Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what advice her Department provides to NHS England on the categorisation of people’s disabilities as outlined in the Equality Act 2010.

It is for individual National Health Service organisations, including NHS trusts and integrated care boards, to comply with the Equality Act 2010, guidance on which is available at the following link:

https://www.gov.uk/guidance/equality-act-2010-guidance

The act defines disability as a physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. Further information on the definition of disability according to the act can be found at the following link:

https://www.gov.uk/definition-of-disability-under-equality-act-2010

No assessment has been made of the potential merits of issuing guidance to NHS England on the categorisation of disability. NHS England has issued guidance for NHS commissioners on equality and health inequalities legal duties. It has also issued guidance with respect to the Reasonable Adjustments Digital Flag (the Flag). Under the Equality Act 2010, organisations have a legal duty to make changes in their approach or provision, to ensure that services are as accessible to disabled people as they are for everybody else. These changes are called reasonable adjustments. The Flag was developed in the NHS Spine to enable health and care workers to record, share, and view details of reasonable adjustments across the NHS, wherever the person is treated. It is now accessible on the National Care Records Service, which is available at the following link:

https://digital.nhs.uk/services/national-care-records-service

The Flag is designed to provide staff with information on their duties under the Equality Act 2010. It lists existing adjustments defined by clinical codes, such as communication needs defined using the Accessible Information Standard clinical codes, which is available at the following link:

https://www.england.nhs.uk/publication/accessible-information-standard-implementation-guidance/

It also provides the opportunity to create highly individualised bespoke adjustments for patients. The service holds records for all patients in England who have been flagged as needing reasonable adjustments. A record is created for a patient when a health or social care worker first records the patient's reasonable adjustments.

The Flag provides basic context about a patient, key adjustments, and the details related to this and further information to aid health and care workers. This legal duty is anticipatory, which means a service should know about a person’s need for adjustments when they are referred or present for care. For this to happen, and for optimum care to be delivered, adjustments need to be recorded and shared across the NHS. The Flag can also record if a patient meets the Equality Act definition of disability, which is an impairment with substantial and long-term adverse effect on normal day to day activity. It can also optionally contain details of the disability or long term condition that is the source of the patient’s impairment, in line with the Equality Act 2010 guidance. The impairment type list in the guidance shows the impairment types that can be recorded.