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Health Inequalities Impact Assessment. Debbie Sigerson, Project Manager Pauline Craig, Head of Equality Equality team, NHS Health Scotland. To cover. Drivers for impact assessment The process and use of evidence Case study - Public Bodies (Joint Working) ( Sc ) Bill
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Health Inequalities Impact Assessment Debbie Sigerson, Project Manager Pauline Craig, Head of Equality Equality team, NHS Health Scotland
To cover • Drivers for impact assessment • The process and use of evidence • Case study - Public Bodies (Joint Working) (Sc) Bill • Integrating with the NRAC acute sub group update of the MLC element of the formula
The Equality Act, 2010 provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. The Act restated and simplified 116 separate pieces of earlier equality legislation into one Act for the UK. The 9 characteristics protected by the Act are: age; disability; gender reassignment; pregnancy and maternity; marriage and civil partnership; race; religion or belief; sex and sexual orientation. The Equality Act places a Public Sector Equality Duty (2012) on public authorities to have ‘due regard’ to the need to: • eliminate unlawful discrimination, harassment and victimisation • 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 relevant protected characteristic and those who do not
Specific Duties - duty to Assess and Review • consider relevant evidence relating to persons who share a protected characteristic (including any evidence received from those persons); • take account of the results of any assessment in respect of that policy or practice • publish, within a reasonable period, the results of any assessment; • make arrangements to review and where necessary revise any policy or practice that a public authority applies in the exercise of its functions. • The Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 • Assessing impact and the public sector equality duty (EHRC, 2012)
SNAP for Human Rights (SHRC, 2013) The expectations on the NHS and its partners are to ‘enhance the respect, protection and fulfilment of human rights to achieve high quality health and social care (Priority 4)’ .
National drivers and benefits of HIIA Legal • Meets legal duties and challenges discrimination and a ‘one size fits all’ approach Business • Risk mitigation • Quality improvement Moral • Works to reduce health inequalities for those facing multiple disadvantage, taking a human rights based approach Equality Act (2010) SNAP for HR (2013), Human Rights Act (1998) 2020 Vision (2013) Patients Rights Act (2011) Equally Well (2008)
Health Inequalities Impact Assessment (HIIA) • HIIA provides a systematic way to consider how a policy may affect people differently. The findings can inform the policy’s development and implementation. • HIIA is a tool which offers an integrated approach to impact assessment drawing on methodology from Health Impact Assessment, Equality Impact Assessment and Human Rights Impact Assessment. • People are not defined by any single characteristic. HIIA therefore encourages consideration of the intersections of different potential impacts on individuals and communities. • The tool was developed following a recommendation in Equally Well and was piloted in 2010 with NHS Boards and the Scottish Government.
Public Bodies (Joint Working) (Sc) Bill • Bill team leader & Health Scotland • Briefing on current evidence sources • Workshop with diverse range of participants formed as an ‘Equality reference group’ • Agreed what issues within scope • National consultation/ analytical services/links with related planning groups www.scotland.gov.uk/Resource/0042/00423510.pdf
Three types of evidence use in HIIA Figure 4: Three types of evidence to use in HIIA. HIIA: Frequently Asked Questions, NHS Health Scotland, 2014
Public Bodies (Joint Working) (Sc) Bill Ethnic minorities, Sexual orientation, religion and belief - gaps in data and understanding of access issues for all groups Charging – monitor impact Adult protection – training www.scotland.gov.uk/Resource/0042/00423510.pdf
Integrating with the NRAC acute sub group update of the MLC element of the formula • Scoping • Prioritisation • Appraisal • Recommendations • Taking action • Core criteria review: • Equity: how are all ‘variations in need’ across the country understood and gaps being addressed, beyond age, geography and rurality? • Transparency: publishing a version of the MLC element of the formula which is accessible to the public?