1. INTRODUCTION

 Kearsley Medical Centre is committed to providing excellent service and delivering high quality patient services.

This policy sets out what a reasonable adjustment is, how to make a reasonable adjustment to us, our duties and responsibilities and what considerations we will take into account when reviewing your request.

We must take reasonable steps in the way that we work to ensure we are compliant with Equality & Diversity legislation and regulations.

This policy does not seek to explain how we will approach every situation, it is intended as a general statement of our policy and

• confirms our commitment to improving accessibility for everybody that we deal with;
• sets out some of the basic principles of our legal duty to provide reasonable adjustments; and
• sets out the factors that we will consider in dealing with requests for reasonable adjustments.

2. WHAT IS A REASONABLE ADJUSTMENT?

 A reasonable adjustment involves making a change to the way that we usually do things to ensure that we are fair to all of our patients. This may involve:

• departing from our usual practice in the way we do things, if we find that the current position places that person at a substantial disadvantage, for instance by allowing more time than we usually would for someone to respond or provide information; or
• providing specialist equipment or additional support, such as a sign language interpreter for a meeting or event; or
• making sure our buildings do not present obstacles for disabled people, for instance by providing a lift or ground level meeting rooms.

We will not make assumptions about whether a disabled person requires any adjustments or about what those adjustments should be. We will discuss the requirements with the person concerned and seek to reach agreement on what may be reasonable in the circumstances.

2. OUR LEGAL DUTIES IN RELATION TO DISABLED PEOPLE

 The Equality Act 2010 requires us to provide reasonable adjustments for disabled people, defined by the Act as those who have a physical or mental impairment which has a substantial and long-term adverse effect on that person's ability to carry out normal day-to-day activities.

This will, in some circumstances, mean that disabled people receive more favourable treatment than non-disabled people, which is lawful in the context of disability.

3. DUTY TO MAKE REASONABLE ADJUSTMENTS AS A SERVICE PROVIDER

 As a service provider, Kearsley Medical Centre has a duty to make adjustments as a service provider if the way that we carry out these functions, the absence of an auxiliary aid, or any physical feature places the disabled person at a "substantial disadvantage" compared to someone who is not disabled.

The duty requires Kearsley Medical Centre to consider what can be done to overcome any such disadvantage, and whether an adjustment can be made which is reasonable in all the circumstances of the case.

4. REQUESTING REASONABLE ADJUSTMENTS

 To request a reasonable adjustment, please contact the Practice Manager, or management team, on your matter.

We will let patients know that we can provide reasonable adjustments, for example in the following ways:

• By asking whether an adjustment might be required over the telephone;
• by including a note on our published documents indicating that we can provide the document in an alternative format on request;
• by publishing this policy on our website; and
• by working with key representative groups and others to raise awareness of this policy, such as our Patient Participation Group (PPG).

 5.TYPES OF REASONABLE ADJUSTMENT WE CAN OFFER

 Whilst we will consider each request for reasonable adjustments individually, there are some common adjustments which we will offer as a matter of course and some other adjustments that we can make particular arrangements to provide.

The adjustments will always be agreed with the person concerned to avoid making incorrect assumptions about a person's needs.

Some examples of the simple reasonable adjustments that staff can make may include:

• providing documents or correspondence in a larger font size
• providing documents on coloured paper or with a specific colour contrast which can often help people with conditions such as dyslexia
• Online triage service- patients are able to complete a request for clinical and non-clinical issues online using SystmConnect our triage service
• allowing a person who has a learning disability or mental health problems more time than would usually be allowed to provide further information—except where there is a statutory deadline which we have no power to change
• using email or the telephone in preference to hard copy letters where appropriate, which may assist those with a vision impairment
• speaking clearly to the people who we deal with and offering additional time to cover the issues they need to discuss—this will help everyone understand our processes and procedures
• using plain English appropriate to the person we are dealing with and avoiding jargon
• arranging meetings in rooms which have appropriate facilities.

Some other arrangements that we can provide will include:

• providing a sign language interpreter.
• communicating with people through their representative (whether or not this is a legal representative) or advocate, if requested and approved by them,
• arranging home visits for those who have mobility difficulties.

A minority of requests may require more detailed consideration and our approach to these requests is discussed in the section below.

5. OUR RESPONSE TO REQUESTS FOR REASONABLE ADJUSTMENT

 In the majority of cases, we will be able to agree and deliver the required reasonable adjustments with a minimum of delay. In some cases, we may need to consider in more detail how best to overcome the difficulty a disabled person may be experiencing. For example, where the adjustment requested may be difficult to provide or where it may interfere with our statutory or regulatory obligations.

6. HOW DO WE DECIDE WHAT IS "REASONABLE"?

 The Equality Act does not define what is "reasonable" but guidance from the Equality and Human Rights Commission suggests that the most relevant factors are:

Will the adjustment help in overcoming the difficulty that the disabled person may have? The adjustment should be designed to fully address the disadvantage it is meant to overcome—for example providing a meeting room which is accessible by wheelchair may not properly overcome the barriers faced by the wheelchair user if there are no disabled toilet facilities also available.

How practical is it to provide the adjustment?
What are the resource implications of making the adjustment? How much will it cost and is this proportionate to the adjustment being requested.

Would the adjustment cause disruption to others?
For example, it would not usually be reasonable for a fee earner to drop all other cases and devote all their time to one person, as others would inevitably suffer. The amount of extra time provided must therefore be "reasonable" in all the circumstances.

7. MONITORING

 Kearsley Medical Centre will record and monitor the reasonable adjustments that have been requested and made. It will be recorded in patient record to trigger alert flags reminding staff of the patient’s reasonable adjustments.  All staff are responsible for asking patients if they have any reasonable adjustments and updating the records accordingly.  This will allow us to review the services we provide and help us identify whether there are any wider steps that we can take to improve our services.

8. Sharing your reasonable adjustments with other healthcare providers

The NHS has introduced the Reasonable Adjustments Digital Flag tool.  This enables practices to record patients’ reasonable adjustments using an approved NHS template with an option to share with other healthcare providers upon consent from the patient to do so.  Your consent will enable other healthcare providers to offer the agreed reasonable adjustment when you attend other health related appointments, for example at the hospital.