Manishta Sunnia, a researcher for the disabled women’s collective, Sisters of Frida, outlines how working in partnership with Deaf and disabled people’s organisations could enable health services to better meet the needs of those who use them.
Between January and November 2020, six in ten of those who died from Covid-19 were disabled. Disabled people have historically experienced a range of barriers to accessing health care, for example, the lack of suitable transport and inaccessible buildings, and the Covid-19 pandemic brought additional challenges. During the lockdowns, shielding concerns, the inappropriate use of DNRs (‘do not resuscitate’) and the mismanagement of vaccine allocations, did not consider the needs of disabled people. As safety measures have been lifted and waves of Covid infection continue, ongoing concerns for shielders and the inability to access care remain unaddressed. All this has left the disabled population’s trust in the health and social care system at a low point.
'As safety measures have been lifted and waves of Covid infection continue, ongoing concerns for shielders and the inability to access care remain unaddressed.'
To ensure that disabled people receive the appropriate health and care services they require, trust needs to be rebuilt between disabled people and health care providers. To do this, health and care services must constructively engage with disabled people at the planning, delivery and review stages of care. This will ensure that services meet the needs of those who use them. Such engagement can be more effective and more powerful if Deaf and disabled people’s organisations (DDPOs), NHS leaders and care providers work collaboratively on the delivery of services.
DDPOs are primarily democratic and disabled-led. They are significant in ensuring that health and care services address disabled people’s concerns and meet their needs. They operate in consultation with disabled people to shape services and often provide peer support and necessary advocacy. For example, when the Joint Committee on Vaccination and Immunisation failed to prioritise disabled people for vaccines, DDPOs lobbied key care and political stakeholders to ensure that disabled people who were vulnerable to Covid-19 were added to the vaccine priority list.
When disabled people report delays in receiving localised services or encounter barriers to having their health concerns addressed, DDPOs step in to ensure that disabled people receive the right services. This happens both in an advocacy capacity, and by providing services such as counselling, acupuncture and physiotherapy. The ability to grasp the complex needs of different impairments and provide a range of support comes from the historic peer-led nature of DDPOs. This uniquely comprehensive view on disability is key to ensuring that health and care systems work for disabled people.
The needs of the disabled community are not homogeneous – factors such as race, class, sexuality, gender and levels (and types) of impairments have an impact on people’s experiences of health and care. While decision-makers and providers recognise the impacts of health inequalities and intersectional ableism, solutions to tackling them often fall short. In contrast, DDPOs such as the Sisters of Frida and Stay Safe East not only advocate for intersectional discrimination to be addressed, they also foster community spaces where different disabled women meet to share their experiences of health inequalities. This sharing of experience between disabled people is a point where key solutions can be generated. Decision-makers and providers can embrace the wealth of knowledge and solutions that DDPOs and disabled people have on tackling health inequalities. DDPOs’ historical expertise on disabled people’s needs will provide crucial insight into improving health care for all.
'This sharing of experience between disabled people is a point where key solutions can be generated.'
Further, DDPOs can provide useful guidance to health and care providers on delivering services that are attuned to different disabled people’s needs. It is imperative for health and care services to be able to cater to different types of impairments, for example, physical disabilities, neurodivergence, chronic illness, etc. To formulate this, DDPOs are valuable allies to providers and can share know-how on the mechanisms of crafting accessible services that meet different access needs. Collaboration will provide insight into different care considerations and expand the work of providers in health and care sectors. This can result in gaining an in-depth understanding of the lived experiences of those with various disabilities thus improving health care services in the long term.
As many disabled people continue to struggle through continuing waves of Covid-19, it is crucial that DDPOs, disabled people and health and care services work in partnership to ensure fair and accessible health and care. Health and care organisations need to listen to and engage with disabled people at every step and ensure that listening to the voices of disabled people is not tokenistic, but leads to real change. This will require financial investment for research and consultation activities, and the time and skills of staff. But above all it will require openness and willingness to engage with and value all voices equally. The advantages of working with DDPOs and disabled people are clear but are health and care providers ready to listen and act to build bridges towards equitable partnership?