Reasonable Adjustments

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Heath and care organisations have a responsibility to make reasonable adjustments to their services to ensure they are accessible to people with disabilities. This includes individuals with physical, sensory, learning, or mental disabilities including Dementia and Autism.

We are currently reviewing our processes and have introduced a more robust way of identifying, recording and supporting reasonable adjustments.

Examples of Reasonable Adjustments may include:

Longer appointments
A quiet space while waiting for an appointment
Easy-read information
Clear & simple explanations, or repeated explanations of treatments and procedures
Extra time during telephone conversations and appointments
Disabled access to the practice and its facilities

Reasonable Adjustments Form

Please complete the questionnaire and consent form (below) to let us know about any reasonable adjustments you may require.

Condition / Disability / Significant Impairment to which this is reasonable adjustment request relates to:

Communication Support

Does lip read Does use a communication device Does use a hearing aid Preferred Method of communication written Uses a citizen advocate Uses a legal advocate Uses British Sign Language Uses deaf blind intervenor Uses electronic note take Uses lip speaker Uses manual note taker Uses personal audio device to record information Uses speech-to-text reporter Uses telecommunication device for the deaf Uses a non-speech system for communication Uses gestures for communication skills Uses non-verbal communication Uses symbols for communication Uses verbal communication Uses voice-aid to support communication

Requires Interpreter

Spoken language interpreter needed BSL interpreter needed Hands-on signing interpreter needed Needs an advocate Requires deaf blind block alphabet interpreter Requires deaf blind haptic interpreter Requires deaf blind communication guide Requires deaf blind manual alphabet interpreter Requires lip speaker (lip reading) Requires manual note taker Requires sighted guide Requires speech-to-text reporter Sign-supported English interpreter needed Visual frame sign language interpreter needed

Requires Specific Contact Method

Requires contact by email Requires contact by letter Requires contact by short message service text message (SMS) Requires contact by telephone Requires contact by text relay Requires contact via carer

Requires Specific Information Format

Requires information by email Requires information in contacted grade 2 braille Requires information in easy read Requires information in un-contracted grade 1 braile Requires information verbally Requires 3rd party to read out information Requires written information in big font size Requires information in different language

Additional Communication Support

Difficulty analysing information Uses apps on mobile device to support communication Difficulty processing information at normal speed Difficulty processing information accurately Needs assistance with communication Requires appointment reminders Has my health care passport (hospital passport) Expresses pain atypically Requires carers to be present at encounters Is an interpreter required

Adjustments for Providing Addiitional Support to Patients Part 1

Has appointed person with personal welfare LPA Requires constant supervision Unsafe to be left alone Care to be delivered in consultation with the patients carers Requires additional staff resource for their sensory impairment Requires additional staff resource for their physical impairment Requires additional staff resource for their mental impairment

Adjustments for Providing Addiitional Support to Patients Part 2

Preference for male health care professional Preference for female health care professional Needle phobia Dependence on seeing eye dog Requires priority appointment Requires extended appointment Patient requires minimal waiting time between arrival and being seen Requires first appointment Requires last appointment Requires home visits where possible Requires distraction for any procedures Requires familiarisation for procedures Requires familiarisation with environment of care Has anxiety related to clinical settings

Adjustments to The Environment

Noise intolerance Photophobia Eyes sensitive to light Requires wheelchair access Requires low-light environment Requires single room during inpatient care

Bespoke reasonable Adjustments

Requires reasonable adjustments for health and care access (Equality act 2010)

If patient requires reasonable adjustments not recorded elsewhere, please specify:

Are you happy for this information to be shared with other organisations in the NHS?

Patient Consent

Does the patient consent to their reasonable adjustments being recorded in this way? If the patient doesn't have capacity, is it being done in the persons best interests?

Full Name

Date of Birth

Address

NHS Number (If known)

Are you filling out this form on behalf of a patient?

Yes No

Mount Pleasant Health Centre will make every effort to meet your reasonable adjustments, as best we can, however there may be occasions where we are limited in doing so. On occasion, where we are unable to provide a specialist interpreter, you would be required to organise this yourself.

Care Quality Commission

Overall Rating: Good

Mount Pleasant Health Centre is the lead practice of Nexus Primary Care Network.

Mount Pleasant Health Centre

Address

Mount Pleasant Road, Exeter, Devon EX4 7BW

Telephone

01392 255722

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