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Equality and Diversity Impact Assessment Toolkit




Better Policy Making and Better Service Delivery

As part of the Changing to Deliver initiative within the Scottish Executive we are looking for ways to streamline the policy-making process and improve the quality of the policies which are developed, as well as the way in which the Scottish Executive works with its partners and members of the public. The Equality and Diversity Impact Assessment Toolkit is one of the tools which will enable us to achieve these aims.

As well as this, the Scottish Executive Health Department's (SEHD) twin tasks of serving Ministers and acting as the national headquarters for NHSScotland creates a unique relationship between policy making and service delivery. SEHD, in developing national policy and guidance, must assess the impact of its policy and functions on individuals. NHSScotland must similarly ensure that its services are accessible to and meet the needs of those it serves.

Strategic Focus

The Equality and Diversity Impact Assessment Toolkit (EQIA) is a strategic document for both the SEHD and NHSScotland intended to support consideration of equality and diversity issues in the design, development and delivery of policies and services across NHSScotland. Equality and Diversity Impact Assessment is a strategic process and it needs to be considered when planning a new, or redesigning an existing, policy, function or service.

NHS Boards have also been issued with draft copies of the Informing, Engaging and Consulting
the Public in Developing Health and Community Care Policies and Services
(IEC) guidance, which looks at five key stages of effective engagement: informing, engaging, consulting, feedback
and evaluation. The EQIA is integral to demonstrating that this process has been planned and implemented and that the needs of specific communities have been considered and addressed
to allow those communities to contribute to the IEC process.

Why there is a need for EQIA?

In 2001 the Scottish Executive published Fair for All1 to address problems of access to and use of NHSScotland services for people from Black and Minority Ethnic communities.

Partnership for Care2 further committed the SEHD and NHSScotland to extending the principles set out in Fair for All across the NHS to ensure that 'our health services recognise and respond sensitively to the individual needs, background and circumstances of people's lives'. The National Health Service Reform (Scotland) Act 2004 3 turned this into specific duties to involve the public and encourage equal opportunities these duties came into effect on 30 September 2004.

The Equality and Diversity Impact Assessment Toolkit provides a mechanism to ensure that equality considerations are integrated within all policy development or service delivery from the outset.


In addition to the requirements set out in the NHS Reform (Scotland) Act 2004, there is other legislation which must be adhered to. The EQIA covers six key strands of equality and diversity, these are: age, disability, gender, race/ethnicity, religious faith/beliefs and sexual orientation or any combination thereof. The majority of these have legislative backing to some degree and all will have by the end of 2006.

The impact assessment requirements of the Race Relations (Amendment) Act 2000 have been used as the benchmark for the other strands because of 1) the disparity in the requirements of existing equality legislation, 2) the fact that it is unlikely there will be an integrated equality act for the foreseeable future, and 3) the need to ensure that the equality and diversity approach does not favour a hierarchy of oppression.

'Patient Focus and Public Involvement'

Within the next phase of the Patient Focus and Public Involvement agenda the Scottish Executive Health Department (SEHD) plans to focus on two key aspects:

  • Engaging with the public
  • Responding to the individual needs of patients

Within these, specific considerations will need to be given to what assistance equalities groups will require to fully participate and contribute to the design, development and delivery of policies and services.

The EQIA forms part of the wider Informing, Engaging and Consulting process. Guidance will be issued in relation to Informing, Engaging and Consulting which will replace the Consultation and Public Involvement in Service Change Draft Interim Guidance, HDL (2002)42. 4

Understanding Equality and Diversity

Within the context of the developing equality and diversity approach in general and the Equality and Diversity Impact Assessment Toolkit in particular the following definitions are being used:

  • Equality is about creating a fairer society where everyone can participate and has the opportunity to fulfil their potential. It is mostly backed by legislation designed to address unfair discrimination based on membership of a particular group.
  • Diversity is about recognising and valuing difference in its broadest sense. It is about creating a culture and practices that recognise, respect, value and harness difference for the benefit of the patients, carers, members of the public and members of staff. We may need to change our existing processes and systems to accommodate diversity.

It is also important to note that:

  • Equality and Diversity are not inter-changeable they need to be progressed together. There is no equality of opportunity if difference is not recognised and valued.

Anticipated Impact of the Equality and Diversity Impact Assessment Process

The implementation of the EQIA will have an immediate effect on the way that SEHD and the NHS Boards design, develop and deliver their policies, functions and services. It will drive a major review within SEHD and each NHS Board to prioritise for relevance5 and assess the impact of all:

  • New and reviewed policies and strategies
  • Existing policies and services
  • Service plans
  • Best value reviews and service re-design processes

The above must be completed by 31 March 2007.

Advantages of the Equality and Diversity Impact Assessment Process

The advantages of using a single impact assessment toolkit are:

1. It provides a strong grounding for the likely development of an integrated Equalities Act;

2. It will lead to the development of needs-led, patient-focused services;

3. It encourages collaborative working across SEHD and NHS Boards with community planning partners, voluntary and community organisations and patients, carers and members of the public;

4. It mainstreams the principles of equality and diversity into the practice of all staff whilst emphasising that it is an organisational responsibility rather than an individual responsibility;

5. It can be used to provide evidence of informing, engaging and consulting the public as part of the Performance Assessment Framework (PAF), completed as part of the Accountability Review process.


To be truly patient-focused, SEHD and NHSScotland need to rethink how we take into consideration the specific needs of those who access services and the likely impact that policy development and service delivery will have on individuals and communities. The Equality and Diversity Impact Assessment toolkit, as part of the informing, engaging and consulting process and the developing equality and diversity approach, is a support tool designed to assist SEHD and NHS Boards meet their legal duty to "discharge their functions in a manner that encourages equal opportunities and in particular the observance of the equal opportunity requirements"6 as well as the requirements of existing equality legislation.