CES BP Consultant
Theoretical costing plan for Clinically enabling support(CES) in the consultant role
This is not meant to be a detailed plan for an individual consultant it is how you could suggest an employer that this should be viable therefore they need to do their own assessment of the specific role.
However it makes it clear even without access to work support it is likely to be difficult to argue that the cost was unreasonable in the Equality Act terms
Business Case for employer for clinically enabling support Support – Consultant with ADHD/Dyslexia(or similar issues from nuero developmental differences)
1. Provision of Targeted Administrative Support as a Reasonable Adjustment for Consultant with ADHD/Dyslexia
2. Executive Summary
This business case proposes the provision of 4–5 hours per week of administrative support for a hospital-based NHS consultant diagnosed with ADHD and/or dyslexia. The purpose is to remove known barriers caused by executive functioning and written communication challenges, enabling full productivity in clinical duties and reducing risks associated with unsupported administrative overload.
The support is cost-effective, legally justified under the Equality Act 2010, and aligned with NHS values of inclusion, safety, and efficiency.
3. Background and Context
The consultant has a diagnosed neurodivergent condition (ADHD and/or dyslexia), which significantly impacts:
- Speed and accuracy of written administrative tasks
- Organisation, memory, and task management
- Efficiency in dealing with routine but essential documentation
These difficulties are well-documented in Access to Work reports, Occupational Health assessments, and neurodiversity guidelines.
The Equality Act 2010 imposes a duty on employers to make reasonable adjustments where a disabled employee is placed at a substantial disadvantage. Delays in implementing such support may lead to:
- Reduced clinical efficiency
- Increased risk of errors
- Detrimental health impacts and staff attrition
4. Proposed Adjustment
Provision of a part-time CES or designated admin support for 4–5 hours per week to assist with the following:
- Typing and formatting clinical letters/reports
- Uploading, scanning, and filing documents
- Scheduling MDT meetings and appointments
- Chasing results or formatting discharge summaries
- Organisational support related to clinical documentation
- Organising and recording documentation for appraisal and CPD
The CES would not engage in any decision-making or clinical communication — only administrative/logistical support.
5. Cost Estimate
| Item | Estimate (Annual) |
| Band 4 PA (5 hrs/week) | £4,000 – £5,000 |
| On-costs (NI, pension) | Included |
| Total Cost | £5,000 (approx.) |
NB. depending on the role the banding might need to be 5 or even 6
Band 5 would increase cost to(£5000-£6000)
Band 6 would increase cost to(£6000-£7000)
6. Expected Benefits
| Benefit | Estimated Value |
| Consultant time recovered (~5 hrs/week) | ~£11,000/year |
| Reduced admin error / missed deadlines | Qualitative |
| Compliance with Equality Act (legal duty) | High priority |
| Risk mitigation (burnout, formal complaints) | High |
| Staff retention and morale | Improved |
| Continuity of care during leave (reduced backlog, improved handover) | Service resilience / patient safety |
6a. Additional Service Benefit – Continuity of Care
The presence of a Clinically Enabling Support (CES) worker provides not only targeted administrative support for the consultant, but also enhances continuity of care across the service. When the consultant is on annual leave, study leave, or otherwise unavailable, the CES can:
- Monitor incoming results, correspondence, and routine documentation.
- Prepare information packs and draft responses for the consultant’s return.
- Ensure documents are filed and circulated promptly, reducing backlogs.
- Support handover to covering consultants, ensuring they are properly briefed.
This reduces disruption, prevents delays in patient care, and ensures the consultant can resume duties smoothly, thereby improving both service resilience and patient safety.
7. Risk of Not Implementing
- Failure to meet legal obligation under Equality Act 2010
- Loss of consultant productivity (~£11,000+ per year)
- Increased risk of adverse clinical events due to admin errors
- Potential formal complaints or litigation
- Loss of talent through avoidable burnout or resignation
8. Recommendation
Approve provision of 4–5 hours/week of targeted admin support for the consultant, via:
- A pooled CES/PA resource within the department
- Job-shared support worker
- Jointly funded Access to Work/NHS arrangement (where eligible)
This represents good value, mitigates legal and operational risk, and enables the consultant to operate safely and effectively.
9. Approvals and Next Steps
| Action | Owner / Dept |
| Approval of funding | Clinical Director / HR |
| Job plan update (if needed) | Clinical Lead |
| Recruitment / allocation of support | Admin Manager / HR |
| Access to Work coordination (optional) | Equality / OH |
while this advice appears to be legally correct that is backed up by AI it is not specific legal advice
