Gateways guidance: 10.2 Making reasonable adjustments and offering support

The duty to make reasonable adjustments arises when disabled people are placed at a substantial disadvantage compared with people who are non-disabled in relation to the environment, procedures, practices, policies and the provision of auxiliary aids and services.

The concept of 'reasonable' is central to the Equality Act. It means that those providing medical training have a duty to find out how they can adapt their course and related services to meet the requirements of the disabled student. This goes beyond simply avoiding treating disabled people less favourably than others. In some cases, it may also mean providing facilities that non-disabled people are not entitled to. One example might be setting aside car parking for disabled people.

Some factors to consider when assessing if an adjustment is reasonable are:

• whether the adjustment will actually overcome the identified difficulty
• how practicable it is to make the adjustment
• the financial and other costs involved
• the amount of disruption caused
• the money already spent on adjustments
• the availability of financial or other assistance.

Many reasonable adjustments can be inexpensive and, in some cases, Disabled Students’ Allowances (DSAs) or other funding from external agencies may be available to cover some of the costs. DSAs are grants to help UK students meet the extra costs of studying that they face as a direct result of a disability or learning difficulty. The medical school is responsible for meeting any additional costs, and it would be unlawful to try to recoup these from the disabled student.

Whether or not an adjustment is reasonable depends on many factors, including cost effectiveness, the impact on other students, and health and safety. Medical schools have to consider whether they can make the adjustment in the light of the following:

• they do not have to make every adjustment that a student asks for
• they cannot claim that an adjustment is unreasonable simply because it is inconvenient or expensive
• it is not the responsibility of the disabled person to suggest what adjustments should be made (although it is good practice for the medical school to ask)
• if a disabled person does suggest an adjustment, the medical school must consider whether the adjustment would help overcome the disadvantage, and whether it is reasonable.

Once a medical school has become aware of the requirements of a particular disabled student or applicant, it would be reasonable to take steps to meet those requirements. This is especially so where a disabled person has pointed out the difficulty that they face in accessing services, or has suggested a reasonable solution to that difficulty.

The Equality Act does not override health and safety legislation. If making a particular adjustment would increase the risk to the health and safety of anyone, including the disabled student, then this is relevant in deciding whether it is reasonable to make that adjustment. Risk assessments should be used to help determine whether such risks are likely to arise and, if so, how to remove them. However, there is no requirement to eliminate all risk, and there should be reasonable adjustments that will remove or minimise risks. Disabled people should be encouraged to have a say in what presents a reasonable risk.

Risk management should be an ongoing process undertaken in consultation with disabled students. However, health and safety must not be used as an excuse to avoid making reasonable adjustments.

Once a reasonable adjustment is to be put in place, it is important to communicate that fact in an accessible form to the disabled student concerned. Failing to make them aware of the adjustment may be tantamount to not making the adjustment at all. It is also important to maintain the adjustment so that it continues to work

Reasonable adjustments must be made on a case-by-case basis. A list of examples is in the Appendix.