Transcript Workforce issues in the English context.

NHS Accessible Information Standard
In the Assistive Technology space
King’s Fund Definition
“Any product or service designed to enable independence for disabled and
older people”.
Stephen Hawking
“The right tools in the right hands help
everyone”.
Hadron Collider
CERN = Tim Burners-Lee = The Web
The genericAT challenge
Much for disabled people because:
More costly
More complex
Much more difficult
Just to do the same as everyone else.
Context
The Information Strategy: Principles
"The widespread use of modern technology to make health and care
services more convenient, accessible and efficient".
“An information system built on innovative and integrated solutions and
local decision-making, within a framework of national standards that
ensure information can move freely, safely, and securely around the
system”.
“No decision about me without me” (individual patients).
“No decision about us without us” (patient groups/communities).
Subsequently: “engaged”, “shared decision-making”.
The essential policy
Context
Patients more informed and engaged
Hence:
More self-care
Better decisions on use of services.
What’s the big idea?
NHS England is developing a new
‘accessible information standard’ to
provide direction to the health and
care system around accessible
information and communication
support for patients, service users
and carers with a disability,
impairment or sensory loss.
www.england.nhs.uk
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Why do we need a new standard?
• The Equality Act 2010 places a legal duty on all service
providers to make “reasonable adjustments” to support
disabled people – including providing information in “an
accessible format”.
• However, in practice, service users with communication
needs often receive inaccessible information and are not
provided with the communication support they need. This
has implications for patient choice, safety, and experience.
• Currently there is a lack of any systematic approach,
consistency or clarity with regards to accessible
information and communication support.
www.england.nhs.uk
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Why do we need a new standard?
I recently went for a routine mammogram. All the
info was in small print. I couldn't read it. I would
appreciate an email; my phone would read it to me
then…A receptionist kept telling me to, "go along
there" I explained I couldn't see where "there" was
or where she was pointing to. I had my white cane
fully extended in my hand. The woman just kept
repeating "go over there.”
www.england.nhs.uk
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Why do we need a new standard?
In a single consultation I had to ask a consultant 5 times
(FIVE) to face me and speak more slowly so I could
understand her. This consultation lasted less than 10mins in
total, including an examination. I felt stupid, and came away
not fully understanding what was wrong with me.
The consultant talked to my parents rather than me. The
consultant then said to my parent ‘she doesn’t understand,
does she, as she’s got disabilities’. I said ‘yes I do’.
www.england.nhs.uk
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Why do we need a new standard?
For years, I would not make the appt…because I
attempt to make them aware that I need BSL signer
but always have let me down. It is much better to
suffer from the health issues that I have than to
tried to and arrange signer because I end up in
more pain, heartache because of what I am trying
to do, I don't want to bring in my family member or
friend because I can't say what is the problem
fully, and it's not fair on my family/friends because
I may want to keep it private...
www.england.nhs.uk
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The standard:
10 steps under 3 categories.
Standard
1. Identifying and
recording needs
Raising the question.
Recording details.
Saving in appropriate place.
2. Sharing and refering to
recorded need
Ensuring local staff are aware of
needs.
Letting other, appropriate
organisations know of needs in
advance.
3. Provision of
support/meeting of need
Locally acting on needs.
Confident on quality.
Settings/doc types in eg. London
Scale
(8 million, multi-cultural population)
GP surgeries, hospitals, social services depts, care homes?
Scale
Impairment prevalences in GB.
(Life Opportunities Survey, ONS).
Impairment rates by age.
Impairment rates among university
students
Additional needs.
In the Infor Strategy “Equality Analysis” but not in
records!
"Low literacy levels is a bigger problem than can be solved by
the health and care system, but improving the health and care
information available to us all, and the ways in which it can be
accessed, could help to improve health and care outcomes for
everyone".
"By far, the area of most concern that came to the fore when
consulting on the Information strategy was around digital
exclusion".
Benefits
Much wider benefits
AIS Draft submission:
• 10.4 How reasonable adjustments translate into social
value
• Beyond medicine … into education, work, communities
and society generally…
• AIS now part of UK Disability Strategy.
Cost savings
Benefits
•
Improvements for sign language users estimated to save £30
million per annum.
• Savings from general switch to emails set at £100 million.
• Are reasonable adjustments really so expensive?
Benefits
Much bigger challenge
Long term effort because:
• Significantly lower life expectancy for Learning Disabled and
Mentally Ill.
• Attributed to “Diagnostic overshadowing”.
And So
AIS guides on the way
Settings and content:
•
•
Different types of accessible information and communication support and who
may need them".
ATs used and needed.
Sharing:
• Data confidentiality within care and support providers.
Quality:
•
•
•
Quality of translated or transcribed information.
Competency of interpreters, communication support workers, translators and
advocates.
Effective ‘easy read’ information.
And So
And so...
• Map settings and documents.
• Model populations and service usage.
• Work collaboratively.
If only one thing:
•Coordinated approach to ATs!
•Perhaps join NHS England’s “Hack days”.
•Pic opposite of “texting with your nose”.