How speaking out and formalising new standards can transform people’s experience of disability at work

As part of its aims to improve the culture for disabled staff at Lancashire Teaching Hospitals NHS Foundation Trust, the organisation has been finding ways to listen and support staff with real change.  

Kate Smyth is Lancashire Teaching Hospitals’ Board sponsor for their Living with Disability Staff Ambassador Forum. Emma Wright is a clinical governance manager and the forum’s chair.

Kate and Emma have formed a supportive connection that provides Emma with an opportunity to speak up and lends her forum authority to further improve aspects of the culture for disabled staff at Lancashire Teaching Hospitals.

Kate goes to Emma’s meetings when she can but does not always stay for entire meetings as she does not want to take over or inhibit discussion and action planning.

What was the aim/problem?

Lancashire Teaching Hospitals NHS Foundation Trust wants to be among the best employers for disabled people and one of the many ways it does that, is by highlighting the contributions made to patient care by colleagues across the full breadth of mental, physical, visible and unseen conditions. The trust is aiming to improve disability declaration rates, and trying to make it easier for less senior colleagues to declare a disability, as well as building trust and safety to keep staff in front of patients and thriving in careers.

What was the solution?

By speaking out about her own lived experiences, which were particularly tough in lockdown during a lengthy period of shielding, Emma stepped up as a reliable, go-to lead for people across the trust who were seeking advice and guidance on disability at work.

As the staff-facing lead, when the approach to disabled colleagues was emphasised by senior leadership, she helped formalise, for the first time on paper, new standards and processes. This included named board sponsors with clear accountability, aligned with the trust’s equality, diversity and inclusion strategy, creating a safe space for members to talk through issues, support for managers to better understand legal requirements, policies and process and more encouragement and signposting to declare disability on ESR.

The trust appraisal process now has a section to discuss any Supporting Disability Agreement and a discussion on reasonable adjustments. It also identifies that some colleagues have caring responsibilities for family members who may have disabilities and includes information about the carers passport and centralised budgets for disability support.

What were the challenges?

Emma cited the negative attitudes towards disabled people as the most significant challenge in building a disability positive workplace. She said ‘We managed the pressures of lockdown to maintain a consistent focus on actions such as examining Workforce Disability Equality Standard data, at national as well as trust level.”

We navigated new ways of working from home and staff being given space to support the network as well as maintaining contact with people who perhaps couldn’t make sessions. We had to make sure we were in the business-critical forums so more people would come forward and have a safe space where they can talk about their lived experience and work on projects to raise awareness.  

What were the results?

‘In my 25 years with the NHS I’ve seen evidence of massive changes in culture, attitude, policies and process. I was told at age 22, “your knees don’t work properly so colleagues will have to take some of your workload”. There was no offer of reasonable adjustments and being called disabled seemed like a taboo word, that one of my managers never used. Instead she said I had “issues” rather than being disabled. Doing what I do now, I want to encourage others to not just accept where they are.

We need to build on the positives and work through the negatives to effect further change. Mentoring in the trust has helped a great deal and the Ambassador forums are a strength. People used to think if they speak up it’s a tick in a box against them. It really isn’t. Having a national group established has really made a difference as the number of people on board has increased because people feel less exposed.

What were the learning points?

Emma says, ‘Disability is a journey we want to help colleagues with. 10-15 years ago, I couldn’t have done this work because of how disability has affected me and my family. It was too emotional, too raw. A lot of disabilities impact on loved ones, lifestyle and careers. In the past I wouldn’t have opened up in front of anyone, but now I know that sharing lived experience is an emotive tool to allow others to put themselves in your shoes and see the world through your eyes.

Want to know more?

If you want to interact with the Ambassador Forum, the email address is and the chair can be contacted on Emma is always happy to share ideas and good practice.

If you would like to speak to Kate about her role as board sponsor for the Living with Disability Ambassador Forum or find out more about the Disabled NHS Directors Network she can be contacted on:

Kate Smyth, is a Non-Executive Director at Lancashire Teaching Hospitals NHS Foundation Trust, and is the Board sponsor for the Trust’s Living with Disability Staff Ambassador Forum. She chairs the Safety and Quality committee and the Charitable Funds committee and is the NED lead for patient experience, equality, diversity and inclusion, health inequalities and anchor institutions and social value. Kate is a co-founder and co-chair of the Disabled NHS Directors Network. Kate is disabled herself and has a sparkly red wheelchair, a very handsome golden retriever assistance dog, and a job aid. She is a disability advocate.

Emma Wright, is a Clinical Governance Manager at Lancashire Teaching Hospitals NHS Foundation Trust, and the current Chair of the Living with Disabilities (LwD) Staff Ambassador Forum. She raises awareness of living with a debilitating and fluctuating physical condition by speaking candidly about her life as a career professional and parent.