Reasonable Adjustment Digital Flag information (RADF)

What is the Reasonable Adjustment Digital Flag

The Reasonable Adjustment Digital Flag is a way of communicating reasonable adjustments that patients have between NHS organisations using the NHS spine.  This means that all organisations using spine services (999, 111, out of hours, secondary care etc) will be able to see that a patient has reasonable adjustments required.

1. What do I need to do to implement this?

1. There is detailed step by step guidance from NHS England to the process your practice should go through to consistently record reasonable adjustments and implement the RADF, and see their guide on how to use the 
   National Care Records Service
    to enter a RADF here.
   

1. There is also some very useful pragmatic guidance from Wessex LMC which gives a very practical approach to implementation.
   

1. Do I have to do this?  Is it contractual?
   

It has been confirmed that this is required under current contracts.  This guidance from Wessex LMC highlights both the legal requirements and also gives a lot of other useful information.

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How do I add a Reasonable Adjustment Digital Flag

In order to add a reasonable adjustment digital flag, users must add both of the following codes:

1. impairment with substantial and long-term adverse effect on normal day to day activity (Equality Act (2010) 1326341000000105
   
2. requires reasonable adjustment for health and care access (Equality Act 2010) 1108111000000107

Note that from 1st November 2024 a consent code is no longer required. Dissent is still applicable.

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What if a patient declines upload of a Reasonable Adjustment Digital Flag?

You should add the code: declined consent to upload data to Reasonable Adjustment Digital Flag (finding) 1853781000000107.  You can still add the two codes required for Reasonable Adjustment Digital Flag recording within your practice to ensure this information is recorded consistently.

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What about reviews?

Users can record a completed review using the code: "review of reasonable adjustments needs (procedure); 1833271000000103"

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How do I remove patients from the Reasonable Adjustment Digital Flag?

The only way to currently remove patients from the Reasonable Adjustment Digital Flag is to delete the original codes.  PCIT have requested the addition of a second code which will remove patients from the Digital Flag.

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PCIT resources to help with implementation

PCIT have created a suite of resources to aid implementation of RADF.  This includes:

EMIS:

1. Searches
   
2. An alert protocol to aid with implementation
   
3. All OneTemplates have been updated to include RADF information where appropriate.
   

See our SystmOne support guide for this toolset here.

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Other useful links:

1: https://www.england.nhs.uk/long-read/the-reasonable-adjustment-digital-flag-action-checklist-what-you-need-to-do-to-achieve-compliance/

2: https://digital.nhs.uk/services/reasonable-adjustment-flag

3: https://digital.nhs.uk/data-and-information/information-standards/information-standards-and-data-collections-including-extractions/publications-and-notifications/standards-and-collections/dapb4019-reasonable-adjustment-digital-flag

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