Equality Impact Assessment Case study

Delivered in collaboration with Catherine Brys

Equality impact assessments (EIAs): Proposed city-wide relocation of GP surgeries to health hubs

Client: NHS South Yorkshire Integrated Care Board (ICB)

Situation

South Yorkshire Integrated Care Board (ICB) was awarded £37m, through the ‘levelling up fund’ to relocate a large number of Sheffield GP practices across the city to up to five new, larger Health hubs. These new health centres would bring together existing GP practices, other health services, and some voluntary services under one roof.

We were commissioned to undertake an independent equality impact assessment of these plans, in two phases. Phase 1 following initial engagement with the public, with the aim to inform a formal consultation; Phase 2 following the consultation.

Challenge

Often equality impact assessments are approached in a mechanistic way and have minimal influence on decision making.

Our equality impact assessments had to be comprehensive, drawing on population data and public health research, as well as on qualitative insights from those who would be affected by this significant change. At the same time, the EIAs had to be accessible to a wide range of audiences. Most importantly, we wanted them to inform the decision making in a substantive way to ensure the best outcome for patients across different population groups.

Our work and approach

From the outset, we worked with the Involvement team at the CCG to establish their commitment to a robust and honest EIA that would inform decision making in a substantive way. We were assured that this was not just ‘a tick box exercise’.

We sourced and analysed a wide range of data, including population demographics, research about health inequalities and needs, both for Sheffield and in the specific geographic areas the changes were planned.

We also analysed the initial engagement surveys and focus groups, as well as the formal consultation. In addition, we spoke to community representative organisations, who were instrumental in informing many of the mitigating actions that were proposed in the final business case.

A key concern voiced was about already strained GP services undergoing major change, and the benefits of the change not being clear, or strong enough to outweigh many people’s concerns about the negative impacts.

The EIA was structured in a way that clearly set out:

• What the changes were that were being proposed
• Who they would affect
• How the ICB had considered their equality duties
• What the impact would be in terms of travel and transport, of moving from a small, dedicated GP surgery to a larger health hub, and the accessibility of new hubs
• Actionable mitigations to minimise any negative impacts

Impact

The client commended us for producing a high-quality, comprehensive assessment within challenging timescales. The EIAs were also well-received by stakeholders such as NHS England and the Health Scrutiny Committee of Sheffield City Council, which commended the honesty of the EIAs in reflecting the concerns of residents.

Most significantly, the EIA led to significant changes in the initial proposals, removing the options that would have had negative impacts on patients in terms of accessibility, transport and travel.

Client quote

“We were very happy with the equality impact assessment (EIAs) that you produced for us. They have now been presented to our Programme team, and Strategic Patient Involvement, Experience and Equality Committee where they have been well received for their thoroughness and accessibility.

The findings from the EIAs have been reflected in the decision-making business case, with all your suggested mitigations to reduce some of the impacts included as part of the programme delivery or part of a transformational package for the GP practices. The EIAs will be presented alongside the decision-making business case at the local Health Scrutiny Committee.

Thank you again for all your support with this work. Your ability to deliver high quality work within the tight timescales has ensured that we have been able to deliver an informed and considered piece of work that has truly influenced the final outcomes." 

Richard Kennedy | Head of Involvement

South Yorkshire Integrated Care Board