The equality duty was created by the Equality Act 2010 and replaces the race, disability and gender equality duties.
The duty came into force in April 2011 and covers age, disability, sex, gender reassignment, pregnancy and maternity, race, religion or belief and sexual orientation. It applies in England, Scotland and in Wales. The general equality duty is set out in section 149 of the Equality Act. In summary, those subject to the general equality duty must have due regard to the need to:
- eliminate unlawful discrimination, harassment and victimisation
- advance equality of opportunity between different groups
- foster good relations between different groups.
The duty to have due regard to the need to eliminate discrimination also covers marriage and civil partnership.
The aim of an equality impact assessment (EIA) is to consider the equality implications of your policy, practice, function or service on different groups of people and consider if there are ways to proactively advance equality.
Evidence gathering and engagement
Evidence
The King’s fund report, ‘Health of people from ethnic minority groups in England’ (2023) identified that structural racism is ingrained into organisations. Kline (2023) recommended the use of 4 explicit tools to disrupt bias in decision-making.
- Accountability
- Leadership
- Debiasing – insert bias interrupters
- Transparency
Since the Framework of Operational Delegations and Assurance (FODA) is essential to our decision-making, the way it operates is critical in our ambitions to be an anti-discriminatory organisation, hence the relevance of this EIA to disrupt potential structural racism and other discrimination. The importance of CQC taking an anti-racist approach was highlighted in the Listening, learning and responding to concerns review 2023.
The completion of this EIA aims to identify opportunities and strengths to minimise potential discrimination in our decision-making, as well as identify areas of weakness within the FODA, and how these can be mitigated. Decisions relating to setting equality objectives are not included in the FODA or in the previous scheme of delegation as they are strategic /policy decisions, rather than operational.
The operation of the interim Scheme of Delegation, part 3, has not been systematically quality assured or monitored in relation to equality and human rights. There are also limitations in the data currently available to us. CQC has conducted research that explored the impact of our decision-making, ‘Ethnic minority-led GP practices: impact and experience of CQC regulation’. As a result, CQC is now working to improve equality monitoring of providers and consider our evidence-gathering approach using the single assessment framework. This will support better analysis and transparency in our work and provide data to evaluate the implementation of the FODA in relation to systemic racism.
There is a need to build on what we have learned and develop mechanisms to further test our decision-making as processes are developed to support implementation of the FODA. The FODA sets out accountability for decisions. A workshop highlighted the need for FODA underpinning processes to include explicit anti-racist and anti-discriminatory leadership and bias interrupter steps e.g. need for decision-makers to justify and for accountable seniors to proactively challenge and prompt on equality and human rights issues; to support fair decisions based on evidence, and; the need for mechanisms to collect and review decisions using equality data to support audit, learning and transparency.
Engagement and involvement
This can be any of the networks (race, disability, carers and LGBT+) or CQC Young Champions. This can also be other teams or departments you are working with both inside and outside of the CQC.
A workshop was held on the 5 June 2023 with interested internal stakeholders, to discuss broadly the opportunities with conducting an EIA for this critical framework, specifically with consideration to institutional racism and how this can be avoided in our decision-making frameworks. We engaged with all CQC staff equality networks and leads. We used feedback received in the final document. Several suggestions were identified related to the processes that will underpin and support the FODA - these will need to be further developed during implementation.
Impact
Age
Impact
We do not anticipate a specific impact on our people in relation to age from this work.
This will be monitored and reviewed annually.
Disability
Impact
There may be an impact on people in relation to disability from this work.
Our data shows that 16% of Executive colleagues identify as having a disability compared to 12% of colleagues at Grade A and B. The FODA moves decision-making from executive colleagues to Grade A and B in many areas of decision-making. There are more colleagues at Grade A or B compared to Executive colleagues.
This means there could be a positive impact as more colleagues with lived experience of disability will be involved in operational decision-making, as a result of the implementation of the FODA.
There may be an impact on the type and number of decisions made using the FODA as a result of changes from the previous Scheme of Delegation (part 3), which we are unable to monitor due to current data limitations.
This may impact people who use services or providers. For example, there may be an impact on the type and number of enforcement decisions made using the FODA as the requirement for consulting learning disability and autism specialists and legal specialists has changed.
Gender
Impact
We are unable to determine if there will be a specific impact on people in relation to gender from this work.
This will be monitored and reviewed annually.
Marriage and civil partnership
Impact
We do not anticipate a specific impact on people in relation to marriage and civil partnership from this work.
This will be monitored and reviewed annually.
Pregnancy and maternity
Impact
We do not anticipate a specific impact on people in relation to pregnancy and maternity from this work.
This will be monitored and reviewed annually.
Race
Impact
There may be an impact on people in relation to race from this work.
Our data shows that 12% of Executive, Grade A and B grade colleagues identify as being from an ethnic minority background. The FODA moves decision-making from Exec colleagues to Grade A and B in many areas of decision-making. There are more colleagues at Grade A and B compared to at Executive grades.
This means that more colleagues with lived experience of race-related issues will be more involved in operational decision-making, because of the implementation of the FODA. This may positively impact on CQC’s aim to be an anti-discriminatory organisation and regulator.
Religion or belief
Impact
There may be an impact on our people in relation to religion of belief from this work.
Our data shows that 45% of Executive, Grade A and B grade colleagues identify as having Christian beliefs. More Executive colleagues identify as atheists compared to Grade A colleagues and grade B colleagues (24% v 13% respectively). 10% of Executive colleagues identify with another religion, compared to 8% of grade A colleagues and 11% of Grade B colleagues. The FODA moves decision-making from Exec colleagues to Grade A and B in many areas of operational decision-making.
This means that a wider range of colleagues with differing beliefs and religious practices will be involved in operational decision-making, because of the implementation of the FODA. This may have a positive impact on CQC’s aim to be an anti-discriminatory organisation and regulator.
Sex
Impact
There may be an impact on our people in relation to sex from this work.
Our data shows that 69% of Executive colleagues are female, 82% of Grade A colleagues are female and 76% of B grade colleagues are female. The FODA moves decision-making from Executive colleagues to Grade A and B in many areas of decision-making. There are more Grade A and B colleagues then Executive level colleagues.
This means that overall, there will be more female colleagues involved in decision-making. Male colleagues will be less involved proportionally, because there are fewer male colleagues at Grade A and B This may have a positive impact on CQC’s aim to be an anti-discriminatory organisation and regulator.
Sexual orientation
Impact
We do not anticipate a specific impact on our people in relation to sexual orientation from this work. There is also no difference in reported sexual orientation across Executive, Grade A and Grade B colleagues.
This will be monitored and reviewed annually.
Carers
Impact
We are unable to determine a specific impact on our people in relation to being a carer from this work. We may need to consider this in relation to access to training and support during implementation and will engage with the equality networks accordingly.
We recognise there will be considerations across protected characteristics and that FODA learning must be accessible and developed in line with equality considerations for uptake of learning across the whole transformation programme.
This will be monitored and reviewed annually.
Socio-economic
Impact
We are unable to determine a specific impact on our people in relation to social-economic factors from this work.
We do however acknowledge that moving decision-making from Executive to A and B grades, by its nature of basis on pay grades, means that decision-making is moved further down the socio-economic scale.
Intersectionality
Impact
The FODA has been created to support methodology in the single assessment framework (SAF). The SAF can be seen as a bias interrupter, since the methodology uses a specific scoring framework, intended to reduce judgemental bias.
As such, colleagues and providers who identify with a range of characteristics (intersectionality) may experience less discrimination as a result of the SAF and accompanying FODA.
Human rights
Impact
There are no explicit prompts for equality and human rights decisions in the FODA, since this framework describes operational decision making. There is therefore an opportunity to ensure all decision-makers at all levels are prompted to make decisions with consideration to equality, human rights issues.
This can be achieved by incorporating this into the supporting guidance and implementation of the FODA, as well as in assurance processes and associated reporting. Senior decision makers (Deputy Director level and above) will hold this accountability to ensure equality and human rights issues are considered within decision-making. Monitoring and quality assurance mechanisms will be developed for this.
Future developments must take account of learning from CQC’s refreshed human rights approach – humanity into action.
Action planning
Action 1
Issue identified
The FODA has an impact for our people since many colleagues will have different accountability for operational decision-making. Colleagues may need support and learning to adapt to this.
Planned action
Engagement and communication approach – working with Academy colleagues and the operations performance and development team within the operations hub to design learning and coaching packages tailored to decision-makers. These must include an understanding of the importance of mitigating bias and anti-racist and anti-discriminatory practice – and how to do this practically (in addition to the existing required learning package on anti-bias and fairness).
Seek feedback from colleagues who are new decision-makers.
Engage with trade union colleagues.
Engage with equality networks.
Lead and timeframe
Hub DDs – by October 2023
Hub DD – August 2023
Hub DD – August 2023
Hub DD - Sept 2023
Hub DD – Sept 2023
Action 2
Issue identified
The FODA specifies who the relevant decision maker is and in what specific circumstances additional colleagues must be consulted. Need to ensure colleagues are supported to make such decisions and use interrupters to minimise risk of bias in decision making and potential impact for people using services.
Planned action
Reference to FODA and equality and human rights issues to be included in all operations hub activity, for instance bias interrupters and equality monitoring, transparency reporting to be built in when designing learning products, operational processes and conducting quality assurance and risk reviews.
Share learning about the 4 types of explicit tools/approaches to disrupt bias and the suggestions made at the workshop, within the wider operations hub team, so that they are better informed about how to deliver on bias interruption when doing this future design and assurance work.
Ensure learning, coaching and guidance is tailored to accountable senior staff, so they are ready to lead on anti-racist practice and mitigating bias, to prompt on equality and human rights issues and challenge evidence using bias interrupters, prompts and processes. There can be progress via planned work on responding to LLR actions (Tyson Hepple workstream).
Expectation is that all senior decision-makers will complete all relevant training.
Lead and timeframe
Hub DDs – October 2023 onwards
Action 3
Issue identified
There may be an impact on the type and number of decisions made using the FODA, which we are unable to monitor due to current data limitations. This may impact people who use services or providers our staff.
Planned action
Need to further explore and develop specific equality monitoring data systems and reporting for transparency as the processes associated with FODA evolve.
Need for engagement with equality networks and trade unions to identify and respond to any emerging equality or human rights issues arising during implementation which may not yet be identified here.
Lead and timeframe
Hub DDS – Sept – October 2023
Action 4
Issue identified
Currently CQC do not have an agreed timeline for equality monitoring of providers.
Planned action
Ensure that this document is developed and refined as agreement on timeline on how equality monitoring of providers is agreed, to inform our understanding of how structural racism works in decision-making.
Monitoring and Review
The regulatory assurance and quality team within the hub will take accountability for monitoring the impact of the FODA is as intended as a delegated responsibility from the Executive Director of Operations.
Regard to the FODA, and whether decisions were made in line with FODA, will be included in learning and improving reviews and audit activity. Similarly, any products developed by the hub for operations, for example SOPs (Standard Operating Procedures), will include a specific reference to the FODA and delegated authority. Equality monitoring and systems for transparency reporting to be developed as we also develop our organisational approach to race/racism and tackling structural inequality, informed by the LLRC review.
This will need to be further developed and specific equality prompts, and learning applied to mitigate, monitor and review. This may also apply to other protected characteristics and data systems will need to be developed to test this.
This equality impact assessment will be reviewed by February 2024.
EIA sign off and review
This equality impact assessment was signed off by:
- Nadiya Rahman, Diversity and Inclusion Manager, October 2023
- Head of equality, health inequalities and human rights January 2024.
This equality impact assessment will be reviewed in July 2024.