Reasonable adjustments not put in place for dyslexia
Summary
NHS England did not meet its legal duty to put in place reasonable adjustments that were requested for an important review meeting. This caused anxiety and distress for the person involved.
The complaint
In May 2019, Derek asked NHS England to hold an independent review panel (IRP) meeting to look at his mother’s eligibility for continuing healthcare funding.
Derek is neurodivergent and has dyslexia. Dyslexia is a learning difficulty that can affect how someone processes information, and planning and organising. Between May and September, Derek contacted NHS England to discuss reasonable adjustments for his dyslexia and a hearing loop for his brother to support him during the meeting.
Derek said NHS England did not properly manage these requests, so he did not have enough time to prepare and present in the meeting and then found it hard to read the report afterwards.
This caused Derek stress, anxiety and distress.
‘The NHS failed to provide the simple reasonable adjustments they had agreed to ensure my brother and me were not disadvantaged at an important healthcare meeting, concerning our mother’s end-of-life care. We are grateful to the Parliamentary and Health Service Ombudsman for ensuring the NHS understood the impact of their failings on our family.’ - Derek
What we found
We found that NHS England did not provide all the reasonable adjustments Derek asked for, so it did not follow the relevant standards. It knew what Derek needed but did not properly think about whether his requests were possible or about offering alternatives. We could not find evidence that it had told the people involved in the IRP meeting about the adjustments.
Before the meeting, Derek asked for the IRP chair to discuss his adjustments with him because dyslexia makes it difficult for him to respond to unexpected changes. NHS England agreed but did not arrange this conversation.
During the meeting, the Chair did follow Derek’s request to discuss each area in the same order as previous meetings. NHS England had also arranged for the meeting to be longer than usual, which was a positive response. But Derek still ran out of time to present his evidence. There was no evidence the Chair made any adjustments on the day, such as offering to continue the meeting on another date.
Derek requested a hearing loop for his brother. NHS England arranged a hearing loop, but the room that was booked could not use the equipment. This meant Derek could not get the support he needed.
Derek also asked for changes to make the decision report more accessible to him. This including not sending it by secure email, setting out the details in the order they discussed them, numbered pages and using a specific font and size. The Chair agreed to the reasonable adjustments but did not do any of these things.
This caused Derek a lot of frustration and distress for over six months. After he complained, we could see that NHS England tried to resolve some of the issues, but it had not done enough to put things right.
Putting things right
We recommended NHS England should accept what it got wrong, apologise to Derek for how this affected him and pay him £500. We said it should explain what it is going to do to learn from what went wrong and improve its service.
Following our investigation, NHS England spoke with Derek to hear his reflections and experience of its service. This led to NHS England making several policy and procedure changes to how it records and fulfils reasonable adjustments.
‘I hope the follow up work I have undertaken with the NHS will remove barriers for others with a recognised disability, to ensure the NHS can be inclusive and fulfil their legal duty.’ - Derek