Document Title. Reference Number. Lead Officer. Author(s) (name and designation) Ratified by. Date ratified. Implementation Date

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1 Document Title Reference Number Lead Officer Author(s) (name and designation) Ratified by Date ratified Implementation Date Date of full implementation Review Date Version number Review and Amendment Log Version Type of change Date Description of change This policy supersedes: Document Number Title

2 (Insert Name of Policy) Section Contents Page No. 1 Introduction 1 2 Purpose 3 Duties, Accountability and Responsibilities 4 Definition of Terms 5 Procedure / Process insert content of policy after Section 4 Identification of Stakeholders Training Implementation Fair Blame Fraud and Corruption Monitoring Associated documents References Standard Appendices attached to policy A B C D Equality Analysis Screening Toolkit Training Checklist and Training Needs Analysis Audit Monitoring Tool Policy Notification Record Sheet - click here Insert Appendices table if appropriate Appendices listed separate to policy Appendix No: Description Issue No: Issue Date Review Date Insert PGN table if appropriate Practice Guidance Notes listed separate to policy PGN No: Description Issue No: Issue Date Review Date Insert Section break next page

3 1 Introduction Insert NTW Policy Number 1.1 This should be a broad description of what the policy aims to achieve. 2 Purpose 2.1 This section should provide a framework for the aims of the policy. It should take into account the target audience and the Trust s expectations of those to whom the policy applies. 3 Duties, Accountability and Responsibilities 3.1 The staff / groups who will take responsibility for implementing and overseeing the policy and a description of the role they will take. 4 Definition of Terms 4.1 Explanation of terminology used within the policy. e.g. Stakeholder is used to refer to a person or group with a direct interest, involvement, or investment in the policy. For example employees, service users and/or carers, ethnic groups, local authorities. Immediate Life Support is Emergency medical care for sustaining life, including defibrillation, airway management, and drugs and medications 5 Procedure / Process 5.1 A description of the process and course of action required to implement and comply with the policy. This many require a number of sections. NB If a policy is likely to be large and or complex it should be developed in the form of a short policy with associated practice guidance notes (PGN) Paragraphs, some of which are mandated, which are to be inserted towards the back of the policy document and numbered appropriately Identification of Stakeholders Any people, groups or organisations that may require involvement or consulted with; e.g. service users and carers, local authorities Training A short statement about necessary training requirements, together with relevant staff groups that this will impact upon; referenced to Appendix B Implementation How the policy will be implemented and if appropriate an action plan to achieve this.

4 Equality and Diversity Insert NTW Policy Number In conjunction with the Trust s Equality and Diversity Officer this policy has undergone an Equality and Diversity Impact Assessment which has taken into account all human rights in relation to disability, ethnicity, age and gender. The Trust undertakes to improve the working experience of staff and to ensure everyone is treated in a fair and consistent manner. (See Appendix A) Fair Blame (mandated paragraph) The Trust is committed to developing an open learning culture. It has endorsed the view that, wherever possible, disciplinary action will not be taken against members of staff who report near misses and adverse incidents, although there may be clearly defined occasions where disciplinary action will be taken. Patient Information Leaflets Any information given to patients needs to be in an accessible format, accurate and branded correctly. (the Trust) follows the process around production of this information as outline in the Trust s, NTW(O)03 Accessible Information for Patients, Carers and Public Policy. Patient Information leaflets will be reviewed every 3 years with the exception of those documents which are reviewed on an annual basis. However, should there be any changes in legislation or practice; all documents will be reviewed immediately irrespective of review date. Fraud and Corruption (Example of paragraph) In accordance with the Trust s policy NTW(O)23 Fraud and Corruption/Response Plan, all suspected cases of fraud and corruption should be reported immediately to the Trust s Local Counter Fraud Specialist or to the Executive Director of Finance. Monitoring A short statement about key elements within the policy that require monitoring and/or audit ; referenced to Appendix C Associated documents Any resources used to formulate the document must be acknowledged within this section, this may include other NTW Trust policies that provide associated guidance. Polices should be referenced by policy number and full title e.g. NTW(O)18 Impact assessment - A reference guide Clinical Policies should always consider the links to Safeguarding

5 References Insert NTW Policy Number e.g. Department of Health guidance; Legislation. Guidance should be referenced by Source title and date e.g. Department of Health Guidance, Refocusing CPA Legislation should be referenced by the name of the act and the date e.g. Race Relations Act 1976 (as amended by the Race Relations (Amendment) Act 2000

6 Insert NTW Policy Number Equality Analysis Screening Toolkit Appendix A Names of Individuals involved in Review Date of Initial Screening Review Date Service Area / Directorate Policy to be analysed Is this policy new or existing? What are the intended outcomes of this work? Include outline of objectives and function aims Who will be affected? e.g. staff, service users, carers, wider public etc Protected Characteristics under the Equality Act The following characteristics have protection under the Act and therefore require further analysis of the potential impact that the policy may have upon them Disability Sex Race Age Gender reassignment (including transgender) Sexual orientation. Religion or belief Marriage and Civil Partnership Pregnancy and maternity Carers Other identified groups Consider and detail any evidence on attitudinal, physical and social barriers. Consider and detail any evidence on men and women (potential to link to carers below). Consider and detail any evidence on difference ethnic groups, nationalities, Roma gypsies, Irish travellers, language barriers. Consider and detail any evidence across age ranges on old and younger people. This can include safeguarding, consent and child welfare. Consider and detail any evidence on transgender and transsexual people. This can include issues such as privacy of data and harassment. Consider and detail any evidence on heterosexual people as well as lesbian, gay and bi-sexual people Consider and detail any evidence on people with different religions, beliefs or no belief. Consider and detail any evidence on working arrangements Consider and detail any evidence on working arrangements, part-time working, infant caring responsibilities. Consider and detail any evidence on part-time working, shift-patterns, general caring responsibilities. Consider and detail other groups experiencing disadvantage and barriers to access.

7 Insert NTW Policy Number How have you engaged stakeholders in gathering evidence or testing the evidence available? How have you engaged stakeholders in testing the policy or programme proposals? For each engagement activity, please state who was involved, how and when they were engaged, and the key outputs: Summary of Analysis Considering the evidence and engagement activity you listed above, please summarise the impact of your work. Consider whether the evidence shows potential for differential impact, if so state whether adverse or positive and for which groups. How you will mitigate any negative impacts. How you will include certain protected groups in services or expand their participation in public life. Now consider and detail below how the proposals impact on elimination of discrimination, harassment and victimisation, advance the equality of opportunity and promote good relations between groups. Where there is evidence, address each protected characteristic Eliminate discrimination, harassment and victimisation Advance equality of opportunity Promote good relations between groups What is the overall impact? Consider whether there are different levels of access experienced, needs or experiences, whether there are barriers to engagement, are there local variations and what is the combined impact? Addressing the impact on equalities Please give an outline of what broad action you or any other bodies are taking to address any inequalities identified through the evidence. From the outcome of this Screening, have negative impacts been identified for any protected characteristics as defined by the Equality Act 2010? If yes, has a Full Impact Assessment been recommended? If not, why not? Manager s signature: Date:

8 Insert NTW Policy Number Communication and Training Check list for policies Appendix B Key Questions for the accountable committees designing, reviewing or agreeing a new Trust policy Is this a new policy with new training requirements or a change to an existing policy? If it is a change to an existing policy are there changes to the existing model of training delivery? If yes specify below. Are the awareness/training needs required to deliver the changes by law, national or local standards or best practice? Please give specific evidence that identifies the training need, e.g. National Guidance, CQC, NHSLA etc. Please identify the risks if training does not occur. Please specify which staff groups need to undertake this awareness/training. Please be specific. It may well be the case that certain groups will require different levels e.g. staff group A requires awareness and staff group B requires training. Is there a staff group that should be prioritised for this training / awareness? Please outline how the training will be delivered. Include who will deliver it and by what method. The following may be useful to consider: Team brief/e bulletin of summary Management cascade Newsletter/leaflets/payslip attachment Focus groups for those concerned Local Induction Training Awareness sessions for those affected by the new policy Local demonstrations of techniques/equipment with reference documentation Staff Handbook Summary for easy reference Taught Session E Learning Please identify a link person who will liaise with the training department to arrange details for the Trust Training Prospectus, Administration needs etc.

9 Insert NTW Policy Number Appendix B continued Training Needs Analysis Staff/Professional Group Type of training Duration of Training Frequency of Training Copy of completed form to be sent to: Training and Development Department, St. Nicholas Hospital Should any advice be required, please contact: (internal 32216

10 Insert NTW Policy Number Monitoring Tool Appendix C Statement The Trust is working towards effective clinical governance and governance systems. To demonstrate effective care delivery and compliance, policy authors are required to include how monitoring of this policy is linked to auditable standards/key performance indicators will be undertaken using this framework. Insert Policy Name - Monitoring Framework Auditable Standard/Key Performance Indicators Frequency/Method/Person Responsible Where results and any Associate Action plan will be reported to implemented and monitored; (this will usually be via the relevant Governance Group). 1. Insert statements what will be audited within the content of the policy How often this will be done Who be responsible to do it How will it be done Insert appropriate group where this will be reported to The Author(s) of each policy is required to complete this monitoring template and ensure that these results are taken to the appropriate Quality and Performance Governance Group in line with the frequency set out.

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