Introduction to Health and Social Care: Disability and UK Access

This essay examines the inequitable access to health and social care services for disabled people in the UK. It delves into the multifaceted nature of disability, exploring impairments, activity limitations, and participation restrictions. The essay highlights that despite legislation like the Equality Act 2010, health inequalities persist, with disabled individuals facing barriers such as high costs, lack of screening, and discrimination. It discusses the impact of prejudice, inadequate healthcare provisions, and the need for reasonable adjustments. The essay analyzes studies and reports, including those from the NHS, to illustrate the challenges disabled people encounter, including long wait times for services and the need for more empathy and awareness from healthcare professionals. The conclusion reinforces the need for improved care and a more inclusive healthcare system to address the inequalities faced by disabled people in the UK.

Running head: ESSAY
Introduction to health and social care
Name of the Student
Name of the University
Author Note

1ESSAY
Introduction- According to the World Health Organisation (2018) disability cannot be
merely defined as a health problem. Rather, it refers to a multifaceted phenomenon, that
provides a thorough reflection of the interaction between different bodily features of an
individual and the components of the community in which the person resides. The
impairments might be intellectual, cognitive, mental, developmental, sensory, physical, or a
combination of all. With the aim of overcoming the problems that are faced by individuals
suffering from disabilities, there is a need to implement interventions for eliminating social
and environmental barriers. Individuals having disability generally report similar healthcare
needs, when compared to their non-disabled counterparts and might even be subjected to
narrower health margin, owing to social exclusion and poverty (Jose, Cherayi and Sadath
2016). This essay will elucidate the fact that access to health and social care services is not
equitable in the UK, in relation to disabled people.
Discussion- Disability is commonly used to refer to mental or physical attributes that
impose constraints on people. It is often measured in terms of physiological functional
capacity (PFC) that assesses the level of performance of a person, thereby evaluating the
capability of accomplishing physical tasks and the ease with which they are accomplished
(Brummel 2020). PFC typically decreases with an increase in age, thus leading to frailty,
physical disorders and cognitive disorders, all of which make an individual disabled.
Presence of an impairment is typically defined as an issue in the physiological function or
body structure. While activity limitation refers to problems that are generally encountered by
people while they execute particular actions or tasks, participation restriction refers to
problems that are experienced by such individuals when they get involved in everyday life
events (Barbour et al. 2017).
According to government estimates there were are not less than 11 million individuals
having limiting chronic disease, disability or impairment in 2014. One of the most commonly

2ESSAY
observed impairment amid people is that which creates an impact on mobility, carrying and
lifting capabilities. An estimated 6% children suffer from disability, in comparison to 16%
disabled adults who belong to the working age (Gov.uk 2014). Furthermore, findings from
survey conducted from 2016-17 suggested that of the 13.9 million disabled individuals, there
were 8% children, 45% pension age adults and 19% working age adults. The reports also
suggested that 1 in 3 individuals have to face prejudice and discrimination owing to their
disability and they are commonly considered as less-productive, in comparison to their non-
disabled counterparts (Sope.org.uk 2018).
According to Booysen, Gordon and Hongoro (2018) health inequalities typically refer
to differences in the dissemination of health and social care resources or health status
between varied population groups that generally arise from the environment and social
circumstances in which people take birth, live, grow, work, and finally die. Research
evidences elaborate on the fact that health prevention and promotion activities infrequently
target individuals with disability. Women who suffer from disability are typically subjected
to less screening facilities for different types of cancer that affect women such as, cervical
and breast cancer (Sakellariou and Rotarou 2017). Likewise, people who report signs and
symptoms of intellectual impairments also demonstrate a less likelihood of having the
provision to seek complete health assessment. There is a growing body of evidence for the
fact that disabled people fare worse when compared to healthy people across a plethora of
health indicators and social determinants. Moreover, they also demonstrated an increased
susceptibility of delaying or skipping healthcare owing to the high costs of these services
(Szanton et al. 2018). Taking into consideration the fact that persons with some disabilities
necessitate additional healthcare resources for the management of their incapacitating
conditions or augmented jeopardy of chronic ailments, it is imperative to measure the delay
in getting the desirable care service. Not only do such disabled people report high obesity

3ESSAY
rates, but are also associated with smoking habits, diabetes mellitus, cardiovascular problems
and sedentary lifestyle (Lin et al. 2019).
There is mounting evidence for the fact that the Equality Act 2010 has made it
imperative for all healthcare services to take efforts for making reasonable adjustments in the
amenities for all disabled individuals, such that they are not marginalised or disadvantaged in
accessing the care services (Heslop et al. 2019). The act makes it necessary to for healthcare
centres to consider the kind of adjustments that are required by disabled people, either
cooperatively, like the provision of easy-read information or manageable toilets, or
individually, like altering the appointment time in order to facilitate easy communication of
the service users with the professionals. The Disability Discrimination Act (DDA) also
mentions that it is unlawful to discriminate disabled people in relation to access of services,
employment, property, and education (RNIB 2019).
Medical treatment is commonly free in the UK under the NHS, however, particular
services that are necessitated by disabled individuals cannot be categorised into either of
these classes, thereby subjecting them to rationing decisions. Additionally, the provisions for
fabric supports by the NHS such as, surgical brassieres or abdominal and spinal supports are
offered by the hospitals to disabled people under the coverage of NHS Low Income Scheme.
Not only does the NHS promote the supply and free of charge maintenance of electric and
manual wheelchairs to disabled individuals who suffer from mobility impairment, but also
delivers a voucher scheme that allows disabled individuals for adding personal funds. There
were an estimated 1.2 million wheelchair users in 2017 in the UK, thus suggesting the
equitable distribution of healthcare resources (NHS England 2017).
Sakellariou and Rotarou (2017) conducted a secondary analysis amid 12840
community-dwelling individuals living across the UK with 5236 having disability, in order to

4ESSAY
determine the discrepancies and inequalities in access to health and social care facilities. The
findings suggested that following adjustment of the confounding factors, disabled people
reported greater odds of meeting their unmet health needs. Largest inequality for the unmet
needs was observed for mental care services, which in turn can be accredited to their high
costs. Furthermore, severely disabled people and disabled women demonstrated 4.5 times and
7.2 times increased likelihood of facing issues due to high cost of prescribed medications, in
comparison to those with mild disability.
While exploring the barriers to utilisation of cancer amenities for physically disabled
people, it has also been found that most disabled people in England have to encounter health
inequalities owing to absence of institutional or attitudinal preparation from the healthcare
amenities and the professionals (Sakellariou et al. 2019). Majority of health personnel display
poor willingness delivering care and support to people with disability. Not only do the
professionals display lack of empathy towards the affected people, but the healthcare services
also do not have proper provisions like staff or parking that would address their physical
needs, thus highlighting the existing inequality. An estimated 5,100 kids accounting for 18%
of disabled population had to wait for several months before they had been delivered
wheelchairs by the NHS in 2017 (Brennan 2018). Furthermore, the North
Staffordshire Clinical commissioning group also declared that people suffering from mild or
moderate hearing impairment will no longer be paid for hearing aids.
Sakellariou et al. (2019) utilised case study approaches for investigating the
experiences of physically disabled people, in relation to accessing cancer facilities in Wales
and England and found that most people faced difficulties while navigating healthcare
systems that under most circumstance fail to demonstrate responsiveness towards their health
needs, thereby resulting in poor care experiences. Discontinuity in care, absence of adequate
familiarity and awareness about disability amid the healthcare staff and normativity

5ESSAY
expectations are the most common problems that were found to directly contribute to health
inequalities. Furthermore, manifestation of aggression by healthcare personnel towards the
right and dignity of the people to receive care services also ignores their disability-associated
needs. This in turn is in accordance to the fact that disabled people often want the hospitals to
share understandable and clear information about their health status or prognosis, however,
do not receive such services in England (Williams et al. 2018). The presence of disability in a
person also leads to patronising treatment. Not only is the event of getting admitted to
hospitals in the UK correlated with anxiety but also requires the patients to make reasonable
adjustments. Furthermore, the need for being subjected to a range of hospital procedures that
are not suited to the healthcare needs of the disabled people also resulted in inequality.
In the words of Kerr et al. (2018) care for individuals suffering from intellectual
disability and epilepsy in the UK is extremely fragmented and people having such disabilities
generally report the presence of complex healthcare needs, concomitant with comorbid
conditions. Not only do they have to wait for longer time in order to participate in routine
health investigations, but do not get the necessary care since there are few clinicians who do
not consider the importance of administering non-pharmacological interventions to such
people such as, vagus nerve stimulation, thereby resulting in discrepancies in the healthcare
services.
Conclusion- Thus, it can be concluded that despite the presence of legislation that
makes it necessary for healthcare organisations to make reasonable adjustments for helping
disabled people, there exists health inequality in the UK. Disability is an umbrella term that
comprise of limitations in activity, impairments, and restriction in participation of the
affected people. People suffering from disability in the UK are not always able to access care
amenities that address their care needs, and are not considered for mandatory health
screenings. In addition, lack of awareness about disability and lack of empathy displayed by

6ESSAY
the healthcare personnel further add to their problems. Not only do the patients have to wait
for longer time to get checked by a personnel, but the absence of adequate ergonomic
provisions in the care facilities further worsens the situation.

7ESSAY
References
Barbour, K.E., Helmick, C.G., Boring, M. and Brady, T.J., 2017. Vital signs: prevalence of
doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2013–
2015. MMWR. Morbidity and mortality weekly report, 66(9), p.246.
Booysen, F., Gordon, T. and Hongoro, C., 2018. Health inequalities and the poor:
Disadvantaged in every way.
Brennan, S., 2018. 'Alarming' figures show thousands still waiting too long for wheelchairs.
[online] Available at: https://www.hsj.co.uk/commissioners/alarming-figures-show-
thousands-still-waiting-too-long-for-wheelchairs/7023132.article [Accessed 18 Mar. 2020]
Brummel, N.E., 2020. Functional Scores of Disability. In Post-Intensive Care Syndrome (pp.
201-212). Springer, Cham.
Gov.uk., 2014. Disability facts and figures. [online] Available at:
https://www.gov.uk/government/publications/disability-facts-and-figures/disability-facts-and-
figures [Accessed 18 Mar. 2020]
Heslop, P., Turner, S., Read, S., Tucker, J., Seaton, S. and Evans, B., 2019. Implementing
reasonable adjustments for disabled people in healthcare services. Nursing Standard.
Jose, J.P., Cherayi, S. and Sadath, A., 2016. Conceptualizing psychosocial disability in social
exclusion: A Preliminary Discourse. Contemporary Voice of Dalit, 8(1), pp.1-13.
Kerr, M.P., Watkins, L.V., Angus-Leppan, H., Corp, A., Goodwin, M., Hanson, C., Roy, A.,
Shankar, R. and of the International, T.B.B., 2018. The provision of care to adults with an
intellectual disability in the UK. A Special report from the intellectual disability UK chapter
ILAE. Seizure, 56, pp.41-46.

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Lin, M.S., Huang, T.J., Lin, Y.C., Jane, S.W. and Chen, M.Y., 2019. The association between
smoking and cardiometabolic risk among male adults with disabilities in Taiwan. European
Journal of Cardiovascular Nursing, 18(2), pp.106-112.
NHS England., 2017. Improving Wheelchair Services. [online] Available at:
https://www.england.nhs.uk/wheelchair-services/# [Accessed 18 Mar. 2020]
Royal National Institute of Blind People., 2019. Disability Discrimination Act (DDA).
[online] Available at: https://www.rnib.org.uk/sight-loss-advice/equality-rights-and-
employment/disability-discrimination-act-dda [Accessed 18 Mar. 2020]
Sakellariou, D. and Rotarou, E.S., 2017. Access to healthcare for men and women with
disabilities in the UK: secondary analysis of cross-sectional data. BMJ open, 7(8), p.e016614.
Sakellariou, D. and Rotarou, E.S., 2017. Utilisation of cancer screening services by disabled
women in Chile. PLoS One, 12(5).
Sakellariou, D., Anstey, S., Gaze, S., Girt, E., Kelly, D., Moore, B., Polack, S., Pratt, R.,
Tyrer, G., Warren, N. and Wilkinson, W., 2019. Barriers to accessing cancer services for
adults with physical disabilities in England and Wales: an interview-based study. BMJ
open, 9(6), p.e027555.
Sakellariou, D., Anstey, S., Polack, S., Rotarou, E.S., Warren, N., Gaze, S. and Courtenay,
M., 2019. Pathways of disability-based discrimination in cancer care. Critical Public Health,
pp.1-11.
Sope.org.uk., 2018. Disability facts and figures. [online] Available at:
https://www.scope.org.uk/media/disability-facts-figures/ [Accessed 18 Mar. 2020]

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Szanton, S.L., Alfonso, Y.N., Leff, B., Guralnik, J., Wolff, J.L., Stockwell, I., Gitlin, L.N.
and Bishai, D., 2018. Medicaid cost savings of a preventive home visit program for disabled
older adults. Journal of the American Geriatrics Society, 66(3), pp.614-620.
Williams, V., Read, S., Mason-Angelow, V., Heslop, P. and Miles, C., 2018. Being a
disabled patient: negotiating the social practices of hospitals in England. Social
Inclusion, 6(2), pp.74-82.
World Health Organisation., 2018. Disability and health. [online] Available at:
https://www.who.int/news-room/fact-sheets/detail/disability-and-health [Accessed 18 Mar.
2020]