Reasonable Adjustments in Healthcare — New NHS Requirements 2026

„What are reasonable adjustments in healthcare and why do they matter?" That's a question many NHS clinicians, managers, and healthcare providers ask when they hear about the new legal requirements.

In this guide, we'll explain what reasonable adjustments are, the new NHS information standard, and what you need to do by the 30 September 2026 deadline.

What are reasonable adjustments?

Reasonable adjustments are changes that healthcare providers must make to ensure that disabled people can access care equally and without discrimination.

The duty to make reasonable adjustments comes from the Equality Act 2010. It applies to all healthcare providers — NHS hospitals, GP practices, mental health services, community services, and private healthcare.

Examples of reasonable adjustments in healthcare:

• Communication support — sign language interpreters, easy-read materials, communication aids
• Physical adjustments — wheelchair-accessible entrances, accessible examination rooms
• Digital accessibility — accessible websites, patient portals, and mobile apps
• Appointment flexibility — longer appointments, quieter times of day
• Information formats — large print, braille, audio, accessible PDFs
• Support during procedures — additional support, sedation, or alternative arrangements

The new NHS information standard — What's changing?

A new information standard came into effect in December 2025 that requires all NHS providers to record, share, and act on patient reasonable adjustment needs.

What does the standard require?

1. Recording patient needs

Healthcare providers must record the reasonable adjustment needs of each patient in their digital record. This includes:

• Communication needs — language, interpreter, easy-read
• Physical needs — mobility, access, equipment
• Support needs — additional support during appointments
• Preferences — appointment times, communication methods

2. Sharing information across the NHS

Patient reasonable adjustment information must be shared across the NHS via the National Care Records Service (NCRS). This ensures that wherever a patient receives care, their needs are known.

3. Acting on patient needs

Healthcare providers must act on the recorded needs. This means:

• Making reasonable adjustments before the patient arrives
• Ensuring staff are aware of patient needs
• Providing accessible information and communication

Key deadlines:

What is the National Care Records Service (NCRS)?

The National Care Records Service (NCRS) is the NHS's digital system for sharing patient information across different healthcare settings.

Key features of NCRS:

• Single patient record — one record across the NHS
• Information sharing — data shared securely between providers
• Patient access — patients can view their records via the NHS App
• Reasonable adjustments — recorded and shared automatically

How does NCRS help with reasonable adjustments?

• One record, multiple settings — patient needs follow them across the NHS
• No repeat questions — patients don't need to explain their needs repeatedly
• Consistent care — all providers know the patient's needs
• Better outcomes — appropriate adjustments made every time

What do healthcare providers need to do?

Step 1: Review your current processes

Review how you currently record, share, and act on reasonable adjustment needs. Identify gaps.

Step 2: Implement the new information standard

Ensure your digital systems can record reasonable adjustment needs and share them via NCRS by 30 September 2026.

Step 3: Train your staff

Train all patient-facing staff on:

• How to ask about reasonable adjustment needs
• How to record needs in the digital record
• How to act on recorded needs

Step 4: Make your website accessible

Ensure your healthcare website and patient portal are accessible to disabled users. Use the free UK HHS checker to test.

Step 5: Document everything

Document all processes, training, and improvements. This serves as evidence of compliance.

What are the consequences of not making reasonable adjustments?

1. Discrimination claims

Disabled patients can bring a discrimination claim against your organisation under the Equality Act 2010. If successful, you could be ordered to pay unlimited compensation.

2. EHRC investigations

The Equality and Human Rights Commission (EHRC) can investigate your organisation and issue a non-discrimination notice.

3. Breaches of NHS standards

Failure to implement the new information standard is a breach of NHS requirements and can lead to regulatory action.

4. Reputational damage

Failure to make reasonable adjustments can lead to negative publicity and loss of patient trust.

Frequently Asked Questions — Reasonable Adjustments in Healthcare

Internal links — Healthcare Accessibility Resources