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					Bradford and Airedale Teaching Primary Care Trust




Disability Equality Scheme Action Plan
Foreword

The Bradford and Airedale Teaching Primary Care Trust (tPCT) is committed to
promoting equality and diversity across the district. As part of this commitment, we
are publishing this Disability Equality Scheme which sets out our agenda on Disability
Equality for the next three years.

Bradford and Airedale tPCT serves a population of 500,000 and is co-terminous with
Bradford Metropolitan District Council. It covers some of the most deprived areas in
the country, and also some of the most affluent; it is an area rich in diversity, made
up of different cultures, skills and talents. The aims of the tPCT focus on improving
health and tackling inequality, developing primary and community health services
and commissioning a broad range of services to meet the needs of local
communities.

As well as providing some services itself, the tPCT supports the work of 91 GP
practices, 104 pharmacists, 63 dental practices and 59 optometrists across the
district. It also works very closely with social services and other council departments
to try and make sure there are no gaps between different services.

The tPCT provides a wide variety of services to disabled people as well as acting as
a major employer across the district. This Disability Equality Scheme seeks to
eliminate any direct or indirect discrimination in these two areas. This will be
achieved through creating a culture of inclusion, improving workforce representation
and monitoring service delivery. This can only be achieved through partnership with
disabled persons and organisations that support disabled persons. We look forward
to working with our partners in this area in order to continuously improve our
services.




Simon Morritt                                               John Chuter
Chief Executive                                             Chairman
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Disability Equality Scheme

Introduction

The Bradford and Airedale Teaching Primary Care Trust (tPCT) is committed to
tackling health inequalities. This Disability Equality Scheme sets out how the tPCT
will improve its services for disabled people. The scheme is divided into four areas:

   i.       information gathering
  ii.       cultural change
 iii.       workforce development
 iv.        service delivery

Numbers of disabled people in Bradford

The 2001 census states that the number of people with limiting long term illness in
Bradford was 86,486 out of a total population of 467,665.

According to the department of health, the number of persons registered blind in
Bradford as of 2003 is 1765 and 1810 are registered as partially sighted.

According to the department of health, the number of persons registered deaf in
Bradford as of 2004 is 395 and 1800 are registered as hard of hearing.

Numbers of disabled staff within Bradford and Airedale tPCT

The tPCT itself currently employs 23 persons who have declared some form of
disability, this represents approximately 1% of the workforce.

The experiences of disabled people

A recent report, Equal Treatment: Closing the Gap, by the Disability Rights
Commission, into physical health inequalities faced by people with learning difficulties
and/or mental health problems found that:

            people with mental health problems (schizophrenia, bi-polar disorder or
             depression) have higher rates of obesity, smoking, heart disease, diabetes,
             respiratory disease and stroke than other people

            people with learning disabilities have higher rates of obesity and respiratory
             disease

            people with schizophrenia are almost twice as likely as other citizens to have
             bowel cancer.




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The Legal Context


The Disability Discrimination Act 2005 as an amendment to the Disability
Discrimination Act 1995 places a statutory requirement on all public authorities to
promote disability equality.

The new duty requires all public authorities to both enhance public awareness of
disability issues and to encourage disabled people to become more active in public
life. Under the new Act public authorities are also required to involve disabled people
more fully in democratic processes.

The organisation recognises that the Act is not merely about structural changes to
buildings, it is essentially about including disabled people in the culture of the
organisation in a way that is practical and demonstrable.

Specific and General Duty

The Disability Equality Duty places both a general and a specific duty on public
authorities to promote equality of access and service for disabled persons.

The General Duty mandates public organisations to:

       Promote equality of opportunity between disabled people and other people

       Eliminate discrimination that is unlawful under the Disability Discrimination Act

       Eliminate harassment of disabled people that is related to their disability

       Promote positive attitudes towards disabled people

       Encourage participation by disabled people in public life

       Take steps to meet disabled people’s needs, even if this requires more
        favourable treatment.

The Specific Duty obliges the tPCT to:

       Produce and publish a DES (include within it an action plan)

       Involve disabled people in producing the scheme and action plan

       Demonstrate they have taken action in the scheme and achieved appropriate
        outcomes

       Review and revise the scheme at regular intervals.




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The tPCT must ensure that in assembling the disability equality scheme it take into
consideration the following factors:

         Involvement of disabled people in the development of the scheme

         A comprehensive impact assessment of the activities of the tPCT on disability
          equality and improving these when necessary

         Gathering information about the performance of the organisation on disability
          equality

         Developing a robust and meaningful action plan.

This Disability Equality Scheme prepared for Bradford and Airedale tPCT sets out the
five main elements that will enable us to address the General Duty and to promote
equality and diversity in the context of disability:

   i)        Performance management: The scheme will provide a governance
             structure that can measure progress at pre-defined intervals;

   ii)       Information management: The scheme will require appropriate information
             systems to be installed in order for effective outcome measures;

   iii)      The culture of the organisation: the scheme will set out an action plan that
             will seek to implement a training programme that challenges stereotypes
             toward disabled people. There will be a particular emphasis on the ‘social
             model of disability’ (this is explained in Appendix 2);

   iv)       Workforce representation: the scheme will present an action plan that will
             seek to make the workforce of the organisation reflective of the district’s
             disabled population;

   v)        Service delivery: the scheme will outline an action plan that provides
             evidence on how the organisation aims to impact assess its services to
             disabled persons and then demonstrate what improvements in service
             delivery will be targeted and monitored.

Through the implementation of the above, the scheme will help us to achieve the
following:

   i)        the organisation will be meeting its legal obligations under the Disability
             Discrimination Act 2005
   ii)       the organisation will involve disabled persons in the design and delivery of
             its services
   iii)      the organisation will challenge stereotypes and misconceptions that have
             a negative impact on disabled persons.




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Consultation for the Disability Equality Scheme

Twenty six voluntary and community sector organisations that serve disabled people
across the Bradford district were sent questionnaires that asked about services
provided for disabled people. The questionnaire can be found in Appendix 3. Five
questionnaires were returned and their concerns have been incorporated into the
disability equality scheme action plan where possible. Two organisations were visited
afterwards in order to follow up on the questionnaire and discuss in detail the
concerns that organisations have about services for disabled people. A draft version
of the Disability Equality Scheme action plan has been sent to five organisations for
consultation. Suggestions for improvement have been incorporated into the scheme.




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Objective 1: Monitoring and Implementing the Disability Equality Scheme

To ensure that the Disability Equality Scheme is monitored and implemented


Objective                      Action                       Outcome                        Person resp.     Timescale
To have robust monitoring      To set up a DES              Steering Committee set up      Ali Jan Haider   March 07
mechanisms that can            governance group that will
effectively measure progress   monitor the implementation
                               of the scheme
To monitor the                 Three monthly meetings of    Regular monitoring of DES      Ali Jan Haider   Ongoing
implementation of the scheme   the governance group
To perform annual reviews of   Annual review                Annual review performed        Ali Jan Haider   Dec 07
progress in the DES
To ensure senior               To appoint a Non             Non Executive Director         Ali Jan Haider   March 07
management involvement         Executive Director level     level champion of disability
                               champion of disability       rights selected
                               rights




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Objective 2: Maintaining a Robust Information System

To ensure that information systems for the monitoring and communicating of services that affect disabled people are in place


Objective                       Action                        Outcome                      Person resp.     Timescale
To set up and manage a          To examine current            A system that allows the     Ian Roberts      Dec 07
profiling system that records   profiling systems and set     tPCT to monitor the
disabilities                    up a comprehensive            effectiveness of its
                                alternative                   services for disabled
                                                              persons
To ensure services are          To record disabilities on     Patients will have their     Jo Coombs        Dec 07
appropriately provided          patient cards in order to     service needs met during
                                inform services of patient    appointments and health
                                needs                         checks
To ensure that all external     To set minimum standards      Communication will be        Ali Jan Haider   Sept 07
communication includes          for external communication    available in a variety of
disabled users                                                formats
To ensure that all external     To set minimum standards      External events are          Helen            June 07
communication includes          for the organisation of       accessible to disabled       Broadbent
disabled users                  events that provide ease of   people
                                access to disabled users




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Objective 3: Training the Workforce in attitudes towards Disabled People

To ensure that the social model of disability is disseminated and understood throughout the organisation


Objective                         Action                        Outcome                       Person resp.     Timescale
To ensure that the social         Inclusion of awareness        More comprehensive            Helen            June 07
model is taught at all            training around social        awareness training            Broadbent
induction events                  model of disability in
                                  induction programmes
To ensure that the whole          All staff to be put through   Change of culture around      Ali Jan Haider   June 07
organisation is made familiar     awareness training around     stereotypes in organisation
with the social model of          stereotypes of disabled
disability                        people
To have an e-learning facility    Awareness training            Challenge of stereotypes      Ian Roberts      June 07
available to all internal users   provided to all staff




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Objective 4: Improving Workforce Representation

To ensure that the tPCT’s workforce is representative of the population it serves


Objective                        Action                          Outcome                               Person resp.     Timescale
To ensure that all disabled      Monitor internal complaints     Feedback from disabled staff on       Helen            Oct 07
staff feel secure within the     and receive feedback from       their working lives is taken          Broadbent
organisation                     appraisals and exit             seriously and appropriate steps
                                 interviews                      are taken to address any issues
                                                                 identified
To ensure that all disabled      To set up a disability staff    Disability staff network group set    Helen            June 07
staff feel secure within the     network                         up and meeting regularly to           Broadbent
organisation                                                     discuss policy and service delivery
                                                                 themes as they impact on disable
                                                                 people
To ensure the PCT can recruit    To ensure that adverts are      Workforce is more representative      Helen            Sept 07
and retain a workforce that      suitably distributed across     of local population                   Broadbent        then
reflects the local disabled      the district, interview                                                                monitor
population                       panels are representative,                                                             annually
                                 and the two ticks criteria is
                                 followed
To ensure all human              To meet the work place          Appropriate and inclusive working     Helen            Dec 07
resources needs are met          needs of disabled persons       arrangements are in place             Broadbent
To ensure that all human         To examine all HR and IT        All HR and IT policies and            Ali Jan Haider   June 07
resources and information        policies and procedures in      procedures are fair and do not
technology policies and          human resources against         adversely impact against disabled
procedures are not negatively    negative impacts                people
impacting against disabled
people




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Objective 5: Improving Service Delivery

To ensure that a high quality standard of care is delivered to disabled people

Objective                       Action                          Outcome                   Person resp.     Timescale
To ensure that all services are All service managers to         Clear identification of   Ali Jan Haider   Dec 07
appropriate for disabled        conduct impact                  areas that require
people                          assessments of their            some improvement
                                functions and policies          with underpinning
                                gauging them for adverse        detailed action plans
                                impact
To ensure that all services are Develop systems that            The tPCT has            Jo Coombs          Dec 07
appropriate for disabled        provide confidence that         demonstrable evidence
people                          services will be shaped to      from user consultation
                                meet the needs of disabled      and governance
                                users                           forums that
                                                                appropriateness of
                                                                services for disabled
                                                                people has increased
To ensure that all services are To monitor the                  All action plans are    Jo Coombs          April 08
appropriate for disabled        implementation of the           meet the required
people                          action plans as agreed to       timescale for progress,
                                by all service managers         and have checked by
                                                                the appropriate
                                                                manager
To ensure that all policies and   To examine all policies and   All policies and        Ali Jan Haider     Nov 07
procedures are not negatively     procedures in clinical        procedures are fair and
impacting against disabled        governance against            do not adversely
people                            negative impacts              impact against disabled
                                                                people




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Appendix 1: Definition of disability

The Disability Rights Commission provides the following description to the definition
of disability:

The Disability Discrimination Act states that a person is ‘disabled’ if he/she has:

       a mental or physical impairment

       this has an adverse effect on his/her ability to carry out normal day-to-day
        activities

       the adverse effect is substantial - the adverse effect is long-term (meaning it
        has lasted for 12 months, or is likely to last for more than 12 months or for the
        rest of his/her life).

There are some special provisions, for example:

       if his/her disability has badly affected his/her ability to carry out normal day-to-
        day activities, but does not any more, it will still be counted as having that
        effect if it is likely to do so again

       if he/she has a progressive condition such as HIV, multiple sclerosis or
        arthritis, and it will badly affect their ability to carry out normal day-to-day
        activities in the future, it will be treated as having a bad effect on him/her now

       past disabilities are covered.

What are ‘normal day-to-day activities’?

At least one of these areas must be badly affected:

       mobility

       manual dexterity

       physical co-ordination

       continence

       ability to lift, carry or move everyday objects

       speech, hearing or eyesight

       memory or ability to concentrate, learn or understand

       understanding of the risk of physical danger.

The Act says that any treatment or correction should not be taken into account,
including medical treatment or the use of a prosthesis or other aid (for example, a
hearing aid). The only things which are taken into account are glasses or contact
lenses. If you are considering whether you can be regarded as ‘disabled’, then it is
important to work out exactly how your disability affects you. Remember to
concentrate on what you cannot do, or find difficult, rather than what you can do.


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For example, if you have a hearing disability, being unable to hold a conversation
with someone talking normally in a moderately noisy place would be a bad effect.
Being unable to hold a conversation in a very noisy place such as a factory floor
would not. If your disability affects your mobility, being unable to travel a short
journey as a passenger in a vehicle would be a bad effect. So would only being able
to walk slowly or with unsteady or jerky movements. But having difficulty walking
without help for about 1.5 kilometres or a mile without having to stop would not.

What does not count as a disability?

Certain conditions are not considered impairments under the DDA:

       lifestyle choices such as tattoos and non-medical piercings

       tendency to steal, set fires, and physical or sexual abuse of others

       exhibitionism and voyeurism

       hayfever, if it doesn't aggravate the effects of an existing condition

       addiction to or a dependency on alcohol, nicotine or any other substance,
        other than the substance being medically prescribed.




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Appendix 2: The social model of disability

The social model of disability makes the important point that the majority of problems
faced by disabled people are caused by society, not by their impairments.

The social model of disability makes the distinction between impairment and a
disability:

Impairment: An injury, illness, or congenital condition that causes or is likely to
cause a long term effect on physical appearance and/or limitation of function within
the individual that differs from the commonplace.

Disability: The loss or limitation of opportunities to take part in society on an equal
level with others due to social and environmental barriers.

Disability is therefore caused by 'barriers' in society due to a lack of consideration for
people who have impairments.

Barriers can be:

Prejudice and stereotypes
Inflexible organisational procedures and practices
Inaccessible information
Inaccessible buildings; and
Inaccessible transport

Also, disabling barriers experienced in the past can continue to have an adverse
effect.




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Appendix 3: Questionnaire sent to voluntary and community sector


Services for Disabled People

In October 2005 the Disability Discrimination Act was amended and a new duty
added. The duty, which comes into force on the 5 December 2006, requires all
public authorities to produce a Disability Equality Scheme. The scheme must say
how a public authority plans to eliminate disability discrimination. The Bradford
and Airedale Teaching Primary Care Trust is therefore in the process of
developing a Disability Equality Scheme. In order to do this most effectively, we
want to ask disabled people and voluntary and community based organisations
that work with disabled people about their experiences with the local health
services. We would therefore be very grateful if you could spare some time to
complete this questionnaire.

                               Are you a disabled person?                 
                               What disability do you have?
              Do you have
              a disability?
                               How often do you use health services?


                               Which services in primary care do you use most
                               often?


                               How have you found the health services?


                               Have you experienced any problems or
                               difficulties in getting services?


                               If so, could you please describe the problem/s?




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Do you
know
anyone                Do you know of anyone with a disability           
from the
NHS?                  who is employed in primary care?

                      How has their experience of the NHS been?




                      Have they experienced any difficulties? If so, please
                      describe them.




                     Have you heard of any difficulties that            
       Have you
                     disabled people have faced in access or
       had any
       problems?     service provision?

                     Could you provide some examples of such problems?




                     Is there anything that you would like to suggest that
                     could help improve services?




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                Does your organisation help provide              
                services for disabled people?
  Does your
 organisation
 help provide   What kind of service does your organisation provide?
 services for
  disabled
  people?

                And to how many?




                What is the opinion of the disabled persons on primary
                cares services in Bradford in general?




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