There are wide-ranging ramifications of the Disability Discrimination Act for GPs.

The DDA applies to any service provider (eg a GP practice) irrespective of size. It ensures reasonable access to services. The courts will decide what is reasonable and can award unlimited damages or compensation as well as issue an injunction prohibiting any repetition of discriminating behaviour. The DDA covers all disabilities, not just mobility problems i.e. mental impairment, those who are hard of hearing, the partially sighted and those with language difficulties.

An NHS Executive Inquiry carried out by ‘Disability Matters’ found the most significant barrier cited by the majority of disabled people was that of ‘inappropriate staff attitudes and behaviours’. This was mainly the staffs’ lack of knowledge of the needs of the disabled, rather than discriminatory attitude as such. The key physical barriers were: car parking, signage, inaccessible information media, inaccessible toilets and poor physical access generally.

The service provider is responsible in law. From October 1999, providers have to take reasonable steps to ensure disabled people can use their service. From 2004 practices should put in place: staff awareness training, improved communication (e.g. way-finding, large print, loop systems), have performed an access audit (by an earlier target date), and overcome physical barriers (remove, alter, provide reasonable means of avoiding, or provide a reasonable alternative).

Access audits are a necessary requirement. There is no certification associated with the DDA i.e. it is not possible to guarantee compliance. ‘Reasonableness’ of physical adjustments to premises depends on: effectiveness and practicability, financial and other costs, disruption, extent of resources, and resources already spent. The access audit could be carried out by staff or by a trained auditor (surveyor). There are so many different aspects to consider that it may be a good idea to employ a professional to carry out an access audit.

Examples of things that need to be considered include: chairs with and without arms, the heaviness of doors, vision panel in doors, handrails on both sides of ramps/ steps/ corridors, availability of both steps and a slope, clear signage, and contrasting colour schemes. It is essential to take DDA into consideration for any new building work. PCTs should show that they have gone through the process in the spirit of the law rather than ensure that every service provider complies with every aspect.

Costs have to be met by the service provider. PCTs may consider top slicing the improvement grant budget. In rented property, the service provider, and not the landlord, is responsible for making changes. This Act of Parliament overrides any restrictions in the lease that prevent alterations but does not override listed buildings, in which reasonable alternatives have to be provided.

Further details: HSC 1999/156 Implementing the DDA in the NHS from your PCT