Baseline Equality Analysis

Shropshire, Telford and Wrekin Integrated Care System (ICS) has developed an Integrated Impact Assessment (IIA) process, forming a core part of the service and policy development process for our ICS.  An IIA enables ICS partners to fully assess the impact of services, policies and functions on their local population and communities.

IIAs asses proposed programme or service changes against the nine protected characteristic groups[1], our climate change responsibilities, health inequalities, deprived groups, socially excluded communities and the workforce.

A desktop IIA screener tool should be completed once a programme or policy plans are sufficiently formed.  If the initial screener identifies that a programme or policy change may have a negative or unknown impact on one or more protected characteristic group, or vulnerable group, then a baseline equality analysis must be completed. 

A baseline equality analysis provides programme leads and local health and care leaders an understanding of the demographics of current service users in relation to the composition of the local population.  It enables the project owner to identify the potential level of impact that any proposed changes may have on segments of the population, at a place, neighbourhood or system level and forms the base for mitigating actions to be identified.

An Equality Analysis involves using equality data and the results of engagement with protected groups and other relevant stakeholders to understand the actual impact or the potential impact of the service change, policy or decision.  It should also identify what actions may need to be carried out to reasonably reduce, mitigate or eliminate any disproportionate impact.

No two situations are the same, the requirements for a baseline equality analysis should be evaluated for each situation to decide what is appropriate to include

The NHS Constitution states that the NHS has a duty to “…pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population”. This is reflected in the Health and Social Care Act 2012, which introduced legal duties to reduce health inequalities, with specific duties on Clinical Commissioning Groups (CCGs) and NHS England.  The Health and Care Act 2022 subsequently transposes the duties previously held by CCGs directly onto Integrated Commissioning Boards (ICBs).

ICBs have duties to:

• Have regard to the need to reduce inequalities between patients in access to health services and the outcomes achieved;
• Exercise their functions with a view to securing that health services are provided in an integrated way, and are integrated with health-related and social care services, where they consider that this would improve quality, reduce inequalities in access to those services or reduce inequalities in the outcomes achieved;
• Include in an annual commissioning plan an explanation of how they propose to discharge their duty to have regard to the need to reduce inequalities; and
• Include in an annual report an assessment of how effectively they discharged their duty to have regard to the need to reduce inequalities.

Similarly, local authorities in England carry legal responsibilities to meet equality and diversity standards.  Many of these are incorporated into the Equality Framework for Local Government 2021, which seeks to “help organisations, in discussion with local partners including local people, review and improve their performance for people with characteristics protected by the Equality Act 2010”.

At an overall level, the framework seeks to:

• Deliver accessible and responsive services to customers and residents in their communities including those from protected characteristics
• Employ a workforce that reflects the diversity of the area they are serving
• Provide equality of opportunity for all staff
• Meet the requirements of the Public Sector Equality Duty (Section 2.2)

This means that health inequalities must be properly and seriously taken into account by public sector bodies, including all NHS organisations and both local authorities within STW ICS.

The NHS Long Term plan aligns the duties and responsibilities of the partner organisations behind the vision that increased collaborative working within health, care services, public health and the voluntary sector is fundamental in tackling equality and health inequality challenges.

The template that follows is designed to enable any service-lead to fully assess the impact of their proposed service or policy change through a Baseline Equality Analysis report.

• There are eight sections of the report, seven of which require input specifically related to the service or policy change.

• Input and feedback is required throughout the report, wherever there is red text. The red text is designed as guidance for each section, and should be deleted and replaced with black text throughout.

• Section 3 contains a number of pre-populated data sets, relating to overall population activity and trends across the system, and broken down by local authority area. This section is not intended to be edited, and should be used, in conjunction with other data sets as described, to inform the sections that follow

• Section 5.1 is a table that should be populated with individual impacts identified through the process.  Replace the red guidance text with input related to this programme.  Additional lines should be added where required.

• Section 5.2 is a table which takes the impacts identified in section 5.1 and investigates mitigations and rationale.  Replace the red guidance text with input related to this programme.

• The Appendix and Supporting Documentation page is in place for any additional documentation, data, insight or engagement which supports any of the findings contained within the report

• Once the document has been completed, please save as a PDF, and send to the Communications and Engagement mailbox