Health and social care - equipment and adaptations provision guidance: equality impact assessment

Background

Policy purpose, aims and context

The purpose of this guidance is to ensure that equipment and adaptations are recognised as an essential component of integrated health and social care services. The policy aims to provide consistency in the provision of equipment and adaptations across Scotland, supporting prevention, early intervention, and self-management. The guidance seeks to streamline pathways, reduce unnecessary hospital admissions, and ensure people can receive the right intervention at the right time.

The timely provision of equipment and adaptations supports the health, housing, social care and educational needs of a broad range of children and adults. It can reduce risks, support independence, and enhance wellbeing. This includes those with short-term and long-term needs, people with physical or learning disabilities, people with mental health conditions including dementia, and those who require support with communication, such as users of Alternative and Augmented Communication (AAC). Many older people who may be frail or find everyday tasks difficult also benefit from these services, even if they do not identify as disabled.

Scotland’s population is ageing. The number of people aged 75 and over is projected to increase by 85% by 2039, meaning that over 800,000 people will be over 75. More people are also living longer with complex conditions, from childhood into adulthood. There are also people living with incurable conditions for whom urgent and proactive support is required. These demographic and health trends increase the importance of consistent, accessible provision of equipment and adaptations.

Development process

The guidance builds on previous policy work to embed a consistent national approach, addressing known variations across local systems. An Island Communities Impact Assessment (ICIA) was also carried out to assess how the guidance may affect island and remote communities differently, in line with the Islands (Scotland) Act 2018. This ICIA, published in July 2025, identified delivery challenges such as supply chains and workforce capacity, but concluded that these can be mitigated through flexible and partnership-based approaches.

Who the policy affects

Anyone requiring equipment and adaptations should experience a seamless journey through the pathway of care, receiving the right intervention at the right time. As well as the general public, the guidance cuts across multiple settings including care homes, prisons and educational settings.

The guidance states that people must be able to access support at the point they feel they need it, including advice and signposting. Fair and consistent access to assessments should be available on a non-discriminating, tenure-neutral and human-rights basis. Assessments should be focused on outcomes and enablement, ensuring that service users and unpaid carers are listened to, respected and responded to.

There should be no discrimination in the provision of equipment and adaptations based on where a person lives. This is particularly important for people living in care homes, where parity of access is essential.

The Scope of the EQIA

Groups and areas assessed

This EQIA assesses and highlights any direct or indirect impact of the guidance on people who access equipment and adaptations with protected characteristics under the Equality Act 2010: Age, Disability, Sex, Pregnancy and Maternity, Gender Reassignment, Sexual Orientation, Race, and Religion or Belief.

In developing and implementing the guidance, the Scottish Government is mindful of the three needs of the Public Sector Equality Duty (PSED). Specifically, the EQIA considers whether the policy:

• Eliminates discrimination for each of the nine protected characteristics. If not, whether the discrimination is justifiable, and whether it can be mitigated.
• Advances equality of opportunity for protected characteristic groups.
• Fosters good community relations between people of protected characteristic groups.

Approach and methods used to assess impact

A variety of sources were used to gather evidence to compile this EQIA. Quantitative data was gathered from Scotland’s 2022 Census, the Care Home Census, SSSC Workforce data, Scottish Prison Services statistics, PHS data, and education datasets.

Qualitative data was collected from online consultation responses and engagement sessions, which included participants from health and social care, housing, education, and community groups. These sessions also explored specific equality issues raised by people with lived experience, including accessibility and communication needs.

Details of evidence gathering and engagement

As part of the online consultation, stakeholders were asked to set out any information they wished to share on the impact of the guidance on groups who share protected characteristics. Engagement sessions were held with colleagues in NHS Scotland, Local Authorities, Integration Authorities, and their Housing and Education partners.

Stakeholders welcomed the revision of the guidance but highlighted the need for accessible formats (such as Easy Read and BSL summaries) to ensure equitable access for disabled people and those with communication support needs.

The EQIA confirmed that a full assessment was required due to the cross-cutting nature of equipment and adaptations provision and its potential impacts across multiple protected groups.

Key Findings

Overview of key evidence gathered and analysed

In addition to the public, this guidance cuts across various settings including care homes, prisons, and educational institutions. For each setting, evidence was gathered and analysed for the following protected characteristics: age, disability, sex, pregnancy and maternity, gender reassignment, sexual orientation, race, and religion or belief. Sources included Scotland’s 2022 Census, Care Home Census, SSSC workforce data, Scottish Prison Services statistics, education data, and stakeholder engagement.

Nearly one in five people report a disability or long-term condition, most care home residents are over 65, and the prison population is ageing, with those aged over 50 now representing 16% of the population.

Summary of positive, neutral and negative impacts

Across most settings, positive impacts were found for all protected characteristics in eliminating unlawful discrimination, harassment and victimisation, advancing equality of opportunity, and promoting good relations among and between different groups. Getting the provision of equipment and adaptations right can support prevention, early intervention, and self-management, allowing individuals to live independently and improve their health and mental wellbeing. By improving equipment provision in care homes, individuals will have better access to equipment that supports mobility and independence, and assessments are person-centred and focused on individual outcomes.

Neutral impacts were found for all protected characteristics in relation to prisons. The guidance will not directly discriminate against those in prison; however, health and safety requirements and additional risk assessments may influence what equipment or adaptations are available.

Preventative care in prisons could still encourage participation in purposeful activities and preparation for transition back into the community, but unmet social care needs were identified as some individuals decline support due to stigma. A neutral impact was also found in relation to promoting relationships between men and women, given their separation in custody.

For LGBT people, especially older individuals, evidence from Stonewall highlighted some concerns about discrimination in care settings, leading to a reluctance to disclose sexual orientation. By ensuring a consistent, person-centred approach, the guidance has the potential to address these concerns and promote dignity and respect.

For people of different races and ethnicities, no negative impacts were identified. However, the EQIA noted that language barriers may limit access, highlighting the need for information in other languages where required.

Intersectional and human rights impacts

Cross-cutting themes were identified across protected groups. Accessibility of information and communication was a recurring issue. To mitigate these, the guidance may need to be supported by Easy Read formats, BSL videos, and translation into different languages. Ensuring consistent access on a non-discriminating and human rights basis is fundamental to the guidance. Independent living, supported through equipment and adaptations, is also a recognised human right, central to dignity, autonomy, and participation in society.

Gaps and limitations in the evidence

The EQIA identified a lack of data gathering and analysis about people with certain protected characteristics who access social care. Many assumptions had to be made, as there is no data specifically relating to those accessing equipment and adaptations. This was recognised as a key limitation, and recommendations have been made to improve future data collection and sharing so that monitoring of equality impacts can be strengthened.