Background

There is a recognised need to accommodate autistic patients via the use of reasonable adjustments so that they can access healthcare (Haydon et al, 2021). However, is it not only autistic patients who need reasonable adjustments in the clinical environment but also the autistic staff who treat them.

Healthcare and research activities regarding autistic people are usually targeted to benefit populations of autistic patients, but there is an urgent need to also consider the welfare of those autistic persons who directly deliver clinical services. To ignore their presence and needs hinders their involvement in their workplaces.

Reasonable adjustments do not have a one-size-fits-all approach; what is suitable for one person’s disability may not be appropriate for another’s. This means that there is a need for assessment and careful planning to tailor adjustments to the needs for each person. However, whilst each package of adjustments needs to be unique to address an individual’s needs to their specific workplace, there will often be adjustments that are commonly made for persons with similar needs.

Whilst we know that autistic registered clinical professionals (AuCPs) are entitled to reasonable adjustments at work, and there is some evidence to suggest that AuCPs receive very little in the way of reasonable adjustments (McCowan et al, 2022); there has been no work undertaken to systematically capture what reasonable adjustments are made for them, what their needs are, or what the barriers are to reasonable adjustment implementation. This pilot project proposes to fill that gap.

Aims, objectives, and expected outcomes

The overarching aim of this pilot project is to gather survey data about AuCP’s experience of existing and desired reasonable adjustments in their workplaces, with a view to informing the design of a co-construction project to produce guidance for clinal employers and employees.

It will do this by meeting the following objectives:

· Gather survey data to describe (a) the reasonable adjustment needs of AuCPs, (b) reasonable adjustments that have been put in place for AuCPs and (3 barriers to requesting/implementing reasonable adjustments experienced by AuCPs.

· Analyse the data to produce a descriptive account of the experience of AuCPs in relation to reasonable adjustments

Researchers

This study is organised by Dr Helen Smith, Research Associate at the Centre for Ethics in Medicine (CEM) at the University of Bristol (who is autistic and a registered nurse); and Prof Jonathan Ives, Deputy Director of CEM.

We are especially grateful for clinician-academic members of Autistic Doctors International (Dr Sebastian Shaw and Dr Mary Doherty) for providing support as a steering committee to help support and guide this work.

Would you like to participate?

We’d love you to consider participating in our survey if you are:

· Autistic (formally diagnosed or self-diagnosed)

· Registered with the General Medical Council (GMC), Nursing and Midwifery Council (NMC), or the Health & Care Professions Council (HCPC)

· Currently employed in clinical practice and working within the scope of your registration.

· Can read and type in English.

· Currently employed in Great Britain (England, Wales, or Scotland).

o The Equality Act 2010 covers only England, Scotland, and Wales, therefore not covering other jurisdictions such as Northern Ireland, but the outputs of this work may still be useful to autistic registered clinical professionals and their employers who wish to enable them worldwide, even in the absence of a legal duty.

Survey responses will be analysed, written up into a report, and submitted to academic journals for publication as well as hopefully being presented at conferences for audiences such as academic and/or clinical professionals.

We hope that autistic clinical professionals can use the resultant publication to start conversations with their employers about the nature of their differences and the variety of reasonable adjustments which can be adopted to help them to continue to contribute and shine in health services.

We additionally aim to use the survey’s responses to inform the design of a co-construction project to produce guidance about reasonable adjustments for clinical employers and employees who are autistic. The aim of this co-construction project would be to improve equality, diversity, and inclusion of autistic clinical professionals in their workplaces.

To participate in the survey, please see details at the top of this webpage.

Ethics Approval

This project has been reviewed and approved by the University of Bristol Faculty of Health’s Research Ethics Committee (Ref: 12134).

Funding

This work is funded by the University of Bristol’s Elizabeth Blackwell Institute Research for Equality, Diversity & Inclusion in Health and Biomedicine. The funds awarded include contributions from the Wellcome Trust Institutional Strategic Support Fund; specifically, from the Open and Transparent Research initiative.

References

Haydon, C., Doherty, M., Davidson, I.A., (2021) Autism: making reasonable adjustments in healthcare. British Journal of Hospital Medicine. 82(12) Published Online: 8 Dec 2021 https://doi.org/10.12968/hmed.2021.0314

McCowan, S., Shaw, S., Doherty, M., Grosjean, B., Blank, P., & Kinnear, M. (2022). A full CIRCLE: Inclusion of autistic doctors in the Royal College Of Psychiatrists’ values and Equality Action Plan. The British Journal of Psychiatry, 221(1), 371-373. doi:10.1192/bjp.2022.14