In the NHS women make up 76.5% of the workforce, including 260,000 women aged 45-54. Menopause and perimenopause can impact retention, productivity, and absenteeism, making it crucial to provide adequate support for women during this transition to retain skilled talent, ensure well-being, and minimise the effects on work and patient outcomes.

To find out more information about the menopause, please see information on our menopause page

Support for Managers

All NHS organisations can access national menopause guidancefrom NHS England which helps line managers understand how menopause symptoms may affect colleagues at work and provides strategies for support.

For colleagues on sick leave due to menopause-related symptoms, line managers are encouraged to maintain regular contact and offer support. Accurate recording of menopause-related sickness can provide valuable insights to improve support for NHS staff.

Managers should have regular well-being conversations to assess whether reasonable adjustments to working patterns could help. Encouraging staff to join local or national menopause support groups and peer networks can also be beneficial. You can find out more on these on our page here

NHS England offers an e-learning module for NHS staff, covering common menopause symptoms, their workplace impact, and how to support colleagues during this time. Additional resources can be found on the NHS England Retention Hub and detailed guidance on supporting colleagues is available from NHS Employers.

Support for Organisations

To build a menopause-friendly workplace, organisations can learn from case studies and examples shared by various NHS organisations. These highlight successful strategies for supporting staff affected by menopause.

References

Overview | Menopause: identification and management | Guidance | NICE

NHS England » Supporting our NHS people through menopause: guidance for line managers and colleagues

NHS England » Wellbeing conversations

Improving staff retention | NHS Employers

Mann E et al MENOS1 trial. Lancet Oncology 2012 13 (3),309-318; Ayers B et al MENOS2 trial. Menopause 2012, 19 (7), 749-759; Duijts SFA et al EVA trial. J Clinical Oncology2012, 30 (33), 4124-4133.

Espie CA. “Stepped Care”: A health technology solution for delivering cognitive behavioral therapy as a First Line Insomnia Treatment. SLEEP 2009;32(12):1549-1558.

Further information:

NHS England » Supporting people in early and late career

NHS England menopause e-learning module

 

Neurodiversity refers to the natural variation in all human brains. An individual whose brain functions differently from what may be considered ‘typical’ may be referred to as neurodivergent. Neurodivergent conditions include but are not limited to Autism, ADHD, Dyslexia, Dyspraxia, Dyscalculia and Dysgraphia. It is estimated that more than 15% of people in the UK are neurodivergent.

In a 2024 survey, a third of neurodivergent employees said that their experience at work in relation to their neurodivergence has had a negative impact on their mental wellbeing. Neurodivergent people can find the workplace environment challenging and may need additional support. However, they bring a range of unique strengths and talents to the workplace and should be supported to reach their potential.

Neurodiversity Awareness

Unfortunately, there are still plenty of misconceptions and outdated thinking about neurodiversity. Therefore, it is important that staff are educated and trained about neurodiversity and actively seek to reduce stigma and discrimination. Managers should be aware of common challenges that neurodivergent people may experience such as communication, information processing and sensory differences and how these may impact someone in the workplace. Employers should aim for a culture where employees are aware of neurodiversity, are informed about the experiences of neurodivergent people in the workplace and the barriers they may face, and recognise the value of neurodiversity. If a manager feels that they do not have the knowledge or skills to support neurodivergent staff, they can seek these out through development, training and supervision.

Every neurodivergent individual is different and it is important that managers do not make assumptions about an employee’s abilities or strengths. For example, it is a common misconception that ADHD is an attention deficit, but rather it is variable and people with ADHD frequently engage in deep ‘hyper focus’, particularly when engaging with a project they are passionate about. Engage with staff collaboratively to learn their strengths and interests and try to incorporate these into their role.

Managers should receive training on how to manage staff inclusively and understand their legal obligations to employees with disabilities or neurodiversity. When an employee tells you they are neurodivergent, they should be offered a conversation about their needs and preferences and how these can be accommodated in the workplace. Some neurodivergent staff will need support in the workplace while others will not. Everyone’s needs will be different and so it is crucial to take a person-centred approach, ask the employee what challenges they face at work and how you can best support their individual needs. It is important for line managers to approach discussions around disability and neurodiversity sensitively and be aware of how to implement adjustments.

Reasonable Adjustments

Not all neurodivergent individuals identify as having a disability. However, most forms of neurodiversity (Dyslexia, Dyspraxia, Dyscalculia, Autism, ADHD) are defined as protected characteristics under the Equality Act 2010 and therefore are protected from discrimination relating to their condition. Under the Equality Act 2010, employers have a legal duty to make reasonable adjustments for these employees.

Not everyone will know what adjustments they need and their needs might change from time to time. Therefore, managers can work collaboratively with the individual to think about what they find difficult at work and share ideas around solutions. We have additional information and resources on reasonable adjustments on our main neurodiversity page here.

Once adjustments are agreed, a letter can be written outlining the planned adjustments and a timeframe for when they will be implemented and reviewed.

Managers should consider changes that could be made to operational procedures that could support staff. For example, group meetings may be difficult for some neurodivergent staff and so managers could consider changes such as providing breaks, providing the agenda in advance, and allowing neurodivergent staff to contribute to group discussions by alternative means.

Many people may not feel confident or comfortable enough to request adjustments. Therefore, it is important for managers to actively promote information about adjustments and aim to create an environment where people feel comfortable asking for the support they need.

Fostering an Inclusive Culture

To ensure that staff feel comfortable sharing information about their neurodiversity and requesting adjustments, it is important that there is an inclusive and empathetic culture that encourages open communication. Diversity, equality and inclusion should be embedded into the organisation at every level. A neuroinclusive culture is one that actively includes all types of learning and communication styles and considers what the team can do to create inclusion for a diverse range of individuals. In an inclusive workplace, diversity is not only accepted but embraced and encouraged.

Managers can strive to promote an environment where individuals feel safe to share their neurodivergence without fear of judgement or negative consequence. To foster an inclusive environment for neurodivergent employees, managers can take these proactive steps:

  • Educate staff on neurodiversity; improve understanding, address misconceptions, reduce stigma and promote acceptance.
  • Encourage open communication for staff to express needs or concerns with their managers.
  • Promote reasonable adjustments and flexible working.
  • Consider sensory differences and creating a sensory-friendly workplace.
  • Communication – ensure that communication is clear and concise, use visual aids and written instructions, give employees time to process information and provide opportunities for questions.
  • Celebrate diversity – Actively value the unique strengths and perspectives that neurodivergent staff bring to the workplace.

Many traditional workplaces are unintentionally designed in a way that does not support neurodivergent people’s strengths and can make it more challenging for them to reach their full potential at work. As well as making reasonable adjustments for individuals, managers can work towards a neuroinclusive work environment by making changes to the way things are done that would benefit a diverse range of individuals. For example, being clear and direct in your communication is something that would be particularly helpful for Autistic employees but would also benefit most people.

The following resources may be helpful for employers and managers striving to make their workplace more inclusive:

Language

The language we use and how we talk about neurodiversity is important to promote equality and acceptance. People may prefer different language when describing themselves. This terminology guide may be helpful. It is important to ask the employee what terminology they prefer.

Additional Resources and Guides