Stop Smoking Cessation Services EINA Adult Social Care

15 June 2016

Equality Impact and Needs Analysis (EINA) Directorate: Adult and Community Services Service Area: Public Health Name of the service/function/policy being assessed:

Stop Smoking Cessation Services

Officer leading on assessment: Pradnya Gaikwad Other staff involved Usman Khan, Anna Raleigh, Nora Cooke O’Dowd, Catherine Stelling

1. Summary of the key findings

A summary of the key findings from the EINA are: Age: In Richmond, in 2014/15, a youth survey estimated that 14.3% of 15 year olds were current smokers and this was the highest prevalence in England. Current smokers include both children who smoke regularly i.e. at least one cigarette a week (6.7%) and occasionally i.e. less than one cigarette a week (7.6%). Regular smoking is considered to be more problematic, this was similar to the English level, but still much higher than London. This high prevalence relative to the rest of the country is likely due to the predominantly white ethnic group in Richmond. The commissioned service is aimed at adults and children 12 years of age and above and hence accessible to the 15 years old who smoke under the Frazer guidelines and therefore we do not consider accessibility as issue. However , due to the higher number of 15 years old in Richmond as compared to other boroughs , the existing and the new stop smoking service will need to target this age group more effectively Sex: In Richmond, 48.6% of the population is male and 51.4% female. Up until 2014/15 there had been an even proportion of men and women accessing the smoking cessation services. In 2014/15, there was a slight increase in the number of females (52%) accessing stop smoking services. This mirrors the gender breakdown in the Richmond population. Nationally, more men population smoke than women, however, this may be less of an issue in Richmond as the adult male population is slightly lower than the adult female population. However, men are less likely to access stop smoking services and hence there is a need for more targeted approach for men to access the service. Gender re-assignment: There is no official estimate of the transgender population in Richmond. Based on national research, it is estimated that between 1,148 and 1,914 transgender people living in Richmond. As the Richmond’s stop smoking services are easily accessible for all the

population who smokes. Therefore, there does not seem to be any adverse impact on this group. Pregnancy and Maternity: In Richmond, only 2.6% of woman smoked at the time of delivery, which is significantly lower than the London and England average. However, this did represent an increase from 1.9% the previous year, contrary to a decreasing trend nationally. In Richmond, 57 women smoked at time of delivery and given the severity of the consequences, it is important that this is addressed. Therefore targeted efforts are needed to help pregnant women quit smoking. The current service specification does state that the smoking services should target high risk groups including pregnant women. Due to an increase in the percentage of women who smoked last year at the time of delivery as compared to the previous year, there is a need for the existing and the new service to target this group more effectively. Sexual orientation: Often estimates of the transgender population are combined with wider estimates of the lesbian, gay and bisexual population to provide an overall LBGT estimate. For example, both the London Boroughs of Hounslow and Newham take the approach of quoting national figures which estimate the LBGT population to be between 5% - 7% of the local population. However, this approach creates an inherent link between sexual orientation that some of the transgender population may not recognise themselves i.e. an individual may be gender variant without considering themselves lesbian, gay or bisexual. A conservative estimate of the number of lesbian, gay, bisexual and transgender, people in Richmond is 9500 (5% of the total population). As the Richmond’s stop smoking services are easily accessible for all the population who smokes, therefore, there does not seem to be any adverse impact on this group. However, the data for Richmond is unavailable. We are working closely with the current provider to incorporate the changes in the contract extension as identified above and also incorporating these in the service specification for 2017/18.

BACKGROUND

2. Briefly describe the service/function/policy:

Smoking is the leading preventable cause of premature death. Quitting smoking significantly reduces the risk of dying from tobacco-related diseases such as cardiovascular diseases, lung cancer and with the incidence of disability and poor health-related quality of life. According to World Health Organisation, the current death toll from direct and second hand tobacco smoking in adults 30 years and over is estimated to be globally well over 5.5 million each year. Smoking initiation is a key behaviour that determines the future health consequences of smoking in a

society. There is a marked difference in smoking patterns around the world, driven by initiation rates. Smoking prevalence in adults in England has been steadily decreasing from almost 21% to 18% in the last 5 years since 2010. Nearly 1 in 5 adults’ smoke and there are around 90,000 regular smokers aged between 11 and 15. Smoking causes 17% of all deaths in people aged 35 and over. However, inequalities do exist and is particularly prevalent amongst certain groups:

Unemployed people were almost twice as likely to smoke as the employed and economically active. The highest prevalence of smoking was amongst the socio-economic classification of “routine and manual” at 29% The proportion of current smokers in the lowest two income quintiles was double the proportion in the highest income quintiles. Smoking is twice as common in people with long-standing mental health problems.

Smoking is the single biggest preventable cause of health inequality. Most smokers initiate smoking as teenagers: two-thirds before the age of 18. The reason for this is complex; ranging from parental and sibling smoking, the ease of obtaining cigarettes, smoking by friends and peer group members, socio-economic status, exposure to tobacco marketing, and depictions of smoking in films, television and other media. Children are more likely to take up smoking if they live with people who smoke. The best way to reduce smoking among young people is to reduce it in the world around them. Stop Smoking Services are the single, most effective public health intervention to prevent ill health. The number of people in Richmond engaging in unhealthy behaviours is substantial and the costs of dependency on health and social care are unaffordable at current trends. However, a significant proportion of long-term conditions are avoidable with the adoption of healthy behaviours. National evidence highlights that unhealthy diet, closely followed by tobacco was the leading cause of poor quality and reduced length of life in 2015. In Richmond, smoking prevalence is much lower than in London and England at only 11.2% (2014). However, there are still an estimated 17,000 adults in Richmond who smoke. Annually, 244 deaths are attributable to smoking, and over 1200 hospital admissions are due to smoking related conditions. Most people make several attempts to quit smoking; however, they find it much harder when they are dealing with stress in their lives. To improve their chances of quitting there is a need for effective services and therapies, supportive social networks and smoker free environments. Local stop smoking services offer the best chance of success. They are up to 4 times more effective than no help or over the counter nicotine replacement therapy. The Stop Smoking Service Contract was awarded by NHS Richmond Primary Care Trust to Thrive Tribe (trading as Kick-it) with Richmond

and Twickenham PCT, for a period of 3 years from 01 October 2012 to 30 September 2015, including two further periods of extension of up to one year each. This is a joint contract between the London Borough of Richmond upon Thames and Royal Borough of Kingston upon Thames; with Richmond council acting as the contract lead. The Kick-It smoking cessation programme supports and facilitates the delivery of stop smoking advice within pharmacies and general practices which represents the greatest opportunity to provide the service to local communities.

3. Why is the equality impact and needs analysis being undertaken?

The smoking cessation programme is a key mechanism for advancing equality, reducing inequalities and improving health. Nationally, the number of people setting a quit date is falling, leading to a fall in the numbers of successful quitters. As compared to London and England, Richmond performs poorly with regard to the numbers of smokers setting a quit date. In 2014/15, 3,638 per 100,000 smokers over 16 years of age set a quit date. Having set a quit date, the number of successful quitters at 4 weeks was 1,486 per 100,000 smokers roughly half the rate of London and England. This number has dropped since last year. The stop smoking service in Richmond for the first two years helped to reach the targets but recently the performance has significantly declined i.e. by 50%. There are multiple reasons for this decline such as wide-spread availability of cheap tobacco and the emergence of niche products such as shisha, disengagement of the primary care providers, introduction of a new IT system and rapid surge in the availability and usage of E-cigarettes. The effects of e-cigarettes are as yet not fully understood, but it is associated with harm reduction. The Comprehensive Spending Review (CSR) announced further challenging cuts to public health budgets which require a review of all commissioned services. Therefore, there is a strong business requirement to secure significant savings from a modernised model of stop smoking provision. Additionally the current stop smoking services contract has exhausted its extension clause, and the council is required to re- procure a new stop smoking service for April 2017. A new stop smoking service model is proposed taking into account an evidence-based approach, a service model consisting of a universal digital offer, targeted specialist provision in primary care and also via contractual arrangements with secondary care, provision of training and education incorporating elements of Young people and Tobacco control. The EINA is therefore seeking to understand the impact of the new service, the benefit to commission at scale with the added advantage to achieve the economies of scale and the saving required and also it will be an integral part of the needs analysis at the start of the commissioning process.

4. Has this service/ function/ policy undertaken a screening for relevance

Yes, the screening for relevance was undertaken and identified potential medium impact for ‘Age’, ‘Sex’ , ‘Sexual Orientation’, ‘Gender Re-assignment’, ‘Pregnancy and Maternity’. The further information is in the ‘Appendix’ attached at the end of the document.

The Equality Act 2010 identifies 9 protected characteristics:

Age Disability Gender Gender Reassignment Marriage/CP Maternity Race Religion/Belief Sexual Orientation

5. What sources of information have been used in the preparation of this equality impact and needs analysis?

http://www.ash.org.uk/files/documents/ASH_596.pdf

ASH. (2014). Second hand Smoke: the impact on children.

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_124917

Department of Health. (2011). Healthy Lives, Healthy People : A Tobacco Control Plan for England. Public Health.

http://www.tgmeds.org.uk/nhsgender2011.html#.Vw_W0NQrJdg

A review of access to NHS gender reassignment services (England only) Updated version – November 2011

https://www.richmond.gov.uk/jsna Joint strategic needs analysis (JSNA) for Richmond

http://www.datarich.info/ Data Rich - population forecast for Richmond

http://www.datarich.info/resource/view?resourceId=488

London Borough of Richmond upon Thames. (2015a). Estimating the Transgender Population of Richmond upon Thames. Retrieved November 23, 2015

http://www.richmond.gov.uk/pharmaceutical_needs_assessment.p

London Borough of Richmond upon Thames. (2015b) LBRuT Pharmaceutical Needs Assessment

http://www.datarich.info/resource/view?resourceId=556

London Borough of Richmond upon Thames. (2015c). The Index of Multiple Deprivation 2015.

http://www.ncsct.co.uk/pub_ncsct-about-us.php

NCSCT. (2013). Stop Smoking Services and Health Inequalities.

http://ash.org.uk/files/documents/ASH_131.pdf

Action on smoking and health (2011)- Tobacco and Ethnic Minorities

http://www.richmond.gov.uk/pregnancy_and_maternity_bite_size_jsna_140304.pdf

Pregnancy and Maternity in Richmond (2014)- Bite- size Joint Strategic Needs Assessment

http://www.richmond.gov.uk/census_borough_profile_2013.pdf

London Borough of Richmond upon Thames Census Borough Profile (2013)

https://www.nice.org.uk/guidance/ph48/chapter/2-public-health-need-and-practice

Smoking: Acute, maternity and mental health services (NICE guidelines, 2013)

http://www.hscic.gov.uk/catalogue/PUB17526/stat-smok-eng-2015-rep.pdf

Health and Social Care Information Centre (2015)- Statistics on Smoking

http://www.hscic.gov.uk/catalogue/PUB17526/stat-smok-eng-2015-rep.pdf

Health and Social Care Information Centre (2015)- Statistics on Smoking

6. ANALYSING IMPACT, NEEDS AND EFFECTS

Protected Group Estimated Impact Findings Age

Medium

National information/data Nationally, smoking prevalence decreases with age, as people quit, or long-term smokers begin to face mortality from smoking-related diseases. In 2014, nationally, 23% of those aged 18 – 34 smoked, dropping to 20% in 35 -49 year olds, 18% in those ages 50 – 64 and halving to 9% in those aged over 65. Those who quit smoking at a younger age, have a longer life expectancy than those who continue smoking. It is thus desirable that a successful intervention comes as early in life as possible, and interventions should primarily target on the working age population. Roughly 20% of the population of Richmond is aged 18- 34. Younger people The commissioned service is aimed at adults, thus we do not consider the accessibility of the service to those under 16. However, it is noted that the adult smoking habits will have an impact on children, both through future behaviours and second hand smoke.

• Children whose parents both smoked were three times more likely to take up smoking. • Exposure to second-hand smoke causes a range of diseases, to which children are

particularly vulnerable. There is now a high level of compliance with smoke- free laws, in enclosed work and public places. However, 67% of pupils reported being exposed to second hand- smoke in the last year, most commonly in someone else’s or their own home or car.

It is thus desirable to direct interventions for younger people for stopping them to initiate smoking.

Richmond information/data A youth survey estimated that 14.3% of 15 year olds in Richmond were current smokers 2014/15- this was the highest prevalence in England. Current smokers include both children who smoke regularly i.e. at least one cigarette a week (6.7%) and occasionally i.e. less than one cigarette a week (7.6%). Regular smoking is considered to be more problematic, this was similar to the English level, but still much higher than London. This high prevalence relative to the rest of the country is likely due to the predominantly white ethnic group in Richmond. The current commissioned service is aimed at adults and children 12 years and above therefore easily accessible to children under the Frazer guidelines. Additionally, the young people and tobacco control element helps to focus on the wider elements including children and young people at schools and colleges. Similarly, the new service model will be accessible to all adults and children 12 years and above who smoke (under the Frazer guidelines) and the Young people and tobacco control will help to target all school age children. However, due to a higher percentage of 15 years old who smoke in Richmond, there is a need for the existing and new service to target and engage this age group more effectively.

Disability Low National information/data People with disabilities often have individual complex and specific needs. It is important that health and social care services are able to provide effective specialist services to meet such needs. Smoking prevalence is significantly higher among people with mental health problems than among the general populations. Prevalence is highest among those with a diagnosis of a psychotic disorder, more than two-thirds (70%) of people in psychiatric units smoke tobacco and it is high as 80% among people with schizophrenia. Young people aged 11-16 years with an emotional, hyperkinetic or conduct disorder were much more likely to be smokers than other young people. Most of the reduction in the life expectancy among people with serious mental illness is attributable to smoking.

• In people aged 18-64 years, a total of 20,510 people have a common mental health problem; 9,155 have two or more psychiatric disorder, 422 anti-social personality disorders and 510 psychotic disorder.

• In people aged 15-64 years, a total of 3,621 have a learning disability, and that of these 770 have a moderate or severe learning disability (London Borough Richmond Upon Thames)

People with mental health problems are able to quit smoking if they are offered evidence –based support. However, research shows that effective stop smoking treatment is not always offered to them.

Richmond information/data In Richmond, 21,477 (12%) people report that they have some form of disability or health problem that affects their day-to-day activities. 370 people are blind, 260 partially sighted, and 550 are deaf or hard of hearing. The Richmond’s stop smoking services are aimed at all the adult population equally including people with disabilities. There seem to be no barriers for people with disabilities to access the service. Therefore, the procurement of a stop smoking service will not have a negative impact on people with disabilities.

Gender (Sex) Medium National information/data Nationally, prevalence of smoking was higher for men (22%) than women (17%). In 2013 on average, men in the age bracket 50-59, smoked 11- 13 cigarettes per day more than women and a higher proportion of men than women smoke hand-rolled cigarettes (40 per cent of men and 23 per cent of women). Men were also more likely than women to initiate smoking before they were 16 years of age (43% of men who had ever smoked regularly compared with 37% of women in 2011). Since the early 1990s there has been an increase in the proportion of women taking up smoking before the age of 16. In 1992, 28% of women who had ever smoked started before they were 16 years of

age; in 2011 the corresponding figure was 37%.

Since 1992, the proportion of men who had ever smoked and had started smoking regularly before the age of 16 has stayed constant at approximately 40%.

Smoking is responsible for about half the difference in death rates in men by socio-economic status. Richmond information/data In Richmond, 48.6% of the population is male and 51.4% female. Up until 2014/15 there had been an even proportion of men and women accessing the smoking cessation services. In 2014/15, there was a slight increase in the number of females (52%) accessing stop smoking services. This mirrors the gender breakdown in the Richmond population. However, as seen nationally, more men in smoke than women, however, this may be less of an issue in Richmond as the adult male population is slightly lower than the adult female population. Generally, we would expect to see more men accessing services. This suggests that men are less likely to access services. Therefore targeted efforts are needed for men to access the service

Gender reassignment

Low National information/data Estimates of the prevalence and incidence of gender dysphoria and Transsexualism are difficult to quantify due to the lack of robust national data. Additionally, there is no central data on how many people request or receive gender reassignment services in England. However, it is estimated a roughly 0.6% to 1% of the population are transgender. The percentage of the population that had undergone gender transitioning treatment in the UK is estimated to be closer to 0.01% of the population. This is a very small proportion of the population, but there are medical risks associated with hormone use and smoking, which require attention because patients who smoke and take estrogens face a significantly higher risk of thromboembolic complications than those who do not. The risk of polycythemia and polycythemic stroke is also increased by androgen supplementation with concurrent smoking. However, gender reassignment services are the priority health issue identified by mist trans-advocacy groups. Richmond Information/data There is no official estimate of the transgender population in Richmond. Based on national research, it is estimated that between 1,148 and 1,914 transgender people living in Richmond. As the Richmond’s stop smoking services are easily accessible for all the population who smokes. Therefore, there does not seem to be any adverse impact on this group.

Marriage and civil partnership

Low National information/data: The prevalence of cigarette smoking varies considerably according to marital status. In 2013, people who were cohabiting were most likely to smoke (29%) while those who were married were least likely (13%). Single people were most likely to have never smoked with 63% not doing so. Richmond Information/data In Richmond, in 2013, 60% of people were living in a couple- either married/in a same sex civil partnership or co-habiting, compared to 53% in Outer London. 26% people are single and have never been married or in a same sex civil partnership. 6% of the population are not living in a couple and have been divorced or in a legally dissolved same sex civil partnership. As the Richmond’s stop smoking services are easily accessible for all the population who smokes, therefore, there does not seem to be any adverse impact on this group.

Pregnancy and maternity

Medium

National information/data: Smoking during pregnancy can cause serious pregnancy-related health problems, including complications during labour and an increased risk of miscarriage, premature birth, still birth, low birth-weight and sudden unexpected death in infancy. Many teenage women smoke during pregnancy. In 2010, women aged 20 and younger were 6 times more likely to smoke throughout pregnancy as compared to those aged 35 and over. In addition, pregnant woman from routine and manual occupations are much more likely to smoke throughout their pregnancy than those from professional and managerial occupations. Overall, 26% of mothers in England smoked before pregnancy, 55% gave up smoking at some stage before the birth and 31% were smoking again less than a year later after pregnancy. As there is stigma attached to smoking in pregnancy there is likely to be significant under-reporting by pregnant women who smoke. Exposure to passive smoking during pregnancy is an independent risk factor for low birth weight. Babies exposed to their mother’s tobacco smoke before they are born, grow up with

reduced lung function. Parental smoking is also a risk factor for sudden infant death syndrome (cot death). In 2000, 21% of non -smoking pregnant women were exposed to the second hand smoke. Richmond Information/ data: In Richmond, only 2.6% of woman smoked at the time of delivery, which is significantly lower than the London and England average. However, this did represent an increase from 1.9% the previous year, contrary to a decreasing trend nationally. In Richmond, 57 women smoked at the time of delivery and given the severity of the consequences, it is important that this is addressed. Therefore targeted efforts are needed to help pregnant women quit smoking. The current service specification does state that the smoking services should target high risk groups including pregnant women. There is a need for the new stop smoking service in 2017/18 to target this age group

Race/ethnicity Medium National information/data: Smoking rates vary considerably between ethnic groups. In men, compared to the general population, rates are particularly high in the Black Caribbean (37%) and Bangladeshi (36%) populations but these differences are explained by socioeconomic differences between the groups. Among women, smoking rates are low (at 8% or below) with the exception of Black Caribbean (22%) and Irish (24%) compared with the general population. Overall, smoking rates among ethnic minority groups are lower than the UK population as a whole. Smokeless tobacco is used by some ethnic minority groups, particularly those from South Asia. Chewing tobacco is most commonly used by the Bangladeshi community with 9% of men and 19% of women reporting that they use chewing tobacco. However these figures may reflect a degree of under-reporting by some respondents. Richmond Information/data: Over the last ten years, Richmond upon Thames has become more ethnically diverse. Although the majority of residents in the borough are White British this proportion has fallen from 78.72% in 2001 to 71.44% in 2011. In total in 2011, 86% of residents in Richmond were of

White ethnicity including White British, White Irish, White Gypsy or Irish Traveller and White Other ethnic groups. The borough is less ethnically diverse than London but generally more diverse than England overall with some notable exceptions. In Richmond, 0.62% is Asian/Asian British and Pakistani and 0.88% ethnic group is Black/African/Caribbean/Black British. Estimates from 2004 are the latest available on smoking and ethnicity. After adjustment for age, Bangladeshi (40%) and Irish men (30%) were more likely and Indian men less likely (20%) to report smoking cigarettes than men in the general population (24%). Self- reported smoking prevalence was higher among women in the general population (23%) than most minority ethnic groups, except Irish (26%) and Black Caribbean women (24%). As the Richmond’s stop smoking services are easily accessible for all the population who smokes, therefore, there does not seem to be any adverse impact on this group. However targeted efforts need to be made to raise awareness about the stop smoking service amongst the BME communities.

Religion and belief including non- belief

Low National Information data: There is little evidence of a link between religious belief and non-belief on smoking activity. As with any service, the smoking cessation service is expected to consider religious and cultural sensitivities. Richmond Information/data The population of Richmond is predominantly Christian (55%) or without a religion (28.45%). The Muslim, Hindu and Sikh communities in Richmond are highly concentrated in Heathfield and Whitton wards. Residents stated their religion in the 2011 Census and the table below indicated the numbers of those who follow each of the major religions in the UK.

Stated religion (Census 2011)

Number of Richmond Residents

Christian 103319 Buddhist 1577

Hindu 3051 Jewish 1409 Muslim 6128 Sikh 1581

As the Richmond’s stop smoking services are easily accessible for all the population who smokes, therefore, there does not seem to be any adverse impact on this group.

Sexual orientation Medium National Information data: According to 2014 statistics, lesbian and gay people are much more likely to smoke than the general population in UK. Young LGB (Lesbian, Gay and Bisexual) people are also more likely to initiate smoking at the younger age and smoke more heavily especially homeless people. LGBT (Lesbian, Gay, Bisexual and Transgender) people are also more likely to suffer from mental ill health and are more likely to suffer from a number of social disadvantages which make them more vulnerable to smoking. Richmond Information/data Often estimates of the transgender population are combined with wider estimates of the lesbian, gay and bisexual population to provide an overall LBGT estimate. For example, both the London Boroughs of Hounslow and Newham take the approach of quoting national figures which estimate the LBGT population to be between 5% - 7% of the local population. However, this approach creates an inherent link between sexual orientation that some of the trans population may not recognise themselves i.e. an individual may be gender variant without considering themselves lesbian, gay or bisexual. A conservative estimate of the number of lesbian, gay, bisexual and transgender, people in Richmond is 9500 (5% of the total population). As the Richmond’s stop smoking services are easily accessible for all the population who smokes, therefore, there does not seem to be any adverse impact on this group. However, the local data for Richmond is unavailable.

7. Have you identified any data gaps in relation to the relevant protected characteristics and relevant parts of the

duty?

Gaps in data Actions to deal with this There appears to be a local gap in the data regarding the protected characteristics. Clarity is needed about what data Richmond commissioned services collect on service users and whether it includes information on protected characteristics.

Identify what information Richmond commissioned smoking cessation services are collecting on the protected characteristics. After the gap analysis, an action plan will be developed to include this in the existing and new service specifications.

There are no reliable or definitive figures locally or nationally available on the size of the LGB communities and lack of research on the impact of smoking on this group.

This is a national issue.

There are no reliable or definitive figures available locally or nationally on the size of the transgender population.

This is a national issue.

8. Consultation on the Key Findings What consultation have you undertaken with stakeholders or critical friends to help inform the EINA process? What consultation has been undertaken about the key findings? What feedback did you receive as part of the consultation? Colleagues from the Health Intelligence team and Public Health team within the council have provided a range of information and advice about smoking cessation and protected characteristics which have been used to shape the EINA. The EINA has been consulted at Community Involvement Group on 21st April 2016 for their comments and their feedback has been incorporated into the EINA document. It has been shared with Public Health DMG (Department Management Group) for their feedback. The draft EINA will be taken to the ACS Directorate Equalities Board on 15th June 2016 for approval and sign-off on behalf of LBRuT

9. ACTION PLANNING

1. What issues have you identified that require equality actions? What are these equality actions, who will be responsible for them and when will they be completed?

Equality Action Planning:

Use summary of issues and actions in the completed EINA Produce action plan with equality objectives and actions Establish ambitious but achievable timescales Set milestones and targets Include actions and targets in performance monitoring

In the equality action plan, set out any of the equality actions you will undertake to address any issues you have identified as part of the analysis. This could be an action to address a disadvantage experienced by a specific protected group, or to implement an activity that will advance equality of opportunity or foster good relations. Lead officers also need to be named along with a proposed completion date.

Issue identified Planned action Lead officer Completion Date

There appears to be a local gap in the data regarding the protected characteristics of people. Clarity is needed about what data Richmond commissioned services collect on service users and whether it includes information on protected characteristics.

Identify what information Richmond commissioned smoking cessation services are collecting on the protected characteristics.

PG July/August 2016

There is lack of awareness amongst BME communities about smoking cessation services available both locally and nationally. Services may not be configured

The service specification should state that the provider should have a robust communications plan to raise awareness about stop smoking cessation services in

UK/PG June/July 2016

for BME community users the community especially amongst BME communities.

There is a high percentage of 15 years old who smoke in Richmond

Although the current smoking services are accessible to children of 12 years and above, but due to a high proportion of children of 15 years of age who smoke, there is a need to focus on this age group. This should be reflected in the service specification.

UK/PG June/July 2016

Men are less likely to access stop smoking cessation services.

This should be included as a KPI in the service specification. The service spec. should also highlight targeting men from both routine and manual occupations, unemployed populations and hard- to –reach target groups.

UK/PG June/July 2016

Pregnant who smoke may not be accessing the service appropriately as there has been a rise percentage of women who smoke.

Include this as a KPI in the new service specification and work with the current provider to help target this group effectively.

UK/PG June /July 2016

Please Note: We are working closely with the current provider to incorporate the changes in the contract extension as identified above and also incorporating these in the service specification for 2017/18.

MONITORING AND REVIEW

10. How will the actions in the action plan be monitored and reviewed? For example, any equality actions identified should be added to business, service or team plans and performance managed.

The completion of the actions in this EINA will be monitored through RP3 updates in alignment with ACS EINA protocol. This will be shared with the existing provider and incorporated in their action plan and monitored via regular contract meetings.

11. PUBLISHING THE FULL COMPLETED ANALYSIS Please provide details below:

Approved by

Signed off outside of the ACS-Directorate Equalities Board

Date of approval

June 2016

Date of publication

17th August 2016

DECISION-MAKING PROCESS

12. Has a copy of this EINA or summary of key findings been provided to key decision-makers, where relevant, to help inform decision making, for example as an appendix to a Cabinet or Committee report or report for DMT or Exec Board?

If so please provide the details including the name of the report, the audience i.e. Cabinet/ Committee, the date it went, and the report author.

Please also outline the outcome from the report and details of any follow up action or monitoring of actions or decision taken:

The EINA will be included as an Appendix to the documents informing the Stop Smoking Cessation Commissioning process.

Public Sector Equality Duty 2011: Initial Screening for Equality Relevance and Impact

Name of Directorate Adult and Community Services

Contact Pradnya Gaikwad Telephone 020 8734 3020

E-mail Pradnya.gaikwad@richmond.gov.uk

Service/ Function Are the areas listed below relevant to your service/ function? Please answer H, M or L for ‘High’ Medium or Low’ or state if there is NO information.

Age Sex Race Disab’ Re&B SO GeR P&M M&CP Eliminating discrimination, harassment or victimisation

Advancing equality of opportunity between different groups

Fostering good relations

1. Stop Smoking Cessation Services

M M M L L M L M L L M M

2.

3.

4.

5.

6.

Legend

Age Age Sex Sex

Race Race Disab’ Disability

Re&B Religion and Belief SO Sexual orientation

GeR Gender re-assignment P&M Pregnancy and maternity