Initial Impact Assessment Template

Please use the following template to help determine whether a community

impact assessment is required.

Name of Policy

Purpose and function of policy

( Please provide a brief description, for example, services affected)

Who does this policy affect

Workforce / Employees

Service Delivery / Communities

Author(s)

Job title and Service Delivery Unit

Date completed:

Sign off (line manager) and date

If signed off by e-mail please confirm by identifying when and by whom

A separate guidance note is available to support you through the completion of this

assessment. You can find it on the intranet.

The general equality duty states that we must have due regard to:

Eliminate unlawful discrimination, harassment and victimisation

Advance equality of opportunity

Foster good relations between different groups

Version 1.3

01/02/2011

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Parent category: Business