Only half of doctors and medical students with disabilities responding to a recent survey said the reasonable adjustments they need at work have been made by their employers.
The British Medical Association’s (BMA) survey of 705 medical students and doctors with disabilities, including roughly 100 GPs, asked participants to list the most important issues affecting their professional lives and to select priorities for action to help create a more equal and inclusive profession.
It found that many struggle to get the adjustments they need and are legally entitled to, with only 55% of respondents stating they have secured the required changes around policies, practices, equipment and facilities.
This has particularly been an issue for those working in smaller practices and where occupational health support is lacking, the BMA report said.
Flexible working was the most common adjustment requested, with just over half (57%) of respondents having asked for an alteration to their work or training hours. One in 10 (11%) had sought changes to buildings or premises and a third (34%) had requested specialist equipment.
Barriers to obtaining adjustments
Difficulties in securing adjustments typically include ‘lengthy and complex processes, slow or only partial implementation, lack of engagement in the process by employers and schools, perceived costs and impacts on others, and [employee] fear about asking in case of negative career consequences’, the report said.
The survey found that only a quarter (26%) of respondents felt their workplace or medical school ‘took proper account’ of their disability or health condition. Almost half (47%) said they had at some point felt pressured to return to work or study before they were well enough to do so.
Doctors and students with disabilities also tend to have ‘significant concerns’ about disclosing their disability or long-term health conditions in their place of work or study, the report found.
Over three-quarters (77%) of respondents said they were worried about being treated unfavourably after doing so, while only 41% said that telling their workplace or medical school had led to improved support.
Seven in 10 (69%) respondents also said they would like to see action on improving awareness of hidden and fluctuating disability and long-term health conditions.
Improving situation a ‘top priority’
The survey, which was carried out between November 2019 and January 2020, found improving access to adjustments was a ‘top priority’ for 69% of respondents.
In the report, the BMA called for centralised budgets for funding reasonable adjustments and streamlined processes for doctors and students to secure changes within a certain timeframe.
The introduction of occupational health passports should also be considered to prevent consultations having to be repeated, it added.
It also pushed for the profession to create more flexible careers and training pathways and opportunities for remote working, as well as improving support for employees with disabilities returning to work after a period of disability-related absence, including phased returns.
Doctors and students with disabilities should be provided with more ‘tailored support’, such as specialist career and pension advice, wellbeing services and peer-to-peer support initiatives, it said.
The BMA also urged employers and schools to ensure disability-related sickness absence is recorded separately, and to introduce a disability leave policy to ensure adjustments are made for disability-related absences such as medical appointments, treatment and rehabilitation.
Employers should end the use of triggers in sickness absence policies based on Bradford factorscoring, ‘which can lead to discrimination’, the report said.
Dr Hannah Barham-Brown, a GP trainee who sits on the Equality, Diversity and Inclusion Advisory Group at the BMA, and who has Ehlers-Danlos Syndrome and uses a wheelchair, said: ‘Anyone working in the health service should receive appropriate support when they need it, including those living with disabilities, be they visible or not, to ensure they can do their jobs properly and without fear of being put at a disadvantage.
‘It’s shocking to see that there are so many barriers when it comes to providing this support, but if Covid-19 has taught us anything it’s that we don’t need to waste time with red tape and bureaucratic stalling. In most cases, it’s unnecessary, slow and incredibly frustrating.’
She added: ‘Not only is this detrimental to patient care, but also to the future of the NHS. Waiting months, even years, for simple adjustments is demoralising, so it’s no surprise that many respondents have considered leaving the NHS altogether as a result.
‘All of this, however, is completely avoidable, which is why we need to see more employers and training and education providers do what they are legally bound to do – provide disabled doctors and medical students with the support they need as a matter of utmost urgency.’