Access to health, social care and integrated services

Disability Equality Scotland outline the key elements that are required to make health and social care integration a success.

This article addresses health, social care and integrated services in Scotland relating to accessibility and the rights of disabled people to be able to inform each step of their care pathway.  As a Disabled Persons Organisation (DPO), Disability Equality Scotland believes that decisions that affect disabled people should be informed by them.  Regardless of what aspect or pathway disabled people find themselves within the integrated health and social care system, their lived experience should inform the conversations that are taking place in Scotland and those opinions are reflected below.  The NHS in Scotland has a responsibility for issues that affect disabled people and equally disabled people should have freedom, dignity, choice and control over their lives.  The Scottish Government are currently working to implement their delivery plan of the UN Convention on the Rights of Persons with Disabilities.  They work with and fund many organisations to help deliver this plan, ensuring the issues which affect disabled people are at the forefront of developments.

Physical accessibility

The right to physical access
All disabled people have the right to access health and social care services, free from physical barriers.  Disability Equality Scotland’s National Access Survey Team (NAST) is soon to start the process of auditing several NHS 24 sites across Scotland.  The aim is to make the premises as accessible as possible for the public and employees. 

Responsibilities
People accessing services will have the responsibility to inform services and staff of their accessibility requirements before appointments.

Timely access

The right of equity of access to health and social care
All disabled people have the right to access health and social care services that they have agreed with their service providers within the stated time.

People also have the right to be informed of the steps that a service provider will take to fulfill the guarantee.  For example, accessing treatment in neighboring health or social care areas, private sector facilities, overseas.

Responsibilities
People will have a responsibility to attend agreed appointments.

Respect
Disabled people have the right to be treated with dignity and respect and service providers should embody human rights principles such as equality, fairness and autonomy.  People should have their values and individual circumstances – including disability – taken into account.

Responsibilities
People have a responsibility to treat service provider staff with dignity and respect. Any form of abuse or violence will not be accepted

Safe and effective care
Service providers should strive continuously to improve quality and safety.  Health and social care services should be provided with care, skill and confidence in a safe environment.  Disabled people will also have access to independent advice and support to raise concerns about safety, effectiveness, cleanliness or other issues that they feel may affect their right to safe and effective care.

Responsibilities
People will accept a role in and responsibility for their own care.  They will be responsible for following advice on medication, treatment and lifestyle and complying with advice on medication and treatment.

Communication

Disabled people will have a right to access clear, accessible and appropriate communication.  Communicating with people should be done in a clear accessible and appropriate way.  This is particularly important where plans change, or something goes wrong.  They should be kept informed at all stages of their journey. Disabled people should be communicated with in a language or format they can understand.  This extends to a duty to communicate clearly with family members.

The right includes a right to be told the names of the staff responsible for care and to be told when care is being handed over to another team or provider.  People should also have access to translation and interpreting services, access to independent advice and support, a right to ask questions and obtain information about diagnosis, treatment and care from members of the service provider team.

Participation
Disabled people should have the right to understand the options open to them and participate fully in decisions about their care and treatment.

Their views should be given the same level of consideration as clinical or other service provider opinion when coming to decisions about their care and treatment.

Service providers are required to show how the views of the people they serve, including the excluded and disadvantaged (including those individuals with disabilities) have been taken into account in their decisions about the development of the services they provide.

Responsibilities
People are responsible for ensuring that they have the information to understand what they need to know about their care and to provide consent to treatment.  They have a responsibility to take part actively and constructively in decisions and discussions about their health.

Privacy and Confidentiality
Disabled people have a right to have accurate, up-dated information stored about their condition and treatment.  This information must be held securely.  Disabled people also have the right to know how the health and social care services uses and shares this information and to be given a copy of it on request.

Disabled people also have the right to expect facilities ensure privacy, especially in relation to personal care and examinations.  These must be conducted in the appropriate environment.  Only those who need to be there, to whom the patient has granted consent or made a specific request for should be in attendance.

Responsibilities
People have a responsibility for ensuring information is accurate and relevant.  This will help in the diagnosis and treatment of their condition.

Independent Support and Redress
Disabled people have the right to clear and simple means of redress. Feedback on the service provided will be actively encouraged.

Responsibilities
People have a responsibility to raise any issues which concern them with the staff caring for them as they arise and to do so in a positive and constructive way.

Disability Equality Scotland can be found on Twitter at @DEScotTweets (this link will take you away from our website).

This Opinion is part of the ALLIANCE’s ‘We Need To Talk About Integration’ anthology which is available at the link below.

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