The Pharmaceutical Journal
Vol 269 No 7216 p389-390
21 September 2002

This article
Reprint
Photocopy

PDF* 120K

Disability awareness: what the new rules mean for community pharmacies

The Disability Discrimination Act, passed in 1995, aims to end the discrimination that many disabled people face on a daily basis. Dawn Connelly (on the staff of The Journal) looks at how legislation passed under the act affects community pharmacies

From 1 October 2004, community pharmacy proprietors will need to make "reasonable adjustments" to the physical features of their premises in order to ensure that they are accessible to disabled people and so comply with legislation passed under the Disability Discrimination Act 1995 (DDA).

Although this is still about two years away, it is important that proprietors begin to think about these changes now since it is easier to incorporate any necessary adjustments into a planned redesign or refurbishment of premises than to have to make changes when the legislation is implemented.

In terms of the DDA and who is protected under it, disability is defined as "a physical or mental impairment which has a substantial and long-term adverse effect on a person's ability to carry out normal day-to-day activities". The definition encompasses a large number of individuals in the United Kingdom with a variety of disabilities, such as physical or mobility impairments, hearing impairments, sight impairments, mental illness and learning disabilities.

The Disability Rights Commission was established by the Government in April 2000 to promote civil rights for disabled people. To help implement the DDA, the DRC has prepared and issued various codes of practice which apply in England, Scotland and Wales. The code of practice for rights of access to goods, facilities, services and premises, for example, is one which has significant implications for pharmacy (available at www.drc-gb.org). It offers practical guidance for service providers as well as helping disabled people to understand the law. Although the code does not impose legal obligations, it can be used as evidence in a court, or at a tribunal, under legal proceedings of the DDA.

The code says that reasonable adjustments might include removal of a physical feature that makes it impossible or unreasonably difficult for a disabled person to access the services offered, alteration of the feature so that it no longer poses a problem, the provision of a reasonable means of avoiding the feature or a reasonable alternative method of making the service available.

Several factors that might affect whether or not it is deemed reasonable to make an adjustment are listed in the code, including the practicality and financial costs of making the adjustment, the extent of disruption likely to be caused, the extent of the service provider's financial and other resources, the amount of resources already spent on adjustments and the availability of financial or other assistance. The code therefore recognises that what might be reasonable for a large multiple might not be reasonable for a small independent pharmacy.

Neil Williamson, head of pharmacy planning and design, National Pharmaceutical Association, incorporates disability awareness into the information he gives to community pharmacists who seek advice on redesigning or refurbishing a pharmacy. He says that whether or not it is reasonable to make an adjustment is often down to common sense. For example, if an entrance is inaccessible to a person in a wheelchair, it may be appropriate to install a ramp, grab rails and an automatic door in a large store, but in other situations, for example in a small independent pharmacy, it might be adequate to provide a push bell that can be used to attract the attention of counter staff who can offer assistance. He emphasises that it is important that community pharmacists consider whether their pharmacy is accessible to disabled people because if they do not then they will be leaving themselves open to possible legal action by organisations or individuals.

Disability access

Disability Stockport, a registered charity, is involved with the "Going for gold" accreditation scheme for community pharmacies run by Stockport Primary Care Trust (PJ, 31 August, p274). Disability awareness is one of four key areas in which standards must be met in order to achieve accreditation. Disability Stockport visits community pharmacies and audits the premises, services and staff.

Liz Williamson, director, Disability Stockport, explains what the assessors look for when carrying out an audit:

Approach and entrance Are there steps or is there a ramp? Are there grab rails? Is there suitable parking nearby? Is the door wide enough to allow wheelchair access? Is the door difficult to open? Is there an automatic door? If so can you hear it opening? Are there contrasting colours on the door? Is there a doormat which could be a potential hazard?

Interior Is the floor non-slip and on which wheelchairs can be manoeuvred? Is there a glare from the floor which might affect the vision of partially sighted people? Is the floor free from clutter? Are the aisles wide enough to accommodate a wheelchair? Is there adequate lighting?

Counters Is there a low level counter where prescriptions can be collected? Is a board provided for the customer to lean on when signing the back of their prescription? Can someone who is sitting in a wheelchair see products for sale behind the counter?

Signage Are labels on shelves large enough? Is there a sign to indicate where prescriptions can be handed in and collected? The extent of signage will depend on the size of the pharmacy.

Seating Are chairs provided for people to use while waiting for their prescriptions? Do the chairs have arms? Are they in a contrasting colour to the floor? Is there a variety of sizes of chairs? Are the chairs in an area where they do not create an obstruction to other customers?

Information leaflets Does the pharmacy provide patient information leaflets in large print, braille or on computer disc or audio cassette?

Staff awareness Do the staff offer information and assistance to disabled people when required? What is their general attitude towards disabled people? Do they possess any skills such as sign language?

Mrs Williamson says that the audit also addresses how the pharmacy tailors its services and medicines to the needs of the patient. For example, is a delivery service offered? Is an induction loop system for people who are hard of hearing installed? Are the staff willing to provide information over the telephone if necessary?

Once the audit is complete, a report is written to advise the pharmacy about areas that are not acceptable and ways in which these can be improved.

Disability Stockport offers a four-hour, intensive, disability awareness training course for pharmacists and their staff. The course incorporates an explanation of the DDA, general information on the needs of disabled people, examples of barriers to communication and how these can be overcome, and information about the availability of specialist equipment.

Mrs Williamson says: "People like to be able to do things for themselves. It is about equality and being able to lead a normal life." However, she admits that there may be some difficulties with the implementation of the new legislation in 2004. For example, if a ramp is needed to allow wheelchair access to a community pharmacy, the proprietor may not own the pavement outside the pharmacy or planning permission may not be granted. "I don't think that the Government took these things into account when they said this is what you must do," said Mrs Williamson.

The Centre for Accessible Environments provides a nationwide consultancy service that offers access audits to service providers. Their audits are intended to assess the current accessibility of a building and outline recommendations on how it can be improved. The centre holds a nationwide register of access consultants, which can be viewed on its website at www.cae.org.uk.

Robert Johnstone, chairman of Access Matters UK, environmental access auditors, and president of Arthritis and Rheumatism International, says that since 1999 there has been an obligation on pharmacists to provide a level of service that allows disabled people to have the same access to services as everyone else. For example, pharmacists should already be providing induction loop systems for people with impaired hearing. These systems are relatively inexpensive and allow customers with hearing aids to eliminate background noise so that they can hear clearly what the pharmacist is saying.

If an area of the pharmacy is currently inaccessible to, for example, a wheelchair user, then there should be a clear sign informing the customer that he or she can seek assistance and a discreet bell which attracts the attention of staff. Of equal importance, the staff should be trained in awareness of the needs of disabled people. Mr Johnstone comments that although these changes may seem complicated and expensive, this is not necessarily the case and if they are not considered "eventually people will bring cases against shops, and they may not only have to change but will also have to pay damages".

There are numerous ways of making a community pharmacy and the services it provides more accessible, not only to disabled people but also to a large number of customers, including carers of disabled people, parents with pushchairs or young children, people carrying heavy shopping or luggage, people with poor eyesight and elderly people. Thinking about these changes now will not only prepare for the legislation being implemented in 2004 but will make community pharmacies more user friendly for large numbers of their customers.