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What Are Reasonable Adjustments For Disabled People?
We’re told that we must carry out disability assessments and make reasonable adjustments if necessary, but what does ‘reasonable adjustment’ actually mean, and what should we be doing? Prof. Nigel Sparrow is the CQC's Senior National GP Advisor who clears up common myths about CQC inspections of GP and out-of-hours services and shares agreed guidance to best practice. In one of his latest ‘myth-busters’ – Nigel’s surgery 67: Reasonable adjustments for disabled people, he explains that GP practices have a duty to make reasonable adjustments for disabled people when accessing services, but what does it mean?
What is ‘disabled’?
People are disabled under the Equality Act 2010 if they have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities. ‘Substantial’ is more than minor or trivial, for example it might take much longer than it usually would to complete a daily task like getting dressed, and ‘long-term’ means 12 months or more, such as a breathing condition that develops as a result of a lung infection. A progressive condition is one that gets worse over time. People with progressive conditions can be classed as disabled. However, people automatically meet the disability definition under the Equality Act 2010 from the day they are diagnosed with HIV infection, cancer or multiple sclerosis.
What is reasonable?
By being reasonable we must consider people who have a learning disability , or a physical or sensory impairment. When deciding whether an adjustment is reasonable, issues such as cost, practicality, health and safety factors, practice size, and whether the adjustment will achieve the required effect should be considered. However, if making the reasonable adjustment(s) for disabled people would lead to the service breaking a different legal obligation, the organisation may not be required to do it.
What can we do?
We need to identify and document the needs of patients, and their carers, which relate to or are caused by a disability, impairment or sensory loss. NHS England has developed the Accessible Information Standard (AIS) which tells providers how they should ensure disabled patients receive information in formats that they can understand and receive appropriate support to help them to communicate. We should provide correspondence and information in alternative formats such as British Sign Language (BSL) interpreters, braille and easy to read documents. We should also review and install, where appropriate, physical features in and around buildings such as ramps, wider doorways and automatic doors, a hearing loop and clearer signage.
CQC – Nigel’s surgery 67:
NHS England – AIS:
Alison Lowerson – QCS Expert GP Practice Manager Contributor