Reasonable Adjustment Digital Flag Briefing for Care Providers

The Reasonable Adjustment Digital Flag is a national record that shows when a person may require reasonable adjustments when accessing health or social care.

Reasonable adjustments could include, for example:

• information provided in an accessible or Easy Read format;
• additional time to communicate or make decisions;
• support from a family member, carer or advocate;
• British Sign Language or other communication support;
• adjustments for sensory needs;
• a quieter environment;
• physical accessibility requirements; or
• changes to the way appointments, visits or care are arranged.

The aim is for this information to be recorded consistently and, where appropriate, shared across health and social care so that staff can understand a person’s needs before providing care or support.

This builds on the existing legal duty under the Equality Act 2010 to make reasonable adjustments for disabled people.

The DAPB4019 information standard includes providers of publicly funded social care within its scope.

This can include organisations in the independent, voluntary and community sectors where they are providing publicly funded health or social care services.

The current full conformance deadline for social care is:

31 October 2027

Although there is time to prepare, providers should not treat this simply as a future IT project. Much of the work involves reviewing processes that should already form part of good care planning, record keeping and person-centred support.

The standard expects organisations to have effective processes for managing reasonable adjustment information throughout the person’s care.

A useful way of thinking about this is:

Identify → Record → Flag → Share → Meet → Review

1. Identify

Providers should have a consistent way of identifying whether someone has a disability or impairment and whether they require reasonable adjustments.

This could form part of:

• initial assessments;
• care planning;
• reviews;
• referral or admission processes;
• conversations with the person, their family or advocate; and
• information received from health or other care organisations.

People should also be given opportunities to tell services about adjustments they need.

2. Record

Reasonable adjustment requirements should be recorded clearly and consistently within the person’s care record.

Providers should consider whether existing care planning templates capture this information clearly enough and whether staff know where it should be recorded.

The information should describe the practical adjustment the person requires, rather than simply recording a diagnosis or disability.

3. Flag

Staff need to be able to see quickly when reasonable adjustments are required.

Where digital care systems support alerts or flags, providers should consider how these can be used to make reasonable adjustment information prominent and accessible to relevant staff.

Having the information somewhere in a care plan is not enough if staff cannot easily find it when they need it.

4. Share

Providers should establish when and how reasonable adjustment information is shared with other appropriate health and care organisations.

This could be particularly important during:

• hospital admission and discharge;
• referrals;
• transfers between services;
• GP or community health appointments;
• emergency care; and
• changes in care provider.

Information sharing must continue to be handled appropriately and in line with data protection requirements.

5. Meet

Recording an adjustment is only useful if staff act on it.

Providers should therefore consider how reasonable adjustment information translates into everyday practice and whether staff understand what they are expected to do.

For example, if someone’s record states that they need information in Easy Read format or additional processing time during conversations, staff should understand how that adjustment will be provided.

6. Review

People’s needs can change.

Providers should have arrangements for checking that reasonable adjustment information remains accurate and should update records when circumstances or preferences change.

This could be incorporated into existing care plan reviews rather than becoming a completely separate process.

One of the most important areas for providers to investigate is whether their digital care record or care management system will support the Reasonable Adjustment Digital Flag requirements.

Providers should speak to their software supplier and ask:

• Does our system currently support a clear reasonable adjustment flag or alert?
• How should reasonable adjustment information be recorded within the system?
• Are you working towards integration with the national Reasonable Adjustment Digital Flag?
• Have you engaged with NHS England regarding the relevant technical requirements?
• What changes or updates should customers expect before October 2027?
• Will providers need to take any action to enable the functionality?

Do not assume that your supplier will automatically manage every aspect of compliance. Providers will still need appropriate policies, processes, training and governance around how the information is collected and used.

October 2027 may seem some distance away, but there are several practical steps providers can start taking now.

A good starting point is to:

1. Nominate a lead for Reasonable Adjustment Digital Flag readiness.
2. Review your current care planning process and identify where reasonable adjustment needs are captured.
3. Check whether adjustments are clearly visible to the staff who need to know about them.
4. Review how this information is shared during referrals, handovers and transfers of care.
5. Speak to your software supplier about their plans for the standard.
6. Review relevant policies and procedures, including care planning, information sharing and data protection.
7. Brief and train staff so they understand reasonable adjustments and know how to record and act on them.
8. Involve people drawing on care and support, families and advocates when reviewing your approach.

Starting with existing processes can make the task much more manageable. Many providers will already be collecting some of this information; the challenge is ensuring it is recorded consistently, clearly visible, acted upon and capable of being shared appropriately.