Appendix 7. Table of policies/legislation/position paper/reviews

Y

X

Equality and inclusion of people with disabilities

Y

X

Accessible transport system, provision of information in an accessible format for people with sensory impairment, establish regional co-ordinating committees, implement a process to evaluate the health services and appoint a Director of Services for people with a physical or sensory disability

Y

Current

National Disability Authority - develop policies and guidelines

Y

Current

Essential for equality and non discrimination

Y

Current

Part 2 and Part 3 -accessibility to service and information, assessment of needs currently restricted to persons aged 0-5yrs

Y

Current

Assignment of personal advocate

Y

Current

Commitment to meet obligation established in provisions of Disability Act (2005)

Y

Replaced

Develop local services, organisation and co-ordination of services and the implementation of initiatives to increase equity and access of service for people with disabilities

Y

Current

Promoting, achieving and maintaining a healthy lifestyle important for people with a physical and sensory disability - these persons must be consulted when planning, implementing and evaluating programmes to promote a healthy lifestyle

Y

Current

Develop primary care. Team based primary care services and the provision of services in a cohesive and continuous manner

Y

Current

New model of Primary Health Care and recommends that primary healthcare centres be accessible to people with a disability. Disability training and awareness for all staff

Y

Current

Disability training and awareness. Funding available for innovative projects and approaches which improved services for women with disabilities

Y

Current

No reference to women with disabilities within the context of maternity care

Y

Current

Developing integrated services, the configuration of hospital services and reconfiguration of resources in order to provide services within the local community

Y

Current

Strategy to facilitate social inclusion and equality of opportunities for people from diverse cultural and ethnicity minority groups.

Y

Amended

Duty of care - equal access, remove barriers, quality care, effective communication, change policies and practices, provide auxiliary aids, physical access, disability training and awareness

Y

Current

Local authorities responsibility Disability Equality Duty (DED) - develop disability equality schemes to facilitate accessibility, non discrimination and participation

Y

Current

Establishes midwife's responsibility, disability awareness and training, professional behaviour and etiquette, effective communication, early assessment of needs, referral mechanism, local provision of care, appropriate information and equipment , care innovative and flexible

Y

Current

Consult with women with disabilities, access to accurate, appropriate information, flexible parenting preparation classes, philosophy of women centred care

Y

Proposed

Standards 3, 7, 22, 26, 30 - access to maternity care, innovative and flexible services, communication and information accessible and appropriate, awareness of facilitators to prevent or overcome barriers

Y

Current

No specific reference to women with disability, promotes local services, choice in type of care, where to access care and place of birth, flexible care, assessment of needs, individual care plan, information about services available

Y

Current

Consult with women, accessibility to built environment, sign language interpreter, recognise and overcome barriers to access, local services, information about services available, access birth environment

Y

Current

Guide to compliance with DDA (1995), guidance on accessible services for senior NHS managers not gender specific, no reference to pregnancy

Clinical standard - advice on planning the service in obstetrics and gynaecology

(RCOG, 2002)

Y

Current

Sets out clinical standards in obstetrics and gynaecology, no reference to women with disabilities but discusses the provision of designated lead consultant obstetrician and clinical midwife manager in labour ward

Y

Current

No reference to women or maternity care - plan to meet obligations enshrined in DDA (2005), recognise diversity, provision of information, disability and awareness

You can make a difference - improving hospital services for disabled people

(DRC, 2004)

Y

Current

Guide to compliance with duty of care set out in DDA (2005), guidelines to improve hospital services for people with disabilities - generic guide, women or maternity services not discussed

Y

Current

Guide to compliance with duty of care set out in DDA (2005), guidelines to improve primary care services for people with disabilities - generic guide, women or maternity services not discussed

Y

Current

Guide to compliance with DDA (2005) - advice to NHS organisations on the development of Disability Equality Scheme

Health reform in England: update and commissioning framework

(DoH, 2006)

Y

Current

Update on health reform for managers in NHS, focuses on commissioning NHS services

Disability Equality Scheme (2006-2009)

NHS Scotland (2007)

Y

Current

Strategy which sets out how NHS organisations intend to fulfil its duties within the DDA (2005)

Disability equality impact assessment and the disability equality duty

(DRC, 2006)

Y

Current

Compliance with DDA (2005) - a document for managers to assist in assessment of suitability of services provided for people with disability

The Disability Equality Duty and Involvement: guidance for public authorities on how to effectively involve disabled people

(DRC, 2006)

Y

Current

Compliance with DDA (2005) - guidance for public authorities on how to effectively involve people with disabilities

Health and the Disability Equality Duty: guidance for public authorities working in health sector in England and Wales

(DRC, 2006)

Y

Current

Compliance with DDA (2005) - guidance for public authorities and managers in health sector in England and Wales to promote disability equality, promoting positive attitudes, eliminating discrimination and encouraging participation of people with disabilities

Health and the Disability Equality Duty: a guide to the DED for NHS health Boards in Scotland

(DRC, 2006)

Y

Current

Compliance with DDA (2005) - guidance for NHS health boards in Scotland to promote disability equality, promoting positive attitudes, eliminating discrimination and encouraging participation of people with disabilities

Y

Current

Action plan devised by the Department of Health, Social Services and Public Services to comply with obligation of DDA (1995) to promote positive attitudes towards disability and encourage participation of people with disability

Maternity services: national for maternity services in Scotland

(NHS QIS, 2005)

Y

Current

Maternity care standards developed by NHS quality improvement Scotland in consultation with health professionals, does not refer to women with disabilities

Y

Current

Reform of maternity services, establishes principles of service organisation and principles maternity care standards indicated, does not refer to women with disabilities

Y

Current

Local policy to manage waiting list, referrals for OPD, investigations and elective surgery to achieve strategic aim of providing timely, accessible patient centred care, no reference to women with disabilities

Y

Current

NICE clinical guideline on routine antenatal care for healthy woman during pregnancy, no reference to women with disabilities

Y

Current

NICE clinical guideline on healthy woman who are giving birth, no reference to women with disabilities

Y

Current

NICE clinical guideline on postnatal care for healthy mother and healthy baby for 6- 8 weeks after birth, does not refer to women with disabilities

Y

Current

Prohibits discrimination on the grounds of disability

Y

Current

Equality of rights - right to equality and non discrimination

Y

Current

Policies need to be responsive to women, provision of effective healthcare services, promotion of good health, collaboration amongst care providers, integrated services, access to environment, refers to Canadian perinatal system, no reference to women with disabilities

Y

Current

Guideline with 13 guiding principles which form the bases of family centred maternity and newborn care, birth is considered as a normal, healthy process, unique to each woman; care is administered within the context of the family unit; the women's autonomy and the concept of informed decision making is promoted and all care is based on best evidence and practice, no reference to women with disabilities

Y

Current

Provincial women's health strategy - compliance with national women's health strategy, no reference to women with disabilities

Y

Current

Improve services and care to reduce rates of maternal and infant morbidity and mortality rates

Y

Current

People with disabilities have a right to accessible services, information and built environment - concentrates on employment and transportation but provisions applicable to health

Y

Proposed

Framework for family centred maternity and newborn care, integrated services, pan Canadian initiative, no reference to women with disabilities

Y

Current

Principles of equality, inclusion and independence, building block for subsequent policy development - not gender specific no reference to healthcare

Y

Current

Policy to improve health of pregnant women, focus on at risk pregnant women - local services, increase accessibility to services

Y

Current

Annual report on Canadian governments progress on disability, focus on disability related initiatives, no reference to women or reproductive healthcare

Y

Current

Statistical profile - no relevance to provision of services

Y

Current

Effective communication and provision of accessible information discussed in context of physical abuse, no reference to maternity or reproductive care

Y

Current

Policy statement to embrace diversity and promote equity of care

Y

Current

Accessible services for women with physical disability - services information and transport, community based local hospitals, risk assessment to determine low or high risk pregnancy if low risk delivery in local hospital, provision of postnatal care in local health centres - staff with multidisciplinary team

Y

Current

Training and education of healthcare personnel

Y

Current

Patients' rights when accessing healthcare

Y

Current

Universal design and accessibility for all

Y

Current

Prohibits discrimination on grounds of disability applies to employment, public transport, vocational and professional education, no reference to health or women with disabilities

Y

Current

Document which discusses the structure, organisation, funding, regulation of Dutch health system

Y

Current

Reform society's attitudes towards people with disabilities, remove barriers to participation, prevent discrimination, main focus is integration of people with disabilities into society, healthcare not included

Y

Current

Refer to assistive devices for people with disabilities

Y

Current

Guideline for employers to assist them in the development of policy to comply with requirements of disability policy,

Y

Current

Facilitates the appointment of a Disability Ombudsman - mechanism for redress of person experiences discriminatory practices

Y

Current

Title II - programs must be accessible, physical accessibility, building standards, use of appropriate auxiliary aids, sign language interpreter, provision of information in appropriate format

Y

Current

Provides guidance to health professionals on appropriate measures to ensure effective communication with deaf or hard of hearing patients

Y

Current

No reference to women with disabilities, outreach services, ongoing assessment of maternal and fetal health during pregnancy, individual care plan developed and updated regularly, co-ordinated services, health and parent education classes to all women, psychological assessment on all women, postnatal follow up and support

Y

Current

Prohibits discrimination on grounds of disability, promote equality of people with disabilities, Section 23 access to services, develop disability standards and action plans

Y

Current

Legislative framework which governs provision of disability services to people with a disability

Y

Current

Legislative framework which governs provision of disability services to people with a disability in Victoria

Y

Current

Legislative framework which governs provision of disability services to people with a disability in Queensland

Y

Current

A guide for service providers outlining their duty of care established under the Disability Service Act (2006) in the provision of disability services

Y

Current

Practical guidance to organisation and services providers on the removal of barriers to services, services, facilities and programs must be accessible to people with disability, service providers obliged to meet requirements of CDS

Y

X

Outlines outcomes achieved within the first 5 years of implementing the Disability Strategy, attitudes towards people with disabilities have improved, better accessibility to built environment, increased awareness of people's needs, information about services is more accessible, progress on implementation slow

Y

Current

South Australian - plan to address the obligations set out in the DDA (1992), sets out measures to ensure accessibility to built environment, effective communication, disability training and awareness, provision of information in appropriate formats, use of auxiliary aids and integrated services

Y

Current

Service providers must ensure that services provided during pregnancy, birth and motherhood to women, services must be consistent, comprehensive, well co-ordinated, women centred, flexible and safe, women should have access to information on reproductive issues and practical parenting assistance

Y

Current

Sets out priority areas requiring action - need to develop strategies that focus and address the needs of women with disabilities with emphasis on reproductive and sexual health

Y

Current

Services must be accessible to all women, conduct individual needs assessment, access to information about services provided, physical accessibility for all, no reference to women with disabilities

Y

Current

A set of standards that service providers are required to adhere to when providing disability services in Victoria, not gender specific, not related to maternity services

Y

Current

Queensland - plan to address the requirements of the DDA (1992), when providing disability services, sets out measures to ensure accessibility to built environment, individual assessment of needs, disability training and awareness

Y

Current

Proposes a new strategy of integrated maternity care - Maternity Care 2010, women with special needs must have their needs met, no reference to women with disabilities

Y

Current

Priority strategy 5: make public services accessible, set out a commitment to ensure accessibility to public services, no reference to women or maternity services

Y

Current

Code outlining the ethical conduct, behaviour and interaction midwives are required to adhere to when engaging and interacting with all women, no reference to women with disabilities

Y

Current

A set of national standards of professional conduct for midwives

Y

Current

Recognise diversity of needs among women - embrace diversity, encourage participation of women, enhance safety and security, improve women's mental and emotional health, accessible health information and services

Y

Current

Promotion of equality and non discrimination

Y

X

The report identifies the progress achieved in various government departments following implementation of the disability action plans.

Y

Current

A framework to attain a high standard maternity service, community based antenatal, comprehensive parent education programme, co-ordinated and integrated of services, continuity of carer, provision of information in appropriate format to facilitate choice and informed decision making, no reference to women with disabilities

Y

X

Guides services provided by Medicare

Y

Proposed

Paper discussing the importance of adopting a model of self advocacy for all women with disabilities, WWDA have committed to undertaking a number of initiatives to advance the human rights of women with disabilities

Y

Current

Information resource for people with disabilities and service providers, discusses how a person can apply for disability services, the assessment process which will be undertaken and the redress mechanisms open to the person

Y

X

Discuss the ACT government's role in the provision of disability services, refer to DDA (1991)

Y

X

A discussion paper which identifies the priority areas that will be addressed in women's health plan, advocates for a sexual and reproductive health strategy

Y

X

Provides information on the health reform programme, reproductive health services not discussed

Y

X

Provides guidance to service provides on the provision of information in appropriate format and how to effectively communicate with women with a disability

Y

X

Provides guidance to service provides on how to achieve an accessible physical environment for people with disabilities

Y

Current

Ten-year strategic plan for health services

Y

Current

Part 2 establish ministerial responsibility to develop a health strategy and a disability strategy

Y

Current

Objective 14 refers to women - improving the opportunities for women with disabilities to access appropriate disability services which will enhance their quality of life , treat women with dignity and respect, provide appropriate information about the services and how to access the services, effective communication accessible buildings, reproductive services not discussed

Y

X

Report on the progress made on the implementation of Disability Strategy, progress achieved on accessibility of services, access to built environment, disability training and awareness

Y

Current

Equitable and fair health service, accessible and appropriate services, information about services are accessible to all

Y

Current

Alternative choices, maternity care provided locally, continuity of carer, integrated services, information about services available to all, consult with disability organisation to removal barriers to care for people with disabilities

Y

Current

Sets the improvement of access to services as a goal for women, including those with a disability, but does not discuss action(s) to achieve this goal

Y

Current

Recognises the importance of reducing inequities in health service provision, services need to be more accessible, timely, culturally appropriate care, remove barriers experienced by women with disabilities and encourage these women to participate more in planning of care

Y

Current

Focus is on indigenous minority population, services need to be more responsive to the needs of a diverse population, improve access to care, conduct a needs assessment, develop culturally appropriate guidelines for assessment process, foster inclusiveness

Y

Current

Primary and specialist health services should be accessible and responsive to the diverse needs of people with disabilities

Y

X

Reports on the progress made in the 6 years since the inception and implementation of the Disability Strategy. Improvements noted in accessible environments, provision of information in alternative and appropriate formats, more positive attitudes towards people with disabilities, services more accessible; however, progress is slow, funding assigned to implementation programme is insufficient and there is no co-ordinated plan for implementation

Y

Current

Part 2 establish ministerial responsibility to develop a health strategy and a Disability Strategy

Y

Current

Sets out eligibility criteria practitioners must meet before applying for funding for services rendered

Y

Current

A framework of principles that will guide policy development and service delivery

Current

Sets out the direction for disability support services - outcome based approach advocated

Y

Current

Act which officially recognises New Zealand Sign Language as preferred language of deaf people

Y

Current

Framework to advance the health wellbeing of children

Y

Current

Access to built environment will facilitate inclusiveness, participation, all polices should consider accessibility to environment

Disability Action Plan

(2006-15)

Y

Current

A framework which policy makers in member states can refer to when designing, implementing and evaluating disability policies and strategies

Y

Proposed

Signatory states must take appropriate action to ensure that people with disabilities have access to the physical environment, to appropriate methods of communication, information must be provided in accessible and appropriate formats, states must ensure that people with disabilities are afforded the same range, quality and standard of healthcare as non disabled persons

Y

Current

Background to current disability policy - discusses policy in relation to accessibility, education, work and social security, supportive measures, Family life and personal integrity, health, housing, transport and culture. Maternity services not discussed

X

Refers to patients' right when accessing general healthcare

X

Refers to pregnancy and maternity but no reference to women with disabilities

Y

Current

Screening and assessment of psychosocial risk factors for depression

Y

Current

Routine assessment of depression and related problems during pregnancy and the postnatal year together with training for GP's, midwives, obstetricians, maternal and child health nurses, child protection workers and social workers

Y

Current

Maternity staff is responsible for identifying symptoms of depression during pregnancy. Screening tools, care plans and early intervention to prevent postnatal depression

Y

X

Main driver for policy recommendations involving the routine screening of all women for perinatal mental health disorders during pregnancy. Suicide and mental illness were main reasons for indirect maternal deaths in the UK

Y

Current

Women should be screened for past or present severe mental illness and for depression. Clinical networks should be instituted for prenatal mental health services

Y

Current

Highlights best clinical practice in relation to postnatal depression and puerperal psychosis

Y

Current

Recommends the introduction of psychosocial risk assessments for every women during prenatal care

Y

Current

Outlines best practice for the care of women with mental illness, their partners and their children during the perinatal period using a bio psychosocial-spiritual framework

Y

Current

Initiation of preventative measures in the early postnatal period; confirming postnatal depression with the Edinburgh Postnatal Scale (EDPS)

Y

Current

One adult psychiatrist and one senior nurse with perinatal experience should be appointed to act as a national resource in the provision of care to women with severe perinatal mental health problems

Y

Current

Recommended early interventions for postpartum depression and emphasised the need to protect the mother child relationship

Y

Current

Maternity hospitals must provide complete information about perinatal mental health disorders in the antenatal period and each woman is invited to complete a mental health assessment

Y

X

Pregnant women and those with new babies targeted by a campaign involving free advertising, free phone service, websites. Midwives are the main caregivers and are best placed to monitor and advise women about postnatal depression

Y

Current

Section 28 - Public bodies most ensure that information is in accessible formats for people with an intellectual disability.

Y

Current

No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

No specific reference to women / mothers with an intellectual disability and maternity care.

Current

According to the Sectoral Plan (Department of Health and Children, 2007a) and the Disability Act 2005 Year 1 Review (Department of Health, 2006a), the Health Service Executive have provided guidance and protocols to services on how to ensure communications are accessible to people with an intellectual disability. The Health Service Executive's National Communications Unit has instructed all services to review their communications to ensure they comply with Section 28 of the Disability Act 2005, in terms of people with intellectual disabilities.

Y

Current

Pregnancy and Disability (Royal College of Nursing, 2007) offers limited insight into the needs of women / mothers with intellectual disabilities accessing maternity care. This advisory document acknowledges that this group of women become pregnant and access maternity services. It encourages professionals to work collaboratively with professionals in the intellectual disability field and to ask parents / cares what is the best ways of communicating with the person with intellectual disabilities, rather than encouraging client empowerment and self advocacy for this group of women.

Y

Current

Acknowledges that women / mothers with intellectual disabilities may have specific maternity care needs but does not specifically refer to what those needs are or how they are best met. It does not offer best practice advice on how this should be legally addressed. No reference is made to the various 'Consent Legislation' within the UK i.e. England and Wales - Mental Capacity Act 2005; Northern Ireland - Guidance on Consent to Treatment 2003 and in Scotland - Adults with Incapacity Act 2000 (Scottish Executive, 2000a).

Maternity Matters: choice, access and continuity of care in safe services

(DoH, 2007)

Y

Current

To ensure that discrimination is not affecting this, and other groups of women, Maternity Matters reminds maternity services of their statutory duties under the Disability Discrimination Act (Parliament, 1995) e.g. that organisations need to conduct disability and gender equality impact assessments as a central component of policy development and service delivery so as to ensure equality for all at every level.

Briefly refers to women / mothers with intellectual disabilities twice. Firstly, in the introduction, it reinforces Maternity Standard 11 within the National Service Framework for Children, Young People and Maternity Services (Department for education and skills & Department of Health, 2004 & Department of Health, 2004a&b) i.e. the need for maternity care to be accessible to all women and address the specific needs of women / mothers with intellectual disabilities. No reference is made to what these women / mothers' needs are in this context, or how they are best met, but the strategy does acknowledge difficulties in gathering data on disability groups. The second brief reference advices partnership working between maternity and intellectual disability services, such as multidisciplinary community intellectual disability teams to help ensure this.

Y

Current

Reference made about people with an intellectual disability and advices partnership working between maternity and intellectual disability services, such as multidisciplinary community intellectual disability teams to help ensure this.

Y

Current

In terms of accessible information, the Department for Education and Skills have funded the publication of 'You and Your Baby' (CHANCE, 2004), but this is not usually given to parents with intellectual disabilities (Working together with Parents, 2008).

Y

Current

The Disability Rights Commission highlight the need for the Nursing and Midwifery Council and Nursing Council of Deans to develop pre and post registration curriculum materials on intellectual disability equality/access. The Disability Rights Commission also highlights that the needs of people with intellectual disabilities have not been a priority on the national agenda (Disability Rights Commission, 2006).

Y

Current

National Strategy for people with an intellectual disability. Principles are rights-based, broad and mainly aspirational. No specific reference made on maternity care. No specific reference to people with an intellectual disability and maternity care.

Y

Current

National Strategy for people with an intellectual disability. Principles are rights-based, broad and mainly aspirational.No specific reference made on maternity care. No specific reference to people with an intellectual disability and maternity care.

Y

Current

National Strategy for people with an intellectual disability. Principles are rights-based, broad and mainly aspirational. No specific reference made on maternity care. No specific reference to people with an intellectual disability and maternity care.

Y

Current

Review of Mental Health and Learning Disability Services in Northern Ireland. No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Review of Mental Health and Learning Disability Services in Northern Ireland. No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Guidance for nursing staff. No specific reference to people with an intellectual disability and maternity care.

Y

Current

In terms of the intellectual disability population, the National Health Plan for Norway (2007-2010) highlights the need for greater patient involvement in the development of health services, including maternity care. It acknowledges that some people with intellectual disabilities may not be best able to ensure their needs and rights are fully met and therefore encourages services to make greater use of relatives as advocates and also promotes the role of patient organisations in policy and service development. The Ministry of Health and Care Services also recognises the limited knowledge base of many health and social care professionals in meeting the care needs of people with intellectual disabilities.

Y

Current

No specific reference to people with an intellectual disability.

Y

Current

No specific reference to people with an intellectual disability.

Y

X

Has agreed to continue funding the advocacy group 'People First' for people with intellectual disabilities.

Y

Current

A 'plain-language' version of the Health and Disability Code of Rights for people with intellectual disabilities has been produced by the Health and Disability Commissioner

Y

Current

Minister of Disability Issues states there is evidence that the response to the sexual activity and reproductive health of women with intellectual impairment has been 'overmedicalised and over-managed'.

Recognises the limited health promotion and illness prevention information in accessible formats.

Y

Current

Reports that the Health and Disability Commissioner (HDC) has developed easy-read posters and pamphlets for people with intellectual disabilities and established a database of advocacy services in partnership with the Office for Disability Issues, and the Human Rights Commission (Health and Disability Commissioner, 2004).

Y

Current

Provides a legislative framework for meeting the needs of people, as defined by Section 7 (ID(CCR) Act 2003) as having an intellectual disability, and been charged with, or convicted of, an imprisonable offence whether or not they are subject to the criminal justice system (Ministry of Health, 2004 p.1). The Act and the Ministry of Health's guides accompanying it do not explicitly make reference to maternity care.

Y

Current

A Guide to Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003. No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Guidelines for the role and function of Care Managers under the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003). No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Guidance for the role and function of Special Assessors under the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003. No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Guidelines for Cultural Assessment - Mäori Under the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003. No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Information to help people with an intellectual disability understand compulsory care and how it might affect them and their rights. No specific reference to women / mothers with an intellectual disability and maternity care.

Y

Current

Review of Maternity Facility Access Agreement (Ministry of Health, 2007). No specific reference to women /mothers with an intellectual disability.