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What
does a ‘reasonable adjustment,’ as stated in the 1995 Disability Discrimination
Act, actually mean in practice for employers, staff and OH?  By Nic Paton

There
are 6.2 million disabled people of working age in the UK, accounting for some
18 per cent of the working population, according to the Employers’ Forum on
Disability (EFoD).

While
much of the debate about disability in the workplace has focused, quite
rightly, on ways to get people who already have disabilities into employment,
in fact, about seven in 10 economically-active disabled people have become
disabled during their working life. This is a trend that is likely to grow in
importance as the population, and the workforce, ages.

Losing
the services of an employee through disability is a costly business. It
deprives organisations of a considerable asset and all the investment in terms
of their skills and experience goes with them. The EFoD estimated one large
employer found the average cost of retiring an employee on medical grounds was
£40,000.

So,
for the OH professional, dealing with a worker who has become disabled or who
already has a disability is a vitally important area. While there have been
many advances, notably the 1995 Disability Discrimination Act (DDA), many
businesses and managers still have something of a blind spot when it comes to
employing disabled people.

‘Disabled
people will mean having to spend a fortune adjusting the workplace’, ‘it will
hit productivity’, and ‘they simply won’t fit in’, goes the argument. Yet,
scrub away the prejudice and misconceptions, and these arguments simply do not
stand up.

Disabled
people, again according to the EFoD, take fewer days off sick and fewer days
absent for reasons other than illness compared with non-disabled workers. Their
productivity rates are on a par with other workers and they have better than
average safety records.

Despite
this, unemployment rates for disabled people are about two-and-a-half times
those for non-disabled people.

Take
Lloyds TSB. For the past two-and-a-half years, the bank has been working with
consultancy Churchill & Friend to improve access to the workplace and the
workplace environment for people with disabilities.

So
far, it has had some 800 referrals from Lloyds, both individuals with a
disability who have joined the bank and people who have become disabled while
already working there.

"About
73 per cent of referrals are still working for the bank, and of the people that
have left, only 18 per cent have left with bad feeling. So far, we have not had
a tribunal case involving the scheme," says senior partner Phil Friend.

Degree
of disability

He
goes on to explain that while disability is a very individual thing, in the
workplace, it can normally be categorised into four levels: A to D. Level D is
the lowest – possibly someone who suffers from back, neck or wrist pain while
working at a keyboard, but who would not be labelled disabled.

In
this instance, the best course of action would normally be an OH assessment,
followed by a report which, if Churchill & Friend is involved, is sent to
C&F for recommendations, which may be things as simple as moving a piece of
equipment or a chair. "But the case is only closed when the individual is
happy that things are better," says Friend.

Level
C is where people are suffering severe pain – they may have difficulties with
their back or neck from postural problems and may, as a result, be taking a lot
of time off. This requires a more specialised assessment, but one that still
involves the OH department.

At
level B, you start to get on to those people who will normally be covered by
the DDA. For these workers, their condition will be permanent and they will
need much more sophisticated work and assessment, not just using the OH
department but also specialists that can provide voice activated software, for
instance.

The
final level – level A – is for those who are definitely covered by the Act,
have a permanent disability and have real problems with day-to-day activities.

While
OH would still be involved, bodies such as the Government’s Access to Work
Agency, which provides advice, support and funding to help people with
disabilities in the workplace, would also play a key part.

At
this level of disability, you might be looking at redesigning a job,
redeployment, buying in sophisticated equipment (the cost of anything above
£300 will normally be covered by between 80 per cent or 100 per cent by Access
to Work), the use of workplace ‘buddies’, sign language support and so on.

The
split at Lloyds is about 30 per cent in the A to B category, with the rest
being C to D level cases, Friend estimates.

In
the past six months, the consultancy has also begun work with BT helping
rehabilitate workers who, for instance, fall down holes or off telephone poles.
So far, there have been some 60 referrals from that pilot. The consultancy
works closely with BT’s OH department, which is outsourced through Accenture,
to try to resolve cases and get people back to work.

Lack
of clarity

One
of the key problems with the DDA, suggests Friend, is the lack of clarity about
what a "reasonable adjustment" actually means. But the main thing to
realise about such adjustments is that the vast majority either cost nothing or
very little, stresses Bill Fine, senior consultant with AbilityNet, a charity
that provides information and advice on disability and computer issues.

Employers
fail to realise that the banks of identical computers they have stacked up on
their desks can in fact be tweaked, at no extra cost, to help such workers.

"We
have one visually-impaired woman who uses a display presentation scheme on her
computer. It is available as a standard part of Windows, but most people do not
know about it. It means she gets very large presentation and huge colour
contrast," he says.

"I
have gone into places where people with established pain, who have a lot of
time off, have been given a trackball instead of a mouse, but they haven’t been
told they do not have to use a mouse at all. Or, for instance, you can get a
big pointer on your mouse, or you can save keystrokes by using auto-text and
auto-correct," Fine adds.

The
charity runs one-day workshops outlining solutions that cost less than £100 –
and never has time to get them all in, he adds. Better training also helps.
With the right sort of training and a basic toolkit of solutions, occupational
health can do 75 per cent of non-standard assessments itself, Fine estimates.

While
the charity charges for its services commercially, it will give free advice to
individuals and one-off advice to companies. It also has free downloads and
fact sheets on its website.

Role
of advocate

Apart
from the practicalities of dealing with disability within the workplace, OH has
a critical role in acting as an advocate for the employee with special needs,
argues Kit Artus, chairwoman of occupational health recruitment agency Cheviot
Artus.

"OH
can say ‘that person can do it’, they may have to do it differently or you may
need to make some adaptations to their workstation, but they can do it,"
she explains.

"The
real angle is sensitivity. People may be coming to terms with the fact they are
disabled and how it is going to affect their job. It is about listening,
sensitivity and concentrating on their abilities rather than their disabilities.

"For
someone who has an established disability, if you listen sensitively, they will
often tell you the answer themselves. So you need to listen and identify what
you can do to make sure they get access to all the facilities," she adds.
"If they cannot, say, grip a tap, then you may need to look at the toilet
facilities."

Other
practicalities – as much common sense as anything – come into play, too.
Arrangements for a person with a history of schizophrenia and irrational
behaviour, but now on a successful treatment regime, might include reviews at
suitable intervals by an OHN.

Banking
giant HSBC, for instance, operates a rehabilitation policy for employees who
have undergone a long-term absence from work for reasons including stress and
depression. This includes a consultation process involving the individual,
their line manager, the OH manager and HR department.

If
appropriate, there is a phased return to work, usually over a period of weeks,
during which the individual gradually increases the hours or days worked until,
if successful, they are able to resume their normal work pattern.

Modifying
a job description to remove non-essential but potentially hazardous duties can
mean employment continuing with minimal disruption. For instance, removing the
occasional requirement to lift for a person with arthritis or the removal of
work at heights for an employee with epilepsy can all help. Replacing a
sensitising or irritant product with an alternative, may, together with health
surveillance, enable an employee with asthma or eczema to continue working as a
paint sprayer or cleaner.

When
a ward clerk who had worked at St Thomas’ Hospital in London for 16 years
developed severe arthritis – necessitating a long period of sickness absence –
the trust moved swiftly to adjust her workstation, and a support worker
assistant was appointed for nine hours a week, with Access to Work covering 80
per cent of the costs.

"If
you can accommodate employees who have been injured and maintain them in the
workplace, why should there be different treatment for people who come into the
organisation with disabilities?" stresses Artus.

Managing
the occupational health of workers with disabilities requires creative
thinking. Sometimes self-treatment is the best course, for instance, having a
place where people can go to lie down once in a while, or providing an area
where diabetics can administer their insulin.

It
is also important to work closely with other care providers, to be aware of
resourcing options such as Access to Work, sources of information and advice
and when to turn to specialist agencies, suggests Artus.

But,
according to Friend, OH nurses still have some way to go. One of the problems
he has had is finding OH assessors who have the right combination of the experience
and commercial nous.

"I
do not think that some of them understand the commercial imperatives. They
might say, for instance, that the display screen needs to be moved more
centrally, but what if they are talking about a cashier in a bank? So you have
to look at other ways of doing it," he complains.

"The
DDA is far less understood by OH professionals than by health and safety. DDA
OH specialists are far fewer – people who really understand what a reasonable
adjustment can mean," he says. "We have been through one or two OH
consultancies and have wondered what we are paying them for," he adds.

Contact:
Churchill & Friend 01707 324466  www.abilitynet.org.uk  www.employers-forum.co.uk
 www.jobcentreplus.gov.uk
 (for Access to Work)

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