4. Reducing Inequalities Inequalities have been identified as a recurrent theme by this Needs Assessment. Examples of inequalities and how they affect people can be found throughout this document. This Section specifically tackles the identification and measurement of inequalities. 4.1 What are inequalities? The Equalities Review defined an equal society as one which “...protects and promotes equal, real freedom and substantive opportunity to live in the ways people value and would choose, so that everyone can flourish. An equal society recognises people’s different need, situations and goals, and removes the barriers that limit what people can do and can be.” There is a concerted effort across national and local policies to build a more equal society in Scotland by addressing inequalities. The Scottish Government website states that: “Although outcomes are generally improving for most people in Scotland they are not improving fast enough for the poorest and most disadvantaged of our society, nor for those who face barriers because of their race, gender, age, disability, sexual orientation or religion or belief” The Equality and Human Rights Commission Research Report 61: “Significant inequalities in Scotland: Identifying significant inequalities and priorities for action” highlighted 7 areas in which significant inequalities exist within Scottish society: Poverty/low income Access to services Employment Education Health Discrimination Targeted violence and safety. Please note: issues around discrimination, access to services, targeted violence and safety are discussed elsewhere in this document (in particular , and ). Inequalities have a significant impact on health and social care issues and can drive ill health and poor wellbeing. Inequalities in education can inhibit people’s ability to access and navigate health and social care services. Inequalities in people’s ability to access services can be affected by geography (such as rurality) and infrastructure (such as public transport links) (see ). People’s health can be affected by inequalities in housing (see ). People’s
something they wish to do. Rehabilitation is the process of restoring a person’s skills following a period of illness or injury so that they may regain maximum function and By comparison, the objective of reablement is to help people “with poor physical or mental health to... accommodate their illness, promote independence and support “to do” rather than “doing to/for people” by learning or re-learning the skills necessary for daily living”. In short, reablement helps people to learn or relearn skills necessary for daily living. All 3 of these skills may be needed to improve a person’s recovery after a stay in hospital. In Dumfries and Galloway reablement services are comprised of: The Short Term Assessment and Reablement Service (STARS) which is an Integrated Health and Social Care Partnership The Care and Support Services (CASS) which is the local authority’s in-house home care service and A development which is currently referred to as ‘Transitional Care’ based within CASS. STARS provide an opportunity for short term intensive rehabilitation or reablement. The focus of STARS is to empower people to live at home confidently, doing things for themselves through various means, such as getting up with a feeling of purpose, being able to get washed and dressed safely; not being restricted in access to the wider community due to a fear of falling; preparing nutritious meals, use of telecare and accessing wider opportunities which create a uniquely meaningful life. This is achieved through the effective team, wider partnerships and signposting. If during the time with STARS full independence cannot be achieved and an individual requires longer-term support and care, STARS will ensure effective communication for safe ‘Care transition’ handovers; this would include the individual’s representatives/Carers where appropriate. Although there is Occupational Therapy within STARS it may not be necessary, or appropriate, to be referred to STARS to achieve activities of daily living or feel confident about living independently at home again. It may be that referral to a dedicated Occupational Therapy Service in health or social care is more appropriate, due to the complexity or specialist specific requirements of the situation The referrals to STARS is shown in Table 69 within Chapter 10. 11.8 NHS Dumfries & Galloway workforce trends