Most reasonable adjustments cost less than £100, whilst many cost nothing at all and simply require a change to a process or a policy.
The benefits of making reasonable adjustments
Whilst it is important to consider the legal context, putting in place some simple adjustments can have a positive impact on the wellbeing, experience and performance of the workforce.
Workplace adjustments can make an organisation a more attractive place to work and can contribute to the development of inclusive working environments and cultures by:
- Helping people to feel more valued, confident and supported in their job and in working towards their career aspirations.
- Improving employee engagement and staff experience, which in turn will increase staff retention.
- Providing higher levels of productivity and reducing levels of sickness absence.
- Reducing levels of harassment, bullying and abuse.
- Increasing understanding amongst senior leaders, managers and colleagues about diversity, equality and inclusion in the workplace, which in turn, will help to improve patient care and outcomes.
How to start implementing adjustments
Managers should use every opportunity to ask their staff whether they need any adjustments; this can be done through:
- One to one meetings
- Health and wellbeing conversations
- Keep in touch meetings (KIT), when people are off on long term leave (sickness and maternity)
Under the Equality Act 2010, a person is recognised as disabled if they have a physical or mental impairment or condition that is either visible or hidden, that has a substantial (more than trivial) and long-term (12 months or longer) impact on their ability to do normal daily activities. However, this definition can be perceived to contain negative language surrounding disability and might not reflect lived experiences of the disabled community. We believe in the social model of disability, that people are disabled by barriers in society and not by their impairment or difference.
Reasonable adjustments are changes that are made to remove these barriers and allow disabled people to participate equally in all aspects of life. This can include changes to the physical environment, such as installing ramps or lifts, or changes to the way things are done, such as providing sign language interpreters or allowing flexible working hours.
Organisations have a legal duty to make reasonable adjustments in the workplace for disabled staff and service users.
To begin the reasonable adjustments process, it is important that employers consider the following questions:
- Can adjustments be made to the way in which the employer works and operates (defined as provision, criterion or practice under the legislation)?
- Can changes be made to the physical features of a workplace to overcome any barriers that may exist?
- Can extra equipment (auxiliary aids) or assistance (auxiliary service) be provided to support any staff?
Employers should consider adjustments for:
- individuals working for the organisation, for example alternative communication methods
- individuals applying for a job with the organisation, for example, giving more time to a candidate with dyslexia to do any written or reading tests that are part of the interview process
- individuals who tell an employer that they are thinking of applying for a job with them, for example alternative formats of the job advertisement if requested
Individual access needs can change over time and anyone can become disabled at any point in their lives. Therefore, employers should ensure they are aware of these changes and not make assumptions.
Employers will also need to consider adjustments for a range of people who will be working in a variety of capacities. For example:
- Permanent staff in clinical and non-clinical roles
- Bank staff
- Students and doctors in speciality training (trainees) who may be on placement within the organisation
When placing students or trainees, consideration should be given to the individuals facing barriers that may potentially impact on their training. Placement providers will have a responsibility for assessing and implementing reasonable adjustments if required. The need to consider adjustments should not be a reason for not offering an otherwise suitable placement to a student or trainee.
What is reasonable?
There are some factors which employers might want to consider when deciding which adjustments are reasonable:
- How effective the change will be in removing, reducing or preventing the barrier someone may experience
- The practicality of making the adjustment
- The cost of the adjustment
- The employer’s resources and size
- The availability of external financial assistance
As no two employers are the same, what may be reasonable for one employer, may not be for another. Regardless of these differences, the aim is to remove any substantial barrier that a person may experience in the recruitment process or within the workplace.
In some cases, individuals are asked for evidence of disability or evidence that a particular adjustment would be beneficial. There are some circumstances where this is required, but often, the cost of the adjustment is lower than the cost of the employer putting a request through an occupational health department. A general practitioner or occupational health referral can also delay the process significantly for the individual. It is not always necessary to insist on evidence where it is obvious that the adjustment would be beneficial.
The cost should be factored into decisions as to whether an adjustment is reasonable or not. Most reasonable adjustments cost less than £100, whilst many cost nothing at all, and simply require a change to a process or a policy. For example, an employee with chronic fatigue syndrome may find it helpful to work from 8am to midday and then from 1.30pm to 5pm, so they can have a rest during the middle of the day.
Where costs are higher, assistance is available through the Access to Work scheme, which reimburses the costs of equipment, adaptations or support worker services. Organisations should familiarise themselves with the scheme, gain expertise and see the benefits it can bring to both the employee and the organisation.
The importance of a reasonable adjustments policy
Organisations should ensure they provide clear guidance and have a comprehensive, equitable and practical reasonable adjustments policy which outlines the step-by-step process for requesting reasonable adjustments, examples of the support available and the role of different functions such as Human Resources (HR), occupational health and Information Technology (IT).
Many organisations have policies in place, some specific to reasonable adjustments and some linked to absence or wellbeing policies. Some examples are:
Raising awareness of reasonable adjustments
Some measures can help to raise awareness of disability and reasonable adjustments, for example:
- Include information on staff intranet pages about trust building sites such as disabled parking, lifts, doorways etc.
- Include information in staff and manager inductions about what resources are available to support staff with reasonable adjustments, for instance health passport, access to work, disability and carer's leave and staff networks.
- Any team events (including out of hours) consider reasonable adjustments.
- Disability and carer awareness training attended by teams rather than just optionally by individuals.
- Have signs at reception trust sites to show what equipment is available for physical meetings, such as hearing loops.
- Ask colleagues and external stakeholders prior to online meetings if anyone needs any reasonable adjustments.
NHS Health passport
Employers may want to consider introducing a NHS health passport which allows individuals to easily record information about the individual barriers they face, and any reasonable adjustments they may already have in place.
The passport helps to ensure there is a clear record and can be used with new line managers to explain what is needed in the workplace to help them carry out their role.
It may also be beneficial to use the support that your local occupational health team can offer to help improve staff wellbeing within your organisation.
Good practice videos
We have produced a suite of videos detailing individual stories of NHS staff who have received workplace support that has enabled them to thrive in their roles:
- An introduction to inclusive recruitment in the workplace
- Paul Belk - a payroll officer at Northumbria Healthcare and a wheelchair user with neurological differences.
- Haseeb Ahmad - a Diversity and Inclusion Lead at Leicestershire Partnership NHS Trust who is partially sighted.
- Naomi Harris - an occupational therapist at East London Healthcare Foundation Trust who is dyslexic.
- Emma Wood – a deputy CEO and director of people at Gloucestershire Hospitals NHS Foundation Trust who has a hidden disability.
- The NHS Health Passport allows individuals to easily record information about their condition, any reasonable adjustments they may have in place and any barriers they face.
- Information on reasonable adjustments in return to work from the NHS Employers ‘Everything You Need To Know About Sickness Absence’ guide.
- Disability equality in medicine from the BMA looks at the experiences of disabled doctors and medical students.
- Employers guide to supported employment produced by the National Development Team for Inclusion.
- Trades Union Congress: Reasonable adjustments model disability passport policy (pdf) and model workplace policy (pdf)
- Diversity and Ability’s AXS passport allows individuals and organisations to record information about their access needs, the barriers they may face, without having to disclose.
- The Empowerment Passport which is a digital platform enabling individuals with long term health conditions or disabilities think about and communicate their unique adjustment needs.
- Managing reasonable adjustments in the workplace
- Managing disability related absence
- Improving disability declaration rates
- The role of senior leaders in supporting the workforce.
- Recruiting and retaining diverse staff - manager responsibilities
- Developing WDES annual reports and action plans
- Learning Disability Employment Programme
Other organisations that can provide support
- Advisory, Conciliation and Arbitration Service (ACAS) provides helpful information on reasonable adjustments.
- Access to Work offers employers assistance by reimbursing the cost of equipment, adaptations or support worker services.
- The Business Disability Forum works in partnership with business, Government, and disabled people to remove barriers to inclusion.
- The Equality and Human Rights Commission provide an explanation of what a reasonable adjustment is in a video, along with practical examples and a guide to employment workplace adjustments.
- The Government has provided guidance on reasonable adjustments for workers.
- Disability Confident shares examples of where reasonable adjustments have supported staff in work.
- Disability Rights UK provides lots of practical guidance, including a summary of the Access to Work scheme.
- Diversity & Ability can provide audit support for recruitment and reasonable adjustments processes, as well as provide external specialist support.