From 1 October 2010, the Equality Act replaced most of the Disability Discrimination Act (DDA). However, the Disability Equality Duty in the DDA continues to apply.

The definition of ‘disability’ under the Equality Act 2010:

'In the Act, a person has a disability if:

• they have a physical or mental impairment
• the impairment has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities

For the purposes of the Act, these words have the following meanings:

• 'substantial' means more than minor or trivial
• 'long-term' means that the effect of the impairment has lasted or is likely to last for at least twelve months (there are special rules covering recurring or fluctuating conditions)
• 'normal day-to-day activities' include everyday things like eating, washing, walking and going shopping

People who have had a disability in the past that meets this definition are also protected by the Act.

Progressive conditions considered to be a disability

There are additional provisions relating to people with progressive conditions. People with HIV, cancer or multiple sclerosis are protected by the Act from the point of diagnosis. People with some visual impairments are automatically deemed to be disabled.

Conditions that are specifically excluded

Some conditions are specifically excluded from being covered by the disability definition, such as a tendency to set fires or addictions to non–prescribed substances.'

Source: Directgov website

• You do not have a legal obligation to disclose a disability, unless there are health and safety issues either for yourself or for your colleagues as a result of your condition. If this is the case, then you are obliged to inform your employer under the Health and Safety Act (1974). The GMC produces the Good Medical Practice (GMP) Guide and this also has some directives on looking after your own health that take into account patient safety. The GMP guide says ‘If you know that you have, or think that you might have, a serious condition that you could pass on to patients, or if your judgment or performance could be affected by a condition or its treatment, you must consult a suitably qualified colleague. You must ask for and follow their advice about investigations, treatment and changes to your practice that they consider necessary. You must not rely on your own assessment of the risk you pose to patients.’ The GMC also provides further information on equality and diversity in their Valuing Diversity Guide.
• Provided there are no health and safety issues as a result of your condition, it is your decision to choose at what stage to disclose.
• Once you have disclosed your disability you are protected by the Disability Discrimination Act (DDA). This means that your employer must provide reasonable adjustments to the workplace and must not discriminate against you because of your disability.
• If you choose not to disclose your disability and subsequently underperform then you may not be covered by the DDA.

• Do not assume that your employer will see your disability in a negative way. You should be clear and confident in explaining your disability and any adjustments you will need to make to your working environment. Remember the NHS has a policy of increasing the diversity of the workforce and is committed to increasing the employment of people with disabilities.
• Think about the skills you have developed as a result of coping with your disability. You may have a greater understanding and therefore empathy with any patients with a disability.
• Note that your employer should only discuss your condition in the context of the job and how it affects your work.

• The application form: There is often a section which asks about any serious health conditions; if you do not wish to disclose then you simply do not have to answer the question on the form. If you do disclose, only discuss any points relevant to your work performance (do not include personal detail not related to this).

The section on the application form is for the use of administrative staff only, not to those shortlisting.  If you declare a disability and you meet the minimum requirements in the person specification, any employer signing up to the “Two Ticks” symbol should offer you an interview, so it may be worth declaring at this time.

• The CV/Covering letter: When applying for jobs where you send in a CV always include a covering letter. You could choose to disclose in either the CV or covering letter. If so, it is recommended that you emphasize how your disability has further developed your skills and experience. (e.g. the fact you have a disability, will mean that you can relate to patient experiences; also you could mention how you have achieved your goals despite the difficulties you have experienced due to your disability). If there is a gap in your work or educational history due to a period of prolonged illness you can also explain this in your covering letter.
• At pre-interview stage: The DDA requires that applicants with a disability are not discriminated against at the interview stage. This may mean that you may need the employer to make practical arrangements so that you can compete on equal grounds with other applicants.
• At interview: You may decide that the interview is the best time to disclose your disability. This way you can talk to the employer to discuss the implications face to face and it may give you an opportunity to tell the employees about the positive effects of how the disability has impacted on your life and how it has improved your employability. You can make suggestions about what adjustments you would need at work, you might feel it is easier to deal with any concerns or misconceptions an employer may have in a face to face interview.

Some disabilities may exclude individuals from working in a certain area of employment. For example, someone with poor vision would unlikely to be able to become a surgeon. However all reasonable avenues should be explored by the employer. See our information on reasonable adjustments (below).

Source: AGCAS Diversity matters: disability (note: this information is accessible to AGCAS members only)

The BMA Equal Opportunities committee in 2007 published a document entitled ‘Disability equality in the medical profession’. Here they highlighted that it was common for doctors not to disclose their disability, and that there was a stigma and that colleagues were often unsympathetic. The recent NHS initiatives such as Improving Working Lives (IWL) and positive action have started to change the culture. The introduction of communication skills and the understanding of the needs of disabled colleagues into the Foundation Curriculum document and in the GMC Tomorrow Doctors and Good Medical Practice publications have also helped. These are aimed at changing the attitudes towards doctors with a disability.

The Equality Act has laid down that employers have a duty to make ‘reasonable adjustments’ in the workplace. Access to work is a government initiative which offers separate funding to help your employer do this.

Reasonable Adjustments

The Act has not laid down what constitutes ‘reasonable adjustments’. However examples may be:

• Providing more time in the application process or for day to day work
• Working/training Less than full time (LTFT)

On this site we have information on working and training on a LTFT contract. See our pages on LTFT.

• Allowing a disabled employee to work from home, e.g. for one day a week
• Reconfiguring tasks amongst the team
• Using modified equipment, eg providing voice activated software for an employee with a visual impairment
• Making adjustments to the physical environment e.g. putting in a lift; providing ramps etc
• Providing instruction manuals in accessible formats, e.g. large print, Braille
• Transferring a disabled employee to another post of equal standing

Source: AGCAS Diversity matters: disability

(note- this information is accessible to AGCAS members only)

N.B. There is a more comprehensive list of examples of reasonable adjustments in the GMC Gateway Guidance (See resources section below).

The ‘Access to work’ scheme was set up by the government. According to the directgov website:

‘Access to Work might pay towards the equipment you need at work, adapting premises to meet your needs, or a support worker. It can also pay towards the cost of getting to work if you cannot use public transport. If you need a communicator at job interviews, Access to Work may be available, too.’

Source Directgov website

It may be therefore possible to get some funding for a support worker to act as a personal assistant to carry things for you or who could drive you to work etc

• Improving working lives

Includes examples of good practice in promotion of Equality and Diversity in supporting disabled staff.

 (For further information see http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4010416 ))

• Positive action

According to the NHS Employers Briefing Issue 46: June 2008 ‘Positive Action includes lawful action which seeks to address an imbalance in employment opportunities among targeted groups.’

(for further information see http://www.nhsemployers.org/Aboutus/Publications/Documents/Positive%20Action%20-%20Five%20years%20on.pdf )

The BMA Equality And Diversity Committee report ‘Disability equality in the medical profession’, states that ‘As 70 per cent of disabled people will acquire their illness or impairment during their adult life or while at work, it is reasonable to suggest that a substantial proportion of doctors will acquire an impairment at some point during their career’.

The Good Medical Practice guide requires doctors to take responsibility for their own health in the interests of public safety. Therefore if you are in this situation and you feel that your judgment or performance will be in any way affected:

• The first step is to visit an occupational health consultant
• You may also consult your medical defence organisation for advice

If you feel that subsequent to having the diagnosis, that you may need to review your career options, or even to decide on a career outside medicine, then you should talk to your Educational Supervisor, who may in turn be able to contact your deanery, to ensure that you have careers advice from a careers specialist.

See our page on doctors with mental health conditions.

See our section on LTFTs.

Resources

BMA Equality and Diversity Committee report ‘Disability equality in the medical profession

NHS Employers

Support4doctors

Hope4medics

Sick Doctors Trust

GMC Valuing Diversity Guide

Equality and Human Rights Commission

Employers Forum on Disability Website

Skill National Bureau for students with disabilities

GMC Gateway Guidance - October 2010

Gateways to the Professions: Advising medical schools: encouraging disabled students

Time taken off work

Dr Rosie Puplett an F2 at North Bristol NHS Trust has written an extremely useful Guide for time taken off work for those that have practical and financial worries due to long absences of sick leave.