Practice owners are required by law to think ahead and be proactive in making reasonable adjustments to prevent discrimination, i.e. where a disabled person would be placed at a substantial disadvantage when accessing treatment compared to a non-disabled person. The overall aim in making reasonable adjustments is to remove, as far as possible, any barriers likely to be faced by disabled people so that they can use a service at a standard as close as reasonably possible to that for non-disabled people.
There is no definitive definition of what is ‘reasonable’. The law uses this phrase to give some flexibility and allow different solutions in different situations (e.g. what constitutes ‘reasonable’ for a practice accessed via three flights of stairs is likely to differ from that for a practice at street level; what constitutes ‘reasonable’ for a small business will differ from that for a large corporation or public sector body). It is up to each practice to decide what is ‘reasonable’ for their circumstances.
The duty of reasonable adjustments contains three requirements:
- the way things are done e.g. changing a policy or procedure
- making changes to overcome barriers created by the physical features of a workplace e.g. ramp into building or automatic sliding doors
- providing extra equipment (auxiliary aid) or person to help (auxiliary service) e.g. providing information in an accessible format or an induction loop for patients with hearing aids
There are local disability access panels that represent the access interests of disabled people and are a useful source of advice and information. Disability Equality Scotland has a list of access panels (see also Access Survey). Some local authorities have an access officer who might be able to visit your practice and advise on access issues.
NB: All rooms and areas in new or refurbished buildings that are accessible to staff, patients and visitors are required to comply with current Scottish building standards.
Refer to Improving Access for Disabled Patients for examples of how access for disabled people can be improved; some changes might also improve access for elderly patients and patients with pushchairs. Note: improving access is not just about physical access and premises.
Identify what would be reasonable adjustments for your practice. To help with this, consider the following factors, provided by the Equality and Human Rights Commission:
- whether taking particular steps would be effective in overcoming the difficulty that disabled people face in getting access
- the extent to which it is practicable for you to take the steps
- financial and other costs of making the adjustment
- the extent of your resources and size
Before making any alterations to premises, consider arranging for an access survey to be carried out by a qualified or experienced person or disability access panel (see Access Survey), and before making physical changes check whether any planning permission or other consents are required.
Be prepared to justify why certain steps were not taken to improve access for disabled people, and record any unmet need.