing technicians, service managers, medical records, social workers for people with sensory impairment, rehabilitation workers, eye clinic liaison officers etc
Primary care practitioners including General Ophthalmic Services (GOS) optometrists and GPs;
Health and Social Care Board (HSCB) Commissioners
Department of Health and Social Services and Public Safety NI (DHSSPSNI) policy makers.
Service users, nursing, medical optometry, admin and clerical staff.
RNIB
(1.9) Other policies/strategies/information with a bearing on this policy/proposal (for example internal or regional policies) - what are they and who owns them?
NICE Clinical Guideline 85 Glaucoma, April 2009 DHSSPSNI proposed Regional Eye Care Strategy ( draft March 2011) Nice Quality Standards for Glaucoma ( issued for consultation Nov – Dec 2010) National Patient Safety Agency Rapid Response Report. 11 June 2009 –
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“ Preventing Delay to Follow Up for Patients with Glaucoma” World Health Organisation Vision 20:20 Strategy The Trust New Directions Strategy
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(2) Available Evidence / Needs, Experiences and Priorities
(2.1) Taking into account the information above what are the different needs, experiences and priorities of each of the Section 75 categories for both service users and staff.
Please note there are separate tables for Service Users and staff.
Service Users
Category
Details of evidence/information
Service users Belfast/ Castlereagh population as a whole
Service users affected Needs, Experiences & Priorities
Gender Female Male
51% 49% *2011 census
52%
48%
There is a slightly higher percentage of female patients, however, the service is provided according to the needs of each individual patient, therefore, there will not be an
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adverse impact in terms of gender.
Age
0-16 16-24 25-34 35-44 45-54 55-64 65+
22% 11% 12% 14% 14% 12% 15% *2011 census
AGE RANGE
AMOUNT OF NEW PATIENTS WAITING FOR APPT
0-16 0
16-24 2
25-35 0
35-44 19
45-54 38
55-64 52
65+ 68
The majority of patients are aged 45 plus with the highest numbers aged 65 plus. Due to the nature of the service it is likely that it will impact on older patients.
NISRA statistics on people with a Disability show that 41% of those aged between 60 and 74 have a disability and of those aged 75+, 60% have a disability. NISRA statistics also show that 54.39% of the 60 plus age group have a long term limiting illness (Source NISRA T48 Age – People,
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Family and Households.)
Religion
Protestant Roman Catholic No Religion or No Religion Stated
42% 41% 17% *2011 census
This data Is not collected, however, census 2011 statistics on the Belfast/Castlereagh population as a whole indicate that the majority of users would be from either the Protestant or Roman Catholic communities with a slightly higher percentage of Protestants and a minority of the population (17%) have no or no stated religion.
Census 2011 statistics for Belfast and Castlereagh indicate that the majority of people win this area are from the Protestant and Roman Catholic religions with a small percentage of people that have no religion or have not stated one. Relating these statistics to the patients that attend Glaucoma services at the Royal Hospitals, it is probable that the percentages would be similar.
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However, the service is provided according to the need of each patient and there is no indication that there would be an adverse impact in terms of religion.
The Belfast Trust is committed to promoting good relations in the areas of race, religion and political opinion and has a number of measures in place to ensure that each patient feels safe and is cared for in a neutral and harmonious environment. The Trust has a Good Relations strategy
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which was endorsed by the BHSCT Board and includes a Good Relations statement that will be displayed in all Trust facilities. The statement expresses BHSCT’s commitment to providing an environment where Health and Social Care is provided in a safe and welcoming environment. The Trust also has a harmonious working environment policy for staff and a policy that all staff must receive equality, good relation and human rights
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training.
Political Opinion
Broadly Unionist Broadly Nationalist Other Do not wish to answer/Unknown
48.3% 45.4% 2.3% 4% * 2011 Assembly election
This The Belfast Health and Social Care Trust do not currently ask service users for their political opinion.
Belfast District Council Election results in May 2011 do give some indication of political opinion.
Belfast District Council Election results May 2011
DUP 15 seats Sinn Fein 16 seats Alliance 6 seats SDLP 8 seats UUP 3 seats PUP 2 seats Other 1 seat ESRC (Economic & Social Research Council) data Is not collected,
Political opinion is not collected. Whilst in Northern Ireland there has traditionally been a correlation between religion and political opinion, It Is not anticipated that the proposal would have an adverse impact in terms of political opinion. Please see the section on Religion that refers to BHSCT’s commitment to promoting good relations in terms of race, religion and political opinion. A
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communication and consultation exercise has been implemented by the BHSCT with a number of patients that may be affected by this proposal. Patients have been encourage to express, concerns, opinions and views etc, in terms of Section 75 legislation. Please see section ? on consultation. The BHSCT is also committed to the promotion of good relations in the areas of race, religion and political opinion, please see these sections above.
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Marital Status Single Married Other/Not known
36% 47% 17% *2011 census
This information is not available, please see Census 2011 statistics for Belfast and Castlereagh area.
The service is provided according to the needs of each individual patient, therefore, it Is not anticipated there would be an adverse impact in terms of marital status.
Dependent Status
Caring for a child dependant older person/ person with a disability
None
Not known
12% of usually resident population provide unpaid care
* 2011 census
This information is not available, please see Census 2011 statistics for Belfast and Castlereagh area.
Disability
Yes No Not known
21% 69% n/a *2011
This information is not recorded. Statistics produced by Disability Action Northern Ireland, state that 1 in 5 of the population in NI have a disability or 20% of the population.
Due to the nature of the service users, there is and will continue to be high attendance
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census Statistics Research Agency statistics show that 45.64% of people in the 50 plus age group have a long term limiting illness (NISRA T46 Age – People, Family and Households). 2011 census statistics indicate that 21% of the population have a disability.
rate of persons with disabilities which may include people with hearing impairment or visual problems. Northern Ireland Statistics and Research Agency (NISRA) carried out a Northern Ireland Survey of Activity Limitation and Disability (NISWALD) which reported early in 2007: Results from NISWALD have found that in 2006/07 18% of all people living in Northern Ireland have some degree of disability, The prevalence rate for adults is 21% and
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6% for children.
The proposal involves the service being provided in a different location that is a new building designed to meet the needs of people with disabilities and is DDA compliant. The new location is premises are located in a central location which is accessible to all public transport. It is, therefore not anticipated that the proposal would have an adverse impact in terms of disability. This proposal will also be treated as an on-going screening to be
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monitored over a 6 month period to monitor for any unforeseen adverse impact.
Ethnicity
White Black/Minority Ethnic Not known
98.21% 1.8% n/a *2011 census
This information is not available, however,
Arabic 3
According to 2011 census statistics the majority of people in the Belfast and Castlereagh area are white with 1.8% from a black or minority ethnic background. Interpreting statistics for the NIRHSC Interpreting service indicate that
It is not anticipated that the proposal would have an adverse impact in terms of ethnicity. Trust staff are
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Bengali 1
Chinese - Cantonese 20
Chinese - Hakka 2
Chinese - Mandarin 9
Latvian 1
Lithuanian 31
Polish 37
Portuguese 11
Romanian 4
Slovak 1
Tetum 1
Total 121
required to attend equality, diversity, good relations and human rights training. Staff are also aware of the NIRHSC interpreting service and the BIG Word 24 hour telephone interpreting service. The BHSCT is also committed to the promotion of good relation sin the areas of race, religion and political opinion, please see these sections above.
Sexual Orientation
Opposite sex
Same sex/Same and Opposite sex
Do not wish to answer/Not known
The general view in NI is that an estimated 6-10% identify as lesbian, gay,
This information is not available, please see Census 2011 statistics for Belfast and Castlereagh area.
The service is provided according to the needs of each person. All Trust staff are required to attend mandatory
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bisexual
*2012 report by Disability Action & Rainbow Project
equality, diversity and good relations and human rights training which incorporates sexual orientation.
It is not anticipated that there would be an adverse impact in terms of sexual orientation.
Staff
Category
Details of evidence/information
This proposal will involve the relocation of 4 staff over the 4 month period. Due to the small number of staff and to ensure confidentiality, , it is not possible to provide Section 75 information. There has been consultation with Trade Unions and the staff involved. All staff has agreed to the relocation and have not identified any adverse impact in relation to Section 75..
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Staff Trust workforce January 2013
Staff affected
Needs, Experiences & Priorities
Gender Female Male
79% 21%
Age
<25 25-34 35-44 45-54 55-64 65+
4% 26% 26% 29% 13% 2%
Religion
Protestant Roman Catholic Not known/Other
45% 50% 5%
Political Opinion Broadly Unionist Broadly Nationalist Other No answer Unknown
7% 6% 7% 25% 55%
Marital Status Single Married Other
38% 57% 3%
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Not known 2%
Caring Responsibilities
For an adult For a child For a person with a disability None Not known
2% 18% 1% 19% 60%
Disability
Yes No Not known
2% 66% 32%
Ethnicity White Black/Minority Ethnic Not known
78% 4% 18%
Sexual Orientation
(towards people of the)
Opposite sex Same sex/Same and Opposite sex Do not wish to answer/Not known
36% 1%
63%
(2.2) Provide details of how you have involved stakeholders, views of colleagues, service users and staff etc when screening this policy/proposal.
Consultation via meetings were carried out with staff and Trade Unions.
RNIB were consulted with via meetings
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Public Health Agency
Health and Social Care Board.
High Street Optometrists
All service users that attended appointments over the last 6 months with consultants and specialist nursing staff were informed about the proposed service relocation and encouraged to provide feedback in terms of impact. Feedback from service users was recorded.
New patients that contacted the appointment office to confirm their appointment date were advised of the proposed move of the clinic location. A letter and an information leaflet was sent to all new and review patients providing information on the proposed new location and transport services, car-parking arrangements etc. The letter also provided information on Section 75 legislation and invited service users to provide information to the Trust in relation to impact with regard to Section 75. To date there has been no communication received from service users that indicates that the proposed relocation of Glaucoma services will have an adverse impact.
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(3) Screening Questions
You now have to assess whether the impact of the policy/proposal is major, minor or none. You will need to make an informed judgement based on the information you have gathered.
Staff
(3.1)What is the likely impact of equality of opportunity for those affected by this policy/proposal, for each of the Section 75 equality categories?
Section 75 Category
Details of policy/proposal impact
Level of impact? Minor/major/none
(3.2) Are there opportunities to better promote equality of opportunity for people within Section 75 equality categories? If yes, provide details. If no, provide reasons.
Gender
None
Age
None
Religion
None .
Political Opinion
None
Marital Status
None
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Dependent Status
None
Disability
None
Ethnicity
None
Sexual Orientation
None
Service Users
(3.1) What is the likely impact of equality of opportunity for those affected by this policy/proposal, for each of the Section 75 equality categories?
Category
Details of policy/proposal impact
Level of impact? Minor/major/none
(3.2) Are there opportunities to better promote equality of opportunity for people within Section 75 equality categories? If yes, provide details. If no, provide reasons.
Gender
None
Age
None
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Religion
Minor The proposal is to relocate Glaucoma services to the Shankill Health and Wellbeing Centre. The Belfast Trust is committed to ensuring that each of its facilities are neutral, safe and welcoming to all service users. In order to achieve this, the Trust has developed a good relations strategy which includes a number of actions and projects which include a Good Relations statement that will be visible in all Trust facilities. The statement expresses BHSCT’s commitment to providing an environment where Health and Social Care is provided in a safe and welcoming environment. The Trust also has a harmonious working environment policy
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for staff and a policy that all staff must receive mandatory equality, diversity good relation and human rights training. The Trust is committed to working in partnership with staff, service users, the community, statutory organisations and voluntary and community organisations to ensure that service users receive the highest quality of health and social care in the right place at the right time in a neutral, safe and welcoming environment. This proposal will be monitored over a 6 month period to assess impact.
Political Opinion Minor As above
Marital Status None
Dependent Status None
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Disability
None The proposal involves the service being provided in a different location that is a new building designed to meet the needs of people with disabilities and is DDA compliant. The new location is located in a central location which is accessible to all public transport. This proposal will also be treated as an on-going screening to be monitored over a 6 month period to monitor for any unforeseen adverse impact.
Ethnicity
None
Sexual Orientation None
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(3.3)
To what extent is the policy/proposal likely to impact on good relations between people of different religious belief, political opinion or racial group? Minor/major/none
Good relations category
Details of policy/proposal impact Level of impact Minor/major/none
Religious belief Please see religion and political opinion in sections 2.1 and 3.1
Minor
Political opinion Minor
Racial group None
(3.4)
Are there opportunities to better promote good relations between people of different religious belief, political opinion or racial group?
Good relations category Please provide details
Religious belief
Please see section 2.1 and 3.1
Political opinion
Racial group
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(4) Is there an opportunity to better address the health and social inequalities of groups/areas in greatest social, economic or educational need by altering the policy/decision?
Suggestions
The service is aimed at providing the highest standard of service to all service users and all service users will benefit from the holistic approach provided by the service. It is probable that a number of service users may have a disability and/or may be disadvantaged and live in an area of deprivation, this service is aimed at improving health and reducing health and social inequalities.
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(5) Consideration of Disability Duties
How does the policy/proposal or decision currently encourage disabled people to participate in public life and promote positive attitudes towards disabled people? Consider what other measures you could take.
Due to the nature of the service it promotes positive attitudes towards people with disabilities and is designed to enhance the experience of those service users with glaucoma. The new premises at the Shankill Health and Wellbeing Centre is designed to accommodate the needs of service users with a disability and is DDA compliant. The Belfast HSC Trust is committed to the promotion of the DDA and Section 75 disability duties and disability awareness training is available to all staff. In line with the above duties the Trust developed a 5 year Disability Action Plan which went out for public consultation and was endorsed by Trust Board. The actions in the Disability Acton Plan are monitored by the Trust Disability Steering Group. The Trust also has developed an Employers Disability Forum for staff which seeks to ensure implementation of the disability duties and improve the health and wellbeing of staff with a disability and reduce health inequalities.
For example, have your staff received disability equality training or training on the Trust’s Patient and Client Experience Standards?
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(6) Consideration of Human Rights (6.1) Does the policy/proposal affect anyone’s human rights in a positive, negative or neutral way? Complete for each of the articles
Article
Positive impact
Negative impact = human right interfered with or restricted
Neutral impact
Article 2 – Right to life
Article 3 – Right to freedom from torture, inhuman or degrading treatment or punishment
Article 4 – Right to freedom from slavery, servitude & forced or compulsory labour
Article 5 – Right to liberty & security of person
Article 6 – Right to a fair & public trial within a reasonable time
Article 7 – Right to freedom from retrospective criminal law & no punishment without law
Article 8 – Right to respect for private & family life, home and correspondence.
Article 9 – Right to freedom of thought, conscience & religion
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Article 10 – Right to freedom of expression
Article 11 – Right to freedom of assembly & association
Article 12 – Right to marry & found a family
Article 14 – Prohibition of discrimination in the enjoyment of the convention rights
1st protocol Article 1 – Right to a peaceful enjoyment of possessions & protection of property
1st protocol Article 2 – Right of access to education
Please note: If you have identified potential negative impact in relation to any of the Articles in the table above, speak to your line manager and/or a representative from the Equality Team. It may also be necessary to seek legal advice.
(6.2) Please outline any actions you will take to promote awareness of human rights and evidence that human rights have been taken into consideration in decision making processes.
The Belfast HSC Trust is committed to the promotion of Human Rights for all staff and service users. All staff must attend mandatory equality, diversity, good relations and human rights training.
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(7) Screening Decision
(7.1) Given the answers in Section 4, how would you categorise the impacts of this policy/proposal?
Major impact
Minor impact
No impact
(7.2) Do you consider the policy/proposal needs to be subjected to ongoing screening?
Yes
No
A full Equality Impact Assessment (EQIA) is usually confined to those policies or decisions considered to have major implications for equality of opportunity.
(7.3) Do you think the policy/proposal should be subject to an Equality Impact Assessment (EQIA)?
Yes
No
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(7.4) Please give reasons for your decision.
The proposal involves the Relocation of the Glaucoma service from the Royal Hospitals to the Shankill Health and Wellbeing Centre. The aim is to develop an appropriate pathway for patient assessment, diagnosis, treatment and on-going monitoring of patients with glaucoma or at risk of developing glaucoma to ensure consistent clinical standards, the targeting of low uptake, inequalities and improved outcomes for patients and carers. It will enable the provision of a more holistic service and is aimed at ensuring that patients receive the right care and treatment in the right place at the right time by the right staff. Clinical staff delivering the service will be led by medical staff specialising in glaucoma who will be supported by a range of clinical staff. The new location is designed to facilitate easy access for all service users. The Shankill Health and Wellbeing Centre offers better car-parking which is free and it is located directly beside the building with no barriers for service users. It is a new modern building which is DDA compliant and user friendly for people with disabilities. It is 1.4 miles from the previous location of the service at the Royal Hospitals. The Glaucoma service will be provided in one location on a main transport service route.
(7.5) If you have identified any impact, what mitigation have you considered to address this? The new location may be traditionally perceived by some service users as a single identity area. However, with the political and social legacy of the peace process and the development of normalisation in Northern Ireland, it Is not anticipated that the proposal would have an adverse impact in this respect. Belfast Trust is committed to the promotion of good relations and ensuring that staff and service users feel comfortable and safe accessing each of its facilities. A recent survey carried out by the Trust as part of the development of its Good Relations strategy revealed that 96% of users felt comfortable accessing any of Trust services and buildings irrespective of their race religion or political opinion. A number of projects and measures have been incorporated into the Trust Good Relations Strategy which are aimed at the promotion of good relations, ensuring access to services and facilities and reducing inequalities. All Trust staff attends mandatory equality, diversity, good relations and human rights training aimed at ensuring that staff and service users are treated with respect and dignity and all locations are regarded as safe, welcoming and accessible.
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(8) Monitoring. In line with the guidance, you will be obliged to monitor this policy every 2 years.
Please detail how you will monitor the effect of the policy/proposal for equality of opportunity and good relations, disability duties and human rights?
DNA rates / referral rates / waiting lists.
Complaints
Feedback from staff /users– which will be reported to the Health and Social Inequalities Team annually for two years.
Approved Lead Officer: Stephen Boyd
Position: Service Manager
Date: 12 March 2013
Policy/proposal screened by
Equality Manager: Veronica McEneaney
Employment Equality Manager:
Miriam Gibson
Please forward completed schedule to [email protected]