A positive impact is that the equipment service will be able to help more people as resources are being used more effectively to assist the most vulnerable.

Disabled people

Some older people may be impacted if they are less likely to use online retailers with delivery to their door.  This is particularly where they don’t have family or friends who support them.

The streamlining of the equipment list also restricts choice although new users will not know what could have been available before the change.

There is a risk that due to a restricted income or other reason that the person does not purchase the equipment leading to increasing dependency and more extensive care needs.

There is a risk that older people are less confident using the internet to self-purchase items.

It is also possible that a referrer may over prescribe a more complex or expensive item rather if a simpler item is not available on core stock list.

This change may affect those transitioning to adult services in the sense that there may be different or reduced choice.

60% of users are female and therefore any impact is likely to greater for females

Disabled people is the largest group that will be affected other than older people.

Same comments apply to this group as for Older People related to retailers, choice and use of resources.

People will a long term condition or disability may find they are not able to get an exact replacement for an existing piece of equipment.

Technology access may be a barrier or a mitigation depending on individual and access to Wi-Fi or digital devices.  For example, access to language translations.

Those within the most deprived SIMD quartile make up 20% of service user.  This group will possibly see greater impact as they may be less able to self-purchase alternatives.

Disproportionate impact if multiple care responsibilities

This change reduces choice especially if they have mobility issues and can’t access shops, online purchase/delivery still available.   Higher delivery costs are not likely within Lothian.  There is a possible delivery time delay.

Internal staff EHSCP/NHS:

Likely challenging conversations will increase as difficult decisions need to be made.

Potential for increased levels of complaints

There could be a per above perceived discrimination against disabled people due to lack of access or less access to equipment.

Mitigations

• A risk stratification approach has been taken to ensure that only items which will have minimal impact on risk have been moved
• Implementation of the Equipment Panel led by professional leads to ensure safe and consistent decision making
• Wide engagement across all partner organisations and professional groups
• If there is an assessed risk that can not be mitigated through the core stock list, there is the option to provide a non-stock item – this would be reviewed and agreement by the equipment panel

Young people

Disabled people

Minority ethnic people

Those vulnerable to falling into poverty

Carers

Geographical communities

Staff

Items chosen which are more readily recyclable.  Possible reduction in waste.  Focus on refurbishing and increasing recycling rates to reduce waste.

Possible positive impact on business supplying items direct to consumers.

Possible impact on commercial equipment suppliers that are receiving less business from CEC