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?

Sorry, I don't understand your point about children being discriminated against if you don't get leave in the school holidays?

I'm following all this with interest as I may encounter a similar situation at some point (trying not to say too much!).

So if they said to me “you can have the holidays you need providing none were in the school holidays” they would be discriminating against my child based on their association with a disabled person (me the parent) by telling that parent they cannot spend any time with their kids in school holidays. They would be treating that child unfairly and putting them at a disadvantage through association.

i only ever ask for one school holiday as the way my needed leave pattern falls it’s always in term time anyway. I’m flexible as to whether it’s whether it’s one specific week or another as two of the weeks at at the very start of a term so I ask for a second week attached to one of them to enable us to take a holiday. The holiday extends into the beginning of term but school authorise it as it extenuating circumstances. All my other weeks are at random times in terms of “busy leave periods” so they can’t say my adjustment isn’t reasonable based on (for example) I was asking for all Christmas off or every school holiday xx

Do you want to dm me if you want to chat about your situation?

I think this is probably the way I’d describe my annual leave pattern … it’s like pacing myself so I don’t get to a point where I get sick. We know it’s worse over specific months so i have shorter gaps between annual leave. The leave is specific dates because

a) the time period I’m traditional better needs a rest point in the middle and so they need to bookended by leave which in turn

b) also bookends the “iffy” period

c) the iffy period is fairly strict because there’s one week in particular that’s risky as heck so flows out from that week

d) the leave pattern then naturally falls very specifically as I’m then also avoiding key times of business ie Christmas/school holidays (bar one week) so I’m not being unreasonable in my request for a set leave pattern (ie — I want all Christmas and all summer off etc which would be unreasonable)

I have a neurological condition and significant fatigue. I think the NHS are piss poor with disabled staff. I work agency so I build a buffer of savings if I need time off. Flexible working has saved me the NHS won't really implement it for permanent staff as others will complain.

Without the massive backstory and detail about illness / disability / sick leave etc etc....

You want to book leave at certain times in the year that you know about now and can request in advance.

Why all the drama? This is how most people book leave??

Are you being refused your preferred leave?

So it needs to be specific set leave planned out in a certain way which helps prevent me getting ill. I approached them about how to enable this to work, they kicked up a bit of a fuss, haven’t followed proper process and demonstrated a poor knowledge of equality law and used some discriminatory language which is concerning they are showing a lack of compassion and tolerance

upshot is they asked me to follow normal booking process and they “are sure it will be fine” however this has left me feeling stressed and uncertain because it’s not guaranteed to be fine, There’s been no disclosure about how they authorise/allocate holidays, no explanation as to how they will prevent me being at a disadvantage by following this process
and there are other staff who are not following the set process which could (if authorising managers choose to ignore) disadvantage me.

all combined I’m feeling really uneasy so I wanted to know if anyone had any issues about dealing with NHS/disability/equality and what peoples advice may be to deal with any issues.

I think this could be an option in future going on bank.

apparently our trust is dead big on FW now but then keep introducing longer service operating times that experienced staff don’t want to do, then force them into it by railroading it through and the staff leave for other sectors. It’s laughable that the NHS are crying out for staff saying how hard it is to recruit yet their own policies and treatment of staff push a huge number out of the door. It’s not stress/wages it’s the trust bosses themselves being absolute dictators who don’t give a shite about people and their personal circumstances. If someone cant do early mornings or lates or night shifts they can’t do them! It doesn’t make them shit at their job fgs.

School should not be authorising absence so that you can have a 2 week holiday instead of a week.
you can not take annual leave instead of sick leave
i’m not sure this will come under reasonable adjustments. You need to provide medical prof that you must have these weeks off as part of your disability and that you will have a flare up otherwise. Otherwise everyone with a disability (which is a large percentage) could just say they need school holidays off to prevent a flare up of their mental
health/ physical health condition 🤷‍♀️

@Tooscaredtoorocktheboat oh that's so kind of you but I don't have the details as yet so just thinking things through. Thank you tho. Hope you get what you need confirmed in black and white soon!

In the kindest possible way, please stop creating all this worry and anxiety when you haven't actually got a problem yet!

For all you know your requests might be approved and all this will be for naught.

Get the request in, with a covering / follow up email that explains (briefly) that this leave is part of your reasonable adjustments then see what happens?!

Otherwise everyone is giving advice based on ifs and buts and it's potentially a non problem!

@BungleandGeorge
School should not be authorising absence so that you can have a 2 week holiday instead of a week.
That’s between op and the school.
you can not take annual leave instead of sick leave
Yes you can, HMRC vs Stringer is the relevant case law.
The government says you can https://www.gov.uk/taking-sick-leave
The OP is not sick when taking leave, it is preventing her from becoming unwell.
i’m not sure this will come under reasonable adjustments.
It does, as it is helping the op to manage a condition that meets the criteria of disability.
You need to provide medical prof that you must have these weeks off as part of your disability and that you will have a flare up otherwise.
The op can do this and has it backed by OH.
Otherwise everyone with a disability (which is a large percentage) could just say they need school holidays off to prevent a flare up of their mental
health/ physical health condition 🤷‍♀️
Agreed but as I and others have posted there is a process to ensure only those who need it get it.

@Foreversearch
you’ll have to highlight in that link where it says you can take annual leave instead of sick leave? It’s against nhs employment terms

the GP was non comittal regarding whether this is required they’ve simply suggested it could be an option if possible. I think she’ll struggle to argue that unless she gets a specific week every year she’ll get unwell

there are clear guidelines as to what can be an authorised absence by school

if these absences are planned so far in advance just put the request in on the first day of requests opening. It’s reasonable to request that is a specific date for all

Agh OP this is so tricky. You are clearly a very diligent employee who wants to come in to work without all this bloody stress and just get your job done.

If I were your manager, I would absolutely want to accommodate you. But I have lots of others too accommodate, many of which also have disabilities, childcare issues etc. Also my priority has to be to safely staff the service. You mention the NHS not being flexible with peoples preferred shift times etc. I understand it seems this way from your perspective, but from my perspective - we have an aspect of our service that really inconveniences everyone; if I let people opt out, then this service just couldn't run as no one would do it. However we are legally obliged to provide this service. I have however sent employees with disabilities to OH before so they can be signed off from this service, which has worked well, as it gives me 'evidence' - not that I discuss it with her colleagues, but should I be formally challenged, the evidence is there.

As much as I want to be flexible and make life easier for everyone, I also have to be fair and provide a safe service.

In your situation, I would refer you to OH in the first instance. I would think it will be difficult for you to prove that you need very specific dates for AL given that you say you haven't actually had a flare up in many years, which I know you say is because you have had your requested AL, but how do you actually prove that?

Everyone in the NHS needs regular rest periods, so I send out a request annually for everyone's AL requests for the following year, advising that AL is spread over the year, then I allocate fairly - which means spreading out 'peak weeks' and sometimes giving priority if someone did not have that week the year before etc etc. I completely understand that you will only see this from your own perspective, but it is actually incredibly stressful to be fair with AL allocation.

Your system sounds really rigid. If people are already requesting way into the future, why don't you too? I would also follow up with an email being very firm that your requests are to ensure adequate rest due to your disability and that it is vital you rest during the periods you requested, due to seasonal fluctuations in your condition etc. Put it all in writing and say you will require to have your leave confirmed/ declined ASAP so you can discuss with them what weeks are available for booking so that you can ensure you don't miss out if your specific weeks are declined. I would include that the uncertainty is causing you excessive stress etc etc. Don't be afraid of being assertive, you clearly are amazing at managing your condition and it sounds like you are happy in the job otherwise, so I would put your foot down and I am sure your manager will do their best to accommodate you! I suspect they will value you as an employee and will be very motivated to do right by you. Good luck!

One reason I don't want to progress to management in my NHS role is that i don't want to have the stress and responsibility of sorting out things like annual leave @NewLifter I don't envy you that!

@BungleandGeorge
“Sick leave and holidayStatutory holiday entitlement is built up (accrued) while an employee is off work sick (no matter how long they’re off).
Any statutory holiday entitlement that is not used because of illness can be carried over into the next leave year. If an employee is ill just before or during their holiday, they can take it as sick leave instead.
An employee can ask to take their paid holiday for the time they’re off work sick. They might do this if they do not qualify for sick pay, for example. Any rules relating to sick leave will still apply.
Employers cannot force employees to take annual leave when they’re eligible for sick leave.”

An employers T & Cs cannot remove a legal entitlement.

@Foreversearch it says that they can ask to do
that, not that it’s a right to be able to

@BungleandGeorge I also quoted the case law HMRC vs Stringer - if you want to prove me wrong feel free to research it.

ACAS https://www.acas.org.uk/checking-sick-pay/sick-pay-and-holiday-pay

Thank you.

i do have a lot of anxiety with regards to my condition. It can be very unpredictable and it’s honestly terrifying when it flares up. I know this may sound weird but it’s the not knowing makes the anxiety worse through fear but then that makes the condition worse and I end up in a vicious cycle and worse off 🙈 I definitely manage better when I know what’s happening so I kinda feel like I want to push for some answers so I know how their allocation works and how they plan to accommodate my needs. But yes you are right - I don’t know yet that they will be refused

I’ll try not to stress though. Thank you for the advice and it’s appreciated

hey thanks for the reply. I appreciate it.

it did say on my pre employment report to have a “discussion” about set leave pattern or trying to accommodate leave with this in mind. I know they were erring on the side of caution with the “or” statement in case I turned around and said “oh my gosh I’m always sick over Christmas I need 3 weeks off” or “well isn’t that funny that I always need school holidays off!” but obviously it’s not what I need 😂 but when I brought up my report the manager dismissed it with “I don’t see that”.

I think that’s what got me anxious … it’s totally been disregarded, there’s been no mention of sending me for another assessment for This and they’ve not made any attempt to be proactive in asking about reasonable adjustments etc or asking for any HR support/advice plus failed to do any kind of risk assessment. It goes against everything they should be doing under equality law.

for example, I made it clear there was one specific adjustment I needed and then after I got offered they dropped something in that would cause me massive problems. I was going to turn the job down as when I spoke to them about it it was “well I don’t see how it’s an issue” “I don’t understand” but then it was “oh don’t worry you won’t be made to do anything you can’t do”

But now I feel the fact that management aren’t seemingly acknowledging my condition which makes me feel that I’m going to have a battle on my hands particularly with any future changes and I feel like I’ve made a massive mistake joining the NHS especially when the unions are saying discrimination cases have gone up massively.

i just don’t want to be in a situation where I’m sick and having to take time away. I want to be healthy and I want to be in work doing my job to the best of my ability. But it feels like I’m not going to win either way Xx

@BungleandGeorge

Otherwise everyone with a disability (which is a large percentage) could just say they need school holidays off to prevent a flare up of their mental
health/ physical health condition 🤷‍♀️

just to reiterate my earlier posts I only ever request one week of school holidays which falls next too a first week of term so that my kids can at least get a family holiday despite my condition. They miss a couple of days of school maximum. School authorise this absence as they recognise that it’s better for them miss a couple
of days rather than me saying “aww well I have two weeks off in term time due to my disability so that’s when we go away so you need to authorise it” - It would be preferable financially because it’s cheaper but I wouldn’t want to take the piss out of school any more than I don’t take the piss out of my employers by trying to use my disability to request all school holidays. Just because someone’s disabled doesn’t mean they automatically use it to take the piss as you seem to be implying.

I suppose when you submit your requests via the system - you should also send an email to say - This week i MUST have off - its x's wedding.

but these 3 days here and here, that can be any block of 3 days within the 2 week period. give them the flexibility and if need to say - here is what i want - when you come to process on the hol chart call me and we can go through it live.

I think you would also need to explain more WHY certain weeks, based on past data, you will be ill.

It makes sense that you need 6 weeks then a long weekend, 6 weeks, etc. (and maybe different period of gaps in warmer or colder seasons)

but it doesn't make sense that you can predict a year in advance that you will be ill in x week so need that week off (unless its very pollen rated?). so that needs to be made much clearer to them. else they may assume you are sicker that week due to something in your private life making you worse.

the predictions are based over 20 years of illness data. All the major flares have been within a 6 month period and this isn’t an un-expected trend based on the way the disease works and progresses. It’s quite normal for some people to be worse here than other times. There are then other stressors that factor into that more a more severe time.

There is one very specific week that’s quite problematic because of a few factors that trigger my illness in the run up to this week (I nearly died the last time I had a severe relapse in this week) so that’s a must have off The other weeks then spread out from That in a pattern that gives “x” weeks in 1 week off “x” weeks in one week off from the start of the crap period to the end. There’s then a 6 month gap where I’m relatively well (still prone to small flares but no major ones historically) where I have one week off in the middle or two if taking a family holiday as 6 months is a long time for anyone to not have a break from work.

hope that explains why there’s a pattern xx