Patients are asked two separate questions as part of the NHS England National Registration Form:
one asking whether they need reasonable adjustments, and
one asking whether they require accessible communication formats.
These questions are asked independently. A patient may answer “Yes”, “No”, or “Prefer not to say” to each question, and may answer “Yes” to one question without answering “Yes” to the other.
What questions do patients get asked about reasonable adjustments?
The NHS England National Registration Form includes the question following question on reasonable adjustments:
“Do you need any reasonable adjustments to make your visit to the GP surgery accessible?”
Patients can select Yes, No, or Prefer not to say.
Below is an image showing how the reasonable adjustment question appears on the NHS England National Registration Form 👇.
If a patient answers “Yes”
They are shown a “About your reasonable adjustments” free-text section, where they can describe:
What reasonable adjustments they require
Why those adjustments are needed
Any specific details that will help support their care
Below is an image showing how the "About your reasonable adjustments" section appears on the NHS England National Registration Form 👇.
If a patient selects “No” or “Prefer not to say”
No additional fields are shown, and no free-text description is captured.
When a patient answers “Yes”, we record this information in the patient’s record to meet the NHS England Reasonable Adjustment Digital Flag criteria.
What questions do patients get asked about accessible forms?
Patients are asked a separate question about whether they need to be communicated with in an accessible form.
Accessible form question
The NHS England National Registration Form includes the following question on accessible forms:
“Do you need to be communicated with in an accessible form?”
Below is an image showing how the accessible form question appears on the NHS England National Registration Form 👇.
If a patient selects “Yes”
They are shown a “About your communication needs” free-text section, where they can describe:
Preferred communication formats
Any accessibility requirements (for example, large print, easy read, email instead of phone)
Below is an image showing how the “About your communication needs” section appears on the NHS England National Registration Form 👇.
If a patient selects “No” or “Prefer not to say”
No additional fields are shown, and no free-text description is captured.
What information is recorded when a patient selects “Yes”?
When a patient selects “Yes” to either the reasonable adjustments question or the accessible forms question, we record the information in the patient’s record. This includes:
Adding the relevant SNOMED codes for that question
Saving the patient’s free-text response as a consultation note
This ensures that both reasonable adjustments and accessible form needs are captured and available for health and care professionals.
Which SNOMED codes are added?
Reasonable adjustments SNOMED codes:
Where appropriate, the following SNOMED codes are added:
Impairment with substantial and long-term adverse effect on normal day-to-day activity (Equality Act 2010)
1326341000000105
Requires reasonable adjustment for health and care access (Equality Act 2010)
1108111000000107
Consent given to upload data to Reasonable Adjustment Digital Flag
1853771000000105
Healthtech-1 has confirmed with NHS England that this consent can be assumed and does not need to be explicitly stated by the patient.
The patient’s free-text description of reasonable adjustments is added as a consultation note, alongside the SNOMED codes listed above.
Accessible forms SNOMED codes:
Impairment with substantial and long-term adverse effect on normal day-to-day activity (Equality Act 2010)
1326341000000105
Needs assistance with communication
737350008
The patient’s free-text description of accessible format needs is added as a consultation note, alongside the SNOMED codes listed above.
What is the Reasonable Adjustment Flag?
The Reasonable Adjustment Flag allows health and care professionals across the NHS to:
Record
Share
View
information about a patient’s reasonable adjustments and accessibility needs.
This helps ensure professionals understand an individual’s needs and can put appropriate adjustments in place to support their care.
The Reasonable Adjustment Flag must be created by a member of staff at the practice
It is created directly on Spine
Explicit patient consent is not required to create a shared Reasonable Adjustment record
NHS England guidance on how to view and create a Reasonable Adjustment Flag is available here: