9 - HSCP Equalities Outcome Plan 22-25
North Ayrshire Council · 16 March 2023
Back to Integration Joint Board — 16 March 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
North Ayrshire Integration Joint Board 16th March 2023 Subject : HSCP Equality Outcomes Plan (2022-25) Purpose : • Awareness • Approval Recommendation : IJB review the contents of the attached Equality Outcomes Plan for the period 2022-25. IJB to provide approval for publication and implementation of the plan. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership PSED Public Sector Equality Duty EHRC Equality and Human Rights Commission IJB Integration Joint Board 1. EXECUTIVE SUMMARY 1.1 As a registered public body, North Ayrshire Integration Joint Board (IJB) is required to publish a set of Equality Outcomes, demonstrating how it intends to improve the lives of people with protected characteristics. 1.2 North Ayrshire IJB previously published a set of equality outcomes in April 2021 which aligned with the one-year strategic bridging plan for 2021-22. Following guidance from the Equality and Human Rights Commission (EHRC) we have developed a more focused set of equality outcomes that more closely reflect our primary service user groups. 1.3 The draft Equality Outcomes Plan 2022-25 has now been prepared and is attached with this covering paper. The new Equality Outcomes Plan must be published by 31st March 2023.
Page 2
2. BACKGROUND 2.1 As a registered public body, Integration Joint Boards are required to comply with the Public Sector Equality Duty (PSED) as set out in the Equalities Act (2010). To meet the PSED, public bodies are obligated to comply with both General and Specific Duties. 2.2 In meeting the General Duty public bodies must ensure that in their day-to-day practice they act to: o Eliminate unlawful discrimination, harassment and victimisation and other prohibited conduct. o Advance equality of opportunity between people who share a relevant protected characteristic and those who do not. o Foster good relations between people who share a protected characteristic and those who do not. 2.3 In undertaking specific equality duties public bodies must: o Publish a set of equality outcomes which it considers would enable it to better perform the general equality duty. These must be reviewed within four years of initial publication. o Assess relevant policies, procedures, and practices through Equality Impact Assessment In addition to those duties listed above, public bodies must publish a report on progress towards identified outcomes and how the organisation is mainstreaming its equality duty. The publications must be in a fully accessible format. 2.4 In 2017, North Ayrshire Health and Social Care Partnership (HSCP) as part of the Ayrshire Equality Partnership (AEP) produced a joint set of Equality Outcomes. These consisted of four, high level outcomes and were adopted by most AEP partners. These outcomes were that, in Ayrshire: 1. people experience safe and inclusive communities. 2. people have equal opportunity to access and shape our public services. 3. people have opportunities to fulfil their potential throughout life. 4. public bodies will be inclusive and diverse employers. 2.5 In working towards these outcomes, the AEP produced joint action plans to produce a more cohesive approach to Equalities across Ayrshire. However, while initially supportive of the overall approach, later feedback from EHRC suggested that the four Ayrshire outcomes were not specific enough to be truly meaningful. 2.6 EHRC advised that Equality Outcomes must be specific in their approach, looking at addressing specific need or issues. They should not be generic or universal in their approach. In summary, equality outcomes should focus on improving the lives of those with protected characteristics.
Page 3
2.7 In response, AEP members decided to set additional more organisational specific Equality Outcomes but agreed to maintain the four high level Ayrshire outcomes. 2.8 In April 2021, North Ayrshire IJB published a new local set of eight equality outcomes. A progress report in relation to this plan is currently being developed and will be presented to IJB in due course. 2.9 On reviewing the 2021 equality plan and following further EHRC advice (para 2.6), a smaller and more focussed set of Equality Outcomes have been identified for publication. 2.10 The draft Equality Outcomes Plan 2022-25 is now ready for publication. The plan sets out how the HSCP will continue to mainstream equality practice into our day-today business. Our set of Equality Outcomes will cover the reporting period of this plan from April 2022 to April 2025. They are: 1. People with complex care needs are supported to live independently at home for as long as possible. 2. People and communities who make North Ayrshire their home can effectively access the health and social care services they need. 3. Children and families in need are supported to live healthy and safe lives. 4. Through improved engagement practices and access to a greater range of health and social care opportunities, people with a learning disability, or those with complex health conditions, achieve better health outcomes. 3. PROPOSALS 3.1 The Equality Outcomes Plan identifies 4 Equality Outcomes for the partnership to address over the lifetime of the plan (2022-25). As per guidance from EHRC these outcomes are more focussed on specific protected groups. The plan also provides a supporting action plan that will help progress towards the identified outcomes. It is proposed that IJB review the contents of the attached Equality Outcomes Plan for the period 2022-25 and provide approval for publication and implementation of the plan. 3.2 Anticipated Outcomes 3.2.1 It is anticipated that through adoption of the identified equality outcomes and implementation of the associated action plan, North Ayrshire IJB will comply with the Public Sector Equality duty and provide effective supports to local people and service users with protected characteristics.
Page 4
3.3 Measuring Impact 3.3.1 To support the delivery of these outcomes, an action plan has been produced drawing on from existing actions with the HSCP Strategic Plan and from additional planned activity identified through facilitated team discussions. 3.3.2 As per national guidance, public bodies are required to publish a progress and mainstreaming report every two years. As such, a mainstreaming report will be published by April 2025. 4. IMPLICATIONS 4.1 Financial None. 4.2 Human Resources None. 4.3 Legal By publishing a set of equality outcomes, the IJB remains compliant with the Public Sector Equality Duty. 4.4 Equality/Socio-Economic The outcomes plan outlines the key processes and actions the IJB/HSCP will undertake to support those in North Ayrshire who possess a protected characteristic. The plan includes what the HSCP does on a to mainstream equalities into everyday business as well as identifies key equality outcomes that focus action to support those with protected characteristics. 4.5 Risk The report falls in line with the agreed risk appetite statement which is low-risk appetite in respect to adherence to compliance duties. 4.6 Community Wealth Building None. 4.7 Key Priorities The Equality Outcomes Plan aligns with the IJB Strategic Plan, ‘Caring Together’. A key focus of the strategic plan is to improve equality of health outcomes across North Ayrshire and address local inequalities.
Page 5
5. CONSULTATION 5.1 The plan has been presented to a number of HSCP Leadership groups for review and comment: • 24th Jan 2023 – Health and Community Care Senior Management Team • 25th Jan 2023 – Mental Health and Learning Disability Senior Management Team • 31st Jan 2023 – Children, Families and Justice Senior Management Team • 31st Jan 2023 – North Ayrshire Strategic Planning Group • 09th Mar 2023 – Partnership Senior Management Team Caroline Cameron, Director Scott Bryan, Interim Programme Portfolio Manager - Strategy, sbryan@north- ayrshire.gov.uk Appendices • Appendix No, North Ayrshire HSCP – Equality Outcomes Plan 2022-25 (Draft)
Page 6
0 With EQUALITY OUTCOMES PLAN 2022-25 North Ayrshire Health and Social Care Partnership
Page 7
1 Contents Introduction ............................................................................................................................................ 2 Diversity in North Ayrshire .................................................................................................................. 2 North Ayrshire Health and Social Care Partnership ................................................................................ 3 Our Strategic Direction 2022-30 ............................................................................................................. 4 Related strategies ............................................................................................................................... 5 Equality Act and the Public Sector Equality Duty ................................................................................... 6 General Duties .................................................................................................................................... 6 Specific Duties ..................................................................................................................................... 6 Mainstreaming our equality duty ........................................................................................................... 8 Equality Outcomes ................................................................................................................................ 11 Ayrshire Shared Equality Outcomes ................................................................................................. 11 NA HSCP Local Equality Outcomes .................................................................................................... 12 Equality Outcomes Supporting Actions ............................................................................................ 14 Equality Outcome 1: Older people with complex care needs are supported to live independently at home for as long as possible ..................................................................................................... 14 Equality Outcome 2: People and communities who make North Ayrshire their home can effectively access the health and social care services they need. ................................................ 15 Equality Outcome 3: Children and families in need are supported to live healthy and safe lives. .............................................................................................................................................. 16 Equality Outcome 4: Through improved engagement practices and access to a greater range of health and social care opportunities, disabled people, or those complex health conditions, achieve better health outcomes. .................................................................................................. 17 Appendix ............................................................................................................................................... 19 Appendix A - Acronym Directory .................................................................................................. 19 Appendix B – Diversity in North Ayrshire (2019) – Infographic .................................................... 20 Appendix C: General Equality Duties and Protected Characteristics ............................................ 21 Appendix D: National Health & Wellbeing Outcomes .................................................................. 22 Appendix E - Ayrshire Equality Outcome Partners ....................................................................... 24 Appendix F - Equality Outcomes Map ........................................................................................... 25
Page 8
2 Introduction In April 2022, North Ayrshire Health and Social Care Partnership published its longer-term Strategic Plan, ‘Caring Together’ 2022-30. This was the first time the Partnership set out a strategic vision beyond a three-year medium term. The plan sets our vision and priorities for improving the health and wellbeing of local people. In 2021, we published a local set of eight equality outcomes. More information on progress made towards those outcomes can be found in our Equality Outcome and Mainstreaming report 2021-22 published on our website: https://tinyurl.com/ye5abj5b. Following the publication of Caring Together, we have now identified a new Equality Outcome set which aligns with our overall strategic plan. However, while the strategic plan is universal in its approach, aiming to support all residents of North Ayrshire, this Equality Outcomes plan provides greater focus on how we intend to improve the lives of those who possess protected characteristics. By its very nature, the HSCP engages with and supports a variety of people with different support needs on a day-to-day basis, many of whom fall under the banner of protected characteristic. This plan sets out how we intend will focus our support on individuals with protected characteristics. National guidance on setting equality outcomes notes that these should be proportionate and relevant to the strategic priorities of the organisations setting them. Following advice from the Equality and Human Rights Commission (EHRC), we have revised our Equality Outcomes for this new planning cycle reducing the number of outcomes from eight to four. The purpose of this revision is to ensure we provide greater focus on concerns facing specific equality groups. Diversity in North Ayrshire As of 2021, North Ayrshire is home to an estimated 134,220 people. Within this group exists a wide range of diversity and identities. Most people in Ayrshire will possess at least one protected characteristic (see page 6 for more information). The annual Scottish Household Survey provides a sample of protected characteristics in North Ayrshire. An infographic showing the diversity in North Ayrshire from the 2019 survey (the most recent publication) can be found in Appendix B.
Page 9
3 North Ayrshire Health and Social Care Partnership North Ayrshire Health and Social Care Partnership (the Partnership) provides locality-based health and social care services for people throughout their life: from birth through childhood, teenage years and adulthood. Our services areas include: • Children, families and justice services, • Adult health and community care services and • Mental health, addictions and learning disability services Our teams include Allied Health Professionals (dieticians, physiotherapists, occupational therapists, speech and language therapists), addictions workers, care at home, care homes, child immunisation, community alarm and digital health, community link workers, money matters, nurses (including specialist nurses), paid carers, psychologists and psychiatrists, social workers (across all age groups), residential adult & childcare staff and volunteers. In addition, dentists, GPs, optometrists and pharmacists (primary care professionals) work together with us. We also work closely with the Third sector, the Independent sector, Housing Services, NHS acute hospitals, Alcohol and Drug Partnerships, Ayrshire wide Partnerships, Police Scotland, local councillors, and many others. We want to ensure all people in North Ayrshire can access community support in their locality and as required, contact the right health and social care professional, at the right time. We all work together to provide high quality, safe and sustainable care, as seamlessly as possible for the person needing support. Lead Partnership Arrangements The Partnership also delivers a Lead Partnership role across all of Ayrshire, which describes what primary care services the North Ayrshire Integration Joint Board (IJB) will manage on behalf of NHS Ayrshire & Arran (NHSA&A). This is also true in East and South Ayrshire, where both council authorities have their own delegation schemes with NHSA&A. Across Ayrshire, the following services are managed by a lead partnership: • Primary Care Services (GP practices, Dentistry, Optometry) are managed by East Ayrshire HSCP • Mental Health Services (Psychiatry, CAMHS, Inpatient Services) and Children’s Health Visiting Service are managed by North Ayrshire HSCP • Integrated Continence Services, Joint Equipment Store, and Family Nurse Partnership are managed by South Ayrshire HSCP Further information in relation to Ayrshire’s lead partnership arrangements can be found in our joint Lead Partnership Statement. https://tinyurl.com/2aaemxym
Page 10
4 Our Strategic Direction 2022-30 Published in April 2022, the Partnership’s Strategic Plan, ‘Caring Together’ 2022-30, sets out our commitment to achieving our vision that, “People who live in North Ayrshire are able to have a safe, health and active life”. The plan can be found on our website: https://tinyurl.com/9mmexs4x As part of our engagement work in developing this plan, we asked local people to tell us what values they would expect to see from a Health and Social Care organisation. They told us they expect us to embody: Care, Empathy, and Respect o By being a Caring Partnership, we look after and support the health and wellbeing needs of those who require it. o By showing Empathy, we understand the needs, wishes and concerns of people accessing our services as we support them on their care journey. o By showing Respect, we see people accessing services as unique individuals and actively involve them, and their family, in the planning and delivery of their care. Going forward, the Partnership will strive to embody these values. The plan recognises that many people living in North Ayrshire experience health and wellbeing concerns that are often disproportionate to others living in their community. We understand that an individual’s unique characteristics and background can have a significant impact on achieving positive health and wellbeing outcomes. Through its strategic plan, the Partnership hopes to improve health and wellbeing standards of all people across North Ayrshire, particularly focussing on our more vulnerable groups. To help achieve our vision, we have identified five strategic priorities for action: These priorities do not exist independently of each other. Instead, the priorities are interlinked and success against one priority is likely to positively impact against others. To support these priorities, our services identified a number of long-term ambitions that they hope to achieve in order to support everyone in North Ayrshire to live safe and healthy lives. Some of the ambitions, that are more relevant to protected groups include: o Ensuring children and young people can grow up in loving and nurturing environments, with families receiving the right support when they need it. o People with mental health concerns receive the support they need in their own communities. o Our workforce is ready and able to meet the health and social care needs of people now, and are always planning for future demand. Enable Communities Provide Early and Effective Support Develop and Support our Workforce Improve Mental and Physical Health and Wellbeing Tackle Inequalities
Page 11
5 o People who require support are at the heart of their care and are able to make informed choices about the service they receive. o People moving between key life, or transitions stages in health and social care are effectively supported. o Older people are able to be supported effectively at home, with little to no waiting times for assessment or receiving care. o We will enhance our community engagement approaches to ensure the voice of local people, particularly those with lived experience are used to help shape and improve our services. The full set of ambitions can be found in our strategic plan, which also outlines the key strategic actions that will be undertaken to achieve them. Related strategies Our endeavours to meet these equality outcomes will be underpinned by several relevant strategies and policy directions including: • North Ayrshire HSCP Strategic Plan, ‘Caring Together’ 2022-30: https://tinyurl.com/9mmexs4x • The Promise: https://thepromise.scot/plan-21-24-pdf-spread.pdf • Caring for Ayrshire programme: https://tinyurl.com/4mxf5ey6 • Mental Health Strategy 2017-27: https://tinyurl.com/2p8jxzek • Learning Disability Strategy – Towards Transformation: https://tinyurl.com/3tsu83r6 • Public Health Scotland Strategic Plan (2020-23): https://tinyurl.com/87n2zps • Independent Review of Adult Social Care in Scotland: https://tinyurl.com/4z5rja59 • Coming Home Report 2022 (improving care for people with complex needs and learning disabilities) https://tinyurl.com/5242y3h9 • North Ayrshire Children’s Service Plan 2020-23 https://tinyurl.com/5n7ptzcu By contributing to each of these plans we will seek to actively improve the access to and quality of public services for all.
Page 12
6 Equality Act and the Public Sector Equality Duty Obligations on Integration Joint Boards As a public authority identified in the Equalities Act 2010, North Ayrshire Integration Joint Board (IJB) must comply with the General and Specific Duties as set out in the Act. General Duties The Act sets out general duties for every public authority to have due regard. The General Duties place an obligation on public bodies to: o Eliminate unlawful discrimination, harassment and victimisation and other prohibited conduct. o Advance equality of opportunity between people who share a relevant protected characteristic and those who do not. o Foster good relations between people who share a protected characteristic and those who do not. The general duties apply to every function within our organisation, including how we plan and deliver frontline services, our role in policy making and in how we procure and contract services from outside agencies. The Act refers to this as ‘mainstreaming equality’. The public sector equality duty covers the following protected characteristics (see Appendix C for further definitions): • Age • Pregnancy and maternity • Disability • Sexual orientation • Race • Gender reassignment • Religion or belief • Marriage and civil partnerships • Sex Specific Duties Specific duties have been designed to help authorities meet the three needs outlined in the general duty. Due to the legislative structure of Integration Joint Boards (IJB), Health and Social Care Partnerships are exempt from certain specific duties. This is due to the unique structure of Integration Boards in that they are not employing bodies. IJBs direct the strategy and operations of Primary Health Care and Social Care services, all staff members remain employees of either NHS Ayrshire and Arran or North Ayrshire Council. North Ayrshire Health and Social Care Partnership must: o Publish a report on how it has mainstreamed equality into the day-to-day operations of the organisation o Publish a set of equality outcomes which it considers would enable it to better perform the general equality duty. These must be reviewed within four years of initial publication
Page 13
7 o Publish a report on progress towards these outcomes o Make any reports published fully accessible to all o Assess relevant policies, procedures and practices through Equality Impact Assessment In terms of our current reporting obligations, IJBs need not: o Gather and use employee information; o Publish gender pay gap information; o Publish statements on equal pay; o Publish information on board diversity* However, while we are not required to report on specific duties in relation to employees, we will work closely with North Ayrshire Council and the Board of NHS Ayrshire & Arran to ensure our staff are treated in a fair and equitable manner. *In relation to the publishing of board diversity information, this aspect of the Public Sector Duty has now been legislated but is yet to be implemented.
Page 14
8 Mainstreaming our equality duty North Ayrshire Health and Social Care Partnership is dedicated to improving the health and wellbeing of local people. In doing so, we work together with other key partners to improve the life chances of all. Our ambitions and strategic intentions are clearly set out in our strategic plan ‘Caring Together’. The five priorities within the strategic plan reflect our ambition to improve the lives of local people. Among these is to work with our communities as we address the high levels of inequality that exist in North Ayrshire as a result of the high levels of local deprivation. Our Strategic Plan is universal in its approach and applies to all residents in North Ayrshire who require health and social care support. We know that people with protected characteristics are often adversely impacted by social and economic inequalities. As such, it is important that we always consider the impact of our decisions and services on those groups. Going forward, we will continue to embed and enhance our understanding of equalities across the Partnership. Some of the key mechanisms we will use to do this are set out below. Transformation and Change The partnership is continually reviewing and improving our services to ensure that we continue to effectively support local people and meet any change in demand. As we undergo these reviews, it is essential that we consider the potential impact on people with protected characteristics to ensure no negative impact arises from any changes we make. Going forward we will ensure that considerations around equalities are considered at the earliest stages of any new development. Equality Impact Assessments The key tool for assessing the potential impacts on those with protected characteristics is our Equality Impact Assessment (EIA). These assessments are carried out on all our key budget proposals and on the majority of the partnerships policies, plans and strategies. During the life of this plan, we will support services to consider the impact of equalities on any new proposals by completing an EIA at the initial planning stages and ensure it is reviewed regularly throughout the development process. In 2023, NAHSCP will launch a new Partnership website that will host a range of information and advice about our services. This site will also host the HSCPs plans, strategies and reports. This site will also host information on our work to mainstream equalities as well as all completed EIAs. The new website will ensure it adheres to full accessibility guidelines in both its overall design and documentation. Training The HSCP provides a range of training options to ensure our workforce can meet the challenges of their roles. A number of these training courses available have a strong equality focus. Some of the equality related training available through HSCP Learning and Development include: • Promoting Equality
Page 15
9 • Autism Awareness • Child Protection Awareness • Adult Support and Protection Awareness • Understanding Mental Health • Understanding Domestic Abuse • Adults with Incapacity In addition HSCP employees also have access to the learning resource of their parent organisations. For NAC contracted employees this includes: • Deaf Awareness • British Sign Language and Tactile BSL • Sensory Impairment and Sight loss Awareness Additional training resource provided to NHS contracted employees include: • Health Inequalities Awareness • LGBT Training • Learning Disability Awareness • Transgender Awareness Other courses are available through NHS Ayrshire and Arran on a demand lead basis. Engagement We understand that meaningful participation and engagement are important parts of enabling healthier and more empowered communities. Since the Partnership began in 2015, we have worked hard to review and improve how we engage with local people and communities to ensure their views are at the heart of how we deliver our services. Through our various engagement methods, we ensure the voice of the people of North Ayrshire is used to inform our decisions making. This includes the people who access health and social care services, unpaid carers and young carers, families, and the staff and volunteers who are involved in the provision of health or social care across all sectors including public, third and independent sectors. Due to the nature of our work, many of our service users often possess one or more protected characteristic. For example, we provide services to older people with physical impairments and long-term conditions, children and adults with physical or learning disabilities, pregnant women and new mothers and protective services to vulnerable young children. As such, it is natural for the Partnership to engage with people with a range of protected characteristics. However, going forward through our developing engagement work we will seek to engage more fully with less represented protected groups, such as LGBTQ, Race and Ethnicity, and religious groups. When we undertake any engagement activity - at any level – we will use the five key principles of participation and engagement:
Page 16
10 • Inform, Consult, Involve, Collaborate, Empower (co-produce) This will ensure we use the best approach whenever we engage with our stakeholders and members of the public, supporting us to better understand their ideas and views and help us to plan and deliver better services for all. Procurement The Partnership commissions a range of health and social care services from Third and Independent Sector Providers. As part of meeting regulations within the Equality Act, we must consider our equality duty when awarding contracts to external providers. Our Contracts and Commissioning employ a robust tendering process that ensures equality is fully considered and embedded in all commissioned services. Going forward, and as we progress towards the creation of a National Care Service our Contracts and Commissioning Team will ensure we retain a strong commitment to ethical commissioning.
Page 17
11 Equality Outcomes National guidance on setting equality outcomes notes that these should be proportionate and relevant to the functions and strategic priorities of the organisation setting them, and that they may include both short and long-term benefits for people with protected characteristics. From the outset of the development process, the following definition was applied to ensure consistency and rigour. Outcomes are not what we do, but the beneficial change or effect which results from what we do. These changes may be for individuals, groups, families, organisations or communities. Specifically, an equality outcome should achieve one or more of the following: • Eliminate discrimination • Advance equality of opportunity • Foster good relations Ayrshire Shared Equality Outcomes To support the mainstreaming agenda across all Ayrshire public bodies, the Ayrshire Equality Partnership (AEP) was created. AEP seeks to bring together local partners to work together on mainstreaming equality outcomes across Ayrshire. By working together, we can produce a more coherent vision for the improving equalities agenda across Ayrshire. More information on the AEP can be found in Appendix E. In April 2017, the Ayrshire Equality Partners published a set of 4 Shared Equality Outcomes. Those are that in Ayrshire: 1. people experience safe and inclusive communities 2. people have equal opportunity to access and shape our public services 3. people have opportunities to fulfil their potential throughout life 4. public bodies will be inclusive and diverse employers These outcomes were reviewed in 2021 and following public consultation were agreed to continue as high level outcomes for all partners.
Page 18
12 NA HSCP Local Equality Outcomes National guidance from the EHRC advised that the Ayrshire Shared Equality Outcomes were too broad in scope to be true equality outcomes. To this end, it was agreed by AEP partners to maintain the 4 Ayrshire Shared Equality Outcomes as long-term aims, but that each partner would also identify a more localised set of outcomes for the short or medium-term. The HSCP published a set of 8 local equality outcomes in April 2021 as part of its one-year Equality Plan in alignment with our strategic bridging plan (2021-22). Following guidance from EHRC, we have reviewed our outcomes and identified a more focussed set of four outcomes. Our set of Equality Outcomes will cover the reporting period of this plan from April 2022 to April 2025. They are: 1. People with complex care needs are supported to live independently at home for as long as possible Rationale: People often express a desire to be cared for at home. The partnership will support people to receive the health and social care support they need at home. We will support people to live as independently as possible, at home for as long as it is safe to do so. We will also be aware and supportive of other protected characteristics that people may have and ensure these are considered as we provide effective care. Partnership services will strive to be more community focussed in the future and will be supported by a vibrant third and independent sector. 2. People and communities who make North Ayrshire their home can effectively access the health and social care services they need Rationale: North Ayrshire is a welcoming place for refugees, as is evidence from the new Scots communities from countries such as, Ukraine, Syria and Afghanistan. Many of these residents intend to remain in North Ayrshire, making it their home. It is essential that these groups are aware of the health and social care services available to them and understand how to access those services when required. 3. Children and families in need are supported to live healthy and safe lives. Rationale: Supporting people at the earliest possible stage can prevent circumstances deteriorating and reaching crisis. This is true for both health and social circumstances. By working to prevent poorer outcomes for children and families and offering help at the earliest possible point, can support positive outcomes. 4. Through improved engagement practices and access to a greater range of health and social care opportunities, people with a learning disability, or those with complex health conditions, achieve better health outcomes Rationale: People with a Learning Disability, or those with complex health conditions, often face barriers to achieving positive health outcomes. This could be due to challenges identifying and accessing the most appropriate services. By enhancing our engagement approaches with service users, families and carers, staff and local providers, we can better identify more meaningful support pathways for individuals; leading to better health and wellbeing outcomes.
Page 19
13 We believe these outcomes provide a more focussed approach for the HSCP to re-dress some of the inequalities many local people face. These outcomes are more focussed on supporting specific equality groups, particularly those that are traditionally supported through health and social care services. However, we will be aware of the intersectionality of protected characteristics, ensuring we do not lose sight of other or additional protected characteristics that people may possess and ensure these are considered when delivering effective health and social care services. How these outcomes align with other strategic priorities and outcomes can be found in Appendix F.
Page 20
14 Equality Outcomes Supporting Actions To support the achievement of the identified outcomes several supporting actions have been identified. Many actions included already exist in our Strategic Plan. This demonstrates our mainstreaming approach to equality and diversity. This plan will be reviewed regularly and be refreshed accordingly as new actions arise and others are completed. We anticipate the through our enhanced engagement activities with local people and protected groups new areas of development will be identified and included for action. Equality Outcome 1: People with complex care needs are supported to live independently at home for as long as possible No. Supporting Action Desired Outcome Protected Groups 1.1 Reduce the waiting list for Social Work Assessment and Review Older people with identified care concerns are able to have their care needs assessed and actioned quickly. People accessing services experience no waiting time for initial assessment and review. Age (Older People) Disability 1.2 Reduce the waiting list for Care at Home Services (both at home and in hospital) Older people with identified care needs do not have to wait long periods of time to receive a Care at Home package. Age (Older People) Disability 1.3 Remobilise Day services for Older People, enhancing options to include both at home and residential provision. We have helped reduce the negative impact of social isolation and loneliness by providing a range of day service opportunities to older people in North Ayrshire Age (Older People) Disability 1.4 Review Local Models of Respite Provision Through provision of an effective Respite service, carers in North Ayrshire are supported to continue in there caring role. Carers are provided appropriate respite support in line with their assessed needs. Age (Older People) Disability Other - Carers
Page 21
15 No. Supporting Action Desired Outcome Protected Groups 1.5 Reduce waiting list for people needing an Occupational Therapy assessment and improve access to aides and adaptations to support independent living. People who require an assessment and support from occupational therapy receive it promptly, and the support received supports ongoing independent living. Age (Older People) Disability Other - Carers 1.6 Review Day Services on Arran for Older People Older people on Arran have access to a range of Day Service options that help support social inclusion, maintain wellbeing and reduce isolation. Age (Older People) Disability Other - Carers 1.7 Continue to develop community-based MDTs to ensure appropriate support for people in communities to support them to remain at home. Local people are able to access the right care at the right time in their local communities. Through improved access to a range of Health and Care professionals, people can be supported to remain in good health in their communities for longer Age (Older People) Disability Other - Carers 1.8 People who have received a period of care within Acute will have access to a range of services to support their transition back home. People are supported effectively in their return home from a period of care in an acute hospital setting. Age (Older People) Disability Other - Carers 1.9 Apply the principles the Ayrshire end of life and palliative care model. People in North Ayrshire are supported through episodes of palliative care and are assisted to die will. Age (Older People) Disability Other - Carers Equality Outcome 2: People and communities who make North Ayrshire their home can effectively access the health and social care services they need. No. Supporting Action Desired Outcome Protected Groups 2.1 Develop a plan to support the transition of new Scots away from Refugee Taskforce support and onto mainstream health and social care supports New Scots who have settled in North Ayrshire are aware of the Health and Social Care services available to them and no longer require accessing the Re- settlement Taskforce for support. Race and Ethnicity 2.2 Undertake a needs assessment of the possible long- term health and social care needs of new Scots We better understand the health and social care needs of new Scots living in North Ayrshire. Race and Ethnicity
Page 22
16 2.3 Deliver locally the actions to support new Scots as identified in the Mental Welfare Commission for Scotland’s Equality Outcome Plan 2021. We have a better understanding of the needs the mental health needs of new Scots and they are aware of the services available to them. Disability Race and Ethnicity Equality Outcome 3: Children and families in need are supported to live healthy and safe lives. No. Supporting Action Desired Outcome Protected Groups 3.1 Implement Signs of Safety approaches to improve how we work with families to develop meaningful childcare plans. Child Care Plans are developed through meaningful collaboration with families and include tangible and measurable agreed outcomes. More children can stay at home in the family unit. Age (Children) 3.2 Improve the quality and accessibility to services for children and young people who themselves (or parent/care givers) are at risk due to the harmful effects of alcohol or drug use, by establishing a speciality support team in Partnership with the ADP. Reduction in family breakdown Increase in children and young people staying within their family home and local communities. Reduction in crisis episodes Increase in resilience and wellbeing. Increased access to community resources. Age (Children) Sex 3.3 Enhance early intervention and prevention provision within the established Infant Mental Health Service There is a pathway of support for expectant and new mums experiencing mental health difficulties and concerns. This service is available to those in need at the earliest possible time. Age (Children) Sex Disability 3.4 Work with leadership across HSCP, NHS and North Ayrshire Council to locally agree that people with Care Experience are considered as a protected characteristic. Care Experience is considered a Protected Characteristic in North Ayrshire. This helps ensure that the impact on care experienced young people are considered in all future budget or policy proposals. Age (Children)
Page 23
17 Equality Outcome 4: Through improved engagement practices and access to a greater range of health and social care opportunities, people with a learning disability, or those with complex health conditions, achieve better health outcomes No. Supporting Action Desired Outcome Protected Groups 4.1 Undertake a Learning Disability Needs Assessment with all current LD Service users to better understand long-term need and resource requirements and consider processes for implementing the Annual Health check for all service users. The needs and aspirations of LD Service Users are listened to and used to inform service improvements and support resource allocation decisions Disabilities, Other – Carers 4.2 Undertake robust stakeholder engagement activity to identify the range of available support options to service users and their families. We have engaged with service providers (third and independent sectors) across North Ayrshire and are fully aware of the range of supports and opportunities available for service users and families. Disability Other – Carers 4.3 Host regular informative drop-in sessions with service users and families to inform them of the range of local community opportunities available. Service users and their families are aware of the range of community-based support options and opportunities available, beyond the traditional day centre options. Service Users, families and carers have a clearer of understanding of what to expect from HSCP services and what further opportunities are available from third and independent sector partners. Disabilities Other – Carers 4.4 Undertake a review of respite provision, including engagement with LD services users and families on their respite/short break aspirations. We have established a clear plan to re-design the delivery of respite services that is fully informed by service user and family feedback. Disabilities Other – Carers 4.5 We will review our Transition processes across Partnership Services. This will include undertaking meaningful engagement with service users. We have improved our transitions processes across all age and service user groups. People who will be subject to service transition will be involved in the decision-making process and their aspirations will be taken into account. Age Disability Other – Carers
Page 24
18
Page 25
19 Appendix Appendix A - Acronym Directory Acronym Descriptor IJB Integration Joint Board EIA Equality Impact Assessment NA North Ayrshire HSCP Health and Social Care Partnership PSED Public Sector Equality Duty EHRC Equality and Human Rights Commission NHS A&A NHS Ayrshire and Arran AEP Ayrshire Equality Partnership
Page 26
20 Appendix B – Diversity in North Ayrshire (2019) – Infographic Based on sample of 530 respondents in 2019 Scottish Household Survey *No responses to 'identified in another way' or 'Refused'.
Page 27
21 Appendix C: General Equality Duties and Protected Characteristics General Equality Duty: • Eliminate discrimination, harassment and victimisation and other prohibited conduct. • Advance Equality of Opportunity - between people who share a relevant protected characteristic and those who do not. • Foster good relations between people who share a protected characteristic and those who do not. Protected Characteristics: Age The Equality Act 2010 protects people of all ages. Disability Disability includes people with physical, learning and sensory disabilities, people with a long term illness and people with mental health problems. Race Under ‘The Equality Act 2010’ ‘race’ includes, colour, nationality and ethnic or national origins. It also includes Gypsy Travellers. Religion or Belief In The Equality Act 2010, religion includes any religion. It also includes a lack of religion. Belief means any religious or philosophical belief or a lack of such belief. Sex Both males and females are protected under The Equality Act 2010 Pregnancy and Maternity The law covers pregnant women or those who have given birth within the last 26 weeks, and those who are breastfeeding Sexual Orientation The Equality Act 2010 protects lesbian, gay, bisexual and heterosexual people Gender Reassignment The Equality Act 2010 provides protection to someone who proposes to, starts or has completed a process to change his or her gender. Marriage and Civil Partnership Marriage is defined as a union between two people of different or of same sexes. In addition to same sex marriage, same sex couples can also have their relationship legally recognised as ‘civil partnerships’. This category only applies to eliminating unlawful discrimination in employment.
Page 28
22 Appendix D: National Health & Wellbeing Outcomes The Public Bodies (Scotland) Act 2014 defines a complete set of principles for the implementation of health and social care services in Scotland. These are the principles against which integrated services should be delivered and the quality of those services should be evaluated. The Act also defines the national outcomes and the health and wellbeing outcomes that integration is looking to achieve. These are as follows: 1. People are able to look after and improve their own health and wellbeing and live in good health for longer People in North Ayrshire feel confident and able to make positive personal decisions about themselves and their families’ health and wellbeing and receive the support they need to achieve their aims. 2. People (including those with disabilities or long-term conditions or who are frail are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community People in North Ayrshire live as independently as possible, playing an active role within their local community. 3. People who use health and social care services have positive experiences of those services and have their dignity respected People in North Ayrshire are actively engaged in the design and delivery of services, ensuring that these are tailored to local needs and preferences. 4. Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services People in North Ayrshire express what matters to them most and help design and deliver services that help them attain this. 5. Health and social care services contribute to reducing health inequalities People in North Ayrshire benefit from improved lifestyles, life circumstances, life expectancies, health and quality of life, with more rapid improvements in communities that experience the highest levels of need and deprivation to reduce the inequality gap. 6. People who provide unpaid care are supported to look after their own health and wellbeing, including reducing any negative impact of their caring role on their own health and wellbeing Carers in North Ayrshire benefit from highly accessible and proactive services designed to maintain high levels of health and wellbeing. 7. People using health and social care services are safe from harm People who use health and social care services in North Ayrshire should do so safely, be free from fear or harm and have their rights and choices respected.
Page 29
23 8. People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide Staff – including those of the third and independent sector – who provide health and social care services in North Ayrshire, actively participate in the programme of continuous improvement and have ownership of the future model of service delivery. 9. Resources are used effectively and efficiently in the provision of health and social care services Individuals who provide or access health and social care services in North Ayrshire are fully engaged in assessing and allocating the resources available to local communities, and use a rigorous and transparent process to agree how maximum benefit can be attained.
Page 30
24 Appendix E - Ayrshire Equality Outcome Partners The Ayrshire Equality Outcome Partnership is comprised of: • NHS Ayrshire and Arran • Ayrshire College • Ayrshire Valuation Joint Board • Community Justice Authority • East Ayrshire Council • East Ayrshire HSCP • North Ayrshire Council • North Ayrshire HSCP • South Ayrshire Council1 • South Ayrshire HSCP 1 While South Ayrshire Council helped developed and supports the delivery of the Shared Outcomes, the organisation did not officially adopt them. At the time of publication, South Ayrshire Council were progressing through a 10 year Equality Action Plan, containing existing approved outcomes.
Page 31
25 Appendix F - Equality Outcomes Map How our local equality outcomes map to the Ayrshire Shared Equality Outcomes, our HSCP Strategic Priorities and the 9 National Health and Wellbeing Outcomes is set out below. HSCP Equality Outcome Ayrshire Shared Equality Outcome HSCP Strategic Priority National Health and Wellbeing Outcomes (Appendix C.) Older people with complex care needs are supported to live independently at home for as long as possible 1. In Ayrshire, people have opportunities to fulfil their potential throughout life • Enable Communities • Provide Early and Effective Support • Improve Mental and Physical Health and Wellbeing 1, 2, 4, & 5 People and communities who make North Ayrshire their home can effectively access the health and social care services they need 1. In Ayrshire, people experience safe and inclusive communities 2. In Ayrshire, people have equal opportunity to access and shape our public services 3. In Ayrshire, people have opportunities to fulfil their potential throughout life • Enable Communities • Improve Mental and Physical Health and Wellbeing • Tackle Inequalities 1, 3, 4 & 5 Children and families in need are supported to live healthy and safe lives. 1. In Ayrshire, people experience safe and inclusive communities 3. In Ayrshire, people have opportunities to fulfil their potential throughout life • Enable Communities • Provide Early and Effective Support • Improve Mental and Physical Health and Wellbeing • Tackle Inequalities 1, 3, 4, 5 & 7 Through improved engagement practices and access to a greater range of health and social care opportunities, disabled people or those complex health 1. In Ayrshire, people experience safe and inclusive communities 2. In Ayrshire, people have equal opportunity to access and shape our public services • Enable Communities • Improve Mental and Physical Health and Wellbeing • Tackle Inequalities 1, 2, 3, 4, 5 & 7
Page 32
26 conditions, achieve better health outcomes. 3. In Ayrshire, people have opportunities to fulfil their potential throughout life
Page 33
27