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A note on language

In the pursuit of equality, diversity and inclusion, language is powerful and can help to shift attitudes and behaviours.

This plan acknowledges that some definitions and terminology in legislation do not always reflect the identities or lived experience of individuals.

Achieving equality of health outcomes requires identification of barriers and biases, and targeted action to overcome specific inequalities, discrimination and marginalisation experienced by certain groups and individuals.

This includes, but is not limited to, those with protected characteristics under the Equality Act 2010[1].

The aim of this plan is to improve equality, diversity and inclusion, and to enhance the sense of belonging for NHS staff to improve their experience. Therefore, while we refer to the protected characteristics as defined in the Equality Act 2010, the actions set out here are intended to positively impact groups and individuals beyond these terms and definitions.

We have developed the high impact actions in this plan to be intersectional. This recognises that people have complex and multiple identities, and that multiple forms of inequality or disadvantage sometimes combine to create obstacles that cannot be addressed through the lens of a single characteristic in isolation[2].

Some specific points on language

When referring to ethnicity, we use the term Black and minority ethnic (BME) to be consistent with NHS Workforce Race Equality Standard terminology.

We use the term 'disability' as it is defined in the Equality Act 2010 recognising that the Act's intention is both positive and protective for disabled people. However, we recognise that 'disability' is a dynamic term, within which terms such as 'neurodivergence' and 'neurodiversity' are emerging and changing, including the relationship between neurodivergence and definitions of disability.

We use the acronym LGBT+ is used in this document, where the 'plus' includes all those identities and sexual orientations not specifically referenced. To promote the use of inclusive language, this document uses the terms 'trans and non-binary', 'gender identity' and 'sexual orientation'.

Foreword

The NHS must welcome all, with a culture of belonging and trust. ​We must understand, encourage and celebrate ​diversity in all its forms
NHS People Plan 2020

It is our privilege to introduce the NHS's first equality, diversity and inclusion (EDI) improvement plan. The NHS workforce is more diverse today than at any point in its 75-year history, and that brings benefits for patients and taxpayers alike.

Our NHS is built on the values of everyone counts, dignity and respect, compassion, improving lives, working together for patients, and commitment to quality. These values underpin how healthcare is provided, but must also extend to our NHS workforce.

Staff are at the heart of everything the NHS does, and always will be. To support the recovery of services following the COVID-19 pandemic, we need to increase capacity by growing our workforce and find new ways of working to enhance productivity.

To build for the future, we must inspire new staff to join and encourage existing staff to stay.

Ensuring our staff work in an environment where they feel they belong, can safely raise concerns, ask questions and admit mistakes is essential for staff morale - which, in turn, leads to improved patient care and outcomes[3].

This can only be done by treating people equitably and without discrimination.

An inclusive culture improves retention, supporting us to grow our workforce, deliver the improvements to services set out in our Long Term Plan, and reduce the costs of filling staffing gaps.

Delivering that kind of working environment in an organisation of any size takes deliberate focus, listening and action.

The NHS People Plan sets out the priorities for supporting the 1.3 million people who work in the NHS in England[4], with specific actions for improving their sense of 'belonging' in the NHS. Thisplan builds on the People Promise and the People Plan, using the latest data and evidence to identify six high impact actions organisations across the NHS can take to considerably improve equality, diversity and inclusion.

It is also right that NHS England holds itself to account to the same standards as the NHS as a whole, and we will be implementing this plan in our organisation.

We would like to acknowledge the contributions, expertise and lived experience shared with us by staff, staff networks, managers and system leaders in the development of this plan, which have provided us with invaluable insights on improving the experience of staff across the NHS.

We would also like to acknowledge the inputs from our strategic partners, including the Health and Care Women Leaders Network, the Race and Health Observatory, NHS Employers, NHS Providers, NHS Confederation, and many more.

On behalf of the whole NHS leadership team, we want to thank you for working with compassion, putting our patients and people at the helm and rising to the challenges we face.

We hope this plan provides the framework for making the NHS the best place to work whoever you are, where all staff feel they belong, can thrive, and - ultimately - deliver the best possible service for our patients.

Introduction

This improvement plan sets out targeted actions to address the prejudice and discrimination - direct and indirect - that exists through behaviour, policies, practices and cultures against certain groups and individuals across the NHS workforce.

It has been co-produced through engagement with staff networks and senior leaders.

The plan:

Sets out why equality, diversity and inclusion is a key foundation for creating a caring, efficient, productive and safe NHS

Explains the actions required to make the changes that NHS staff and patients expect and deserve, and who is accountable and responsible for their delivery

Describes how NHS England will support implementation

Provides a framework for integrated care boards to produce their own local plans.

The findings and recommendations of the Messenger Review - Leadership for a collaborative and inclusive future (July 2022) reaffirmed the need for this plan's actions, which forms part of our response to recommendation two of the review. Future iterations of this plan will address how we tackle EDI challenges within social care, and will be developed in collaboration with integrated care boards (ICBs) and other key stakeholders including the Department of Health and Social Care (DHSC).

The NHS Long Term Workforce Plan will define the size, shape, mix and number of staff needed to deliver high quality patient care, now and into the future. This EDI improvement plan supports the Long term workforce plan by improving the culture of our workplaces and the experiences of our workforce, to boost staff retention and attract diverse new talent to the NHS. The plan also supports the achievement of strategic EDI outcomes, which are to:

Address discrimination, enabling staff to use the full range of their skills and experience to deliver the best possible patient care

Support the levelling up agenda by improving EDI within the NHS workforce, enhancing the NHS's reputation as a model employer and an anchor institution, and thereby continuing to attract diverse talents to our workforce

Make opportunities for progression equitable, facilitating social mobility in the communities we serve.

These actions should be implemented in partnership with trade unions / staffside colleagues and forums, and in collaboration with staff networks. In line with our operating framework, NHS England will provide guidance to assist trusts and ICBs in adopting an improvement approach to the implementation of this plan, supported by a repository of good practice and a dashboard to enable the measurement of progress. We will also implement this plan internally to ensure consistency with the NHS as a whole.

Where diversity - across the whole workforce - is underpinned by inclusion, staff engagement, retention, innovation and productivity improve. Inclusive environments create psychological safety and release the benefits of diversity - for individuals and teams, and in turn efficient, productive and safe patient care.

Staff survey and workforce data reflecting the lived experience of NHS staff demonstrates that we have more to do before we can say inclusive workplace environments are the norm across the NHS.[5] For example, women make up 77% of the NHS workforce but are under-represented at senior level.[6]. Just over 24% of the workforce are from black and minority ethnic (BME) backgrounds but face discrimination across many aspects of their working lives The 2022 Workforce Race Equality Standard (WRES) data showed that 27.6% of Black and minority ethnic (BME) staff experienced bullying, harassment or abuse from other staff in the preceding year; The NHS Staff Survey along with the Workforce Disability Equality Standard (WDES) shows that disabled staff in the NHS are under-represented when compared to the general population. The NHS staff survey data shows that 25% of disabled staff have experienced bullying from their colleagues, compared to 16.6% of non-disabled staff. Similarly, 23.5% of our LGBT+ colleagues face bullying and harassment at work compared to 17.9% of heterosexual staff.

Organisational efficiency correlates with staff and patient experience: :

Staff who are bullied are less likely and less willing to raise concerns and admit mistakes[7].

Increased leadership diversity correlates with better financial performance.[8]

In hospital settings, managing staff with respect and compassion correlates with improved patient satisfaction, infection control, Care Quality Commission (CQC) ratings and financial performance.[9]

High work pressure, staff perceptions of unequal treatment, and discrimination against staff all correlate adversely with patient satisfaction.[10]

A workforce that is compassionate and inclusive for all has higher levels of engagement, motivation and wellbeing, which results in better care and reduced staff turnover.[11]

Fair treatment of every individual in the workforce helps reduce movement of substantive staff into bank and agency roles to avoid discrimination at work.

A diverse workforce that is representative of the communities it serves is critical to addressing the population health inequalities in those communities.[12]

Organisations with more diverse leadership teams are likely to outperform their less diverse peers.[13]

Psychologically safe work environments, where people feel they are treated with dignity and respect, achieve more effective, safer patient care.[14]

Simply put, a diverse workforce in an inclusive environment will likely improve staff engagement, lower turnover and enhance innovation.

Elective recovery is a top priority for the NHS[15]. Key to our success is boosting capacity, by filling vacancies, reducing turnover and improving morale[16]. To achieve this stability and to lay the foundations from which to grow the workforce of the future, the NHS must improve staff experience across all protected characteristics if we are to sustainably reduce staff turnover, increase recruitment, reduce absenteeism and create more inclusive and productive teams.

High impact actions

This plan prioritises the following six high impact actions to address the widely-known intersectional impacts of discrimination and bias.

High impact action 1

High impact action 1:

Chief executives, chairs and board members must have specific and measurable EDI objectives to which they will be individually and collectively accountable.

Leaders set the tone and culture of their NHS organisation.

Leaders who demonstrate compassion and inclusion, and focus on improvements, are key to creating cultures that value and sustain a diverse workforce. Staff will in turn feel more empowered to deliver great care and patient experience.[17]

As highlighted in the Messenger Review, principles of EDI should be embedded as the personal responsibility of every leader and every member of staff. It is in this context that all chief executives, chairs and board members should have distinct objectives on improving inclusion in their organization and have a personal commitment to mainstream EDI as the responsibility of all, such that the provision of an inclusive and fair culture should become a key metric by which leadership at all levels is judged.

NHS organisations and ICBs must complete the following actions:

Every board and executive team member must have EDI objectives that are specific, measurable, achievable, relevant, and timebound (SMART) and be assessed against these as part of their annual appraisal process (by March 2024).

Board members should demonstrate how organisational data and lived experience have been used to improve culture (by March 2025).

NHS boards must review relevant data to establish EDI areas of concern and prioritise actions. Progress will be tracked and monitored via the Board Assurance Framework (by March 2024).

Success metric for high impact action 1

Further information and case studies can be found in the EDI repository.

High impact action 2

High impact action 2

Embed fair and inclusive recruitment processes and talent management strategies that target under-representation and lack of diversity.

We know diverse boards make better collective decisions for the communities they serve.[18] There has been progress in improving diversity of senior management teams; the total number of BME staff at very senior manager level has increased by 69.7% since 2018 from 201 to 341 [19] and the percentage of board members declaring a disability has increased from 2% in 2019 to 4.6% in 2022. However, in relation to the three protected characteristics for which reliable data exists (race, disability and gender); senior teams across the NHS are less representative of their organisation's workforce. For example, WRES data (31 March 2022) shows that BME people make up 24.2% of the NHS workforce [19] but only 13.2% of board members; 85% of people with a disability do not believe that their trust provides equal opportunities for promotion [20] and women represent 77% of the NHS workforce but only 37% of very senior managers.[21]

Talent management strategies must recognise the importance of equitable recruitment and career progression for all staff. If they do not, the NHS risks losing talent because everyone does not see themselves as having the same opportunity, leading to a direct impact on patient care.

The national 'Inclusive recruitment and promotion practices framework'[22] highlights the principles for an evidence-driven approach. It supports boards in achieving the aspirations of the Long Term Workforce Plan by addressing workforce vacancies.

NHS organisations and ICBs are to complete the following actions:

Create and implement a talent management plan to improve the diversity of executive and senior leadership teams (by June 2024) and evidence progress of implementation (by June 2025)

Implement a plan to widen recruitment opportunities within local communities, aligned to the NHS Long Term Workforce Plan. This should include the creation of career pathways into the NHS such as apprenticeship programmes and graduate management training schemes (by October 2024). Impact should be measured in terms of social mobility across the integrated care system (ICS) footprint.

Success metrics for high impact action 2

Further information and case studies can be found in the EDI repository.

High impact action 3

High impact action 3:

Develop and implement an improvement plan to eliminate pay gaps.

As an inclusive employer, the NHS should take steps to address gender, ethnicity and disability pay gaps.

The gender pay gap in the UK has been declining slowly over time; over the last decade it has fallen by approximately a quarter among full time employees.[23] The pay gap is relatively small for the 88% of NHS staff employed on Agenda for Change (AfC) terms and conditions. However, it is 47% for the 12% of NHS staff who are not, essentially doctors and senior leaders.

The independent review Mend the gap (2020) describes the actions that the NHS should take to address the gender pay gaps in medicine, such as promoting flexible working for all. Many of its recommendations can also be applied to non-medical senior leaders. For example, for every 80 pence earned by Black female doctors their White counterparts earn £1.[24] In younger age groups, the pay gap favours female doctors, reflecting the large numbers of women joining the NHS, but this reverses between the ages of 30 and 34 and then widens with age.[25]

Data on organisational ethnicity and disability pay gaps will become available in the coming years.

NHS organisations are to complete the following actions:

Implement the Mend the Gap review recommendations for medical staff and develop a plan to apply those recommendations to senior non-medical workforce (by March 2024).

Analyse data to understand pay gaps by protected characteristic and put in place an improvement plan. This will be tracked and monitored by NHS boards. Reflecting the maturity of current data sets, plans should be in place for sex and race by 2024, disability by 2025 and other protected characteristics by 2026.

Implement an effective flexible working policy including advertising flexible working options on organisations' recruitment campaigns. (March 2024)

Success metric ​for high impact action 3
Further information and case studies can be found in the EDI repository.

High impact action 4

High impact action 4:

Develop and implement an improvement plan to address health inequalities within the workforce.

In England, 1 in 19 working age adults is employed by the NHS[26], making NHS organisations one of the largest employers within local communities.

This creates an opportunity to positively impact population health by addressing health inequalities in the workforce [27]. A proactive approach to reducing health inequalities in the workplace[28] can make a significant contribution to the levelling up agenda[29] within local communities, supporting targets set by CORE20PLUS5[30].

NHS organisations should start by delivering action in two specific areas.

Firstly, reducing bullying, increasing civility, and having a robust approach to all abuse and harassment. This will address some common causes of ill health, absenteeism and turnover within the workforce which disproportionately impact on those with some protected characteristics, and will improve inclusive team working, staff health and wellbeing.

Secondly, as anchor institutions in local communities, NHS organisations can make a positive impact by offering routes into employment, good work[31] and career development.

Organisations are to complete the following actions:

Line managers and supervisors should have regular effective wellbeing conversations with their teams, using resources such as the national NHS health and wellbeing framework. (by October 2023).

Work in partnership with community organisations, facilitated by ICBs working with NHS organisations and arm's length bodies, such as the NHS Race and Health Observatory. For example, local educational and voluntary sector partners can support social mobility and improve employment opportunities across healthcare (by April 2025).

Success metrics for high impact action 4

During 2024/25, NHS England will work with ICBs and other key stakeholders to establish a mechanism for measuring improvements in workforce health inequalities

Further information and case studies can be found in the EDI repository.
High impact action 5
High impact action 5:

Implement a comprehensive induction, onboarding and development programme for internationally-recruited staff.

Since its inception in 1948, the NHS has benefitted from the expertise, compassion and commitment of internationally recruited healthcare professionals. A warm welcome and comprehensive induction and pastoral support package will make them feel valued from the start and help retain this staff group.

NHS organisations should complete the following actions:

Before they join, ensure international recruits receive clear communication, guidance and support around their conditions of employment ; including clear guidance on latest Home Office immigration policy, conditions for accompanying family members, financial commitment and future career options (by March 2024).

Create comprehensive onboarding programmes for international recruits, drawing on best practice. The effectiveness of the welcome, pastoral support and induction can be measured rom, for example, turnover, staff survey results and cohort feedback (by March 2024).

Line managers and teams who welcome international recruits must maintain their own cultural awareness to create inclusive team cultures that embed psychological safety (by March 2024).

Give international recruits access to the same development opportunities as the wider workforce. Line managers must proactively support their teams, particularly international staff, to access training and development opportunities. They should ensure that personal development plans focus on fulfilling potential and opportunities for career progression (by March 2024).

Success metrics ​for high impact action 5

Reduction in instances of bullying and harassment from team/line manager experienced by (internationally recruited staff).​

NHS Staff Survey

Further information and case studies can be found in the EDI repository.

High impact action 6

High impact action 6:

Create an environment that eliminates the conditions in which bullying, discrimination, harassment and physical violence at work occur.​

Bullying and harassment at work results in increased sickness absence and employee turnover, diminished productivity, sickness presenteeism, governance and employee relations costs. Workplace bullying therefore adversely impacts patient safety.

In the 2022 NHS Staff Survey 18.7% of NHS staff reported they had experienced bullying by colleagues, 11.1% by line managers and 27.8% by patients or their relatives. These statistics are consistently higher for people with some protected characteristics, and particularly those with a disability or and in the LGBT+ community.[32]

Staff who are bullied in the workplace are less likely to speak up and to admit mistakes, and therefore are less likely to contribute to effective team working. Bullying affects bystanders and witnesses too,[33] eroding psychological safety within the workplace culture.[34]

Relying on local policies to prevent bullying or discrimination is not enough. A proactive, preventative approach that seeks early informal intervention wherever possible is more likely to be effective, with escalation only where that fails.

NHS organisations are to complete the following actions:

Review data by protected characteristic on bullying, harassment, discrimination and violence. Reduction targets must be set (by March 2024) and plans implemented to improve staff experience year-on-year.

Review disciplinary and employee relations processes. This may involve obtaining insights on themes and trends from trust solicitors. There should be assurances that all staff who enter into formal processes are treated with compassion, equity and fairness, irrespective of any protected characteristics. Where the data shows inconsistency in approach, immediate steps must be taken to improve this (by March 2024).

Ensure safe and effective policies and processes are in place to support staff affected by domestic abuse and sexual violence (DASV). Support should be available for those who need it, and staff should know how to access it. (By June 2024)

Create an environment where staff feel able to speak up and raise concerns, with steady year-on-year improvements. Boards should review this by protected characteristic and take steps to ensure parity for all staff (by March 2024).

Provide comprehensive psychological support for all individuals who report that they have been a victim of bullying, harassment, discrimination or violence (by March 2024).

Have mechanisms to ensure staff who raise concerns are protected by their organisation.

Success metrics for high impact action 6

Further information and case studies can be found in the EDI repository.

Making change happen

As England's largest employer, the NHS must lead the way in establishing equitable and inclusive workplace environments.

The key change management principle guiding this work is that EDI is everyone's business - our leaders set the tone and culture, but we all have a role to play. Progressing the EDI agenda requires not only a change in systems and processes, but also cultures and behaviours.

NHS leaders, specifically chairs and chief executives, must lead by example and demonstrate that they are committed to creating an EDI environment for their workforce. Board members should collectively and individually decide what support and development they require to confidently lead this complex and challenging agenda.

We expect NHS employing organisations to implement the six high impact actions. They should be confident in explaining to their workforce - especially leaders, HR professionals and line managers - the rationale for this work and what is expected of individuals and teams. Using the repository of good practice, organisations should identify suitable interventions for local implementation, based on local context and conditions. NHS England will support this by collating and disseminating best practice.

Accountability is important for setting clear expectations, coupled with a focus on learning and improvement. NHS England, ICB and provider accountabilities and responsibilities for delivery of the NHS EDI improvement plan follow the principles set out in the NHS Operating Framework and are outlined in the table below. NHS England will provide regulatory accountability and oversight through existing mechanisms, such as the NHS Oversight Framework, and the CQC through the well-led domain of the single assessment framework, which is being refreshed to include a review and assessment of EDI in organisations.

Measurement of progress is critical to guide targeted action. Progress should be measured at organisation and system level to inform delivery, and will be monitored by NHS England to inform the support we provide.

Delivery of high impact actions and interventions by protected characteristic at trust level. ​ Measure progress against success metrics consistently within the organisation.

Engagement with staff and system partners to ensure that actions are embedded within the organisation. ​

Effective system working and delivery to ICS strategies and plans​

Compliance with provider licence, Care Quality Commissions standards and professional regulator standards.

Effective system leadership overseeing NHS delivery of EDI improvement plan, ensuring progress toward achievement of high impact actions and Long-Term Plan priorities.​

Ensuring delivery of ICB statutory functions of arranging health services for its populations and compliance with statutory duties.

Measure progress against success metrics consistently and coordinate a system view.

Compliance with Care Quality Commissions assessment frameworks.

Primary interaction between national and systems​

Translate national policy to fit local circumstances, ensuring local health and workforce inequalities are addressed​

Agree 'local strategic priorities' with individual ICSs and provide oversight and support.

Measure progress against success metrics consistently and coordinate a regional view.

Set expectations for equality and inclusion through the NHS EDI improvement plan ​

With regions, facilitate supportive interventions to implement the high impact actions, improve EDI performance and outcomes​

Measure progress against success metrics consistently and coordinate a national view. ​

Support from NHS England

We will work alongside systems and organisations to support the delivery of the NHS EDI improvement plan.

A national EDI repository

We will create a repository of good practice on the FutureNHS platform to share examples of what is working in the NHS and in other public and private sector organisations. This will help prevent duplication of effort and promote learning. The repository will be continually updated and include:

case studies from organisations

practical toolkits and resources

the latest research and evidence.

A national EDI dashboard

A national dashboard of key EDI metrics is being developed and will be available in the coming weeks by region, within ICBs and within similarly benchmarked trusts. This will enable local organisations and NHS England to monitor progress, identify challenges and assist peer-to-peer learning alongside the EDI repository. It will incorporate relevant education and training metrics, created by Health Education England.

There is currently a range of EDI information datasets and we intend the dashboard to provide one source of information that both organisations and regulators, such as the CQC, can use to track the impact and outcomes of the NHS EDI improvement plan.

In developing the dashboard, we are conscious that there are limitations on the availability of datasets for certain protected characteristics, such as for transgender colleagues. . Furthermore, the declaration rates on the Electronic Staff Record (ESR) for certain characteristics are not a true reflection because the available options, for example, do not reflect that Judaism is a religion and Jewish an ethnic identity. We will continue to work with DHSC and other external stakeholders to harmonise and expand the quality and extent of datasets as we engage with DHSC's Unified Information Standard on Protected Characteristics (UISPC) programme.

We are committed to updating the dashboard with new and refreshed datasets as they become available.

Data

Reliable, consistent and timely data is crucial to effective progress. There are significant differences in the range and quality of data held for the protected characteristics. This is reflected in the sections for each protected characteristic. In 2023/24, NHS England will seek to improve the range and quality of data, working with DHSC and other partners. So, for example, with the addition of a question to the NHS Staff Survey, data is now available on whether staff are internationally trained. In addition, NHS England will seek to develop a new mandated workforce standard on gender identity (gender/sex) and sexual orientation.

Review and evaluation

Sustained improvement is central to this NHS EDI improvement plan. Trusts and ICBs will want to adopt implementation approaches that include learning. NHS England will evaluate progress, particularly on the high impact actions, in years 2 and 5 of the plan, to understand the plan's impact in transforming culture to engender a sense of belonging in the NHS across the workforce, and what does and does not work to inform changes to our approach.

Interventions by protected characteristic

The interventions in the table below address the negative experiences of staff with individual protected characteristics, as defined in the Equality Act 2010. They supplement the intersectional high impact actions and suggest how organisations can go further in specific areas. To inform implementation and prioritisation of their actions, organisations should use robust datasets for each protected characteristic. It is important to note that no person is only one protected characteristic, and so organisations should consider the impact of intersectionality, when implementing these interventions.

The 9 protected characteristics as defined in the Equality Act 2010 are:

1. Age

2. Disability

3. Race

4. Religion or belief

5. Sex

6. Pregnancy and maternity

7. Sexual orientation

8. Gender reassignment

9. Marriage and civil partnership

Engagement with staff networks informed the decision to combine some protected characteristics who face similar challenges in the workforce. To this end, gender reassignment and sexual orientation are covered together. Similarly, pregnancy and maternity are incorporated into the sex protected characteristic. The following section does not include specific interventions on the protected characteristic of marriage and civil partnership because the available evidence does not currently suggest that there is a need for a national focus on this protected characteristic from a workforce perspective, however this will be kept under review.

Case for change

Age

As the largest employer in the country, all NHS organisations should create an age inclusive culture which addresses the needs of staff from pre-employment to post-retirement. Discrimination against both younger and older workers has been identified in the application and selection processes[35]. The NHS has an ageing workforce across all professions with over 41% of NHS staff now aged 45 years and over[36]. We must proactively seek to retain the skills, experience and knowledge of NHS staff close to retirement.

Disability

Successive reports of the Workforce Disability Equality Standard (WDES) and NHS Staff Survey show that more must be done to achieve parity of experience and outcomes for staff with a disability, in areas such as bullying and harassment and formal capability processes.

Race

The 2022 WRES data report for NHS trusts provides evidence that race discrimination continues to impact every aspect of the working lives of BME staff. This discrimination has an impact on the long term physical[17] and mental health[18] of our workforce contributing to structural health inequalities[19].

Religion or belief

Religious identity is an often overlooked area in the NHS.[37] Approximately two-thirds of our 1.3 million people working in the NHS declare a religion or belief. NHS Staff Survey data shows that staff from all faiths experience discrimination based on their religion or belief, and this is highest against Muslim and Jewish colleagues.[38] Recent data highlights increasing levels of antisemitism in wider society, as well as discrimination against Sikhs and other faiths, and this is likely to be reflected among NHS staff.[39]

Sex

77% of the NHS workforce are women, so addressing sex discrimination must be a key focus for organisations. The discrimination is multifaceted - bias in recruitment and career progression and contributing to the gender pay gap, under-representation within senior leadership teams, sexual harassment and inflexible working practices - and may deter potential recruits or force talented women to leave the NHS.[40]

Elimination of the gender pay gap would bring social economic benefits as would likely lower poverty rates among women and reduce the gender gap in old age pensions. Government's Women's Health Strategy for England reports a strong correlation between the lack of support for, and understanding of, how women's health affects their experience in the workplace including progression, retention and productivity levels.

Pregnancy and maternity

There is a growing evidence that the protected characteristic of pregnancy and maternity is associated with poor employment outcomes and health inequalities, and health-related outcomes may be poorer as a result of pregnancy and maternity. Additionally, in a survey of over 6,000 women and employers, over three-quarters of mothers reported negative or possibly discriminatory practices during pregnancy, maternity and/or on their return to work.[41]

Women also experience specific inequalities in relation to the menopause.

It is important to acknowledge that trans, non-binary and intersex staff may also experience inequalities in relation to pregnancy and menopause and may require specific support during these times. The CQC's Maternity Survey reported that trans respondents experienced inequalities, including in to how they were communicated with during labour and birth, their length of hospital stay after giving birth and the information and care they received after leaving hospital.[42][43]

The recommended interventions to address this inequity are similar for colleagues of one or both protected characteristics and have been reflected as such in this document.

Gender reassignment and sexual orientation

LGBT+ staff are more likely to face discrimination from their colleagues and patients,[44] andthis can have a detrimental impact on their health.[45]

The 'plus' within the term LGBT+ acts to include those identities and sexual orientations not specifically referenced. However, we recognise that this group is diverse and their lived experience is varied.

A significant barrier in understanding the experiences of LGBT+ staff is the absence of complete and accurate data. The DHSC Unified Information Standard for Protected Characteristics (UISPC) programme is considering the current data limitation within the ESR with respect to LGBT+ staff declarations. NHS England is working with DHSC and other key stakeholders to expand the workforce data currently available on ESR to make it accurate and representative.

Protected characteristic: Age

Line managers should have meaningful conversations with their teams, to align personal aspirations with job roles and requirements. This should include the option of phasing retirement and exploring alternative work patterns.

Organisations should encourage flexible working as part of local attraction, recruitment, retention and return plans. The plan should embed the NHS Pension Scheme and highlight its value across the career journey, with special focus on flexible retirement for staff in late stage careers.

NHS organisations should work in partnership with local educational institutions and voluntary sector partners to support social mobility by improving recruitment from local communities, and by considering alternative entry routes to the NHS, such as apprenticeships and volunteering.

Protected characteristic: Disability

Demonstrate year-on-year improvement in disability declaration rates so that ESR data is accurate about people with a disability, as measured by the WDES.

all

Promote the visibility of leaders with a disability through effective campaigns alongside providing leadership and career development opportunities tailored to disabled staff, such as the Calibre Leadership programme[46] or Disability Rights UK[47] development programmes. Progress can be measured by tracking the number of disabled staff in leadership roles.

2

Implement recommendations from the inclusive recruitment and promotion practices programme, and ensure each stage of the recruitment pathway is accessible, does not discriminate and encourages people with disabilities to apply for roles in the NHS. This can be tracked via the WDES, using Trac data.

2

Commissioners and providers of talent management and career development programmes must ensure that these are fully accessible and inclusive. Progress can be measured by tracking the number of Disabled people in leadership roles.

2

NHS organisations should take steps to address the disproportionate levels of bullying and harassment experienced by disabled staff. Progress can be measured from NHS Staff Survey results.

6

NHS organisations should ensure that their reasonable adjustments policy is effectively and efficiently implemented and achieves year-on-year improvement in NHS Staff Survey metrics relating to reasonable adjustments at work.

2,4

Protected characteristic: Race

Boards should be able to demonstrate their understanding of and progress towards race equality, an essential criterion in job descriptions for board members and all very senior manager (VSM) grades. Appraisals of senior executives will include a focus on EDI, as recommended by the Messenger Review.

Board will use the EDI dashboard to establish internal data driven accountability and scrutinise progress at an organisational, divisional, departmental, occupation, and site level to address under-representation and pay gaps.

To tackle race discrimination effectively boards must give due consideration to national policies and recommendations from other arms length bodies such as the Equality and Human Rights Commission inquiry[48] and General Medical Council[49]. In addition, boards must proactively raise awareness of their commitment with patients and public.

Boards should ensure concerns raised about race discrimination are dealt with in a proactive, preventative, thorough and timely manner, including encouraging diversity in Freedom to Speak Up Guardians[50].

Protected characteristic: Religion or belief

ESR and qualitative data should be tracked to highlight the experience of people with different faiths or no faith through all stages of the employment journey. For example, NHS organisations can track turnover data by religion to identify and address trends.

all

NHS organisations should review their policies and processes to ensure they are supportive of religious expression in the workplace. This includes access to facilities for prayer, understanding of cultural differences, including religious clothing, and flexibility around religious observances such as the Sabbath and Ramadan.

all

Boards should ensure concerns raised about religious discrimination are dealt with in a proactive, preventative, thorough and timely manner, including by encouraging diversity in Freedom to Speak Up guardians[50].

6

Protected characteristic: Sex and pregnancy and maternity

NHS organisations to focus on closing the gender pay gap and improving the experiences of the lowest paid people, extending the Mend the gap review recommendations for medical workforce to the wider workforce.

2,3

NHS organisations should ensure that their flexible working policy is easily accessible and suitable for all their staff; supporting their work-life balance, management of caring responsibilities, health and wellbeing, and enabling continued professional development.

2

NHS organisations are encouraged to adapt NHS England's policy on menopause awareness as applicable to their local workforce. They should also adopt and implement the Supporting our NHS people through menopause: guidance for line managers and colleagues. This will ensure they fully support colleagues experiencing menopause, maximising their wellbeing and allowing them to work for as long as they wish to contribute.

all

Protected characteristic: Gender reassignment and sexual orientation

Where colleagues feel comfortable, actively encourage LGBT+ staff to self-declare their sexual orientation on ESR and TRAC, emphasising how this can improve the experiences of LGBT+ staff. We recognise that national changes to ESR must be made before trans and non-binary staff are able to do so.

all

Review organisational data for LGBT+ staff across multiple sources such as ESR, TRAC, NHS Staff Survey and local qualitative and quantitative data from LGBT+ staff networks and communities. This will inform the key areas of concern that need to be addressed.

all

Organisations to ensure that diversity training on gender reassignment and sexual orientation is included within mandatory training.

1

Executive teams within the organisations should actively talk about the benefits of allyship as well as champion, and sponsor LGBT+ staff networks. They should also build the concept of allyship into existing and new development programmes.

1

Organisations to ensure that LGBT+ staff are closely involved in the development and delivery of its LGBT+ training and educational interventions and its health & wellbeing programmes so that these are fully inclusive.

all

Conclusion

Our organisations must be more inclusive and our leadership more diverse. We have an obligation to improve the experience of staff so that they feel like they belong. This plan articulates meaningful action to transform the lived experience of our staff and realise the benefits that we know come from greater equality, diversity and inclusion.

There is a wealth of evidence that shows having a diverse workforce and making sure everyone feels part of a team delivers the best care for patients.

It is the job of NHS leaders to ensure we deliver, taking an active role in ending all forms of discrimination, role-modelling inclusive behaviours and creating an environment in which our workforce feel safe and empowered. But everybody has a role to play supporting, encouraging and promoting inclusion.

References

[1] Equality, diversity and inclusion in the Workplace | Factsheets | CIPD

[2] Using intersectionality understand structural inequality Scotland evidence synthesis (www.gov.scot)

[3] West M (2021) Compassionate Leadership: Sustaining Wisdom, Humanity and Presence in Health and Social Care

[4] Hemmings, N et al (2021) Attracting, supporting and retaining a diverse NHS workforce https://www.nuffieldtrust.org.uk/files/2022-10/1636121852-nhs-workforce-diversity-web.pdf https://www.nuffieldtrust.org.uk/files/2022-10/1636121852-nhs-workforce-diversity-web.pdf

[5] Cambridge Dictionary definition for 'lived experience' - the things that someone has experienced themselves, especially when these give the person a knowledge or understanding that people who have only heard about such experiences do not have.

[6] NHS Confederation (2020) Action for Equality: the time is now https://www.nhsconfed.org/system/files/media/Action-for-equality-the-time-is-now_4.pdf

[7] Lucian L Leape , Miles F Shore, Jules L Dienstag, et al (2012) Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians. Acad Med. 2012 Jul;87(7):845-52. doi: 10.1097/ACM.0b013e318258338d.

[8] Gomez LE, Bernet P (2019) Diversity improves performance and outcomes. J Natl Med Asso 111(4): 383-392. doi: 10.1016/j.jnma.2019.01.006. Epub 2019 Feb 11. https://pubmed.ncbi.nlm.nih.gov/30765101/

[9] Dixon-Woods M, Baker R, Charles K, et al (2014) Culture and behaviour in the English National health service: overview of lessons from a large multimethod study. BMJ Qual Saf 2014;23:106-15. doi:10.1136/bmjqs-2013-001947 See also West M (2021) Compassionate leadership: sustaining wisdom, humanity and presence in health and social care.

[10] Dawson J (2018) Links between NHS staff experience and patient satisfaction: Analysis of surveys from 2014 and 2015 links-between-nhs-staff-experience-and-patient-satisfaction-1.pdf (england.nhs.uk); see also West M (2021) Compassionate leadership: sustaining wisdom, humanity and presence in health and social care.

[11] West M (2021) Compassionate leadership: sustaining wisdom, humanity and presence in health and social care and King's Fund (2022) What is compassionate leadership.

[12] Public Health England (2021) Addressing health inequalities through collaborative action. Briefing note.

[13] Gomez LE, Bernet P (2019) Diversity improves performance and outcomes[1] J Natl Med Asso 111(4): 383-392. doi: 10.1016/j.jnma.2019.01.006. Epub 2019 Feb

[14] Edmondson A (2018) The fearless organisation: creating psychological safety in the workplace for learning, innovation and growth. Harvard Business School: Whiley

[15] NHS England (September 2022) NHS delivers on elective recovery plan with progress on treatment and tests. https://www.england.nhs.uk/2022/09/nhs-delivers-on-elective-recovery-plan-with-progress-on-treatment-and-tests/

[16] National Audit Office (2022) Managing NHS backlogs and waiting times in England

[17] Ashikali T, Groeneveld S, Kuipers B (2021) The role of inclusive leadership in supporting an inclusive climate in diverse public sector teams. Review of Public Personnel Administration 41(3): 497-519. https://doi.org/10.1177/0734371X19899

[18] NHS Improvement (2018) NHS provider board membership: survey and findings. https://www.england.nhs.uk/1sthi5thew4y/wp-content/uploads/sites/54/2020/08/NHSI_board_membership_2017_survey_findings_Oct2018a_ig.pdf

[19] NHS England " NHS Workforce Race Equality Standard (WRES) 2022 data analysis report for NHS trusts

[20] Statistics " NHS Staff Survey in England

[21] Narrowing of NHS gender divide but men still the majority in senior roles - NDRS (digital.nhs.uk)

[22] NHS Employers (2021), Inclusive recruitment: Leading positive change.

[23] Appleby J, Schlepper L (2019) The gender pay gap in the English NHS. Analysis of some of the underlying causes.

[24] UK Government (2019) NHS basic pay. Ethnicity facts and figures

[25] Mend the Gap: The Independent Review into Gender Pay Gaps in Medicine in England - December 2020 (publishing.service.gov.uk)

[26] See endnote reference 1

[27] Public Health England (2015) Local action on health inequalities: Promoting good quality jobs to reduce health inequalities https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/460700/2a_Promoting_good_quality_jobs-Full.pdf

[28] Ten Ways businesses can help to reduce inequalities. Infographic. NHS England. https://www.england.nhs.uk/wp-content/uploads/2022/01/10-ways-businesses-can-reduce-health-inequalities-infographic-1.pdf

[29] UK Government levelling up the United Kingdom

[30] NHS England " Core20PLUS5 - An approach to reducing health inequalities for children and young people

[31] The CIPD (2019) describes good work as follows: Good work is fairly rewarded. Good work gives people the means to securely make a living. Good work gives opportunities to develop skills and a career and ideally gives a sense of fulfilment. Good work provides a supportive environment with constructive relationships. Accessed 05.12.22: https://www.cipd.co.uk/Images/uk-working-lives-summary-2019-v1_tcm18-58584.pdf

[32] Statistics " NHS Staff Survey in England

[33] Statistics " NHS Staff Survey in England

[34] Edmondson A (2018) The fearless organisation: creating psychological safety in the workplace for learning, innovation and growth. Harvard Business School: Whiley

[35] (2021) Good Recruitment for Older Workers: An Employers Guide. https://ageing-better.org.uk/sites/default/files/2021-10/GROW-a-guide-for-employers.pdf

[36] NHS Digital. NHS Workforce statistics March 2022: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/march-2022

[37] Héliot YF (2020). Religious identity and working in the NHS. NHS Employers

[38] King's Fund (2015) Making a difference to diversity and inclusion in the NHS

[39] https://commonslibrary.parliament.uk/research-briefings/cbp-8537/

[40] Government Equalities Office (2019) Gender Equality at Work: Research on the Barriers to Women's Progression

[41] Pregnancy and maternity-related discrimination and disadvantage: summary of findings (publishing.service.gov.uk)

[42] LGBT Foundation - Revealed: Improving Trans and Non-binary Experiences of Maternity Services (ITEMS) report

[43] https://www.cqc.org.uk/publication/surveys/maternity-survey-2022

[44] Statistics " NHS Staff Survey in England

[45] https://www.kingsfund.org.uk/blog/2021/04/supporting-lgbtq-nhs-staff

[46]Details on the Calibre Disabled Leadership Programme as at December 2022: https://www.ossiesway.com
[47] Details on the Disability Rights UK Leadership Programme as at December 2022 https://www.disabilityrightsuk.org/how-we-can-help/leadership

[48] Report finds evidence of inequality in treatment of ethnic minority 'Covid heroes' working in health and social care | Equality and Human Rights Commission (equalityhumanrights.com)

[49] Racism in the workplace - GMC (gmc-uk.org)

[50] Kline R, Somra G (2021) Difference matters: The impact of ethnicity on speaking up (National Guardian Office)

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NHS equality, diversity, and inclusion improvement plan

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In the pursuit of equality, diversity and inclusion, language is powerful and can help to shift attitudes and behaviours. This plan acknowledges that some definitions and terminology in legislation do not always reflect the identities or lived experience of individuals.

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The learning experiences of dyslexic medical students during the COVID‑19 pandemic: a phenomenological study

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https://london.hee.nhs.uk/professional-development

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https://www.bloomberg.com/news/articles/2022-03-30/richard-branson-hails-linkedin-for-adding-dyslexic-thinking-as-official-skill

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https://london.hee.nhs.uk/professional-development/dyslexia

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https://www.nice.org.uk/guidance/cg142/resources/autism-spectrum-quotient-aq10-test-143968

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https://adhduk.co.uk/adult-adhd-screening-survey/

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Adult ADHD Self Screening Tool - ADHD UK

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Since adult ADHD is under-diagnosed, People with the condition are not getting the help they need. WHO and the Workgroup on Adult ADHD created a screener survey

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Scattered Minds: The Origins and Healing of Attention Deficit Disorder

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Scattered Minds: The Origins and Healing of Attention Deficit Disorder

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https://www.amazon.co.uk/dp/1785042211/ref=cm_sw_r_awdo_SSKZ1940FZPSST5EPDPQ

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Scattered Minds: The Origins and Healing of Attention Deficit Disorder

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Where your work meets your life. See more from Ascend here.

Every time I write about autism and neurodiversity, my inbox fills with notes from talented young professionals. I've heard from people who mask their autism to avoid stereotyping or discrimination at work. I've read painful recollections from employees who are shunned, bullied, exploited, or underpaid as a result of being neurodivergent. Then, there are those who were rejected or fired after disclosing autism, ADHD, or another neuro-difference. Some of them want my advice. Others want to be heard. Their stories vary, but each resonates, in some way, with my own.

I am a professor of organizational psychology. I am also autistic. I always knew I was different, but until last year, when I was officially diagnosed, I genuinely believed that to be treated better, I had to work harder to fit in - adjust to and please others, often at the expense of my wellbeing.

Throughout my career, I've had a hard time regularly socializing with colleagues over lunch and attending large gatherings. My hypersensitivity to sound and smell makes crowded spaces highly unpleasant. Lunchtime chatter, and especially music, hit my ears with the intensity of a leaf blower. Certain aromas make me physically sick. While some colleagues have been considerate of my needs, others have weaponized them. A coworker once threatened to play loud music if I did not comply with their request.

For a long time, I blamed myself for the bullying I experienced. In every instance, I responded by working harder. I would stay up late, take on more, and prioritize the needs of others over my own. The more I tried to fit in and please people among credit-stealing and cutthroat competition, the more I struggled. I started using ableist terms like "weird" to describe myself.

Think of it this way: If you are neurotypical, or part of any majority group, you likely see reflections of yourself wherever you look: on billboards, in magazines, while watching your favorite TV shows, in novels and in movies, and in the coworkers you relate to. Now imagine if all of that was taken away, if more often than not, you were surrounded by people who didn't experience the world, feel, or think like yourself. You would feel alone. You might even lack the tools you needed to explain those feelings to other people, because you would have to do more work to seek out and discover them. I even invented a word for this feeling - unincludable.

The thing is, I am not an unfeeling robot, a math whiz, or a child. I am a highly independent adult who likes helping people and cherishes a sense of community. It was only when I found a neurodivergent community that I discovered just how nuanced and diverse we are. We are creative, funny, sensitive, empathetic, accomplished people who help one another work through lifetimes of self-blame and self-hate. Through these relationships, I've realized that we are not the problem. Rather, it is miseducation surrounding what it means to be autistic and neurodivergent - especially in the workplace.

The Autism-Employment Paradox

This discrimination is a systemic problem. For instance, consider a major workplace barrier: the job application process. Both the process and the content surrounding "how to nail a job interview" heavily favor neurotypicality. As a consequence, many autistic people feel pressured to follow popular advice and appear as non-autistic as possible to land and keep a job.

The personality-focused job application process is a barrier for many people who may be better at performing the job than at talking about themselves - and it is just one example of the many workplace "norms" that are not inclusive of neurodiversity.

Building an Inclusive Workplace

The true onus lies on companies to create an equal playing field by crafting policies inclusive to all employees. When our workplaces fail to recognize our experiences - in all of their nuances - they also fail us because they lack the understanding and the tools to create welcoming environments.

That said, to debunk the harmful stereotypes and change the exclusionary norms, much-needed conversations surrounding what autism is and is not should be led by autistic voices. The same holds true for other kinds of differences as well.

Autism is not an intellectual, learning, or mental health disability (though it may co-occur with any of these). It is a complex developmental condition that affects our social, sensory, and communication experience, and it may manifest differently in men and in women. Autism is a "spectrum" with many dimensions, and the specifics of navigating the world as an autistic individual are different for everyone.

There are some things autistic professionals (or anyone) can do to own their identity and excel at work.

Your disclosure is your decision.

People hide their identities at work for many reasons. Some may want to disclose their autism early in the application process because they need specific accommodations, like receiving interview questions in writing or a quiet environment at work. Others may want to get to know their colleagues and build some trust before disclosing. Whatever your decision is, it can come from a place of dignity and strength.

For instance, if you're in a job interview, you could be upfront while also pointing out your strengths by saying something like: "I am sensitive to noise, but that also means I'm highly focused at work." If you wish to disclose without revealing your diagnosis, you can make your preferences clear in a subtler way: "I work better when I'm in a quiet space. It makes me more productive."

While some managers or coworkers could react to disclosure negatively, don't let that discourage you. When you own who you are, you may end up finding some allies or even inspire others to disclose their disability or identity.

Personally, I find disclosure both liberating and socially responsible. When we assimilate into systems that discriminate against us, we may unwittingly perpetuate discrimination. That said, don't pressure yourself. You might be a private person, your environment may not feel safe, or perhaps you just want to do more research. So, take your time and if (and when) you feel prepared to talk about your identity, remember that your difference isn't a flaw. It's just that: a difference.

Define what career success looks like to you.

People work for different reasons, and these reasons can affect how we define our success. For some, work is a job that helps them pay the bills. For others, a job can be their calling or an opportunity to build a career.

Your career path depends on your goals and priorities. Take the time to understand what you value, why you value it, and how you see those impacting your long-term growth. Ask yourself what motivates and drains you to understand what it is that you really want - it could be a flexible work-life, an intellectual challenge, money, or a career in industries that have been traditionally unwelcoming to us.

Know that it's okay to take your time to figure out what path feels best to you. If you're still unsure, I like the advice Dorie Clark gives in her new book, The Long Game: "Optimize for interesting." Think about what you find interesting instead of forcing yourself to optimize for money, passion, or success. (Is it books? Nature? Technology? Science?) Developing yourself in that area can open up opportunities that work with your mind and will help you create your unique niche and personal brand.

Craft your own job.

To overcome this challenge, focus on your unique abilities by practicing job crafting, a strategy of changing some aspects of your tasks, mindset, and relationships to align with your strengths. For undiagnosed or undisclosed autistics, this might be the key to a sustainable work-life.

When job crafting, it is essential to respect organizational and coworker needs. For example, if your job involves communications with clients, check if the company allows for emailing rather than cold-calling as a strategy. Perhaps writing smart and persuasive messaging is your strength - so don't sell yourself short. Ask your manager if you can switch strategies for a month and report back with your progress.

In another instance, perhaps one of your teammates prefers social interaction but hates research while you enjoy research and dread social overload. In this case, you could propose to your colleague - and then to your manager - trading responsibilities so that everyone benefits.

That said, if the core responsibilities of your role are a poor match for your abilities, you may need to explore opportunities better aligned with your skills, interests, and values. To do that, ask yourself what you like, what you are objectively good at, and what energizes you. Internships, temporary jobs, shadowing, and informational interviewing can help you learn about non-obvious aspects of jobs without a full trial-and-error. (You can also use this free Holland RIASEC assessment of interests.)

Make space for purpose in your work.

Research shows that autistic people are often passionate about making a difference. Most organizations provide opportunities to contribute to your workplace culture via Employee Resource Groups (ERGs) and committees. These internal employee groups are typically focused on bringing people of specific identities or life circumstances together (e.g., culture, disability, caregiving) and can help you share your ideas with like-minded and supportive colleagues.

If involvement opportunities at work are limited, look for local and online collaborations with communities or associations that champion a cause you're passionate about. These could be disability-rights organizations, gender advocacy groups, or animal shelters. You can also use your professional skills to further this cause. Finding interest-based groups beyond your work will help you build meaningful connections and build community.

This has been the most useful strategy in my career. While my work centers on creating evidence-based, inclusive workplace strategies and teaching students, I make time for writing about issues that affect the autistic community. Most of my writing focuses on educating mainstream leaders and managers about neurodiversity inclusion in the workplace. More recently, I've also created a LinkedIn group, Neurodivergent (non)Networking, to provide a judgment-free space for neurodivergent professionals to discuss work-related issues, brainstorm strategies, and seek advice.

Office politics are hard. But know that you can be your best ally.

In every organization, there are politics. In the autistic community, we all have stories about bosses and colleagues who deceive and scapegoat us or bully and manipulate us into doing their work. While this can be emotionally draining, understand that not all politics are dirty. Sometimes, influence can be used honestly and to the benefit of all. For example, you can improve inclusion practices by forming alliances with people from different backgrounds and identities - one positive way to gain and use influence.

On a more personal level, be anchored in who you are. Know your goals and your values. Understand your vulnerabilities. If you have a hard time reading peoples' body language or motives, a trusted mentor could help. Listening, observing, and analyzing inconsistencies in coworker behaviors can also help you identify the "hidden" patterns of interactions. If politics are exhausting, make sure to pick your battles - focus on issues that impact the quality of your performance and your work goals.

Lastly, give people the benefit of the doubt. It is tempting to ascribe evil motives to people we don't understand, especially if others have done it to you often and unfairly. However, it is rarely productive. Remember that non-autistic people may have just as much trouble reading you, so try to practice kindness toward yourself and toward them. But if your kindness is not reciprocated and you're in a toxic environment, know that it's not your fault.

You deserve better, and it is not disloyal to challenge or leave an abusive situation. That is you being loyal to the person who very much needs your allyship: yourself.

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Autism Doesn't Hold People Back at Work. Discrimination Does.

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Where your work meets your life. See more from Ascend here. Every time I write about autism and neurodiversity, my inbox fills with notes from talented young professionals. I've heard from people who mask their autism to avoid stereotyping or discrimination at work.

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From Cognassist

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The BBC have produced videos demonstrating how neurodiverse individuals may struggle with busy working environments and interacting with colleagues:

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ND Mode - Neurodiversity  in the Workplace

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Neurodiversity and Buildings

Design for the Mind

This Sensory Environment Checklist has been produced as a guide to help consider the different sensory responses to an environment that some people may experience. In the same way that environments such as workspaces and public buildings are usually audited to consider physical accessibility, if sensory responses and preferences of Neurodiverse communities are better understood it will be possible to create shared environments that more closely meet everyone's needs.

What is Neurodiversity?

Neurodiversity is a relatively new term, recognising the diversity of human cognition and includes neurodivergent conditions such as Autism Spectrum Condition, ADHD, Dyslexia, Dyscalculia and Dyspraxia as part of that natural diversity.

What does this have to do with our building environment?

Many people with Neurodivergent conditions process everyday sensory information such as sounds, sights and smells differently.

This means that for some people, an office environment might appear like this.

The toilet could look like this. Note how the light reflects on the shiny surfaces.

The many different sounds in a open plan office for example, can be disorienting.

Smells are also amplified.

Why the building checklist?

Sensory distractions can make it really challenging for staff and visitors with Neurodivergent conditions to concentrate and focus in some office environments.

We need to make reasonable adjustments for these visitors and staff.

The checklist is designed to help identify things like busy patterns, lighting, acoustics and layout, which should be considered when thinking about environment accessibility.

When should I use the checklist?

The checklist can be used when assessing an existing environment for cognitive accessibility and to inform accessible design considerations for new environments.

The checklist can also be used to help people talking about environmental factors when considering reasonable adjustments in the workplace.

'Yes' or 'No' options have been provided to identify whether actions are required as part of an audit assessment or a reasonable adjustment following a workplace induction conversation, for example. A scoring system has been provided to Indicate the severity or priority of any action required. Any identified actions or comments can be noted in the section provided at the end of the checklist.

This checklist is intended to be a guide only and is not exhaustive.

An overview of the checklist

VISUAL

Many neurodivergent people are sensitive to light levels, flickering lights, strong reflections, bright bold colours and busy patterns. Lighting and reflection can also be difficult for those who are neurotypical.

AUDITORY

Some noises can cause difficulty and distress (some people use noise cancelling headphones to help).

OLFACTORY

Unexpected odours can be a problem.

TACTILE

Are all the furnishing fabrics/sources of visual stimulation minimised and comfortable to touch?

Ready to start the environment checklist?

Please bear in mind that this checklist is for your information only. The BBC can't be responsible for anything that happens if you use this checklist (or any other information on this document).

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This Sensory Environment Checklist has been produced as a guide to help consider the different sensory responses to an environment that some people may experience. In the same way that environments such as workspaces and public buildings are usually audited to consider physical accessibility, if sensory responses and preferences of Neurodiverse communities are better understood it will be possible to create shared environments that more closely meet everyone's needs.

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The guide aims to raise awareness among employers of neurodiversity in the workplace and to inspire more employers to take action to create more inclusive workplaces where neurodivergent individuals can thrive.

In this video, Jill Miller introduces the new CIPD and Uptimize Neurodiversity at work guide, asking how it benefits organisations, and how employers can support neurodivergent people in the workplace.

Read the video transcript

We're delighted to be bringing you our new guide on Neurodiversity at Work, in collaboration with Uptimize.

Neurodiversity refers to the natural range of difference in human brain function, but in a workplace context, it's an area of diversity and inclusion that refers to alternative thinking styles, such as dyslexia, autism, ADHD and dyspraxia. And these alternative thinking styles can be associated with some unique strengths, such as an ability to spot patterns and trends, a capacity to process information at extraordinary speed, and with data-driven thinking, all of which I'm sure you'll agree are really valuable within the workplace.

However, despite around 10% of the UK population being estimated to be what we refer to as neurodivergent, workplaces are still typically designed for neurotypicals, which means we're not enabling everybody to be performing at their best within work, and we're not making full use of a really valuable talent pool.

So we're really pleased to be bringing you this guide, and the aim of this is to increase awareness of what neurodiversity is. Also we provide some practical recommendations of some really simple things that you can do in your own workplace which enables everybody to be performing at their best. We talk about how you can adapt recruitment practices, the way you need to think about management style, and also the physical work environment. And what we've found is that some of the simple adjustments that organisations are making are actually good for everybody, they're universal adjustments.

So we very much hope that you enjoy this guide.

This guide is for HR professionals and leaders across functions who want to learn more about neurodiversity, the benefits for their organisation, and how they can support neurodivergent people to be comfortable and successful at work.

The guide has two main aims: first, to raise awareness of neurodiversity in the workplace among employers; and second, to inspire more employers to action - to take steps to encourage neurodiverse job applicants, remove potential 'friction points' in the hiring process and to support their staff to achieve their potential.

In this guide, you'll find practical examples from organisations already appreciating the benefits of a neurodiverse workforce and actively supporting their staff. Through our case study research, it's clear that adjustments made to enable neurodivergent individuals to thrive at work frequently benefit everyone. Most are low-cost and easy to implement - and can make a significant difference to an individual's working life, their potential to contribute to the organisation and to build a lasting career.

This guide provides the starting point for both greater awareness and action. Sections of the guide cover definitions and understanding of neurodiversity as it relates to the workplace, the case for action (and risks of inactivity) and how you can make both your people management approach and workplaces more 'neurodiversity smart'. There is equal emphasis on the necessary culture change needed for greater understanding and acceptance of neurodiversity - and its value to employers - and tangible action steps that can be taken to create a more inclusive, engaged, and potentially more innovative organisation.

This guide is intended to spur on action from employers to create more inclusive workplaces where neurodivergent individuals can thrive. We hope the practical suggestions in the last two sections are useful as a starting point for action and help develop greater confidence in talking about and embracing neurodiversity at work.
Ed Thompson, CEO, Uptimize
Dr Jill Miller, Policy Adviser, Diversity and Inclusion, CIPD
Download the report below:

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The guide aims to raise awareness among employers of neurodiversity in the workplace and to inspire more employers to take action to create more inclusive workplaces where neurodivergent individuals can thrive. In this video, Jill Miller introduces the new CIPD and Uptimize Neurodiversity at work guide, asking how it benefits organisations, and how employers can support neurodivergent people in the workplace.

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What is dyslexia? - British Dyslexia Association

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Dyslexia is a specific learning difficulty which primarily affects reading and writing skills. However, it does not only affect these skills. Dyslexia is…

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Disclaimer: This list is for informational purposes only. AADD-UK does not endorse or recommend any commercial products, processes or services. Inclusion on this list does not necessarily state or reflect the views of AADD-UK, and inclusion here may not be used for advertising or endorsement purposes.

Since coaching is a self-regulated profession without regulatory standards, we strongly recommend that you contact the coaches and satisfy yourself regarding their quality and suitability. Also, whilst care is taken to ensure that information included on this website is accurate, changes and mistakes may occur.
If you are an ADHD coach and wish to be added to this list, or want to have your contact details updated, please email us at aadd.org@gmail.com. Please include the following details: Location, Contact, Specialism, Any Additional Expertise, Hours, and Date of Qualification. For everyone else, if you have any questions or just want to talk, please join us on our forum here.
Here are a few tips and questions that may be helpful:

Interview 2 or 3 coaches before you decide (or as many as needed).

Look for a coach with an accurate breadth and depth of knowledge about Adult ADHD.

Ask the coach if they have received specific ADHD traininng.

Ask the coach about their level of experience (how many delivered hours of coaching, how many coaching clients).

Ask questions about their coaching techniques and tools (look for a coach with a flexible approach rather than a 'one-size fits all').

Ask the coach for details about their formal training, accreditation, and continuing professional development (what did their training cover, the length of the training programme, are they keeping their skills up to date, are they being supervised, are they a member of a coaching body such as the International Coach Federation, the Association for Coaching, the Special Group in Coaching Psychology, and the European Mentoring and Coaching Council).

Ask the coach about any other training or work/life experiences they may have incorporated into their coaching style (eg psychology, creative arts, law, counselling etc).

Look for someone who is a good listener and is also asking you the right questions (questions that will help you see the direction in which you wish to move).

Ask if they subscribe to a coaching code of ethics, and ask to see the code.

Ask the coach for at least 2 references and then contact them. Do not rely upon testimonials.

Make sure that their contract for services includes a schedule of coaching sessions, all costs including any extra expenses/fees, payment terms, outcomes and deliverables, a confidentiality clause, and termination of the service.

And finally don't forget that coaching is an important relationship so you should feel that the connection between yourself and a coach is right and appropriate. If in doubt, don't select!

England
Bedfordshire
1. Sharon A Fuccillo; Location - Bedfordshire; Tel - 01234 857876 or 07759 037880; e:Mail - sfuccillo@btinternet.com ; Website - http://www.adhdtherapybedford.co.uk/index.html ; Specialism - ADHD/ASD Behaviour Management Coach; Additional Expertise - Parental coaching; Hours - Variable, phone, in-person or email coaching

2. Hanna Eklund-White, B.A., Pg. Psych.Dip., Ph.D. at Hanna White Coaching; Email: hanna@hannawhitecoaching.co.uk; Phone: 07812 487226; Location: Bedfordshire/Buckinghamshire. Specialism: Coaching for ADHD, facilitating CBT workshops for adults with ADHD, working 1-1 with individuals with neurodevelopmental conditions, e.g., Autism, ADHD. Young adults transitioning from childhood to adulthood, parents, creatives, entrepreneurs, students. Enquiries welcome regarding one-to-one coaching. Most coaching takes place via phone or skype. Face-to-face sessions for those willing to travel to Eversholt, near Milton Keynes. Date of qualification: 2013. Website: http://www.hannawhitecoaching.co.uk
Berkshire Birmingham & Area
1. Jan Pra; Location: Solihull; Tel: 0121 678 7113; e:Mail: jan.pra@solihull.ac.uk ; Specialism: Further Education: mostly teens ranging from 16 - 19 years old. Works exclusively with students at Solihull College; Additional Expertise: Qualified Skills for Life Literacy Tutor; 9 years experience teaching in FE; Hours: Variable, phone or in-person coaching; Date of Qualification: October 2008
Bristol
1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Buckinghamshire
1. See Bedfordshire: Hanna Eklund-White, B.A., Pg. Psych.Dip., Ph.D

1. Rebecca Champ UKCP MBACP MCCP: in Cambridgeshire and via Skype, WhatsApp. Psychotherapist & Coach for adult individuals and couples - providing practical, research based positive self development tools for those living and working with ADHD. Monthly local social meetups for ADHD adults, their partners, and parents also available. Tel - 07855 298536; e:Mail - rebecca@rebeccachamp.co.uk; Website

1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Cumbria Devonshire
1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Dorset
1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Durham Essex Gloucestershire
1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Herefordshire Hertfordshire
1. Anne Ross; Location - Hertfordshire; Tel - 01727 833963; e:Mail - herts@add-vance.org; Website - http://www.add-vance.org/; Specialism - Specialist coaching for Attention Deficit Hyperactivity Disorder (ADHD), Aspergers and related conditions; Hours - In-person coaching
Isles of Scilly
1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Kent
1. Linda Fox; Location - Sussex/Surrey/Kent borders; Tel - 01342 327749 or 07811 206098;
e:Mail - adhdcoachuk@aol.com ; Website - www.lindafox.co.uk and w ww.twitter.com/lindafox ; Specialism - Adult ADHD Coaching; University Students with ADHD; Parent Coaching & Behaviour Management; Training, Workshops & Speaking
Additional Expertise - Certified NLP Practitioner (Neuro Linguistic Programming); EFT Level II Practitioner; teaching study skills; Hours - Variable, phone or in-person coaching
Date of Qualification - December 1999

2.Kim Algar; Location: Skype and phone coaching services available nationally. In person, coaching is available in London, Kent, Surrey and Sussex. More information and contact details are available on the website: Specialism: Specialist strategy coaching for adults (aged 18-plus) with ADHD/ADD. Workplace Assessor for ADHD/ADD. Business advice and mentoring for ADHD/ADD business owners, entrepreneurs, senior managers. Training provision for organisations and advisors/professionals who support people with ADHD/ADD. Nutritional support and holistic life coaching. Additional Expertise: CMI L5 Management Coaching & Mentoring; SFEDI Gold Business Advisor; Nutrition (Gut & Psychology Syndrome Practitioner); IAAPT NLP Diploma; Holistic Life Coaching HLC1 certified. Hours: Variable (phone, Skype or in person coaching)

1. Christine Jarvis, Ian Hall & Claire Greasley; Location - Leicestershire, Rutland & Nottinghamshire; Tel - 07947 047573; Website - h ttp://sb2.tradingforchange.org.uk/home-page; Specialism - ADHD & Autistic Spectrum Disorder coaching; Additional Expertise - Experience with multi-agency/multi-disciplinary working; Hours - In-person coaching

1. Lisa Leonard; Location Lincolnshire; Tel: 077809 38446; e:Mail: adhdlifechanges@yahoo.co.uk; Website - http://www.adhdlife.co.uk/home; Specialism - ADHD coach providing one-to-one coaching, family coaching, group coaching, and workshops.

1. Andrew Lewis; Location - West London; Tel - 020 8816 7752; e:Mail - andrew.lewis@simplywellbeing.com; Website: http://www.simplywellbeing.com/; Specialism - ADD Coaching; Workshops; Training and Information for ADHD Adults and Parents of ADHD children; Additional Expertise - Certified NLP and Hypnotherapy Practitioner (Neuro Linguistic Programming); training in Positive Psychology, the study of Happiness, Meditation, Nutrition, Health and Neuroscience; Hours - Variable, phone or face-to-face coaching

2. Lorrine Marer; Location - London; Tel - 0208 537 0104; e:Mail - info@behaviouralmanagement.co.uk; Website - http://www.behaviouralmanagement.co.uk/index.php; Specialism - ADHD Coaching: Training teenagers and adults who have difficulties with organisational skills, appropriate behaviour and managing their time effectively

3.Erin Remien, Location SE London. Website.

4. Kim Algar; Location: Skype and phone coaching services available nationally. In person, coaching is available in London, Kent, Surrey and Sussex. More information and contact details are available on the website: Specialism: Specialist strategy coaching for adults (aged 18-plus) with ADHD/ADD. Workplace Assessor for ADHD/ADD. Business advice and mentoring for ADHD/ADD business owners, entrepreneurs, senior managers. Training provision for organisations and advisors/professionals who support people with ADHD/ADD. Nutritional support and holistic life coaching. Additional Expertise: CMI L5 Management Coaching & Mentoring; SFEDI Gold Business Advisor; Nutrition (Gut & Psychology Syndrome Practitioner); IAAPT NLP Diploma; Holistic Life Coaching HLC1 certified. Hours: Variable (phone, Skype or in person coaching)

5. Joseph Aquilina; Located in South West London, and can cover London and parts of Surrey in person. Joseph can also provide support via Skype/VOIP. Contact: 07971 714 217 or j.aquilina@neuroknowhow.com ; Website: http://www.NeuroKnowHow.com ; Specialism: ADHD, Dyslexia, Higher Education (DSA) and also Access To Work. Additional Expertise: Highly skilled in Assistive Technology. Working to develop organisational skills, time management, mindfulness and memory strategies. Hours: Flexible hours, weekdays/evenings and some weekends; Qualifications: UKAAN course in Assessing and diagnosing ADHD (2011); PgCert Dyslexia HE (2009), PgCert ADDs (dyslexia support), PgDip ADDs (dyslexia and dyspraxia diagnosis), supporting neurodivergent people for over 12 years; First hand experience of ADHD; UKANN (ADHD) sub-committee member
Manchester & Area
1. Faigy Liebermann ACC; Location-Manchester (nationwide coaching by telephone); Contact- 0780 515 9803 or email-focuswithfaigy@gmail.com; ADHD coaching for adults with ADHD, and parents of children who have ADHD and ASD. Also offering Professional Organising and Time Management services; Hours-Variable; Face to face or phone consultations; Member of APDO-UK and ICF

2. Mags Smith; Location - Rochdale; Tel - 01706 659320; 07971 653897; e:Mail - m4gs@btinternet.com ; Specialism - Adult ADHD; Family coaching; Additional Expertise - AST (Advanced Skills Teacher) Behaviour Management; Life Coaching; Teacher Trainer
Hours - Mon-Wed 6pm-8pm; Thurs-Fri 9.00am-5.00pm, phone or in-person coaching
Date of Qualification - April 2009

1. Christine McLanachan; Location: Merseyside; Tel - 0161 790 2165; 07799 827760;
e:Mail - chris@addsuccess.co.uk ;Website - http://addsuccess.co.uk/ ; Specialism - ADHD, Aspergers Family and Adult coaching; Life Skills Coach; mentoring coaching; training packages for both families and professionals; Additional Expertise - Charity Management & development; monitoring and evaluation; Hours - 8.30am-4.30pm; 7.00pm-8.00pm, phone or in-person coaching; Date of Qualification - February 2004

3. Sandra Glenny; Location - Merseyside; Tel - 0151 287 3491 or 07845 191694; e:Mail - mimulus66@hotmail.com ; Specialism - Females; Hours - Can be arranged, phone or in-person coaching; Date of Qualification - March 2009

4. Lynette Evans-Gardner; Location - Liverpool; Tel - 01827 872514; e:Mail - levansgardner@kingsbury.lpplus.net ; Specialism - Under 16s & Parents; Additional Expertise - Learning Support under 16s; Hours - Mon-Friday 6.30pm-8.30pm, phone coaching only; Date of Qualification - March 2009
Middlesex Norfolk Northamptonshire Nottinghamshire
1. Christine Jarvis, Ian Hall & Claire Greasley; Location - Leicestershire, Rutland & Nottinghamshire; Tel - 07947 047573; Website - h ttp://sb2.tradingforchange.org.uk/home-page; Specialism - ADHD & Autistic Spectrum Disorder coaching; Additional Expertise - Experience with multi-agency/multi-disciplinary working; Hours - In-person coaching
Oxfordshire Rutland
1. Christine Jarvis, Ian Hall & Claire Greasley; Location - Leicestershire, Rutland & Nottinghamshire; Tel - 07947 047573; Website - h ttp://sb2.tradingforchange.org.uk/home-page; Specialism - ADHD & Autistic Spectrum Disorder coaching; Additional Expertise - Experience with multi-agency/multi-disciplinary working; Hours - In-person coaching
Shropshire Somerset
1.Kim Algar; Location: Skype and phone coaching services available nationally. In person, coaching is available in the counties of Devon, Cornwall and Somerset. Tel: M-F 9:00 am to 5:00 pm 01392 357501; Website: ; Specialism: Specialist strategy coaching for adults (aged 18-plus) with ADHD/ADD. Workplace Assessor for ADHD/ADD. Business advice and mentoring for ADHD/ADD business owners, entrepreneurs, senior managers. Training provision for organisations and advisors/professionals who support people with ADHD/ADD. Nutritional support and holistic life coaching. Additional Expertise: CMI L5 Management Coaching & Mentoring; SFEDI Gold Business Advisor; Nutrition (Gut & Psychology Syndrome Practitioner); IAAPT NLP Diploma; Holistic Life Coaching HLC1 certified. Hours: Variable (phone, Skype or in person coaching)
Suffolk Surrey
1. Linda Fox; Location - Sussex/Surrey/Kent borders; Tel - 01342 327749 or 07811 206098;
e:Mail - adhdcoachuk@aol.com ; Website - www.lindafox.co.uk and w ww.twitter.com/lindafox ; Specialism - Adult ADHD Coaching; University Students with ADHD; Parent Coaching & Behaviour Management; Training, Workshops & Speaking
Additional Expertise - Certified NLP Practitioner (Neuro Linguistic Programming); EFT Level II Practitioner; teaching study skills; Hours - Variable, phone or in-person coaching
Date of Qualification - December 1999

2. Kim Algar; Location: Skype and phone coaching services available nationally. In person, coaching is available in London, Kent, Surrey and Sussex. More information and contact details are available on the website: Specialism: Specialist strategy coaching for adults (aged 18-plus) with ADHD/ADD. Workplace Assessor for ADHD/ADD. Business advice and mentoring for ADHD/ADD business owners, entrepreneurs, senior managers. Training provision for organisations and advisors/professionals who support people with ADHD/ADD. Nutritional support and holistic life coaching. Additional Expertise: CMI L5 Management Coaching & Mentoring; SFEDI Gold Business Advisor; Nutrition (Gut & Psychology Syndrome Practitioner); IAAPT NLP Diploma; Holistic Life Coaching HLC1 certified. Hours: Variable (phone, Skype or in person coaching)
Sussex
1. Linda Fox; Location - Sussex/Surrey/Kent borders; Tel - 01342 327749 or 07811 206098;
e:Mail - adhdcoachuk@aol.com ; Website - www.lindafox.co.uk and w ww.twitter.com/lindafox ; Specialism - Adult ADHD Coaching; University Students with ADHD; Parent Coaching & Behaviour Management; Training, Workshops & Speaking
Additional Expertise - Certified NLP Practitioner (Neuro Linguistic Programming); EFT Level II Practitioner; teaching study skills; Hours - Variable, phone or in-person coaching
Date of Qualification - December 1999

2. Caroline Williams; Location - West Sussex; Tel - 01403 733931; e:Mail - mail@addvancecoaching.co.uk ; Website - www.addvancecoaching.co.uk/contact.php
Specialism - ADHD & Aspergers Syndrome coaching for young children, adolescents and adults

3. Kim Algar; Location: Skype and phone coaching services available nationally. In person, coaching is available in London, Kent, Surrey and Sussex. More information and contact details are available on the website: Specialism: Specialist strategy coaching for adults (aged 18-plus) with ADHD/ADD. Workplace Assessor for ADHD/ADD. Business advice and mentoring for ADHD/ADD business owners, entrepreneurs, senior managers. Training provision for organisations and advisors/professionals who support people with ADHD/ADD. Nutritional support and holistic life coaching. Additional Expertise: CMI L5 Management Coaching & Mentoring; SFEDI Gold Business Advisor; Nutrition (Gut & Psychology Syndrome Practitioner); IAAPT NLP Diploma; Holistic Life Coaching HLC1 certified. Hours: Variable (phone, Skype or in person coaching)
Tyne and Wear Warwickshire West Sussex
1.Anna Schlapp, B.A. at Remarkable Difference ADHD Coaching; Email: adhdcoachanna@gmail.com; Phone: 07934 171048; Location: South West England. Specialism: Coaching for ADHD, facilitating groups and workshops for adults with ADHD, working 1-1 with individuals with various neurodiversity conditions, eg. Autism, ADHD. Women, parents, creatives, entrepreneurs, students & young adults. Teleclasses also available from time to time. Enquiries welcome regarding one-to-one or group coaching, or to go on mailing list. Most coaching takes place via phone or Skype.
Worcestershire
1. Lorraine Forbes; Wakefield, West Yorkshire; Tel: 01924 370548 or 077908 24595; e:Mail: Lorraine@thelifecompany.me.uk; Website: www.thelifecompany.me.uk; Specialism: Adults with ADHD; Hours: Mon-Friday 9.00am-5.00pm, phone or in-person coaching; Date of Qualification: October 2007

Northern Ireland

Wales

1.Lorraine Holt; Location: Wrexham; Tel: 07528 676656 or 01978 353714; e:Mail: loholt1964@gmail.com; Specialism: Coaching for adults, teens and children with ADD or ADHD, as well as coaching for parents of children and teens with ADD or ADHD; Additional Expertise: Honours Degree in Psychology, Diploma in Social Work, expertise in Mental Health problems ad addictions. Life Coaching Qualification. Mentor/coach ADHD Coaching qualification for Adults, Children, Teens and Parents; Hours: Phone, Skype, in-person or email coaching.

Coaching Websites

Further information about coaching & ADHD coaching can be found on the following websites:

UK

1. Association for Coaching (England & Wales)

2. Centre for Coaching (UK)

3. European Mentoring & Coaching Council (UK Branch)

4. International Coach Federation (UK Chapter)

5. Special Group in Coaching Psychology (UK)

6. Life Coach Directory Contains a listing of UK Life Coaches searchable by postcode as well as other coaching information

USA

1. ADD Coach Academy (USA)

2. IAAC: Institute for the Advancement of AD/HD Coaching (USA)
If you are an ADHD coach and wish to have yourself added to this list, or want to have your contact details updated, please email us at aadd.org@gmail.com. Please include the following details: Location, Contact, Specialism, Any Additional Expertise, Hours, and Date of Qualification. For everyone else, if you have any questions or just want to talk, please join us on our forum here.
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As an employer, you can help make the world a more autism-friendly place. We know that many of you are leading the way and making great progress in adapting your practice and making small adjustments that make a big difference to autistic employees.
In this guide we explain the benefits of employing an autistic person, offer tips for recruitment and interviewing, and provide advice for managing an autistic employee.

"Autistic people have some very valuable skills which can be applied in the workplace. They might have very good attention to detail, or be really good at sticking to routines and timetables. Therefore, they are likely to be very punctual and reliable. Everyone has different skills but there will always be something." An autistic job seeker

What is autism?

Autism is a lifelong developmental disability that affects how people perceive the world and interact with others.

Autistic people see, hear and feel the world differently to other people. If you are autistic, you are autistic for life; autism is not an illness or disease and cannot be 'cured'. Often people feel being autistic is a fundamental aspect of their identity.

Autism is a spectrum condition. All autistic people share certain difficulties, but being autistic will affect them in different ways. Some autistic people also have learning disabilities, mental health issues or other conditions, meaning people need different levels of support. With the right sort of support, all can be helped to live a more fulfilling life of their own choosing.

You can read more about autism.

Recruiting an autistic employee

As an employer, you may not realise that autistic people can be highly skilled and qualified, and may be extremely employable.

Why employ an autistic person?

Many autistic people have a variety of sometimes exceptional skills, that enable them to thrive in roles ranging from sales assistant to computer programmer, and journalist to statistician, to name just a few.

However, autistic people are often disadvantaged when it comes to getting and keeping a job because of other people's lack of understanding and support.

Autistic employees may need some, often simple, support within the workplace. As well as their individual strengths and talents, autistic candidates often demonstrate above-average skills in some or all of the following areas:

high levels of concentration

reliability, conscientiousness and persistence

accuracy, close attention to detail and the ability to identify errors

technical ability, such as in IT

detailed factual knowledge and an excellent memory

This means an autistic person may well be better at a particular job than someone who is not autistic. By gaining an understanding of autism, you can open up new possibilities for your organisation.

Employing an autistic person demonstrates your organisations commitment to equality and diversity and shows a positive attitude to disabled people. Having a diverse workforce brings benefits to staff and business alike, and managers and colleagues often describe working with an autistic colleague as an enriching experience that encourages them to think more carefully about how they communicate, organise and prioritise their work.

"Mark joined Max Fordham's in March 2002 as a drawing filer, quickly grasping the complex procedure. He applies care and attention to detail, constantly using his initiative to improve efficiency. He regularly attends progress meetings, where his input is invaluable and he supervises temporary cover within his group." M. Jones, Partner/Head of Administration, Max Fordham LLP

The recruitment process

Recruitment procedures often inadvertently create barriers for autistic people. There are many minor adjustments your organisations can make to your processes that will help autistic candidates to apply for jobs, and enable them to demonstrate their skills as potential employees. Many of these adjustments may also benefit other candidates and enhance overall efficiency in recruitment.

By taking these simple steps, your organisation will be meeting the Equality Act (2010) and Northern Ireland Disability Discrimination Act requirement for employers to make 'reasonable adjustments' for people with disabilities.

Job descriptions

Job descriptions often include skills that are not essential for the job to be carried out effectively. Qualities such as 'excellent communication skills' or 'good team player' are often included as default skills, even if they are not necessary - and many autistic people will not apply for jobs demanding these attributes. This can mean that suitable applicants may assume themselves to be ineligible for a job even where they have strong skills that are directly relevant to the tasks involved.

Application forms

It is not always obvious what information the applicant needs to provide on an application form. It is important to provide clear guidance on this, and to make sure that the form includes a space for applicants to highlight any support or adjustments they may need at an interview. If you are asking an applicant to write about their skills or suitability for a role, it can be helpful to include a word count limit.

Job adverts

Job adverts are not always concise and written in plain English. They should list essential skills, and avoid jargon or unnecessary information. The advert should be clearly presented, avoiding complex design. Try to be really objective about what abilities and experiences are genuinely essential for the job to be done well, and leave out any that are not.

Interviews

Interviews - particularly 'traditional' conversational type interviews - rely heavily on social and communication skills, so autistic candidates may well struggle to 'sell themselves' in an interview, even if they have all the right skills. In particular, they may face challenges with:

understanding body language and maintaining appropriate eye contact

knowing how to start, maintain and end conversations or answers to questions

judging how much information to give - especially if questions are open

thinking in abstract ways, or considering 'what if?' scenarios

varying their tone of voice and finding the appropriate level of formality.

Interview adjustments

Making reasonable adjustments during an interview is essential to allowing autistic candidates to portray their skills and competencies fully, so that you can make an informed choice about who to recruit.

If you want to interview the candidate, it is important to realise that asking each applicant exactly the same question does not always equate to equality of opportunity. You could adapt the interview for autistic candidates by:

providing interview questions in advance - up to two days before the interview

providing clear and concise written and visual information about the interview, including;

directions to, or maps of, the location of the interview and photographs of the entrance of the building (such as google street view)

the procedure for arriving at the interview location (e.g. sign in at front desk where you will be collected by Jane (name of the person) you shortly before your interview)

the names of the people who will be on the interview panel (with photographs) and information about what their role will be during the interview (e.g., note taking, or asking technical questions)

a clear timetable of events during the allocated interview time, for example, the first 30 minutes will focus on questions about your CV and experience relating to the role, and the second 30 minutes will be an aptitude test or technical trial

providing a quiet and calm space for the candidate to wait, prior to their interview, away from other visitors or general staff

avoiding general questions (e.g. 'Tell me about yourself')

asking specific questions based on the candidate's real/past experiences, e.g. 'In your last job, did you do any filing or data input?'; 'What processes/procedures did you use to do this effectively?'

avoiding hypothetical or abstract questions, e.g. 'How do you think you'll cope with working if there are lots of interruptions?' A better question would be 'Think back to your last job. Can you tell us how you coped with your work when people interrupted you?'

telling the candidate if they are talking too much as they may find it hard to judge how much information you need e.g. 'Thank you, you've told us enough about that now, and I'd like to ask you another question'.

prompting the candidate in order to extract all the relevant information and gather sufficient information

being aware that the candidate may interpret language literally e.g. asking, 'How did you find your last job?' may result in an answer of 'I looked on the map'

being aware that eye contact may be fleeting or prolonged, depending on the individual

providing adequate breaks during long interviews and prompt the interviewee to take a break when needed

allowing and prompting the candidate to refer, during the interview, to any written notes that they have made

Alternatives to the traditional interview

If adapting your interview skills to the needs of an autistic person sounds daunting, or if you feel that an interview might not be the best way to gauge the person's suitability for the post, there are other options:

Inviting a supporter to accompany the person

Many autistic people perform much better in interviews if they have a supporter with them. This person can act as a go-between to ease communication between the interviewer and the candidate, rewording any unclear questions for the candidate and helping them understand exactly what the interviewer wants.

The supporter will not answer on behalf of the person, but may help to rephrase unsuitably worded questions (although ideally the employer should do this in preparation for the interview). The supporter can help them to communicate with the interviewees, in order to clarify their relevant knowledge and skills. This does not only benefit the candidate: it can also help employers understand what the candidate has to offer.

Work trials

Some employers find that a work trial, or a period of work experience, is a better way of assessing skills than a formal interview. This approach may also help if you think that an autistic person is likely to do well in a job but you have concerns about how well they will cope in the workplace. If you would like to take this approach, our Employment Training Service can offer support and advice.

Thomas' story

Thomas applied for a position as a filing clerk at Camden Council. He was shortlisted and invited for an interview, which included a short filing test. During the interview, Thomas did not come across well. He tended to take questions very literally and gave 'yes' or 'no' answers to questions rather than elaborating on his experience. However, his prospective employers were extremely impressed when Thomas scored almost 100 per cent in the filing test - significantly higher than other candidates.

Following discussions with our employment service, which was supporting Thomas in his job search, Camden Council agreed to offer Thomas a work trial as an alternative method of assessing his ability to do the job. Thomas completed this with great success and was offered a four-week contract, working ten hours a week.

At the end of this time, his managers were delighted with his accuracy and reliability, and his contract was extended. Three years later, Thomas was still working for Camden as a filing clerk, enjoying and performing consistently well in his job.

Managing an autistic employee

Working with an autistic person can be an enriching experience for managers and colleagues alike, however support is important to make it successful.

Your organisation can avoid and overcome challenges in order to ensure enjoyable and effective working relationships via:

formal activities - from job coaches to state-funded initiatives to help with extra costs such as adaptations in the workplace

our Employment Training Service  can provide information about state-funded initiatives and the training and consultancy we provide

Autism at Work programme may be of interest if you are thinking about recruiting autistic people for a new role

informal activities -such as making sure communication is clear, that the  environment takes account of sensory needs, and the necessary support is at hand.

Understanding your autistic employee

"I have difficulty picking up social cues and difficulty in knowing what to do when I get things wrong." Autistic person

If an autistic person seems aloof or uninterested in talking to colleagues, or often says the 'wrong' thing, remember (and, where appropriate, remind colleagues) that this is probably unintentional and is likely to be due to communication challenges.

If an autistic person tries too hard to fit in and irritates colleagues by seeming to interrupt a conversation, be patient, and explain the boundaries if necessary. Other staff may also need reminding that their attitudes may have a strong impact on the job performance of their autistic colleague.

If an autistic person becomes anxious for any reason, try to find out what is causing the problem. One-to-one sessions are probably the best situation for doing this. You may need to think laterally. For example, the stress may not be caused by a difficulty in the job but by a colleague not being explicit in their instructions, by things not working efficiently (such as a computer crashing), or by difficulties in getting to their work. Trying to think around the immediate issue may help, as well as supportively asking the employee specific (though not invasive) questions to try to get to the root of the problem.

There may be occasions where problems do arise for an autistic person, particularly in social interactions, where communication can break down. If you become aware of any of these problems, try to deal with them swiftly and tactfully, and make colleagues aware of the potential for misunderstanding.

Your autistic staff member may also have some challenges in adapting their existing skills and knowledge to new tasks or environments. This can make the work environment hard and may cause misunderstandings among other staff, particularly as autism is an invisible condition. They may misconstrue the person's behaviour as rude, insensitive or unfriendly. However, the good news is that there are plenty of simple ways to make sure that the person has the support they need and to ensure good positive working relationships.

"I have an excellent memory for facts and figures for example, car number plates and timetables. I never have to write down telephone numbers. I have an excellent memory for jokes anecdotes and even whole movie scripts." Autistic person

Top tips

Clarify expectations of the job

You may need to be more explicit about your expectations for an autistic member of staff. As well as the job description, you need to explain the etiquette and unwritten rules of the workplace. Make it clear that any adaptations for them in the workplace are there to help them keep doing their job well, not because they are not good enough.

Provide training and monitoring

Clear and structured training is invaluable. This can be provided informally on the job, by a manager, colleagues or a mentor, or may take the form of more formal training. Various organisations and schemes offer job coaches, and funding for this form of training may be available from the Department of Work and Pensions. Our Employment Training Service can provide more information.

Make sure instructions are concise and specific

Try to give your employee clear instructions right from the start about exactly how to carry out each task, from start to finish, as this will lay the foundations for good working practices. Don't assume the person will infer your meaning from informal instructions - for example, rather than saying 'Give everybody a copy of this', say 'Make three photocopies of this, and give one each to Sam, Mary and Ahmed'. You may also choose to provide written instructions. It can be helpful to ask the person to repeat back instructions so you are sure they have understood.

Ensure the work environment is well-structured

Some autistic people need a fairly structured work environment. You can help by working with them to prioritise activities, organising tasks into a timetable for daily, weekly and monthly activities, and breaking larger tasks into small steps. Some people will appreciate precise information about start and finish times, and help getting into a routine with breaks and lunches.

Regularly review performance

As with any employee, line managers should have regular one-to-one meetings with the person to discuss and review performance and give overall comments and suggestions. For an autistic staff member, brief, frequent reviews may be better than longer sessions at less frequent intervals.

Provide sensitive but direct feedback

Autistic people often find it difficult to pick up on social cues, so make sure your feedback is honest, constructive and consistent. If they complete a task incorrectly, don't allude to, or imply, any problems - instead, explain tactfully but clearly why it is wrong, check that they have understood, and set out exactly what they should do instead. Be aware that some autistic people may have low self-esteem or experience of being bullied, so ensure that any criticism is sensitive, and give positive feedback wherever appropriate.

Provide reassurance in stressful situations

Autistic people can be quite meticulous, and can become anxious if their performance is not perfect. This means they may become stressed in a situation such as an IT failure. You can help by giving concrete solutions to these situations - for example, by explaining "If the photocopier breaks, use the one on the third floor." Similarly, reassure them that if they occasionally arrive late due to transport problems or other unpreventable factors, this is not a problem. Your employee may benefit from having a mentor or buddy in the workplace - an empathetic colleague who they can go to if they are feeling stressed, anxious or confused.

Support your staff member to prepare for changes

Give information about changes to the workplace or tasks well in advance.

Ask about sensory distractions

Autistic employees sometimes benefit from things like screens around their desk, noise-cancelling headphones, or their desk being in the corner.

Help other staff to be more aware

If your autistic employee consents to their condition being disclosed, then providing colleagues with information and guidance on autism can benefit everyone. Sometimes the employee may find it helpful to write a document for other staff explaining what their colleagues can do to support them. You could consider staff training, or our online modules.

David and Jacqui's story

"David already worked in my team as a Customer Sales Assistant when I became his line manager in 2002. I had no previous experience of working with people with autism, so I did some reading around the subject and David's  NAS support worker popped in and introduced herself early on, which was really helpful.

"David is very good with customers and has excellent interpersonal skills. In the time I've worked with him we haven't really had any particular challenges to overcome, mainly because Prospects has shown us how to prevent any difficulties from arising in the first place. But it's good to know that they are always there to provide back up if we need it. I feel I'm very fortunate to have someone like David in my team.

"Managing him has taught me that everyone is different, with their own individual strengths. Everyone in the team values David as a member of our working family." Jacqui Copas, Customer Reception Supervisor at First Great Western Railways

Our Autism at Work Programme

Our Autism at Work programme in association with the Bloomfield Trust aims to bridge the gap between skills shortages in industry and talented autistic candidates.

Through this programme, we support employers across a wide range of industries to create accessible job opportunities and to support candidates to access those opportunities. These opportunities could be in the form of:

paid internships

apprenticeships

paid roles (standard roles within the business)

We also support candidates to prepare for, and succeed in their employment.

Why should my organisation join?

We have a proven track record of working with employers as well as:

national reach

2000+ employees trained from a variety of sectors in 2018

working with prestigious organisations such as Virgin Loyalty, BT, Lloyds Banking Group, HMRC and Forever Beta

116 volunteer-run branches, 80 social care services and our schools (reach people in every county)

We campaign to improve public understanding, develop professional practices, and shaping government policies benefits a huge amount of autistic people and their families.

To find out about how your organisation can benefit from our programme and help bridge the gap between skills shortages and talented autistic candidates, please contact us.

Our hospitality work experience programme

HelmsBriscoe (HBcares) is our hospitality employment programme offering autistic people the opportunity to gain work experience opportunities within the hotel hospitality industry.

The programme comprises of:

an eight-week work experience placement for autistic adults (comprising of two days or 16 hours per week)

free autism awareness training for your staff from our team

free in-work support from one of our Job Coaches for your organisation and the work experience candidate

If your organisation would be interested in our programme, please contact us.

Further links and resources

Training

Sign-up for our half-day Recruiting Autistic Employees training course that aims to provide managers and HR professionals with the knowledge and skills they need to confidently recruit and support autistic employees into the workplace.

Complete our online training modules, developed by autistic people and autism specialists, and have been created to enhance your autism knowledge and fit into your busy schedule.

Find out more about our Employment training and consultancy services that include:

Useful articles

Useful books

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As an employer, you can help make the world a more autism-friendly place. We know that many of you are leading the way and making great progress in adapting your practice and making small adjustments that make a big difference to autistic employees.