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Reasonable adjustments

A reasonable adjustment is a change to an existing approach or process which is essential to ensure a person’s access to a service. Making reasonable adjustment for a person’s disability creates an inclusive environment and facilitates meeting the NSQHS Standards.

Reasonable adjustments in health care include policies, processes, systems, and communication that adjust for the needs of the person with intellectual disability. Reasonable adjustments prevent direct and indirect discrimination against a person with a disability.

Reasonable adjustments are underpinned by person-centred communication, multidisciplinary teamwork and creating pathways to health care.

Legal framework for reasonable adjustment

Within Australia, Commonwealth and state and territory legislation is in place to: acknowledge the human rights of people with a disability; promote independence, economic and social inclusion; facilitate access; provide safeguards and enact the United Nations Convention on the Rights of Persons with Disabilities (CRPD).

Under the Commonwealth Disability Discrimination Act 1992 (the Act), reasonable adjustments are described as a duty of care to prevent discrimination.

State and territory governments each have disability inclusion legislation for public authorities, including health, mandating disability inclusion action plans. The inclusion of a Disability Access and Inclusion Plan (DAIP) ensures services meet the needs of people with a disability, their families, and carers.

To provide safe and inclusive health care for people with intellectual disability, the Four Steps to Inclusive Health Care assists in making reasonable adjustments.

Examples of reasonable adjustments

Pre-appointment:

  • Accessible information pack about the hospital/clinic/appointment
  • Pre-appointment visit to the hospital/clinic to become familiar
  • Flexibility in appointment times, for example, appointment times which fit around their daily routines
  • Telephone reminders for the appointment
  • Accessible car parking.

Appointment

  • Speaking directly to the person with intellectual disabilities throughout the healthcare encounter, for example, to explain during the procedure what is happening and what is happening next
  • A longer appointment time, for example, a double appointment
  • An appointment during a quiet time, for example, first or last appointment of the day
  • The family being present during the appointment
  • Explaining consent procedures and providing Easy Read information
  • Checking for understanding of the information that has been given
  • Demonstration of a physical examination using either yourself or another to show what is planned to gain the person's permission
  • Procedure explanations in Easy Read or pictorial format, or if available, a video of a planned procedure
  • Access to toilets before and after a visit
  • Playing the person with intellectual disability’s favourite music, or music in general during the procedure to relax and distract them.

Further resources

Some resources to guide and support reasonable adjustments and different ways of communicating with individuals, and providing health-related information:

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