National Guidelines on Accessible Health and Social Care Services: Introduction etc

Acknowledgements

We would like to take this opportunity to thank all of those who gave their time so generously in developing this document. We would like to acknowledge in particular the hard work, guidance and patience of the members of the HSE Universal Access Steering Committee and all those whose expertise and experience was critical to the development of this document.

Thanks also to all of the staff and service users who made submissions during the consultation phase of this work and who were significant stakeholders in the development of these guidelines.

We would also like to thank in advance all those who will, in the coming months, read and implement the guidelines. We hope that the National Guidelines on Accessible Health and Social Care Services will be a useful guide for staff and, in turn, will make a real difference to the service user’s experience of health and social care services in Ireland.

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Foreword

The Disability Act 2005 is a positive action measure, which provides a statutory basis for making public services accessible. It gives effect to the underlying principle that mainstream public services provided to the general public must also serve people with disabilities as an integral part of the service they provide.

The health service is obliged to ensure that its buildings, its services, the information it provides, and how it communicates with people, are all accessible to people with disabilities. These Guidelines offer the practical guidance to make that a reality.

This document, the National Guidelines on Accessible Health and Social Care Services has been written to give practical guidance to all health and social care staff about how they can provide accessible services. While these guidelines refer to specific disabilities, if we take steps to routinely provide accessible services for all, we will positively influence the experience of everybody who uses our services.

The ethos of accessibility is reinforced by A Future Health, A Strategic Framework for Reform of the Health Service 2012 - 2015, published by the Department of Health in November 2012; by legislation such as the Disability Act 2005, the Equal Status Acts 2000 – 2008, by the National Healthcare Charter ‘You and Your Health Service’ and the many other health and social care policies and procedures.

The guidelines describe a standard to which we can aspire. They detail what obligations are in statute to provide accessible services. They also serve as a resource for health and social care professionals who may be planning services in the future.

Many of the key initiatives outlined in the guidelines to make services more accessible are cost neutral. Consideration, compassion and open communication are free. Time spent identifying a person’s needs is an investment in safe, effective care which can prevent unnecessary risks to the individual and the staff member, and negative feedback.

We hope that the guidance will help all staff to build on their existing knowledge and to recognise that people with disabilities are often experts in what they need. The key message reinforced throughout the guidelines is Ask, Listen, Learn, Plan and Do.

We look forward to services working in partnership to ensure that the National Guidelines on Accessible Health and Social Care Services make a positive difference to the experience of all those who use Ireland’s health and social care services.

Tony O’Brien
Director General
Health Service Executive
Siobhan Barron
Director
National Disability Authority

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1. Introduction

1.1 Providing responsive care for service users

It is important that health and social care services provide appropriate and responsive care for all service users. In the course of their lives, some people will have regular interaction with the health and social care services. They may have a disability or a prolonged illness, or because of a preexisting condition may be more vulnerable to other illnesses. Many people who have continuous contact with services do not consider themselves ill.

An understanding of the needs of service users with disabilities is important for every person employed or contracted by the HSE.1 This understanding will help ensure that people who work in the health and social care services, in whatever capacity:

  • are equipped with the knowledge and skills to identify and where possible meet the needs of patients with disabilities
  • design premises and systems with those needs in mind
  • communicate with service users in ways that are appropriate to their needs

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1.2 Some key facts about disability in Ireland:

The National Disability Survey 2006 reported that between one in five and one in ten persons has a long-term disability. Most people will experience some degree of disability over the course of their life; however, as people get older, the proportion of people with a disability rises. Based on the following statistic, the number of people with a disability will increase in the coming years:

“Each year the total number of people over the age of 65 years grows by around 20,000 persons and the population over 65 years will more than double to over one million by 2035. People are living longer – those aged over 65 years increased by 14% since 2006.”2

Disability may be classified into a number of groupings, for example:

  • physical disability
  • sensory disability – impaired sight, impaired hearing, or impaired speech
  • intellectual disability
  • mental health conditions

The National Disability Survey 2006 showed that the most common forms of disability in Ireland are, in order of frequency:

  1. Difficulties with mobility or dexterity
  2. Pain
  3. Mental health difficulties
  4. Memory difficulties
  5. Breathing difficulties
  6. Hearing loss
  7. Impaired vision
  8. Intellectual disability

Disabilities vary in terms of the nature and degree of difficulty experienced for each individual. Some people experience more than one kind of disability at the same time. In general, the number of people with some degree of impairment is much larger than the numbers with total loss of function.

We need to be aware that there are both visible and hidden disabilities

  • Visible disabilities: Sometimes, it is very obvious that a person has a disability, such as a blind person who uses a white cane or someone who uses a wheelchair
  • Hidden disabilities: It is not immediately obvious when someone has a hidden disability. Not all people who have a visual impairment need a white stick or use a guide dog. Someone’s appearance will not tell you if they have epilepsy, or if they are likely to get panic attacks

Extract from: NDA document “Providing public services to people with disabilities. A Self-Study Guide”

  • The most common types of disability in Ireland are mobility disabilities
  • About 184,000 people have difficulty walking more than 15 minutes
  • About 31,000 people use a wheelchair. Many more people – about 83,000 – use walking aids, or a stick
  • Other common disabilities in Ireland are dealing with pain, difficulty remembering information, or having mental health difficulties
  • Some people are born with a disability
  • Many more people deal with a temporary disability because of injuries or illness

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1.3. A range of solutions

Where possible, it is important to offer a range of solutions that meet the individual needs of people with disabilities. Something that works well for a person with a partial loss of function may not be the best solution for someone with a more severe difficulty. For example, someone who walks with difficulty may find it easier to manage steps than a ramp, once there is a handrail, while a wheelchair user would need a ramp to negotiate a change in level.

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2. Purpose

2.1 Purpose of guidelines

The purpose of these guidelines is to:

  • assist health and social care providers to comply with legal obligations under the Equal Status Acts,theDisability Act 2005, the associated statutory Code of Practice on Accessibility of Public Services and Information provided by Public Bodies, and health and social care policy and procedures
  • assist health and social care providers to meet the principles of the National Healthcare Charter, You and Your Health Service
  • assist health and social care providers to meet the provisions of the National Standards for Safer Better Healthcare 2012 (HIQA)

  • provide a resource for Access Officers to support health service staff respond to the access requirements of people with disabilities in all health and social care settings
  • provide a guidance document for use in education and training in relation to disability, accessibility and customer care
  • provide a reference manual for all staff in all health and social care settings

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2.2 Structure of guidelines

The guidelines are divided into two sections – Part One includes guidelines for use in all health and social care settings and Part Two includes guidelines for specific service areas.

While each guideline can be used as a stand-alone document, a greater understanding can be achieved by reading all of the guideline documents.

Part One: Guidelines for all health and social care settings

  • Guideline One: Developing accessible health and social care services
  • Guideline Two: Developing disability competence
  • Guideline Three: Accessible services - general advice
  • Guideline Four: Communication
  • Guideline Five: Accessible information
  • Guideline Six: Accessible buildings and facilities
  • Guideline Seven: Consent
  • Guideline Eight: Role of family members and support persons

Part Two: Guidelines for specific services

  • Guideline Nine: Accessible GP surgeries, health care centres and primary care centres
  • Guideline Ten: Accessible Hospital Services
  • Guideline Eleven: Accessible Emergency Departments
  • Guideline Twelve: Accessible maternity services

The guidelines contain links to further information and resources, as well as contact details for disability organisations.

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3. Scope

These Guidelines were developed in a partnership between the National Disability Authority and the Health Service Executive, and with input from an Advisory Group, drawing on:

  • research evidence
  • focus groups and interviews with people with disabilities and their organisations
  • feedback on drafts

A background paper, commissioned by the NDA, sets out the material that underpins this guidance. This paper summarises research findings, reviews other guidance on health services and disability, and considers the points raised in the consultation with Irish disability organisations.

The Guidelines are available in paper and electronic format, and have links to other sources of guidance and information – see Resources section.

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4. Legislation and related policies, procedure and guidelines

4.1 Overview of legislation and other related healthcare policy

It is a legal requirement to provide accessible health and social services for service users. The following section, while not exhaustive, sets out the key pieces of legislation and policy which are important in providing accessible services for people with disabilities.

The National Guidelines on Accessible Health and Social Care Services are written to complement existing policies, procedures and legislation governing health and social care in Ireland. The guidelines do not replace other policies of the HSE or indeed contravene existing legislation in any way.

These guidelines should be read in conjunction with other governing documents of the HSE and the legislation so that staff can provide the best possible service to all patients and service users of health and social care services. Matters appropriate to other procedures will continue to be treated in the same manner and in accordance with these agreed procedures.

Examples of relevant documents include: National Consent Policy; National Healthcare Charter; Equal Status Acts 2000 – 2008; Integrated Care Guidance: A practical guide to discharge and transfer from hospital; Your Service Your Say – Policy and Procedure for the Management of Consumer Feedback to include Comments, Compliments and Complaints; On Speaking Terms; the Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners; the Disability Act 2005 and the Health Act 2004.

The National Guidelines on Accessible Health and Social Care Services will be reviewed at regular intervals to ensure that the content of the document is in line with new policy changes or developments in healthcare.

The following are some of the key documents for your information.

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4.2 The National Healthcare Charter, You and Your Health Service

The National Healthcare Charter, You and Your Health Service was developed following wide consultation with and input from the Irish public, service users, staff, the voluntary and statutory sector, patient advocacy groups and individual advocates, the management team of the HSE, the Department of Health, the Health Services National Partnership Forum and regulatory bodies.

The result of this consultation is a charter document which sets out eight principles of expectation and responsibility which underpin high quality, people-centred care. The first principle of the charter "Access" sets out our commitment to provide health and social care services which are organised to ensure equity of access to all who use them. The charter also clearly acknowledges that patients and service users have responsibilities to meet so that they are active participants in their care.

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4.3 Future Health, A Strategic Framework for Reform of the Health Service 2012 - 2015

Future Health will allow the health and social care services to move towards a new integrated model of care that treats patients at the lowest level of complexity that is safe, timely, efficient and as close to home as possible. In providing accessible care, as outlined in these guidelines, services will support the goals of Future Health to provide care that is preventative, planned and well-coordinated.

Extract from: Future Health, A Strategic Framework for Reform of the Health Service 2012 - 2015

Keeping People Healthy: The system should promote health and wellbeing by working across sectors to create the conditions which support good health, on equal terms, for the entire population.

Patient-centredness: The system should be responsive to patient needs, providing timely, proactive, continuous care which takes account, where possible, of the individual's needs and preferences.

Lack of Integration: "We need much better integrated delivery systems based on multi disciplinary care. This will reduce costs and improve quality."

"Achieving integrated care means that services must be planned and delivered with the patient's needs and wishes as the organising principle. It is preferable that the term integrated care rather than "integration" be used so that it is clear that the focus is where it should be i.e. on patients and families and the services they need rather than on funding systems, organisation or professionals. Each of these will be important levers in enabling and facilitating integrated care - but they in themselves are not the objectives."

In practical terms, this means that services must recognise that people with disabilities have a degree of expertise in the own requirements and that, by the applying the guidelines "Ask, Listen, Learn, Plan, Do", services can provide more integrated care. (See Guideline One: Developing Accessible Health and Social Care Services for more information).

Different health service settings or specialties should not operate as individual silos unless there is good reason. Liaison between professionals is important to identify the services needed for individuals and to enable professionals to deliver integrated care that is centred on the individual and their needs. This should happen in whatever setting those needs are met from time to time. For example, where appropriate:

  • Teams working in primary, specialist, rehabilitation and hospital care can share their knowledge and experience so that person-centred care becomes the norm
  • Those treating general illnesses can liaise with those providing specialist care or support for the underlying disability; and
  • Hospitals can put in place discharge planning and follow-up with the person's GP and specialist disability support, to ensure continuity of care and support on discharge. This is essential, especially for those with a severe and prolonged disability

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4.4 Integrated Care Guidance: A practical guide to discharge and transfer from hospital

Professionals should refer to the Integrated Care Guidance: A practical guide to discharge and transfer from hospital.3

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4.5 The Equal Status Acts 2000 - 2008

The Equal Status Acts 2000 - 20084apply to all services in the public, voluntary and private sectors. These Acts make discrimination on grounds of disability illegal.

The Acts also require reasonable accommodations of people with disabilities and allow a broad range of positive action measures. Services and premises must reasonably accommodate someone with a disability. However, they are not obliged to provide special facilities or treatment when this costs more than what is called a nominal cost. What amounts to nominal cost will depend on the circumstances, such as the size and resources of the body involved.

The definition of disability covers the broad range and kinds of disability, and is not limited to people with more serious difficulties. It is broadly defined, including people with physical, intellectual, learning, cognitive or emotional disabilities and a range of medical conditions. Further information on the Equal Status Acts 2000 - 2008 is available from the Equality Authority http://www.equality.ie/en/Publications/Information-Publications/Your-Equal-Status-Rights-Explained.htm.

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4.6 Part 3, Disability Act 2005

Part 3, Disability Act 2005 (Access to Buildings and Services and Sectoral Plans) covers the public sector, and its focus is on those who experience more significant difficulties.5 It sets out what public bodies must do where this is practicable and appropriate, as follows:

  • Mainstream services must include people with disabilities
  • Where a person with a disability requests it, they must be given assistance to use a service
  • Public services, in communicating with people with disabilities, must use appropriate forms of communication when communicating with people; for example, with people who have problems with vision, problems with hearing, or those who have an intellectual disability
  • Public areas must meet minimum standards of accessibility. By end 2015, they must meet the standards set out in Part M of the Building Regulations 2000 and, by January 1 2022, they must meet the standards set out in Part M of the Building Regulations 2010; and
  • The goods and services procured must be accessible to people with disabilities Under the legislation, as a public body, the health service must have at least one Access Officer to provide or arrange the provision of assistance and guidance for people with disabilities when they are accessing its services.

The Health Service Executive has a National Complaints Officer (referred to as an Inquiry Officer in the act) who deals with appeals and complaints about failure to provide accessible services, premises, information or communication. There is a further avenue of appeal to the Ombudsman.

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4.7 National Disability Authority Code of Practice and Guidance

There is a statutory Code of Practice on Accessibility of Public Services and Information provided by Public Bodies6 which gives guidance on how to comply with the Disability Act requirements. Compliance with the Code of Practice is taken as compliance with the Act.

For further information, see the Guide to the Disability Act 2005 (http://www.justice.ie/en/JELR/Pages/Guide_to_Disability_Act_2005).

The National Disability Authority's accessibility toolkit (http://accessibility.ie) contains general information on how to make services, buildings, information and websites more accessible to people with disabilities. This website is updated regularly.

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4.8 National Consent Policy

Extract from the National Consent Policy:

"Consent is the giving of permission or agreement for an intervention, receipt or use of a service or participation in research following a process of communication in which the service user has received sufficient information to enable him / her to understand the nature, potential risks and benefits of the proposed intervention or service."7

The need for consent extends to all interventions conducted by or on behalf of the HSE on service users in all locations. The ethical rationale behind the importance of consent is the need to respect the service user's right to self-determination (or autonomy) - their right to control their own life and to decide what happens to their own body.

It includes social, as well, as health care interventions and applies to those receiving care and treatment in hospitals, in the community and in residential care settings. How the principles are applied, such as, the amount of information provided and the degree of discussion needed to obtain valid consent, will vary with the particular situation. Except in emergency situations, an interpreter proficient in the service user's language is required to facilitate the service user in giving consent for interventions that may have a significant impact on his or her health and well-being. Where practicable, this is best achieved in most cases by using a professional interpreter.

Knowledge of the importance of obtaining consent is expected of all staff employed or contracted by health and social care services. To ensure that they are aware of their obligations when seeking consent and for guidance on obtaining valid consent from people with disabilities, staff should read the National Consent Policy.

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4.9 The National Emergency Medicine Programme

Professionals should refer to The National Emergency Medicine Programme - A strategy to improve safety, quality, access and value in Emergency Medicine in Ireland. This document gives helpful advice specific to the Emergency Medicine programme relevant to accessibility.

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4.10 Other

The UN Convention on the Rights of Persons with Disabilities (CRPD), which was adopted on 13 December 2006 and signed by the Irish Government in December 2007, has not yet been ratified. This and emerging legislation, such as theAssisted Decision Making (Capacity) Bill and the Health Information Bill, may impact on the content of guidelines and require them to be reviewed at the appropriate time.

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5. Glossary of Terms / Definitions

5.1 Glossary

In these Guidelines, the term ‘accessible’ means user-friendly for people with disabilities.

Accessible building
An accessible building is one that people with disabilities can readily enter, move around, use comfortably and exit safely.

Accessible communication
Accessible communication means communicating with people with disabilities in ways they can readily follow.

Accessible information
Accessible information means that people with disabilities can readily access and understand it.

Accessible service
An accessible service is one which is geared to serve people with disabilities alongside other service users.

Disability
The legal definition of disability, as set out in the Disability Act 2005, used in relation to a person means “a substantial restriction in the capacity of that person to carry on a profession, business or occupation in the State or to participate in social or cultural life in the State by reason of an enduring physical, sensory, mental health or intellectual impairment”

Easy to read
Easy to Read is the term for very simplified text with pictures, which is important for people with literacy problems or limited English.

Health and Social Care Professional
Health and social care professional is generally used as an umbrella term to cover all the various health and social care staff who have a designated responsibility and authority to obtain consent from service users prior to an intervention. These include doctors, dentists, psychologists, nurses, allied health professionals, social workers.

Plain English
A way of presenting information that helps someone understand it the first time they read or hear it.

Service user
We use the term ‘service user’ to include:

  • People who use health and social care services as patients
  • Carers, parents and guardians
  • Organisations and communities that represent the interests of people who use health and social care services; and
  • Members of the public and communities who are potential users of health services and social care interventions

The term ‘service user’ also takes account of the rich diversity of people in our society, whether defined by age, colour, race, ethnicity or nationality, religion, disability, gender or sexual orientation, and who may have different needs and concerns.

We use the term ‘service user’ in general, but occasionally use the term ‘patient’ where it is most appropriate.

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5.2 Appropriate Terms to Use

When writing or speaking about people with disabilities, it is important to put the person first. Catch-all phrases, such as ‘the blind’, ‘the Deaf’ or ‘the disabled’, do not reflect the individuality, equality or dignity of people with disabilities.

Listed below are some recommendations for use when describing, speaking or writing about people with disabilities.

Some examples of appropriate terms:

Term no longer in use: Term Now Used:
the disabled people with disabilities or disabled people
wheelchair-bound person who uses a wheelchair
confined to a wheelchair wheelchair user
cripple, spastic, victim disabled person, person with a disability
the handicapped disabled person, person with a disability
mental handicap intellectual disability
mentally handicapped intellectually disabled
normal non-disabled
schizo, mad person with a mental health disability
suffers from (for example, asthma) has (for example, asthma)

Reproduced from the NDA Guidelines on Consultation Source: Making Progress Together, 2000 - People with Disabilities in Ireland Ltd.

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5.3 Abbreviations

Abbreviation Stands for
ASL American Sign Language
BSL British Sign Language
CD Compact Disc
DCSP Directorate of Clinical Strategy and Programmes
DHSSPS Department of Health, Social Services and Public Safety
DVD Digital Versatile Disc
ECN Emergency Care Network
ED Emergency Department
EDD Estimated Date of Discharge
EDIS Emergency Department Information Systems
ELOS Estimated Length of Stay
EM Emergency Medicine
EMA Emergency Multilingual Aids
EMP Emergency Medicine Programme
GAIN Guidelines and Audit Implementation Network
GP General Practitioner
HIQA Health Information and Quality Authority
HSE Health Service Executive
IRIS Irish Remote Interpreting Service
ISL Irish Sign Language
IT Information Technology
LIU Local Injury Unit
MRI Magnetic Resonance Imaging
MRSA Methicillin-resistant Staphylococcus aureus
NALA National Adult Literacy Agency
NCBI National Council for the Blind of Ireland
NDCS National Deaf Children's Society
NDA National Disability Authority
NECS National Emergency Care System
NHS National Health Service
NICE National Institute for Health and Clinical Excellence
NPSA National Patient Safety Agency
PA Personal Assistant
PDD Patient Discharge Data
PHN Public Health Nurse
PPG Policy, Procedure or Guideline
SCIE Social Care Institute for Excellence
SDU Special Delivery Unit
SLIS Sign Language Interpreting Service
UK United Kingdom
UN United Nations
US United States
UNCRPD United Nations Convention on the Rights of Persons with Disabilities
WC Water Closet

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6. Roles and Responsibilities

6.1 All Staff

Each member of staff working in health and social care services has a responsibility, relevant to their own role, to ensure that services are accessible to people with disabilities, and that their interactions and communication with people with disabilities are appropriate, respectful, and are delivered in ways that people with disabilities can receive and understand.

Medical, nursing, and other professional and therapy staff have a responsibility to listen and to communicate appropriately, and to take account of concurrent issues in relation to the person’s disability in their treatment programmes.

Receptionists and administrative staff have a responsibility to ensure that people with disabilities are informed of appointments and are called for their turn in ways that can be received and understood.

Care assistants, porters, catering and cleaning staff who interact with patients and service users in the course of their work have a responsibility to communicate in ways that can be understood.

Maintenance and cleaning staff may maintain accessibility of buildings and facilities by ensuring that there are no obstructions which could hinder accessibility or cause a hazard.

Frontline staff should seek to resolve, at all times, concerns and queries from patients and service users at the first point of contact with the patient / service user and / or their advocate. Where this is not possible, they should seek advice from the relevant line manager or from a specialist disability organisation, depending on the issue. If the issue cannot be resolved at this level, further advice can be sought from the Access Officer.

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6.2 Senior management role

Senior managers have a responsibility to support and promote the provision of accessible services for all service users. All health and social care management should aim to ensure that the capacity of the service is developed to fully support people with disabilities in mainstream health services. The following are key tasks / responsibilities for senior managers:

To comply with all policies, procedures and legal obligations:

  • Ensure compliance with legal responsibilities under theEqual Status Acts 2000 – 2008 and the Disability Act 2005.

To provide leadership to other staff:

  • Set out roles and responsibilities
  • Ensure all other staff access appropriate disability training
  • Ensure access officer(s) are in place and are released for and have accessed appropriate training;
    and
  • Ensure that staff are aware of the National Healthcare Charter and the 8 principles of Access, Dignity and Respect, Safe and Effective Services, Communication and Information, Participation, Privacy, Improving Health, Accountability, the availability of these guidelines and other relevant policies

To ensure that all mainstream service planning, service delivery or performance evaluation systems are developed so that services are accessible for all service users and support compliance with the relevant policies, procedures, guidelines and legislation:

  • Integrate accessibility into service planning in each service; for example:
    • Build-in systems to ensure the individual’s needs are co-ordinated across different levels or centres of care
    • Develop patient and service user information systems that ensure that the accessibility requirements of service users and information on managing any pre-existing conditions can follow through their patient journey across different health services
  • Ensure that delivering on accessibility requirements is built into systems for managing and monitoring performance of staff and departments; and
  • Budget to meet accessibility commitments

To ensure that, as part of the regular planning cycle, senior managers set goals and clear priorities which will allow them to meet legal requirements and enhance accessibility:

  • Set goals and clear priorities for achieving accessibility
  • Set key performance indicators or comply with the provision of data for existing national performance indicators on accessibility
  • Ensure there are policies and / or protocols that set out how accessibility is to be achieved in each local area; and
  • Put in place a system for reporting and reviewing what has been achieved and for planning and agreeing the next steps

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6.3 Access Officer role

The appointment of Access Officers is a legal obligation under Part 3 of the Disability Act 2005. The Act requires that Access Officers be appointed to all sites where the general public use health and social services. The Act also extends to organisations that have a service agreement with the HSE; for example, those organisations that are funded under Section 38 and 39 of the Health Act 2004.

Section 26 (2) of the Disability Act 2005requires health and social care services to authorise at least one member of staff to act as an ‘Access Officer’, to provide or arrange for and co-ordinate the provision of assistance and guidance to persons with disabilities in accessing its services. Please note, this is not specifically the role of staff from Disability Services, and staff from any background should be considered.

Given that the HSE provides health and social care services in hundreds of locations throughout the country, access officers are necessary where there are service users, patients and clients; for example, hospitals, primary care centres, health and social care clinics and / or locations where health and social care is delivered.

The role is not limited to physical access, such as car parking, ramps or wheelchair access, but extends to all aspects of the patient / service user journey including the provision of accessible information, consultations and procedures, appointments and applications for service provision.

It is the duty and role of all health and social care professionals at all levels to attend to the access needs of people with disabilities. Access Officers will not replace this duty. Rather, Access Officers will provide additional support to frontline services to attend to the access needs of people with disabilities.

Most access and disability issues are already being managed effectively by frontline services on a day-to-day basis. This role will not take from this existing practice. In instances where an issue cannot be dealt with locally, this matter can be referred to the National Specialist in Accessibility for further support. The HSE appointed a National Specialist in Accessibility in 2010 whose role is to provide guidance, advice and strategic support in the promotion of access to mainstream health services for people with disabilities.

People with disabilities face many barriers in accessing health and social care services. Some of these barriers are owing to a poor physical environment. However, most of the existing barriers are owing to a lack of understanding of how to accommodate a person’s disability. Access Officers will play a key role in supporting the organisation to address some of these barriers and, in doing so, in ensuring greater accessibility for people with disabilities. The role is designed to support health service staff respond to the access requirements of people with disabilities in all health and social care settings. Access officers will be provided with on-going comprehensive training, information and resources materials to enable them carry out this role.

The role of an Access Officer in health and social care services is to support health service staff to respond to the access requirements of people with disabilities in all health and social care settings. The main duties of an Access Officer are to:

  • Respond to and deal with requests from health service staff for assistance regarding access issues where such requests have not been dealt with or cannot be managed at the first point of contact
  • Advise health service staff on the provision of information in an accessible format
  • Develop protocols for responding to specific requests for assistance and document how such assistance can be sourced Disseminate information on best practice regarding accessibility
  • Liaise with relevant disability organisations if necessary and / or support frontline services to do so as appropriate
  • Log and appropriately record responses to requests and queries
  • Promote awareness of the role of access officer as appropriate
  • Liaise with the National Specialist in Accessibility and

It is not the role of an Access Officer to:

  • Provide one-to-one advocacy for people with disabilities
  • Relieve frontline staff of their access responsibilities to patients / clients / service users
  • Be a one stop shop on all matters of disability; and
  • Deal with complaints (these should be directed through Your Service, Your Say). If the issue cannot be resolved or the patient / service user is not satisfied with how the issue has been dealt with, s/he can refer the matter to the HSE complaints system, ‘Your Service, Your Say’ or may refer the issue onwards to the Office of the Ombudsman or the Office for the Ombudsman for Children. Further details of ‘Your Service, Your Say’ are available on www.hse.ie

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1 The HSE is in the process of reform and will transition into a new commissioning agency. These guidelines will be subsumed by this new agency. (back to footer 1)

2 HSE Annual Report and Financial Statements 2012. www.hse.ie (back to footer 2)

3 This practical guide to integrated care is designed to support healthcare providers to improve their discharge and transfer processes from the acute hospital setting back into the community and thereby, support the delivery of high quality safe care. The National Integrated Care Guidance has been developed by the National Integrated Care Advisory Group under the auspices of the Quality and Patient Safety Division. http://www.hse.ie/eng/about/Who/qualityandpatientsafety/safepatientcare/ integratedcareguidance/IntegratedCareGuidancetodischargefulldoc.pdf (back to footer 3)

4 The Equal Status Acts 2000-2008 promote equality, makes sexual harassment and harassment, victimisation and certain kinds of discrimination (with some exemptions) across nine grounds illegal. One of these grounds is disability.(back to footer 4)

5 The legal definition of disability in relation to a person means "a substantial restriction in the capacity of that person to carry on a profession, business or occupation in the State or to participate in social or cultural life in the State by reason of an enduring physical, sensory, mental health or intellectual impairment" (back to footer 5)

6 http://nda.ie/Good-practice/Codes-of-Practice/Irish-Code-of-Practice-on- Accessibility-of-Public-Services-and-Information-Provided-by-Public-Bodi es-/(back to footer 6)

7 National Consent Advisory Group, HSE. National Consent Policy. May 2013 HSE (back to footer 7)