Ensuring That Surgery Is Accessible Is Easy To Do
Two aspects of the Disability Discrimination Act 1995 (DDA) may be causing confusion for GPs. These are the employment duties contained in part 2 of the Act and the duties of service providers set out in part 3.
Confusion arises because of the differing nature of the duties and the timetables that apply. Most confusion is being generated by the duties to be met by October 2004.
These are being variously interpreted or misinterpreted to mean that GPs whose surgeries are not fully wheelchair accessible by this date will not be able to continue to practise in those premises.
Access rule changes
Part 2 of the DDA was introduced in December 1996. It currently applies to those employing 15 or more people in total, although they may work in several premises.
From 2004, the small-employer ceiling will be lifted and almost all employers will be covered by this part of the Act.
Part-2 duties relate to individuals – currently employed or being considered for employment – and any adjustments required will need to be tailored to the member of staff or job applicant in question.
Part 3 of the DDA, unlike part 2, applies to disabled people who are members of the public. The part-3 duties are generic, anticipatory and constantly evolving.
Once understood, they are a powerful tool for the constant improvement of services and customer care, with benefits for all concerned. It should also be said that the duty is to do only what is reasonable in all the circumstances of the case, and there is no intention to force service providers to act unreasonably or to the detriment of their business or service.
Part-3 duties are being introduced in three stages. Since December 1996, it has been unlawful for service providers to treat disabled people less favourably for a reason related to their disability.
Since October 1999, service providers have had to make ‘reasonable adjustments’ for disabled people, such as providing extra help or making changes to the way that they provide their services.
The auxiliary aids and services envisaged include, for example, temporary ramps and portable induction loops and the provision of practice literature in large print.
From 1 October 2004, service providers may have to make other ‘reasonable adjustments’ in relation to the physical features of their premises to overcome any physical barriers to public access.
The part-2 duties are set out in full in Code of Practice: rights of access, goods, facilities, services and premises, published by the Disability Rights Commission (DRC) and obtainable from the Stationery Office or the DRC website www.drc-gb.org.
This code of practice sets out the duties of service providers, illustrates through case studies what this might mean in practice and offers advice on good practice and the ‘inclusive’ approach.
With regard to the 2004 changes, the code of practice says that where a physical feature of premises makes it impossible or unreasonably difficult for disabled people to make use of any service, which is offered to the public, a service provider must take reasonable steps to rectify the situation.
Options include removing the feature, altering it, providing a reasonable means of avoiding the feature or offering a reasonable alternative method of making the service available to disabled people.
The objective is to ensure that disabled people have access to the range of services offered by a GP or other service provider.
Buildings are significant to the extent that aspects of a premises may present barriers to accessing the service.
GPs have all the above options at their disposal when considering how to ensure that their services are accessible to all of their patients.
Service providers must do only what is reasonable and the code of practice has advice on the factors which may be relevant in deciding what might be reasonable steps to take. These include: cost, effectiveness, practicability, any disruption that might be caused, resources available and the availability of financial or other assistance.
The code of practice recommends commissioning an access audit as a means of preparing a long-term access plan or strategy and the DRC recommends the National Register of Access Consultants as the only source of accredited practitioners currently active in the access field.
A good access audit will look at the building in relation to the service provided.
The auditor will have a thorough briefing session with the client to establish the parameters of the audit, identify known problems and agree aspirations. Client and auditor will also agree the technical standards for the audit and the format in which the findings will be presented.
The audit itself will require time spent on site, measuring, and observing the premises in use. It will involve discussion with those working on site and, with prior agreement, with service users.
The report should identify a number of access improvements that can be made, some immediately, some over the longer term.
Many will only require simple management decisions and will be without cost.
CASE STUDY – GOOD PCT PRACTICE
A small number of PCTs have advisory posts in relation to the Disability Discrimination Act (DDA). Karen Shook is service adviser on disability equality and user involvement for Brent Primary Care NHS Trust, in north London.
She said: ‘Brent PCT has a DDA implementation plan, which is integrated into our access and equality work plan.
‘The access and equality committee has representatives from PMS GPs, community involvement and the local community health council.
‘I am responsible for putting the DDA plan together and chairing the DDA implementation group. This is still in its infancy but will consist of representatives from relevant PCT directorates, estates departments and voluntary organisations.
‘We will be issuing guidance on all aspects of DDA compliance via the practice development managers, with whom I will work closely.
‘I am also encouraging GPs to send me designs when refurbishments and rebuilds are imminent so that I can comment and make suggestions.
‘I have the assistance of the local authority access officers who are willing to offer help and advice if I need it.
‘I am also in discussion with the regional office about issuing guidance about responsibilities of PCTs
under the DDA.’
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