2. Able Nurses and Midwives Barbara Waters Ex CE Skill: National Bureau for Students with Disabilities UK

3. Impact of anti-discrimination legislation Disability Discrimination in UK was made unlawful in 1995, 2001 and 2006 for students and people in employment and covers admissions, recruitment processes and policies, practices and procedures Can conflict with professional regulation Previous reliance on vague ‘fitness to practice’ screening needs to be reviewed

4. Culture Risk averse Barriers posed by statutory regulation Surfeit of requirements often vague Disabled people are patients not colleagues Focus on what is wrong with people rather than what they can contribute

5. Impact of nursing as a profession Substantial work force Highly rated by the public Public services need to reflect full diversity of society Wealth of skills and personal experiences that can enrich the work Framework of competence and conduct Public still protected

6. Evidence of risk – fact or prejudice Review by UK Disability Rights Commission of high profile cases where patients harmed or killed No evidence regulation of mental or physical fitness would have prevented criminal acts but pointers to inadequate management Many standards not legitimate competence standards

7. What is the problem with existing competence standards? Do not determine whether someone is competent to practice in a profession eg ‘ to be of ‘good health’ and ‘good character’ Frequently lead to discriminatory attitudes, policies and practice Impact assessment will help to identify where this is happening Link with anti discrimination legislation and human rights act

8. Finding of Disability Rights Commission UK 2007 Generalised health standards encourage a diagnosis-led approach to the assessment of risk rather than individualised approach No useful function in predicting future conduct or competence or in assessing risk

9. Do specific disabilities pose a risk? People with mental health difficulties are excluded without assessment/support Outspoken prejudice drives people underground, making work more difficult without accommodations ‘honest students and staff are penalised, so the unsuitable candidates are not being identified’ Nurse with mental health history

10. Nurses with dyslexia might make mistakes Being expert in the accommodations you need means better prepared Good use of technology for checking drugs and dosages People with dyslexia know they have to check No cases of medical mistakes recorded as caused by dyslexia, stress, tiredness and lack of attention more likely causes

11. Issues about disclosure of disability (Stanley et al 2011) Disclosure is a process rather than an event; involves a series of decisions or negotiations once on training programme for example each work placement Disability legislation gives people new confidence – need to build on this approach

12. Two distinct and different concepts of disclosure Rational - as a transaction to share information with employer, training institution or professional body in return for accommodations and support. Individual assess risk of exclusion and hopes to control pace and extent of the process of disclosure

13. Two distinct and different concepts of disclosure A positive sense of self – Engaging with and owning the label of disability Commitment to identity eg honesty, sense of responsibility to profession and patients Willingness to disclose shaped by attitudes encountered on the way These concepts are not exclusive

14. How to move forward Actively promote entry of disabled people into the profession through websites, literature, promotional events and careers services Provide clear information about disclosure process Monitor and research under represented groups and use impact assessments to identify where there are barriers Combat the perception that all disabled people are vulnerable receipients of care

15. How to move forward 2 Make it clear why information about disability is being collected, who will see it and what use it will be put to Create an inclusive culture: Where there are role models Mistakes made by disabled people are dealt with as they would be with any student and not automatically attributed to disability

16. Useful reading Into Nursing published by Skill www.skill.org.uk/bookshop Maintaining Standards: Promoting Equality, report of a UK Disability Rights Commission Formal Investigation 2007 www.maintainingstandards.org Stanley, Nicky, Ridley, Julie, Harris, Jessica and Manthorpe, Jill(2011) 'Disclosing disability in the context of professional regulation: a qualitative UK study', Disability & Society, 26: 1, 19 — 32

17. Contact Skill Skill Information Service Tuesday 11.30am-1.30pm Thursday 1.30pm-3.30pm Website www.skill.org.ukwww.skill.org.uk EmailInfo@skill.org.ukInfo@skill.org.uk Voice0207 450 0620 Text0200 068 2422 Fax 0207 450 0650 Unit 3, Floor 3, Radisson Court, 219 Long Lane, London SE1 4PR