Hospital Policy on Reasonable Adjustments under the Equality Act 2010
Dear Mid and South Essex NHS Foundation Trust,
I am writing to make a formal request for information under the Freedom of Information Act 2000 regarding any policy and procedures related to the identification and implementation of reasonable adjustments for patients with disabilities, in accordance with the Equality Act 2010.
The Equality Act 2010 imposes a legal duty on organisations, including healthcare providers, to make reasonable adjustments to their services to ensure that they are accessible to individuals with disabilities, and on par with services provided to individuals without disabilities. It has come to my attention that you utilise the Reasonable Adjustment Flag on the National Care Records Service (NCRS) to record, share, and view details of reasonable adjustments for patients across the NHS in England. I am interested in understanding how you implement and adhere to this policy to ensure equitable healthcare access for patients with disabilities.
Therefore, I kindly request the following information:
A copy of your policy or guidelines regarding the identification and implementation of reasonable adjustments for patients under the Equality Act 2010.
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.
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 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.
Information on how you ensure that reasonable adjustments are applied promptly and consistently across all care settings within the hospital.
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.
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.
Any additional documentation, reports, or guidance related to your efforts to satisfy your legal obligations under the Equality Act 2010 and NHS contracts.
Details on any training or education provided to staff within your organisation regarding reasonable adjustments for patients with disabilities.
The contact information of the designated individual or department responsible for overseeing the implementation of reasonable adjustments within your organisation.
Please provide the requested information in electronic format where possible, and within the statutory timeframe of 20 working days, as stipulated by the Freedom of Information Act 2000.
If there are any fees associated with processing this request, please inform me in advance. If you require any clarification or further information to fulfill this request, please do not hesitate to contact me.
I understand the importance of complying with the law and ensuring that individuals with disabilities receive equitable healthcare services. Your assistance in providing this information will greatly contribute to our collective understanding of how hospitals like yours work to fulfill these vital obligations.
Thank you for your attention to this matter, and I look forward to receiving the requested information in due course.
Yours sincerely,
Mr Ryan Jarvis
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Dear Mr Jarvis,
Thank you for your Freedom of Information request dated 28.09.2023, which
has been handled under the Freedom of Information Act 2000 (FOIA).
Your request and our response are as follows:
I am writing to make a formal request for information under the Freedom of
Information Act 2000 regarding any policy and procedures related to the
identification and implementation of reasonable adjustments for patients
with disabilities, in accordance with the Equality Act 2010.
The Equality Act 2010 imposes a legal duty on organisations, including
healthcare providers, to make reasonable adjustments to their services to
ensure that they are accessible to individuals with disabilities, and on
par with services provided to individuals without disabilities. It has
come to my attention that you utilise the Reasonable Adjustment Flag on
the National Care Records Service (NCRS) to record, share, and view
details of reasonable adjustments for patients across the NHS in England.
I am interested in understanding how you implement and adhere to this
policy to ensure equitable healthcare access for patients with
disabilities.
Therefore, I kindly request the following information:
1. A copy of your policy or guidelines regarding the identification and
implementation of reasonable adjustments for patients under the Equality
Act 2010.
The following policies support identification and implementation of
reasonable adjustments:
MSEPO-21009 Supporting People With A Learning Disability In Hospital
(Currently Under Review)
MSEPO-21042 Making Reasonable Adjustments For Children And Adults With
Disabilities
MSEPO-21200 Accessible Information For People With Disabilities
MSEPO-20249 Caring For Children And Adults With Autism In The Acute
Setting
MSEPO-21103 Application Of The Mental Capacity Act Of 2005 Policy
MSEPO-20253 Care Of Patients With Dementia
MSEPO-21139 Caring For Carers Policy
MSEPO-21231 Admission & Treatment Of Patients With A Mental Health
Disorder In An Acute Hospital Setting
MSEPO-21228 Policy For Enhanced Supervision And Engagement
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.
The following policy supports staff to record and communication reasonable
adjustments
MSEPO-21200 Accessible Information For People With Disabilities
this policy only covers communication related reasonable adjustments.
For people with learning disabilities/autistic people, we are also
developing a reasonable adjustments card, which they can present when in
hospital to advise staff of the specific reasonable adjustments that they
require.
We are working with system partners to have referral forms/templates
amended to prompt identification of additional needs and any reasonable
adjustments required.
Safeguarding Flags to highlight Vulnerabilities for individual patient
MSEPO-21009 Supporting People With A Learning Disability In Hospital
(currently under review)
MSEPO-21042 Making Reasonable Adjustments For Children And Adults With
Disabilities
MSEPO-21200 Accessible Information For People With Disabilities
MSEPO-20249 Caring For Children And Adults With Autism In The Acute
Setting
MSEPO-21103 Application Of The Mental Capacity Act Of 2005 Policy
MSEPO-20253 Care Of Patients With Dementia
MSEPO-21139 Caring For Carers Policy
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.
We are able to add flags to each Patient Administration System (PAS) to
identify reasonable adjustments. Will also be enabling a personalised care
plan for long term conditions including reasonable adjustments, within the
patient portal.
Safeguarding Flags to highlight Vulnerabilities for individual patient
CPIS Information for Safeguarding Children
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.
The following policies and associated appendices support assessment
recording of patients’ needs for reasonable adjustments:
MSEPO-21009 Supporting People With A Learning Disability In Hospital
(currently under review)
MSEPO-21042 Making Reasonable Adjustments For Children And Adults With
Disabilities
MSEPO-21200 Accessible Information For People With Disabilities
MSEPO-20249 Caring For Children And Adults With Autism In The Acute
Setting
MSEPO-21139 Caring For Carers Policy
MSEPO-20253 Care Of Patients With Dementia
5. Information on how you ensure that reasonable adjustments are applied
promptly and consistently across all care settings within the hospital.
The following supports application of reasonable adjustments:
Reference to appropriate policies, procedures and appendices as listed
Access to training as listed
Support from the learning disability and autism liaison nurses and
learning disability and autism practitioners as required
Consideration of additional needs when environments and services are being
redesigned
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.
See separate spreadsheet for data
Reasonable adjustments commonly provided include:
Longer appointment times
First/last appointment
Side rooms
Provision of necessary equipment
Provision of resources to support occupation/engagement
Departmental walk abouts/visits
Facilitating carer support/flexible visiting
Communication resources
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.
The following supports anticipatory reasonable adjustments:
Flags on the EPR
Liaison with carers/families
Information contained within referrals (although this is currently limited
and we are now working with system partners to have referral
forms/templates amended to prompt identification of additional needs and
any reasonable adjustments required)
Contact with the learning disability and autism liaison nurses and
learning disability and autism liaison practitioners
8. Any additional documentation, reports, or guidance related to your
efforts to satisfy your legal obligations under the Equality Act 2010 and
NHS contracts.
MSEFT Annual Report 2022 – 2023 which is available on our website
Scheme improving healthcare access reaches national awards | Latest News
at our mid and south Essex hospitals (mse.nhs.uk)
Trust shortlisted for triple National Learning Disability and Autism
Awards | Latest News at our mid and south Essex hospitals (mse.nhs.uk)
Host of initiatives recognised in 2023 health and care awards for mid and
south Essex teams - Mid and South Essex Integrated Care System
(ics.nhs.uk)
Hospitals are recognised for patients’ dementia care | Latest News at our
mid and south Essex hospitals (mse.nhs.uk)
Improved help for patients with dementia thanks to launch of dementia hubs
- Mid and South Essex Integrated Care System (ics.nhs.uk)
Mid & South Essex NHS Foundation Trust | John's Campaign
(johnscampaign.org.uk)
Understanding inequalities report – attached.
NHSEI Improvement Standards – Year 5 – attached.
9. Details on any training or education provided to staff within your
organisation regarding reasonable adjustments for patients with
disabilities.
• Oliver McGowan Mandatory Training in Learning Disabilities and Autism
(Statutory/Mandatory – level according to staff group)
• Learning Disabilities Nursing CPD Award (Optional)
• Accessible Information Standards Training (Optional)
• Makaton for Beginners (Optional)
• Learning Disability Champions Training (Optional)
• Dementia Awareness (Tier 1) and Dementia (Tier 2) (Stat/Man – level
according to staff group)
• Care Certificate
• NQN Induction and Development Programme
10. The contact information of the designated individual or
department responsible for overseeing the implementation of reasonable
adjustments within your organisation.
The clinical and front-line staff always work to make service, care and
treatment person centred. They are making very small to significant
changes to tailor care for every patient. As you can see from the response
that there is not a single policy or department solely responsible for
reasonable adjustment but, we work collectively, and it is almost every
department’s responsibility to make reasonable adjustment when needed.
This is taken from the trust reasonable adjustment policy
Role & Responsibilities within the Trust
4.1 MSE joint Safeguarding Committee – To provide assurance to the trust
in regards to compliance with all local and national guidance regarding
service provision for patients requiring reasonable adjustments in an
acute healthcare environment.
4.2 Associate Director Safeguarding services –
• Responsible for
• The development and leadership of a robust culture of safeguarding
practice across the MSE group, providing strategic and corporate direction
including complex professional advice on matters relating to safeguarding
individuals at risk:
• To lead the organisation on collaborative working practices across both
agency and geographical boundaries, with providers of health and social
care and other partner agencies, to provide a seamless approach to
safeguarding individuals at risk. An approach that incorporates a holistic
family approach to any individual at risk of or being abused
• Ensuring that national and local recommendations from emergent
safeguarding work are implemented across the Trust and are included within
its policies and practice
• Leading a robust culture of safeguarding, directed through the approved
MSB safeguarding governance reporting structure, including the
Safeguarding Operational Groups, Learning Disabilities Operational Group,
Children and Adults Safeguarding Committee in Common and the Quality
Committee in Common
• Provide expert advice to staff across the MSE group on all matters of
safeguarding adults and children
• Demonstrate advanced skills and competencies to influence the pathways
of care in safeguarding children and young people and adults at risk
• Initiate and add to research evidence in the field of safeguarding to
ensure that evidence-based practice is inherent in all aspects of care
• Ensure a Safeguarding Audit Programme is in place to facilitate learning
4.3 Learning Disability Service Lead –To act as the strategic lead in the
development of equitable and high-quality health care for adults with
learning disabilities within acute care across the MSB Group.
4.4 Learning Disability Acute Liaison Nurse Specialist – To provide advice
and support to clinical areas to meet the needs of people with learning
disabilities and or Autism when they are admitted / attend for treatment /
appointments. They have specialist expertise which will enable clinical
teams to plan and support the patients care to ensure that they have a
positive experience.
114.5 Dementia Nurse Specialist - to provide advice and support to
clinical areas to meet the needs of people with Dementia when they are
admitted / attend for treatment / appointments. They have specialist
expertise which will enable clinical teams to plan and support the
patients care to ensure that they have a positive experience.
4.6 Matrons - will in the absence of the ward manager review the decisions
made by ward staff and assess the appropriateness of the reasonable
adjustments that have been made. When required the matron will authorise
additional resources. Matrons will be involved in the escalation of
concerns, and support teams to plan and deliver appropriate care thus
ensuring positive patient experience.
4.7 Ward / Department Manager - will review the decisions made by ward
staff and assess the appropriateness of the reasonable adjustments that
have been made.
4.8 Ward / Department staff - The admitting nurse needs to undertake a
comprehensive assessment, to identify individuals needs such as
communication and support needs to ensure continuity of care and to
maintain appropriate levels of support during the hospital admission.
Please provide the requested information in electronic format where
possible, and within the statutory timeframe of 20 working days, as
stipulated by the Freedom of Information Act 2000.
If there are any fees associated with processing this request, please
inform me in advance. If you require any clarification or further
information to fulfill this request, please do not hesitate to contact me.
I understand the importance of complying with the law and ensuring that
individuals with disabilities receive equitable healthcare services. Your
assistance in providing this information will greatly contribute to our
collective understanding of how hospitals like yours work to fulfill these
vital obligations.
I hope that the response that the Trust has provided is satisfactory.
However, if you are dissatisfied with the way in which your Freedom of
Information request has been dealt with you can request an internal
review. Please email [1][MSEFT request email]. within 40 working days with
clarification of what you would like to be reviewed. We will aim to
provide a review response within 20 working days.
If you remain dissatisfied, you have the right under section 50 of the Act
to apply to the Information Commissioner to seek resolution to the matter.
Further details can be found on their website:
[2]https://ico.org.uk/make-a-complaint/ and....
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Kind regards.
Nicola Frost
Freedom of Information Manager – MSE Group
Corporate Affairs Team
Corporate Services
Mid and South Essex NHS Foundation Trust
Basildon University Hospital, Nethermayne, Basildon, Essex, SS16 5NL
Telephone: via email
Email: [5][MSEFT request email]
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══════════════════════════════════════════════════════════════════════════
From: Ryan Jarvis <[FOI #1032208 email]>
Sent: 28 September 2023 04:27
To: FOI.SUHFT (MID AND SOUTH ESSEX NHS FOUNDATION TRUST)
<[MSEFT request email]>
Subject: Freedom of Information request - Hospital Policy on Reasonable
Adjustments under the Equality Act 2010
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Dear Mid and South Essex NHS Foundation Trust,
I am writing to make a formal request for information under the Freedom of
Information Act 2000 regarding any policy and procedures related to the
identification and implementation of reasonable adjustments for patients
with disabilities, in accordance with the Equality Act 2010.
The Equality Act 2010 imposes a legal duty on organisations, including
healthcare providers, to make reasonable adjustments to their services to
ensure that they are accessible to individuals with disabilities, and on
par with services provided to individuals without disabilities. It has
come to my attention that you utilise the Reasonable Adjustment Flag on
the National Care Records Service (NCRS) to record, share, and view
details of reasonable adjustments for patients across the NHS in England.
I am interested in understanding how you implement and adhere to this
policy to ensure equitable healthcare access for patients with
disabilities.
Therefore, I kindly request the following information:
A copy of your policy or guidelines regarding the identification and
implementation of reasonable adjustments for patients under the Equality
Act 2010.
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.
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 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.
Information on how you ensure that reasonable adjustments are applied
promptly and consistently across all care settings within the hospital.
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.
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.
Any additional documentation, reports, or guidance related to your efforts
to satisfy your legal obligations under the Equality Act 2010 and NHS
contracts.
Details on any training or education provided to staff within your
organisation regarding reasonable adjustments for patients with
disabilities.
The contact information of the designated individual or department
responsible for overseeing the implementation of reasonable adjustments
within your organisation.
Please provide the requested information in electronic format where
possible, and within the statutory timeframe of 20 working days, as
stipulated by the Freedom of Information Act 2000.
If there are any fees associated with processing this request, please
inform me in advance. If you require any clarification or further
information to fulfill this request, please do not hesitate to contact me.
I understand the importance of complying with the law and ensuring that
individuals with disabilities receive equitable healthcare services. Your
assistance in providing this information will greatly contribute to our
collective understanding of how hospitals like yours work to fulfill these
vital obligations.
Thank you for your attention to this matter, and I look forward to
receiving the requested information in due course.
Yours sincerely,
Mr Ryan Jarvis
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