Improving care for people with migraine, including those whose symptoms are associated with menopause, is supported through a range of National Health Service initiatives. National Institute for Health and Care Excellence guidance provides evidence-based recommendations on the diagnosis and management of migraine, while NHS England supports improvements in headache and migraine services through initiatives such as the NHS RightCare Headache and Migraine Toolkit, which aims to improve pathways between primary and specialist care and ensure patients receive the right intervention at the earliest opportunity.

NHS England announced on 10 September that migraine would be added to the list of conditions for which individuals can get further support from participating prescribing pharmacies under the Pharmacy First programme, later this autumn. While migraine affects a higher proportion of women than men, the services referred to above are available to both men and women in need of support.

The Equality Act 2010 (the Act) places a duty on service providers and those who exercise public functions to make reasonable adjustments, to improve services for disabled service users or potential service users.

The duty on service providers is anticipatory. This requires service providers to consider reasonable adjustments even before an individual disabled person accesses their services.

The duty to make reasonable adjustments creates a powerful, flexible duty to ensure that disabled people are entitled to the same opportunities as everyone else, without imposing unreasonable burdens on service providers.

The Equality and Human Rights Commission (EHRC) has a monitoring and enforcement role in relation to the Act, including in relation to the duty to make reasonable adjustments. It has statutory powers to enforce compliance with the Act, and to challenge organisations where required. The EHRC is independent from the government and makes its own operational decisions on enforcement and regulation.

We are committed to helping working people balance their jobs with their personal lives, including those managing health conditions such as endometriosis. Endometriosis can be classified as a disability, in some cases, under the Equality Act 2010. Where an employee’s symptoms meet the definition, employers may be required to make reasonable adjustments. The Equality and Human Rights Commission has published advice for employers on making reasonable adjustments. Where symptoms are not considered a disability, flexible working can also help people with long-term health conditions thrive at work, allowing employees and employers to agree arrangements that support individual needs alongside work.

The department offers a wide range of reasonable adjustments for claimants, including production of communications in a range of different (or alternative) formats to ensure that information is presented in an accessible way that suits their needs. Alternative formats offered include Braille, large print, audio, coloured paper, and screen-readable formats such as word and web-accessible PDF.

Once a claimant’s communication need or reasonable adjustment requirement has been identified, it is recorded on the claimant's record in such a way that it is easily seen each time a member of staff looks at that record, helping to ensure ongoing engagement remains appropriate to the claimant's circumstances.

NHS England is working to support implementation of the revised Accessible Information Standard, published on 30 June 2025, to help ensure that the communication needs of people with a disability, impairment, or sensory loss are met in health and care provision. More information is available at the following link:

https://www.england.nhs.uk/accessible-information-standard/

The responsibility for monitoring compliance with the Accessible Information Standard sits with the commissioner of the service.

Information on NHS England’s approach to patient communications, including accessibility and inclusion, is available at the following link:

https://digital.nhs.uk/about-nhs-digital/digital-first-messaging#accessibility-and-inclusion-is-a-priority

The English higher education (HE) sector is independent of government, and institutional autonomy is a defining principle of our world-class sector. This autonomy protects academic freedom and means that decisions regarding staff appointment and selection rightly sit with providers, not ministers.

Nevertheless, the government’s view is that a diverse workforce is essential to supporting innovation and creating the right conditions for debate and challenge. Moreover, young people from diverse communities should be inspired to see excellent role models in the academic sector.

The Higher Education Statistics Agency (HESA) publishes data on staff within the sector. This data can be found here: https://www.hesa.ac.uk/data-and-analysis/staff.

The department continues to monitor published sector data, while recognising that responsibility for staff recruitment, support and career progression ultimately rests with HE providers.

Integrated care boards are responsible for assessing local need and commissioning services to best meet the needs of their local population, including determining how services are delivered locally to reduce the health inequalities. Therefore, staffing models may differ between areas to reflect local needs and existing provision. All staff within health and social care must have learning disability and autism training specific to their role as set out in the Health and Care Act 2022, which means that staff who see patients should be better able to meet the needs of people who have a learning disability.

We are committed to ensuring that, under the Reasonable Adjustment Digital Flag Information Standard 2025, all publicly funded health and social care service providers are able to share, read, and write reasonable adjustment data by 30 September 2026. The Information Standard is mandated across all publicly funded health and social care providers, commissioners, and IT suppliers. Should issues of non-compliance arise, commissioners of health and publicly funded social care services will be able to enact contractual sanctions at their discretion.

The Government continues to recognise the value of involving patients and family carers in decisions about the care of people with a learning disability. The Health and Care Act 2022 sets duties for involving carers in healthcare. Acute trusts are responsible for determining how best to involve family carers in the delivery of care, taking account of the needs of their patients and local circumstances. There are currently no plans to establish independent or statutory audits to monitor whether acute trusts are consistently involving family carers from admission to discharge. The Friends and Family Test is an important feedback tool that supports the fundamental principle that people who use National Health Services should have the opportunity to provide feedback on their experience.

NHS England has previously published guidance to support primary care to identify people with a learning disability, titled Improving identification of people with a learning disability: guidance for general practice. This information can be shared with other health providers if a patient gives their permission. The Summary Care Record is a national database that holds electronic records of important patient information such as current medication, allergies, and details of any previous bad reactions to medicines, created from general practice medical records. It can be seen and used by authorised staff involved in the patient's direct care, including in other organisations such as an acute trust, with the patient’s consent. We expect acute hospitals to have appropriate arrangements in place to record learning disability information, including through the use of SNOMED codes, which are mandated for use across the NHS including in acute trusts.

We welcome the National Confidential Enquiry into Patient Outcome and Death’s Learning Together, A review of the quality of care provided to adults with a learning disability when admitted to hospital acutely unwell report and we are committed to improving the health outcomes of people with a learning disability.

The Government’s approach, as set out in the 10-Year Health Plan, is to ensure a clear national framework for the National Health Service while empowering local systems to design and deliver services that best meet the needs of their populations. Within this approach, integrated care boards act as strategic commissioners to ensure care better meets patients’ needs at a local level. Decisions about the design of services are matters for independent NHS employing organisations, who manage service delivery at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care, based on population need. This includes investing in the future of their workforce and ensuring appropriate ongoing training and continuing professional development so that they can continue to provide safe and effective care.

We recognise the value of involving patients and family carers in decisions about the care of people with a learning disability. The NHS England website has information to support services, including acute trusts, with involving family carers of people with a learning disability and autistic people.

There are currently no plans to establish senior learning disability consultant roles based on the model in the Netherlands. NHS England published guidance in 2023, updated in 2025, to support frontline staff in acute hospitals caring for people with a learning disability and autistic people.

Under the Reasonable Adjustment Digital Flag Information Standard 2025, all publicly funded health and social care service providers must be able to share, read, and write reasonable adjustment data by 30 September 2026. The Information Standard is mandated across all publicly funded health and social care providers, commissioners, and IT suppliers. As a mandatory information standard, compliance is supported through contractual and regulatory mechanisms.

The Mental Capacity Act 2005 and the Mental Health Act 1983 and their respective statutory codes of practice lay out the guidance for National Health Service trusts regarding Lasting Powers of Attorney (LPA) and Enduring Powers of Attorney (EPA), including verification through the Office of Public Guardian (OPG).

The OPG provides online guidance on the verification of an LPA and EPA on the GOV.UK website, which is available to NHS trusts. This includes the online “Use and View an LPA” service for LPAs registered on or after 1 January 2016. This service allows attorneys to provide a digital access code through which organisations, including NHS trusts, can digitally verify that the LPA is registered, and view details of the attorneys authorised to act. The OPG guidance also provides that if the LPA cannot be shared via the “Use and View an LPA” service, an attorney may present an office or certified paper copy to the institution, to use the LPA.

NHS trusts are also bound by the Equality Act 2010 to make relevant reasonable adjustments where appropriate which would cover attorneys acting under an LPA.

The Department does not hold information on individual LPA or EPA verification outcomes in NHS trusts.

As announced on 20 May 2026, the Government is testing reform of the fit note through pilots in four ICB areas in England.

The pilots will support more effective conversations on workplace adjustments by replacing the traditional fit note with a voluntary service in which Community Work and Health Teams will work with individuals to develop personalised workability plans. These plans will set out work capacity, recommended workplace adjustments and any additional support needed to help people remain in or return to work sustainably. Employers will be encouraged to engage in the process, including through direct dialogue with the individual and their case coordinator where appropriate, helping to ensure that any adjustments are reasonable, proportionate and practical. Employers will retain responsibility for all employment decisions, and the service will not replace existing occupational health provision or override workplace policies.

Officials are working with a wide range of employer groups, including representatives for small and medium-sized employers such as the Federation of Small Businesses to shape design and delivery of the pilots. Evidence gathered through the pilots, including qualitative research, will capture the experiences and views of a range of stakeholders, including small and medium‑sized employers, to assess the viability and deliverability of the models being tested.

This Government will provide a response to this consultation in due course.