Equality impact assessment: health and social care statutory guidance refresh

1. Policy Aim

The proposed work concerns a review and update to statutory guidance which supports integration authorities (IAs) with the production of strategic commissioning plans (SCPs) and annual performance reports, as directed by the Public Bodies (Joint Working) (Scotland) Act 2014. There are no proposed legislative or policy changes as part of this work programme.

A 2018 report by Audit Scotland indicated that while integration has led to improvements in some areas, more needs to be done, including on strategic planning. A recent internal review of IAs’ SCPs highlighted variation in content and approaches.

The strategic commissioning plan guidance, published early in the integration process in 2015, also appears outdated. It includes statements about future releases on best practice, does not reflect some duties that apply to IAs, and does not capture more recent developments. Linked to the commissioning guidance, the annual performance reporting statutory guidance will also be refreshed.

The desired outcomes of this work are to improve the guidance to support IAs to produce effective integrated strategic commissioning plans and, in turn, commission services effectively to meet the needs of their local communities. In addition, refreshing the performance reporting guidance is aimed at supporting IAs to improve local annual performance reporting.

These desired outcomes are intended to have a wide range of positive impacts on individuals and communities, aligned to national health and wellbeing outcomes set by the Public Bodies (Joint Working) (Scotland) Act 2014.

In addition to the national health and wellbeing outcomes, wider national outcomes – from the National Performance Framework – that this work relates to are:

• We are healthy and active;
• We live in communities that are inclusive, empowered, resilient and safe;
• We respect, protect and fulfil human rights and live free from discrimination.

Who will it affect?

The update to guidance will directly affect Integration Joint Board (IJB) members and officers working within integration authorities who produce strategic commissioning plans and annual performance reports. It is envisaged that officers will use the updated guidance to produce strategic commissioning plans and annual performance reports.

However, the potential impacts that updated guidance may have on IAs’ commissioning arrangements and service delivery are far reaching and therefore may impact:

• people using services;
• people who will use services in the future;
• family and friends of people who use services;
• organisations and people providing services;
• wider local communities;
• other service delivery areas.

Underpinning the programme of work is a desire to listen to lived experience and the experience of those who are planning and delivering services. As a result, the planned programme of work includes significant engagement, through both a Short Life Working Group and written public consultation. It is therefore intended that each group that may be indirectly impacted by the programme of work will have an opportunity to input into the revision of the guidance.

What might prevent the desired outcomes being achieved?

Various factors may prevent the desired outcomes being achieved.

The production of ineffective revised guidance may lead to poor commissioning, planning, and reporting and subsequent negative consequences for service users, families, people/organisations providing services, wider local communities and beyond.

Poor engagement and/or lack of involvement of key partners and groups when revising the guidance may lead to missed opportunities for improvement or other unintended consequences and therefore prevent the desired outcomes from being achieved.

The intended audience may not use the revised guidance once produced, which may prevent the realisation of the desired outcomes.

Overall, in order to reduce the risk of negative consequences and the risk of the desired outcomes not being achieved, the following should take place:

• Clear and open engagement, including the appropriate amount of time to fully engage partners in the process;
• An iterative, flexible approach in planning and consulting a short life working group;
• Promotion of the revised guidance, so that those planning/commissioning will know to make use of it;
• Continued engagement following publication to ensure that the guidance is useful and having the desired impact.