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Jump to Key Points For people with disabilities across Europe, accessing healthcare means facing obstacles that can delay diagnoses, limit treatment options, and contribute to poorer health outcomes.
“The problem isn’t a wheelchair; it’s a hospital where stairs are the only way in. The problem isn’t that a person with a psychosocial or intellectual disability can’t understand their diagnosis or treatment; it’s a healthcare system that fails to provide information clearly and accessibly,” Vera Bonvalot, an executive committee member of the European Disability Forum, told Medscape News Europe.
Nearly 1 in 4 people aged 16 years or older in the EU reported some degree of activity limitation in 2024. Of these, 17.2% reported some limitations, and 6.7% reported severe limitations. People with disabilities are also four times more likely to have unmet healthcare needs that contribute to poorer health outcomes and shorter life expectancy, according to the European Commission’s guidelines on improving healthcare access for people with disabilities.
“The European Union and most of its member states have agreed to uphold the United Nations Convention on the Rights of Persons With Disabilities, but there is a gap between the rights recognized by the Convention and their implementation in everyday life,” Bonvalot said.
- EU: 24% report activity limitation; 6.7% severe limitation.
- Disability linked to 4x higher unmet healthcare needs; worse outcomes.
- Access barriers: stairs, poor communication, inaccessible formats, limited adjustments.
- Ask patients directly; document needs early, e.g., Reasonable Adjustment Flag.
- Diagnostic overshadowing can delay dx; staff training in disability inclusion needed.
“No country in Europe is doing great. Some countries have more conscious systems than others, such as the Scandinavian countries, but there’s an overall challenge,” Stelios Charitakis, PhD, senior consultant on equality at ICF Consulting and one of the authors of the European Commission’s study, told Medscape News Europe.
Although addressing these inequalities requires changes to healthcare policy, infrastructure, and funding, clinicians can take practical steps to make everyday care more accessible, said Sara Rotenberg, PhD, an assistant professor at the International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine (LSHTM) in London, UK.
Ask Patients, Don’t Make Assumptions
Making healthcare more accessible begins with a simple conversation about what each patient needs. “It’s all about having an open conversation with patients about how they can be best supported, just as you would with any patient. Asking specific questions about accessibility rather than making assumptions about what someone might need is really useful,” said Rotenberg.
These conversations can help clinicians identify practical adjustments, such as offering longer appointments, delivering information in more accessible formats, or providing a quieter consultation space, said Hannah Kuper, PhD, founder and co-director of the International Centre for Evidence in Disability at the LSHTM.
She said one approach is the UK’s Reasonable Adjustment Flag, which allows healthcare professionals to record accessibility requirements in a patient’s health record. A flag alerts staff to adjustments that may be needed during future appointments.
Kuper suggested discussing these requirements when patients first register with a healthcare service, allowing staff to anticipate their needs rather than responding only when difficulties arise. “Even when an adjustment of this kind is already in place, it’s worth considering how it could be implemented more effectively,” she said.
Accessible Communication
Communication barriers can prevent patients with disabilities from understanding their diagnoses, discussing treatment options, and making informed decisions about their care. Milan Šveřepa, MA, director of Inclusion Europe, Brussels, Belgium, said that healthcare professionals should speak directly to patients, even when family members or caregivers accompany them. “It’s mainly about working directly with that person, taking their choices into account, and explaining everything clearly so they can make informed decisions about their health, just as you would with anyone else,” he said.
Bonvalot suggested that clinicians begin by asking a straightforward question, such as: “What is the best way for us to communicate with you?” This could involve using plain language, easy-to-read materials, Braille, large print, captioning, or sign language interpretation.
Accessible communication is also essential to informed consent. Patients must be able to understand the potential benefits, risks, and treatment alternatives and participate meaningfully in decisions about their health.
“Consent is more than signing a form. Clinicians must explain the treatment, its benefits, risks, and alternatives in an understandable way. They must also respect a person’s right to accept or refuse the treatment,” Bonvalot said.
Avoiding Diagnostic Overshadowing
Making assumptions can lead clinicians to overlook symptoms because they may attribute these to a patient’s existing disability rather than investigating other possible causes. This phenomenon, known as diagnostic overshadowing, can contribute to missed or delayed diagnoses, Rotenberg said.
These biases can affect access to preventive and routine healthcare. Women with disabilities, for example, may encounter barriers to sexual and reproductive healthcare because clinicians make assumptions about their sexuality or ability to have children, she said.
“In many cases, symptoms experienced by people with disabilities are assumed to be part of their disability, so they don’t receive proper treatment.” Šveřepa agreed.
To challenge these assumptions and ensure more equitable access to healthcare, Charitakis stresses the need for comprehensive training in two key areas: integrating disability awareness and accessibility into healthcare education curricula, and providing healthcare professionals with practical, hands-on training throughout their careers.
“Disability inclusion is not a luxury; it’s not a nice thing to do,” said Kuper. “Because of a failure to include, people are dying when they shouldn’t.”
Bonvalot, Rotenberg, Kuper, and Šveřepa reported no financial relationships. Charitakis’s research received funds from the European Health and Digital Executive Agency (HaDEA) and the European Commission (DG SANTE).
Luca Arfini is an Italian science journalist and communications specialist based in Amsterdam, with expertise in health, sustainability, and EU policies.
