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Doctors urged to improve care of disabled patients

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GPs should not always be expected to make major alterations to their practices to cater for disabled people, according to a report published today by doctors’ leaders.

The British Medical Association (BMA) report calls for more action to address the inequalities that disabled people face in both accessing services and their health outcomes. Receptionists and doctors should improve they way they communicate with these patients, GPs should provide extended appointment slots, and practices should consider making adjustments such as installing ramps and induction loops.

But the report adds “it must be acknowledged that some practices, especially smaller ones, may find it very difficult to make physical adjustments to make their premises more accessible. This may either be because their existing premises are designed in a way or are too small so that such refurbishments are unworkable; because the resources and funding needed to make the adjustments are not available; or because it is not possible to carry out the work without causing disruption to the services that they provide”.

The BMA calls on primary care organisations (PCOs) to take responsibility for supporting premises development, deciding where in a locality adjustments are most needed. PCOs should also take a lead on providing accessible information, such as pictorial resources for those with learning disabilities, and also make arrangements for providing primary care to aggressive or abusive people with disabilities who cannot be registered with a GP.

The GP contract could be used to provide enhanced services with people with disabilities, the report adds. “There is some evidence, for example, that annual health checks for people with learning difficulties can result in improved health outcomes for this group; provided that relevant resources and funding are available from primary care contracting bodies this is an enhanced service that GPs may choose to provide for these patients. The BMA will continue to engage with the Disability Rights Commission and the Department of Health on these matters during contract negotiations.”

Acting BMA chairman Dr Sam Everington, a GP in east London and co-chair of the association’s equal opportunities committee, said: “Our report provides doctors with information on how the healthcare they provide to their disabled patients can be optimised and to develop more inclusive and flexible ways of working that meet their needs. It is essential that political will and resources support this approach.”

About 11m adults and 770,000 children in the UK have a disability. Previous research has shown that people with learning difficulties:

• may be 58 times more likely to die before the age of 50 than the general population;
• have higher rates of respiratory disease than the general population (20% compared with 15%);
• are more likely to be obese (28% compared to 20%).

Studies have also found:

• psychiatric outpatients are nearly twice as likely to die prematurely as the general population from a range of often preventable conditions - rates that cannot be accounted for by suicide alone;
• four in ten visually impaired people consider that their GP is not fully aware of their needs, and the majority never receive health advice, letters or prescriptions in preferred formats such as Braille or large print;
• Nearly three in ten people who are deaf or hard of hearing people found it difficult to contact their GP surgery to get an appointment;
• More than four in ten deaf or hard of hearing people had found it difficult to communicate with hospital staff.

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