Under the Management of Health and Safety at Work Regulations 1999, employers have a duty of care to support the health, safety and wellbeing of all employees. This includes ensuring the working environment is safe, making “reasonable adjustments” if required, ensuring staff are protected from discrimination and performing risk assessments.
Employees with a disability are protected from workplace discrimination under the Equality Act 2010. This includes both direct discrimination, such as maltreatment, and indirect discrimination, such as policies or working practices that place an employee at a disadvantage (e.g. fixed hours or lack of a sickness absence policy).
Despite this, a survey by the Royal Pharmaceutical Society (RPS) in 2019 found that out of 839 respondents, 43% believed disability to be the biggest barrier to inclusion and diversity within the profession and 56% of the respondents believed more should be done to support pharmacists with disabilities.
According to the non-profit organisation, the Business Disability Forum, a third of all employees have a disability or are close to someone with a disability.
In 2017, NHS Employers said there were currently 31,322 people who have disclosed and identified themselves as disabled who are employed by the NHS, which represents 2.6% of the workforce.
Given the number of people living with disabilities in the UK, this is something no employer can afford to ignore. Employees who feel they have been discriminated against because of a disability have the right to bring a claim to an employment tribunal where the amount of compensation awarded for discimination is uncapped — but any responsible employer would take measures to prevent this from happening.
Mark Pitt, director of defence services at the Pharmacists’ Defence Association (PDA) says one example of a case represented by the PDA involved a pharmacist who had been diagnosed with Asperger’s Syndrome later in life that was wrongly dismissed by their employer, a large NHS trust.
“The trust had not properly considered what reasonable adjustments might be made to the pharmacist’s working environment, and did not obtain the assistance of the National Autistic Society, as suggested by their own occupational health adviser,” says Pitt. “The Trust also acted contrary to their own attendance management policy which required that occupational health advice should be obtained and reasonable adjustments tried before considering dismissal. The Trust put the onus on the claimant to put forward reasonable adjustments, rather than recognising their own responsibility to consider what reasonable adjustments might be made.”
In February 2019, the trust was ordered to pay almost £215,000 in compensation to the pharmacist for discrimination and unfair dismissal.
To help prevent cases such as the one above, this article outlines five ways pharmacy employers can meet their statutory obligations and support pharmacy professionals with disabilities in their workplace.
1. Recognise that not all disabilities are visible
Under the Equality Act 2010, a person is disabled if they have a physical or mental impairment that has a “substantial” and “long-term” negative effect on a person’s ability to do normal daily activities.
This definition of “substantial” is a condition that is more than minor or trivial, for example it takes much longer than it usually would to complete a daily task like getting dressed. “Long-term” relates to a condition that lasts for 12 months or more, although there are special rules about recurring or fluctuating conditions, such as arthritis.
By disclosing a disability, an employer will be able to better support them with any potential challenges they might face
Gareth Kitson, former lead for the inclusion and diversity group at the RPS, says the scale of support individuals require may be extensive given that people’s disabilities can also be hidden. “Although the illness creates challenges for the person who has it, the nature of the disability makes it difficult for other people to recognise.
“This is in contrast to a visible disability, one that you can see and is obvious to the observer. This could be a person in a wheelchair, use of mobility aids, a guide dog or a white stick,” Kitson explains.
Examples of hidden conditions include brain injuries, Crohn’s disease, fibromyalgia, epilepsy, chronic pain, chronic fatigue syndrome, depression, attention deficit hyperactivity disorder, bipolar disorder, schizophrenia, and other mental health conditions.
Prospective and current employees are not legally obligated to notify employers of their disability and may not wish to do so for fear of being discriminated against. However, by disclosing a disability, an employer will be able to better support them with any potential challenges they might face (see Box 1).
Box 1: Challenges faced by pharmacy professionals who have a disability
- Individuals with autism may face disciplinary and fitness-to-practise proceedings owing to misunderstandings around communication and behaviour;
- Pharmacy professionals with mental health illnesses, such as anxiety or obsessive-compulsive disorder, might check and re-check work, leading to delays in their dispensing process;
- Preregistration trainees with mental health illness may find that their symptoms worsen during the training year, particularly if the placement is poor;
- Trainees may request reasonable adjustments to sit the preregistration assessment, such as additional time required for conditions such as dyslexia or anxiety;
- Some members of staff with a disability may find their requests for necessary adjustments to be made to the working environment are denied by an employer, which could result in difficulty or inability to carry out required tasks.
Source: Pharmacist Support
2. Perform an occupational health assessment
If an employee chooses to notify their employer of their disability, the employer should obtain an occupational health report about the employee that should outline how their disability affects them.
Larger employing organisations might have their own occupational health service but smaller organisations might not. In the latter case, the employer should take the advice of both the employee and the employee’s GP — medical advice can be obtained via a written note obtained by the employee. Guidance can also be found in the Employment Statutory Code of Practice, which forms part of the Equality Act 2010 and gives an explanation of how the law applies to disability.
Employers should also carry out a workplace risk assessment. According to the UK government’s Health and Safety Executive, this involves:
- Identifying hazards that could potentially cause injury or illness within the workplace;
- Determining the likelihood that someone could be harmed and how seriously;
- Taking action to eliminate the hazard, or if this isn’t possible, controlling the risk;
- Recording any significant findings including the hazards, who might be harmed and actions taken to control risk;
- Regularly review risk assessment especially if new equipment, substances or procedures are introduced which may increase risk of hazards occurring.
3. Make ‘reasonable adjustments’
Employers are obliged to make “reasonable adjustments” to remove or reduce any disadvantage that an employee might have at work as a result of their disability.
Stephen Robson, senior solicitor in employment and discrimination at the Disability Law Service, explains: “Reasonable adjustments can involve changes to working patterns, making alterations to premises or providing mentoring or training.” However, an employer does not have to make changes to functions which are essential to an employee’s role. For example, pharmacists will still need to clinically screen prescriptions if that is a core function of their role.
Adjustments can be as simple as ensuring a chair is available in the dispensary for an employee to sit on. Other measures include having wheelchair access, mobility aids, and better access to medications and products. However, what constitutes as ‘reasonable’ will vary between organisations. See Box 2 for how employers can access additional support.
4. Consider flexible working
One way that employers can create adaptations or opportunities for pharmacy professionals with physical disabilities is to create more defined roles, says Anita Cawley, vice president of Pharmacist Support. “Some aspects of pharmacy are less physically demanding and creating bespoke roles around these would be useful,” she explains. This might be easier to achieve with bigger teams where it is easier to reallocate tasks.
The challenges of working in pharmacy with myalgic encephalomyelitis (also known as chronic fatigue syndrome) and fibromyalgia meant that Emily Beardall, who describes her conditions as “hidden”disabilities, was unable to progress in her career when she qualified as a pharmacist in 2012. She says it is challenging “both physically, mentally, and emotionally”, and that the long hours, responsibilities of being the sole pharmacist, and “breaks being frowned on”, make it difficult for people with disabilities to work in the profession.
Beardall believes employers should consider increasing flexibility around working hours. Sharing the workload with job shares or defining hours that fit different staff needs, including those with disabilities, could encourage recruitment and retention. This may be easier to achieve in the hospital or general practice settings compared with community pharmacy.
5. Keep talking
If an individual and employer work together with respect and mutual understanding there are ways to overcome most obstacles. This approach not only helps the employee, but also supports them to perform their role effectively — ultimately benefiting the organisation.
Potential employees with disabilities are most likely to be aware of their physical limitations and have ideas on how to adapt and change processes to their own way of doing things. It is these straightforward conversations that might result in an altered — but no less effective — process with the same outcome.
Cawley was born with a physical disability that affected her mobility. “I am very aware of my own physical limitations, but I’ve adapted,” she explains. “For example, in the days when we used tablet counting triangles and had to decant the tablets into the bottle, I couldn’t use my hand to create a funnel to guide the tablets. But I worked out my own technique, which was no less effective, just different, and the outcome was the same.”
Box 2: ‘Disability Confident’ employer scheme
‘Disability Confident’ is a government scheme encouraging employers to change the way they approach recruitment, retention and development of people with disabilities.
It was developed to be easily accessible — particularly for smaller businesses. The scheme is voluntary and access to guidance, self-assessments and resources is completely free and available here.
In December 2019, the Royal Pharmaceutical Society (RPS) became accredited as a ‘Disability Confident committed employer’, dedicated to improving employment access for disabled people. Emer Bellis, senior people partner at the RPS, says: “‘Disability Confident committed’ means we commit to improving employment access for disabled people. In 2020, we’re promoting our paid internships to pharmacy students with a disability and we’ll interview any applicant who meets our minimum criteria.”
The Royal Pharmaceutical Society launched its pharmacy inclusion and diversity programme in August 2019. Find out more about what the Society is doing for members here.
Box 3: Additional resources
- Equality and Human Rights Commission – report ‘Being disabled in Britain: a journey less equal’;
- Health and Safety Executive — UK government agency responsible for workplace health, safety and welfare;
- The Disability Confident scheme — UK government scheme encouraging employers to change the way they approach disabilities;
- The Department for Work and Pensions — UK government department repsonsible for welfare and penison policy;
- The Advisory, Conciliation and Arbitration Service — public body which offers free, impartial advice on workplace rights, rules and best practice;
- NHS Work Disability Equality Standard — a set of metrics that will enable NHS organisations to compare the experiences of disabled and non-disabled staff;
- Business Disability Forum — a not-for-profit membership organisation that makes it easier and more rewarding to do business with and employ disabled people;
- Disability Rights UK — charity which represents the needs of people with disabilities;
- Access to Work— a government scheme which provides grants towards specialist equipment, as well as help with travel to work. It also provides a mental health support service;
- Pharmacist Support — pharmacy charity;
- Pharmacist Defence Association— help and advice for members.