Using clinical and lived experience to design a unique web application for people with disabilities. The Empowerment Passport™

The Empowerment Passport™ is a secure web application, built to facilitate communication between an individual with a disability or long-term health condition and their line manager or tutor. It can be used in both education and employment and can act as a bridge to communicate adjustment needs in different environments and during transition e.g., between education and employment for students with disabilities entering work. It is currently being trialled in the NHS.

Why was it created?

There are many different types of employment passports in circulation. Many of them are similar to the Empowerment Passport and most are provided by employers. Nearly all are paper-based, and many are only presented to an employee once a problem has been identified, or following a disclosure.

Much work has still to be done to ensure recruitment processes are inclusive. How often does the employer follow up on a disability declaration to explore adjustments needed for an interview and where is this documented?

How can individuals be empowered to normalise and lead inclusive conversations and prevent employers from being placed at a disadvantage if they are unaware of the adjustment needs of the individual (CIPD Disability)? This process can be fraught with anxiety on both sides.

Occupational Health (OH) is often the first service where disabled candidates can confidently discuss their reasonable adjustment needs. Occupational Health reports, guide the employer to consider adjustments, or services such as Access to Work, etc but what about the small/discreet non-cost adjustments that can assist with a greater impact on productivity for the employee? The comprehensive questionnaire tool within the Empowerment Passport™ facilitates such conversations. Each licence allows individuals to build their adjustment profile and provides an Empowerment Passport™ Action Plan for the employer to record and document all agreed adjustments. A copy is then kept with the employer and a copy is uploaded to the individual’s Empowerment Passport™ ready for any updates, reviews or amendments when required.

With over 37 years of experience as a state registered Occupational Therapist (OT), I have been one of the lucky few OTs to work in the field of Occupational Health. I hold a voluntary role as a representative of the OT/OH speciality on the National Executive Committee for the Royal College of Occupational Therapists (RCOT): Specialist Section for Work. Growing a multidisciplinary approach within Occupational Health services (SOM 23) is important for all, as many realise OTs are perfectly positioned to use their dual training skill set, (physical and mental health) enabling full holistic analysis of the functional impact of health conditions or disabilities.

Back in 1997, I had the privilege of setting up and working in an innovative new role as a Disability Adviser for my local NHS Hospital Trust. The Occupational Therapy Service lead managed to write a successful business case to secure temporary funding for a pilot to assist the Trust in supporting its disabled staff in light of the new legislation of the Disability Discrimination Act (DDA) 1997. 

My colleagues in OH had long identified a gap in the provision for staff with long-term health conditions and disabilities, to stay well at work and to promote self-management through identifying reasonable adjustments.

Referrals came from OH, HR, managers and individual staff members. All are seeking support for work capacity assessments, job-task analysis, return to work planning, ergonomic assessments, dyslexia screening, etc, ensuring the Trust was compliant in its employment activities under DDA legislation.

The pilot was successful and became a permanent position in 1999, however, it required additional training to achieve a thorough working knowledge of specific legislation and emerging discrimination cases.

The Equality Act 2010 came into force. The Disability Advisory service continued to develop and became the central hub for coordinating all staff Access to Work applications. This service was ahead of its time in providing practical and effective solutions for staff health and wellbeing.

Fast forward to 2020, I left the NHS with over 21 years of accumulative experience working in the field of disability employment and OH. Working with a variety of individuals with physical, mental, neurodiverse and sensory issues, my focus was always on the interplay of person, environment and task. One major lesson learnt throughout that time was the importance of truly listening to the experts: the staff member with lived experience of disability.

My experience also taught me 2 things: – firstly, “Never assume” because surprises and workarounds are always an option. Secondly, Everyone is an individual, meaning how we learn, how we cope and how we operate as human beings are all different, even if you have the same health condition or disability. These are essential ingredients that have helped shape the creation of the Empowerment Passport™.

I have also joined several people with the lived experience of disability after having been diagnosed with Dyslexia in my early 40s and currently awaiting a diagnosis of ADHD, in addition to an endocrine disorder. Therefore, I have transitioned from being a provider to a recipient.

I am the main carer to 2 of my 3 children who have disabilities; Autism and learning disability and ADHD and Dyslexia. I understand how challenging it can be to have to repeatedly explain what works well and what doesn’t in the work /educational environment. Diagnosis is not as important as the impact of the condition and how to communicate this to others can be extremely tricky.

Each Empowerment Passport™ has enough storage space to host up to 5 scanned documents, stored securely as supplementary evidence when requesting reasonable adjustments e.g., a consultant/specialist letter, a wellness recovery action plan, a previous Access to Work report, or a disabled student allowance (DSA) plan.

At the press of a button, the passport holder can choose to share this information which may be particularly helpful at times of change, such as a new manager, new role or new employer. From an Occupational Health point of view, the Empowerment Passport™ can become a supplementary source of information to reinforce recommendations of reasonable adjustments, saving time not just for OH clinicians but also for the employer. The Empowerment Passport™ Action plan provides an important audit trail, should any disputes arise.

The effectiveness of the Empowerment Passport™ is being tested in 2 NHS pilots: One for existing staff with disabilities and one focusing on disabled students attending placements in NHS or entering employment. These pilots will be concluded in March 2023.

Early feedback indicates some quick wins:

• Improvement in disability disclosure rates
• Greater confidence in communication between an employee and their manager
• Improvement in the speed of implementation of reasonable adjustments
• Creation of a centralised budget for all Access to work claims.

Areas for improvement and development:

• To produce a “light touch/strength-based version of the Empowerment Passport™ To enable all action plans to be fully digital instead of PDF documents.

Choice and control are vital ingredients when embarking on any new service initiative particularly if it involves conducting sensitive conversations regarding disability in the workplace. Therefore, using the Empowerment Passport™ should always be an opt-in process and never enforced.