This report is about making reasonable adjustments in end of life care for people with learning disabilities.
Under English equalities law public sector organisations are required to tailor the ways they provide care so that disabled people are not disadvantaged. Law governing the regulation of healthcare services is more explicit about the requirement for healthcare providers to ‘avoid unlawful discrimination including, where applicable, by providing for the making of reasonable adjustments in service provision to meet the service user’s individual needs’, and to have systems in place to enable them to assess and monitor the quality of the services provided regularly against this and other requirements. Reasonable adjustments can mean alterations to buildings by providing lifts, wide doors, ramps and tactile signage, but may also mean changes to policies, procedures and staff training to ensure that services work equally well for people with learning disabilities. For example, people with learning disabilities may require clear, simple and possibly repeated explanations of what is happening, and of treatments to be followed, help with appointments and help with managing issues of consent in line with the Mental Capacity Act. Public sector organisations should not simply wait and respond to difficulties as they emerge: the duty on them is ‘anticipatory’, meaning they have to think out what is likely to be needed in advance.