In a healthcare system that aspires to be inclusive, the concept of reasonable adjustments is not just a courtesy – it’s a legal and moral imperative. Under the Equality Act 2010, all health and care organisations are required to make reasonable adjustments for individuals with disabilities to ensure they can access services equitably.

Yet, despite this legal foundation, many patients still face barriers to care. These barriers are often not due to the complexity of their needs, but rather the system’s inability to consistently recognise and respond to them. That’s where the Reasonable Adjustment Digital Flag comes in – a tool designed to ensure that vital information about a patient’s needs is visible and actionable across the health and care system.

“We’re not talking about luxury or preference,” explains Dr Hannah Brown, GP and subject matter expert for the digital flag. “We’re talking about legal rights and basic fairness. It’s about moving from equality to equity – making sure everyone has the same view, even if they need a different box to stand on.”

Making Instructions follow the patient across health care settings

The Reasonable Adjustment Flag is a digital marker that identifies a patient’s specific needs and the adjustments required to support them. Crucially, it allows this information to follow the patient across settings – for example GP practices, hospitals, ambulance services, and eventually, even screening programmes.

This is more than a minor technical fix, it’s a major transformation in the way care is being delivered. For example, one patient repeatedly missed urgent appointments because her letters were written in complex language and small print. Once her needs were flagged, she received simplified communication and a follow-up phone call. She attended her next appointment and received the care she needed on time.

“It’s not rocket science,” says Dr Brown. “She just needed a letter she could read. That small change avoided a two-month delay in care. It’s better for the patient, better for the NHS, and just fair.”

Another patient required a specific comfort item to complete a scan. Once this was recognised and accommodated, the scan went ahead without distress or delay.

“People often assume adjustments are expensive or complicated,” Dr Brown adds. “But often it’s something really simple – like letting someone wear headphones or have a quiet space to wait. If you don’t put it in, you risk missed referrals, failed procedures, or unnecessary hospital stays.”

How can GPs help patients?

GPs and primary care teams are often the first point of contact for patients and are uniquely placed to identify and record reasonable adjustments. The process is straightforward:

1. Identify patients who may need adjustments – this includes anyone with a disability or long-term impairment, even without a formal diagnosis.
2. Record the adjustments using local templates and SNOMED codes.
3. Flag the information clearly in the patient’s record so it’s visible to all staff.
4. Share the information in referrals and communications with other services.
5. Meet the adjustments
6. Review and update the adjustments regularly to ensure they remain relevant.

“Most of us already know which of our patients need longer appointments or a carer with them,” says Dr Brown. “The digital flag just helps us make sure everyone else knows too.”

The Reasonable Adjustment Digital Flag is designed to integrate with existing systems through a national database and API connections. This means that once recorded, the information can be accessed by other services. This ensures continuity of care.

Next steps for the project

The Reasonable Adjustment Digital Flag is already live and is being piloted with several major system suppliers. The goal is full integration across health and care settings by the end of September 2026.

Free e-learning is available to all health and care staff covering what the flag is, how to use it, and why it matters.

“This isn’t just about compliance,” Dr Brown concludes. “It’s about dignity, respect, and making sure no one is left behind. Reasonable adjustments should be baked into everything we do.”

For more information around Reasonable Adjustment Digital Flags and how they should be used please visit: NHS England » The Reasonable Adjustment Digital Flag action checklist: what you need to do to achieve compliance

Dr Hannah Brown