Disabled people's experiences of accessing reasonable adjustments in hospitals: a qualitative study

BMC Health Serv Res. 2018 Dec 4;18(1):931. doi: 10.1186/s12913-018-3757-7.

Abstract

Background: The UK Equality Act 2010 requires providers of health services to make changes or 'reasonable adjustments' to their practices in order to protect disabled people from discrimination or disadvantage when accessing care. Existing evidence suggests that despite this legislation, health services are not always providing reasonably adjusted care for disabled people. This paper presents the perspectives of disabled people themselves in relation to their experiences of accessing reasonable adjustments in hospitals in England.

Methods: Twenty-one semi-structured interviews were held with disabled people who had a recent experience of hospital care in England. Participants were asked about the extent to which the hospital provided reasonably adjusted care, and if necessary, how they thought the provision of reasonable adjustments could be improved. Each interview was anonymised and transcribed, and the data analysed using thematic analysis.

Results: Participants reported mixed experiences about whether and how reasonable adjustments were provided: some shared positive examples of good practice; others spoke about difficult encounters and limited provision. Recommendations made include a need for culture change in how reasonable adjustments are perceived and enacted; improvements in identifying the needs of disabled people; improvements to the hospital environment and the provision of information; and the need to involve disabled people themselves in the process of change.

Conclusions: Gaps remain in how reasonable adjustments are provided for disabled people accessing hospital care. It is important for hospital staff to listen to the perspectives of disabled people about the provision of reasonable adjustments, and make improvements as necessary. Hospital staff could also do more to share good practice in relation to the provision of reasonable adjustments to effectively inspire and embed positive change.

Keywords: Disabled people; Equality act 2010; Hospital care; Reasonable adjustments.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Disabled Persons*
  • England
  • Female
  • Health Services Accessibility / standards*
  • Healthcare Disparities / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Hospitals / standards*
  • Humans
  • Male
  • Middle Aged
  • Personnel, Hospital / standards
  • Professional Practice / standards
  • Professional-Patient Relations
  • Qualitative Research
  • Young Adult