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On this page you can find an introduction to the College's Reasonable Adjustments guidance for employers.

Why the guidance matters

In this short video, RCPsych President Dr Lade Smith CBE talks about why we produced the guidance and why it is important employers act on it.

As we launch this guidance in summer 2025, persons with disabilities face persistent inequities and discrimination, not only through overt biases but also through systems, policies, and processes that fail to consider their needs.

Equality legislation mandates reasonable adjustments to prevent workplace disadvantages, and you’ll find more on this legislation in the appendices of our guidance document.

But systemic challenges – including complex processes, poor communication and bureaucratic delays – often undermine these efforts.

Nearly a quarter of employers still fail to consistently provide the necessary adjustments for staff with disabilities, highlighting the disconnect between legislation and reality.

Among the NHS workforce, more than 52,000 people (3.7%) declared a disability through the NHS Electronic Staff Record in 2021.

There is no formal data available for the prevalence of disabilities among psychiatrists, including trainees and SAS doctors. As psychiatry is considered a more inclusive profession by many, it’s possible that rates of disability could be higher than in other medical disciplines.

How we've developed the guidance

We've brought together professional expertise and lived experience of disability to develop this comprehensive guidance.

It aims to support organisations to implement reasonable adjustments and embed equitable, inclusive workplaces where individuals with disabilities can flourish.

Key objectives

The guidance provides actionable recommendations for providers of mental health services, emphasising

• systemic accountability
• attitudinal change, and
• practical workplace adjustments.

It is underpinned by the Equality Act 2010 in England, Scotland and Wales, and the Disability Discrimination Act 1995 and Special Educational Needs and Disability (Northern Ireland) Order 2005.

Core principles

The guidance is rooted in:

• Co-production: it has been developed with and by psychiatrists with a range of disabilities, which has ensured that we can highlight the gap between existing policies and people’s lived experiences of trying to access reasonable adjustments.
  
• Fairness for All: this is one of the RCPsych’s six strategic priorities. Within it, the College is making an intentional move from aiming for equality towards aiming for equity, where structural and institutional barriers are acknowledged and addressed.

Background to the guidance

See this article on page 17 of this issue of RCPsych Insight about why we created the guidance.

Spreading the word about the guidance

We want as many mental health employers as possible to hear about the guidance and to adopt its 15 recommendations - so we've launched a campaign called Delivering for Disability #DeliveringforDisability.

You can support the campaign in a range of ways - see our Toolkit to help spread the word and support the campaign.

This guidance is dedicated to Dr Onikepe Ijete

This guidance is dedicated to Dr Onikepe Ijete, whose picture appears on the front page of the guidance document.

Onikepe was a driving force and member of the working group who produced this guidance.

She sadly passed away in 2023. We remember Onikepe for her lived experience that she shared, her endless energy and enthusiasm, her ability to quietly but effectively push for change that would benefit all people with disabilities, and for making our workplaces more disability friendly.

She was an accomplished mentor, guide and support for so many people, and an experienced and award-winning clinician in the forensic services in Barnet, Enfield and Haringey Mental Health Trust in London.

Our thoughts remain with her family and loved ones, especially her daughter Elohor Ijete, also a doctor, who was her main carer and best friend.

Rest in Peace, Onikepe.