Help people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care.
Policy | Action | By whom | By when | Outcome expected | Progress and Measure |
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Cancer The DRC Formal Investigation into health inequalities experienced by people with mental health problems and learning disabilities in England and Wales reported that analyses of some 8 million patient records identified that these groups have much lower rates of health screening, e.g. cervical screening, higher rates of certain health conditions, e.g. diabetes, are more likely to die young; and live with physical ill health than other citizens. It is likely that experience in Scotland will be similar. We have agreed with our Fair for All - Disability partners that we will address the issues identified beginning with our key clinical priorities, starting with cancer services. Research has been commissioned to gather evidence of the inequalities faced by different groups in epidemiology; accessing services; services delivery and outcomes in relation to the design, development and delivery of cancer services. Fair for All - Disability partnership will provide the evidence base. Work we fund at the Scottish Cancer Care Research Centre identified poor deaf awareness amongst healthcare professionals and a lack of accessible information on conditions and treatment | A detailed plan is being drawn up, to be agreed with the DRC in December for implementation across Health Department ( SEHD) / NHS Scotland in 2007-08 | Patients and Quality Division; Staff Governance Unit, Healthcare Planning Division, Diversity Taskforce and Fair for All initiatives | December 06 | Action Plan to mainstream disability equality across services beginning with Cancer service pilot | A detailed plan has been drawn up in partnership with a range of stakeholders, including disability representation and has been supported by both the DRC at our biannual meeting with the Heads of the Equality Commissions and by the Diversity Taskforce. The Project Plan is now being implemented and is available for scrutiny. |
A research project has commenced to draw together the evidence on the inequalities disabled people face in relation to Cancer services. | As above | Dec 06 | Evidence collated of inequalities experienced by disabled people in cancer services | This initial piece of work has been completed and was launched at the NHS Scotland Event in June 2007. Fair for All 'Health Topic Briefings' ( www.fairforall.org.uk) brings together current evidence of inequalities experienced by people from all equality groups, including Disability. |
Support key stakeholders, eg Cancer leads, in Impact Assessing their policy, and in reviewing how to promote equality for disabled people. | As above | Ongoing | Equality Impact Assessed Policy sets expectation for the equitable and fair delivery of cancer services to disabled people. | Our Fair for All Disability Team are currently reviewing progress across NHS Scotland in relation to Disability Equality Schemes. This will include a review of work done to EqIA Cancer policy, strategy or activity. This will be reported to the Diversity Taskforce on 22 nd November 2007 |
Joint work with other UK health departments on sharing best practice. | As above | Ongoing | Share/develop best practice/learning | Developing a 5 countries programme to share learning on patient monitoring. |
Work with Scottish Cancer Group, regional cancer networks, patient and staff groups involved in the design, development and delivery of cancer services, on improving outcomes. | As above | Ongoing | Shared ownership of approach to improving the disabled people's access to, and experience of cancer services. | Resources have been identified to establish 3 'Equalities Service Redesign' posts in the 3 Boards that host the Cancer Regional Advisory Networks. These posts will drive forward a programme of work outcomes focussed work in promoting equality and tackling discrimination in cancer. It is expected that these co-ordinators will be in post by January 2008. |
Work with NHS Quality Improvement Scotland ( NHSQIS) to Impact Assess clinical standards/guidelines are involved in their development. | NHSQIS | Ongoing | Improved access and outcomes for disabled patients | Work with NHS Quality Improvement Scotland ( NHSQIS) to Impact Assess clinical standards/guidelines are involved in their development. |
Work with Scottish Health Council ( SHC) to measure impact through annual assessment of Boards. | SHC | Ongoing | Evidence of improved patient experience. | The 2006/7 SHC assessment provides us with a clear picture of progress across Boards in terms of involvement of disabled people in key health targets and sets out actions for improvements |
Mental Health There is significant evidence that people with mental health problems experience discrimination from health care providers (In one study, 44% of respondents reported discrimination from GPs, 32% from other health services - De Ponte, 2000) in that physical illnesses were not taken seriously or attributed to mental distress. The DDA prohibits discrimination against disabled people in recruitment and employment, yet research consistently records that, generally, people with mental health problems experience barriers in retaining and/or gaining access to employment. The Equal Minds report brought together evidence of the mental health inequalities experienced by disabled people and laid out the implications for policy and practice. A new Mental Health Delivery Plan ( MHDP) has been with a focus on inclusion and equality issues. | Work to ensure all providers of care and the public more generally adopt behaviours which support and embrace the agenda around promoting equality, non-discrimination, social inclusion and equal rights | National Programme for Improving Mental Health and Wellbeing and Mental Health Division | Ongoing | Better public understanding of, and less stigmatising of people with mental health problems and better outcomes for users of mental health services | This aspect is being delivered on a periodic basis. This aspect is being delivered on a periodic basis. |
Training for staff and peer workers to recognise and respond to inequalities, including disability equality | Mental Health Division working with Scottish Recovery Network | Ongoing | Improved experience of services |
Develop robust mechanism to measure progress MHDP Commitment: We will develop a tool to assess the degree to which organisations and programmes meet our expectations in respect of equality, social inclusion, recovery and rights. | Mental Health Division Mental Health Division working with Scottish Recovery Network | Ongoing The tool is currently being piloted in three health board areas and be in general use by 2010 | Evidence of improved service user outcomes and experience Services being delivered in a manner that better addresses disability equality issues. |
MHDP Commitment We will improve the physical health of those with severe and enduring mental illness by ensuring that every such patient where possible and appropriate has a physical health assessment at least once every 15 months. | Mental Health Division | Ongoing | Better physical health outcomes for those with mental illness. |
Coronary Heart Disease/ Stroke ( CHD/Stroke) Our work will focus on our key clinical priorities, including CHD/Stroke. Research commissioned to gather evidence of the inequalities facing different groups in epidemiology, accessing services, experience of services and outcomes in relation to the design, development and delivery of CHD/stroke services, building on our current anticipatory care model Prevention 2010. Evidence from the recent DRC Formal Investigation (see 1 above) will be used in developing this approach. The SE Disability Working Group; SE Get Involved consultation group; and the Fair for All - Disability partnership will help provide an evidence base | As noted above, a detailed plan is being drawn up to use cancer services to pilot a single system approach to mainstreaming disability equality across SEHD/ NHSScotland. A research project has commenced to draw together the available evidence on the inequalities disabled people face in relation to CHD/Stroke services. | Patients and Quality Division, Diversity Staff Governance Unit, Diversity Task Force, Fair for All initiatives and Healthcare Planning Division As above | Ongoing | Action Plan to mainstream disability equality, initially piloted in cancer services. A resource providing evidence of inequalities experienced by disabled people in CHD/Stroke | As above - work underway in Cancer in the first instance Information CHD / Stroke inequalities experienced by different groups including disabled people launched as part of Fair for All publication in June 2007 |
Work with CHD/Stroke leads in SEHD/ NHS to ensure equality impact assessment of policy. | As above | Ongoing | Equality Impact Assessed policy sets expectations for equitable and fair CHD/Stroke services across NHS Scotland | CHD strategy currently under review and will be Equality Impact Assessed as part of this |
Patient Focus Public Involvement ( PFPI) Fair for All - Disability, part of the wider PFPI programme, aims to enable SEHD/ NHS Scotland address its responsibilities in relation to DDA Part III - provision of goods, services and facilities - by developing practice that goes beyond a DDA compliance model and delivers the spirit as well as the letter of the law. The overarching objective of Fair for All - Disability is to improve the rights, independence, choice and inclusion of disabled people through ongoing development of our wider PFPI programme. | Develop implementation plan for Achieving Fair Access, Fair for All - Disability's guidance on mainstreaming disability equality across NHSScotland policies and functions. Qualities assure NHS Board Disability Equality Schemes; share good practice and provide targeted support to NHS Boards. | Patients and Quality Division and Fair for All - Disability Fair for All - Disability | 2007 2007 | Improved access to healthcare for disabled people Improved access to healthcare for disabled people | Quality assurance of NHS Boards Disability Equality Schemes almost complete. A summary of findings will be presented to the Diversity Taskforce for consideration & action as necessary. Individual responses will be fed back to each Board with a consideration of improvements |
Support NHS Boards engage with disabled people in the design, development and delivery of their services and functions. | | Ongoing | Improved patient experience | Targeted support to 5 NHS Boards to improve disabled people's involvement in their DESs. Guidance / Best Practice statements being developed on involvement |
Support national Boards, eg NHS Quality Improvement Scotland, to mainstream disability equality into their work. | | Ongoing | Disability equality built into all aspects of NHS. | Work is underway to bring all our Fair for All activity into a single Directorate of Equalities & Planning in NHS Health Scotland. This will aim to ensure that all NHS Scotland Boards - territorial and national - mainstream equalities, including disability equality into their work. |
Advocacy NHS Boards are required to work with their planning partners to ensure that independent advocacy is available to all who need that support. Evidence from the Disability Working Group and Get Involved events confirmed that disabled people want this. Under the Mental Health (Care and Treatment)(Scotland) 2003 every person with a mental disorder has a right of access to independent advocacy. SEHD fund the Scottish Independent Advocacy Alliance ( SIAA) to provided advice and support to service commissioners and providers. | Guidance to NHS Boards being updated to ensure that local provision meets the identified need for advocacy and that people with a disability are involved in the planning and design of local services. | Patients and Quality Division and Scottish Independent Advocacy Alliance ( SIAA) | Spring 2008 | Improved access for people with a disability to independent advocacy. | Delays in recruiting staff has delayed this action. |
Work with NHSQIS and Scottish Health Council to ensure that their standards/guidance and assessment of NHS Boards service delivery meets the identified local need for independent advocacy. | As above | Ongoing | Improved patient experience. | As above |
Community Care Services | Equality Impact assess Community Care policies and functions | Community Care Division | Ongoing | Improved access and outcomes for disabled people | Currently conducting Equality Impact Assessment of NHS Carer Information Strategy Policy. |
The same as you?' the review of learning disability services The review set out a 10 year agenda in 2000 to ensure equality of opportunity and eliminate discrimination for people with learning disabilities. It seeks personalisation not just through better health and community care but also through improving access to employment, education, leisure and communities. Inclusion and involvement of people with learning disabilities in central to all of the recommendations, in particular in the design and delivery of local services. | Managing Implementation programme Scottish Consortium of Learning Disability funded to raise awareness and tackle stigma, build capacity in mainstream services through training and information dissemination. | Adult Care and Support Change Team, working with stakeholder groups Working with Primary Care colleagues Working with Mental Health and Nursing | 2010 2008 March 2008 | Improved quality of life and services for people with a learning disability Improved access to general health care | Annual statistical returns show progress in implementing recommendations of the review. SWIA inspections National outcomes for Community Care People with learning disabilities are Boards members and trainers. National Implementation Group and Users and Carers Group engage with policy leads and service providers to address access to services. NHSQIS role in assessing NHS Boards against 2003 Quality Indicators Health Inequalities New GMS contract to include enhanced services for people with learning disabilities. Use of NHS beds for people with learning disabilities being assessed under mental health delivery Plan |
Implementation of PHIS needs assessment report for Autism spectrum disorders Recommendations aim to improve diagnosis, training, research and information for people with ASD. | The National ASD Reference Group involves people with ASD, their families and service providers with the aim of improving diagnosis, training, research and information. | Adult Care and Support Change Team | March 2008 | Ensure appropriate health and social care service provision to people with ASD | he National ASD Reference Group has delivered improved services through innovative projects in all areas of the recommendations. Significant work with NHSNES to improve knowledge within primary care and to give families accessible information at point of diagnosis. Main action now for local services and commissioners to build on learning from projects. Group working to produce guidance to commissioners. National outcomes for Community Care |
Sensory Impairment Action Plan Action Plan published in 2003 aims to improve information and access to community care services for people with sensory impairment, including visually impaired, deaf and deafblind | Work to implement the plan involves people with sensory impairment and voluntary organisations. | Adult Care and Support Change Team | March 2008 | Improved access to community care services for people with a sensory impairment | National Steering Group to implement the plan involves people with sensory impairment and voluntary organisations. Group has contributed to guidance to local agencies, issued in March this year. Funding provided for sensory awareness training for social care staff Group members involved in development of National Occupational Standards for support staff National outcomes for Community Care |
Direct Payments (self-directed support) Self-directed support aims to increase the flexibility, choice, and control service users have over the community care they receive, in order to help them live more independently. Those eligible are disabled adults and children and older people aged 65 and over who are assessed as needing care services. | Work has been done with a number of stakeholder groups to increase local access to self-directed support, including older people, users of mental health services, and families of children with disabilities. | Adult Care and Support Change Team | Ongoing | Improved quality of life for people with a disability | Annual statistics show increase in uptake of direct payments. Comprehensive guidance issued in July this year to encourage more support for service users, specifically including people with disabilities, to exercise choice and control of their care. Amendment regulations effective from November 2007 will allow greater flexibility in allowing family members to provide support in certain circumstances. |
Healthy Working Lives (Work Well) | Steps in place to promote attendance and keep staff well in work and remove barriers for those who become unwell or are disabled to remain in work | Staff Governance Unit | March 2007 | Increased opportunities to enter employment for disabled people or to stay in employment for staff that become disabled or have long term health conditions. | The Managing Health at WorkPIN policy provides guidance to Boards to promote attendance and to manage issues relating to illness and disability. Work is ongoing to promote and develop the "Working Well" concept across Scotland, pulling together all the elements of the employment package that support staff to remain fit and healthy in employment for as long as they want and is appropriate. |
E- Health Strategy | Our e-Health programmes will be Disability Equality Impact Assessed | Head of Computing and IT Services | 2007 | Achieve key aim of involving the patient in the use and disclosure of their personal health information | Reference to Equality & Diversity is being referenced in the eHealth strategy due to be published in March 2008 EQIA is included as part of the 'checklist' of things that needs to be considered by each eHealth project at each stage in its lifecycle. For example, the Design Authority checklist. EQIA is also referenced in the project lifecycle document templates which have to be completed by each eHealth Project/Programme. Each project in developing their requirements needs to consider EQIA; for example, this is included in the commission for PMS and IPACC requirements projects that are currently ongoing. The requirement to undertake EQIA will be disseminated through eHealth forums including the meeting of the eHealth Divisions. The Scottish Government's eHealth Directorate is currently reviewing the Information Governance mechanisms relating to overseeing the access and use of clinical information. An Information Governance Study approved by the eHealth Programme Board includes consultation with the Scottish Consumer Council (amongst others) to recommend future Information Governance frameworks and controls; it is anticipated that these recommendations will include appropriate representation of public and patient interests. |
National Framework for Child and Adolescent Mental Health Services ( CAMHS) | Improve children and young people's mental health care via "The Mental Health Delivery Plan" and "Delivering a Healthy Future: an action framework for children and young people's health in Scotland . | Mental Health Division and Child and Maternal Health Division | 2006-2007 | Needs of children with mental health problems are met with improved outcomes | Have continued attention on delivery of the recommendations, have since published (2006) timetabled objectives for change and improvement, to reduce inappropriate admissions to adult bed and increase numbers of child and adolescent beds. Have also published a Milestones Action Framework (2007). All used to guide then benchmark local and national progress. On reducing the use of inappropriate care settings, there were 186 admissions to adult wards in 2006, a significant reduction from the 290 recorded for 2002. This progress reflects our overall drive to increase the number of dedicated beds. Beds for this important care group will increase from 44 beds to 56 by 2010. Our attention continues also on improving provision to support children and young people in the community, to prevent inappropriate admissions and to facilitate earlier and safe discharge from hospital care. |
Workstream concerning 'Specialist Children's Services' | Review a range of services which aim to meet needs of children with impairments conditions - consult directly with service users and their families | Child and Maternal Health Division | Ongoing | Improved outcomes for patients | A National Delivery Plan event is being held on 26 November 2007. Public consultation on the Plan in early 2008. |
Delivering a Healthy Future: an action framework for children and young people's health in Scotland' | Will include significant commentary on the need to recognise that diversity and equality needs to be better integrated into the planning and delivery of child health services | Child and Maternal Health Division | 2007 | Improved outcomes and patient experience for people with a disability | Framework published in February 2007. |
Improving Primary Care Infrastructure - Premises | Funding and guidance has been provided to secure compliance with DDA across the primary care estate. We will use Joint Venture initiatives, which provide services that span the health and local authority sectors to widen service access to minority and/or relatively deprived communities. | Primary Care Directorate | Ongoing | Improved access and better experience for people with a disability | There is an ongoing premises development programme at individual Board level to modernise the Primary Care estate by adaptation of existing premises and in appropriate cases by provision of new builds and joint working with other public sector service providers. These programmes continue to address identified deficiencies in terms of access for disabled people. A specific programme is also currently in hand to encourage Dementia Friendly design into the existing and planned Primary Care estate. |
Dental Services A number of initiatives are targeted at meeting DDA requirements and improving the care offered to disabled people | Practice improvement funding supports general dental practitioners address DDA requirements. Scottish Dental Access Initiative grants require dentists setting up or expanding NHS practices to comply with the DDA - to be extended to offer specific grants to relocate to better quality and more suitable practice premises which meet DDA requirements. Specific fees paid to practitioners for domiciliary visits to patients who are unable to leave home unaccompanied because of physical or mental illness or disability. The new career structure for the Community Dental Services includes senior posts related to the provision of GDS to patients with special needs or who are medically compromised. The new consolidated National Health Service (General Dental Services) (Scotland) Regulations will enable dentists to choose to undertake a less complete range of general dental services where this is necessary through physical or mental illness or disability. | Primary Care Directorate | Ongoing | Improved safety, access and outcomes for disabled people | In the past financial year dental practices have received over £21m through the general dental practice allowance to help address health and safety issues. Funding continues through the scottish dental access initative ( SDAI) and the SDAI has been revised with an increased funding package available. Funding continues to be available In place Work on the consolidation continue |
Eye Care Review | The review will improve the quality and coordination of community eye care services in Scotland was developed with the involvement of people with a visual impairment. The final report recommended that service users be involved in planning services, and gives examples of good practice. | Primary Care Directorate | Ongoing | Better services for people with a visual impairment | Bids were invited from NHS Boards (and their partners and stakeholders) for pump priming funding to plan and develop local services. An announcement on the funding is expected soon. |
Community Pharmacy | The community pharmacy contract makes provision for new services, including services targeted specifically at support for: (i) frail elderly people (ii) persons with severe and enduring mental health conditions; and (iii) provision of compliance aids for vulnerable patients who otherwise would have difficulty in identifying when, what and how many medicines they should take. | Primary Care Division | Ongoing | Better services for people with a disability | Community pharmacists can, where appropriate, assess a patient's ability to take their medicines and where they identify any problems put in place a range of measures to help patients, including disabled people, who have any difficulties with taking their medicines. A Scottish Health Planning Note was issued in 2007 which provides guidance on community pharmacy premises developments to ensure that they meet the needs of pharmacy users, including the needs of disabled people. |
Wheelchair services | Ministers are currently carefully considering the recommendations in the report of the review of the Wheelchair and Seating service submitted to them on 31 March 2006. Officials have been asked to explore the recommendations in detail and the Executive will respond formally in due course. | Patients and Quality Division | Ongoing | Better outcomes for disabled people | Following the Scottish Government's response to the independent review of NHS wheelchair and seating services in January 2007, a Project Board has been established and a Project Manager has been appointed to drive forward and support the modernisation and redesign of the services. They will carry out an in-depth analysis of the 40 recommendations flowing from the review and, by the end of 2008, will produce an Action Plan on the delivery of the recommendations. They will then implement the recommendations, in partnership with stakeholders, that will be most beneficial to all those who access the services. |
Equipment and adaptations Environmental barriers can limit the potential of disabled and older people to take part in mainstream employment, educational, social and recreational opportunities. Equipment and adaptations help overcome these barriers, having a positive impact on their and their carer's lives, and can influence the need for other care services. They help people of all ages to carry out ordinary activities of daily life that have become difficult or impossible due to impairment, ill health, traumatic injury, the effects of ageing or a change in circumstances. This work is being taken forward with advice from an external advisory group that includes disabled people and carers and voluntary sector organisations that support and represent disabled and older people. | A proposed good practice framework is phase 1 of work in response to the reports Equipped for Inclusion and Adapting to the Future. Phase 2 will address: mainstreaming, including inclusive design of buildings and products; information, advice and demonstration; and quality and innovation. A communication network, based around developing Community Health Partnership arrangements is being set up to engage locally with people of all ages using equipment and adaptations, their carers, voluntary sector organisations that represent and support them, and the statutory sector across health, housing and social care. | Partnership Improvement and Outcomes Division | Ongoing | Better outcomes for disabled people | Following transfer to a new division, the focus of this work has changed. |
1. What arrangements will you put in place to ensure that the policies you develop and/or the services you provide pay due regard to the need to eliminate any unlawful discrimination against disabled people? | Action | By whom | By when | Expected Outcome | Progress and measure |
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Awareness sessions on the implications of the DED and the needs of disabled people being rolled out across SEHD with Fair for All - Disability supporting NHS Boards | SE Equality unit and Patients and Quality Division | March 2007 | Policies and functions that take account of disability equality | Sessions held with most Directorates, including targeted work identifying current & future policies &identifying disability considerations. |
Disability Impact Assessment currently being rolled out across SEHD. All new and reviewed policies will be equality impact assessed before submission to HD Management Board level. | Heads of Division | Ongoing | Policies and functions designed to deliver better outcomes for disabled people. | Ongoing - the first of these will be published shortly |
Piloting NHS Complaints equality monitoring procedure to ensure that e.g. people with a disabled are not being discriminated against | Patients and Quality Division | April 2007 | Targeted action to address any incidence of disability discrimination. | This has now been piloted successfully over 2 x 3 month periods. The complaints monitoring form has been piloted and is now being used in a range of settings. We intend to use these results to roll out patient profiling / monitoring across NHS Scotland |
Continue Fair for All - Disability partnership and develop formal links to disabled people/organisations and ensure effective communication with DG Health and NHS Scotland | Fair for All - Disability | Ongoing | Needs of disabled people included in all HD policy and planning | Following a review of NHS Disability Equality Schemes, 5 NHS Boards were advised to review their involvement of disabled people in their schemes. This has now been addressed |
Fair for All - Disability Guidance to be implemented across NHSScotland Disability Impact Assessment built in to Workforce policies and business planning process. Steps in place to remind Higher Education Institutions and service partners of the requirement to eliminate possible discrimination in recruitment to, and delivery of programmes. Access to additional support highlighted to students with a disability from the Nursing and Midwifery Student Bursary | Fair for All - Disability Workforce Directorate Heads of Division | Ongoing Ongoing Ongoing | Mainstream disability equality across DG Health and NHS Scotland | Work is underway with each DG Health Directorate to review current and forthcoming priorities and to plan disability / equality impact assessment and involvement mechanisms. |
Disabled people involved in policy development and implementation e.g. through involvement on Departmental Groups, in Focus Groups etc | | | | Work is underway with each DG Health Directorate to review current and forthcoming priorities and to plan disability / equality impact assessment and involvement mechanisms. |
2. What arrangements will you put in place to ensure that the policies you develop and/or the services you provide are able to pay due regard to the need to promote equality of opportunity between disabled and non-disabled persons? | All new and reviewed policies will be Disability Impact Assessed before submission to Management Board level. | Heads of Division | Ongoing | Better access, outcomes and patient experience | We are currently auditing progress on achieving this aim |
Disability equality is explicit in DG Business plan. | Heads of Division | Ongoing | As above | Better Health Better Care - An Action plan for health & wellbeing, currently under consultation, makes explicit reference to prioritising disability equality |
Work with NHS National Support Services ( NSS) to implement national programme of patient monitoring | NSS | Ongoing | Identify needs within service. | Disability dataset has been consulted on and agreed. Work now underway with the eHealth Team to integrate patient monitoring |
All SEHD/ NHS events and publications will be accessible, promote equality and portray disability positively | Heads of Division | Ongoing | Equal access to events and publications while ensuring disabled people are seen positively and negative stereotypes challenged. | Guidance on improving information for disabled people was made available to all staff via the Scottish Government intranet. |
Work with Scottish Health Council to build disability equality into NHS Boards' Patient Focus Public Involvement assessment | Scottish Health Council | Ongoing | Evidence that actions are achieving positive outcomes for disabled people accessing NHS services. | Involvement of disabled people and disability equality impact assessment (as part of broader EqIA) now an integrated part of the Council's assessment process. The Council have recently established a 'patient focus unit' to address development issues in relation to this. |
Information (research, consultation, national surveys etc) gathered and utilised systematically includes and take due account of the needs of disabled people | Analytical Services Division | Ongoing | Where appropriate and relevant health information and evidence includes an analysis of the needs of disabled people. | NHS Workforce database now includes a field to record whether a member of staff is disabled. Community Care statistics collect information on registered blind and other types of disability. The Scottish Patient Experience Programme Invitation to Tender contains a requirement for the technical partner to collect information across all equality strands. Proposals are being assessed from an equality perspective by Health Scotland. Better Health Better Care Consultation events are collecting information across equality strands. An equality pilot is being run in three Health Boards to collect equality information on NHS Complaints. Work on developing the questions for the Scottish Health Survey is ongoing and includes equality strand information. |
Health inequalities research database developed online to support actions | Analytical Services Division | Ongoing | Policy makers informed of the needs of disabled people where appropriate and relevant. | Health Inequality database live on the Scottish Government Website http://www.scotland.gov.uk/Topics/Health/Equality Work is now ongoing to make updating this resource web based. |
PEDA process developed to carry out pre-expenditure and delivery assessments, which includes confirmation that an Impact Assessment has been carried out. | Analytical Services Division | Ongoing | Policy makers reminded of duty to undertake EQIA. | PEDA now developed. Spending is assessed for deliverability, effectiveness and equalities impact. |
Impact assess the work under way to review the Scottish Health Survey and the NHS Scotland National Resource Allocation Formula | Analytical Services Division | Ongoing | Better outcomes and experience for disabled people. | NRAC's review of the Arbuthnott Formula involved revising and improving the way in which the learning disabilities and mental health needs are taken into account. However, the Committee also recognised that our understanding of the impact of disability on health needs could be improved with better data. Question on disability have been piloted by the Scottish Health Survey. |
Action to be taken on the outcomes of the DRC Formal Investigation into Fitness Standards | Chief Nursing Officer Directorate | ongoing | Positive behaviours and increased awareness of interaction between disability and fitness standards. | This commitment has been built into the Better Health Better Care - An Action Plan for Health & Wellbeing consultation document. |
3. What arrangements will you put in place to ensure that the policies you develop and/or the services you provide are able to pay due regard to the need to eliminate any harassment of disabled people, related to their disability? | Disability Equality Impact Assessment explicitly identifies actions to promote equality and good relations between disabled and non-disabled people | Heads of Division | Ongoing | SG Health Directorate policies and NHS Scotland services promote equality and good relations | The Scottish Government has developed an Equality Impact Assessment ( EQIA) toolkit which can be used across 6 equality strands. The toolkit is supported by guidance and by a programme of briefing sessions, training and ongoing support from the Scottish Government's Equality Unit for individual impact assessments. EQIA will be used in relation to policies and practices contributing to our strategic objectives. We will consider all new policies, including reviews of and changes to existing policies, to establish whether disability equality impact assessment is necessary. In line with our toolkit, this will cover any policy which impacts on people. |
Dignity at Work Policy is to be reviewed | Staff Governance Unit | 2007 | Staff survey reports Improved experience. Improved recruitment and retention and improved declaration of disability status by disabled colleagues. | A resource has been identified to review all PINs (including Dignity at Work): this work is about to begin and is estimated to take six months. |
Reporting from HEI at annual meeting to review the provision of nursing and midwifery education | Ongoing | | | |
4. What arrangements will you put in place to promote positive attitudes towards disabled people? | Work with SE corporate learning services to ensure disability equality is built into all training programmes. | SE Equality Unit and HD Corporate learning | Ongoing | Staff aware of disability issues across all areas of HD business | Ongoing |
Work with NHS Education for Scotland ( NES) develop training and education programmes that mainstream disability equality for all NHS staff | NES and Education & Learning Unit | Ongoing | NHS staff to develop knowledge and competence to ensure services are accessible and promote positive disability images/challenge stereotypes | Draft Framework currently out for consultation. Framework expected to be completed by April 2008. |
As part of disability equality impact assessment all publications and promotions will be expected to consider how they promote positive attitudes/good relations towards disabled people | Heads of Division | Ongoing | Challenge stereotypes, prejudice and discrimination so that disabled people valued as colleagues and members of society. | |
Ensure opportunities for Ministers and senior officials to engage with disability groups, issues and events; build key disability equality messages into speeches etc. | Heads of Division | Ongoing | As above. | DG Health has hosted a Disability Forum event to bring leaders from a range of sectors together to discuss promoting disability equality at a societal level |
Include disability equality issues in: - NHS Board Development days
- Front Line Diversity Champions Work
- Internal NHS Scotland Diversity Campaigns
Recent policy initiatives have focused on maximising the potential of the elderly, disabled people and those with long term conditions to live full and active lives. Presentation on equality and diversity to be included in the Nov 2006 student conference being organised by NMAHP. Encourage HEIs and service areas to continue to consider suitability of disabled people for nursing and midwifery. Implement recommendations of the DRC Formal Investigation into Fitness Standards. | Reputation and Attraction Unit Chief Nursing Officer Directorate | Ongoing Action to be taken on the outcomes of the DRC Formal Investigation into Fitness Standards | Positive behaviours demonstrated at board level and front line and increased awareness of diversity issues and disability issues across workforce Positive behaviours demonstrated and increased awareness of diversity issues and disability issues across workforce | Health Directorate Leadership Board attended equality and diversity workshop 27/06/07 Report on Board development day key themes shared with Chief executives and Diversity Task Force and Organisational Development leads. Evaluation of Diversity Champions pilots due in March 2008 Presentation held. DRC report launched in September 2007, now being considered for implications. |
5. What action will you take to encourage the participation of disabled people in public life? | Disability Equality Impact Assessment will encourage participation of disabled people in health service design, development and delivery | Heads of Division | Ongoing | Disabled people are involved in shaping health policy and planning | A Health Director has recently met with a group of disabled people to discuss their views in shaping health policy and planning. We are participating in developments being taken forward at a pan-Government level on involvement |
Endorsement of, and monitoring of NHS Scotland implementation of National Standards for Community Engagement | Scottish Health Council | Ongoing | Ensure that the above is taking place | Embedded in assessment process |
Fair for All - Disability works with disability groups and communities to support their engagement with NHS public involvement structures, including a range of community capacity building activity | Fair for All - Disability | Ongoing | Disabled people are encouraged and supported to participate in public life, with a particular focus on shaping the health services they use | Ongoing. |
Fair for All - Disability works with NHS Boards to address barriers disabled people face in participating in health service involvement activity including accessible information, physical environments etc | Fair for All - Disability | Ongoing | To support the above to take place | Achieving Fair Access ( FFA - Disability) guidance has been launched and disseminated across NHS Scotland. FFA - Disability now working with DG Health & Wellbeing to review progress and consider what further steps required to ensure implementation of guidance. |
Work with the Scottish Health Council to: - assess progress of NHS Boards in involving disabled people across all PFPI activity
- progress of NHS Public Partnership Forums' inclusion of disabled people and groups
| Scottish Health Council | Ongoing | To measure above outcome is achieved. To ensure mechanisms being put in place by NHS Boards' and their Community Health Partnerships support participation of disabled people. | Involvement of disabled people and disability equality impact assessment (as part of broader EqIA) now an integrated part of the Council's assessment process. The Council have recently established a 'patient focus unit' to address development issues in relation to this. |
In line with ICE and staff governance standard increase involvement with disabled colleagues | Workforce Directorate | Ongoing | To ensure disabled colleagues are valued members of the team | |
Recent policy initiatives have focused on maximising the potential of the elderly, disabled people and those with long term conditions to live full and active lives. | Chief Nursing Officer Directorate | Ongoing | Positive behaviours and improved outcomes patient experience | |
Encourage involvement of disabled students in curriculum development through user groups | As above. | Ongoing | To ensure disabled colleagues are seen as valued members of the team | |
6. How will you ensure that disabled people are involved in the development of your department's policies and activities? | Participation in SE Disability Working Group and engagement processes | Equality Unit and Patients and Quality Division | Ongoing | Joined up involvement and establishment of good practice | We are participating in developments being taken forward at a pan-Government level on involvement |
Implementation of Disability Equality Impact Assessment will require involvement of disabled people | Heads of Division | Ongoing | Disabled people are routinely involved in the development of policies | We are participating in developments being taken forward at a pan-Government level on involvement |
Implementation of Fair for All - Disability guidance on involving disabled people across SEHD/ NHS Scotland | Fair for All - Disability | Ongoing | Systematic involvement of disabled people across policy development and service planning | Fair for All - Disability are currently reviewing all NHS Boards Disability Equality Schemes against the principles of the General Duty - including involvement. Findings will be reported to the Diversity Taskforce for consideration and recommendations |
Establish a high level reference group and undertake specific outreach and involvement activities as appropriate, both to disabled staff and members of public. Retain membership of Employers Forum on Disability and seek guidance from DRC as appropriate Involvement of disabled colleagues and lay people in policy development steering groups and working groups. Involvement of disabled people in the recruitment and retention sub-group of Facing the Future | Reputation and Attraction Unit Heads of Division Chief Nursing Officer Directorate | December 2006 Ongoing Ongoing | Meeting held with DRC policy officers and Workforce policy leads 06/07 Virtual network of frontline staff to be developed to assist with policy development and impact assessment by end January 07 Increased awareness of needs of students with disabilities. | Demonstrable outreach to disabled people to inform policy development. Director General Health member of Presidents Group of EFD. Hosted roundtable discussion with leading Edinburgh companies 17/08/07 and events agreed for late 07. |
7. What arrangements will you put in place to ensure that we are able to report on progress on an annual basis? | Participate in SE Equality Scheme Implementation Group | SE Equality Unit and Patient and Quality Division | Ongoing | Develop a framework and timescale for reporting | Named Health Directorates Co-ordinator works with Equality Unit to report annually. Work underway across Health Directorates to develop robust auditing of progress across all equalities responsibilities, including disability |
Include in annual business planning arrangements with outcomes monitored and reported annually | SE Equality Unit and Patients and Quality Division | April 2007 | Disability equality becomes a core business function | |
We will identify Key Performance Indicators from a range of sources such as Workforce Information ( SWISS) and Staff Survey results | Workforce Directorate | Ongoing | Ensure key performance indicators are agreed measured and action taken as appropriate | Staff survey data is available and can be interrogated. Respondents are asked to indicate whether they consider themselves to have a disability under the Disability Discrimination Act. All respondents are asked whether they have been discriminated against and the reason for this. SWISS is the repository for information on staff with disability and this information is collected for all new starts. Existing staff details are being updated. |
Implement the recommendation in the review of Health and Care Statistics in Scotland that more detailed analysis by equality strand be undertaken. | Analytical Services Division and Information Services Division | | Evidence of better access and outcomes | |
Monitoring through reporting by HEI at annual review of pre-registration nursing and midwifery education. | Chief Nursing Officer Directorate | Ongoing | Increased understanding of needs of students with disabilities and retention of such students on pre-registration programmes. | |