Gateways guidance : 5.1 The anticipatory duty

The anticipatory duty is the requirement to prepare for the inclusion of all disabled students, not just specific individuals. Medical schools should not wait until a disabled student has begun their course before making adjustments, as they may find they are already in breach of the law. Medical schools need to think ahead about the needs of a wide range of people with different impairments and plan to improve services accordingly.

Fulfilling the anticipatory duty makes a real difference:

1. ‘Instead of identifying problems early on, and therefore having systems in place in advance should problems arise in the future, the attitude seems to be one of ”waiting and seeing”. This then means months are wasted, and in my case I had to take a year out whilst things were put in place in order for me to return to work. I feel there should be more of a standardised system for people who declare that they have a disability, even if it is not affecting them greatly as a student.’
2. Medical student
3. ‘Bristol strongly encouraged me to apply on the basis that they had an “access for deaf students” initiative, and would therefore be able to obtain all the necessary equipment and support I needed.’
4. Medical student

Medical schools should review all their estates, policies and practices to determine the reasonable adjustments that will remove potential barriers that may prevent people with a range of impairments from successfully applying to the school or succeeding on their course.

The reasonable adjustment duty has been strengthened under the Equality Act to clarify that it is almost always reasonable to provide information in alternative formats. In meeting the anticipatory duty and the strengthened reasonable adjustment duty it would be prudent therefore to consider the need to ensure that information is as accessible as possible for students.

The following are examples of areas worth considering:

• making notes available in electronic format to enable the use of assistive software, for example, for visually impaired or dyslexic students
• forming links with specialist organisations in case help is needed
• ensuring that material on the intranet is compatible with specialist software that might be used by, for example, visually impaired or dyslexic students
• making budgetary provision for unanticipated adjustments that might be needed especially by overseas disabled students who are not eligible for Disabled Students’ Allowances
• drawing up clinical attachment policies
• drawing up assessment methods and processes
• ensuring that the estates division is fully trained in systematically planning and costing improvements.⁶

The following physical features should be reviewed as part of the anticipatory duty:

• access to buildings, such as level or ramped entry
• emergency evacuation arrangements, such as flashing light fire alarms or vibrating pagers for deaf people
• fire refuges or alternative escape routes for people with mobility impairment
• accessible external paths and landscaping
• easy routes and interior layout within buildings
• effective lighting and signage, and colour or tone contrast on doors and walls to aid orientation
• acoustics appropriate for hearing aid users, and working loop systems in lecture theatres and reception desks
• desks, laboratory benches, work surfaces and reception desks at different or flexible heights
• appropriate seating
• access to services, such as catering facilities or payphones
• accessible toilets
• convenient and reserved parking spaces.⁷