Decision making and Equality Impact Assessments and engagement

Case law guides how we assess impact.

These are the Brown and Bracking priniples that help guide decision makers when undertaking impact assessments:​

• Knowledge - decisions makers need to know the Equality Duties​
• Impact should be considered during decision making - not retrospectively​
• Consideration must be done properly with rigour with an open mind in such a way that it influences the final decision​
• The Health Board must assess the risk and extent of any negative impact and the ways in which such risk may be eliminated before the adoption of a proposed policy / decision​
• Proper record keeping encourages transparency and how BCUHB / providers have undertaken the duty conscientiously – including meetings where issues are discussed​
• The PSED responsibilities cannot be delegated - e.g. you can not pass it to another organisation​
• The PSED duty is a continuing one​

Each NHS organisation within Wales has its own procedures to carry out an assessment to assess impacts with regards to the Public Sector Equality Duty and Socio-economic Duty.

For Public Sector organisations in Wales (such as Health Boards) they are a statutory requirement.  Examining impacts are an integral part of the decision-making process to ensure that the decisions have positive impacts, and any adverse impacts are identified and can be addressed.  ​

The following information brings together some general information and best practice for NHS Organisations that are required to carry out these assessments.​

Before the assessment work:​

• Seek advice / training – most Equality Teams run regular training sessions or drop ins.​
• Put some time aside to complete the assessment​
• Ensure you have the most up to date template within your organisation​

During the assessment work:​

• Start at beginning of a proposal / review so it informs ongoing decisions. Retrospective assessments will fail the legal duty​.
• Involve a small group of people – this could include staff involved,  patient representative / stakeholders. This will help identify bias.​
• Engage with affected groups as soon as possible – link with your Engagement Team for advice.  ​
• Use a range of evidence – this may include local, national data and research. See your Equality Team if you need advice.​
• Avoid use of jargon – explain abbreviations. Assessments are subject to Freedom of Information requests​.
• Review and ensure that any future actions are addressed. Think about and document how potential negative impacts be mitigated.
• Ensure your assessment accompanies your proposal / decision making paper within your governance process.

Engagement​

Engagement work can help inform decision-making and should form part of the evidence within Equality Impact Assessments.

What do we mean by Co-production?

Co-production Network for Wales defines it as ‘Co-production is an asset-based approach to public services that enables people providing and people receiving services to share power and responsibility, and to work together in equal, reciprocal, and caring relationships. It creates opportunities for people to access support when they need it, and to contribute to social change’.​  ​

Co-production in decision making:​

Co-production across the NHS refers to involving patients, their families, and communities in designing and delivering healthcare services. It is used in situations where healthcare providers recognise that they need to work in partnership with patients and service users to develop and deliver effective quality care. Co-production can be used in various healthcare settings, such as in the:

• Development of healthcare policies and/or services​
• Development of guidance and best practice​
• Service redesign​
• Provision of care

There are many benefits from this approach. One of these is building close relationships with stakeholders.

For a practical guide please find the Co-Production toolkit.

Engagement work can help inform decision-making and should form part of the evidence within Equality Impact Assessments.

What do we mean by Co-production?

Co-production Network for Wales defines it as ‘Co-production is an asset-based approach to public services that enables people providing and people receiving services to share power and responsibility, and to work together in equal, reciprocal, and caring relationships. It creates opportunities for people to access support when they need it, and to contribute to social change’.​

Co-production in decision making:​

Co-production across the NHS refers to involving patients, their families, and communities in designing and delivering healthcare services. It is used in situations where healthcare providers recognise that they need to work in partnership with patients and service users to develop and deliver effective quality care. Co-production can be used in various healthcare settings, such as in the:​

• Development of healthcare policies and/or services​
• Development of guidance and best practice​
• Service redesign​
• Provision of care​

There are many benefits from this approach. One of these is building close relationships with stakeholders.​

For a practical guide please find the Co-Production toolkit.

A report from the Auditor General for Wales was published in September 2022 which audited the impact of carrying out Equality Impact Assessments across NHS organisations in Wales.

The report provides a range of improvement areas which organisations should be aware of in order to make assessment work more than a tick box exercise.