NHS Greater Glasgow and Clyde believe that all staff should be able to thrive and flourish at work. It is a core role of the organisation and managers to support staff to enable them to do this.
For a staff member with a disability and / or a long-term health condition, standard working practices should be reasonably adapted to enable that member of staff to continue to work. Doing this will:
- Enable the staff member to feel appreciated and valued at work
- Help us retain staff and reduce sickness absence
- Ensure that we comply with relevant equality legislation
- Remove barriers to full participation to all our staff
- Implement reasonable adjustments to avoid the time spent managing sickness absences.
Putting in place a reasonable adjustment can mean that a member of staff is treated differently from their colleagues and is in fact what we are required to do under the law. This is the difference between treating team members equally and equitably.
Our Reasonable Adjustment Guidance explains what reasonable adjustments are and how managers should support any of their staff with disabilities or long-term conditions.
This is accompanied by the Workplace Adjustment Passport and Reasonable Adjustment Review Form, which should be used by staff and managers to record any agreed adjustments.
Some helpful case studies and links to further resources are below.
Case Study 1 – a member of staff who experiences sensory issues and wears hearing aids
Susanne, aged 23 years, is a newly recruited staff member within an inpatient setting. She is a trainee within the Audiology team. She wears hearing aids in both ears and did not disclose information about her disability during the interview. However, she informed her manager when offered the job. Her manager contacted HR to seek advice about how to proceed and support this recruitment process as well as Susanne with reasonable adjustment to work within the team.
What adjustments would make a difference?
- Discussing the role and responsibilities with Susanne.
- Speaking with Susanne to gain a greater understanding of her needs.
- Making a referral to Occupational Health.
- Discussing potential adjustments to equipment or environment that may be required. Providing extra time to carry out record keeping and lengthening appointment time with patients.
- Gaining consent from Susanne to disclose information about her needs with the team and specifically her supervisor.
- Provision of emotional support from peers and colleagues to ensure Susanne feels that she is heard and listened to.
- Creating a personalised fire evacuation plan.
Case Study 2 – an employee returning to work after a long-term sickness absence following a stroke
The experienced employee was referred to Occupational Health (OH) following his return to work after a stroke. He is 41 years old and does not want to go for medical retirement.
The employee has difficulty concentrating, focusing on tasks and can appear to be anxious, and therefore to be struggling physically. During the OH consultation, the employee indicated that his cognition, hearing and physical functions were impacted. He was under the care of rehabilitation for 8 months. Prior to the appointment, the staff member had no clue about any adjustments but was keen to return to work to keep him occupied.
At the rehab centre, he met therapists (OT, Physio, and Audiology) who were able to improve the functioning to manage activities of daily living (ADLs), but this required time.
Key Issues:
- The ward environment is busy and distracting.
- Having difficulty remembering processes and therefore anxious that they appear to be not coping, which affects physical functioning such as typing/ writing.
- Unable to walk long distances.
Adjustments suggested:
- The OH Staff Nurse identified and proposed a graded return to work with increased meetings with the supervisor. Would be happy for workplace adjustments passport to be completed covering:
- Support with routine planning.
- To use a quiet office to complete his written work, such as care plans.
- Prepare check lists for tasks/processes.
- Using flowcharts to make following processes easier, as the standard operating processes contained too much information, which caused confusion.
- During rounds/meetings, they use a note-taking app on their work phone.
- Use of aid when walking.
- Taking frequent breaks as and when required.
- Flexibility to work from home when too tired to stay on site. It was noted throughout this agreement that duties would gradually increase and skills improve.
Case Study 3 – Member of staff entering the menopause
Anna is a nurse in a community setting. About 4 years ago – aged 48, she stared to notice symptoms. “Not the stereotypical night sweats and changes to my periods, but struggled with sleeping, sore joints, low mood and generally not feeling myself”.
She was lacking in confidence – been in her job a long time so was feeling that she should be at the top of her game, but couldn’t remember things, was worried about driving, prescribing and stressed that she would make mistakes at work.
Lucky that she worked where there are lots of colleagues who were really supportive and said that it sounded like the peri-menopause. They suggested Anna had a chat with her GP who provided her medication.
Anna didn’t talk to her line manager about it at the time, because she felt that she should have been able to manage things. Anna didn’t want to be seen to be moaning or seen as weak. While she feels she should have been able to, Anna didn’t have that relationship with her line manager at that time.
What adjustments would have made a difference?
The single biggest thing that would have made a difference is some flexibility with start times. Her team had an 8.30am meeting before the clinic day starts and Anna liked be present at the meeting, not rushing in at 8.30am. If she’d had had a bad night with no sleep, that was incredibly difficult for her. Just to have known it was OK to text and say ‘had a bad night’ and get support from her manager to start a bit later, took away a lot of her stress and anxiety.
The other thing that was important was emotional support from peers and colleagues. Just someone to off-load to, have a chat and listen to.
Anna reflects that this needs a gentle approach because people might not be ready to accept the stage they are at, can be resistant to accepting that the symptoms are menopause. Her experience was that self-care is a big thing too – not just about medication.
Case Study 4 – adjustments for individual with Attention Deficit Hyperactivity Disorder
The employee was referred to Occupational Health as a Management referral due to performance and capability issues as a newly qualified Staff Nurse.
The employee had difficulty with focussing on tasks and appeared to be anxious. During the Occupational Health consultation the employee indicated that when they were university they had been diagnosed as having ADHD and had been supported with written work assignments and placements as a student. As this was their first qualified Nurse post they did not know if they needed any adjustments.
As a newly qualified Staff Nurse they had a Preceptor (mentor) who was already providing one to one support to become familiar with the ward and processes to be followed. The Staff Nurse identified that they were developing a good bond with their Preceptor, and would be happy for a workplace adjustments passport to be completed and shared with the Preceptor and the Senior Nursing team.
Issues identified by the Staff Nurse was that they found the ward environment busy and distracting and had difficulty remembering processes and anxious that they appeared to be not coping.
We discussed the Scottish ADHD coalition Guide to ADHD (www.scottishadhdcoalition.org) in the workplace and used this to identify specific issues and solutions that the Staff Nurse may find useful.
Adjustments suggested
- Increased meetings with the mentor, initially daily to supervise work and plan the daily tasks.
- To work with the Preceptor as buddy rather than ad hoc catch ups.
- To use a quiet office to complete her written work, care planning and prepare check list for tasks/ processes.
- There was already SOP (standard operating processes) but the Staff Nurse identified they were too much information on them and these caused them difficulty. They realised if they made bullet points they could follow processes easier.
- During rounds/ meetings, use a note taking app on their works phone.
- Once they became familiar with the ward routine they did not require as much feedback but continued to have meeting with the mentor so any difficulty was identified as soon as possible.