The following case study looks at action taken by Glasgow City Health and Social Care Partnership (GCHSCP) to increase the number of adults receiving support through a Shared Lives scheme. This was as an alternative to residential care and other more traditional forms of care and support services. 

The case study focuses on changes made to the tendering process to reduce health inequalities.

Reason action was taken

As noted in our take the right actions page, one of the key ways to reduce health inequalities is through procurement and commissioning processes.

All commissioning staff in Glasgow have to do an Equality Impact Assessment (EQIA) when implementing a significant policy change. This applied to doing a Shared Lives tender. 

The Principal Officer in procurement was very keen not to see the EQIA as a tokenistic task. They wanted it to be a meaningful process that could further change procurement processes and reduce inequalities. 

Action taken

As a result of the EQIA, amendments were made to the Shared Lives policy and practice. For example the

• commissioning team added a dedicated clause to the invitation to tender describing the equality duties under the 2010 Act
• service specification was changed to ensure the provider recruited and assessed carers in ways that promoted equal opportunity and were not discriminatory
• disabilities commissioning team were to closely monitor uptake of the service through provider liaison meetings and other analysis
• GCHSCP were to continue to develop strategies to engage with hard to reach groups such as people with disabilities.

It was decided that when a public body proposed to award a contract or framework on the basis of the most economically advantageous tender (MEAT) it must consider whether the award criteria should include considerations to allow the supplier to better uphold the general equality duty.

The disabilities commissioning team met this obligation by asking all tendering organisations to answer some evaluation questions as part of the procurement exercise. They also asked that they deliver a 10 minute presentation on a scenario and interview question.

These are examples of evaluation questions designed to ensure equality was embedded in the tendering process.

• Glasgow is a culturally and ethnically diverse City. How would your organisation respond to culturally or ethnically diverse needs of service users and carers?
• Demonstrate how you intend to successfully identify new and appropriate Shared Lives Carers from within Glasgow City’s boundaries in response to new referrals
• Demonstrate how you will test and explore compatibility between Shared Lives service users and Shared Lives carers.

People who helped

An Equality Officer was key in helping with the EQIA by thinking about other potential impacts on diverse communities.

Impact and lessons learned

The EQIA was originally conducted to help with the policy change however, it also helped look at how the tendering process can contribute to reducing inequalities.

Changes in the tendering process were made to consider the impact on diverse communities and in future the Principal Officer will aim to involve more staff and stakeholders. 

The EQIA was seen as a huge learning experience for the Principal Officer. They are now keen to carry out similar tendering processes that involve asking specific written and interview questions around equality and diversity. These questions go beyond asking the basic ‘what is the public sector duty’. The intention is that this will show if the supplier has a deeper understanding of equality issues.

Further information

You can find out more about ways to reduce health inequalities within our reducing health inequalities section.

This case study is based on information provided by Paul Nolan of GCHSCP. If you would like to discuss further, you can contact our Health Promoting Health Service (HPHS) team by email at nhs.HealthScotland-hphsadmin@nhs.net.