Reasonable Adjustment Digital Flag (RADF)
Page Contents
Introduction
Practices are aware of the need to comply with the Reasonable Adjustment Digital Flag (RADF) requirements which are mandated for use in all care settings in England and sit within both the Equality Act 2010 (sections 20,21,& 22) and the NHS Long Term Plan (section 3.32) and which were published in the Health & Social Care Act 2012 (section 250) in September 2023.
Although there is no GMS contractual regulation relating specifically to Reasonable Adjustment Digital Flag (RADF), there is the compliance clause in the GMS regulations which says:
23.1 Compliance with Legislation and Guidance
23.1.1. The Contractor must comply with all relevant legislation and have regard to all relevant guidance issued by NHS England or the Secretary of State or local authorities in respect of the exercise of their functions under the 2006 Act.
NHSE has information on the Reasonable Adjustment Digital Flag (RADF) which says:
What the Reasonable Adjustment Digital Flag is and why this should be implemented
The Reasonable Adjustment Digital Flag is a national record which indicates that reasonable adjustments are required for an individual and optionally includes details of their significant impairments, key adjustments that should be considered and underlying conditions.
NHS England has built the Reasonable Adjustment Digital Flag in the NHS Spine to enable health and care professionals to record, share and view details of reasonable adjustments across the NHS, wherever the person is treated.
The Equality Act (2010) places a legal duty on all health and care services to make changes to their approach or provision to ensure that services are as accessible to people with all disabilities, as they are for everyone else. This duty aims to address the recognition that people with disabilities may appear to have equal access to care and services, but without specific adjustments being made, that access may not be equitable.
In September 2023, a Reasonable Adjustment Digital Flag Information Standard was published (under section 250 of the Health and Social Care Act 2012) that details what all NHS and social care organisations in England are required to do about the flag.
The following information is a high-level summary of actions required and an example of how to achieve compliance. For more detailed information, please access the Information Standard (and implementation guidance) and the NHS Digital information page.
What Organisations need to do (Updated for 2026)
A new information standard for the reasonable adjustment digital flag, published in December (2025), requires all primary care providers to be able to read, write and share reasonable adjustments via the National Care Records Service by 30 September 2026. Full details in the above ISN, accompanying implementation guidance and this summary checklist.
Providers whose software suppliers have completed national registration and onboarding will be able to use their software to access the digital flag. Alternatively, they can do so directly via the NCRS online portal. Providers are advised to establish if their software supplier has registered their interest in the onboarding process for the digital flag by consulting NHS England’s national supplier interest list or Information about suppliers (NHS Futures – requires login). If their supplier’s software isn’t registered, providers should ask them to do so.
Suppliers can use this link to register: Patient Flag API supplier interest form – NHS England Digital
Details of how to read and write reasonable adjustments are here: Guide to Using the Reasonable Adjustment Flag in NCRS – NHS England Digital.
It’s the latest stage in the national roll-out of reasonable adjustment digital flags that will help millions of disabled people to access publicly-funded health and care services more easily.
Under the ISN, providers must also ensure:
- all staff learn about reasonable adjustments using either their own training or using the national training developed here: Reasonable adjustment digital flag – e-Learning
Resources and Other Reading
NHS in conjunction with e-learning for health have an e-learning session on the RADF programme available on the Learning Hub
The GMC guidance Good Medical Practice, which was updated in January 2024, makes several references to making reasonable adjustments in sections 33, 65a and 70e.
The information standard and implementation guidance is available on NHS Digital’s website and a dedicated project mailbox has been set up for all enquiries regarding implementation of this Standard. Contact england.radfproject@nhs.net and include “Reasonable Adjustment Digital Flag” in the subject line.
Further information, including examples of categories and types of adjustments that can be recorded in the Reasonable Adjustment Digital Flag is also available on NHS Digital’s website.
Future NHS has guidance for RADF to support with the implementation phase, as well as a Good Practice Resource Package (if you do not have currently have access, you can request this by clicking on the link and requesting an account).
CQC have information on Meeting the Accessible Information Standard which may also be helpful towards meeting your RADF requirements
Some patients with Learning Disabilities or Autism may already have their Health Passports, detailing their required adjustments, that they can share with you.