Equality Impact Assessment (EIA) - Differential health impacts on staff of Covid 19

Equality Impact Assessments (EIAs) are public documents. EIAs accompanying reports going to County Councillors for decisions are published with the committee papers on our website and are available in hard copy at the relevant meeting. To help people to find completed EIAs we also publish them in the Equality and Diversity section of our website. This will help people to see for themselves how we have paid due regard in order to meet statutory requirements.

Name of Directorate and Service Area Council-wide 
Lead Officer and contact details Deborah Hugill deborah.hugill@northyorks.gov.uk 
Names and roles of other people involved in carrying out the EIA 

Shanna Carrell – Participation and Engagement Manager (HAS)

Deborah Hugill – Senior Strategy and Performance Officer (CS)

Sarah Longstaff – HR Business Partner (CS) 

Vicky Waterson – Health Improvement Manager (HAS)

Victoria Turner – Public Health Consultant

Charlotte Scott – Principal Social Worker (HAS)  

Cath McCarty – Head of Human Resources (HAS)

How will you pay due regard? For example, working group, individual officer  Officer working group
When did the due regard process start?  1 May 2020 

Section 1. Please describe briefly what this EIA is about, for example are you starting a new service, changing how you do something, stopping doing something?

This EIA considers the current evidence of differential rates of infection of Covid-19, and ultimate outcome if infected, for different protected characteristics and identifies mitigating actions for NYCC in relation to staff in those groups. These actions will form part of the County Council’s response to Covid-19 and will be actioned appropriately across the Council, in particular in job roles with higher risk of exposure to the virus.  
 
Covid-19 is a new disease and knowledge about it is still constantly evolving. A considerable amount of research nationally, and internationally, is underway to understand its effects on people in general and in particular, for example in relation to a range of characteristics.  
 
Some vulnerabilities have been known about for some time, such as the fact that Covid-19 is more likely to be more serious in older people.  Emerging UK and international data suggests that Covid19 is also disproportionately affecting people from Black, Asian and Minority Ethnic (BAME) backgrounds. This evidence suggests that the impact may also be higher among men, those in the higher age brackets and those with an existing underlying health condition. Evidence for other vulnerabilities is more recent and further research is being undertaken to verify, or otherwise, these findings. Despite this changing picture it is important that the County Council acts on the evidence as it emerges and protects its staff effectively.  
 
This equality impact assessment is based on current thinking about likely impacts on different equality groups and may change as understanding develops. Changes and additions to the EIA will be clearly marked and dated. 
 
Much of the evidence so far available in the UK for differential impacts and best practice for mitigation comes from the NHS workforce and involves front line workers in frequent contact with symptomatic cases of Covid-19. Whilst many County Council staff are office based and therefore not directly comparable with frontline NHS workers, there are considerable numbers of NYCC staff who work on the frontline in more high-risk occupations when it comes to coronavirus. Some examples would be staff working in care homes, reablement staff and social work staff.  
 
In paying due regard, therefore, NHS guidance for risk assessment of staff in relation to Covid-19 has been taken into account. You must be logged in to view the article.
 
2.6.20 – The Public Health England review Disparities in the risk and outcomes of COVID-19 has been published and the findings have been incorporated into this equality impact assessment. It is a descriptive review and finds overall that the impact of COVID-19 has replicated existing health inequalities and, in some cases, has increased them. Specific findings for particular protected characteristics are detailed in section six. The review acknowledges that results of this review need to be widely discussed and considered by all those involved in and concerned with the national and local response to COVID-19, but makes the point that it is already clear that relevant guidance, certain aspects of recording and reporting of data, and key policies should be adapted to recognise and wherever possible mitigate or reduce the impact of COVID-19 on the population groups that are shown in this review to be more affected by the infection and its adverse outcomes. 

Actions which NYCC have already taken:  

Risk assessment and monitoring

  • staff have been encouraged to disclose any vulnerability that could affect their susceptibility to Covid-19
  • some staff have been identified as falling within the ‘shielding’ category, i.e. who have received a letter from the NHS advising them to remain at home and avoid contact with others for 12 weeks. Any member of staff who falls into this category must not attend work during the 12-week period of shielding and is encouraged to do work from home where at all possible
  • for those staff who fall into the wider ‘vulnerable’ category, i.e. anyone aged 70 or older (regardless of medical conditions), under 70 with an underlying health condition as listed by the government, pregnant women and those from a BAME background, especially when combined with other risk factors including age, gender, underlying medical conditions, any workplace risks are assessed by the line manager and the individual directed to work at home if at all possible
  • restrict exposure to high viral load environments for colleagues in high risk groups
  • adjustments to working arrangements include moving to a lower-risk area, undertaking lower-risk tasks, limiting exposure (for example through reducing shift lengths) and remote working
  • any requirements for changes to the individual risk assessment process for colleagues in high risk groups are identified through national guidance and managers will review existing risk assessments periodically and as guidance is updated
  • continuing to review the categories for inclusion as high risk and acting accordingly
  • targeted awareness raising of the risk assessment process is undertaken
  • managers listen carefully to staff concerns and provide support and consider adjustments or redeployment for any staff identified as at greater risk
  • management and HR teams provide information, support and guidance for managers so that they are confident to have conversations with staff and can understand and accommodate any cultural factors which need to be taken into account in order to facilitate these conversations
  • ensuring any bank and agency staff know if they are going to be working in a Covid19 positive environment and undergo risk assessment in the same way as other staff
  • additional support is available through an employee assistance helpline (#askSAL), employee assistance programmes and occupational health where required
  • ongoing exploration of how to manage the risk to high risk group staff
  • reducing the use of bank and agency staff wherever possible
  • avoiding sharing bank and agency staff between high risk and lower risk areas, wherever possible

 Numbers identified as vulnerable (as 23.6.20) 

Vulnerability Group NYCC Nos Identified HAS Nos Identified 
70+  226 22
Underlying medical condition  1187 380
Pregnancy 74 26

Black, Asian and Minority Ethnic status was added to the wider vulnerable group on 7 May 2020. There is some data on ethnicity within the HR system but it is not complete. The guidance for managers in managing staff during the pandemic was updated to reflect that those from a BAME group are now classified as within the vulnerable category and individual risk assessment have been undertaken for these members of staff.

  • established workstream on staff health and wellbeing, led by HAS Head of HR and with involvement from public health, occupational health, health and safety etc.
  • monitoring of Covid-19 related sickness absence which is reported in the HAS weekly KPI update  
  • task and finish group on staff health and wellbeing resources during Covid-19 

PPE

  • supplies for staff boosted with the help of local companies.
  • emergency supply hubs set up for out of hours / weekends emergency purposes.
  • prioritisation approach developed and in use.
  • ensured PPE requirements met in line with national guidance, that fit is good and staff are clear about how and when to use PPE.
  • intranet guidance on use of PPE
  • a learning package is available to staff via Learning Zone (Covid-19 and Personal Protective Equipment)  
  • webinars on specific issues for example, PPE 

Testing

  • testing process implemented and staff accessing testing across a range of locations.
  • testing now accessible to all staff with symptoms. Testing in care homes is also available to those who are asymptomatic.
  • initially a central team were working 7 days a week, picking up referrals and submitting staff for testing before these were available in the community.
  • staff updating MyView (staff information and absence system) with test results
  • self-isolation practices are in place in relation to the NHS Test and Trace scheme where staff members are being requested to self-isolate because of close contact with a Covid-19 positive person

Health and wellbeing

  • NYCC response to Covid-19 – task and finish group on Staff Health and Wellbeing resources  
  • health and wellbeing advice and support through intranet
  • #AskSAL advice line established for staff and this is continuously promoted
  • guidance for staff and managers is available on the intranet and is updated on a regular basis
  • access to 24/7 counselling services through Health Assured
  • NYCC Mental health / Mindful Employer subgroup  
  • NYCC signposting and referral pathway for mental health  
  • NYCC work on bereavement (instigated by Covid-19) through task group    
  • NYCC work on alcohol awareness through task group
  • NYCC work on domestic abuse through task group
  • campaigns and awareness raising for example, mental health awareness week  
  • ese of blogs for example, Head of HR’s guest blog on mental health  
  • comprehensive training offer including mental health awareness and psychological first aid 
  • communicating the relative risks identified to colleagues in a sensitive and timely manner ensuring that all managers and colleagues are aware of those groups at greater risk
  • wellbeing calls from managers to colleagues who are shielding

Staff engagement

  • home but not alone intranet campaign to share stories of home working
  • providing information on the actions that can be taken to support staff who are anxious about the greater risk for them of contracting Covid-19
  • weekly updates on HR and staff issues to all NYCC staff  
  • communications and awareness raising plan which includes email banners, update of intranet material on staff health and wellbeing  through Boost and Covid-19 micro site
  • NYCC Behavioural Insights work on staff health and wellbeing  
  • consultation and dialogue with trade union representatives including health and safety representatives
  • Pulse staff survey carried out in August 2020 included specific COVID questions and results show that staff feel well supported:
    • People within my team have supported each other during the Covid pandemic working arrangements (92% agreed)
    • I know where to access health and wellbeing resources that might support me (92% agreed)
    • My manager has done a good job of keeping me informed during the Covid pandemic (90% agreed) 

Workplace considerations (including Covid-19 Secure workplaces, redeployment, homeworking)

  • all staff who can work at home are asked to and being supported to do so
  • necessary equipment and guidance has been provided for home working - homeworking risk assessment being rolled out
  • Homebot has been developed to answer staff questions about home working
  • where staff cannot work at home, social distancing is in place and other adjustments have been made to working spaces
  • developing guidance, risk assessments, induction and communications in relation to accessing, attending and returning to office bases for agreed staff members
  • supportive conversations with colleagues identified for the deployment pool, including risk assessments to identify appropriate areas for deployment and Health Passport information for colleagues with a disability
  • all offices and other workplaces to be set up to meet the Government’s ‘Covid Secure’ guidelines. These will include reduced numbers of usable desks, restrictions on the use of tea points and meeting rooms and enforced one-way circulation routes
  • risk assessments revised for use of council vehicles and where staff undertake home visits

General

  • engaging with national shared learning opportunities to identify best practice
  • updating policies and advice where necessary – for example NYCC’s bereavement guidance has been updated as a result of recommendations from the bereavement task group
  • managing impact on the remaining non-high-risk staff group to ensure they are not overburdened by covering work of high-risk colleagues

Section 2. Why is this being proposed? What are the aims? What does the authority hope to achieve by it? For example to save money, meet increased demand, do things in a better way.

The aim is to ensure that measures are in place to mitigate, as much as possible, the effect of differential impact on different staff groups and in particular, those with specific vulnerabilities and/or specific protected characteristics which may make them more susceptible to contracting coronavirus and/or being adversely affected by it. 

Section 3. What will change? What will be different for customers and/or staff?

Recommended future actions: 

Risk assessment

Recommendation Purpose of recommendation 
Improve our recording / understanding of information about the protected characteristics of staff  To be able to better identify those staff who have specific protected characteristics which might warrant workplace interventions to protect their health and safety

PPE

Recommendation Purpose of recommendation
Ensure PPE use as per corporate guidance This is based on work being undertaken not the vulnerability of the individual doing the work. Face coverings are not PPE but are now mandated in shared spaces in council office buildings too.

Health and wellbeing

Recommendation Purpose of recommendation
Ensure that health and wellbeing offer is tailored to any differential needs of high risk groups  Awareness that one size fits all approach may not be appropriate and that particular groups may need tailored offer 

Staff engagement

Recommendation Purpose of recommendation
Develop ways to proactively engage with staff in high risk groups to ensure concerns are heard.  To ensure that all high risk staff have the opportunity to raise concerns in a way which they can engage with.
Share stories of recovery especially for all vulnerable groups / relevant protected characteristics To help staff put concerns into perspective and ensure that they are proportionate. 
Career reassurance that future progress or job role will not be affected by Covid-19 related absence To provide reassurance to high risk staff and ensure they are not discriminated against. 

Workplace considerations

Recommendation Purpose of recommendation
Continue to engage with national shared learning opportunities to identify best practice To ensure that we are acting on the best evidence available and using practice which is proven.

General

Recommendation Purpose of recommendation
Continue to engage with national shared learning opportunities to identify best practice  To ensure that we are acting on the best evidence available and using practice which is proven. 

General 

Recommendation Purpose of recommendation
Team Managers to monitor to ensure that the higher risk of contracting COVID for BAME staff is not leading to discrimination in the workplace.  Anti-racist practice work in HAS has found that some BAME members of staff have described feeling isolated within their teams. This recommendation is intended to embed an anti-racist approach and identify and tackle potential discrimination. 

Section 4. Involvement and consultation (What involvement and consultation has been done regarding the proposal and what are the results? What consultation will be needed and how will it be done?) 

Consultation and engagement is being carried out with staff and union representatives. All work to adapt offices and other workplaces is being carried out in collaboration with Unison and issues of concern can be raised, considered and addressed. Unison is also being consulted in relation to risk assessments.

Section 5. What impact will this proposal have on council budgets? Will it be cost neutral, have increased cost or reduce costs?  

Please explain briefly why this will be the result. 

  • increased cost due to adaptations to workplaces – low occupancy, PPE, screening, signage etc
  • increasing staffing costs where staff are having to cover duties of those staff who are not working/unable to work
  • additional cost to provide extra kit and equipment to employees working from home – likely to increase as homeworking risk assessment is rolled out.
  • cost savings due to lots of staff working at home – heating, power, mileage costs

Section 6. How will this proposal affect people with protected characteristics? 

Section 6. How will this proposal affect people with protected characteristics ? No impact  Make things better  Make things worse  Why will it have this effect? Provide evidence from engagement, consultation and/or service user data or demographic information etc. 
Age     X

Evidence so far shows that, in general, older people are worse affected by Covid-19 than younger people. As of 29 May most COVID-19 deaths in England and Wales have been among those aged 65 and over (40,796 out of 45,748) (Office of National Statistics.)

The data show that for each decade of life the risk factor typically increases by 2 to 4 fold after your 40s. Using the 40s as a comparison point, people in their 50s are 3 times more at risk, people in their 60s are 8 times more at risk and people in their 70s are 25 times more at risk. The age related impact is also skewed by sex, with males experiencing significantly higher risk factor as each decade passes, relative to female counterparts.  
 
Older people are more likely to experience comorbidities and pre-existing medical conditions. 
 
Data showing mortality chances published by the Office of National Statistics, Our World in Data, and Intensive Care National Audit and Research Centre (ICNARC) all show an adverse trend of 2-4 times higher death rates as the decades rise between the ages of 40 and 70. 
 
The PHE review shows that the largest disparity found was by age. COVID-19 diagnosis rates increased with age in both male and females. Among people already diagnosed with COVID-19, people who were 80 or older were seventy times more likely to die than those under 40.
 
Younger people and particularly children are less likely to be as badly affected, although there is some research that shows that younger female NHS workers may have a mortality rate approximately twice that of their peers who are notNHS staff. This seems to suggest that the work setting is the paramount factor. 
 
9% of NYCC’s total workforce is aged 60 years and above. 12% of HAS workforce is aged 60 years and above (As of 18.5.20). 
 
As of 23.6.20 226 staff members have identified themselves as over 70 years old which equates to 2% of NYCC’s total staff. Of these 22 work in HAS which equates to 1% of HAS staff members. 

Disability     X

Evidence so far indicates that Covid-19 disproportionately adversely impacts people with pre-existing medical conditions including coronary heart disease, Chronic Obstructive Pulmonary Disease (COPD), diabetes and hypertension. Obesity is also identified as a risk factor. A Glasgow University study analysed data from 428,225 people and found that as body mass index (BMI) increased, so did their risk of having a severe case of the disease. Obesity is, of course, also a risk factor for other health problems such as diabetes and heart disease. 

The PHE review found that among deaths with COVID-19 mentioned on the death certificate, a higher percentage mentioned diabetes (21%), hypertensive diseases, chronic kidney disease, chronic obstructive pulmonary disease and dementia than all cause death certificates. 

Some disabled staff members may have a weak immune system leaving them more vulnerable to getting an infection. There may also be issues associated with personal protective equipment and those with a mental health condition may feel increased levels of anxiety and stress. 

A recent rapid evidence review of the psychological impacts of quarantine identified a negative psychological effect which can still be detected months or years later. This evidence review also highlighted healthcare workers are having a higher prevalence of psychological distress.

A systematic review and meta-analysis of coronavirus indicated that people diagnosed with Covid-19 should recover without experiencing mental illness. However, there is a possibility of depression, anxiety, fatigue or post-traumatic stress disorder in the longer term.

Currently provision of data in respect of staff disability is voluntary at NYCC and therefore it would be difficult to provide an accurate profile of staff in relation to this characteristic as there is limited data held.
 
As of 23.6.20 1187 members of NYCC staff have identified as having a relevant underlying medical condition. This equates to 8% of the total staff. Of these 380 work in HAS which equates to 20% of HAS staff members. 

Sex     X

Whilst the ONS found no evidence of differences in the percentage of men and women testing positive for COVID-196, emerging evidence indicates that it disproportionately adversely impacts men. The PHE review concluded that working age men diagnosed with COVID-19 were twice as likely to die as females. Despite making up 46% of diagnosed cases, men make up almost 60% of deaths and 70% of admissions to intensive care units.

As of 29 May there were more Covid-19 deaths among men than women in England and Wales (25,359 men and 20,389 women) - Office of National Statistics. 

The risk factor for sex typically on average places males to a 2-fold adverse impact from Covid-19 after the age of 50.

An ICNARC study also implicates sex as an essential demographic for consideration. This shows a 2.58 times likelihood of admission into critical care for men with Covid-19 versus only a 1.18 times fold difference in admission for the nonCovid-19 pneumonia control group. The reasons for this may be a combination of biological and behavioural factors.
 
One issue that has received less publicity is that PPE is not necessarily designed for the average female body, which could result in poor fitting equipment and greater physical discomfort for female health and care workers. 
 
19% of NYCC total staff is male. 12% of HAS staff is male. (As of 18.5.20) 

Race     X

Evidence is emerging that indicates that Covid-19 disproportionately adversely impacts people of black, Asian and minority ethnic origin.  
 
Guardian newspaper research into the first patients critically ill with Covid-19 in UK hospitals indicates that Black and Asian people are more likely to be badly affected by coronavirus than White people. ICNARC found that 35% of almost 2,000 patients were non-white, nearly triple the 13% proportion in the UK population as a whole. 14.9 % of those with the most serious cases were Asian (2 times adverse) and 11.2% were Black (3.4 times adverse).

The Institute of Fiscal Studies found that the death rate among British black Africans and British Pakistanis from coronavirus in English hospitals is more than 2.5 times that of the white population, and that deaths of people from a black Caribbean background were 1.7 times higher than for white Britons. IFS research strips out the role of age, sex and geography and indicates that they do not explain the disparities.

Evidence from the NHS - Despite only accounting for 13% of the population in England and Wales, 44% of NHS doctors and 24% of nurses are from a BAME background.  Data shows a 3.55 times higher death rate for BAME nurses and Midwives, 3.29 times higher rate for HCSWs, a 2.13 times higher rate for Doctors and Dentists. Many of the other features of the data - such as the preponderance of women in this dataset, compared to the male dominated figures among those infected or admitted to ICU likely reflect the female dominated population delivering health and social care. Overall doctors who died tended to be older and the vast majority were male, whereas most fatalities among nurses and supporting health care workers were in females. In 63% of cases the individual was of BAME background.  
 
HSJ analysis also showed that a minimum of 53% of healthcare workers who died were not born in the UK compared to about 18% of NHS staff (mainly BAME individuals, with at least 3 White fatalities with country of birth in Europe). A high number of deaths among Filipino staff have also been highlighted.
 
A rapid evidence review has indicated that there is early observational evidence to suggest that Covid-19 hospital deaths among the general population in England are greater in BAME groups compared to White British groups. The number of deaths is not consistent across BAME groups, with per capita deaths and excess deaths highest amongst Black populations. 
 
Data on health and care worker deaths show disproportionately high deaths in BAME populations, with the greatest number occurring in medical staff when compared to other staff categories. 

The PHE review found that death rates from COVID-19 were highest among people of Black and Asian ethnic groups. This is the opposite of what has been seen in previous years, when the mortality rates were lower for these group than White ethnic groups. An analysis of survival among confirmed COVID-19 cases shows that after accounting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death than people of White British ethnicity. People of Chinese, Indian, Pakistani, Other Asian, Caribbean and Other Black ethnicity had between 10 and 50% higher risk of death when compared to White British.
 
The reasons for the emerging differential impacts are considered to be considerably more dependent upon socio-economic factors than biological factors.  

Potential underlying reasons:  
 
Health literacy is an issue in some Black and Ethnic Minorities

Language Barriers may exist making it harder to understand advice and guideline

Different Ethnic Backgrounds predisposed to higher levels of certain conditions for example, Diabetes  

Cultural differences make social distancing difficult at times of illness and death

Socio-economic deprivation leading to underlying health conditions. (Razeq, A., Harrison, D.,Karunanithi,S.,Barr,Asaria,M and Khunti, K ( 2020) BAME Covid19 deaths. Rapid Data and Evidence Review: Hidden in  Plain Sight and Independent sage

Housing: combination of culture and socioeconomic deprivation may be linked to living in higher density accommodation and in multigenerational households, thus making social distancing difficult, leading to increased risk of transmission during lockdown

Immunity and potential vitamin D deficiencies living in UK with reduced exposure to sunlight

Key workers with disproportionate BAME employment in lower salary key worker roles who either work in high exposure care environments or are unable to implement safe social distancing due to their roles. (Razeq)

Less likely to speak up and raise concerns (Francis report 2015)

Co-morbidity exposure risks especially for cardio-vascular disease, diabetes, renal conditions and complex multi-morbidities in ICU.17 When comorbidities are included, the difference in risk of death among hospitalised patients is greatly reduced.

Currently provision of data in respect of staff ethnicity is voluntary at NYCC and therefore it would be difficult to provide an accurate profile of staff in relation to this characteristic as there is limited data held.

Gender reassignment  X     No evidence available currently to suggest that there is a differential impact 
Sexual orientation  X     No evidence available currently to suggest that there is a differential impact
Religion or belief      X Cultural differences in how illness and death is dealt with may make social distancing difficult and could make certain people who observe particular religious practices more vulnerable to contracting Covid-19. 
Pregnancy or maternity      X

Pregnant women at whatever stage of pregnancy are classed as at risk.  
 
Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop coronavirus. As yet, there is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals. 
 
It is known from other respiratory infections (for example, influenza, SARS) that pregnant women who contract significant respiratory infections in the third trimester (after 28 weeks) are more likely to become seriously unwell. Given these additional considerations for women who become seriously unwell in the later stages of pregnancy, the Government has taken the precautionary approach to include pregnant women in a vulnerable group. This is so that pregnant women are aware of the current lack of available evidence relating to this virus in pregnancy, and particularly to encourage awareness that pregnant women in later stages of pregnancy could potentially become more seriously unwell.

As of 23.6.20 74 female staff members have identified as pregnant. Of these 26 work in HAS. These figures equate to 0.5% of NYCC staff and 1% of HAS staff. 

Marriage or civil partnership X     No evidence available currently to suggest that there is a differential impact 

Age totals North Yorkshire Council Council

Age bands NYCC % total in age group NYCC % female in age group NYCC % male in age group
<30 12% 10% 3%
31-40 21% 18% 4%
41-50 28% 23% 6%
51-60 30% 24% 6%
60+ 9% 6% 2%
  100% 81% 19%

Age totals in HAS

Age bands HAS % total in age group HAS % female in age group HAS % male in age group
<30 11% 10% 1%
31-40 21% 19% 2%
41-50 23% 20% 3%
51-60 33% 30% 3%
60+ 12% 10% 1%
  100% 88% 12%

Vulnerability group - age

Vulnerability group NYCC nos identified HAS nos identified % NYCC total % HAS total
70+ 227 20 2% 1%

NYCC Total staff

NYCC total staff NYCC % staff female NYCC % staff male
14696 81% 19%

HAS Total staff

HAS total staff HAS % staff female HAS % staff male
1939 88% 12%

Vulnerability group - pregnancy

Vulnerability group NYCC nos identified HAS nos identified % NYCC total % HAS total
Pregnancy 72 25 0.5% 1%

Section 7. How will this proposal affect people who… 

Section 7. How will this proposal affect people who…  No impact  Make things better  Make things worse  Why will it have this effect? Provide evidence from engagement, consultation and/or service user data or demographic information etc. 
..live in a rural area?    X X Rurality may reduce the likelihood of contracting coronavirus due to less exposure. However, those in the most remote areas may be adversely affected by the lack of nearby medical facilities.
…have a low income?      X Evidence so far indicates that Covid-19 disproportionately adversely impacts people in deprived areas. The rate of deaths involving COVID-19 in England and Wales is more than twice as high in the most deprived areas compared with the least deprived – Office of National Statistics. (Deaths occurring between 1 March and 17 April 2020). 
 
The PHE review findings echo this: the mortality rates from COVID-19 in the most deprived areas were more than double the least deprived areas, for both males and females. This is greater than the inequality seen in mortality rates in previous years, indicating greater inequality in death rates from COVID-19.
 
While the Government have taken several steps to mitigate the economic impact of Covid-19, these measures have not equally benefitted all groups in the labour market. Many women and BAME groups at the bottom end of the socio-economic spectrum are currently falling into poverty because of barriers to social security. 
 
People who live in deprived areas are more likely to work in occupations with higher exposure risk. Additionally, for people who are receiving benefits there may be additional social circumstances and financial pressures due to Covid-19 such as increased food and utility costs. People on a low income may be disadvantaged as they find it difficult to stockpile or bulk-buy food. They are also often economically unable to isolate and there is therefore an increased risk of further spread in that population. 
 
Poorer housing with shared washing facilities makes it harder to avoid cross-contamination or achieve physical distancing.
 
…are carers (unpaid family or friend)?  X     No evidence available currently to suggest that there is a differential impact in terms of risk of infection or outcomes if infected. However, they will be in close contact by necessity with more people and unpaid carers do not generally get PPE. 
 
There is potential for increased pressure of caring on unpaid carers as support and services normally available may be closed temporarily. This may have an impact on physical and mental health. 

Section 8. Geographic impact – Please detail where the impact will be (please tick all that apply) 

Section 8. Geographic impact – Please detail where the impact will be (please tick all that apply) 
North Yorkshire wide X
Craven district  
Hambleton district  
Harrogate district  
Richmondshire district   
Ryedale district  
Scarborough district  
Selby district  

If you have ticked one or more districts, will specific town(s)/village(s) be particularly impacted? If so, please specify below.

 

Section 9. Will the proposal affect anyone more because of a combination of protected characteristics? For example, older women or young gay men) State what you think the effect may be and why, providing evidence from engagement, consultation and/or service user data or demographic information etc.

Current evidence shows that the risk factors for worse outcomes from Covid-19 are multiple and any combination of those higher risk protected characteristics for example, older BAME male is more likely to result in an adverse impact. For this reason, individual risk assessments are key to ensure that all vulnerabilities are identified. 

Section 10. Next steps to address the anticipated impact. Select one of the following options and explain why this has been chosen. 

Section 10. Next steps to address the anticipated impact. Select one of the following options and explain why this has been chosen. (Remember: we have an anticipatory duty to make reasonable adjustments so that disabled people can access services and work for us)  Tick option chosen 
1. No adverse impact - no major change needed to the proposal. There is no potential for discrimination or adverse impact identified.   
2. Adverse impact - adjust the proposal - The EIA identifies potential problems or missed opportunities. We will change our proposal to reduce or remove these adverse impacts, or we will achieve our aim in another way which will not make things worse for people. X
3. Adverse impact - continue the proposal - The EIA identifies potential problems or missed opportunities. We cannot change our proposal to reduce or remove these adverse impacts, nor can we achieve our aim in another way which will not make things worse for people. (There must be compelling reasons for continuing with proposals which will have the most adverse impacts. Get advice from Legal Services)   
4. Actual or potential unlawful discrimination - stop and remove the proposal – The EIA identifies actual or potential unlawful discrimination. It must be stopped.   
Explanation of why option has been chosen. (Include any advice given by Legal Services.)  
 
The EIA has been developed and amended during the course of the pandemic. The aim has been to identify differential impacts on staff and proportionate means of addressing these. All reasonable adjustments are being made to mitigate or reduce the impact of COVID-19 on all groups of staff, particularly those shown to be more affected by the infection and its adverse outcomes, in line with the actions in section 3. 

Section 11. If the proposal is to be implemented how will you find out how it is really affecting people? (How will you monitor and review the changes?) 

Measures to address differential impacts on staff will be kept under review and revised as necessary. 

Section 12. Action plan. List any actions you need to take which have been identified in this EIA, including post implementation review to find out how the outcomes have been achieved in practice and what impacts there have actually been on people with protected characteristics. 

Action Lead By when Progress Monitoring arrangements 
Actions have been identified in section 3 HR Ongoing during pandemic     

Section 13. Summary Summarise the findings of your EIA, including impacts, recommendation in relation to addressing impacts, including any legal advice, and next steps. This summary should be used as part of the report to the decision maker. 

There is emerging evidence of differential health impacts and outcomes on a number of groups with protected characteristics. NYCC will ensure that all relevant staff guidance and policies, and recording and reporting of data reflect this and are kept updated. All reasonable adjustments will be made to mitigate or reduce the impact of COVID-19 on all groups of staff, particularly those shown to be more affected by the infection and its adverse outcomes, in line with the actions in section 3. 
 
This EIA will be kept under review during the period of the outbreak. 

Section 14. Sign off section 

This full EIA was completed by: 
 
Name: Deborah Hugill

Job title: Senior Strategy and Performance Officer  

Directorate: Central Services

Signature: Deborah Hugill 

Completion date: 2.12.20 

Authorised by relevant Assistant Director (signature): Justine Brooksbank 

Date:10.12.2020

For more information contact equality@northyorks.gov.uk.