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​Just What Are Reasonable Adjustments When Dealing With The Disabled?

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There’s plenty written about how organisations must adapt premises so that they aren’t deemed to be discriminating against disabled people, especially disabled employees. Less well covered is how service providers such as GP practices should approach modifying their premises and procedures with necessary ‘reasonable adjustments’ that ensure disabled people are not disadvantaged.

The term ‘reasonable adjustments’ immediately causes confusion, probably because what is deemed to be reasonable by one person may seem unreasonable to another. This article seeks to remove that subjectivity with some objective guidance about the steps your GP practice should be taking to accommodate its disabled employees and patients.

Removing the confusion surrounding ‘reasonable’ in reasonable adjustments

Adjustments that you’ll need to make cover three areas:

- Premises

- Services provided

- Policies and procedures

The reasonable status is bought into play by considering factors associated with adjustments. These factors include things like:

- Cost

- Healthy and safety issues

- Practice size

- Practicality

- Legal issues

For example, a larger practice would be expected to suffer a higher cost of making a physical adjustment to its premises. However, if in doing so it would be breaking the law (perhaps against planning laws, for example) then the adjustment couldn’t be made.

For employers, the requirements are covered in the disability rights section of the government website. An example of reasonable adjustments that might have to be made is where a previously fit employee has suffered a debilitating back injury. Upon the employee’s return to work, it may be necessary to change the employee’s work station (for example provide a chair with bespoke back support), working patterns, and even his or her duties. (This is an area we touched on when discussing circumstances in which it is fair or unfair to sack an employee.)

Addressing patients’ disabilities in the GP practice

There is a host of adjustments that are deemed to be reasonable in the healthcare context when dealing with patients. What must be done on a collective and individual basis depends on the type of disability.

Reasonable adjustments for physically disabled patients

There is a list of adjustments that should be made, and these generally relate to premises and are generally well-known. They include:

- Installing ramps, lifts, and widening doorways

- Better lighting and signage

- Disabled toilets

- Hearing loops

Reasonable adjustments for sensory impaired patients

Care should be taken to enable access to services for those patients who are sight or hearing impaired or have communication needs. This may mean an adjustment to procedure in individual cases. For example, if the waiting room calls patients appointments by electronic screen the doctor may need to verbally call a blind patient by name.

Interpreters may be required, and this might include interpreters of sign language. Documentation, posters, and warnings should be produced and/or displayed appropriately. A partially sighted patient is likely to need letters in large print, for instance, or in braille.

Reasonable adjustments for patients with learning disabilities

Consider these patients on an individual basis. You may need to call in a learning disability nurse, or provide enhanced services for patients with learning disabilities. Appointment times are likely to be longer, and you should ensure that an annual health check is offered.

The law and reasonable adjustments

The Equality Act 2010 dictates how the GP practice must approach its duties with regard to making reasonable adjustments for disabled people (employees, suppliers, patients, and other stakeholders). In brief, the approach you should take is:

Identify the needs (communicative and support) of patients

On this basis implement the Accessible Information Standards (AIS)

Communicate and correspond in an appropriate manner and format

While the AIS doesn’t cover interpretation issues, reference should be made to guidance provided by NHS England.

Finally, review your premises, procedures, polices, and practices. Examine issues that might arise because of the physical features of your premises, or a lack of specialist equipment, or procedures that disadvantage the disabled – and then make the reasonable adjustments that are necessary to remove that disadvantage.

To aid your practice make reasonable adjustments we have brought on a range of disability and training aids

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If you have any questions or feedback, please do not hesitate to contact me -alex.henman@esuppliesmedical.co.uk - 01865 261451

eSupplies Medical is a trading name of Williams Medical Supplies Ltd, a DCC business