Reasonable adjustments in healthcare

In short

• Health services must make reasonable adjustments so that autistic people can access their care.
• In Great Britain, the Equality Act 2010 sets this duty. In Northern Ireland, the Disability Discrimination Act 1995 applies.
• In England, ask your GP to record the NHS Reasonable Adjustment Flag so that staff know what helps you.
• A hospital passport can explain your needs, and special care dentistry may be available for some people.
• If an adjustment is refused, ask for the reasons in writing and use the complaints process.

Your legal rights

In England, Scotland and Wales, section 20 of the Equality Act 2010 requires service providers, including health services, to take reasonable steps to avoid putting a disabled person at a substantial disadvantage. This can mean changing a practice or policy, providing information in an accessible format, or providing an auxiliary aid or service.

In Northern Ireland, the Disability Discrimination Act 1995 applies. Section 21 of that Act sets out a duty on service providers to make adjustments. The Equality Act 2010 does not extend to Northern Ireland.

Under the Equality Act, you cannot be asked to pay for the cost of an adjustment, unless the law says otherwise.

Adjustments at the GP

You can ask your GP practice for:

• A longer appointment, or the first appointment of the day.
• Information in easy read or large print.
• Reminders by text, email or letter, in the format that works best for you.
• Help with checking in, or a quiet place to wait.
• A named contact at the practice, if you have one.

Practices may have their own forms for these requests. Ask the reception team what is available.

Adjustments in hospital

Hospitals can make planning easier. You can ask for:

• Information about your appointment and what will happen, in advance.
• A quiet waiting area or a place to wait away from busy areas.
• A familiar person to stay with you, where the hospital allows.
• Notes to be shared with staff who will treat you.

A hospital passport is a document you write or complete to describe your needs, communication style and sensory preferences. It is not a formal NHS requirement, but many people use one. Ask the ward or department to add it to your notes.

The NHS Reasonable Adjustment Flag

In England, the NHS Reasonable Adjustment Flag is a national record held on the NHS Spine. It tells NHS staff that a person needs adjustments and what they are. For example, it can show that a patient needs a longer appointment, or a quiet space to wait.

Ask your GP whether your adjustments can be recorded. You can also ask for a copy of what is recorded, and ask for it to be updated when your needs change.

Dental care

Dentists can be a difficult environment for many autistic people. Some areas offer special care dentistry services, which can provide support for people with additional needs.

Access depends on local criteria. In many areas, a referral is made by a dentist, GP or other health or social care professional. Some areas specify a level of need, such as significant support needs. Ask your dentist or local integrated care board how to be referred.

If an adjustment is refused

If a service refuses an adjustment you need, you can:

• Ask for the reason in writing.
• Ask to speak to the practice manager or service lead.
• Use the service's complaints process. In England, you can also contact the Patient Advice and Liaison Service (PALS) at your local hospital or trust.
• Ask an advocacy or information service, such as Citizens Advice, for help.

Keep a note of dates, names and what was said. This can help if you need to make a formal complaint.

This guide is general information, not legal advice.