Accessibility Policy and Procedure


Twickel Dental Practice

1. Purpose

Twickel Dental Practice is committed to providing a safe, inclusive, respectful and accessible environment for patients, visitors and team members.

The purpose of this policy is to explain how the Practice supports people with disabilities, additional needs, communication needs, mobility difficulties, sensory impairment, cognitive impairment, mental health conditions or other access needs.

The Practice aims to remove or reduce barriers to access wherever reasonably possible and to ensure that patients are not disadvantaged because of disability or additional need.

This policy supports:

  • equality and inclusion
  • patient dignity
  • patient safety
  • reasonable adjustments
  • communication support
  • mental capacity and consent
  • safeguarding
  • health and safety
  • practice governance
  • compliance with the Equality Act 2010 and relevant health and social care requirements.

2. Scope

This policy applies to all team members at Twickel Dental Practice, including:

  • dentists
  • hygienists
  • therapists
  • dental nurses
  • reception and administrative team members
  • visiting clinicians
  • locums
  • self-employed clinicians
  • contractors
  • trainees
  • Practice Owners and management.

This policy also applies to patients, prospective patients, visitors, carers, companions and other people accessing the Practice.

3. General principles

Twickel Dental Practice will aim to:

  • treat all people fairly, respectfully and without discrimination
  • make reasonable adjustments where required and practicable
  • support patients with mobility, sensory, cognitive, communication or mental health needs
  • provide information in a way patients can understand where reasonably possible
  • support patients to make informed decisions about their care
  • respect privacy, dignity and confidentiality
  • consider individual needs rather than making assumptions
  • seek feedback and use it to improve access where appropriate.

Reasonable adjustments will be considered on an individual basis and will depend on the person's needs, clinical circumstances, Practice facilities, safety requirements and what is reasonably practicable.

4. Definition of disability and access needs

A person may be disabled under the Equality Act 2010 if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.

Access needs may relate to:

  • physical disability
  • mobility difficulties
  • sensory impairment
  • visual impairment
  • hearing impairment
  • communication needs
  • learning disability
  • autism
  • cognitive impairment
  • dementia
  • mental health condition
  • long-term health condition
  • frailty
  • anxiety or phobia
  • temporary injury or illness
  • pregnancy-related mobility or health needs.

A person does not need to use the word "disabled" for the Practice to consider reasonable adjustments.

5. Responsibility

The Practice Owners are responsible for overseeing this policy and ensuring that accessibility and reasonable adjustments are considered as part of Practice governance.

The responsible persons are:

Dr Mihail Drug-Ionescu
Dr Roxana Drug-Ionescu

All team members are responsible for treating people respectfully, recognising possible access needs, offering reasonable support within their role and escalating concerns or requests where needed.

6. Access to the Practice

The Practice will aim to support patients and visitors with mobility needs wherever reasonably possible.

Current access arrangements include:

  • level access into the building where available
  • waiting room space suitable for wheelchair users where reasonably practicable
  • an accessible toilet with handrails and emergency pull cord
  • nearby public parking, including St Mary's pay-and-display car park to the rear of the Practice, which has disabled parking spaces.

Patients with mobility needs are encouraged to inform the Practice before attending where possible, so that appropriate appointment and access arrangements can be considered.

Where a patient's needs cannot reasonably be met within the Practice environment, the Practice will discuss alternative arrangements, which may include referral to a more suitable service.

7. Appointment support and reasonable adjustments

The Practice may consider reasonable adjustments to appointment arrangements where needed.

This may include:

  • longer appointments where clinically and operationally appropriate
  • appointment times that better suit the patient's needs
  • quieter appointment times where possible
  • allowing extra time for communication or mobility
  • supporting carers or companions to attend where appropriate
  • allowing breaks during appointments where clinically appropriate
  • planning staged or acclimatisation appointments
  • booking with a familiar clinician where possible
  • considering downstairs or more accessible surgery arrangements where available
  • using telephone or video communication for appropriate administrative or preliminary discussions, where suitable and safe.

Reasonable adjustments must be balanced with patient safety, clinical need, staffing, appointment availability and the Practice's ability to provide appropriate care.

8. Communication support

The Practice will aim to communicate clearly and in a way patients can understand.

Support may include:

  • using plain language
  • avoiding unnecessary jargon
  • speaking clearly and at an appropriate pace
  • allowing extra time for questions
  • checking understanding
  • providing written information where helpful
  • providing information in larger print where reasonably possible
  • using models, photographs, diagrams or videos where helpful
  • helping patients navigate forms or documents where appropriate
  • using translation or interpretation support where required and available
  • using a portable hearing loop where available
  • considering communication needs when booking and planning appointments.

The Practice recognises that communication support may be required for both NHS and private care.

9. Patients with hearing impairment

Where a patient has a hearing impairment, team members should consider practical support such as:

  • facing the patient when speaking
  • speaking clearly without shouting
  • reducing background noise where possible
  • checking whether the patient lip-reads
  • providing written information where helpful
  • using the portable hearing loop where available and appropriate
  • checking understanding before proceeding.

10. Patients with visual impairment

Where a patient has a visual impairment, team members should consider practical support such as:

  • offering verbal explanation of forms or written information
  • providing larger print where reasonably possible
  • offering assistance with navigating the Practice
  • ensuring the patient is guided safely if help is requested
  • explaining clinical procedures clearly before and during care
  • avoiding unexpected physical contact without explanation.

11. Patients with cognitive impairment, autism or learning disability

Where a patient has cognitive impairment, autism, dementia, learning disability or another condition affecting understanding or communication, the Practice will aim to provide clear, calm and respectful support.

This may include:

  • concise and unambiguous explanations
  • extra time for questions
  • visual aids, models, pictures or photographs
  • a staged approach to appointments
  • allowing a familiar carer, family member or advocate to attend where appropriate
  • checking understanding before treatment
  • considering the best time of day for the patient
  • reducing sensory overload where possible
  • avoiding unnecessary pressure or rushing.

The Practice will consider reasonable adjustments and will follow its Consent Policy and Mental Capacity Act Policy where capacity or consent concerns arise.

NHS England notes that reasonable adjustments may include practical changes to the environment or changes to processes to help patients with learning disabilities access dental care.

12. Mental health, anxiety and dental phobia

The Practice recognises that mental health conditions, anxiety and dental phobia can affect access to dental care.

Where appropriate, the Practice may consider:

  • calm communication
  • reassurance
  • longer or staged appointments
  • explanation before procedures
  • breaks during treatment
  • familiar clinician continuity where possible
  • signposting or referral where a higher level of support is needed.

Patients should not be judged or dismissed because they are anxious or find dental care difficult.

13. Consent and mental capacity

The Practice will support patients to make their own decisions wherever possible.

Where capacity is in doubt, the Practice will follow the Mental Capacity Act Policy and assess capacity in relation to the specific decision at the relevant time.

Where a patient lacks capacity for a particular decision, any decision made on their behalf must be in their best interests and must consider the least restrictive option.

Relevant family members, carers, advocates or legal representatives may be involved where appropriate and lawful.

14. Carers, companions and advocates

Patients may be accompanied by a carer, companion, family member or advocate where appropriate.

The Practice will respect the patient's confidentiality and autonomy.

Where a patient has capacity, information should only be shared with others with the patient's consent, unless there is another lawful basis.

Where a patient lacks capacity or is at risk, information sharing will be considered in line with the Mental Capacity Act Policy, Safeguarding Policy, Confidentiality Policy and Data Protection Policy.

15. Physical environment and signage

The Practice will aim to maintain a welcoming and accessible environment where reasonably possible.

This may include:

  • clear signage
  • well-lit areas where possible
  • safe walking routes
  • appropriate waiting room layout
  • attention to trip hazards
  • accessible toilet arrangements
  • clear routes for wheelchair users where reasonably practicable.

Team members should report any environmental issue that may affect accessibility, safety or dignity.

16. Emergency evacuation and safety

The Practice will consider the needs of disabled people and those requiring assistance during fire or emergency evacuation.

This may include:

  • asking patients or visitors whether they need assistance
  • ensuring staff understand evacuation arrangements
  • considering mobility, sensory or communication needs
  • supporting wheelchair users or those with mobility limitations where safe to do so
  • following the Practice Fire Safety and Health and Safety procedures.

Staff should not place themselves at unreasonable risk during an emergency.

17. Staff and team member accessibility needs

The Practice will also consider reasonable adjustments for team members with disabilities, health conditions or access needs.

This may include adjustments to:

  • duties
  • working arrangements
  • equipment
  • communication
  • training
  • supervision
  • workplace layout where reasonably practicable.

Requests should be discussed with the Practice Owners or authorised management and handled sensitively and confidentially.

18. When the Practice cannot reasonably meet a need

There may be occasions where the Practice cannot safely or reasonably meet a patient's particular needs because of premises limitations, equipment, staffing, clinical complexity or patient safety considerations.

Where this occurs, the Practice will aim to explain the position sensitively and consider appropriate alternatives, such as:

  • adapting the appointment where possible
  • offering a different appointment time
  • arranging care in a more suitable surgery where available
  • referral to another service or specialist provider
  • signposting to a service better equipped to meet the patient's needs.

The aim is to support access, not to exclude patients unnecessarily.

19. Feedback

The Practice welcomes feedback about accessibility.

Patients, carers, visitors and team members may provide feedback verbally, in writing, by email, through NHS Friends and Family Test feedback where applicable, Google reviews, surveys where used, or any other appropriate route.

Feedback may be used to identify barriers, improve access and review reasonable adjustments.

The Practice will consider accessibility-related feedback as part of practice governance where appropriate.

20. Complaints

The Practice takes complaints about accessibility seriously.

Any complaint relating to access, reasonable adjustments, communication, discrimination, dignity or disability-related concerns will be managed under the Practice Complaints Policy.

Complaints will be handled respectfully, fairly and in accordance with the Practice's normal complaints process.

21. Training and awareness

Team members should be aware of this policy and the importance of accessibility, reasonable adjustments, disability awareness, communication support, equality, consent and safeguarding.

Training or guidance may include:

  • disability awareness
  • autism and learning disability awareness
  • communication support
  • Equality Act duties
  • Mental Capacity Act principles
  • safeguarding
  • emergency evacuation support
  • respectful communication.

Training will be proportionate to the person's role and responsibilities.

22. Access review and audit

The Practice may periodically review accessibility arrangements.

This may include considering:

  • premises access
  • waiting room arrangements
  • toilet facilities
  • signage
  • communication support
  • feedback from patients or carers
  • staff suggestions
  • incidents or complaints
  • reasonable adjustments provided
  • action needed to improve access.

Where actions are identified, these may be recorded and reviewed as part of Practice governance.

23. Relationship with other policies

This policy should be read alongside:

  • Equality, Diversity and Inclusion Policy
  • Consent Policy
  • Mental Capacity Act Policy
  • Safeguarding Policy
  • Confidentiality Policy
  • Data Protection Policy
  • Complaints Policy
  • Patient Feedback Policy
  • Fire Safety Policy
  • Health and Safety Policy
  • Chaperone Policy
  • Translation Policy.

24. Review of policy

This policy will be reviewed annually, or sooner if there are changes in legislation, regulatory requirements, Practice premises, accessibility arrangements, patient feedback, complaints, staffing or business needs.