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How disability differs in some ways from the other ‘protected characteristics’

The Disabled NHS Directors Network is completely committed to supporting all of the ‘protected characteristics’ (as defined in the Equality Act) and to eliminating all forms of discrimination and/or disadvantage in the NHS.

Disability has much in common with other ‘protected characteristics’, but it also has some characteristics which are unique to it, or which manifest themselves in slightly different ways from the other ‘protected characteristics’. 

Below we summarise some important aspects of disability from the point of view of NHS staff.   Some of these also apply to other ‘protected characteristics’; some are more specific to disability.

• Every disabled person is disabled in a different way – the label ‘disability’ covers an almost infinite variety of circumstances and needs among the millions of disabled people in the UK.   
• The ‘challenge’ of disability (to the disabled person themselves and to their NHS employer) plays out in different ways for each individual, with different options and solutions.  This is intensely individual but is also cross-cut in several broad ways – for example, by the nature of their impairment or disability; whether their impairment is static or progressive; when in their lives they acquired their disability (for example, before commencing employment or during their working life); by their profession within the NHS; and so on.   It is also affected by a person’s support framework e.g. friends, family, employer, etc. and their mindset.
• Many disabilities are ‘hidden’ or ‘invisible’ e.g. mental ill health, autism, epilepsy, some long term conditions.
• About one-fifth of disabled people acquire their disability at birth or during childhood (i.e. before they enter their careers or join the NHS), and about four-fifths acquire their disability during their working life, so develop the ‘challenge’ during their careers.
• The opportunities disabled people have and the way they view their condition and manage it, may in part be affected by when they acquired their impairment/disability.
• For those who acquire their disability at birth or in childhood, their childhood and young adult experiences (including medical, social, educational and career entry challenges and opportunities) will shape how their disability affects them and their careers. 
• People who acquire a disability later in life may already have established themselves in their lives generally, and in their careers in particular, but then have to change the way they live completely to accommodate their impairment, and this will shape how their disability affects them and their careers.     
• This means employers need to support not just employees who join them with a disability, but also those who become disabled during their careers, especially if their condition progresses and deteriorates.
• Not all disabled people can do all NHS jobs, by virtue of their disability e.g. some people with mobility impairments probably could not be acute ward nurses or porters, but they could be physicians or radiographers.
• Disabled people often need ‘reasonable adjustments’ (including ‘reasonable consideration, behaviours and support’) to enable them to undertake or sustain their careers.
• ‘Reasonable adjustments’ are not just physical (e.g. ramps, chairs, lifts, software), but also (depending on an individual’s disability) include ‘reasonable consideration, behaviours and support’ by their line managers, colleagues and organisations.Historically, the typical employment paradigm in the NHS (both at entry to jobs, careers and professions and during careers) has placed the onus on the disabled person to ’prove’ they can ‘do the job’, rather than employers accepting that the onus should be on them to enable the disabled person to ‘do a job’ or enter a career.
• Historically, the typical employment paradigm in the NHS (both at entry to jobs, careers and professions and during careers) has placed the onus on the disabled person to ‘prove’ they can ‘do the job’, rather than employers accepting that the onus should be on them to enable the disabled person to ‘do a job’ or enter a career.
• Line managers and colleagues of a disabled employee need training with respect to understanding disability and what ‘reasonable considerations, behaviours and support’ they should offer employees with disabilities. 
• There may be different challenges for employers or line managers depending on the nature of the employee’s disability.   Particular training should be considered with respect to how to support employees with some ‘hidden’ or ‘invisible’ disabilities e.g. mental health, autism, epilepsy, long term conditions.
• Resources are required to provide physical ‘reasonable adjustments’ and training with respect to disability for line managers and colleagues of a disabled employee.  The budgets for these should be held centrally in NHS organisations, not at line manager level.

Why the DNDN Network was set up?

Disabled leaders in the NHS – some compelling statistics

• 22% of UK working age population have declared a disability
• 20.2% of staff indicate they have a disability in the NHS Staff Survey (which is anonymous)
• However, only 3.7% (52,007) of NHS trust workforce have recorded a disability on NHS Electronic Staff Record (ESR) (i.e. declared their disability to their employer)
• ESR disability recording rates at individual trusts range from 0.9% to 13.4%
• 3.7% of NHS trust board members are disabled people (2.0% in 2019)
• 58.5% (127) of trusts have no disabled board members; only 23 trusts have more than one
• In 2019 there were 63 trust board members who declared a disability (incl. 35 non-executive and 28 executive directors); in 2021, 121 declared a disability (incl. 60 non-executive and 61 executive directors)
•  Across the national healthcare organisations there is only one disabled board member
• 2.8% of Very Senior Manager (VSM) pay grade leaders in 2020 were disabled people (1.6% in 2019)
• 59% of trusts (128 out of 217) have five or fewer disabled staff in senior positions (Band 8c and above, including medical consultants and Board members)
• 1.1% of medical consultants have declared a disability

The source for almost all NHS data above is the ‘Workforce Disability Equality Standard’ report published by NHS England in May 2022, WDES 2021 Data Analysis report, or its predecessor reports published in 2020 and 2021

Objectives

Objectives of the disabled NHS Directors Network

• To strengthen the collective impact and voice of disabled leaders and disabled staff.
• To provide a support network for disabled NHS directors – common concerns, best practice, development needs, buddying, mentoring, advocacy.
• To strengthen the recruitment pipeline for disabled directors.
• To offer a national level advisory group re disabilities and EDI in the NHS.
• To be ambassadors for the service and business benefits of bringing the lived experience of disabilities to leadership positions.
• To identify and promote best practice in supporting and recruiting disabled staff.
• To support research into under-representation of disabled people at all levels in NHS and in clinical professions.
• To work with Health Education England and professional bodies to improve careers for disabled staff.

Benefits of Recruiting More Disabled Leaders

• Broaden the diversity of NHS leadership – a boon in the new world of collaboration 
• Bring lived experience of being disabled to Boards, so many of whose patients experience disability
• Increase the number of high quality applicants available (22% of working age adults are disabled)
• Support the creation of a workforce which values difference by having disabled role models
• Strengthen the voice of disabled patients in NHS decision-making

History of the Network

• Formed autumn 2020
• First national network representing NHS leaders with disabilities
• Open to Board or Governing Body members of NHS providers, CCGs, CICs, and ALBs (non-executive and executive)
• 49 members (39 NEDs and 10 executives)
• Wide range of disabilities and impairments represented (autism, hearing impairments, long term conditions, mental ill-health, mobility impairments, visual impairments)
• Good range of gender, ethnicity and geographical coverage