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Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 5.1 Facilities and access

Our practice provides a safe and effective environment for our practice team and patients.

Criterion 5.1.3

Physical access

Our practice provides appropriate physical access to our premises and services including access for people with disabilities or special needs.

Indicators

► A. There is wheelchair access to our practice and its facilities, or if physical access is limited, our practice provides home or other visits to patients with disabilities or special needs.

► B. Our GPs and other practice staff can describe how they facilitate access to our practice for patients with disabilities or special needs.

Key points

  • General practitioners and other practice staff need to consider practical ways to facilitate access to the practice and its services
  • This criterion cross references to Criterion 5.1.1 Practice facilities.

Good physical access is important

For more information relating to the Federal Disability Discrimination Act (1992) and legislation regarding the right to access general practices, the Disability Discrimination Act is described in a fact sheet entitled ‘A brief guide to the Disability Discrimination Act’ available at www.hreoc.gov.au/disability_rights/dda_guide/dda_guide.htm.

Consumer representatives have informed the RACGP that access to general practice facilities and services is of high importance to patients. Practices need to make reasonable efforts to facilitate physical access to their premises and services for all patient groups including those people with a disability or other special needs. When considering what is reasonable, practices need to consider the needs of patients with restriction of movement that prevents safe access to the practice. For example, it is useful to make wheelchair access available for patients with a disability or special needs including pathways, hallways, consultation areas and toilets that are wheelchair friendly. The practice may find it useful to have its own wheelchair to assist patients as necessary.

The practice can usefully be equipped with appropriate ramps and railings to assist a patient with special needs and pictorial signage may assist patients with an intellectual disability or vision impairment.

In Aboriginal medical services, patients may be brought in to a general practice from an outlying area in a car, accompanied by an Aboriginal health worker or a practice nurse.

Disability (Access to Premises – Buildings) Standards for new buildings and renovations

The Premises Standards come into operation on 1 May 2011 and will apply to buildings where building approval is lodged on or after that date.

A fact sheet on the Premises Standards can be obtained from www.ag.gov.au/www/agd/agd.nsf/page/humanrightsandanti-discrimination_Disability(AccesstoPremises-Buildings)Standards.

When a new practice building is planned or renovations are to be undertaken, practices need to be cognisant of changed requirements, for example:

  1. Improvements in signage in relation to accessible facilities
  2. Increases in the number of accessible entrances and doorways to buildings
  3. Increases in circulation space requirements in most areas such as in lifts, accessible toilets and at doorways
  4. The introduction of a requirement for passing and turning spaces on passageways in some contexts.

Accessible parking

Where possible, patients with a disability need to be able to park their vehicles within a reasonable distance of the practice and practices are encouraged to provide parking bays specifically marked for the use of patients with a disability parking entitlement. Ideally, parking spaces should accommodate the loading and unloading of wheelchairs.

Home or other visits

For patients who are not able to access the general practice premises because transfer to the practice is too difficult or could cause harm, the practice needs to provide home or other visits. Patients in this category could include people receiving end stage palliative care, people with severe motor dysfunction such as quadriplegia or motor neurone disease and residents of nursing homes.

Services providing care outside normal opening hours

This criterion and indicators are not applicable for services providing care outside normal opening hours that provide visit only care.

Standard 5.1 Facilities and access

Our practice provides a safe and effective environment for our practice team and patients.

Criterion 5.1.3

Physical access

Our practice provides appropriate physical access to our premises and services including access for people with disabilities or special needs.

In a nutshell

You need to make reasonable efforts to assist patients who have limited capacity to physically access your health service, including those who have limited mobility or a disability.

Key team members

  • Health service manager
  • Aboriginal health worker
  • Driver 

Key organisational functions

  • Service and program planning
  • Outreach services
  • Home and other visits policy and procedures
  • Servicing patients with a disability

Indicators and what they mean

Table 5.3 explains each of the indicators for this criterion. Refer to Criterion 5.1.3 Physical access of the Standards for general practices for more information and explanations of some of the concepts referred to in this criterion. 

Table 5.3 Criterion 5.1.3 Physical access
IndicatorWhat this means and handy hints
▶ A. There is wheelchair access to our practice and its facilities, or if physical access is limited, our practice provides home or other visits to patients with disabilities or special needs. Your health service needs to make reasonable efforts to assist patients with limited mobility, other disabilities or special needs to physically access your health service. This includes the provision of wheelchair access at the entrance, pathways, hallways, consultation areas and toilets.

Home or other visits might be provided for patients who are unable to come to the health service because it may be too difficult to physically attend.
▶ B. Our GPs and other practice staff can describe how they facilitate access to our practice for patients with disabilities or special needs. In addition to physical aids such as ramps and railings, your health service could improve physical access for patients with disabilities by providing services or information in different ways such as those described below. All staff need to know about and be able to describe these practices. They could include:
  • the use of pictorial signage to assist patients with an intellectual disability or visual impairment
  • the provision of a transport service accompanied by a health worker or nurse to assist patients with no means of getting to your health service, due to distance or other transport issues
  • a disability car park area that is close to the entrance and is specifically marked and reserved for disability parking. It also needs to be sufficiently wide to accommodate loading and unloading wheelchairs.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can provide appropriate physical access, including for people with disabilities or special needs. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

Note that it is well recognised that many Aboriginal and Torres Strait Islander patients face barriers to accessing primary healthcare services. These barriers include financial, geographical, cultural and race-related issues, as well as the physical access issues covered in this criterion. ACCHSs have been developed to address many of these access barriers, but some barriers are outside their direct control. This criterion covers only the provision of physical access for patients with disabilities or special needs. 

The health service has wheelchair access for clients and it also has wheelchairs available for patient use. The doors within the service are wide enough to accommodate wheelchairs. There is a designated disabled car space in the car park. The service contains pictorial signage for the toilets.

The clinic provides a transport service with a designated transport driver to assist those patients who have difficulty accessing the service because of lack of transport. The service also provides outreach clinics to isolated communities on a regular basis, including use of a mobile van. Its Aboriginal health workers and registered nurses provide home visits to patients where it is deemed safe and reasonable to do so.

Review of the service’s Medicare billing item numbers will show evidence of home and other visits.

Showing how you meet Criterion 5.1.3

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.

  • Through the use of direct observation.
  • Through the use of staff interviews.
  • Maintain a policy and procedure manual.
  • Use patient information sheets.

Related RACGP Standards and criteria

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Search Interpretive guide Advanced Search

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