How do I ask for reasonable adjustments at a medical appointment?

A request such as “Please be autism aware” asks staff to interpret what your child might need. A useful adjustment request tells them what blocks access, what to change and what that change makes possible.

The aim is not a perfect appointment. It is an appointment in which the child can communicate, be examined and receive care as safely and accurately as possible.

Start with the healthcare task

Name what needs to happen: discussion, weighing, blood pressure, mouth examination, blood test, scan, vaccination or another procedure. Then identify the point at which ordinary delivery becomes inaccessible.

For example:

• a long noisy wait uses the capacity needed for examination;
• open questions produce no usable pain information;
• unexpected touch leads to panic;
• fluorescent light worsens distress or headache;
• several staff speaking prevents processing;
• the child cannot remain still without first seeing the equipment; or
• a parent is prevented from supporting communication.

Now request the smallest change that addresses that barrier:

“Please show each item before it touches her, use one instruction at a time and allow ten seconds for processing.”

This is more actionable than a list of diagnoses or general preferences.

Choose the adjustments that matter most

Possible requests include:

• first appointment, a quieter time or reduced waiting;
• waiting in a car, corridor or quiet room with a telephone call when ready;
• a longer appointment;
• written, visual or easy-read information in advance;
• photographs or a brief visit to the room beforehand;
• one speaker and additional processing time;
• direct questions with concrete choices where appropriate;
• demonstration before touch;
• examination in a different order;
• reduced light, noise or number of people;
• permission for a familiar supporter, communication device, headphones or regulating item; and
• a pause signal and agreed explanation of what cannot safely be paused.

Do not request every possible adjustment by default. Too many instructions can obscure the two changes that determine whether care is accessible. Mark requests as essential, helpful or not relevant today.

Three concise examples show the structure:

“He cannot answer while several people speak. Please nominate one person to ask questions, pause for processing and accept his communication-device response.”

“She cannot tolerate an automatic blood-pressure cuff without warning. Please show it on another person first, explain each step and use the agreed stop signal.”

“After more than ten minutes in the waiting room, he may leave or become unable to enter the clinic. Please book the first suitable slot, let us wait outside and telephone when the room is ready.”

Avoid claiming an adjustment guarantees calm or completion. Say what it improves: usable communication, sufficient regulation for examination, safer positioning or reduced waiting load. That gives the service a clinical and operational reason to preserve the change even if a different adjustment must deliver it.

The adjustment must also fit the procedure. Headphones may be useful while waiting but incompatible with an ear examination. Waiting outside may work for a clinic but not after a medicine requiring observation. Ask the service to reconcile access with clinical safety.

Send the request before the appointment

Contact the booking team, clinic, GP practice, dentist, radiology department or hospital liaison service as early as practical. Use the route the service gives you, then ask:

1. Has the request been added to this booking?
2. Who will coordinate it on the day?
3. Does the clinical team need to review any part in advance?
4. What should we do on arrival?
5. Who should we contact if the plan changes?

Keep confirmation. If you telephone, note the date, name or team and agreed actions. A portal message or email may create a useful written record, but do not send sensitive information to an address the service has not authorised.

If the appointment is urgent, make the request concise and prioritise immediate access. Do not postpone necessary acute care because the preferred room or time cannot be guaranteed.

Use a health passport without hiding the headline

A health or hospital passport can record:

• communication method and processing time;
• how the child shows pain, fear and consent or refusal;
• relevant sensory barriers;
• what distress looks like and what helps;
• allergies, medication and clinical risks; and
• the support the child wants from a familiar person.

Leicestershire Partnership NHS Trust describes passports as a way to share communication, pain, sensory and distress information and recommends keeping them current and sharing them in advance where possible.¹

The passport supplements the booking request. Do not assume somebody will open an attachment and find page four before the child arrives. Put the essential adjustment in the message itself and bring a current copy.

Involve the child or young person in what is written and who receives it as far as possible. Remove outdated childhood information and distinguish current health facts from strategies that merely helped once.

Understand the Digital Flag in England

The Reasonable Adjustment Digital Flag is an England-specific record marker intended to show that a disabled person needs adjustments and allow relevant services to record, view and share them. NHS England says publicly funded health and social-care providers must be able to use the standard by 30 September 2026.²

Ask the service:

“Can these needs be recorded through the Reasonable Adjustment Digital Flag, and how can we check or update what is held?”

Do not assume implementation is identical in every service during rollout. Confirm the adjustment on the actual booking even when a flag exists. Scotland, Wales and Northern Ireland use their own health systems and local recording arrangements; ask how enduring adjustment needs are recorded there.

A flag is not a substitute for checking today's procedure. Needs change, and one clinic may require different preparation from another.

Prepare the child honestly

Tell the child what is known, what remains uncertain and which choices are real. “The nurse will look at your arm; we have asked them to show the equipment first. I do not yet know whether blood will be taken” is more trustworthy than promising it will not hurt or finish immediately.

Use pictures, a sequence or a short script only if it helps this child. Include the end: where belongings go, how the child communicates a pause and what happens afterwards.

Do not practise compliance. Practise communication: showing “stop”, locating pain, choosing an arm where there is a genuine choice, or telling staff that words have stopped working.

If previous healthcare was frightening, tell the team what occurred and which part must not be repeated. Avoid requiring the child to recount the event to multiple staff.

Confirm the plan on arrival

Use one sentence at reception: “There are adjustments on this booking; the essential one is waiting outside until the clinician is ready.” Ask staff to check rather than explaining the child's whole history within hearing of others.

When the clinician arrives, confirm communication and touch before examination. Provide the passport and say which page contains the essentials. Ask who is leading so several adults do not give competing instructions.

If the planned adjustment is unavailable, ask for an alternative that meets the same need. No quiet room may mean waiting outside; no longer slot may mean prioritising the essential examination and booking a separate follow-up.

An adjustment may improve access without removing all distress. Judge it by whether it reduces the barrier and enables safer, more accurate care, not whether the child appears calm.

Keep a copy of the request available in case the booking note cannot be found. This avoids rebuilding the child's history at reception and makes the agreed wording easy to pass to the clinician.

When care cannot be completed

Stop and clarify when continuing is unsafe, clinically ineffective or likely to escalate beyond the agreed plan. Ask the clinician to record:

• what was and was not completed;
• the barrier encountered;
• adjustments that were tried;
• any immediate health risk; and
• the next clinical plan.

Do not accept “did not cooperate” as the entire record. “Blood pressure could not be obtained after the unplanned waiting-room delay; child could not tolerate cuff; quieter first appointment and demonstration requested” supports better care next time.

Some essential procedures cannot simply be abandoned. That requires clinical planning, proportionate risk discussion and the appropriate team, not repeated surprise attempts by different staff.

Update the record after the appointment

Write down what worked, what failed and what changed. Ask the service to correct or update the adjustment record. A helpful plan is specific: “Waits in car and responds to a phone call” rather than “needs quiet”.

York and Scarborough Teaching Hospitals describes liaison support that helps identify adjustments, coordinate with staff and prepare a passport.³ Availability varies, but hospital learning-disability, autism, accessibility, patient-experience or liaison teams may help when ordinary booking routes do not resolve access.

If a confirmed adjustment was not provided, first ask the service how it will prevent a repeat. Keep the focus on the missed barrier and the care that could not be accessed.

Your child's access needs are part of healthcare planning, not an optional courtesy around it. Name the barrier, request the change, confirm ownership and carry forward what the team learns.

Footnotes

1. Leicestershire Partnership NHS Trust guidance explains how a current patient passport can communicate adjustment, pain, communication, sensory and distress information before healthcare. ↩

2. NHS England describes the Reasonable Adjustment Digital Flag and the September 2026 implementation requirement for publicly funded health and social-care providers in England. ↩

3. York and Scarborough Teaching Hospitals describes autism liaison work that identifies adjustments, coordinates with staff and supports hospital-passport preparation. ↩