Adjustment Duties Compared: How the United Kingdom and Australia Set the Standard
Neurodivergent nurses bring pattern recognition, sustained attention within a domain, and a directness that serves patient safety to clinical work. Whether those strengths are usable often turns on a workplace adjustment, and the duty to provide one is written differently here from the way it is written in the United Kingdom. The two set the threshold in different places, and they place the burden of proof differently. Read together, they make the Australian standard visible as a drafting decision.
How each duty is framed
In the United Kingdom, section 20 of the Equality Act 2010 (UK) sets out the duty to make adjustments in three requirements. Where a provision, criterion or practice puts a disabled person at a substantial disadvantage in comparison with persons who are not disabled, the employer must take such steps as it is reasonable to have to take to avoid the disadvantage. Section 20(7) adds that the employer cannot require the disabled person to pay any part of the cost of complying.
In Australia, the Disability Discrimination Act 1992 (Cth) (DDA) approaches the same ground from the other side. Section 5(2) treats a failure to make reasonable adjustments as disability discrimination where that failure leaves the person treated less favourably because of the disability. Unjustifiable hardship is the limit the Act sets, and section 11 lists what must be weighed in deciding whether a hardship is unjustifiable, including benefit and detriment, the effect of the disability, the employer’s financial circumstances, the expenditure required and the assistance available. Section 11(2) places the burden of proving unjustifiable hardship on the person claiming it.
| Question | Equality Act 2010 (UK) | Disability Discrimination Act 1992 (Cth) |
|---|---|---|
| What limits the duty | Steps it is reasonable to have to take | Unjustifiable hardship on the employer |
| Who proves the limit | Assessed as part of what is reasonable | The person claiming hardship (s 11(2)) |
| Who pays for compliance | Cannot be charged to the disabled person (s 20(7)) | Employer expenditure is a section 11 factor |
What the difference means on a ward
For a nurse asking for a roster change, a quieter handover space or an adjusted documentation workflow, the difference shows up in where the conversation starts. A duty framed around reasonable steps opens with what would remove the disadvantage. A duty framed around unjustifiable hardship opens with what the change would cost. Both questions get asked in the end, and the order decides who does the explaining. Section 11(2) matters here: an employer that wants to refuse carries the onus of establishing the hardship, and many nurses are never told.
Framing is only part of what determines whether adjustments happen. A systematic review of health care providers with disabilities found discrimination operating inside the health professions (Lindsay et al., 2023), and Australian research in health professions education describes recognition, disclosure and accommodation as one connected process shaped by the setting (Gray et al., 2026). A neurodivergent cognitive profile becomes visible to an employer only when someone raises it, and neither statute triggers itself.
The burden of adaptation is structurally misplaced wherever a nurse has to build the case for a change the setting could have accommodated by design, and the wording of the statute decides how heavy that case has to be. Related reading covers what Australian law requires on reasonable adjustments, how to ask for an adjustment at work, and the experience of internationally qualified neurodivergent nurses in Australia. Anyone in an adjustment dispute should take advice from the Australian Nursing and Midwifery Federation (ANMF) or another union, an indemnity insurer, or a lawyer.
References
Disability Discrimination Act 1992 (Cth). https://www.legislation.gov.au/C2004A04426/latest
Equality Act 2010 (UK). https://www.legislation.gov.uk/ukpga/2010/15/section/20
Gray, L., Mcneill, B. A., Woodman, J., Bernard, S., Kos, J., Hewitt, Y., Goldingay, S., Hayley, A., Hitch, D., Macfarlane, S., Pecora, L., Watchorn, V., & Evans, S. (2026). “You Have So Much to Offer as a Health Professional”: Neurodivergent Students’ Experiences of Recognition, Disclosure, and Accommodation in Australian Health Professions Education. Teaching and Learning in Medicine, 1–18. https://doi.org/10.1080/10401334.2026.2632753
Lindsay, S., Fuentes, K., Ragunathan, S., Lamaj, L., & Dyson, J. (2023). Ableism within health care professions: a systematic review of the experiences and impact of discrimination against health care providers with disabilities. Disability and Rehabilitation, 45(17), 2715–2731. https://doi.org/10.1080/09638288.2022.2107086
This post contains general information only and does not constitute legal, medical, or professional advice. Information is accurate to the best of the author’s knowledge at the time of publication. For advice specific to your situation, please consult an appropriately qualified professional.