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Discrimination in health and care services - duty to make reasonable adjustments

This advice applies to Wales

If you’re disabled, you may find it more difficult to access healthcare or care services than other people. The Equality Act 2010 says organisations such as hospitals, care homes and GP surgeries must take steps to remove the barriers you face because of your disability. The Act calls this the duty to make reasonable adjustments.

Read this to find out more about healthcare and care providers’ duty to make reasonable adjustments.

When must a healthcare and care provider make reasonable adjustments?

Places like hospitals, clinics and care homes must make sure you can access and use their services if you’re disabled. They must take reasonable steps to remove the barriers you face because of your disability.

Someone has a duty to make reasonable adjustments if you’re disadvantaged by something because of your disability and it’s reasonable to make the changes. But they mustn’t wait for you to ask them to do something. They should consider in advance what they need to do to make their services accessible to all disabled patients, clients and other people.

Is it reasonable to make the changes?

Healthcare and care providers must make changes or adjustments to how they provide their services if it’s reasonable to do so. Whether something is reasonable depends on the size, resources of the organisation and type of service they provide. It also depends on what changes or adjustments are needed and how practicable or easy it is to do them. It’s the courts who decide if something is reasonable or not.

What must a healthcare or care provider do?

There are three different things healthcare and care providers must do to make it easier for you to access their services.

Change the way things are done

A healthcare or care provider may have a certain way of doing things, like a policy, rule or practice which makes it more difficult for you to access or use their services.  They should change these things if they are a barrier for you, unless it’s unreasonable to do so.

Example

A GP surgery requires people to come in and queue for same day appointments. You have a disability which makes it difficult for you to stand for any length of time. The surgery should consider how this policy affects disabled people like you.

Reasonable adjustments might involve changing the policy to allow people to phone in as well as come to the surgery. They could also allow you to sit and wait and then treat you as if you were in the queue.

Change a physical feature

Sometimes a physical feature of a building, like a hospital or care home may make it more difficult for you to access or use it.

Here are examples of physical features:

  • steps and stairs
  • passageways and paths
  • entrances and exits
  • internal and external doors
  • toilets
  • signs.

A healthcare or care provider must do what’s necessary to remove, change or provide a reasonable way of avoiding the barrier, if it’s reasonable to do so.

Example

You social services department has steps leading up to the entrance door. They must make sure there’s another way of accessing the building if - for example, you’re mobility impaired. A reasonable adjustment could be providing a ramp or lift.

Provide extra aids or services

Sometimes you may need particular aids or equipment to help you access or use healthcare or care services. Or you may need additional services. The Equality Act calls these auxiliary aids and services.

Here are examples of auxiliary aids and services:

  • a portable induction loop for people with hearing aids
  • BSL interpreters
  • providing information in alternative formats, such as Braille or audio CD’s  
  • extra staff assistance.

Examples of reasonable adjustments

Your local GP provides all information leaflets in Braille. This is a reasonable adjustment to make sure sight impaired people can get the information they need.

A social worker takes extra time to explain the social care services available to you if you have a learning disability. This is a reasonable adjustment to make sure you can understand what your options are.

Your hospital provides BSL interpreters for all its patients who require it. This is a reasonable adjustment to make sure hearing impaired patients can communicate with the healthcare staff.

What can you do if you face barriers to access healthcare or care services?

You can ask your healthcare or care provider to make the necessary changes so you can access or use their services. If a service provider refuses to do this, it’s discrimination and you can take action under the Equality Act.  

Next steps

Other useful information

Equality Advisory Support Service (EASS)

If you have experienced discrimination, you can get help from the EASS discrimination helpline.

Equality and Human Rights Commission (EHRC)

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