Legislation, Policy and Equality: Evaluating deaf people’s access to the National Health Service

Abstract

The Equality Act 2010 imposes a duty on healthcare providers to make an adjustment for people who are disabled to enable them to access the service in such a way that is equal to a person who is not disabled. Existing research shows that many deaf people have had poor experiences when accessing the National Health Service (NHS), which has resulted in negative outcomes when reasonable adjustments have not been made. Although medical settings have a duty to make adjustments for deaf people, it is unclear what the ‘reasonable adjustment’ should be. Therefore, this thesis aims to investigate what the ‘reasonable adjustment’ duty implies, as outlined in the Equality Act 2010, in the specific context of paramedic practice, as no official definition has been given within the legislation.

This qualitative study uses an Interpretative Phenomenological Analysis (IPA) framework which investigates the lived experiences of both deaf people and paramedics when communicating in medical emergency encounters. Analysis of the interviews with these two participant groups are drawn together into common themes to gain an understanding of the issues experienced by both groups, what they were concerned about, and how interaction was facilitated with each other. This research also draws upon NHS hospital policies across England to understand how hospitals intend to make the ‘reasonable adjustment’ duty that is placed on them through the Equality Act 2010. The policies are then reviewed alongside the identified themes from both participant groups to explore similarity or discrepancy between policy aims and outcomes, including whether the adjustments that need to be made for deaf BSL users are understood.

The findings in this thesis demonstrate that qualified British Sign Language interpreters are essential to facilitating deaf people’s access to healthcare, and NHS policies struggle to meet the anticipatory duty outlined in the Equality Act. This study concludes that medical settings and personnel must be prepared for when emergency situations arise, and must have clear policies and expectations about how to obtain a qualified interpreter within a reasonable timeframe, and the communication methods that are acceptable until a qualified interpreter arrives.