Consultation to amend the Civil Contingencies Act 2004 to include Integration Joint Boards: EQIA

Equality Impact Assessment Record

Screening

Policy Aim

This policy aims to formalise the role of Integration Joint Boards in emergency planning by amending the Civil Contingencies Act 2004, ensuring their inclusion in groups considering planning for emergency scenarios.

The Civil Contingencies Act 2004 establishes a clear set of roles and responsibilities for those involved in emergency preparation and response at the local level. It requires organisations in the health system (emergency services, Local Authorities, NHS bodies) to prepare for adverse events and incidents. Integration Joint Boards were not originally included as Category 1 responders in the Civil Contingencies Act 2004 with a consequential amendment to that Act when the Public Bodies (Joint Working) (Scotland) Act 2014 was passed because they are not employers of staff who deliver services.

Integration Joint Boards, Health Boards and Local Authorities share a joint responsibility and accountability for drawing up strategic plans which take account of functions managed by each individual body. Therefore, the Integration Joint Board Chief Officer and their team are expected to work alongside Health Board and Local Authority colleagues when carrying out the duties relevant to the Civil Contingencies Act 2004.

Whilst Chief Officers have already been contributing to local emergency and resilience planning, they have only formally done so through their roles as directors of Health Boards and Local Authorities and without the appropriate reference to their accountable officer status within the Integration Joint Boards. By including Integration Joint Boards as Category 1 responders, it ensures that where there is a risk of an emergency which will impact functions delegated to the Integration Joint Board there will be formal coordinated and appropriate arrangements in place for emergency planning; information sharing and cooperation with other responders; and joined up information sharing and advice for the public. Although the Civil Contingencies Act sets out a number of requirements, it is expected the Integration Joint Board Chief Officer will draw on resources from their integrated teams, many of whom will already be involved in this work as Health Board and Local Authority staff.

As public authorities in Scotland, Integration Joint Boards must already comply with the public sector equality duty set out in the Equality Act 2010 to take action to eradicate discrimination and to pro-actively promote equality of opportunity.

This policy contributes to a number of the National Outcomes. Principally, it ensures that people:

• live in communities that are inclusive, empowered, resilient and safe,
• are healthy and active

Who will it affect?

Integration Joint Boards are responsible for planning, commissioning and resourcing – as a minimum – adult social care services, adult community health services and a proportion of adult acute services. This is a significant proportion of the adult health and social care functions being delivered. Ensuring Integration Joint Boards are at the centre of emergency planning enables all bodies accountable for community health and social care services to be appropriately represented. In turn, presenting the opportunity for more robust emergency plans, taking consideration of the spectrum of integrated health and social care services, and the impact on their local communities and populations, to be put in place to support individuals and their families, providers, staff and carers.

Almost anyone in the population may at some point in their lives make use of the services that are delegated to Integration Joint Boards. However, there are a number of protected characteristics that are likely to be more prevalent among health and social care service users than among the general population. For example, older people are more likely to have a long-term health condition and/or be long stay care home residents.

As well as people using services, this policy may affect Health Boards and Local Authorities who provide these services, or procure these services to be delivered by independent and third sector partners. The Health Board and Local Authorities directly employ the workforce who deliver services on the behalf of the Integration Joint Board, and on the basis of their Strategic Commissioning Plan. As with service users, a number of protected characteristics are likely to be more prevalent among the health and social care workforce compared to the general population. For example, over three quarters of the NHS Scotland workforce are women, the majority of social care employees are women and 60% of unpaid carers are female. Carers are more likely than non-carers to have a long-term condition or illness.

The Integration Joint Board membership varies from area to area but may include Health Boards, Local Authorities, the Chief Social Work Officer for the constituent Local Authority, a general practitioner representative, a Secondary Medical Care Practitioner, a nurse, a staff-side representative, a third sector representative, a carer representative, the Chief Officer of the Integration Joint Board and a Section 95 Officer. The integrated health and social care functions are operationally led and delivered by the Chief Officer of the Integration Joint Board. The Chief Officer is the key staffing resource, with their integrated teams drawn from the Health Board and Local Authorities, which contribute to local resilience planning for all three types of body regarding their respective accountabilities for community health and social care.

The policy will require those who sit on Integration Joint Boards to be given formal footing of the duties that they carry out to meet the requirements of the Civil Contingencies Act. Consideration will need to be given through discussion with Integration Joint Board Chief Officers and their respective Boards to ensure that members will not be unable to perform the required functions as a result of accessibility or barrier issues raised by certain protected characteristics.

What might prevent the desired outcomes being achieved?

Achieving the desired outcome of Integration Joint Boards being Category 1 responders under the Civil Contingencies Act will be dependent upon, and will involve a need for, Health Boards, Local Authorities, the Third Sector and Stakeholders to work in collaboration in the interest of service users. The key factors that may prevent the desired outcome may be:

• Individuals who sit on the Board of Integration Joint Boards or the Chief Officer having accessibility issues or barriers resulting from one or more protected characteristics. This may impact on their ability to carry out the requirements of the Civil Contingencies Act. As the representative for the Integration Joint Board, the Chief Officer will be responsible for ensuring that those who sit on the Board are able to fulfil, with any reasonable adjustments, the requirements of the Act.
• • Integration Joint Boards, with their resilience partners, don't fully engage with local stakeholders to effectively assess risks, put in place emergency plans and make arrangements for emergency information to be available to the public. The arrangements that Integration Joint Boards put in place for emergencies will need to apply to the population as a whole and all service users will need to be considered. However, consideration will need to be given to traditionally hard to reach groups or those who may experience the delegated services differently from the rest of the population to ensure that the arrangements are suitable for these groups.