Adapting premises and providing information for those with sensory disabilities need not be difficult, says Dr Charles Sears
The Guide Dogs for the Blind Association has just launched Enhancing Care Provision for Blind and Partially Sighted People in GP Surgeries: Guidelines for Best Practice.1 This was based on an initial user survey 2 of 400 guide dog owners and 432 blind or partially sighted individuals without dogs, and subsequent audits of access in 27 general practices. It also involved feedback from the practices and focus groups and input from experts. The guidelines are timely, as they come when the Disability Discrimination Act is finally fully in force, and when other surveys 3,4 have revealed shortcomings in access to primary healthcare for people with disabilities.
Most of the standards the guidelines set are achievable without great cost, and many can be effected during routine refurbishment of the building. For instance, using contrasting colours for rails, doors or door frames when redecorating can help partially sighted people to find their way around.
One of the big problems facing us in general practice is that we have to address the issues raised by many interest groups. How does improving access for the blind fit in with the needs of others, for example people in wheelchairs or the deaf?
Similar guidance for improving the experiences of deaf people is available; RNID recently produced A simple cure: A National report into deaf and hard of hearing people's experiences of the National Health Service, based on a survey of 866 deaf or hard of hearing people.
Both documents make useful reading for GPs. Their main messages have a lot in common, and are also transferable to other kinds of disability. It is quite possible to work the needs of one group in with the other, once we are aware of the relevant issues.
Involvement of users is an important part of the equation. A good place to start is by creating a register of patients who are blind or partially sighted,and deaf or hard of hearing. This is straightforward when the practice uses computerised records. It can be based on those that already contain codes for these conditions and built up opportunistically from there, especially if the whole team is involved.
All GPs are obliged to address the availability of alternative formats for documents such as advice sheets, prescriptions and practice leaflets, and the provision of British Sign Language interpreters. These, along with disability awareness training, are subjects that are worth raising with your PCT.
It is worth contacting your PCT if you are considering installing a loop system, for instance, as group discounts may be available.
Educational resources for staff are available through various charities for the disabled, but be aware that courses providing general disability awareness and equality training do not always pay enough attention to sensory disabilities. The Disability Partnership has recently published a new edition of One in Four of Us,5 initially designed for medical students but now in a form applicable to all healthcare professionals. The RCGP also provides various courses and learning opportunities.6
- The Guide Dogs for the Blind Association. Enhancing Care Provision for Blind and Partially-Sighted People in GP Surgeries: Guidelines for Best Practice. Reading: The Guide Dogs for the Blind Association, 2005.
- Nzegwu F. The experiences of visually impaired users of the NHS:A Survey. Reading: The Guide Dogs for the Blind Association, 2004.
- Heaven C, Knight J, Christie I. Inclusive Citizenship: Social Equality for Disabled People. London: Leonard Cheshire, 2002.
- RNID. A simple cure:A National report into deaf and hard of hearing people's experiences of the National Health Service. London: RNID, 2004.
- The Disability Partnership. One in four of us: The experience of disability. London: The Disability Partnership, 2005.