NHS Waltham Forest: Equality Impact Assessment on World Class Commissioning

Equality Works was commissioned to carry out an Equality Impact Assessment (EqIA) on the development of World Class Commissioning (WCC) in NHS Waltham Forest. After discussion, it was decided that we would use EqIA methods and ideas to comment on NHS Waltham Forest’s progress towards WCC; specifically to review the Commissioning Strategy Plan (CSP) in relation to equalities.

We have used a variety of methods to carry out this screening exercise. Mostly they have entailed reading and analysis of existing documents; selecting indicative or statistical information, or information likely to generate ideas and investigation; using our experience of working with equality issues to flag up areas where there might be opportunities to promote equality (in line with the public duties); or risks of differential impacts on different equality groups.

Our work has included the following steps:

• We examined WCC proposals and guidance from the Department of Health and their potential impact on equality groups.
• We examined key documents supplied by NHS Waltham Forest, including the EqIA template, the Single Equality Scheme and its associated Action Plan.
• We identified opportunities and risks in:
  • the CSP as a whole; and
  • the 5 initiatives highlighted in the CSP.
• We had as supplementary information the Operating Plan and the Out of Hospital detailed plan.
• We examined the 11 competencies identified as essential to WCC and the equalities implications inherent in those competencies.
• Finally, we drew all this together into a set of recommendations, linked wherever possible to the Single Equality Scheme (SES) and its Action Plan.

The final report included recommendations for the trust to consider. The recommendations tend to be similar across different work streams and include:

• Engaging with different equality and community groups;
• Collecting equality-relevant information;
• Using that information to target equality groups (within universal provision);
• Specifying different access, services and outcomes where differences in the population justify this;
• Monitoring performance against agreed targets; and
• Managing performance to achieve better and fairer outcomes.

The report has also informed a second EqIA, which examines the process of transferring provider services from Waltham Forest PCT to a separate and autonomous organisation.