A Reasonable Adjustment Flag is a national digital record used within the NHS. It shows that a person needs reasonable adjustments and sets out what those adjustments are. It may include details about the person’s needs, any underlying condition, and the support required.
It forms part of the NHS Patient Flags Service and is stored on national systems. Authorised staff can view it across different services.
Put simply, it highlights that care should be delivered in a different way. It supports consistency and reduces the need for people to repeat themselves.
Introduction
People access health and social care with different needs. Some may need more time. Others may need information in a different format or a quieter space.
Standard care does not always meet these needs. The Reasonable Adjustment Flag helps services respond in a clear and consistent way.
It supports person-centred care. The focus stays on the individual and how care should be delivered. The aim is simple. Record what helps, share it, and use it.
Why Reasonable Adjustment Flags Are Needed
Barriers can affect how people access care. These may include communication difficulties, sensory sensitivities, or unfamiliar environments.
Reasonable adjustments reduce these barriers. The flag makes these adjustments visible to staff.
- Reducing inequality: People with additional needs can access care on equal terms
- Improving safety: Clear communication reduces risk
- Supporting involvement: People can take part in decisions about their care
- Building confidence: Familiar adjustments reduce anxiety
- Meeting legal duties: Services must make reasonable changes
The Equality Act 2010 requires services to make reasonable adjustments for disabled people.
What Counts as a Reasonable Adjustment?
A reasonable adjustment is a practical change to how care is delivered. It allows a person to access services in a way that suits their needs.
Adjustments vary depending on the individual.
- Communication adjustments: Easy read information, large print, or interpreters
- Environmental adjustments: Quiet areas or reduced noise
- Time adjustments: Longer appointments or flexible timing
- Support adjustments: Involving carers or advocates
- Clinical adjustments: Adapting how care is carried out
The NHS England supports these changes through national standards such as the Accessible Information Standard.
What Information the Flag Includes
The flag includes clear and specific information about reasonable adjustments. It may also include details about the person’s needs or condition.
The information must be easy to understand and act on.
- Communication needs: How the person prefers to receive information
- Triggers: Things that may cause distress
- Support preferences: Who should be involved in care
- Practical actions: What staff should do differently
- Review details: When the information was last checked
Clear wording is important. For example, “needs easy read information and extra time to respond” is more helpful than “needs support”.
How the Reasonable Adjustment Flag Works in Practice
The flag appears in electronic patient records. It is accessible through national systems so staff across services can view it.
In practice:
- Staff check the flag before contact
- Adjustments are prepared in advance
- The environment is adapted
- Care is delivered in line with recorded needs
For example, a quiet waiting area may be arranged or information may be explained in simple language.
The flag supports care, but it does not replace communication. Staff still confirm needs with the person.
How to Add a Reasonable Adjustment Flag
Adding a flag involves identifying that a person meets the definition of disability under the Equality Act 2010. This means they have a physical or mental impairment that has a substantial and long-term effect on daily activities.
The process includes:
- Identifying needs: Speaking with the person and recognising barriers
- Agreeing adjustments: Deciding what changes will help
- Recording information: Adding clear details to the system
- Sharing appropriately: Making sure relevant staff can access it
- Reviewing regularly: Updating the flag if needs change
The person should be involved throughout. Their preferences guide what is recorded.
When and Where the Flag Is Used
The flag is used whenever a person needs changes to standard care. It applies across health and social care services.
- Hospitals: Adjusting environments and procedures
- GP surgeries: Adapting appointments and communication
- Community care: Planning visits based on individual needs
- Mental health services: Reducing distress through tailored approaches
The flag allows information to follow the person across services.
Examples in Practice
Examples show how the flag supports care in everyday settings.
A person with autism attends a hospital appointment. The flag shows they need a quiet space and clear explanations. Staff prepare a side room and explain each step. The person feels more at ease.
A person with a learning disability visits a GP. The flag shows they need easy read information. The GP uses simple language and visual aids. The person understands their care.
A person with hearing loss receives community care. The flag shows a preference for written communication. Staff provide written notes and confirm understanding.
Small changes can improve the experience of care.
How the Flag Supports Person-Centred Care
Person-centred care focuses on individual needs and preferences. The Reasonable Adjustment Flag supports this by making those needs visible.
- Consistency: Staff follow the same guidance
- Preparation: Adjustments are in place before care begins
- Respect: Care reflects personal preferences
- Reduced distress: Environments and communication are adapted
The Care Quality Commission expects services to provide safe and person-centred care.
Legal and Professional Responsibilities
Health and social care staff must follow legal and professional standards when using the flag.
- Equality Act 2010: Requires reasonable adjustments
- Health and Social Care Act 2012: Supports information standards
- Reasonable Adjustment Digital Flag Information Standard: Sets how information is recorded and shared
- Accessible Information Standard: Supports communication needs
Staff responsibilities include:
- Checking the flag before providing care
- Following the recorded adjustments
- Updating information when needed
- Respecting confidentiality
Common Mistakes to Avoid
Some issues reduce the effectiveness of the flag.
- Vague information: Lack of clear detail
- Not checking the flag: Missing important information
- Outdated records: Needs not reviewed
- Not involving the person: Ignoring their preferences
- Poor communication: Using unclear language
Accurate and up-to-date information supports safe care.
How Communication Supports the Flag
Communication helps staff understand and apply the information in the flag.
Good practice includes:
- Using plain English
- Speaking clearly and calmly
- Checking understanding
- Allowing time for responses
Clear communication improves care and reduces confusion.
Final Thoughts
The Reasonable Adjustment Flag supports fair and consistent care. It allows individual needs to be recorded and shared across services.
It works best when the information is clear, accurate, and regularly reviewed. Staff use it alongside direct communication with the person.
Small adjustments can make a meaningful difference.
Subscribe to Newsletter
Get the latest news and updates from Care Learning and be first to know about our free courses when they launch.
