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DAPB4019: Reasonable Adjustment Digital Flag

The digital flag is held on the National Repository (NHS "spine"), enables health and care professionals to record, share and view details of reasonable adjustments across the NHS and social care, wherever the person is treated.

Under the Equality Act 2010, organisations have a legal duty to make changes in their approach or provision, called reasonable adjustments, to ensure that services are as accessible to people with disabilities as they are for everyone else. This duty aims to address the recognition that people with disabilities may have equal access to care and services, but without specific adjustments being made, that access may not be equitable.

The flag indicates that reasonable adjustments are required for an individual and optionally includes details of their significant impairments, underlying conditions and key adjustments that should be considered.

The flag aims to enable:

  • Clear identification of all patients for whom reasonable adjustments may be required.
  • Identification of patients with impairments including learning disability or autism (and all other relevant key impairments).
  • Identification and sharing of key adjustments that will help a care episode go well or happen at all.
  • Ubiquitous, consistent visibility and structure of the information – wherever a patient is seen or treated in health and care.
  • Identification and maintenance of the information recorded and shared through the Reasonable Adjustment Digital Flag in conjunction with the wishes of patients and carers - leading to tailored, personalised care.

Publication: Information Standards Notice

What's changed

1. Change to implied consent as lawful basis for data processing 

2. Change to conformance criteria (Phase 2)  

3. Change to technical description of the national asset from “the NHS spine” to the “national repository/ asset” 

Scope

  • All providers of NHS care or treatment.

  • All providers of publicly-funded social care.

  • Social care or services bodies (in their role as service providers).

  • Independent contractors providing NHS services including primary medical services (GP practices), dental services, optometric services, and pharmacy services.

  • NHS Foundation Trusts and NHS Trusts.

  • Providers of NHS and / or social care from the voluntary and community or private sectors.

  • Providers of public health services, including advice and information.

Type

Standard

Responsible authority

Data Assurance Board

Date of approval

21 October 2025

Publication date

19 December 2025

Release name

Amd 24/2025

Release number

Version 2

Status/stage

Publication

Implementation date

19 December 2025

Full conformance date

30 September 2026

End date of assurance

31 October 2028

Legislation

This information standard is published under Section 250 of the Health and Social Care Act 2012, as amended by the Health and Care Act 2022.

Those subject to this information standard must comply within the required timeframes or they may be subject to enforcement action.

Key documents

Implementation guidance (Amd 41/2025)

Change specification (Amd 41/2025)

Requirements specification (Amd 41/2025)

Further information

Patient Flags Service - FHIR API - NHS England Digital

Access to test data

Contact details

[email protected] (Public)

[email protected] (Technical)

 


Earlier updates and releases

March 2024

6 March 2024: Following discussion and feedback, the RADF team have reviewed & adjusted time frames as set out below:

Phase 1: By March 31 2024, organisations will have a process in place to record reasonable adjustments.

Phase 2: By 30 June 2024, suppliers are asked to register with NHS England for connection to the national asset. Full conformance to be achieved by 31 December 2025.

January 2024

19 January 2024: A dedicated project mailbox has been set up for all enquiries regarding implementation of this Standard. Please contact [email protected] and include “Reasonable Adjustment Digital Flag” in the subject line. The Information Standards Notice (ISN) and associated documentation have been updated to reflect this change. No other changes have been made.

September 2023

Release date

12 September 2023
Release number Amd 77/2020
Release title Version 1.0
Stage Implementation (to 30 June 2024)
Key documents
Further

Further Information on reasonable adjustments and the Reasonable Adjustment Digital Flag are published by NHS England

Last edited: 11 May 2026 8:41 am