NHS catches up with equality legislation.

What do you think:

  • Does your GP or hospital always give you information that you can read and understand?
  • If not, does it mean that you miss out on appointments, treatment, care or health checks?
  • Does your health suffer?

It has taken the NHS 21 years, some significant disasters in care and its own internal Standard to take the law seriously: providing accessible information and communications as originally laid down in the Disability Discrimination Act (1995) and then strengthened by the Equality Act (2010).

Back in 2014, the Chief Medical Officer reported on the poor health outcomes for people with sensory impairments:  in addition to increased prospects of dementia or Alzheimer’s disease, people with blindness or deafness are more likely to have other long-term health conditions, anxiety or stress and have less confidence in managing our health (xx insert report link).  I wrote to her and blogged suggesting that our difficulties in getting information from the NHS was probably a significant contributory factor because our contacts with medical care are fewer and probably less successful.

Now the NHS has introduced a new Standard aimed at those involved in health care and adult social care to change how they treat patients, service users, carers and parents, where their information and communication support needs relate to a disability, impairment or sensory loss.

If you have information or communication needs (or look after someone who does):

  • tell your GP practice manager (ideally in writing) and;
  • give them permission to share your requirements with others in the NHS or adult social care (which saves you from repeating it).

Then they should flag your records and take action to meet your needs.

Act Now:  The more of us who ask, the better they should become and then we have more chance of better health in the future.


Penny Melville-Brown OBE

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000

Boasting about talent in the family.

What do you think:

  • Do you like the look of my house?
  • Know anyone who might like something similar?
  • Interested in supporting young artist?

160728 - House picture

My nephew, Toby, started out in car design (following in his brother Guy’s footsteps – designer of the new Honda Civic exterior).  But his true skill shone out in architectural illustration and other types of design.  I remember him as a very small boy always sitting at the kitchen table, pencil in hand and endlessly drawing.

He’s already had some very prestigious clients but still likes working at the personal and individual level – hence his venture in to home portraits: every one an original special to someone’s home.

Here’s his leaflet and you can see more of his work at http://www.tobymelvillebrown.com/


Penny Melville-Brown OBE

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000

Will halving the disability employment gap be a key test of “compassionate Conservatism”?

What do you think:

  • Did “disability vote” turn referendum in to democratic revolution?
  • Will halving disability employment gap be the test of BREXIT success?
  • Practical UK action better than EU strategies?

I’ve just been reading a rather bleak assessment that suggests that BREXIT risks removing much of the hard won protection of people with long-term health conditions and disabilities.  Yes, of course, the EU has been great in championing inclusivity and equal opportunities for us as a right rather than being optional.  But has all of this worked?

Even the Clear Company commentator acknowledges that “the objective of the European Commission’s European Disability Strategy 2010-2020 is to significantly raise the number of people with disabilities working in the open labour market. They represent one-sixth of the EU’s overall working-age population, but their employment rate is comparatively low at around 50%.”  So the EU as a whole hasn’t succeeded in this area and the numbers mirror the UK situation – not much evidence of success anywhere after decades of membership.

So do strategies and policies, directives and legislation really make a difference?  With the Equality and Human Rights Commission report from January this year suggesting that over 50% of UK small and medium sized businesses still discriminate during recruitment, the answer seems to be a resounding NO!  Perhaps we need to accept that all those words, worthy and well-meaning as they are, are little more than optimistic incantations.  So what could change reality?

  • Power to the people. It would be perfect if everyone facing work-place discrimination knew all about their rights, could get through employer processes and, if necessary, have easy access to a tribunal.  Wouldn’t it be sensible if they had to show that all of this is underway before being able to claim benefits? That way, publicly-funded support becomes the backstop to individual and employer responsibilities.  But life doesn’t quite work like that: people mostly ignore their rights until it is too late and ill-health makes it all too difficult; complaint procedures are often deliberately so daunting and interminable to deter anyone, let alone those already sick; successive Governments have effectively distanced the tribunal option – disabled people are well-known to have least means to cope with the contest and cost.  Legal stick is there but, in practical terms, is out of reach for most disabled people unless backed-up by a trade union or other support group.
  • Market pressure. Another perfect solution: unemployment so low that employers are scrabbling around for workers to the extent that they overcome their innate prejudices.  If BREXIT doesn’t create the fear-factored recession and there are no longer migrant workers filling the jobs that no-one else wants, there could be jobs aplenty for disabled people as long as they can accept the associated pay and work conditions.    Perhaps it was the “disability vote” that turned the referendum in to a democratic revolution – hoping that turning off the tap of worker supply would force employers to give more value to those already on their doorstep?  Entry-level jobs can be the start of new careers as employers discover that their fears were just based on ignorance.
  • Political will. Politicians, of whatever hue, will want to show that the new EU-free UK can successfully stand-alone for every part of society.  Failing any group would risk revealing the UK as institutionally unfair (and reinforce the EU sense of good riddance). And, having emphasised the “compassionate” agenda, there is no room to exclude the most vulnerable.  The short-term economic benefits may be less obvious: disabled people getting back to work will contribute to the overall economy and come off benefits but many may rely on tax credits and/or pay little tax.  But the longer term gains are more powerful: people progressing to more sustainable jobs, work ethos replacing inter-generational benefit dependency, more tolerant employer attitudes plus all the hearts-and-minds of caring politics.  With the Opposition benches in turmoil, the current Government has the time luxury to reap those economic benefits, evidence non-elitism and prove that it isn’t the Nasty Party.

So what might be the top tactics to move this all forward?

Target the willing.  If every disabled person who wants to work was helped to do so, we would be a long way down the road to halving the employment gap and more employers would know that we can do the job.  Instead of benefits sanctions, perhaps there should be penalties for employment support providers who fail their clients?  Plans to prevent “parking and creaming” within the forthcoming Work and Health Programme may still not be enough to make sure that every participant has more than a 50% chance of sustainable job success – but it all takes time, money, the right approach and, above all, employers willing to take on disabled people.

Upskilling.    Re-tool the learning and training providers so that they have the awareness and skills to improve the basic literacy, numeracy and IT skills of disabled people and help them translate existing work experience in to new vocational attributes.  The plans to make apprenticeship Maths and English eligibility more accessible is only a first step and won’t work if those training and employing the apprentices aren’t ready to play their part.

  • Tackle employers. There’s a whole business and trade Department that can persuade – with stick or carrot – and should be held accountable for changing employer behaviour.  Employers are the “elephant in the room”:  there can be pressure on individual benefit claimants, incentives for those who support them and funding for new programmes but, if employers still discriminate, it is rather like hitting your head against a brick wall.
  • At least double the Access To Work support funding and promotion. Show employers that the Government is confident that disabled people can contribute to the workplace in the most practical way they will understand,  put the whole system on a statutory basis so that employers know how the system , decision-making and disputes work, and promote everywhere.

So simple!

Penny Melville-Brown OBE

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000

Letter to Damian Green at DWP.

Dear Damian,

Congratulations on your new role as Secretary of State in charge of a Department that can change so many lives for the better – and is going to be at the forefront of the Conservative’s inclusive and compassionate agenda.  Here are some different perspectives to that massive pile of briefing notes you are ploughing through!

What do you think:

  • Has the Department been making the most of disabled people’s desire to get back to work?
  • Do you need support from other Departments to halve the disability employment gap?

Is the new Work and Health Programme going to be radical enough?

The recent Work Foundation paper on halving the gap rather pulls the punches.

It doesn’t quite make the point that, to have fewer unemployed disabled people in the future, it makes sense to consider those currently working despite long-term health conditions/disabilities and stop them dropping out of their jobs.  This would suggest targeting health interventions at:

  • those with more than one such condition (likely to be amongst the growing band of older workers aged 45+)
  • those conditions posing most risk to continued employment and
  • those conditions that could be most likely to present re-employment barriers if current jobs are lost (such as mental ill-health).

Surely this is a simple matter of crunching the numbers and the cross-Departmental costs of such interventionist treatment v benefits/lost tax and productivity/further treatment for other unemployment-caused conditions etc?

They do recognise that lots of people with long-term health conditions and disabilities want to work.  They suggest perhaps 50% of those with mental health conditions as an example – this sort of level has been the pan-disability rule of thumb for many years. The impact of such desire to work can be powerful – they cite the success rates of the Work Choice programme which, despite its recognised tendency to “cream and park”, could have been even more impressive if work under 16 hours per week had been counted (one has to start somewhere).  But they don’t quite explain how such desire can be sustained in the face of unsuccessful employment support or Jobcentres actively shedding disability expertise and assuming a policing role.  If you’d previously been on Incapacity Benefit, would you go anywhere near a programme that offers nearly 90% chance of failure, doesn’t understand your situation and could impose sanctions that further damage your health?  All of this goes to the very heart of future employment support that needs to make the most of the willing so that the hearts and minds of the more reluctant will follow.

Significantly, the paper concentrates on what employment support is available/successful without tackling the continuing high-levels of prejudice and discrimination prevalent amongst the largest group of employers (see the Equality and Human Rights Commission report on businesses employing under 250 people – January 2016).    And, of course, inadequate funding, poor promotion and arbitrary decision making on Access To Work support hardly breeds employer confidence.  So our horses are already thirsting to work but the trough is pretty dry!  Its going to take something much more wide-ranging and innovative than the “Disability Confident” initiative to resolve.

The paper utterly ignores self-employment and the poor showing of New Enterprise Allowance.  The NEA success rate for disabled people should be significantly higher when taking in to account:

  • Disabled people make up the large majority of claimants eligible for NEA.
  • Self-employment is at a historic high.
  • Disabled people who work are more likely to be self-employed than their non-disabled peers.

This whole work option seems to have been side-lined for those who may use it most.  Complete re-design of NEA is probably needed but, in the short term, contract managers should be checking on how well providers are complying with equality legislation.

The Work Foundation recommendation of closer links between DWP/Jobcentres and NHS Clinical Commissioning Groups and business-led Local Economic Partnerships seems eminently sensible.  But only until one considers that Jobcentres have no great success record with disabled people and is actively reducing specialist support, the NHS doesn’t see work as a health outcome and LEPs are driven by business growth.  There would need to be a radical shift in their respective priorities and, most importantly, their engagement, knowledge, understanding and capacity to undertake such roles – none of which is currently readily apparent.  So possible but only with really strong political direction.

The paper recognises many of the shortfalls of current policy but probably needs to be more radical – isn’t it time to strike out those processes and provision that actively undermine success?  What is the point of the costly Work Capability Assessment – it’s effectiveness and credibility is eroded by the huge appeal rate, it doesn’t take account of other key employability factors and it dissuades people from engaging with the system.  There must be better ways of identifying those for whom any form of work is never going to be a realistic prospect (if such is needed in the first place).   Likewise, the concept of large contracts with multiple tiers of sub-contracting not only puts huge distance between the living, breathing human beings and contractors’ decision-makers but tends to force out the small, specialist and local providers that can better engage and support those furthest from work.  And perhaps DWP itself would be more successful in managing contracts on a smaller scale too?

Future employment support should exploit the innate desire to get back to work through smaller, local and more manageable contracts that integrate specialist provision; consistent data and evaluation of skills, work, health and social inclusion outcomes could realise cross-Departmental support and benefits (and achieve Departments’ social value goals and equality objectives – everyone gains).

There are lots of us with good practical experience in this field and who share your goals.  Please use us as you design the policies and processes to make your tenure an outstanding success.  Good luck!

Penny Melville-Brown OBE

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000

Layers of buried history and chocolate shape Perugia’s 600 years.

What do you think:

  • How has 600 years shaped Perugia?
  • What’s it like to smell history?
  • Blind people getting their tax allowances?

 How has 600 years shaped Perugia?

Throughout the weekend of 11/12 June this year, Perugia was alive with a joyous cacophony of crowds cheering tug-of-war contests and bands of drums and horns competing for maximum volume.  Shops were decked out with medieval costumes and, before the next deluge, citizens paraded to celebrate their traditional skills: from the armourer to the farmer followed by his sheep, goat, chicken and duck!

Umbrian locals doubtless commend this regional capital as a city.  But the hill-top intimacy, cobbled streets, stone homes and piazzas speak of the community growing from roots entrenched in living tradition.  That underground history bustles to this day with locals’ short- cut alleys casually offering visitors insight in to the very foundations: layers of cellars and storerooms surviving the centuries’ cycle of destruction and regeneration.   The temperature drops and the air is filled with the smell of damp earth as the escalator descends from street level to ancient paving – sounds re-bounding, hand-made bricks and rough stone.

Re-surfacing to warmth and light, a short stroll will circumnavigate the centre with stops for spectacular views and shopping forays (not, I’m told, a chain-store in sight).  Ceramics feature majolica from near-by Deruta and, while stores offer home-produced oils, cheeses, meats and more, it is the Baci chocolate factory and emporia that have re-shaped the local economy and gained international currency.

What a privilege to be there marking a date in1416 – it made one feel like rather a newcomer to civilisation but part of a much longer continuum.

Blind people getting their tax allowances?

The UK Blind Person’s Allowance is an extra amount of tax-free allowance. It means you can earn more before you start paying Income Tax. The allowance is £2,290 in 2016-17. The allowance is the same for everyone who is entitled to it, regardless of age or income. It is added to your yearly Personal Allowance.  The Blind Person’s Allowance can be transferred to a spouse and backdated to the previous four tax years if you were eligible during that time.

Marriage tax Allowance

The UK Marriage Allowance lets you transfer £1,100 of your Personal Allowance to your husband, wife or civil partner if both are eligible, saving up to £220 in tax in 2016-17. This transfer will increase their Personal Allowance and reduce your own Personal Allowance. You can apply for Marriage Allowance if you meet all the following conditions:

  • you’re married or in a civil partnership
  • your annual income is £11,000 or less
  • your partner pays tax at the basic rate
  • you and your partner were born on or after 6 April 1935

Special support from HMRC.

With more tax forms and information now being on-line, you can get extra help from your friendly tax man or woman if you explain that your health condition makes using IT too difficult.


Penny Melville-Brown

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000


Guitars make great pasta.

What do you think:

  • Tried cooking in Umbria?
  •  Social networking easier “hands-free”?
  • Lost touch with old pension contributions?

Tried cooking in Umbria?

A traditional old farm with its own vineyards and olive groves is the perfect place to learn about this robust rural regional cuisine.


There’s lots of emphasis on vegetables plus pork and game but little fish (just one lake species or dried cod).  Umbrians have become really enthusiastic about chilli over the last ten years –they grow, dry and grind to make fierce powder that heats many a recipe.  Salt is used with alarming liberality – a handful for the pot of pasta water but none in the local bread which all dates back to a medieval Pope and his salt taxes.  Typically, olive oil and garlic or onions are heated in a pan from cold to flavour the oil and wine is added as a “seasoning” so simmer off the alcohol of a glass or so rather than the half bottle.

Rosemary and I weren’t the easiest students for Italian fare: one no cheese, one no gluten.  But Raffaella still managed to help us produce a great selection of antipastos, gnocchi, spaghetti (how could I have lived without a pasta guitar?)

rabbit, guinea fowl, chicken, pork dishes – and four typical Italian dessert cakes.  Each morning’s cooking with just two other students produced our four-course lunch with left-overs for supper and indulgent breakfasts (cake!)

The season was late or we would have used more of the farm-grown vegetables along with their own jams, olive oil (cold-pressed extra virgin) and wines that are all produced by her undauntable mother-in-law.   In the stone barn conversion, we each had our own “apartment” of living/dining/kitchen room, bed and bathrooms – and could sit outside under the vines sipping wine or having breakfast.  The rain started in the first hour and built to crescendos of thunder and land-slides over four days but, with so much to do and enjoy, we barely noticed.View from farm

Now I’m back home practicing the recipes– new guitar to hand and a whole 5 litre can of oil surfaced from my luggage.  It’s probably heretical to add orange zest to torta caprese but it does go well with the chocolate and breadcrumbs at least add texture in place of parmesan.  (Thanks to Rosemary for the images!)

For more information about the farm and courses:  Let’s Cook in Umbria – Italy

Strada comunale San Marino 25 06125 – Perugia (Italy); +39 075 5899951/ +39 075 7823188/ +39 3406461480


 Social networking easier “hands-free”?

If using a keyboard or text fields is just so difficult or boring that you don’t meet new people on-line, can’t find out new information or just miss out on networking worldwide, try the new Vorail app.  Once you have set up an easy profile (no images or photos needed), you can simply leave voice messages for others to hear and reply to.  Visit: http://eab.li/1n ; Download Vorail for free at the Apple iOS App Store: http://eab.li/1p .

 Lost touch with old pension contributions?

If you have worked for different employers and paid in to their pension schemes, it can be easy to lose touch with what you will be entitled to.  There is a new database on www.gov.uk where you can enter the details of past employers so that you contact them and check out any pension you may be due.

Penny Melville-Brown

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000

Poor accessibility review for Rome – but great assistance.

What do you think:

  • How to pick up men in Rome?
  • Accessibility more than just lifts and ramps?
  • Physical impairments limit work in the fitness industry?

How to pick up men in Rome?

Relaxing at destination


Completely impossible to book passenger assistance at the main Termini railway station in Rome –lots of long-distance phone calls rang impregnable option menus but never quite connected with a living, breathing human.    It feels rather like a metaphor for modern life.

Faced with a trolley-free panorama, I and utterly diminutive co-traveller, not-quite-shoulder length Rosemary, exerted our double death grip to drag stacked luggage towards the distant horizon beyond the station’s 20-odd platforms.  As Number 1 hove in to view, we knew that the struggle was succeeding –the medley of directions had all confirmed our train was just around the corner and along a bit.  Celebrations all round and Rosemary deployed on lunch logistics.

Nonchantaly confident, I stood guard over the bags and surveyed the station soundscape (basic building site).  Same sensors picked them up: incoming at 12 o’clock and another to starboard; close range; Intelligence limited but signalling native, purposeful, non-hostile – General Alert but Hold Fire.  “Are you Penelope and where is your friend?” was subtle opening gambit: superior Intel on force composition and deployment.  Need to avoid friendly fire and decode remaining unintelligible message.  Colossus-like, the enigma came through en Claire: SIGINT discarded as phone calls had target-error; honey trap HUMINT source confirmed as conversational airport assistance (code name Guiseppe) deploying tradecraft to side-step the system.

OK, it was two of the station assistance chaps offering us a lift in the buggy –but how was I to know? And, when Rosemary got back, we had to be persuaded that just around the corner and along a bit really justified the help.  But it seemed discourteous to decline. Buggy was duly mounted and Rosemary consigned to luggage bay.  Off we trundled, round the corner and on a bit – and a bit more and then a very lot more: down slopes and up again, out of the main station, along seemingly endless stretches of concrete with no perceptible alternative life forms except the odd birdsong.  It measured at least a mile by buggy and an impossible 10 by bag-dragging foot – we would never have made it alone.  Our laughter became increasingly hysterical as we realised the disaster so narrowly adverted.

Lessons learned:

  • Be as chatty and nice to anyone who helps you – you never know when you might need them and their friends again.
  • Tempering flight or fight urges is one of the advantages of being blind.

Taxis can be safer and easier – but far less exciting!

Accessibility more than just lifts and ramps?

Even leading UK retailer Marks and Spencer has realised that awful music doesn’t improve our shopping experience.  And you can imagine that noisy venues are even more difficult for people who rely on their hearing, have hearing loss or find that volume disturbs their mental health – we just spend our money elsewhere.  The new international Access Earth website allows anyone to rate venues on their accessibility and provide comments about places to eat and drink, sleep, shop and do other activities.  Hopefully they might extend this to other less-optional venues such as doctor and dentist surgeries, schools and colleges, hospitals and other public buildings such as Jobcentres and Council offices.  There will be a mobile app too in a couple of months.  Visit: http://eab.li/1m

Physical impairments limit work in the fitness industry?

Of course not.  We all know that physical impairments don’t stop sports fanatics competing at the highest level such as the Paralympics.  So it makes complete sense that work in the fitness and leisure industry can also be open.  The award-winning “Instructability” programme run by charity Aspire is one route to such jobs.  Visit: www.aspire.org.uk


There’s also a vacancy for a part-time “inclusive sports coach” in Liverpool – a good way of getting on to the sports and leisure industry ladder.  For an application form, or if you have any further enquiries or issues, please contact Daisy Inclusive UK on 0151 261 0309 or email info@daisyuk.com – closing date for applications is 8 August.


Penny Melville-Brown

Disability Dynamics ltd www.disabilitydynamics.co.uk

Helping disabled people to work since 2000