We have detected that you are using Internet Explorer to visit this website. Internet Explorer is now being phased out by Microsoft. As a result, NHS Digital no longer supports any version of Internet Explorer for our web-based products, as it involves considerable extra effort and expense, which cannot be justified from public funds. Some features on this site will not work. You should use a modern browser such as Edge, Chrome, Firefox, or Safari. If you have difficulty installing or accessing a different browser, contact your IT support team.
NHS Digital and NHS England have built the Flag in the NHS Spine to enable health and care professionals to record, share and view details of reasonable adjustments across the NHS, wherever the person is treated.
Having been successfully piloted, the capability is now in further final development, and will be available for wider use from the end of 2020.
Recording of impairments - details of disability or long term condition
Along with the details of adjustments to care, the Flag can optionally contain details of the disability or long term condition that is the source of the patient’s impairment(s) in line with the Equality Act 2010.
The list below shows the information that can be recorded and, where relevant, the Equality Act 2010 definition:
Please note: the examples used in the video and e-Learning tool are created using the current version of SCRa.
The capability may look slightly different in the new private beta version of SCRa or clinical systems integrated with the capability in the future, but the approach will be the same.
In addition, co-production and discovery work was undertaken with clinical system providers including screening services and many individual patients and their carers and families.
In response to findings, NHS England commissioned NHS Digital to create a Reasonable Adjustment Flag on the NHS Spine for the benefit of all relevant patients covered by the definition of impairment under the Equality Act.
This supports the findings of the CIPOLD report and the NHS Long Term Plan requirement that by 2023/24, a ‘digital flag’ in the patient record will ensure staff know a patient has a learning disability or autism.
The first phase of work has seen the capability built into the NHS Spine and available for Flag creation, viewing and update through use of the SCR application (SCRa) and SCRa 1-click enabled clinical systems (initially in Servelec Rio).
In addition, a FHIR software Application Programme Interface (API) has been designed for integration of clinical and screening systems with the Flag.
Further information
-
external
NHS England reasonable adjustments information for NHS staff
How can I help make sure these adjustments are made? Including what digital flagging means for patients a short film is about how sharing information can help staff in health services know the right way to work with people with a learning disability and/or autism.
-
external
Reasonable adjustments for people with a learning disability
Public Health England Guides on how reasonable adjustments should be made to health services and adjustments to help people with learning disabilities to access services.
-
external
Making reasonable adjustments
Social care guidance about making reasonable adjustments for people with learning disabilities.
-
external
The confidential inquiry into premature deaths of people with learning disabilities
The inquiry found: 1) The lack of reasonable adjustments … was a contributory factor in a number of deaths. 2) GP referrals commonly did not mention learning disabilities, and hospital ‘flagging’ systems to identify people with learning disabilities who needed reasonable adjustments were limited. 3) There is a need for clear identification of people with learning disabilities on the NHS central registration system and for this information to be made available to care professionals in healthcare record systems. Merely identifying that a person has learning disabilities is not sufficient - this information needs to be supplemented by a statement of the reasonable adjustments required.
-
external
Equality Act 2010 guidance
Equality and Human Rights Commission guidance on the Equality Act 2010.
-
external
Definition of disability under the Equality Act 2010
You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.
-
external
Accessible Information Standard
All organisations that provide NHS or adult social care must follow the accessible information standard by law. The standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand with support so they can communicate effectively with health and social care services.
-
internal Reasonable Adjustment Flag: GDPR information
Why and how we process your data in the Reasonable Adjustment Flag and your rights.
-
external
NHS Long Term Plan
By 2023/24, a ‘digital flag’ in the patient record will ensure staff know a patient has a learning disability or autism.