What are Reasonable Adjustments?

Reasonable Adjustments are changes or adaptations put in place by an organisation to make it easier for a person with a disability to access services or employment. Under the Equality Act (2010), Health and Social Care organisations have a responsibility to remove and reduce the barriers that individuals with a disability face to accessing services. This includes people with a physical disability, sensory disability, learning disability or a long term condition, such as dementia. Reasonable adjustments can often be small changes and generally fall under three categories

  • changing a rule or way of doing things

  • changing a physical feature of a building
  • Providing an individual extra equipment or help

“Reasonable” adjustments are not defined under the Equality Act and depend on their potential impact and the practicality of any changes for the organisation offering them. If a requested change is deemed unreasonable, an organisation should work to find alternatives.

For more general information about reasonable adjustments, please review the links and posters at the bottom of the page.

 

Reasonable Adjustment Digital Flag

In December 2025, the Information Standards Notice (ISN) was published which makes it mandatory for all NHS, health and social care service providers that are publicly funded to be able to share, read and write reasonable adjustment digital flags by 30 September 2026.

Once implemented nationally, it will be a game changer for millions of disabled people, making it easier for them to receive reasonable adjustments whenever and wherever they use health and social care services that are publicly funded.   

 

How does it work?

In short, the reasonable adjustment digital flag provides a national visible marker on a person’s record (available via the NHS’s National Care Records Service) which indicates any reasonable adjustments needed by a person with a disability whenever they are seen or treated.  

Reasonable adjustments are tailored to an individual’s needs and may include things like providing wheelchair access, providing information in large print or enabling a supporter or carer to accompany a disabled person to a meeting. They are a legal requirement under the Equality Act 2010 to ensure NHS, health and social care services are as accessible to disabled people as they are to everyone else. 


The new information standard changes the basis of consent required by a provider to share a person’s personal information from explicit to implied consent. However, people can raise objections to their data being shared at any time, unless there is a valid reason why it should be shared. The Mental Capacity Act 2005 should be consulted with regards to decisions about capacity and competence. 

All NHS and other publicly-funded health and social care providers must fully comply with the reasonable adjustment digital flag by 30 September 2026. If their supplier’s system software has not completed the onboarding process by this date providers must instead be able to share, read and write reasonable adjustment data directly via the NHS’s National Care Records Service.

 

Three things that NHS and publicly-funded health and social care providers must now do:

1. They must ensure all staff who use disabled people’s records continue to learn about and understand reasonable adjustments. Free training is provided in partnership by NHS England and e-Learning for Health here: Reasonable adjustment digital flag - eLearning  An updated version covering all health and social care sectors is expected to be launched by March 2026.

2. They must identify people who need reasonable adjustments to access their care, record and regularly review these on their own IT systems or via the NHS’s National Care Records Service (previously known as “the spine”). This is in preparation for the data to be shared with other health and social care providers via the National Care Records Service by 30 September 2026. 

3. The new information standard requires that all NHS and other publicly-funded health and social care service providers must be able to share, read and write reasonable adjustment data by 30 September 2026.

Reasonable adjustments staff poster

Reasonable adjustments patient poster

  • Consider visiting the ICB’s Learning Disability and Autism pages for more information about adjustments for LD Annual Health Checks and creating “Sensory Friendly Environments” in healthcare for Neurodiverse people.
Here's a short video on the importance of reasonable adjustments
Reasonable Adjustments staff Poster
Reasonable Adjustments Patient Poster