Reasonable adjustments: 15 recommendations for employers

How:

• Explicitly acknowledge the diversity of disabilities and the potential impact of intersectional discrimination, emphasising your organisation’s role in destigmatising neurodivergence and mental illness.
• Hold the appointed Board member and an operational lead accountable for delivering the agreed actions through an annual performance review as part of their job role.
• Ensure the accountable operational lead facilitates the removal of barriers to implementation and provision of reasonable adjustment caused by procedural systems delays (see Recommendation 2).
• The accountable Board member should sponsor and support the Chair of a Disability Staff Network. This should not be a line management relationship, but one that allows for independence of the Chair (see Recommendation 6).

Related case study

See Case study: Using reasonable adjustments for physical disability.

How:

Set up a task and finish group representative of people with personal experience of physical and mental health disability and neurodivergence, working with the human resources and occupational health, estates and procurement, IT, finance and communications teams.

This group should:

• Review existing evidence of staff members’ personal experience, using staff surveys and national standards and strategies (such as WDES in England).
• Commission any further research to inform the strategy, including focus groups and surveys to understand the experiences and ideas of staff with disabilities.
• Use a robust methodology for assessing and addressing needs, such as Quality Improvement approaches.
• Communicate the co-produced strategy and implementation plan on all organisational platforms, through recruitment resources and via staff networks.

How:

• Set up a disability workforce implementation committee, representative of people with personal experience of physical and mental health disability and neurodivergence, as well as disability allies.
• This committee will oversee data, including data on compliance, with timelines about provision of reasonable adjustments and remedial actions to be taken  (see Recommendation 5).
• This committee may also advise the organisation on emerging issues and good practice.

How:

• Encourage openness and honesty about disability and intersectionality, at all levels within your organisation.
• Be welcoming and inclusive of staff with disabilities, so that they feel as supported, respected and valued as their non-disabled peers.
• Check in with staff as needed – help them raise concerns, support and accompany them to meetings, amplify their voice, promote their stories, acknowledge their work and achievements. You can achieve this by implementing the other recommendations in this guidance and being explicit about the actions your organisation is taking.
• Launch a campaign or communications strategy to highlight the work you’re doing, co-produced by staff with lived experience and your Disability Staff Network (see Recommendation 6).
  • Create highly visible statements about the organisation’s commitment to being a disability-welcoming environment.
  • Use preferred language – endeavour, with guidance from staff with disabilities, to use language preferred by the majority with personal experience (this can change over time).
  • Ensure all communication is inclusive – for example, it’s clear, literal and specific, meets screen reader requirements, has ALT text added to all visuals, uses dyslexia friendly fonts and colours, and so on.
  • Encourage staff to become allies for colleagues with disabilities, through the campaign and through training.
• Offer recurring training – such as workshops and/or seminars at different levels of the organisation – about disability, the medical and social models of disability, the benefits to the organisation of welcoming disability diversity and how to support staff with disabilities to thrive in their roles.
• Monitor this through staff surveys, like the annual NHS staff survey in England.
• Foster a culture of ‘respectful curiosity’ among the whole workforce and being able to ask questions about disability in order to learn and not to feel that this would automatically be seen as being discriminatory. This may mean having named staff leading on these conversations e.g. from information governance or Post Graduate Medical Education (PGME) departments.

Related case studies

See Case study: Managing the impact of perceived special treatment.

How:

• Training:
  
  Introduce training that increases managers’ knowledge and understanding about:
  
  • Their duties under the Equality Act 2010 or Disability Discrimination Act 1999.
  • The policies and procedures for assessing for and implementing reasonable adjustments and/ or how to access advice and support about this.
• Training should help managers to appreciate:
  
  
  • The difference between the medical and social models of disability.
  • That people with disabilities add value to the organisation in terms of diversity of thought, skills and experience.
  • That a person can have a disability regardless of what caused the impairment, and that the impairment may not affect them all the time and may change at different times.
  • That a medical diagnosis is not necessary for a person to be considered as disabled – they can still have a disability as long as they can show a substantial and long-term adverse effect on their ability to carry out day-to-day activities.
  • That they should not focus on trying to establish presence of disability, but addressing reasonable adjustments.
• Reverse Mentoring:
  
  
  • Consider signing up for a recognised and properly implemented reverse mentoring scheme.
• Feedback:
  
  
  • Consider setting up line managers’ feedback to ensure feedback from staff with disabilities and reflecting on this as part of the formative learning process

Related case study

See Case study: Prioritising practical support over discussion of principles.

How:

• This requires adequate resource to ensure there is a Chair with personal experience of disability, who has allocated, protected time to do this role.
• The Chair should have adequate administrative support and a budget to enable them to create and sustain a thriving and effective staff network.
• The Chair should have support and sponsorship from the Director of Human Resources or Board member who has senior officer responsibility for implementing the strategic plan (whichever is more suitable).
• The staff network should be independent of the Board and should act as a critical friend for the organisation, contributing to its accountability structures (see Recommendation 1)

How:

• Ensure that this includes information for those affected by discrimination concerning access to reasonable adjustments and career progression, or bullying, harassment, microaggressions, differential attainment and disciplinary action.
• Ensure signposting to the Freedom to Speak Up Guardian in England, the Independent National Whistleblowing Officer (INWO) in Scotland and Designated Whistleblowing Contacts in Wales and Northern Ireland, but also signpost to options outside the organisations, such as unions and the Royal College of Psychiatrists.
• Promote this facility widely and ensure visibility so that staff with disabilities and allies are aware of their options.
• Signposting should include both practical and emotional support to those raising concerns and signposting to a disability staff network if you have one.

How:

• Ensure that this includes issues around access to reasonable adjustments and career progression, or of bullying, harassment, microaggressions, differential attainment and disciplinary action.
• Make it clear that raising these concerns is positively welcomed and provide clear assurance that staff will not be victimised for speaking up.

How:

Ensure that this includes issues around access to reasonable adjustments and career progression, or of bullying, harassment, microaggressions, differential attainment and disciplinary action.

Provide guidance and training in the organisation’s policy and procedures about how to respond to these concerns, including actions to be taken, escalation routes and reasonable timelines for responses and resolution (see Recommendation 5).

Include signposting or referring the staff member for support (see Recommendation 7).

How

• Make a clear statement in advertisements and interview invitations that applications from people with disabilities are actively welcomed and that reasonable adjustments are available.
• Create mechanisms to encourage and support staff with lived experience of disability to apply for senior roles to improve their representation at all levels of the organisation.
• Be clear in adverts about how candidates can request reasonable adjustments for interviews, with a clear point of contact.
• Provide adequate training to recruiting managers and the Human Resources team (or equivalent) about supporting the recruitment of staff with disabilities, and providing reasonable adjustments, in order to ensure that requests for reasonable adjustments are welcomed and accommodated.
• Ensure adverts signpost applicants to support for communication in interviews. In England, Wales and Scotland, this is the Government “Access To Work” scheme and in Northern Ireland, it is “NI Direct” (see page 35).
• Discuss and create reasonable adjustments for the recruitment process collaboratively between the candidate and the recruiting lead(s). This may include providing candidates with a clear idea about the format of the interview process in advance, and having written questions in the interview for neurodivergent candidates, for example.
• Consider making some interview/assessment questions or topic areas available to ALL candidates before the interview

How:

• Have in place co-produced policies and guidance for line managers about how to assess for reasonable adjustments (see Recommendation 2).
• Line managers should have collaborative, person-centred, culturally-sensitive conversations with the staff member with a disability when assessing for reasonable adjustments. The BMA has a comprehensive guide on how to have these conversations. These assessments may need additional advice from the occupational health team.
• Put in place adequate signposting and information for staff with disabilities and their managers about the process for applying for Government Access to Work grants in England, Wales and Scotland and for NI Direct grants in Northern Ireland (see references).
• Put in place a reporting mechanism to the Board, which monitors compliance with the locally agreed timelines (see Recommendation 3).
• Line managers should communicate any delays beyond agreed timelines to the staff member with a disability as soon as the delay is known about. This should include an explanation about the cause of the delay and a revised schedule, along with a collaboratively agreed mitigation plan for the interim period.
• Put a clear procedure in place for quickly addressing delays in implementing reasonable adjustments caused by protracted organisational procurement processes. This should include escalation and support for the responsible manager to their seniors (and if required, the senior board member responsible for reasonable adjustments) in order to unblock barriers to acquiring any required equipment. (see Recommendations 1 and 9)

Related case studies

See Case study: Evolving support to enable gradual return to work.

See Case study: Organisational strategies to support people with neurodevelopmental conditions.

How:

As an organisation, be proactive about deciding whether funding will come from the service or from a central organisational budget. This is a common cause for delays and frustration. Creating this policy will save significant resources at organisational level if done once for the policy rather than repeated for each individual case.

The policy should include escalation and support for the line manager to their seniors (and if required, the senior Board member responsible for reasonable adjustment) in order to unblock barriers to acquiring the funding (see Recommendations 1 and 9).

Related case study

See Case study: When conditions aren't openly disclosed.

How:

Have access to occupational health expertise, not just in physical disability but also mental illness and neurodivergence. If this is not available in-house, consider buying in this expertise as required.

Have occupational health resources available to monitor individuals over time (for example, those with episodic or relapsing and remitting conditions).

Have expertise within the occupational health service to support and advise line managers about assessment for and provision of reasonable adjustments or NI Direct and Access to Work applications, as well as if, when and where redeployment should be considered.

Related case study

See Case study: The importance of Mental Health Occupational Health for recurring and relapsing conditions.

How:

• Co-produce the template for these passports with staff who have lived experience of disability, or use templates like the one from the Department of Work and Pensions – but ensure they are not overly burdensome to fill out.
• Ensure that any reasonable adjustments agreement is made with the organisation, rather than with the responsible manager. It therefore doesn’t depend on who is in post as manager and can follow the person if they move roles.
• Familiarise yourself with the General Data Protection Regulation (GDPR) before handling any data.
• Where individuals change roles, the existing reasonable adjustment should constitute a valid starting point for revision or adaptation.
• Ensure that managers are trained on how to use these not as just a tick-box exercise, but as something that facilitates supportive conversations.

Related case studies

See Case study: The importance of Mental Health Occupational Health for recurring and relapsing conditions.

See Case study: The need for constant vigilance as circumstances change.

How:

• Have this information online as well as in induction programmes and resources within employing organisations.
• Providing this information to ALL staff aids inclusion and ensures that staff with undeclared or less visible disabilities will have access to it.
• It also supports allies and active bystanders to understand what your organisation’s position is on disability rights and how to support their colleagues.
• Ensure that there is clear information available about the Government’s Access to Work Scheme in England, Wales and Scotland, and to NI Direct in Northern Ireland.