Roger Gullidge reviews what steps need to be taken to make a practice wheelchair compatible.
Not having access to a dentist with disabled access can put someone with limited mobility off seeing a dental professional. So making sure they can access your practice is incredibly important, even if it isn’t always the easiest process. People with limited mobility need to be able to receive dental attention with minimal difficulty. Under the Disability Discrimination Act (DDA) ‘reasonable adjustments’ should be made to premises to make sure this is possible. When building a new practice or refurbishing your current one, actions will need to be taken to make sure that any patients who use a wheelchair can access the facilities. Though it is likely there will be PCT requirements regarding what should be provided, the legal requirements will be found in the building regulation's requirements under various headings.
When we think of making a dental practice suitable for wheelchair users most of us immediately think of making it practical for disabled patients. However, the possibility of employing disabled staff will also need to be taken into consideration. For instance, it is a little known fact that a typical dental practice does not have to provide its patients with a toilet (as they are not deemed to stay for a sufficient length of time to require the use of one). Legally toilet facilities are only required for staff. So, the possibility of hiring, for instance, a receptionist who uses a wheelchair must be contemplated during a refurbishment or new build and measure must be taken to accommodate this occurrence. The height of the reception desk and the position of the privacy panel are also quite an important DDA requirement.
Whether your practice is on the first floor or the ground floor will effect how you are able to make your practice suitable for a wheelchair user. Being located on the first floor raises additional requirements when it comes to compliance. For instance, a stair lift should be provided if possible and a new build is expected to install a lift if there are two floors. This can obviously be an expensive demand to implement, but there are several different grades of lift, so it can work out cheaper than expected.
One feature that should be installed during a refurbishment is a fully DDA compliant toilet. This will need to be 2.2m by 1.5m with a 1m wide door that opens outwards. The reason the door must open outwards is that in the event that the wheelchair user falls from their chair and lands against the door, nobody will be able to get in to provide assistance. If the practice has insufficient space for a door that opens outwards, special door furniture is available with hinges that allows the door to open both inwards and outwards. A pull wire must also be installed in a disabled toilet, this will alert staff to an accident. The toilet will need a Doc M Pack which includes safety rails and other fittings that will assist a disabled user. The main difference between a refurbishment and a new build when it comes to disabled toilets is that a new build must have a door that opens outwards. It is considered that plans should be made to accommodate this and as such the door with custom hinges and so on will not be adequate to meet compliance.
In terms of the surgery itself, making sure there is enough space for a patient in a wheelchair is of paramount importance. The door to the surgery, unlike a disabled toilet, does not need to be 1m wide as an 838mm or even a 762mm door will suffice. It doesn’t matter which way the door to the surgery opens as the patient should be accompanied by a member of staff who will be able to help them. The most important aspect is to make sure there is enough room on one side of the dental chair for the patient to be seen without having to get out of their wheelchair. As well as space allowance, it must also be made sure that all dental equipment can comfortably reach the patient.
When refurbishing appropriate ramps should be installed at the entrance of the practice. The gradient of the ramp can vary from 1:12 to 1:20 depending on the length available for the ramp; the ramp should be 1,500mm wide. If the ramp changes direction a level landing area must be provided, a landing area must also be provided at the top of the ramp. The door at the top of the ramp can be a standard door opening inwards, but electronic sliding doors are preferred, ideally operated via pushing a button. A ramp alone will not suffice for all patients. Elderly patients may find negotiating a ramp more of a struggle than steps, so it is required that a practice gives its patients access by both. Ramps will also require appropriate handrails that are easy to grip, visually contrasting and constant throughout the flights, ramps and landings. On new builds ramps must be provided.
When refurbishing, the entrance requirements for the building are less ominous, however on new builds there are set guidelines. Most external doors have a step/threshold (to stop rain and so on from entering the premises) but a new dental practice will need a level threshold or one of no more than 15mm at the entrance. It is also required that the door handle is ‘warm to the touch’, though some practices are eliminating door handles completely by using sliding doors which are triggered by sensors.
A new build must be sure to provide at least one disabled parking space for patients, depending on the capacity of the car park more may be required. These parking spaces need to be located immediately by the practice entrance and must be clearly visible to all who enter the car park.
For a new build, there is also a regulation regarding the safety of a wheelchair user on the first floor in the event of a fire. A suitable emergency voice communications system and signage is required in a wheelchair refuge area, with communication to a suitable location at ground floor level for fire service use. If a fire were to occur, the team member looking after the wheelchair user, or the wheel chair user themselves, may need to notify authorities of the emergency. This is why there needs to be an area with a call point.
There is a lot to be considered when making a dental practice accessible for a wheelchair user, more than can be explained in his article. Complying with the regulations may at times seem taxing or expensive but ensuring everyone has access to dental health care makes it worthwhile.