Reasonable adjustments

The Equality Act (2010) states all organisations including health and social care, such as hospitals and GP surgeries must take steps to remove the barriers individuals face because of disability.

The NHS must make it as easy for disabled people to use health services as it is for people who are not disabled.

Disability is one of the nine protected characteristics under the Equality Act 2010. The Act says that a person has a disability if they have a “physical or mental impairment”, and the impairment has a “substantial and long-term adverse effect on [their] ability to carry out normal day-to-day activities.”

People who need reasonable adjustments and how you might be able to help them

If you support someone with a physical or mental impairment that has a substantial and long-term adverse effect on their ability to do normal daily activities, please make sure they have good access to healthcare.

You can do this by making changes, often quite small, to the way that you care for people. These changes are called reasonable adjustments.

Reasonable adjustments can be things like:

  • making sure there is good access for people who use a wheelchair in GP surgeries and hospitals
  • providing plain English or easy read appointment letters
  • giving someone a priority appointment if they find it difficult waiting in their GP surgery or hospital
  • offering a longer appointment if someone needs more time with a doctor or nurse to make sure they understand the information they are given
  • having a quiet space available for people waiting for their appointment
  • making sure there is a hearing loop system in consultation rooms
  • making sure you fill in information about the appointment If a person has a hospital or health and care passport
  • ensure there is access to a British Sign Language (BSL) interpreter to support at appointments or an internet video-link that could be used with BSL interpretation remotely
  • using a communication chart to support a person with dementia during an appointment

Reasonable adjustments are a legal requirement to make sure health services are accessible to all disabled people. Please watch the film below to find out how a simple reasonable adjustment can make a big difference to a person’s experience of quality and access to care.

Watch the film below about Kareem and his mum Fazilla’s experience of reasonable adjustments and the difference it makes to them when reasonable adjustments are offered.

Reasonable Adjustment Digital Flag – information for health staff

The Reasonable Adjustments Digital Flag is a national record which indicates that Reasonable Adjustments are required for an individual.

NHS England have built the Digital Flag in the NHS Spine (on the National Care Records Service) to enable health and care professionals to record, share and view details of Reasonable Adjustments across the NHS, wherever the person is seen and /or treated.

The Reasonable Adjustment Digital Flag is for all people with a disability.

In September 2023, the NHS published a Reasonable Adjustment Digital Flag Information Standard that sets out what all NHS and publicly funded social care organisations in England are required to do to implement the Reasonable Adjustment Digital Flag in their services. The Information Standard Notice says that organisations must have processes in place to be able to identify, record, flag, share, meet and review and update people’s reasonable adjustment needs on their systems.

We have published a useful checklist to help health and social care providers know what steps to take to start using the Reasonable Adjustment Digital Flag in their local systems in line with the Information Standard Notice.

Health and social care staff can also access free staff training to implement the Reasonable Adjustment Digital Flag – helping it to become part of a standard approach to care and treatment for all disabled people.

Further resources

You can find examples of how organisations are achieving compliance and resources to support your organisation to do the same, including examples of each of the 6-step process on the NHS Futures platform (if you do not have currently have access, you can request this by clicking on the link and requesting an account).

Other key relevant policy and guidance: