Workplace adjustments podcast

Roxanne Steel

Welcome everyone to the Diversity and Ability and NHS Employers Inclusive Conversations podcast. Today we are focusing on demystifying workplace adjustment. This is the first of two episodes on this topic.

In this episode, we will discuss and share insights on what workplace adjustments are, why they're important, the legal duty for employers, some of the barriers and also the benefits that workplace adjustments bring to both individuals and organisations. In our second episode, we will explore how disabled people request workplace adjustments, how organisations can implement centralised budgets, along with some of the barriers and benefits.

I'm Roxanne Steel, Accessibility and Inclusion Specialist Lead from D&A and with me is Lydia Warren from Barts Health NHS Trust and Angela Peake from North Staffordshire Combined Healthcare NHS Trust. Thank you for being with us and we hope you enjoy our inclusive conversation. 

I'm so excited to get stuck in, but before we do, thank you Lydia and Angela for being part of the conversation. Lydia, would you like to introduce yourself for those who may not know you? 

Lydia Warren

Yes, my name's Lydia Warren and I'm the Project Inclusion Officer for the Workforce Disability Equality Standard (WDES) at Barts Health NHS Trust. 

Roxanne Steel

Amazing. Is there anything you'd like to tell our listeners that they may not know? Maybe a fun fact? Maybe something you enjoy? 

Lydia Warren 

Yes, so I do have a disability, and it's called, it's a long word, arthrogryposis and I love my music as well, so yeah. 

Roxanne Steel

Amazing. And Angela, would you like to introduce yourself to our lovely listeners today? 

Angela Peake

Yes, thank you Roxanne. My name's Angela, it's Angela Peake. I developed the Differently Abled Buddy Scheme at North Staffordshire Combined Healthcare Trust. And I took this scheme, specifically for supporting new staff that came into the organisation that identified as having a disability and to support them within the first three to six months with joining them up with somebody that knew the organisation, that knew new stuff around the place and also then took it across the ICS and to Staffordshire Training Hub. So, it's been a fabulous project that I've been involved in.

I'm a nurse by background. I worked in oncology for 18 years and because of my kidney transplant, COVID changed my life. So, thank you for the invite today. 

Roxanne Steel

Thank you for being here. So, our topic today is workplace adjustments. And we are having this conversation to help you understand what workplace adjustments are and how you can help promote and create inclusive spaces. Why? We want everyone to thrive in the workplace and making workplace adjustments accessible for all is essential for that. 

So, let's start with the basics. What are workplace adjustments and an employer's legal duties? Under the Equality Act 2010, public sector organisations have to make changes in their approach or provision to ensure that services are accessible to disabled people, as well as everyone else. Workplace adjustments can mean alterations to buildings by providing lifts, wide doors, ramps and tactile signage. But this also may mean changes to policies, procedures and staff training to ensure that services work well for everyone. It's important to remember under the Equality Act, workplaces have a legal responsibility to provide reasonable adjustments. 

So, Lydia, with that in mind, over to you. What are workplace adjustments and what are the common examples of workplace adjustment applied at your organisation? 

Lydia Warren

So, the workplace adjustments for us and the common examples that we do have over our five sites are individuals who ask for different chairs, adjustable desks, headsets, monitors, and different software like for example, Dragon. Dragon is an assistive technology for those who are neurodiverse or visually impaired. So, this assists them with, like, reading the text on the page, assist with listening as well if they need to be able to listen to the text on the page. 

Also, we do disability awareness training as well, so that the managers are able to have that knowledge to help their colleagues. 

Roxanne Steel

Thank you. Thank you very much. Great shout out to a bit of assistive technology and ergonomic equipment there. I am an avid Dragon user myself, and it's really helped with my fatigue and productivity. 

Just pivoting a bit here and moving on to looking at, people can apply for workplace adjustments, but actually are there any barriers when applying for workplace adjustments? So, with that in mind, Angela, in your experience, what are some of the barriers that disabled employees face when applying for reasonable workplace adjustments? And even what can prevent them from requesting these? 

Angela Peake

I think initially, one of the biggest challenges is people don't quite understand that they live with a disability, that they sit under that umbrella of the Equality Act, that the organisations have a legal responsibility to support them within their workplace. People often live with conditions that they've had all their lives, so they just get on with it. And so when they come to an organisation, they've often been in a place where they've just dealt with what they've needed to do and they've worked around it and you learn the little tricks and tips for doing things. When they move to a new job, often that's when the challenges can happen. If you're taking that step up, if you may be dyslexic, you've had those skills that you've used all these years to ensure that you get the work done that you need to get done and you have your way of doing it. But when you step up and you change your roles, often that can be a really big challenge to people. So that's one of the biggest things is people don't actually know that they have a disability. 

Some people know they have a disability in their previous employments, have actually spoken to their employers about that. And they've been stigmatised for that, even discriminated against. And so when they come to a new employment, they just say, I'm going to keep my mouth shut. I'm not going to say anything, because if I do, then I'll have the same reaction again. So, I think it's really important that employees from the very beginning, from induction, in fact, really from the recruitment process should make it that people understand that if you do have a challenge, even if you don't have a diagnosis of a challenge, then if you've got something that you require supporting, ask for that support.

And I think the biggest fear for people is that they're going to be seen as being different. They won't fit in. And they have real reasons for that because that's often happened to them within their lives. Sometimes it's just too difficult. There is just too much to deal with, you know, Lydia was saying about having particular tech that you can use. Well, if it's not being used automatically within an organisation, you've then got to find the right people to get that sorted, who's going to pay for that. And so it becomes a challenge and sometimes managers don't quite understand their responsibilities. 

It's fabulous that Lydia's organisation, they do that training and organisations do that training, but they often don't remember that training until they need to use it. And then, you know, where do you find that information? So it's really important for organisations to be pushing it from the very beginning, but it can be really challenging because it pushes onto the individual all the time. It often, it comes back to the individual to have to do the work to get those workplace adjustments in place. And they can be very tiny things. They don't have to be, you know, knocking walls down to get access. 

They can be really small things in the way somebody's being communicated with, but then how do you communicate that out? And if the manager isn't leading that conversation because they don't know how that conversation can be led, that can be a real challenge for staff. 

They don't have to be new to the organisation, they may just move job. So, with the buddy scheme, we supported people that were moving job. It started at the first three to six months, but actually there was people that were coming to us that were saying, I really need some support because things have changed in a way, different manager, you know, new role that you've taken on. So, I think that's, that's important to understand there are challenges and if managers can take the lead and support individuals, then that just takes off a lot of pressure. 

Roxanne Steel

Thank you, Angela. From my own experience of the physically disabled person, for those who may not know, probably unlikely to know as we are podcasting. I am a person that utilised the wheelchair to remain independent both at work and at home. So, I always say to a certain degree, I'm in a place of privilege. I go into a workspace and whether I want to or not, there isn't any hiding my disability at all. I'm able to mask a certain level of support if I wanted to, but actually I'm the sort of person that manages kind of flag down and recognize as disabled. 

So, my conversations start pretty early, but actually, like you say, a lot of people don't realise that they are disabled. And I think that's because there's been a lot of stigma around what disability actually means. I think we look at it through the lens of the charity model, not saying charities are bad, but thinking about the influences of things like Children in Need and those adverts, where it's usually someone that's really unable, very visibly disabled, needs a lot of support. But actually, a lot of individuals may not even realise they're disabled until a barrier is removed. 

So, it's really important that we celebrate what we mean by disablement. We celebrate that term. We celebrate in organisations what we can do. We enable staff, like you say, those managers to understand and feel confident to have those conversations. Because like you say, the onus shouldn't be on me as an individual to know exactly what I need, where to go, and being expert in your organisation on day one. Of course, involve me in the conversation because I'm the expert on my own body and I will know what's worked for me before. 

But actually, for some people, it's about not saying even what workplace adjustments do you need, what disability do you face, what diagnosis do you have. Just sitting down and say, how can we help you? How can you best do your job? What do you need? Like you say, it's not always those sweeping changes of knocking down walls, popping in lifts. Obviously, I love a lift. I'm never going to say I don't love a lift, but actually, like you say, it's about the way we communicate. Does that long piece of information need to be an email? Can we voice note? Can we meet? That is an adjustment. Just discussing what we need and working as a team to understand what we need to work together is really important. And it takes away that fear of discrimination because it says, hello, we welcome this. We want the conversation and we're not scared and we're excited to have it. 

Angela Peake

I think that's really important. There's often a real fear, especially from a manager's perspective that they'll get things wrong. So, it's easier not to say anything. Whereas when I have a discussion with the manager, because I work with managers and employees as well. So, when you're having a discussion with a manager and they say, but I don't know anything about this condition. I don't know anything about that at all. And I just say to them, just ask, ask what they need. I said, sometimes they may not know what they need because it may be new to them. We're having a lot of people that are newly diagnosed ADHD, autism in later life. And so, they may not know what they need.

So, support them, work with them for them to draw out what their needs are to be the very best they can be for you. And it's amazing how much that just takes off. It manages just yeah, because they're thinking they've got to tell you what you need. You don't need to be told, you live it. 

Lydia Warren

I totally agree with what both of you just said. For me, I think it's about supporting those managers and giving them the understanding as well. And because it's like they're getting pressure from the top and the bottom, so they're like in the middle. So sometimes they may not have the time, then that comes off as being really discriminative. But, it's because they don't know. So, I think information is very, very important. 

Roxanne Steel

So, we will go on to talk about good reasons for applying, the benefits and how that can help. I really want to hear from you, Lydia. What would you say to someone who is feeling nervous about applying or discussing potential workplace adjustments?

Lydia Warren

So, I would like to say to them, please use your health passport. It helps with you having that conversation with your manager and you expressing what you need. There's loads of information out there. You've got Access to Work. You can apply to them as well. If they're feeling nervous, I'd say to them, I'll go through with them to go and sit with their manager and help them talk that through if they're nervous. Yeah. 

Roxanne Steel

So you're saying that you could be an advocate or someone could have an advocate with them to also have that conversation as well? 

Lydia Warren

That's right. Yes. To be that advocate. Yes. Like Angela said, a buddy with that person as well. 

Roxanne Steel

Amazing. So, there is a lot of support out there. You deserve that support and we encourage people to access that support. I think that is the main thing that I'm kind of taking away from that, which I think is absolutely amazing. And I want to talk around the word just for a second of deserving that support, because support and accessing support is a positive thing. It shouldn't be seen as like a failure or something that makes you unequal. Actually, it's providing equitable opportunities so that you can thrive as an employer and as an employee and as a team. And I heard that you mentioned Access to Work, which we will discuss in just a few moments. 

But what I want to do is we've talked about barriers and how people can be nervous, which is completely understandable. This is the real-world situation. We're having honest, inclusive conversations, but actually I want to look at it from a different lens and looking at the benefits and reasons for applying for a reasonable adjustment. 

So, Angela, this is where I come back to you with that, okay? If there are people experiencing barriers when they're applying for workplace or reasonable adjustments, why should employees ask for these reasonable adjustments? What are the benefits for the person and the whole team when someone does receive these adjustments? 

Angela Peake

Well, I think initially by making it known that you have a disability, then your organisation knows about you. So, if your organisation don't know about you, then they're not going to prioritise you. So, the more people that do say that they require this support, then the more priority your organisation will put onto that. But I think the biggest thing for me, especially in those first three to six months where you are starting a new job, for anybody it's really challenging to start a new role. The expectation on yourself as well as your expectations of colleagues. But if you get those adjustments and you get the support that you require, then being able to settle into a role or to do any of the roles that we do in our working days, which are vast and varied within healthcare. When you're able to do that, you can be the very best you can be. And, you know, so often within healthcare, the end point is the patient. They are the people that we do what we do for. Even if you're working in admin, you're working in admin to support the patient.

So, if you are being the very best you can be, the outcome is, it's that the patients get the very best support, they get better care, they get what they need. If you're supported, because those foundations are in place, it really helps with that sense of belonging within an organisation, even though each one of us are very different. Knowing that your organisation cares about you, and is willing to put those steps in place, whatever they may be, then just having that makes you feel so much more wanted, respected, and valued in your work. And you're more likely to stay. So, from a recruitment perspective, it is really, really important that organisations put these things in place because it means so much not only to the individual, it also means an awful lot to the organisation. 

And there's also that fear of often with disability, not always, but sometimes with disability, what comes with that is hospital appointments and excess things like that that a lot of other people may not be having. And if you're fearful of asking to go for a hospital appointment, then your health will deteriorate because that fear and concern and that anxiety often increases symptoms. So if you can be comfortable in asking for what you need and your organisation are really supportive in you receiving that, then generally you're just much more well and able to be well and less likely to be off sick. And less likely to go into work when you really shouldn't be there because you're afraid of, you know, the consequences of that. 

And generally, you know, we learn from each other, don't we? So if you are talking and asking for workplace adjustments, your colleagues are hearing those sorts of things and beginning to understand the challenges that people with disability have. Now that can sometimes be quite negative with individuals because it's, why can't I have that? If you've had it, why can't I have it? So that's what's really important for robust managers to understand why that is, why we do what we do. So, ultimately, we're much better at what we do. We're much more confident, settled, and that ripples into all our life if we get what we need from a workplace adjustment point of view. 

Roxanne Steel

Absolutely. Thank you again for such an in-depth and think really clear and emphatic response. I absolutely agree. Within my work as a specialist lead at D&A, lot of the conversations we have is it's not only the right thing to do legally, like we have to do it as employers, as service providers, but actually it makes good business sense.

Thank you, Angela and Lydia for participating in this inclusive conversation. And thank you to our listeners. We hope this podcast was helpful. Just a reminder, watch out for our second episode on this topic, which explores how disabled people ask for workplace adjustments, how organisations can implement a centralised budget, along with some of the barriers and benefits.

You can access further guidance and resources on this topic via the NHS Employers and Diversity and Ability websites.

Roxanne Steel

Welcome everyone to the Diversity and Ability and NHS Employers Inclusive Conversations podcast.

In this second episode in the series on the topic of demystifying workplace adjustments. In the first episode, we talked about workplace adjustments, what they are, why they're important. And in this second episode, we explore how to request workplace adjustment, how to implement a centralized budget, along with some of the barriers and benefits. I'm Roxanne Steele, accessibility and inclusion specialist for Diversity and Ability, also known as D and A. And with me is Lydia Warren from Barts Health NHS Trust and Angela Peake from North Staffordshire Combined Healthcare NHS Trust. Thank you for listening and we hope you enjoy our inclusive conversation.

So, the first question is, how can someone apply for a workplace adjustment? What is the process and what should employees expect? Is there a standard? 

Angela Peake

Not in my knowledge, there's no standard and that can change from one working environment to the next within the same organisation. I think it will very much depend on the individual manager, so always start with your direct line manager. Always start with that conversation with them and the hope would be that the ball can start to roll from there. And often it will just be that conversation with them and how you interact with them and the team. So, it doesn't necessarily go any further than that. 

But if it is a requirement for tech, maybe that needs to go on to your systems. Maybe you've used tech previously and then you would like to come onto your system. But if you're working within the NHS, that may be a big challenge because of the firewalls and different things. So, if your organisation has a team of people that you know that you can contact- we've got a brilliant guy at Combined who I happened to find and now he's just sick of hearing from me because I'm just like, can you do this, Dave? Can you do that? But it's really helped them as digital transformational team to really understand the needs of our disabled staff and understanding again what the disability is. You know that people are highly, highly intelligent, but if you're dyslexic, then you require certain things. So yes, it's knowing who to turn to. So, start with your manager. What to expect, ideally they listen and they actually implement what you require. That's the ideal scenario. Start with your manager, go from there and see what they have to say first. 

Roxanne Steel

Thank you very much for that Angela. If, for example, and I completely understand your advice around going to your line manager first, what if you don't feel enabled to go to your line manager? Whether this be as a new starter or if someone just within the organisation. 

Angela Peake

Yeah. So I would always say find the person you feel really comfortable with that you're happy to disclose to. If you've not disclosed to people that you have a disability, that you feel comfortable to start that initial conversation. And that sometimes can be a senior manager. It can be sometimes maybe somebody on your own level, but if you're going then to seek support from different people within the organisation, you've got somebody there to support you. So find that person, find that buddy. If there's no buddy scheme, find that buddy, somebody that you connect with. 

And then you can always contact Human Resources. So HR within your areas, you should have a HR person that will be in your area that will understand the policies, that will understand the procedures will help and support the manager to put what's required in place. 

You've always got occupational health, and I think there's a bit of a fear about occupational health. It's like, well, but you know, I'm being referred to occupational health. That's never a good thing. I always think occupational health's great because it really gives you an opportunity to have a conversation with somebody who's not within your workplace to really discuss what your needs are and they're there for you. They can then put a report together that can really help to then take to a manager and say, these are the reasons why we're needed, that I need what I do. And it's backed up by the Occupational Health team. 

You've also got the equality, diversity and inclusion teams within your organisation and your networks. They're always a brilliant place to go to. So, if you've got disability networks within your organisation then they're always a really good place to go because often people have had the same challenges. 

Roxanne Steel

I think it reminds me of the old saying, it's not what you know, it's who you know and I think I definitely agree with that when kind of accessing support. And I say unfortunately because I think it is unfortunate because I don't think you should need to be an expert in these spaces especially acknowledging that on average we will spend 13 years of our lives facing a level of disablement, whether that be kind of permanently like myself or even through a temporary accident, for example, or an acquired disability. I think it's really important to remember that disability looks so different. So I think that is also really important. 

You were talking about networks. What networks are in place for disabled staff at your organisation. And when I say disabled as well, I do mean disabled and neurodiverse, of course, any intersectional networks that there may be. 

Angela Peake

So we have the Combined Ability Network, it's called, and they're just a brilliant group of people. And the lead of that at the moment is Deb, and she's absolutely phenomenal. She pulls people together brilliantly, is a real great advocate.

And that encompasses all disability, neurodiversity as well. There was, before I came to Combined, was a separate neurodiversity, but then we brought it together. And one of the really nice things is, is that we have Teams chats. So we'll have regular meetings, but in between, because many people can't make the regular meetings, people will post things and ask questions and that in Teams chats.

You get all sorts of people answer. And you know, the really interesting thing is somebody wrote one time that “I've learned so much about neurodiversity because of the Teams chats that I wouldn't have known it's really helped me in my workplace.” So you never know what impact that has on people. So sharing support information, it's a really lovely place to be.

And I think what's really important about networks is that we have the input from our senior teams. So our networks are actually sponsored by a board level member. And so I think that is really, really important that they hear what's needed for people, but also that staff also have the ability to have conversations without them there because it can often be a little bit intimidating if somebody from board levels they're listening in. And I'm not saying that in a bad way. I think, you know, they use what they hear in a really positive way, but some people do not feel confident to speak. But I think it's really important to have those links to be able to do that. And different people from our organisation have gone and spoke to the board because they have that ability, you know, they're invited to different sessions. So there's real movement through what happens in the network to what can change within the organization. And I think that's really vitally important. And I don't know if that used to happen in the past, but it feels like there's a real movement that now for all of the networks that they are really linked to the higher levels in the organization. their message gets out there.

Roxanne Steel

Amazing. So a really good call to action there. Go and find your networks, go and support them because if that movement's happening, can you be part of the echo? Could you be part of that support? Absolutely. Go and find your networks. We spoke about this before, so probably quite briefly, you did mention health passports. Could you just give us an overview of what a health passport is and how an employee can actually access one? 

Angela Peake

Different organisations will potentially have their own health passports that they will have developed. Within Combined we use the NHS Health Passport. So if you just Google ‘NHS Staff Health Passport’, it's an NHS Employers document and you'll find it quite easily. It looks a very simple document to use, but I think if it's used wisely then, and that was part of the training that I did, was to help people to complete the passport, because it's asking about all aspects of your life, really. And I would always say to people, do two passports. Do one, which is your utopian workplace, where you get everything that you need and you're able to speak to everybody and you get everything that you want and then one that you're willing to share. And that may, that will change over time, I'm very sure, but some people are very afraid of sharing their stories and their needs. So do one that feels comfortable for you that you're willing to share. For me, it's very important that that passport is yours to keep and it's not a document that you hand over to somebody else to look after for you. It's yours. It's your document. It's yours to choose what you do with that and who you share that with. 

But if you're a manager in your organization and the health passport is part of your organization and you're not seeing people use, then I would be asking the question, why? Is there a fear of using passport? Are people afraid of saying that they have a disability? So the passports are really, really helpful documents. 

And it just breaks down the technology maybe that you require how you want to be communicated with. And often we don't even think about that. You know, we just know what works for us, but we don't think about how we can help others to understand that better. I have hearing loss and within these sorts of situations, it's absolutely fine. But if I'm in a busy office and somebody's speaking to me and I can't see them, then I actually don't know that they're speaking to me until maybe the rest of the team are laughing because, you know, they're shouting at me and I'm still not hearing them. Now, that for me, I really, that's okay. That's not a problem. But for some people to have others laughing because they can't hear can be really disconcerting and really make them feel as if they didn't want to be in that workplace. And so, you know, for other people to understand how they need to communicate with you is really important. So I would say to people, if you need to speak to me, you need to contact me, get my attention, then make sure I can see you, make sure you're looking and I'm looking at you and make sure that you're not standing on my right hand side because I'm completely deaf on that side and everything I hear is from the left. So come to my left and speak to me from there. And then once people know that, they get all of, I'd forgotten, sorry you know, and then they come and they do it the way, then they can communicate with me. But enabling people to understand that helps everybody. And also it makes you feel a lot better, a lot more empowered and not disempowered by the way people respond in your workplaces. 

So using that health passport and understanding yourself is one of the most vital things for me. 

Roxanne Steel

Absolutely, absolutely.

I couldn't agree more. I haven't used the NHS passport, but I have used D and A's very own passport and that's been very enabling for me. Like you say, it's my information, it's my responsibility, you know, but it's also my right to say, actually, I don't want to share that because it comes back to that stigma and that understanding around disability. So thank you very much for sharing that again.

After this podcast, I will keep saying after because I don't want anyone to run away too quickly. Do Google the NHS Passport, download it, have a look, even if you're a respective talent person that wants to apply for a job, maybe having a look at what that passport looks like will give you an insight into how the NHS can support you. I think that's really great. 

But before we go on to the final topic or main topic of the podcast, I think we can't leave out one of the most important questions I think in my mind. Lydia touched on it before. Access to work, something I like to call affectionately, and I will say affectionately, the government's best kept secret. But we're going to blow the lid on that secret and let people know what access to work is. So Angela, again, over to you.

What is access to work and is it available to employees? Is it something to do with the NHS? I've probably given that away in my intro. 

Angela Peake

No, it's not to do with the NHS. It's a government funded grant to help pay for practical support within work. And it is available to people that have a disability. You don't have to have a diagnosis. But you know, when you look at the term disability and the Equality Act, it's something that affects you on a daily basis and has affected you for over 12 months. So if it's affecting you on a daily basis and it's challenge that you are living with, then you are very likely to be able to get support from Access to Work. Dependent on your needs will depend on what Access to Work will give you but there's a lot of money available for some individuals because that's what they require. But on the whole, it's often being able to get equipment that really supports you within your workplace. You know, if the organisations themselves, dependent on the size of them, will need to pay a contribution towards Access to Work and within the NHS, their answer is always yes. Will we do that? The answer is yes. So if you've got somebody that maybe requires a bespoke chair for them to sit and do the work that they do, and they can cost thousands upon thousands of pounds. And as an employer, it's like, “you know, am I going to employ somebody that is going to cost me those sorts of things to ensure that they get what they need?” Well, through Access to Work, the employer only pays a minimal amount towards those, and there's set amounts dependent on the numbers of staff that they employ. So yes, it gives the opportunity for that individual to have the chair that they require or the tech they require. When you were talking about the Dragon software, Dragon Medical Software, a lot more expensive than the Dragon Standard Software because it uses all the terminology that you may use in healthcare. So consequently, it's a lot more expensive. So if you are able to get hold of that because you have an Access to Work ground, then that is brilliant because you can get what you need to ensure that you can do the job and have a level playing field. It's not giving you extra. It's not giving you stuff that, you know, is going to make you absolutely phenomenal. It gives you a level playing field and it supports you to ensure that you can do your role equally compared to somebody who doesn't have a disability. 

The challenges that we have with Access to Work is currently, it's about eight to nine months before people are actually getting some responses. So that message is getting out there now compared to what it was. But unfortunately then Access to Work will take in much longer to be able to answer all the queries and answer the people that need the support.

But to be able to apply for that, it's a government website. So if you go to the government website, you just Google Access to Work and the application form used to be very, very simple, but they've made it a little bit more detailed. So if you need support, there is a lot of support out there to be able to get Access to Work in the first place. So don't be afraid of asking for help to be able to just fill those initial documents in.

The grant, it's a grant, it doesn't have to be paid back. They will tell you what you're able to get. And then dependent on the organisation, that can sometimes be the challenge, being able to get the equipment that you've been provided with, getting that and then getting it implemented within your organisation. And that's sometimes they've got a very slick process for that but it will very, very much depend on the organisation that you're in. 

So for me, with us now at Combined, we've got the team that saying, okay, if we've got somebody who's got Access to Work stuff, they know that they need to look at that immediately to get it onto the systems as soon as possible so they can use it. So if you're using Dragon or multiple other software that you may have been given, then you need that support.

And that sometimes can be a real challenge and managers, again, don't know necessarily where to go. So if you've got that streamlining within your organisation, that's a phenomenal thing to have. 

Roxanne Steel

Again, it's probably a case of not what you know, but who you know. So again, that person that knows everything about Access to Work. So yes, in regards to access to work, I have to be an advocate in this space and I have to say, do you know what? Without access to work, I wouldn't be here today to be able to present this podcast down from the table that I'm able to use, the input software that I am utilising, and even having a PA to enable me to actually be able to join this conversation today. And that is all thanks to Access to Work. I think we need to go on to our final topic, which is around centralised budgets and I'm really excited Lydia. From my understanding, Barts Health was one of the first trusts in the company to implement a centralized budget for those workplace adjustments that we've been discussing. Would you like to tell us more about that? More about your experience, essentially kind of the benefits that you've seen and some of the challenges that you faced? Over to you, Lydia. 

Lydia Warren

Oh hi. Yeah. So, the centralized budget was formed back in 2017, I think. It's been a long time ago. It went through, so being the former co-chair of our network, Disability Network, BartsAbility. BartsAbility were asked by the non-exec board to attend and do a presentation. And then from there, we had to explain what we needed. So they asked us how can they help us to be able to support our colleagues who have a disability and to help them remove the barriers. So I explained to them what was needed. For example, the equipment for colleagues and being able to have that for the department as well. So our network at the time held four listening into action events across our four sites. And we engaged with our colleagues to get their feedback and information. And one of them was to be able to have equipment put into place. And that's how the centralised funding came about. 

So, we do have support from our boards. So we have several boards. So we have our non exec board and we have our inclusion board and various different boards. So it had to go through that process in order for it to be signed off. I think a business case was put together for that. And the turnaround time for that was roughly about two years, but also linking it in with the away days as well and how we presented our data. 

We also work with our employee wellbeing service, which is occupational health and at first that was a bit challenging, but now we have our links with them in a way of having a focus group each month to discuss any obstacles or issues that come through. And the challenges that we do have are that managers understanding that they don't have to use their budget to get the workplace adjustments put into place. So it's about giving them the information.

And working with finance and procurement, that was really difficult, but we're still working on that as well. And ICT because there's certain equipment or software that we are unable to use. 

And the learning from implementing the budget, we have our workplace adjustments focus group, as I mentioned before, and we work closely with OH. That we do need a disability policy where workplace adjustments process are needed to support for managers to be able to assist our colleagues with the workplace adjustments. 

Roxanne Steel

Amazing stuff. What is just one line maybe, what is the advice do you give to anyone listening that's chomping at the bit to get a centralised budget put in place at their organization? 

Lydia Warren

Just one bit of advice. One bit of advice, get your exec boards, your exec sponsors as well on board with this because it does help because we collect the data and we can see from our data that there is a need for the centralised budget. 

Roxanne Steel

Really backing that up with data? 

Lydia Warren

Yes, yes, definitely. Data is a big major part of this.

Roxanne Steel

Amazing stuff. Honestly, wow. Thank you to both of you. I've been so grateful and so privileged to be part of this kind of conversation. But I would love to just pass over to you for two seconds to Angela and could you give me your final kind of thoughts? Jerry Springer style, what advice would you give a disabled employee considering applying for workplace adjustment?

Angela Peake

I would say know what you need before you take that step forward or have an understanding of your needs that you can then have a two-way conversation with your manager to ensure that they can support you in those things. And that's where the workplace adjustments start to come from. If you don't know what you need, then others are going to tell you what you need and it may not be what's right for you because we're all so very different. So there is no blanket of what anybody needs dependent on the disability you give them, this, that and the other. It's if you know what you need, then you can empower yourself to be able to ask for the support and get it to ensure that you can do your job to the best of your ability. 

Roxanne Steel

Absolutely, absolutely. I couldn't agree more. Angela or Lydia, any final words? 

Lydia Warren

Yes, ask for help and don't be afraid of asking for it because there is always help and do your health passport as well. 

Roxanne Steel

Accessing support is something everyone deserves, it is something that you are legally entitled to and again it shouldn't matter, but it makes good business sense and it is going to support, yourselves, to your patients and anyone that you will be working with. So again, I couldn't agree more.

Thank you Angela and Lydia for this fantastic, inclusive conversation and thank you to our listeners. We hope you find this podcast helpful and you can access further guidance and resources on this topic via the NHS Employers’ and Diversity and Ability’s website.