Equality and Human Rights Commission

This section explains how changing working practices such as changes in the range of skills and competencies of other health care practitioners present a number of opportunities and challenges in providing safe, effective care. There are comments on the following sections of the GMC's guidance:

• Point 41.b.
• Point 41.c.
• Point 41.d.
• Point 41.e.
• Point 46
• Point 47
• Point 48

41.b. Communicate effectively with colleagues within and outside the team.

This is particularly important if you have a disabled colleague on your team. For example if a colleague has dyslexia and at team meetings updates are given on written bulletins then this may mean the disabled colleague is being excluded from information. They may prefer information being distributed via email so they could use adapted software to read this.

The steps needed to fulfil the access or communication  requirements of disabled patients or employees are known as ‘reasonable adjustments’. For employees these adjustments should be part of a range specifically designed to assist that one employee. They should be regularly reviewed, and, where appropriate ( and with the agreement of the disabled employee), they should be communicated to other staff who need to know.

41.c. Make sure that your patients and colleagues understand your role and responsibilities in the team, and who is responsible for each aspect of patient care

If a disabled person has specific mobility and communication requirements, this should have been ascertained before arrival whenever possible, particularly if adjustments need to be made in advance and passed to treatment staff (with the patient’s consent).

For example if a person has a hearing impairment and lip reads, this information should be passed on to other medical staff to enable the person to access other medical services. This must be done with the patient’s consent. The disabled person should not have to keep repeating this requirement when being seen by different people.

Some people with a learning disability have prepared their own ‘Passport’ for healthcare. This contains relevant information about the person, their particular requirements, current and past illnesses and treatment. This can be used when they find it difficult to explain their requirements. It can also tell someone about other relevant issues.

41.d. Participate in regular reviews and audit of the standards and performance of the team, taking steps to remedy any deficiencies

Where surgeries or departments have performance measures these should include reference to equality and diversity, particularly where they relate to patient care.

Standards and targets in patient treatment and care should be enhanced by reference to issues such as how race, gender, disability age or sexuality are applied when considered. For example, when cancer patient care is being assessed, patients should be asked about the quality of all their care including any adjustments they requested (such as when or how they needed to use a wheelchair).

41.e. Support colleagues who have problems with performance, conduct or health.

After 4 December 2006 all services provided as public services now need to demonstrate that they are taking steps to eliminate victimisation and harassment of disabled employees or service users. In employment the behaviour of all staff towards disabled colleagues has become everyone’s responsibility; and lack of team or leader support can be the most devastating form of victimisation for a disabled employee.

If a colleague is off sick for a long period of time it is important that they feel supported by their manager and colleagues. Their return to work agreement may involve them doing a reduced number of hours for a certain period of time. Their colleagues should support them in this, and managers should ensure that such adjustments are properly resourced, for example by providing additional cover to make up the hours of that person. This reasonable adjustment should not be viewed as a negative factor when assessing that person’s performance at work.

Further guidance on employment, including the provision of reasonable adjustments is available on this site. 

46. You must treat your colleagues fairly and with respect. You must not bully or harass them, or unfairly discriminate against them by allowing your personal views to affect adversely your professional relationship with them. You should challenge colleagues if their behaviour does not comply with this guideline.

After 4 December 2006 employers in the public sector now have to actively look at ways of ensuring that disabled people are treated equally. The law now requires organisations across the public sector (including hospitals, local and central government, schools and colleges) to be proactive in ensuring that disabled people are treated fairly.

This might include steps to increase the level and quality of employment of disabled people and this can include positive action.

For example when team meetings are held if a colleague has a visual impairment the materials should be available in an accessible format.

For example if a colleague has a speech impediment, which means that it may take them longer to finish a sentence this should not be the subject of comment or ridicule by colleagues.

47. You must not make malicious and unfounded criticisms of colleagues that may undermine patients’ trust in the care or treatment they receive, or in the judgement of those treating them.

For example if a colleague is disabled, avoid inappropriate criticism, comment or even humour around their impairment.

For example if a colleague has dyslexia and has difficulty with their medical notes this should not be the subject of comment, particularly in front of others.

48. You must be satisfied that, when you are off duty, suitable arrangements have been made for your patients’ medical care. These arrangements should include effective hand-over procedures, involving clear communication with healthcare colleagues. If you are concerned that the arrangements are not suitable, you should take steps to safeguard patient care and you must follow the guidance in paragraph 6.

This means that if a disabled person has a specific access requirement this should have been ascertained before arrival whenever possible, particularly if adjustments need to be made in advance and passed to other treatment staff.

For example if a person has a hearing impairment and uses Lip reading as a form of communication this information should be passed on by receptionists to other medical staff, the disabled person should not have to keep repeating their requirements when being seen by different people.