COVID-19 and the Peer Support Service

Information and resources for healthcare professionals who are disabled during the COVID-19 outbreak

The RCN understands that if you are a healthcare professional with an impairment, if you are Neurodiverse and/or if you consider yourself to be disabled that you face additional challenges both in and out of work.

Our Peer Support Service enables members to network to share lived experience of disability and uses that experience to inform policies and guidance. The service supports members at all stages of their careers including students and those who are not currently employed or who have retired. 

As the COVID-19 outbreak progresses you can find RCN position statements and guidance pertaining to COVID-19 and disability here, as well as links to other services and resources that may be useful.

Reasonable adjustments

The legislation that protects disabled workers from discrimination (The Equality Act 2010, the Disability Discrimination Act 1995 Northern Ireland) continues to apply during the COVID-19 outbreak. Furthermore, allowing all staff to access reasonable adjustments at work (whether they meet the legal definition of "disabled" or not) brings many benefits.

If you are a healthcare professional who has (or needs) adjustments at work, or on student placement, then you are still entitled to these during the COVID-19 outbreak, including when you are redeployed. You should not face negative treatment because of your disability/impairment/health issue. 

If you are a line manager or employer of healthcare professionals with impairments then remember the advantages that a diverse workforce with the skills and equipment needed to thrive in their roles bring to their teams and to patients. 

The RCN Peer Support Service's guides on Disability Passports and Removing Disabling Barriers at Work look further at the advantages of a diverse nursing workforce.

The Equality and Human Rights Commission has produced advice for employers during COVID-19.

RCN Members can access support and advice on employment issues including discrimination by contacting RCN Direct

You can see the RCN's full list of COVID-19 FAQs here, but below are some popular FAQs and links that refer specifically to disability issues.

What if I have an underlying health condition and have concerns about exposure?

Social distancing

Government guidance lists people who may be more vulnerable to or have a higher risk of complications and higher mortality than the general population.  

The guidelines advise that these individuals should practice social distancing. This means that they should avoid contact with someone who is displaying symptoms of coronavirus. Also avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible and work from home where possible.  

If you meet the definition of vulnerable as set out in government advice, and during the course of your work, you are likely to come into contact with someone who is displaying symptoms of COVID-19, you should inform your line manager immediately.

The RCN would expect employers and occupational health lead to carry out a health and safety risk assessment and put systems in place to minimise the risk of harm and allow the health care worker to work safely. The employer also has a duty to make reasonable adjustments where the staff member has identified themselves as disabled.   

Organisations such as Diabetes UK provide additional advice on working with long term conditions.   

Please also see our guidance on redeployment.

Shielding

Government guidance also lists people who are extremely vulnerable and so at very high risk of severe illness from COVID-19. People in this group need to ‘shield’ themselves. See ‘shielding’ above for more information.

Asthma

Members have raised concerns that there is conflicting advice regarding whether they should be following shielding recommendations for those classified as very vulnerable due to a diagnosis of asthma. This is particular concern relating to differing advice from Asthma UK, the Government and individual GPs. 

The government has provided clear advice on social distancing. If you have not been contacted, you should follow the social distancing rules for everyone. If you later receive a letter asking you to shield, you should do so. Otherwise, you should follow the social distancing rules.

The RCN recognises that members with a diagnosed long-term condition may lead to concerns as to whether it is safe to continue direct patient contact during the COVID-19 crisis. Individuals with asthma and other long-term conditions have a spectrum of severity that will need to be taken into account. 

If you have received a letter from your clinician stating that you have been identified as very vulnerable you should; inform your employer, follow the shielding guidance and stay at home. You should continue to discuss the situation with your GP and Occupational Health services for any ongoing risk assessment.

There may be opportunities to work remotely depending on their role/ employer.

If a family member who lives with a member receives a shielding letter, please see the sections on 'shielding' above. 

Speaking to your employer

You should escalate your concerns to your line manager in the first instance, having checked your employer’s COVID-19 response policy. The RCN has advice on how staff can approach raising concerns should your manager be unsupportive. 

Further guidance for employees and employers is also available.

Please call RCN Direct on 0345 7726100 if you cannot resolve your concerns with your employer.

The Coronavirus Job Retention Scheme is a temporary government scheme to support employers whose operations have been severely affected by coronavirus (COVID-19). The government expects that the scheme will not be used by many public sector organisations, as most should continue to provide essential public services. This means the scheme may not be relevant to members working in the NHS, but some members working for independent employers or those working via an employment agency may benefit from the scheme.

The scheme allowed employers to ‘furlough’ employees (place them on a leave of absence) and then claim for 80% of the employees’ usual monthly wage costs, up to £2,500 a month. From August 2020 employers still using this scheme have been asked to contribute towards these costs. The scheme will run until the end of October 2020 and employers are no longer able to place employees onto furlough - unless that employee has been furloughed under the scheme previously.

How do I apply for the scheme?

The scheme is now closed to any employee who has not previously been furloughed for at least three weeks before the end of June 2020. Employees who are currently on furlough can remain on furlough until the end of October 2020 unless their employer decides they should return to work sooner. Employees who have previously been furloughed for three weeks or more can be furloughed again if their employer wishes. Any subsequent periods of furlough do not need to last for three weeks, and employers can furlough eligible employees as many times as they wish before the scheme ends (assuming the employee agrees to this). 

Employees and workers do not have an automatic right to be furloughed - it remains a decision for employers and agencies to take whether to furlough staff based on the needs of their business. Each time you are furloughed you and your employer need to agree it in writing (an email exchange may be enough to count as this written agreement). If you have returned from furlough and think you would benefit from being furloughed again then in the first instance you should speak to your manager about the scheme, details of which can be found on the government website.

What is 'part time furlough'?

If you are furloughed under the scheme, your employer now has the option to place you on furlough for only part of your working week and to ask you to work the remainder of your working hours. For this to happen you and your employer would need to agree which days/hours you will be at work and which will count as furlough. If you agree to this then you will be expected to work as normal for the hours you are not furloughed (and will receive full pay for those hours) and will be paid through the furlough scheme for the remainder of your working time. It is important that if you are on part time furlough that you only undertake work for your employer for the hours you are expected to be at work and that you do not undertake any work for them during the hours you are being paid through the furlough scheme.

I was shielding previously - does my furlough now need to end?

If you were shielding in line with public health guidance or were staying home due to an individual in your household shielding, your employer may have placed you on furlough. Now that shielding is ending in some parts of the UK, some employers may be asking employees to return to work from furlough. It remains your employer’s decision when to furlough you through this scheme and the do have the discretion to keep you on furlough until the scheme ends in October 2020 if they wish.

If you were shielding and on furlough, you employer should conduct a risk assessment before you return to work. If this risk assessment indicates it may not be safe for you to return, or you do not believe it is safe, then you may wish to discuss with your manager whether the will extend your furlough. If your manager insists that it is safe for you to return to work and you do not agree, you should seek RCN support by raising your concerns with your local RCN representative or by contacting RCN Direct on 0345 772 6100.

Shielding is a measure to protect extremely vulnerable people by minimising interaction with others. This means that those who are extremely vulnerable should not leave their homes, and within their homes should minimise all non-essential contact with other members of their household.

The situation around shielding is complex as the governments across the UK are easing restrictions at a different pace. Furthermore, as we’ve seen outbreaks becoming localised, the advice is likely to be subject to change at different times and at a local level.

Members who have received a shielding letter are asked to ensure they familiarise themselves with their respective country and (if appropriate) local guidelines. A summary of the current position relating to shielding and pay, with a link to the relevant guidance for each country, is provided below.

England

Recent changes to shielding guidance announced by the government have relaxed certain restrictions for the general public, for example from 6 July, clinically extremely vulnerable people who are shielding will be able to meet outdoors in groups of up to six and create a ‘support bubble’ with one other household. However, at this stage, people who are shielding should still maintain strict social distancing and minimise contact with others, and this includes not going in to work.

Employers should continue to support people who are clinically extremely vulnerable to shield, including supporting them to work from home or, if there is no prospect of them working from home, following guidance on pay during shielding.

Therefore, if you need to shield, then your employer must look at ways to support this and take steps (wherever possible) to enable you to work from home. Occupational health may also need to be involved to facilitate this and support you. If it is not possible to work from home and you work in the NHS, you will not need to attend work and should receive full pay, as if you were at work, including all enhancements.

You may need to contact your medical adviser (GP or Consultant) if you need confirmation of the reasons for shielding. The guidance secured by the RCN and other health unions clearly states that the NHS will support staff who are shielding to stay well and contribute to work, where adjustments can be made to enable staff to work from home. All employers need to follow the guidance on supporting staff to work from home and develop specific local support for those working from home during the pandemic. 

The recent changes in guidance also state that from 1 August, clinically vulnerable people who are shielding will be able to return to work if they cannot work from home if the workplace is COVID-19 secure. However, employers should undertake an individual risk assessment. Risk assessment guidance is available to support individuals who are shielding to return to work and implement adjustments or redeployment for any staff in these groups. If at this point you are concerned about returning to work, we strongly recommend that you speak to your line manager to understand their specific policies around health and safety and workplace attendance, especially in relation to COVID-19. 

Please see the government's guidance on protecting the vulnerable and if you work in the NHS, please see the NHS employers joint guidance on shielding due to COVID-19.  

Wales

The Welsh government guidance states, “If you are employed, please show the shielding letter from the Chief Medical Officer for Wales (or your GP) to your employer. You should not go to your normal place of work – you will need to work at home until the 16 August 2020, if you can do so. You do not need to get a fit note from your GP."

Scotland

The Scottish government have advised that people who are shielding will no longer need to do so from 1 August 2020. 

Northern Ireland

The government in Northern Ireland announced that from 8 June 2020, people advised to shield are permitted to go outdoors while maintaining strict social distancing: with members of their household or if they live alone they can meet one person from another household (preferably the same person each time).

From 6 July 2020, and if the risk continues to be low, people who are following the shielding advice are able to meet up to six people outside of their home, as long as social distancing is strictly observed. People who are shielding remain vulnerable and should continue to take precautions. It is still best to stay at home as much as possible until shielding is paused.

From 31 July 2020, it is anticipated that shielding for extremely vulnerable people will be ‘paused’.

Many health care professionals have impairments that could mean standard issue PPE is not effective. These include but are not limited to:

  • sensory impairments 
  • use of prosthesis 
  • the use of mobility aids.

For some, PPE is a disabling barrier, for example, employees who communicate well through the ability to lip read will have this communication route disrupted if colleagues are wearing face masks. 

Where there is a change in PPE requirements such as in response to a pandemic, new issues can arise for health care professionals who have not previously been disabled at work. It is essential that processes allow the opportunity for employees to discuss their specific needs regarding PPE and that they are supported by managers in this process.

The Equality Act 2010 (and in Northern Ireland the Disability Discrimination Act 1995) states that employers have a duty to make reasonable adjustments for employees who meet the definition of disabled. This applies to PPE equipment and the processes around administering PPE. The RCN believes that reasonable adjustments should be granted whether this definition is met or not, on the grounds that reasonable adjustments help us to work to the best of our abilities. 

The RCN expects that all employers support their staff to make known their needs in respect of PPE.

Your employer should work with you to ensure that any risk of PPE affecting your impairment and ability to continue in your role is recognised and processes put in place to mitigate the risk. This may mean adjusting processes around donning and doffing of PPE, exploring options for adapted PPE and/or opportunities to fit PPE, and be confident that it is fit for purpose prior to use in a clinical setting.

The RCN expects that line managers undertake a workplace risk assessment and refer to Occupational Health for further advice if appropriate. Where adjustments cannot be made, temporary redeployment to work that does not require PPE should be considered.

Our publications Removing disabling barriers at work and Disability Passports cover the benefits of a diverse workforce including those with impairments and the reasonable adjustments process 

The Health and Safety Executive also provides guidance for employers and employees on reasonable adjustments

Raising concerns

If you feel you are not being supported or that your concerns are not heard, please see our section on  raising concerns about PPE. Support is also available from the RCN Peer Support Service


Redeployment of disabled staff

Governments from across the UK have published guidance for the NHS on staff health, safety and well-being issues, including for people who are most vulnerable. The RCN fully expects that employers and managers will adhere to this.

We fully expect that managers to be aware of and complying with the guidance and that there should be clear guidance on the redeployment of staff with disabilities across the health sector. There must also be systems in place to provide support to staff when making a decision on redeployment (e.g. occupational health services) and staff should be supported to raise concerns when appropriate and these concerns should be given priority.

Our members who identify themselves as disabled provide a vital contribution to the nursing workforce, and must be properly supported during the emergency period. In the current circumstances, individual members may be asked to move to a different clinical setting. It would not be acceptable for this redeployment to put their health and wellbeing at risk.

We continue to provide advice to our members with individuals issues through RCN officers, including the Peer Support Officer. If anyone is concerned they should contact RCN Direct.

Removing Disabling Barriers at Work

Click to read our new guidance, based on the lived experience of our members. 

peer.support@rcn.org.uk

If you can't find an answer to your disability related query in our existing resources, or have suggestions for additional resources at this time, please email us.
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