This Resource Guide provides a brief outline on legislation and good practice with reference to disability discrimination.

The Disability Discrimination Act 1995 (DDA) (as amended), the Disability Discrimination Act 2005 and the Equality (Disability etc.) (Northern Ireland) Order 2000 introduced measures that aim to end discrimination faced by disabled people in employment, access to goods, facilities and services, education, and property rights.

The legislation covers treatment of disabled people that is less favourable than the treatment of others when this is without justification, for a reason related to their disability. Discrimination also occurs in the workplace if an employer, without justification, does not make a 'reasonable adjustment' for the disability.

Since October 2004, there is no longer an exemption from the DDA requirements for small businesses/organisations¹. The DDA 2005 also places a duty on public authorities to promote equality of opportunity for disabled people.

Service providers are required to make reasonable adjustments, including changing a practice, policy or procedure, or providing alternative services, for example, the installation of a lift or ramp, to overcome barriers to accessing the service.

There are some instances where a service provider can treat a disabled person less favourably or not make reasonable adjustments, such as where this is necessary in order to avoid endangering the health or safety of any person, including the disabled person.

In summary, 'services covered include everything from reception, equipment and of course buildings, to issues such as :

• how a doctor might examine a patient with a physical impairment
• access to BSL interpreters for Deaf NHS patients (in March 2003 the UK Government recognised British Sign Language as a Language in its own right²), or
• how information and signage is accessible to people with learning disabilities³'.

Practical tips and information

• Arrange an extended appointment time for people with communication difficulties.
• Record a patient's access needs - for example wheelchair access, sign language interpreter needed, information to be supplied in large print.
• Provide interpreter services, induction loops, textphone, audio-visual paging systems and tactile signage, wherever possible.
• Provide adapted cutlery and crockery for inpatients, visitors and in public refreshment areas, and make space in waiting areas for wheelchair users, where fixed seating is in use.
• Where necessary, provide a particular service in an alternative venue if the usual one is unsuitable, for example, if someone has difficulty walking, the doctor should meet them 'in a location which involves less walking or provide the service from accessible premises⁴'.
• Where possible, make arrangements for hearing tests and speech therapy in languages other than English and ensure eye tests are conducted using relevant language symbols.
• 'When the patient is shown into the treatment or consultation area the health professional should introduce themselves and check how the patient would wish to be examined, for example, remaining in their wheelchair, if this does not compromise the examination. If a hoist or any other assistive equipment is required by the disabled patient, please ensure all staff are trained on using this'.
• 'If someone is left mid-treatment for any length of time, make sure they know why and occasionally check out their requirements as a disabled person. For example, they may need to change posture, or they might have difficulty in communicating a personal care need, or they may be experiencing anxiety'.
• 'Are there any auxiliary aids to make the service more flexible, for example, a portable loop for hearing-impaired people? Deaf patients may need a sign language interpreter, particularly if the issues are sensitive or complicated⁵.'

The following web sites have detailed information on disability issues.

Key Web Links

General issues

The Equality and Human Rights Commission website contains sections on disability in employment and access to services.

The Equality Commission for Northern Ireland is an independent public body established under the Northern Ireland Act 1998. The Commission works towards the elimination of discrimination on the grounds of disability, race/ethnicity, gender, disability, sexual orientation, marital status, religious belief and political opinion, and fair employment, including equal pay. This web site provides information on all the relevant laws.

Scotland's National Disability Information Service provides a range of information-related services to organisations, agencies and individuals, including Factsheets and transcription services. UPDATE Scottish Formats is a resource that provides contact details of transcription, translation, interpretation and other communication services. Service providers in other countries are also featured.

The London Health website has information about health issues specific to disabled people, with a UK Links section.

Blind and partially sighted people

Royal National Institute for the Blind's guidance includes information regarding adjustments most relevant to blind and partially sighted people, e.g. lighting, signage and colour contrast.

Clinical communication

The Intellectual Disability web-based learning resource for medical and healthcare practitioners includes How to... guides: Top Ten Tips for Clinical Consultation, Clinical Communication and Communicating with Pictures.

The Scottish Accessible Information Forum provides downloadable publications such as Standards for disability information and advice provision in Scotland; Barrier free information; Scottish formats resource - contact details of transcription, translation and interpreting services in Scotland.

Deaf and hard of hearing people

The Royal National Institute for the Deaf has Communication Factsheets, e.g.

• Communication Tips
• Deafblind Manual Alphabet
• Lipreading and Lipspeaking
• Irish Manual Alphabet
• Welsh Manual Alphabet

and Medical Factsheets, for example

• Balance problems
• Drugs and hearing loss
• Hyperacusis.

Other leaflets include:

• The duty to provide a sign language interpreter under the Disability Discrimination Act and
• The information needs of black and minority ethnic deaf people.

HIV and AIDS

Department of Health funded HIV Healthcare Pack (for non-specialists), which addresses HIV-related stigma and discrimination in healthcare (order on-line), and free Fact Files, including topics related to gay men, sex workers, injecting drug users and prisoners.

The Terrence Higgins Trust is a leading HIV & AIDS charity in the UK. This site has a section on Information for Healthcare Workers, e.g. Working with African People Considering HIV Testing: Important Information for Clinicians and Other Professionals; Practice Guidance on Developing HIV Primary Care Services.

HIV-positive led activist group i-base produces treatment information for HIV positive people as well as for health care professionals.

Hospitals

Disability Rights Commission leaflet:You can make a difference: improving hospital services for disabled people (pdf).

The government's Valuing People website has a short presentation of issues faced by people with learning disabilities in hospital.

The US Department of Justice website has information on communicating with people who are deaf or hard of hearing in hospital settings.

Learning disabilities

CHANGE fights for the rights of learning disabled people, especially people with learning disabilities who are deaf or blind. The CHANGE Picture Bank and the CHANGE Health Picture Bank are for people with learning disabilities, people who work with them and those who provide services. Both Picture Banks are available in CD Rom or print formats and can be ordered from the CHANGE website.

Mental health

The Mental Health Foundation site has a Links section covering the UK. It also has information for GPs and other health professionals, for example, Up and Running? Exercise therapy and the treatment of mild or moderate depression in primary care.

The Royal College of Psychiatrists' site has downloadable leaflets for parents, including some material in Chinese, e.g. Depression in people with learning disabilities.

The National Institute for Mental Health in England has a booklet, 'Cases for Change: Anti-discriminatory Practice', which explores the literature on mental health services and practices relating to women, people from minority ethnic communities and gay men, lesbians and bisexual people and looks at the changes needed to provide anti-discriminatory services and practices for patients/service users from these groups.

Parents

The Disabled Parents Network site contains information for disabled people who are, or hope to be, parents. There is a 'Professionals and Researchers' section which includes details of training provided by the Network and information about specialist equipment for parents with a disability.

Primary care services

Leaflet from the Department of Health: You can make a difference: improving primary care services for disabled people (DRC/DH, 2004) (pdf).

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Footnotes

1. 1. The DDA applies equally to commercial and public service providers, including for example, doctors' surgeries, hospitals and other health providers). (return to paragraph containing footnote 1)
2. 2. Guidance on developing local communication support services and strategies (Department of Health, 2004), p3.
   (return to paragraph containing footnote 2)
3. 3. Working with disabled people for inclusive access - health issues (Greater London Authority, 2004), p.22. (return to paragraph containing footnote 3)
4. 4. You can make a difference: improving primary care services for disabled people (Disability Rights Commission/Department of Health, 2004), p.2. (return to paragraph containing footnote 4)
5. 5. You can make a difference: improving hospital services for disabled people (Disability Rights Commission/Department of Health, 2004), pp6-7. (return to paragraph containing footnote 5)

http://www.gmc-uk.org/about/valuing_diversity_disability.asp