Reasonable Adjustment Flag

Overview of work

The Reasonable Adjustment Digital Flag is a locally and nationally available record which indicates the reasonable adjustments required for an individual.

The North East and Cumbria Learning Disability Network are leading the NENC ICB (North East North Cumbria Integrated Care Board) reasonable adjustments flag project. We are a Fast Follower project that will help to ensure as a region we can roll out the reasonable adjustment flag, giving people the best possible support and care.

The Equality Act 2010 states health and care organisations must take steps (reasonable adjustments) to remove the barriers individuals face because of disability. This is a legal requirement for all organisations.

The NHS Long Term Plan states by 2023/24, a ‘digital flag’ in the patient record will ensure staff know a patient has a learning disability and/or autism.

E-learning for health and care staff

Reasonable Adjustments Digital Flag: Health and social care staff training

Staff training for the Reasonable Adjustment Digital Flag is now available on the eLearning for healthcare website.

This training is available to all health and social care staff and support organisations to meet their obligations under the Reasonable Adjustment Digital Flag Information Standard. Under this Standard, organisations must provide training as mandated within the Health and Social Care Act (2012).

The training has been developed with subject matter expertise and has been thoroughly tested across a range of clinical and administrative professions.

The training will support staff working across health and social care to be able to provide the right care and treatment by making sure that the reasonable adjustment needs for disabled people are supported.

This is a single module covering the background, what reasonable adjustments are and the 6-step process to identify people with a disability or impairment (including autistic people and people with a learning disability) and their reasonable adjustment needs, to make access to care fair.


Advice and support reasonable adjustments digital flag checklist

We are currently in phase 1 of preparing for full roll out of the reasonable adjustments digital flag. To support organisations in conforming to the requirements of the information standard notice NHSE has produced a checklist and support Good practice resource package.

Information Standard

An Information Standard has been developed and published here: DAPB4019: Reasonable Adjustment Digital Flag – NHS Digital. This mandates what organisations have to do.

What the digital flag will do

  • Identify a patient requires adjustments to their care.
  • Allows details of the patient’s impairments (disabilities or long-term conditions) to be shared – this is optional, the patient may prefer not to say.
  • Allows adjustments to care, that have been identified, to be shared.
  • Enables digital systems to be linked with the flag so information can be shared

Broader use of the flag

Initially we have a focus on people with a learning disability and autistic people, but the Reasonable Adjustment Flag is not just for people with a learning disability or autistic people.

28% of the wider population, who under the Equality Act are entitled to reasonable adjustments, could benefit having their reasonable adjustments recorded using the Flag.

More information from the national project can be found here.

Update: Webinar April 2024

Julie Tucker held a webinar for the Northern Cancer Alliance. The webinar can be found here.

Stakeholder update event 26th January 2024

The reasonable adjustments stakeholder event for the North East and North Cumbria was held on the 26th January 2024. Here are the resources and additional information from the event.

RADF Jan24 Easy read overview– Overview of the event and key points discussed

1RADG Jan24 Experts feedback– PowerPoint presentation given by experts by experience engaged in the project.

Report for Tasks 1 and 2 The Reasonable Adjustment Flag– Full report of tasks one and two completed by experts with lived experience.

2RADF Jan24 National update– PowerPoint presentation, National update, Dr Hannah Brown, GP and NHSE RADF subject matter expert.

3RADF Jan24 Digital update– PowerPoint presentation, Digital update, Darren McKenna, System Chief Information Officer for Mental Health, Learning Disability and Autism, North East and North Cumbria ICS.

4RADF Jan24 examples of good practice and RA campaign– PowerPoint, Examples of good practice and the reasonable adjustments campaign, Julie Tucker, North East and Cumbria Learning Disability Network.

RADF Jan24 Examples of good practice– Document with links to films and resources shared on the day.

Treat me well top 10 reasonable adjustments– Mencap document, Top ten reasonable adjustments.

RADF Jan24 Resources discussed – Some of the resources, links to films and documents discussed at the event.

If you have any questions regarding the information shared or the reasonable adjustments digital flag project contact: [email protected]

Update webinar – 8th December 2023

We held a Reasonable Adjustments Digital Flag update webinar on Friday 8th December 2023. This was an opportunity to hear where we are at with the reasonable adjustments digital flag project and ask questions of our experts.

Speakers were:

Julie Tucker, Project Manager, North East and Cumbria Learning Disability Network

Dr Hannah Brown, GP and Subject Matter Expert for the Reasonable Adjustment Digital Flag, NHS England.

Darren McKenna, System Chief Information Officer for Mental Health, Learning Disability and Autism, North East and North Cumbria ICS

To watch the full webinar at:

Information Standard Notice – Reasonable adjustments Digital Flag

The information standard was released 12th September 2023. the full documents can be found at:

Information Standards Notices – NHS Digital

For more information from the National programme check:

Reasonable Adjustment Flag – NHS Digital

Reasonable adjustments Digital Flag update meeting 14th July 2023

Out first broader stakeholder meeting was held on the 14th July 2023. An overview of the meeting is available here.

RA flag – meeting overview 14 july23

SNOMED codes

List of the SNOMED codes for clinicians to use to record an individuals reasonable adjustments.

FINAL Reasonable adjustment SNOMED codes

Reasonable adjustments impairment and adjustment codes

List of adjustments by category code, category display value, SNOMED CT code and description.

Working with Experts by experience

The reasonable adjustments digital flag works with people with a learning disability, autistic people, families and carers. They work to support the project and ensure the voices of experts by experience can influence the work.

Their initial report asked important questions including: What is understood by the term reasonable adjustments? Do you know how to ask for reasonable adjustments? Their full report with recommendations is Report for Tasks 1 and 2 The Reasonable Adjustment Flag.