Category Archives: practitioner health

Reflections on being a disabled clinician in the NHS

All of things which worry all clinicians – burnout, feeling overstretched, a workforce which is undervalued and under numbered – worry disabled doctors too. Disabled doctors are good people too.

‘Today I feel male. Today I feel disabled.’

All of this is true for me, channeling my inner FIFA president identity.

Infantino had added that he knows what it means to be discriminated [against]’.

I know that feeling too. ‘Institutional racism’ is not just a description that there are many people who are racist in an institution. But it’s a known issue that systemic racism does exist in the NHS. Partha Kar (find him here) has been chipping away at this iceberg gallantly for some time, and the task of tackling this racism is daunting. I find myself excluded all the time from a seat at the ‘top table’ despite me being physically disabled myself, and having trained in equality law through my pre-solicitor training and in performance management through my MBA. NHS leaders can certainly do better, that I agree with from Roger Kline (find him here) (and many other things especially regarding race equality). I am the specialist advisor for an amazing institution called NHS Practitioner Health (find them here), and my job is to advise our clinicians on how best to look after doctors who are disabled. It’s a great privilege, and with my colleague Dr Kelly Lockwood I produced many resources on being a disabled doctor and how to navigate through the system.

I don’t think we value doctors who are disabled highly enough in the NHS. This is such an enormous waste, especially given the workforce crisis that the NHS is in. As I wrote in the BMJ Leader blog, some experiences of disability are good – some are catastrophic. The NHS can be dire in implementing legal requirements such as ‘reasonable adjustments’ allowing disabled individuals to function properly. I wrote about that too for the BMJ Leader blog. Did you for example know that a phased return to work is actually a legal obligation under the Equality Act as it is classified as a ‘reasonable adjustment’?

I was an unpaid family carer for years, and I never thought of myself as a carer. I have a professional medical identity, which has gestated over many years. That is a big part of my life inevitably. But I don’t think of myself as a ‘disabled doctor’ or a ‘BAME doctor’.

There are advantages of not seeing yourself in terms of a label. For example, you don’t ‘other’ yourself – and see yourself as a hapless victim. I don’t think that I have ever ‘benefited’ personally from any equality, diversity and inclusion initiative in the NHS, especially the costly ones such as conferences and marketing. I do have needs which come out of being physically disabled, such as the need for a chair with a back. Virtually all of us who are learning as registered practising clinicians in the NHS are mindful that there is an optimal clinical learning environment. Most of us are very conscious of our teaching requirements in the NHS. I have published many books in medicine (examples here), and I am much enjoying my Masters in medical education at Nottingham University currently as one of their Scholars. As a member of the Association of the Study for Medical Education, I am very proud to promote our collective values of equality, diversity and inclusion.

I lead the special interest group in the neurology of delirium for the American Delirium Society, and indeed lead a group producing a systematic review – including 4 profs – on the rather niche subject of delirium superimposed on dementia. I say ‘niche’, but a very important presentation on the acute internal medical take. As a member of the Royal College of Physicians of London, I am concerned about the application of research to the everyday care of patients. The ‘internet of things’ – and the pandemic – has made remote working feasible and socially acceptable as far as I am concerned.

I feel sorry that there is a lot of marketing to do with disability, a field known as ‘diversity marketing’. It’s a rather corporate thing to do, with a tendency towards a lot of virtue signalling. The PR for conferences or booklets on #ourNHS can’t be cheap. But the reality is that we need to have proper infrastructure support for occupational health in the NHS. Members of the workforce need to be valued and welcomed, as indeed the General Medical Council described and discussed most impressively. Immaculately produced reports on disability such as that produced by the BMA need to be read, understood and acted upon. Collection of data such as WDES is necessary but insufficient.

There’s quite a few of us who are disabled and who are happy to talk about disability. Somebody I admire is Dr Hannah Barham-Brown (find her here). Somebody who is possibly the most inspirational contemporary I’ve ever met is Dr Kelly Lockwood (find her here).

Finally, I was asked recently what I would tell my younger self about disability. I said this.

I’ve got news for you. Disabled doctors are part of the solution, not the problem.