Equalities Impact Assessment (EQIA) for the Health (Tobacco, Nicotine etc and Care) (Scotland) Bill

EQIA for the provisions of the Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill


Title of Policy

Organisational Duty of Candour for Health and Social Care Organisations

Summary of aims and desired outcomes of Policy

To require organisations providing health and social care to follow the duty of candour procedure when there has been an unintended or unexpected incident or event resulting in death or harm; and to impose requirements as to reporting and monitoring.

Directorate: Division: team

Healthcare Quality and Strategy Directorate: Planning and Quality Division: Person-Centred and Quality Team

Executive summary

The new organisational duty of candour will create a legal requirement for health and social care providers to inform people (or their families/carers acting on their behalf) when they have been harmed (physically or psychologically) as a result of the care or treatment they have received. The procedure to be followed will be set out in regulations and will include matters such as support to be given to those affected and steps to review incidents. There will be a requirement too for organisations to report annually on the duty of candour.

Equality issues were considered during the policy development process and the proposals were not considered to give rise to the possibility of those affected being treated less favourably due to any of the protected characteristics.

It was therefore considered that a relatively limited Equality Impact Assessment (EQIA) would be appropriate. The focus of the data gathering and consideration was on determining whether there may be any inadvertent effects on different groups by examining the populations likely to be affected by the proposals.

The EQIA confirmed that the proposals are unlikely to have any negative effect on the basis of the protected characteristics. There is potential for the provisions to have some positive differential effects to ensure that everyone who is affected by unexpected or unintended events that have resulted in harm receives an organisational responses that is supportive.

No changes to the policy were considered necessary following the EQIA. However, the Scottish Government will continue to work with stakeholders to ensure full account is taken of equality issues.


The Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry , chaired by Robert Francis, QC included recommendations in support of an essential aim to ensure openness, transparency and candour throughout the health system about matters of concern. It was recommended that every healthcare organisation and everyone working for them must be honest, open and truthful in all their dealings with patients and the public, and organisational and personal interests must never be allowed to outweigh that duty to be honest, open and truthful.

The Inquiry recommended that where death or serious harm has been or may have been caused to a patient by an act or omission of the organisation or its staff, the patient (or any lawfully entitled personal representative or other authorised person) should be informed of the incident, given full disclosure of the surrounding circumstances and be offered an appropriate level of support, whether or not the patient or representative has asked for this information.

The Berwick Report 'A Promise to learn - a commitment to act' emphasised the importance of the requirement that patient or carers affected by serious incidents should be notified and supported. It recommended that where an incident qualifying as a serious incident occurs the patient or carers affected by the incident should be notified and supported.

The Dalton Williams Review clearly outlined the expectations that all those involved in caring roles have a responsibility to be open and honest to those in their care. They noted that the evidence they heard reaffirmed what was already known: that when things do go wrong, patients and their families expect three things: to be told honestly what happened, what can be done to deal with any harm caused, and to know what will be done to prevent a recurrence to someone else.

Improvements in arrangements to support the disclosure of harm, is a key element supporting a continuously improving culture of safety. There are several healthcare systems and organisations worldwide that have introduced initiatives or arrangements to support open disclosure of harm. For example, The Australian Open Disclosure Framework is a national initiative of the Australian National, state and territory governments, in conjunction with private health services, through the Australian Commission on Safety and Quality in Health Care. It is intended to contribute to improving the safety and quality of health care.

The Scope of the EQIA

Policy officials from the Scottish Government were involved in carrying out the EQIA.

Key Findings

People who are in receipt of care or treatment in healthcare or social care settings will not be adversely affected by these proposals. From conducting our EQIA we have found no evidence of unlawful discrimination which our proposals need to address.

In respect of advancing equality of opportunity, there is no evidence to suggest that the Bill will have either a positive or negative impact on anyone due to their protected characteristic.

On promoting good relations, there is no evidence to suggest that the Bill will have either a positive or negative impact on anyone due to their protected characteristic.

Recommendations and Conclusion

The Scottish Government has concluded that no changes to the policy are necessary as a result of the EQIA, as the proposals in the Bill are intended to apply equally to all affected, and appear to have no significant differential effect on the basis of the protected characteristics.


Email: Person-Centred and Quality Team

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