035 Reasonable Adjustments Digital Flag search suite

035 Reasonable Adjustments Digital Flag search suite

Introduction

The Reasonable Adjustment Digital Flag (RADF) searches are designed to help practices manage the workload of:
  1. Finding appropriate patients for consideration of a Flag.
  2. Ensuring that the correct codes are added (in conjunction with our templates and alert).
  3. Tracking where the patient is along the "process".
  4. Identifying errors and gaps in coding.



The codes you need:

Code term:
Code ID:
Code Purpose
Requires reasonable adjustments for health and care access (Equality Act 2010)
1108111000000107
Use the Associated Text field to enter the adjustment that is requires (e.g. double appointments, wheelchair access)
Impairment with substantial and long term adverse effect on normal day to day activity (Equality Act 2010)
1326341000000105
Use the Associated Text field to enter the impairment that other staff need to be aware of (e.g. learning disability, severe anxiety)
Consent given to upload data to Reasonable Adjustment Digital Flag
1853771000000105
This code is used to record consent to upload data to the NHS Spine - not consent to record the flag.
Declined consent to upload data to Reasonable Adjustment Digital Flag
1853781000000107
This code is used to record dissent to upload data to the NHS Spine - not dissent to record the flag.

Info
If a patient dissents to the entire flag, Primary Care IT recommend coding "Review of Reasonable Adjustment needs (1833271000000103)", with text entered alongside to say the patient declined. This will cause our alerts, templates and searches to stop flagging this patient for 12 months.

The Categories, or "Standards"

RADF has been build around finding certain risk codes on the patients record. These codes are dictated by the Accessible Information Standard, the Impairment Harmonised Standard, and a couple of our own recommendations. The broad categories that we search for are as follow:

Accessible Information Standard

  1. Communications support
  2. Requires communications professional
  3. Requires specific contact method
  4. Requires specific information format
  5. Accessibility Needs identified

Impairment Harmonised Standard

  1. Vision
  2. Hearing
  3. Mobility
  4. Dexterity
  5. Learning, understanding, concentrating (including your LD register)
  6. Memory (including your Dementia register)
  7. SMI register
  8. Stamina, breathing, fatigue
  9. Social behaviour (including your Autism and ADHD registers)
  10. "Disability code - Other"
  1. Speech Impairment
  2. Frailty (mild, moderate or severe)
How your practice prioritises these categories beyond the NSHE recommendation is up to your team; this is just our recommendations.

1 High priority Long Term Conditions


  1. The first two searches 1a and 2a, are based on your surgery's Learning Disabilities (LD) register and Autism (ASD) register. These are recommended by NHSE to review firstly.
  2. 3a and 4a highlight any patient who is in 2 or more of the recommended categories.
  3. 5a-8a are High priority PCIT-recommended registers for review.

2 Work to do


  1. The first report is a "Master" report, containing every patient that falls into at least one of the Categories. We recommend only reviewing this list after you have worked through the High priority registers. As stated above, coding "Review of Reasonable Adjustment needs (1833271000000103)" with associated text will remove a patient from this report.
  2. The second report is where your team may have missed recording consent or dissent, but the patient has the other two required codes. Consent is of course essential for the information to go to the Spine, but our alert and templates will still show that these patients have a RADF for "internal" use.
  3. The third report is where the patient only has one of the two initial required codes. If you are coding correctly, there should ideally never be patients in this search/report.

3 Complete



These are your achievement searches. A breakdown of the high priority registers is provided should you want a quick view of a specific register. 

4 12 month review


NSHE recommends a review is coded every 12 months, with a note of "No change/change required" (or similar note). If a change is required, we have been informed that staff should recode the "Requires" or "Impairment" code, with new associated text following the code table above.

Development Log

Version 1.0 - Released 1st September 2024

Communications Log


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