What is Disability?
A person has a disability that is covered by the Equality Act 2010 if they have a physical or mental impairment that has a substantial and long-term effect on their ability to carry out normal day-to-day activities.
For example:
- Sensory impairments such as being blind or deaf
- Mobility difficulties and other physical disabilities
- Learning disabilities and people who are autistic (go to our Learning Disabilities page)
- Mental health problems
- Facial disfigurements
- Neurodiversity or autism
- Speech impairments
- Memory problems, such as dementia.
- Long-term conditions, such as epilepsy, dyslexia and cancer.
It is important to note that the definition can cover illnesses and conditions which some people may not immediately think of as a disability, such as asthma, depression, heart disease or diabetes. Also, not all disabilities are immediately apparent and may be described as “hidden disabilities” These could include long term conditions such as epilepsy, Autism, some sensory impairments and mental health conditions.
The social model of disability
This model recognises that an individual is disabled not by their impairment or medical condition, but by a society which fails to meet their needs.
For example, if an individual is unable to read information provided at an open day because they have a visual impairment, the social model sees the organisation as the problem because they have not provided suitable material that can be read by someone who is visually impaired, such as Braille or large print documents.
The lived experience Model of disability
The Lived Experience Model of disability recognises that each individual experience may be different but that there will be commonalities too and it is these commonalities which should inform policy and services etc. Many people see this type of model as a development of the social model.
It is the social and, increasingly, the lived experience models of disability that the Equality & Human Rights Team place at the core of its work in relation to disability
Disability and Discrimination
The Equality Act is designed to ensure that large public organisations like NHSGGC promote disability equality and challenge discrimination on the grounds of disability.
Discrimination occurs when a person or organisation treats a disabled person less favourably than they would treat others. This discrimination can affect issues such as education, employment, income and health.
For example:
- Disabled people of working age face considerable disadvantage compared to people without an impairment. On average their incomes are about 20 per cent lower than the incomes of non-disabled individuals and their employment rates are half the size
- International evidence shows that people with learning difficulties or long term mental health problems on average die 5-10 years younger than other people, often from preventable illnesses
- 15% of deaf or hard of hearing people say they avoid going to their GP because of communication problems
Following is a short film by the Equality & Human Rights Commission titled ‘What is Disability discrimination?’.
Disability and other Protected Characteristics
A recent survey of people with disabilities found the following:
- 63% of respondents reported that they were not in work, and 91% of those were not seeking employment – well above national averages.
- Over 30% of respondents stated that they found it difficult or very difficult to manage on their current income.
- In the UK Black people are more likely to be detained under the Mental Health Act
- Women are more likely to become disabled throughout the course of their lives
- More than one third of LGBTQ+ identify as having a disability
Identifying as a disabled person does not mean that a person does not also identify in some other way in relation to, for example, their religion, sexuality or social class. Such intersecting identities need to be considered when promoting disability equality and when ensuring equal access to services across NHSGGC.
Why Disability matters to health
In the 2011 census, 22% of NHSGGC’s population declared a disability.
People with disabilities can suffer poorer health for a wide variety of reasons. For example, it may be due to the fact that:
- people can’t get access to services or communicate with service providers
- how we plan our services does not take account of the needs of disabled people e.g. having an adult changing table, quiet space for autistic people
- the health of disabled people is given less priority than that of other patients
- an illness may be wrongly thought to be part of a person’s mental or physical disability
- people with long term disabilities are particularly likely to live in poverty
- some conditions are linked to a higher rate of a particular health problems
NHSGGC promotes the social model of disability, which means that it is up to the organisation and the people in it to ensure that disabled people have the same opportunities to enjoy good health as non-disabled people.
How we are addressing disability issues
NHSGGC’s The Equality & Human Rights Team works directly with disabled people (patients and staff) and disabled people’s organisations to gain insight and understanding of their lived experience. This insight is then used to inform the work of the team
It is the responsibility of service providers and employers not to discriminate against a person on the grounds of their disability, regardless of how the person may describe themselves. This is important because many people may not regard themselves as ‘disabled’, but they will still have rights under the Equality Act. The law applies to all disabled people who use NHS services. This includes visitors and members of the public, as well as patients and staff
Specific examples of work include:
Sensitising Patient Pathways for Autistic People
Starting with day surgery, the Equality and Human Rights Team are exploring how our patient pathways can be made sensitive to non-neurotypical people and autistic people. Working with staff and the charitable sector we will publish as a learning tool for staff.
Deaf People & Health Services
A range of work currently being undertaken by NHSGGC to promote British Sign Language (BSL) as a language and culture and improve the experience of our Deaf BSL patients. This includes a BSL Online Interpreting Service, a plan to better meet the mental health needs of Deaf and hard of hearing people, staff training in BSL and a BSL Health Champions Group. We are also consulting with our patients regarding NHSGGC’s response to the BSL Act.
Facilities & Estates
The Facilities and Estate Department have a programme of actions to ensure our estate is accessible for disabled people. We work with our disabled patients through the Disability Access Group and our Staff Disability Forum to drive actions for change. For example, a guide for people using mobility scooters to access NHSGGC sites has been produced.
Interpreting Service
Interpreting services address a number of risks for both service users and staff. For example, patients whose first language is British Sign Language or who utilise Deaf Blind communicators must always have interpreters at their out patent appointments and at key times during in-patient stays such as admission, discharge, doctors rounds, significant nurse interventions and to communicate with family members if needed.
Ensuring that everyone has an equal opportunity to engage in the health care process benefits all concerned. In addition, equalities legislation stipulates that the organisation must be pro-active in ensuring that this is the case.
NHSGGC’s in-house interpreting service provides interpreters to our patients on request. BSL user can now also access on line interpreters through our communication support iPads. The iPads also contain a number of support apps including the AVA app which subtitles what staff saying in real time, to help those who have a hearing loss.
Clear to All Accessible Information Policy
Effective information and communication are vital for the provision of high-quality services and care. Many of those who access services have difficulty understanding the information provided. An accessible information policy has been produced to ensure that all information can be made available in the appropriate format to meet the needs of disabled people who may need this e.g. Braille, words and pictures, British Sign Language or audio version.
Details are available on the ‘Clear to All’ Accessible Information Policy web page.
People’s Experiences
Margaret’s Story
Margaret is Deaf. Her first language is British Sign Language.
Margaret fell at home. She couldn’t move and thought she had broken her leg. She couldn’t call for an ambulance as she couldn’t use a hearing phone so she asked her mother to take her to her local Accident & Emergency.
When Margaret got to A&E she told the person checking her in that she was Deaf. She explained her mother was also Deaf. She said that she would not be able to hear her name being called.
Margaret waited for over an hour and was getting anxious about her appointment, so approached the desk again. She was told she hadn’t been called. She waited again. Eventually after 5 hours and having approached the desk on more than one occasion she was told that she missed her appointment.
Margaret was distressed and frustrated that her needs as a deaf person were not taken into account. She may have had a long wait in A&E if other emergencies had come in but she felt she had waited so long because she was deaf.
NHSGGC’s Communication Support and Language Plan aims to ensure that the communication needs of individual patients are assessed, in order for the right kind of support to be provided.
Support and Resources
Publications
- Assistance Dog Policy
- Being Disabled in Britain
- BSL National Plan (2017-2023)
- Disability Perceptions Gap
- Health Needs Assessment – Deafblind and Deaf Communities
- Staff Guidelines for people who are Deaf, have hearing loss or are Deafblind
- NHSGGC Staff Guidelines – Working with people with visual impairment
- Principles of Inclusive Communication
