NHS equality for disabled staff

[Tooscaredtoorocktheboat]

Hey, name change and sorry about length but don’t want to drip feed and lack of clarity for fear of outing details

particularly interested in hearing responses from NHS staff or anyone who is knowledgeable about equality law

Ive been with NHS for a bit, I’m still on regular probation and have A long term medical condition classed as a disability. So far no issues and probation is proceeding fine with no issues.

I was open and honest & only reasonable adjustments that came up at pre interview stage was hours. After I was offered the job it came out there may a requirement in future for a change to shifts. I told them I couldn’t do it due to disability. The manager seemed a bit pissed off but also said “don’t worry it’s not on the cards yet and we wouldn’t make you do anything you can’t do” so I accepted the job at agreed hours.

after I started I approached the manager about another reasonable adjustment I needed and have had the last 15 years (regards annual leave) and how can I ensure I get the time I need.

I explained I want to use annual leave rather than potential sick because I don’t want to use my sick pay for regular health related stuff due to reducing my sick pay allowance, disadvantage to my attendance record and also put them in the shit by unplanned absences because it puts the service under strain. I know using my annual leave works to manage my condition as I’ve not had to have any sick time off with it for years although I’ve had an unplanned hospitalisation (which resulted in change to annual leave to better manage condition) a fair few near misses and flare ups.

They were pissed off (comments made about wishing they’d known at interview!!). Outcome was I was told to request my AL as soon as allowed too in advance using the normal department process/policy because if I was given reasonable adjustments and allowed to book them separately they could be accused of treating me unfairly as they had to treat ALL people equally (but equality act allows for this if it means preventing disadvantage so work are protected from this accusation ‘anyway) and they were “sure” I’d have the leave I need by following the process (sounds possibly like a first come first served)

I don’t know how annual leave is granted but There’s no guarantee despite the reassurances of it not being a problem I will get what I need when other colleagues don’t even follow the stated procedure (ie requesting too far in advance so if it’s first come first served I’ll not get my leave if people put requests in early before me)

I’m worried I’m going to end up having to take sick days to either manage my condition or even worse end up Flaring up and being ill, which then leaves me a disadvantage. My requested leave isn’t unreasonable (ie not at key service times or all in school holidays - I’m not taking the piss). If I need to take sick cos I wasn’t granted the leave they’ll have maximum number of staff on leave plus me off sick so down on service level (plus anyone else off sick!)

I’m too scared to ask again in case they ditch me at end of probation due to being seen as difficult.

question? are the nhs crap when it comes to disability discrimination and reasonable adjustments for disabled staff?

the aibu?

yabu: you should bring this up now with management and see hr about getting your reasonable adjustments

yanbu: Don’t rock the boat. Wait til probation finished - Take whatever annual leave they give and then take sick as needed then try to sort out later through hr and occupational health when in a stronger employment position

any advice/suggestions?

Hi everyone thanks for the replies. I’m trying to not be too outing and I apologise for the lack of clarity. I’ll try to explain as best I can

so basically I use my annual leave for planned rest (which is kind of the purpose of annual leave). My condition is worse at a certain time of the year and I’m more vulnerable to “flares” at this time. Using my previous history Of “severe”recurrences I request my annual leave to cover these “key” times. This also reduces the amount of time I’m in work over this period Of time. In for a bit off for a week in for a bit off for a week etc. Unfortunately I picked a career where the most stressful and busiest time is one where my illness is worse.

My illness and symptoms can get in a vicious cycle, my illness causes fatigue which in turns causes symptoms which in turn worsen the fatigue etc etc. The fatigue builds up the symptoms worsen and a major recurrence can occur that can result in injury, hospitalisation or death. Symptoms can start off small and infrequent, a lot of the time the medication and management systems I have in place work and they don’t go anywhere and subside but its unpredictable and it’s a bit like a pressure cooker and can keep building up and up to an inevitable severe recurrence

The annual leave offers a fire break if you like at regular points through the most vulnerable period. A chance to rest/recuperate and prevent this.

This has worked for the last 15 years bar one year where a severe recurrence occurred in work that resulted in hospitalisation as I nearly died. The ambulance service were starting to talk my colleagues through the start of CPR.

then a couple of years ago where I ignored some other reasonable adjustments regarding shift patterns to do overtime and my condition ended up flaring up but luckily it came back under control before a serious event happened probably because I’d not long had a week off so it probably worked then too. I had to become more strict with enforcing reasonable adjustments after this and a planned trial increase in hours didn’t happen as I wasn’t sure if I could cope (I’d been doing extra - I’m already part time and can’t financially afford to drop any hours). My sickness record is exceptional BECAUSE of reasonable adjustments including my annual leave that help keep my condition under control

I don’t feel like I’d be allowed to use sick leave as the annual leave is something I use as a preventative measure, a precaution to prevent my Illness deteriorating to a point where I can become very ill. I can’t imagine ringing up and saying “I need a week off - my illness is getting worse and if I come in I will become very sick” hence why I want to use my annual leave. That’s what it’s there for surely? To use to take planned time away from work. Surely you can’t “plan” sick leave.

my medication helps a LOT and without I’d be very sick all the time but there’s only so much it can do and can’t prevent everything and there is an element of lifestyle and preventative management including reasonable adjustments

it’s a biggish team - Three people can be off at any one time. (One of one grade one of the next grade plus one more from either grade). In my few months there I’ve already seen a fair bit of sickness absence from other people. Sometimes even an additional two or three people and I don’t want to potentially add to that. I just feel that surely it would be better to have my rest periods planned in etc rather than having to take unplanned leave.

hope that helps explain a bit more

Hi that would work if it’s allowed. It’s basically using my annual leave as a preventative measure to help stop me becoming seriously ill. I’ve explained in more detail above xx

Thank you for explaining a bit more OP.

How far in advance do you pre booked your planned A/L/rest time? Is it ad hoc, the next week or say a set amount per month? Like 2 days this month, 2 days next month that you plan and booked weeks/months in advance?

I use my annual leave booked in advance to help prevent the illness recurring based on my history. It’s worked every year bar 1.

To use sick leave instead of annual leave I’d have to use sick leave as a preventative measure which I feel would be frowned upon because I’d be using it at a time of increased fatigue and possibly minor symptoms in the anticipation that staying in work at that time would cause a major recurrence.

not having a break (either annual leave or sick) basically means I will most likely have a full recurrence which is quite dangerous which we lead to longer sick leave at a minimum plus the inherent risks of injury hospitalisation or death.

my thoughts were surely it’s better to use annual leave booked well in advance so that service provision can be accounted for (bearing in mind 2 other members of staff could be off still at the same time) but not out the service provision at risk by there being Three people off plus me off sick plus whoever else might go off sick at the same time if that makes sense?

i understand that if they accepted it as sick leave it probably wouldn’t count against me in terms of absence reporting but what about loss of wages on ssp or if say I ended up breaking my leg and being off longer than contractual sick pay covers. It would all go against me when I could be potentially having 5 weeks off sick a year

I’d be requesting it 12 months in advance (what the policy is in department and what the manager has told me to do) but the allocation policy is not transparent. I don’t know who does them, whether it’s first come first served etc. i got the impression that when the manager said put them in as soon as allowed it was first come first served but then people are requesting them 13/14/15 months ahead 🤷‍♀️

there’s also no provision to add the reason so that wouldn’t help allocation of holidays (eg someone going to their wedding etc) so I’m not sure that’s a deciding factor

i feel in a bit of a stuck situation because if one got refused, I could easily find that the weeks either side are then booked up and that the next available week would be too far from the previous rest break which then leads to too much fatigue and a major recurrence happening.

also if say I couldn’t get week “1” but was given week “4” but then I was completely symptomatic in week 3 and had to call in sick to prevent a major recurrence (as I’d be too At risk to work that week) it looks completely shit because they’ll think I’m pulling a sicky right before a holiday.

i feel like I can’t win 🤷‍♀️

Occupational health can help you with reasonable adjustments.

Have you had an occupational health reference and asked them to support your request for your AL dates? If occy health sent me this advice for a member of my team I would follow it.

This is going to depend largely on your manager. But if you are able to book it far in advance I’d get into the habit of doing that as early as possible. IME sone people on first come first served (often those who need childcare) will book as soon as they can, others tend to be more flexible and book at short notice when the leave calendar is a bit less busy. You may be able to manage this without anyone actually knowing.

I would join a union though and if you do have problems Occ health, HR and the equalities advisor can all help. We’ve got enough trouble staffing without chasing off would who would be able to work with some minor adjustments.

Sorry I should add as well… I’m not trying to pull a fast one by requesting all school holidays or all of christmas or Easter or bank holidays off etc.

when my child started school several years ago my previous employers suggested we moved three separate weeks “forwsrd” a week to adjoin 1 week of school holiday on a “trial” on two separate half terms so that I could add one week of school holiday on to one of half terms so that we can have a family holiday still. Luckily it worked and I had no adverse affects from that change. It means I have to pull my child out of school 4 days for a family holiday but because my annual leave is set based on my disability school authorise it because to not would be seen as discrimination. I have one week of school holidays a year adjoining a term time week which all the rest are

so if school can see that why can’t my boss?

I would be a bit wary of ‘we have to treat everybody equally’ though. Equity is not the same as equality. I’d be surprised if they were hauled over the coals for not treating everyone equally when the reason for that is a reasonable adjustment for a disability.

My ex line manager tried to pull that shit once. It didn’t end well for her.

@Dontlistitonfacebook @LiquidGlee

hi so I had to have an oh “fit slip” to start.

it was a bit crap because it was over the phone when I was sat in McDonalds before work at my old job. It wasn’t even a doctor just someone typing away and then “I’ll pass this on to the doctor to review”

when I got the fit slip/okay to work I was a bit miffed because some of the stuff I’d told her she’d got wrong and she definitely didn’t get everything in but the relevant bit would be

“Discussion about a set leave pattern annually if possible as illness tends to be worse between “month and month” or trying to accommodate leave with this in mind”

i get why they worded it like that because they are trying to cover themselves if I was to try and take the piss eg , I want all
of Christmas off or all school holidays (she actually said this on the call to me that something like that couldn’t be agreed)

I mentioned the OH fit slip to manager and they said “we don’t see that report it’s confidential” so I don’t really know how to take it from there if they are just seemingly dismissing it outright. So the discussion that they were supposed to have with me resulted in what I’ve detailed in this post.

i feel like I will need to eventually go back to OH and set it out clearly as to why I have a set leave pattern but I feel like due to the feeling that I got that the management were pissed off I should wait til I’m over probation etc

Well that was the reasoning for not slowing me to book my annual leave separately in some fashion “we have to treat everyone equally and to allow you a separate process means not treating you equally and I could get in trouble”.

feel like the point of the whole equality act was completely missed there 🤷‍♀️

if I get sick/have to take more sick leave etc due to not allowing me an adjustment to bring me to a level of equity means I’m at a disadvantage.

i also can’t see how what I’m asking is terribly unreasonable.

I felt like the suggestion to request as soon as allowed was to stop other people kicking off about preferential treatment. I will absolutely continue to request as soon as “policy” allows but if it is first come first served I’m at a disadvantage straight away because others request too early. It literally stresses me out all the time and I’m constantly worrying about it x

I explained I want to use annual leave rather than potential sick because I don’t want to use my sick pay for regular health related stuff due to reducing my sick pay allowance, disadvantage to my attendance record and also put them in the shit by unplanned absences because it puts the service under strain.

It might be the language you've used isn't what you were intending to convey, but this raises red flags to me I'm afraid. Sick pay if for when you are too sick to attend work. It's not an allowance and you don't get to choose how you use it.

I really don’t understand what it is you’re asking for. Is it possible that they don’t either?
If I were your manager I would make a referral to OH and await their report and recommendations.
If you're asking for a/l at short notice that may prove tricky as the needs of the service still have to be met.

I'm not really understanding what the issue is.

If you're booking your AL within the department guidelines.... i.e up to 12mths ahead, only 3 off at one time etc.... what is the issue?

What you use it for is your personal business.

Hence why I want to use my annual
leave. And the fact that apart from an unrelated operation needing 3 weeks recovery and being hospitalised once after a severe recurrence in work due to my disability (resulting in blue lighted to hospital from my work place after I nearly died) I’ve had 0 absences due to sick leave in 14 years would be highly suggestive that all my reasonable adjustments work in the way they should and keep me healthy and working. To the point I’ve been offered my old job back three times since leaving.

So please tell me how a disabled member of staff trying to secure reasonable adjustments to keep them healthy and working in a way which completely minimises risk of unplanned sick leave to their employer is a red flag?

if I’m wording it wrong please please let me know how you feel it could be worded better

With respect, I don't think the equality act says they have to set up entirely separate processes in order to treat disabled people fairly or that just because they are asking you to request your leave at the same time as everyone else means it's necessarily first come first served. It may well be that they are in fact planning to (quietly) give you priority if they possibly can (because obviously they don't want you to go off sick either), but don't want to make any promises until they know for sure. It may just in a lot of ways be easier to manage for them if you are using the same leave booking system as everyone else and they are considering all the leave requests at the same time (like I said earlier, you may not be the only one in the team with a disability or requiring special consideration for another very valid reason). Or if others in the team notice you have booked leave but it's not on the e-rostering system or the team calendar or whatever that could lead to awkward questions which could compromise your confidentiality. Nothing they've said so far indicates to me they're planning on turning you down, or not arbitrarily anyway.

And also, I'd say if you are down to work but are experiencing a flare-up which could lead to major complications, you are entitled, indeed should, take that time off sick. Just because you 'could' theoretically drag yourself to work albeit putting yourself at risk of major complications doesn't mean you 'should' - I'd say the majority of NHS sickness episodes are for things that if the hospital was on fire people could just about function through - coughs, colds, flu, headaches, period pains, back backs and other MSK issues, stress/anxiety/depression - but you'd never say people shouldn't take a day here and there for these things. So if your condition means you either need to take a few sick days or put yourself at risk of major complications, for god's sake take the sick days. I'd can almost guarantee that a few days off sick even at a busy time of the year will be absolutely fine, will not cause you to fail probation and you shouldn't be at risk of only getting SSP, even in your probation/first year of employment you are entitled to one month's full pay and two month's half, that should cover the odd R&R day if really needed? And it only goes up from there. Basically I'd really try not to panic too much unless and until it actually becomes a problem...

You need to read the rest of the OPs thread Dinopaws. That’s not what she’s asking for.

OP, do you have an easy way of seeing what is booked already? That might put your mind at ease if you can see what the availability is like. It’s easier said than done but try not to worry about it now. Like I said, not everyone wants to book all or any of their AL 12+ months in advance so first come first served May be less of an issue than you think.

I mentioned the be wary bit because it might say a lot about your specific managers attitude to disability and reasonable adjustments. I think she’s unlikely to be backed up by the trust though.

I'm not NHS, and I spent years in the private sector. Nearly everywhere I worked had what they called family friendly leave policies, where you could use your annual leave in place of an unpaid carers day off. I also knew of a few people who had holiday arrangements in place to cover health issues. So it must depend upon industry or employer, I guess!

Occupational health, go and see them. And don't even bring up the sick leave - I know you're only using it for illustrative purposes, but it does sound like you're trying to do something you shouldn't be doing. I can see how that could confuse management! Keep it simple - you're asking for a reasonable adjustment for your condition to prevent you from getting very ill. Occupational health will ask if they can see your medical records, which I'm presuming will back up what you're asking for, and then they can override your line manager because it will be them and HR dealing with the matter.

Good luck!

Sorry just to clarify

i Book annual leave months in advance to “split up” the time of year I’m most at risk of recurrence and I book these weeks based on previous medical history ie: highest risk weeks.

if I didn’t have annual leave on those weeks my illness would deteriorate to the point of becoming sick and needing sick leave.

the reasonable adjustment I wanted was to be able to protect those key weeks as annual leave so that i wasn’t put into a situation where I do get too sick to work so that I’m using my annual leave as a preventative tool that based on the last 15 years has only failed once (I nearly died in work - I stopped breathing) and has potentially prevented a serious relapse on another occasion

If the system in place already allows you to book AL as you’ve described, then what’s the issue?If you feel like your illness is flaring up, why do you not want to take sick leave?
Not having any SL in 15 years by booking AL is surely just masking your illness. An external analysis of your SL would show you’re managing just fine.
Ive worked with people who have disabilities that can flare up any time. They take SL as necessary. Everyone knows and accepts that it’s needed in order to support their disability. They have had personalised arrangements outside of the workplace absence policy. This, to me, feels more like equity.

I think I know what you are getting at OP as I also had a condition (not recognised as a disability at the time but had become increasingly disabling) that by careful management I could avoid going downhill and ending up being off sick for longer. Unfortunately I have had very negative experiences of the NHS around sick leave ,for my self and observing others with chronic conditions….I ended up having to leave my job and saw other people being “managed out” through unfair sickness policies during my career.Personally I can only suggest working with occupational health to find a way to clarify what you need and how the employer can work with you to achieve this. The NHS can actually be very poor at caring for its own staff and even though logically it makes sense to you as you know your own health patterns, the nhs seems to struggle to be flexible in this way….but as you have a known disability this may mean a different approach .

if I didn’t have annual leave on those weeks my illness would deteriorate to the point of becoming sick and needing sick leave
The issue here is that this is theoretical as you say you haven’t been off sick. It’s a bit like a chicken and egg scenario.

Ps I hope you are also a union member …if not please join asap!