Full Equality Impact Assessment Pro- forma (Stage 2) Group: Care, Wellbeing and Learning Service: Public Health Section: Public Health Officer responsible for assessment: Carole Wood Support officers: Emma Gibson/Moira Richardson (1) Name & purpose of the policy, strategy, function or budget proposal: Completion date: 1/10/2015 Review date: 19/11/2015, 07/12/2015 Reduce elements of the Drug and Alcohol Programme: (a) Discontinue Hospital Alcohol Specialist Nurse post based at the Queen Elizabeth Hospital (year 1) (b) Reduce and cap the budget for provision of inpatient detoxification services (year 1) (c) Include a built in saving to the CRI contract (already in place) (d) Carers Support withdraw funding (year 2) (e) Balance (North East Regional Alcohol Office) reduce funding (year 2) (f) Oaktrees (Changing Lives) withdraw funding (year 2) (2) Is this new or existing? This is a new proposal. (3) Who are the main customer groups affected by this policy, strategy, function or budget proposal and has there been prior consultation undertaken? Men and women who have substance misuse issues (drugs and/or alcohol) and families, including parents/carers who are affected by another person s substance misuse.
(4) What information and data has been analysed to inform this assessment? National Drug and Alcohol Treatment Monitoring System ONS Data Public Health England data Glasgow University data The population of Gateshead in 2012 was 200,200. Currently we know that the gender split is 51% female and 49% male. Have you identified any gaps? Drugs Glasgow University Drug Prevalence estimates that in Gateshead 1,565 people aged 15-64 are opiate or Crack users. Drug data 2013/14: There were 1228 people in drug treatment Gender breakdown was 883 male (71.9%) and 345 female (28.1%) Age range: 18-24 = 115 people (9.4%) 25-29 = 217 people (17.7) 30-34 = 358 people (29.2%) 35-39 = 243 people (19.8%) 40-44 = 172 people (14%) 45-49 = 72 people (5.9%) 50-54 = 32 people (2.6%) 55-59 = 13 people (1.1%) 60+ = 6 people (0.5%) Ethnicity: White = 1203 people (98.5%) Asian/Asian British = 11 people (0.9%) Other = 7 people (0.6%) Alcohol Public Health England has produced an estimate which suggests there are 2546(n) 18 to 75
year old dependent drinkers in Gateshead. However other estimates, using different criteria, have suggested a far higher number of up to 13,200 for the age 16+ population. Alcohol data 2013/14: There were 742 people in alcohol treatment Gender breakdown was 467 male (62.9%) 275 female (37.1%) Age range: 18-24 = 36 people (4.9%) 25-29 = 62 people (8.4%) 30-34 = 112 people (15.1%) 35-39 = 95 people (12.8%) 40-44 = 118 people (15.9%) 45-49 = 107 people (14.4%) 50-54 = 97 people (13.1%) 55-59 = 67 people (9%) 60+ = 48 people (6.5%) Ethnicity: White = 734 people (99.3%) Missing/unknown = 5 people (0.7%) During 2013/14 862 people started a new treatment journey in Gateshead (drugs or alcohol) and 298 (34.6%) of these people declared that they had a mental health issue in addition to a substance misuse issue (dual diagnosis). Carers The precise number of family members and carers that are affected by someone else s substance misuse is not known. However, research by ADFAM (Families, Drugs and Alcohol), Supporting Families Affected by Drugs and Alcohol (2007) shows that at least 3 family members are affected by substance misuse at any one time. Therefore based on this research and the number of people that were in treatment in 2013/14 there could potentially be at least 5,910 family members who may need family/carer support in Gateshead.
(5) Does your analysis indicate a disproportionate impact relating to: a. Gender (Male/Female/Transgender) We cannot identify that there will be any disproportionate impact on this protected characteristic in relation to any of the proposed changes in relation to Hospital Alcohol Specialist Nurse (proposed change A), Inpatient Detoxification (proposed change B) and Balance (proposed change E). 71.9% of the numbers in drug treatment are male and 62.9% of the numbers in alcohol treatment are male. Therefore a reduction in the funding to the CRI contract (proposed change C) could potentially have an impact on the numbers of males accessing treatment if service capacity reduces. We cannot definitely demonstrate that a reduction in the funding to the CRI contract (proposed change C which is already in place) will have a disproportionate impact for women. However we know anecdotally from treatment services that women substance users are reluctant to come forward for treatment because they are afraid their children will be taken into care and therefore at times may appear to be underrepresented in drug and alcohol treatment services. We also know that approximately 74% of carers who access support from Gateshead carers are women so withdrawal of the Carers Support service (proposed change D) will impact significantly on this protected characteristic. In addition the support families and carers give to people who are in drug and alcohol treatment is a crucial asset in relation to a person s treatment recovery journey. Therefore carers need help to meet their own needs but also to assist them to provide effective support to their substance using relative and to other family members. There may be slightly larger impact on women caused by the proposed withdrawal of the Oaktrees funding (proposed change F). Slightly higher numbers of women access Oaktrees (40%) than the treatment service provided by CRI (28.1% for drugs and 37.1% for alcohol). CRI (proposed change C) will continue to promote access to services for women and as part of their quality standards offer: The timing of groups and other sessions take account of different needs including school hours and school holidays
Women only groups and/or appointment times are provided Childcare needs of service users are considered and local arrangements made as needed Carers Support service (proposed change D). The Clinical Commissioning Group and CRI (Gateshead Evolve) may assist in identifying capacity to work with drug users and carers. However it must be borne in mind that the contract for CRI is reducing from 1 November 2015 by 360,000 and from 1 November 2016 by a further 240,000 (proposed change C) so their capacity to take on any additional work to support carers and family members will be very limited. Further consultation with Gateshead Carers may let us discuss a range of possible courses of action but these cannot be considered as mitigation in as much as they have uncertain outcomes. b. Race / ethnicity Whilst data is collected on ethnicity we are not able to demonstrate that the proposed service changes A to F will have any impact on this protected characteristic. c. Disability The services do not collect data in relation to physical disabilities. However during 2013/14 out of 862 people starting a new treatment journey 298 declared they had mental health issues (dual diagnosis). Therefore any reduction in funding to drug and alcohol service provision for the proposed changes with the exception of proposed change E (Balance) could potentially impact on people who have
mental health and drug and alcohol issues but we are not able to quantify any disproportionate impact at this time. CRI will continue to provide substance misuse services on an open access basis to all people who refer into the service and will continue to offer support and signposting to those people who have declared mental health and substance misuse issues. Data will be monitored on dual diagnosis via the National Drug and Alcohol Treatment Monitoring system. d. Sexual Orientation The services do not collect data relevant to this protected characteristic and therefore we are not able to demonstrate any disproportionate impact on this area. e. Religion or belief The services do not collect data relevant to this protected characteristic and therefore we are not able to demonstrate any disproportionate impact on this area.
f. Age (People of all ages) The majority of people accessing drug treatment are in the age bracket 25-34 and the majority of people accessing alcohol treatment are in the age bracket 30-54. Therefore there could be a potential impact on this protected characteristic but at this stage we would be unable to determine this. There are no specific actions that can be taken to address this potential impact. However we will be able to continue to monitor the age breakdown of people in services via the National Drug and Alcohol Treatment monitoring system. g. Marriage and Civil Partnership Does your analysis indicate the potential to cause discrimination in relation to marriage and civil partnership? If yes, please indicate what actions will be taken to address these. h. Pregnancy and Maternity Does your analysis indicate the potential to cause discrimination in relation to pregnancy and maternity? If yes, please indicate what actions will be taken to address these.
(6) What ongoing or future monitoring will be put in place to ensure the policy, strategy, function or budget proposal is achieving its stated aims, for all groups equally? Contract monitoring process for CRI (proposed change C which is already in place) Public Health Outcomes Framework treatment completions, treatment representations, alcohol hospital admissions SIGNED: Catherine Scott Completing Officer SIGNED: Alice Wiseman Consultant in Public Health SIGNED: Carole Wood Director of Public Health