[Reasonable Access Letter head] Reasonable Access C/O Inclusion London 336 Brixton Road London SW9 7AA hello@reasonableaccess.org.uk 11th June 2020 Open letter asking about accessibility of the entire COVID-19 Test and Trace system. Dear NHS England, Copied to: Public Health England (PHE) and Department for Health and Social Care. Having seen the recently announced information about the COVID-19 NHS Test and Trace services in England as outlined at https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works, we are concerned that no mention has been made of disabled people and the specific needs we may have during the test and trace processes (including the app, communications, information and tests implementation). The signatories to this letter are deaf and disabled people, parents and carers of disabled people and supporters who have a number of questions about accessibility that we would like answered to reassure us that the NHS testing and tracing is accessible as required by law. Several people have fed back to Reasonable Access that they do not know how they would access the test and trace process because of apparent access barriers and would not know where or how to find out. NHS Legal obligations. When answering the questions below, please consider the NHS's legal obligations under the following : Equality Act 2010. Section 20, the anticipatory duty to make reasonable adjustments, especially 20(6). http://www.legislation.gov.uk/ukpga/2010/15/section/20 Section 149, the Public Sector Equality Duty: to pay due regard to the need to Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act. Advance equality of opportunity between people who share a protected characteristic (disability, age) and those who do not. http://www.legislation.gov.uk/ukpga/2010/15/section/149 The Services, Public functions and Associations: Statutory Code of Practice. Paragraphs 7.3, 7.4, 7.20, 7.21. https://www.equalityhumanrights.com/en/publication-download/services-public-functions-and-associations-statutory-code-practice Accessible Information Standard (SSCI1605) Accessible Information Guidance v1.1. Sections 7.3, 7.4, 8.2, 11.1, 11.6.2, 15.3. https://www.england.nhs.uk/wp-content/uploads/2017/08/implementation-guidance.pdf Human Rights Act 1998. Article 2 - Right to life. Article 8. - Respect for private and family life, home and correspondence. Article 14. - Protection from discrimination. Please note: Responses which suggest that a disabled person: * provides their own adjustments, * communication support or * asks a family member or friend to help them are all unlawful under Section 20 of the Equality Act. The duty to make reasonable adjustments belongs to the service provider or organisation carrying out a public function. Questions about access barriers. Has any information been published which tells disabled people how their access needs will be met and how they can disclose access needs, have access needs recorded and complied with? If so, where is this information and how has it been publicised and promoted? Accessible information and communication Is there any way a deaf or disabled person can alert the Covid19 testing services of their access needs for communications? For example: * Requesting the use of SMS or email only communications. * Opting out of voice telephony, SMS or postal communications. If not, how are deaf and disabled people expected to access test and trace services in accordance with their legal rights? Is the proposed test and trace app going to be fully accessible to all disabled users? Including: * Screen-reader and text to speech users. * Magnification users. * People who need to change colours to read text. * People with dexterity impairments. * People with cognitive impairments. Can people access the NHS 119 telephone service in British Sign Language (BSL) free at the point of use? What effort has been made to liaise with BT's Relay UK text-relay (formerly TypeTalk) service to ensure NHS 119 calls are prioritised? Prioritisation is vital to ensure Relay UK operators are not taken off 119 calls to deal with other priorities. Accessing Information and instructions. Are the instructions around testing and tracing available in different accessible formats for disabled people who require it? Including: * Braille. * Audio. * Large print, or. * Word format. Is there any government or NHS hosted information about Covid19 test and trace available in British Sign Language (BSL)? Are instructions relating to all elements of testing and tracing provided in British Sign Language (BSL)? Is there high quality British Sign Language information about testing and tracing which is freely and easily available to any Deaf BSL user who wishes to access it? Has information about test and trace been translated into Easy Read format, commonly provided for people with learning disabilities? Drive-thru or other test centres. For people who cannot drive or have access to a private vehicle in their household. Can you ensure that they are not disadvantaged by having to wait longer for home or other test options? At a drive-thru, many centres are reported to use verbal instructions from masked staff. What plans are in place to fully support a patient who cannot hear or understand those instructions? At drive-thru or other testing centres there have been reports that systems are used where the patient has to: * Receive a voice phone call to be alerted for their appointment or to move between areas. * Make a voice phone call to talk to staff and receive instructions. What alternatives are available for people who do not have a mobile phone, disabled and deaf people who cannot access voice telephony? What options are provided for Deaf people who need communication in BSL? How are these alternatives advertised to people who may need them? Are these alternatives guaranteed to be available at every testing centre? Can it be guaranteed that no one will be turned away from any drive-thru or other testing centre because of their need for adjustments to verbal and voice telephony communications? Some test centres require people to wait around outside. Has any provision been made for those who don't have a car to wait in, who may for example have difficulty safely social distancing or standing for any period of time? Dealing with self-testing. Is there tactile information on Covid19 testing items such as swabs, to enable someone with no sight or low vision to use them safely and effectively? Can it be guaranteed that visually impaired people will not have to wait longer to access accessible testing? Some people will have difficulties doing swab testing for reasons related to their impairment or condition. Examples include: * Arthritis or physical impairment affecting someone's dexterity skills. * People experiencing tremors or uncontrolled movements from their impairments or medication side effects. * People with impairments that have altered their ear nose and throat anatomy. What options are there to ensure prompt and appropriate testing is available to people who cannot self-test using throat and nose swabs? Can it be guaranteed that people will not have to wait longer for testing which is appropriate for their needs? Adjustments to testing processes Some disabled people will need extra time to manage the sample acquisition process. Can this be guaranteed? Some disabled people will be unable to tolerate the discomfort of nasal and throat swabs. Will alternative testing options which are less painful or difficult be readily available as quickly as needed? Many disabled people have conditions with symptoms that mimic one or more of the key symptoms of COVID-19. Access to vital healthcare can require people to be COVID-19 symptom free or have proof of a recent negative COVID-19 test result. Some people have reported being unable to access testing because they do not drive and or cannot test themselves safely. Will accessible testing options be made available to ensure these people can get access to appropriately accessible testing in a timely manner? Response As access to COVID-19 test and tracing services is an urgent public and individual health issue, it is vital that these questions are answered and public information is updated to provide disabled people with reassurance that we will have access to testing. We can therefore only allow 10 working days for a full response to these questions and an update to the webpage https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works. The best response method is by email to hello@reasonableaccess.org.uk. Please use a sans-serif font of at least 12 point size to ensure it is readable to us. If a satisfactory response is not received by 26th June 2020 we will have no choice but to seek legal advice with a view to taking urgent legal action against NHS England to enforce our legal access rights. Yours faithfully. Reasonable Access – and signatories as below: Signature/name Role Amy Mason disabled person Daisy Holder Disabled person K Swinton Disabled person Jen Slater Reader in Disability Studies, Sheffield Hallam University Karen McAtamney Lawyer Nicola Alloway Trainee BSL/English Interpreter Emily Wright Supporter Natalya Dell Disabled and deaf person, trustee Reasonable Access. Doug Paulley Disabled person Beth Oliver Disabled person Liz Ward Deaf person with sight. Kim Wall Lisa Egan Disabled person Vera Kubenz Disabled person with mobility impairment Tony Jennings Disabled person and campaigner Christiane Link Disabled person Francesca Di Giorgio Disabled person Peter Wouda Supporter Zara Bain disabled person Bruno Girin Supporter Ali Stangoe disabled person Kelly Sinclair Sam Pugh Deaf campaigner Anneka Owens Disabled person Catherine Wright Activities in Care for Older People Bristol Reclaiming Independent Living Marie Chadwick Disabled person Tina Hodgkinson Disabled person and London Ambassador for Euan's Guide, disabled access charity Di Gorton Supporter Kelly Sinclair Ian Lawson Mobility & speech impediments Chris Fry Disability Rights Lawyer Jeffrey Harvey disabled person Maja J Lewis Disabled Gwen Perkins Carer for disabled person Clare Nelder Deaf Teacher of the Deaf Ann Jillings Parent of a Deaf child Lynn Stewart-Taylor Deaf BSL Consultant/Campaigner Steve Lanys-Morris TBI survivor Sally Reynolds Deaf Craig Pothecary Disabled person and parent of disabled child Craig Crowley Disabled person (Deaf & Sign Language User) & Deaf Charity CEO Euan McCutcheon disabled person with a hearing impairment Jay Bansal Person on the Autistic Spectrum Audrey Ludwig Solicitor with hearing impairment Yvonne Benson Suppporter Harriet Clough ambulatory wheelchair user John Burgess Theresa Monaghan Partner of deaf person and have deaf adult daughter. Also worked within deaf education for 20 years Svetlana Kotova Director of Campaigns and Justice at Inclusion London, disabled person with sight impairment Katiie Clarke Director of Bringing Us Together and Visits Unlimited Anne Collinson Parent of young adult with autism Jon Abrams Inclusion London, Campaigns and Justice Coordinator Steve Lanys-Morris PWD M Welch Supporter Helen McLean Disabled person Sam Gamblin Charity Manager - University Mental Health Advisers Network and parent of autistic teenager Linda Green community volunteer G. Tiley disabled person Jude Gibbons Rebecca Brown Ally Catherine Bailey Bristol Disability Equality Forum Pan-impairment wholly Disabled people run organisation Silvana Kelleher Disabled Councillor Jessica Glanz Adam Birchall Person with chronic illness and mental health problems Danielle Lavigne Disabled Artist Dr Sophie Meekings Profoundly deaf disabled person Alfred Chow Esther Leighton Trustee, Reasonable Access Karen Passmore Wheelchair user Steph Driver Disabled Person Liath James Ehlers Danlos sufferer Ria Foster MJ Black Disabled person Tina Hodgkinson Disabled person Sheila Donnan Parent of adult with disabilities / supporter Ria Disabled person and supporter Richard Fletcher Supporter / Professional S. Heyhoe Supporter Susan Pickford Mother of deaf and disabled person Alan Crombie Retired professional, supporter and uncle and grand uncle Victoria Tye Disabled person Dasi McGough Dr Ian G Donnan Medical Practitioner Bethan Griffiths Supporter Nicola Roome Parent carer of an autistic adult Lisa Gilby Supporter Ian Reynolds Profoundly deaf person Tricia Higgins Disabled person, wheelchair user G Sabini-Roberts Parent of a disabled child Katy Harrad Supporter Holly Matthies disabled person with a sight impairment (also carer to other disabled adults) Naomi Rowe Disabled person Sanji Supporter Louise Penman supporter AJ Eliot Supporter Susanne McGowan Disabled person Yvonne Lewis Sarah Cotterill Rowan Evenstar Disabled person Steve Ratcliff Maria Waldron Sarah Stephenson-hunter Disabled person with a serious sight impairment Fiona MacMillan Disabled person Harry Wright Nora Casey Supporter Phil Samphire Disabled person S M Platt Parent of 2 disabled children Emma Wileman Disabled non-driver, live alone Rachel Evans Disabled person Nila Gupta Brown Disabled Person Katharine Ratcliffe Disabled person Rachel George Parent of a disabled child Audrey Ludwig Solicitor with hearing impairment Anna Kaminska Disabled person Matthew Dell Supporter Gregory Burke Disabled person and discrimination barrister Natalie Burnapp Deaf, Positive Behaviour Support Consultant Melanie Crowley Alex Brett disabled person