1 Hidden Disabilities at Work Awareness and Information Booklet Introduction Not all disabilities are visible. Hidden disabilities, sometimes called non-visible or invisible disabilities, can affect how a person works, communicates, processes information, manages energy, or experiences the workplace, even when there are no obvious outward signs. At Airedale NHS Foundation Trust, raising awareness of hidden disabilities supports our commitment to inclusion, wellbeing, and helping colleagues bring their whole selves to work. It also helps create a culture where staff feel safe to ask for support, managers respond appropriately, and colleagues understand that different people may need different adjustments to thrive at work. Key Facts • Many disabilities are hidden, and hidden disabilities may include physical, mental health, neurological, sensory, developmental, or long-term health conditions. • The Equality Act 2010 protects disabled staff from discrimination and requires employers to make reasonable adjustments where needed. • Airedale NHS Foundation Trust, as a Disability Confident Employer, is committed to building an equitable and inclusive workplace where colleagues can bring their whole selves to work. • At Airedale, disability inclusion is supported through the Workforce Disability Equality Standard, the Enable Network, the Reasonable Adjustments Guide and Toolkit, wellbeing conversations, and the Enable Passport.
2 Myths and Facts about Disabilities • Myth: If I cannot see a disability, it is not real. • Fact: Many disabilities are not visible but still have a substantial impact. • Myth: Adjustments are always expensive. • Fact: Many effective adjustments are simple and low cost. • Myth: Disclosure gives employers all the information they need and I may be disadvantaged. • Fact: The most helpful approach is an ongoing conversation about barriers and support. • Myth: Supporting one person is unfair to others. • Fact: Adjustments help remove disadvantage and enable fairness. Examples of Hidden Disabilities Hidden disabilities vary widely and every person’s experience is different. Remember, some conditions fluctuate, meaning a person’s support needs can change over time.
3 How Hidden Disabilities Can Affect Work • Fatigue, pain, or fluctuating symptoms that affect stamina and attendance. • Difficulties with concentration, memory, reading, processing information, or organisation. • Sensory overload from noise, lighting, busy environments, or multiple demands. • Anxiety about disclosing a condition because of stigma or fear of being judged. • Challenges with communication, social interaction, or unfamiliar changes in routine. • Need for flexibility for appointments, treatment, recovery, or symptom management. Supporting Staff with Hidden Disabilities Support should be individual, practical, and based on conversation rather than assumptions. Small changes can make a significant difference. Useful approaches may include: • flexible working arrangements where possible • clear written instructions • quieter workspaces • adjusted lighting • assistive technology • extra time for tasks or training • regular wellbeing check-ins • agreed changes to duties or schedules Confidentiality should be respected, and staff should be involved in deciding what support works best for them.
4 Reasonable Adjustments Reasonable adjustments are changes that remove or reduce workplace disadvantage for a member of staff with a disability. Adjustments should be tailored to the individual and regularly reviewed. Examples of reasonable adjustments include:
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6 Most adjustments cost nothing at all. Estimates suggest that the average cost of a workplace adjustment is under £100. Reasonable adjustments up to £1,000 can be approved by your line manager and paid for from their local budget. For reasonable adjustments costing over £1,000 you might want to consider an application to Access to Work who offer grants following an assessment.
7 Access to Work The first £1,000 of reasonable adjustments can be approved by your line manager and paid from their local budget without the need for an Access to Work assessment. If you’ve identified reasonable adjustments over £1,000 or would benefit from an assessment, then consider Access to Work. Access to Work offer grants to cover reasonable adjustments they recommend above £1,000. Access to Work is a self-referral process. Following the assessment, Access to Work provide you with a report of recommendations for reasonable adjustments. You then have a conversation with your line manager about the recommendations and agree what is reasonable. Your line manager will do the rest for you and keep you informed of progress and timeframes with procurement. Please note, the waiting list for Access to Work assessments is significant (currently at 36 to 38 weeks) from receipt of application. Find out about eligibility and start the application process to Access to Work here - https://www.gov.uk/access-to-work
8 The Sunflower Lanyard / ID Holder How can wearing the sunflower lanyard/ID holder benefit you? You may find that people around you may ask what they can do to assist you, or you can use your Hidden Disabilities Sunflower to tell people who are aware of the Sunflower about the additional help you may need. Wearing the sunflower simply indicates that you may need additional support, help or a little more time. The Enable Passport At Airedale we promote the use of the Enable Passport to record adjustments, restrictions, adaptations, and flexibilities so these can be reviewed and carried with the colleague if roles or managers change. The Enable Passport can help record agreed adjustments and support in one place.
9 Guidance for Managers Create a safe environment where staff can talk about barriers without fear. Listen carefully, avoid assumptions, and focus on what support is needed. Use the Trust’s Reasonable Adjustments Guide and Toolkit and review support regularly. Encourage use of the Enable Passport so agreed support is recorded clearly. Seek advice from the Health and Wellbeing Team, People Partnering Team, staff networks, or policy guidance where needed. Remember that good support improves wellbeing, retention, performance, and inclusion.
10 How Colleagues Can Help Don’t judge someone’s needs by appearance. Respect privacy and don’t ask intrusive questions. Be patient and flexible where possible. Use clear communication and check understanding when needed. Challenge stigma, stereotypes, bullying, or dismissive comments. Help create a team culture where asking for support is normal. Updating your disability status on ESR You can update your disability status through ESR self-service, and this will help the Trust understand its workforce’s support needs. By updating your disability status on ESR you also help inform national policy to support staff with disabilities working across the NHS. To update your disability status – 1. Log in to the NHS ESR Portal. 2. From the Homepage, go to My Equality and Diversity.
11 3. Click on the arrow next to view details 4. Next to Disability Details click on ‘Click here to view details’. This is where you can update and verify your information. You can review your disability status on ESR at any time and update as required. You can also click on this image here or from your ESR dashboard to access guidance for updating your ESR record. Have a Conversation at Work A key challenge for both colleagues and line managers are that some disabilities are hidden. The purpose of having a conversation about a hidden disability gives you the opportunity to explain how your disability might impact you at work. You may want to have a dedicated conversation, or as part of a wellbeing conversation, during a 1:1, supervision or other meeting. You may also feel comfortable having a conversation as part of a team meeting or huddle, to help your colleagues understand how your condition/s may impact you at work. It might be you need some flexibility around your hours of work, some adaptations or need support or something more specific. Your line manager can discuss with you how this might be accommodated. Any conversation about disabilities will be treated sensitively and confidentially and will allow your line manager to understand your needs and focus on the support you might need at work. It’s important to note that you may not want to disclose about a hidden disability as it doesn’t affect you at work, and that is ok too.
12 Where to Get Support at Work At Airedale, lots of support is available to you through your line manager, colleagues, the Health and Wellbeing Team, the People Partnering Team, Staff Side or your trade union representative, Chaplaincy Team and the Enable Network. The Enable Network The Enable Network are there to support, guide and make working at Airedale a better place for anyone with a disability or long term health condition. They meet monthly, and it’s an open invite. Their dedicated email address is anhsft.enable@nhs.net Employee Assistance Programme Your employee assistance programme through Vivup is a FREE and CONFIDENTIAL service that has a wealth of information including in the moment support and counselling. You can contact them free by phone – 0800 023 9324 – or via their website www.vivup.co.uk – once logged on go to ‘Health and Wellbeing’.
13 Further Information Invisible Disabilities Index On the Hidden Disabilities Sunflower website, you can find an index of Invisible Disabilities. Under each condition you’ll find detailed information including symptoms, living with and challenges faced daily, support and assistance that can be offered and links to further information about that condition. They are in alphabetical order and include: ADHD Aphasia Asthma Autism Brain Injury Chronic Obstructive Pulmonary Disease (COPD) Coeliac Disease Chron’s Disease Dementia Diabetes Type 1 Diabetes Type 2 Dysautonomia Dyslexia Ehlers-Danlos Syndrome (EDS) Endometriosis Epidermolysis Bullosa (EB) / Butterfly Skin Epilepsy Fibromyalgia Syndrome Foetal Alcohol Spectrum Disorder (FASD) Functional Neurological Disorder (FND) Haemophilia Leprosy (Hansen’s Disease) Long Covid Lupus Migraine Motor Neurone Disease (MND) / Amyotrophic Disease Multiple Sclerosis Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS) Narcolepsy Ostomy Pancreatic Cancer Parkinson Peri / Menopause Postural Tachycardia Syndrome (PoTS) Schizophrenia Scleroderma Stuttering Tourette’s Syndrome Ulcerative Colitis Click this link to access the index of hidden disabilities - https://hdsunflower.com/uk/insights/category/invisible-disabilities
14 Sunflower Conversations Podcast The Sunflower Conversations podcast is where Hidden Disabilities explore the experiences of disabled people with non-visible disabilities through the lens of the Hidden Disabilities Sunflower. This is a space to hear authentic stories from disabled people navigating life with non-visible disabilities such as chronic illness, mental health conditions, neurodivergence, and more. While most episodes focus on lived experience, they also feature occasional insights from experts in healthcare, accessibility, and inclusion. Whether you or someone you care about wears the Sunflower, these conversations aim to raise awareness, build understanding, and help create a more inclusive and compassionate world. Empowering voices. Raising awareness. Challenging assumptions - one conversation at a time. Access the podcast series here - https://conversations.hiddendisabilitiesstore.com/
15 Final Message At Airedale, awareness of hidden disabilities is everyone’s responsibility. By listening, responding with compassion, and making practical adjustments, we can help colleagues feel valued, included, and able to give their best at work. An inclusive workplace is better for our people, our teams, and the patients and communities we serve. REMEMBER ….