An insight report into reasonable adjustments in Torbay

Healthwatch Torbay wanted to understand how health care services were implementing reasonable adjustments for people with disabilities.  They spoke to 70 people.

Although hospital passports, digital flags and liaison roles are in place to support equitable care, their impact is often limited by inconsistent use, low awareness and wider system barriers. People with learning disabilities, neurodivergence and mental health conditions face additional challenges in securing reasonable adjustments, leading to delays and difficulties in accessing timely and appropriate support. 

Key Observations 

•  Tools need simplification – passports and digital flags are often overly complex or overlooked.
• Small, personalised adjustments – such as quiet spaces, flexible communication and staff continuity – can make a significant difference.
• Training matters – neurodiversity-informed training improves outcomes and must include agency staff.
• Listening builds trust – proactive, compassionate communication reduces distress, particularly during crises.
• Transitions are a pressure point – families describe the move to adulthood as a “cliff edge” and need to be actively involved in planning.
• Carers are essential partners – their insight is critical when individuals cannot fully express needs.
• Flexibility is vital – automated and digital systems can unintentionally exclude those needing human support.
• Complexity requires more support, not less – people with multiple needs require tailored adjustments.
• Culture change is key – consistent, person-centred practice must be embedded across services