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REASONABLE ADJUSTMENT


In the last few months my daughter has had some routine hospital appointments and some not so routine GP appointments, and as she is now 17 she is seen as an adult. This situation has lead to me looking into and thinking about what reasonable adjustments are and what adjustments can be made for my daughter.

According to NHS England they must make it as easy for disabled people to use health services as it is for people who are not disabled. This is called making reasonable adjustments.

These could be things like:

  • making sure there is wheelchair access in hospitals

  • providing easy read appointment letters

  • giving someone a priority appointment if they find it difficult waiting in their GP surgery or hospital

  • longer appointments if someone needs more time with a doctor or nurse to make sure they understand the information they are given.

My recent experience at the GP indicates that they have difficulty in providing priority appointments or longer ones. The GP acknowledged that she was struggling for time, her clinic was already running 20 minutes behind and she had little opportunity to respond to my daughter’s need for a longer consultation. The GP had never met my daughter before, so had no idea of how to work with her, I had no way of booking to see a familiar GP as the appointment was required quite urgently. We discussed how a familiar face may be an advantage, but she could not offer a solution, sadly the appointment did not go so well, with anxiety being high. Unfortunately we need to return to the practice for another appointment, and although I have spoken to the receptionist, the follow up will be with another GP. My daughter has met the doctor once before so I hope it will be a success. When I asked about reasonable adjustments the receptionist said that they had made some adjustments, as the appointment given was not available to book on line, and was with a preferred GP. She apologised that that was all they could offer. Could I or should I have insisted for more?

How can these reasonable adjustments be made for longer appointments and a better consultation experience when time is precious, demand is high, waiting lists are long and clinic is behind schedule?

NHS England also say:

If you support someone with a learning disability please make sure they have good access to healthcare by supporting them to:

  • be on the GP learning disability register

  • ask their GP practice for additional information adding to their summary care record

  • have the right health checks, screening and immunisations

  • carry out the actions in their health action plan.

I am now beginning the process of adding my daughter to the GP’s learning disability register, I have received information on health checks, and at the moment consenting to immunisations is proving very difficult. My daughter refused her flu jab twice, and that’s with practice nurses making reasonable adjustments. I am gearing myself up to complete her health passport to make any future appointments that bit easier.

At the end of this year my daughter has a routine hospital appointment, where the consultation is planned for prior to clinic commencing, and the initial met and greet taking place in the hospital cafe. My daughter will be supported by the LD nurses and we, as parents, will begin to take a step back. This was a way of reducing anxiety and enabling my daughter to take a more active role in her consultations. Blood tests have also been scheduled to be taken in the community with support prior to appointment to reduce the association of a certain discipline with blood tests. I feel that this is a positive step, and a reasonable adjustment.

Having read around the topic, I keep returning to the question, what is a reasonable adjustment? Who decides if an adjustment is reasonable, the service making the adjustment or the person requiring the adjustment? And fundamentally what constitutes reasonable? It all seems very subjective to me.


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