Dear Requestor

I acknowledge receipt of your request as below seeking information about the Trust. Thank you for your interest in the Trust.

We are now assessing your request to determine whether we hold the information requested, and to estimate the effort required to locate, retrieve and extract it. Provided that we hold the information and the estimate does not exceed the appropriate limit of £450, then I shall endeavour to collate the information for you and forward it on within 20 working days, in accordance with the Trust’s Publication Scheme guidance under the Freedom of Information Act 2000.

Please note the Data Protection statement at the end of this email. If you have any concerns about the Trust recording your contact details securely in our database, please contact me to discuss the arrangements.

If you have any queries in the meantime, please do not hesitate to contact me.

Data Protection Statement:
Your contact details will be recorded and maintained securely on a database, together with details of your request and the response we give to you. This database is solely for the Trust’s internal use by staff with a need to know. Your contact details will not be transferred outside the Trust.

Best regards
Carole Sheppard

Freedom of Information Team
Great Western Hospitals NHS Foundation Trust
___________________________________________

[Great Western Hospitals NHS Foundation Trust request email]

Great Western Hospital
Marlborough Road
Swindon
SN3 6BB

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Good Morning Ryan

Further to your request under the Freedom of Information Act 2000 that was received on 28 September 2023, the Trust’s response is as follows:

1. A copy of your policy or guidelines regarding the identification and implementation of reasonable adjustments for patients under the Equality Act 2010.

Please see attached - this is a sample of the Policy and Guideline documents that the Trust has in place as all policies and guidelines that relate to delivery of patient care will have been subject to an equality impact assessment before they are ratified and made live.

2. Information on the processes and procedures in place for health and care workers within your organisation to record and communicate reasonable adjustments for patients, including the use of the Reasonable Adjustment Flag on the NCRS.

Every patient has a full individualised nursing assessment on admission. This assessment includes a review of all clinical and personal needs along with any adaptations, adjustments or factors that need to be taken into account when caring for that person. The Trust also has a process in place within the main electronic patient administration system, where an alert can be added to indicate any specific care needs or adjustments that need to be made.

3. Details about the categories of adjustments and types of adjustments that can be recorded for patients on the Reasonable Adjustment Flag, as specified in the NHS guidance.

Any individualised adjustment can be recorded on the main electronic patient administration system. In accordance with the Equality Act 2010, organisations have a legal duty to make changes in their approach or provision to ensure that services are as accessible to people with disabilities as they are for everybody else. The Reasonable Adjustment Flag was developed in the NHS Spine to enable health and care workers to record, share and view details of reasonable adjustments across the NHS, wherever the person is treated. This capability is now available via the National Care Records Service (NCRS). It will be available for API-based integration with local point-of-care applications in the future. By 2023/24, there is a mandate that a ‘digital flag’ will be recorded in patient records. The mandate in the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board (BSW ICB) is to go live by June 2024. Currently this Trust has a ‘reasonable adjustments’ alert on the electronic patient record that can be individualised to patient's needs. The ‘digital flag’ will supersede this.

4. Any documents or guidelines that you provide to your staff regarding the assessment and recording of patients' needs for reasonable adjustments, including communication requirements and impairments.

Please see attached document - pesonalised care plan

5. Information on how you ensure that reasonable adjustments are applied promptly and consistently across all care settings within the hospital.

The Trust achieves this through basic training for every registered nurse, doctor and Allied health professional who are taught about the need for dynamic, individualised assessments of each patient and the importance of making adjustments according to their specific needs. The Trust would address any concerns raised at the time and monitors themes and trends regarding patient concerns and implement actions to address as appropriate.

6. Any data or statistics related to the number of patients within your organisation who have been flagged as needing reasonable adjustments, and the types of adjustments commonly provided.

I confirm, in accordance with Section 1(1)(a) of the FOI Act, that the Trust does not hold any data or statistics relating to the number of patients whose records have been flagged for reasonable adjustments. The types of adjustments available are appointments at the beginning and end of clinic sessions, desensitisation visits prior to planned surgery, support for patients to have people familiar to them say with them in hospital (this list is not exhaustive)

7. Information on how you comply with the legal obligation under the Equality Act 2010 to make anticipatory reasonable adjustments, particularly in cases where patients are referred or present for care.

Please see response to question 3 - the Trust also reviews any information received following referral from other organisations, primary care etc, and promotion and use of the hospital passport. The Learning Disability Liaison Service also provides training for staff, reassurance to patients during their time in hospital and works with staff and patients on bespoke care pathways that meet the patients’ additional needs.

8. Any additional documentation, reports, or guidance related to your efforts to satisfy your legal obligations under the Equality Act 2010 and NHS contracts.

Please see attached Equality, Diversion and Inclusion Policy

9. Details on any training or education provided to staff within your organisation regarding reasonable adjustments for patients with disabilities.

In addition to the training mentioned in the responses to the above questions, the Trust provides mandatory training modules in equality, diversion and inclusion and in Safeguarding. There are various levels of training tailored to an employee's role in the Trust.

10. The contact information of the designated individual or department responsible for overseeing the implementation of reasonable adjustments within your organisation.

The Trust is currently looking to recruit someone to fulfil this role, but in the meantime, please contact the Chief Nurse - Lisa Cheek - [email address]

If you are dissatisfied with the way your request has been handled, you can request an internal review by writing to me at the above address within two months of the date of this email. If you are still dissatisfied after an internal review, you can apply to the Information Commissioner’s Office (ICO) for an independent review. The ICO will normally accept such applications only where they have already been through the Trust’s internal review process. The ICO’s address is:

Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow, Cheshire SK9 5AF

If you need any further assistance in this matter, please do not hesitate to contact me.

Yours sincerely

Carole Sheppard
Freedom of Information Team
Great Western Hospitals NHS Foundation Trust

Great Western Hospital
Marlborough Road
Swindon SN3 6BB

E: [Great Western Hospitals NHS Foundation Trust request email]

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