Research and analysis

Disabled people’s employment in the UK: A thematic review of the literature

Published 17 July 2025

Dr Emma Croft, Dr Jason Olsen and Dr Theo Blackmore

1. Executive summary 

This report reviews academic and other material about disabled people’s lived experience of employment in the UK. These materials were identified in a systematic literature review commissioned by the Cabinet Office’s Disability Unit (DU) in 2021 which was conducted by the Centre for Disability Studies at the University of Leeds and Disability Rights UK. The aim of this report is to better understand the lived experience of disabled people in the UK in employment. 

1.1 Methodology

There were over 130 articles, reports and books catalogued during the review which were relevant to the theme of employment. Research that was not about employment or did not cover the lived experience of disabled people was excluded. The remaining materials, around 75 documents, were reviewed, and themes and subthemes were identified through a thematic analysis. This evidence was then assessed and summarised to develop an understanding of disabled people’s lived experience of employment in the UK. 

As the review focuses on secondary lived experience research, there are some limitations including small sample sizes and limited peer review. Lived experience research gives us a better, but far from complete, understanding of the issues faced by disabled people and people with health conditions in relation to employment. 

1.2 Summary of findings

Experiences of employment 

Disabled people in the UK are currently more than twice as likely as non-disabled people to be unemployed (6.9% versus 3.6%). They are also 3 times as likely to be economically inactive (43.1% versus 15.4%).^{[footnote 1]} 

Good quality employment is an important factor in good health. Poorly-designed jobs are major social factors in health inequalities. These include jobs with high demand but low control, and an imbalance between effort and reward. The quality of employment is often contingent on:

• the job the disabled person gets
• the treatment they receive
• the manager and leadership they are given
• their access to reasonable adjustments
• other factors often outside the disabled person’s control

Disabled people face barriers in every aspect of employment including:

• recruiting
• applying
• interviewing
• hiring
• training
• career progression
• retention

Negative perceptions from employers about impairment heavily influence the organisation’s:

• hiring of disabled people
• willingness to provide reasonable adjustments
• views about the disabled person’s expertise
• social inclusion of disabled people into their workplace
• treatment of disabled people by the employer and their colleagues
• other issues that can create barriers to a disabled person’s employment

Telling employers about their impairment or health condition has sometimes led to a negative experience for disabled people. This often stems from negative reactions and stigma from their manager and colleagues. 

People with learning disabilities remain significantly underrepresented in employment.

While people with different impairments face different obstacles, they also have many overlapping barriers and shared experiences of exclusion. 

Systemic discrimination

Within our analysis, an emerging theme is discrimination. By far the most prominent type of discrimination is ‘systemic discrimination’. This indicates that barriers to work arise more from barriers in society than from people and their impairments.

Some of these barriers relate to the views employers hold about disabled people. The research indicates that when some managers have negative attitudes, this can affect the quality of reasonable adjustments and therefore affect disabled people’s employment. 

To reduce systemic discrimination, organisations must make it easier for people to disclose their health conditions. They must also take more responsibility to improve outcomes. The literature showed that when disabled employees experienced negative perceptions, attitudes, and treatments from colleagues, they felt negatively affected.

Some disabled workers in the evidence reviewed said there was a lack of career progression for disabled people. There were also few positive disabled role models in organisations.

There needs to be more value placed on disabled employees. This will improve with more representation and role modelling opportunities.

Improving experiences in the workplace

The experiences of people in the workplace can significantly affect more general well-being and feelings of belonging in wider society.

The perceived value of the employee to the organisation can shape their participation and retention in the workplace. For disabled people, who can place great importance on work and employment, this fact alone should steer us towards greater inclusivity in the workplace. 

Equality and diversity training in organisations can often be inadequate. Another issue is colleagues and managers not attending such training. This has led to a lack of basic awareness of how to support disabled people in their work and professional development. 

Organisations and businesses sometimes stereotype disabled people as being less productive.

Quality training for employers in recruitment and support for disabled employees is vital.

2. Introduction

This report is a summary of literature identified by University of Leeds Centre for Disability Studies and Disability Rights UK in 2021, commissioned by DU. It presents the findings on the theme of employment. The goal of this report is to better understand the lived experience of disabled people in the UK in employment. 

The major themes affecting disabled people’s access to the labour market include:

• employer attitudes
• educational support
• employment support
• identity
• discrimination

The materials reviewed also highlight subthemes for each of these main themes. Some of these subthemes include:

• educational qualifications for employment
• workplace experience
• desire to work
• managing your own disability
• disability disclosure
• employers’ responses to disability
• reasonable adjustments
• equality protection laws
• the precariousness of employment

Removing the barriers identified in this research – and others – is critical to ensuring that disabled people have fair and equal access to the UK labour market. Removing these barriers relates both to employment specifically, and to the general principles described in Article 3^{[footnote 2]} of the Convention on the Rights of Persons with Disabilities (UNCRPD). More precisely the sections of Article 3 that state that disabled people shall have:

• accessibility
• non-discrimination
• equality of opportunity
• full and effective participation and inclusion in society

Article 27^{[footnote 3]} of UNCRPD (Work and Employment) expands on these principles. It calls for the prohibition of discrimination based on disability in all forms of employment. This includes throughout the entire employment processes of recruitment, hiring, retention and development. It calls for equal pay for equal work, protection from harassment, and the right to reasonable adjustments in the workplace. 

It also calls for disabled people’s employment:

• in the private sector
• as entrepreneurs
• through self-employment

Finally, it calls for the retention of disabled people through vocational and professional rehabilitation, job retention, and return to work programmes. These and other parts of Article 27 spell out the commitments the UK made when it signed the UNCRPD.^{[footnote 4]}

3. Methodology 

The Centre for Disability Studies at the University of Leeds and Disability Rights UK conducted a systematic literature review of the lived experience of disabled people in the UK. The review  in 2021 covered literature published from 2010 to 2021 on a range of themes. It included sources published since the start of the COVID-19 pandemic in 2020. 

This report focuses on evidence relating to the experiences of employment by disabled people. During the evidence review, 132 articles, books, and reports were identified that were relevant to the employment of disabled people. Research that was not about employment or did not cover the lived experience of disabled people was excluded. The remaining materials, around 75 documents, were reviewed, and themes and subthemes were identified through a thematic analysis.^{[footnote 5]} The social model of disability was used as the theoretical position which understands that people with impairments are disabled by barriers in the environment and society. While there are some issues with its use, its ethos of ‘disability’ versus ‘impairment’ can be valuable when conducting research into the lived experience of ‘disability’ within society. 

3.1 Limitations of this research

This report gives a perspective on the barriers affecting disabled people’s lived experiences of employment. It is based on the limited materials identified in the previous literature review. It is not meant to include all aspects of someone’s life, their training and development, or the barriers they face while seeking inclusion. This research helps us understand the issues faced by disabled people and people with health conditions seeking employment. But it is far from complete. There are some important limitations to consider, including small sample sizes and limited peer review. 

The researchers recommend further research should be done into:

• the life stages of employment
• intersectionality
• impairment-specific barriers and how to address them
• other topics relevant to disability employment

There should also be research into the nature of what is ‘work’. Disabled people often use their time and efforts volunteering or performing family roles that others cannot due to their own impairment. This can further increase the value that disabled people bring to the labour market and wider society. 

4. Findings

4.1 Employment

Employment can be valuable. Someone’s productivity can enhance their feelings of social entitlement, worthiness, citizenship, and inclusion.^{[footnote 6]} It can influence the impressions and judgements others make about their status, wealth, and class.^{[footnote 7]} 

Disabled people who are employed are often still labelled as socially ‘less than’, as others assume they are actually unemployed.^{[footnote 8]} People may feel confident in making this assumption as 6.9% of disabled people in the UK are unemployed, compared with 3.6% of non-disabled people.^{[footnote 9]}

The unemployment rate only includes economically active people. 43.1% of disabled people want to work but are considered economically inactive (not actively seeking work). This is nearly 3 times the rate for non-disabled people (15.4%).^{[footnote 10]} Disabled people face many barriers to finding and staying in employment. 

Prior to employment

Some barriers to employment begin even before disabled people are old enough to work. These include things such as getting educational qualifications and work experience, disability management, personal resources, and more (covered later in this report). These highlight the many disadvantages disabled people can face preparing for, and taking part in, the labour market. 

After reaching working age, disabled people continue to face barriers to employment. One of the first is employers’ attitudes towards recruiting them. Organisations and businesses might stereotype disabled people as being less productive and unable to produce work of the same quality as non-disabled people. Such perceptions can prevent disabled people from being actively recruited. 

This means that employers may not be:

• sharing job announcements with disability student services at universities
• reaching out to rehabilitation services
• ensuring that their application processes are accessible and equitable which helps improve the employment of disabled people^{[footnote 11]}
• training their hiring managers to make  reasonable adjustments during interviewing and hiring, non-traditional work histories, and other ways to ensure equal opportunity in hiring and evaluating applicants

Some barriers can be associated with the views employers hold about disabled people. These views are often attributed to being based on the ‘deficit model’.^{[footnote 12][footnote 13]} 

The deficit model is:

“A perspective which attributes failures such as lack of achievement, learning, or success in gaining employment to a personal lack of effort or deficiency in the individual, rather than to failures or limitations of the education and training system or to prevalent socio‐economic trends.”^{[footnote 14]}

These beliefs often reflect stereotypical ideas of disability found in society. These ideas combine lack of ability, the need for help and support, and impairment together into one concept. A workplace culture based on a deficit model of disability often fails to consider the impact that culture, attitudes, and established recruitment methods can have on disabled people. It also ignores the impact it can have on the recruitment and hiring process. 

This can lead to employers unknowingly letting disabled interviewees know they were unsuccessful after they disclosed their impairment. This can harm the applicant’s confidence – an integral part of obtaining employment for visually impaired women, for example.^{[footnote 15]} This part of the process is important as disabled people seek employment for many reasons. One is that it can often play a large role in someone’s identity. Identity at work has been shown to matter to disabled people. It influences how they see themselves and how they feel others see them.^{[footnote 16][footnote 17]}

Employment and health

Employment can be a factor which highly contributes to someone’s health being better than those without employment and it can also boost their confidence, functioning, and life satisfaction more than other activities of daily living.^{[footnote 18][footnote 19][footnote 20]} These lifestyle and functional improvements are often due to higher levels of income, which can alleviate some issues such as poverty and social exclusion.^{[footnote 21][footnote 22]} However, for this to occur successfully, the employment must be compatible with the person’s physical and mental capabilities. 

Reasonable adjustments

To aid disabled people, and to ensure they have equal opportunity in the workplace, reasonable adjustments must be provided to them. The employer’s obligations concerning the provision of reasonable adjustments are found in section 20 of the Equality Act (2010). It states that there are 3 requirements employers must meet under their duty to make adjustments: 

1. A requirement, where a provision, criterion or practice of a person on whom the duty is imposed (for example, an employer) puts a disabled person at a substantial disadvantage in relation to a relevant matter in comparison with persons who are not disabled, to take such steps as it is reasonable to have to take to avoid the disadvantage.

2. A requirement where a physical feature puts a disabled person at a substantial disadvantage in relation to a relevant matter in comparison with persons who are not disabled, to take such steps as it is reasonable to have to take to avoid the disadvantage.

3. A requirement where a disabled person would, but for the provision of an auxiliary aid, be put at a substantial disadvantage in relation to a relevant matter in comparison with persons who are not disabled, to take such steps as it is reasonable to have to take to provide the auxiliary aid.^{[footnote 23]}

Even though these legal provisions exist, disabled people seeking employment often run into large barriers concerning reasonable adjustments.^{[footnote 24]} This is important as the employer’s decision as to whether or not to provide reasonable adjustments can be one of the main factors in whether a disabled person can gain or remain employed. Yet employers, and the powers they have to make the determination of the provision of reasonable adjustments, have been shown to be a barrier itself.  

The evidence shows that many disabled people reported having managers, and others responsible for approving reasonable adjustments, who used language of equality, as those who implemented oppressive working conditions. This includes dyslexic people, people with systemic lupus erythematosus and autistic people who had managers that had a disbelief in non-visible impairments, bullying, isolation and mistreatment.^{[footnote 25][footnote 26][footnote 27]} In one study, managers were reported to have negative attitudes that affected visually impaired women’s employment and the provision of reasonable adjustments to them.^{[footnote 28]} 

While an organisation may have policies in place that support reasonable adjustments, if the line manager’s attitudes about disability are negative it can lead the employee either losing or leaving their position or obtaining employment elsewhere.^{[footnote 29]} For example, this often left dyslexic people feeling as though obtaining adjustments was dependent upon what managers they had and what senior staff they had contact with.^{[footnote 30]} This along with other evidence reviewed shows how disabled people’s employment experiences are significantly affected by how accepting management, senior staff, and leadership were about them as employees.^{[footnote 31]} Disabled employees were also affected by negative perceptions, attitudes, and treatments from colleagues. Co-workers often made assumptions about the disabled person’s skill set and often equated their impairment with incompetence or laziness.^{[footnote 32]} 

Attitudes were not the only barriers disabled people faced when seeking to obtain and/or maintain both employment and/or reasonable adjustments. Organisational factors played a role as well. These include barriers such as established static inflexible company policies that limit the employment of people with chronic health conditions in organisations.^{[footnote 33][footnote 34]} These could be policies that prevent flexibility in the workplace, implementation of technologies, and other policies that blocked effective reasonable adjustments or inclusion. These policies can prevent employers from supporting employee’s impairments.^{[footnote 35]} 

Disclosure

Employers convey that they wish for disabled people to inform them if they have an impairment such as disclosing that they are a disabled person. However, research demonstrates that people with mental health conditions who disclose their impairments are rated as less employable than others.^{[footnote 36]} Yet, to obtain reasonable adjustments disabled people are often required to disclose their impairment(s) to their employer, something that people can be unwilling to do for fear of losing their position.^{[footnote 37]} Disabled people often fear, or have experienced, the stigma and mistreatment that can result from disclosure. Employers’ reactions to one disclosing an autism diagnosis have been found to not always be positive.^{[footnote 38]} People with chronic health conditions such as systemic lupus erythematosus report that they are punished if they ask for reasonable adjustments, even by employers who say they like to have their employees tell them if they have an impairment.^{[footnote 39]} 

After disclosure, employees felt that they are placed under observation, not given adjustments, ambushed with performance improvement plans, have their hours reduced, and encouraged to seek employment elsewhere.^{[footnote 40][footnote 41][footnote 42]} This leads to them needing to decide if disclosure would be advantageous or disadvantageous.^{[footnote 43]} If disabled people do disclose they can be met with negative reactions. If they do not disclose, they may not receive the reasonable adjustments they need to succeed, eventually questioning if they even wish to continue struggling through the pain and exhaustion required to remain employed.^{[footnote 44]} 

Taking on the role of self-advocate can be exhausting for disabled people.^{[footnote 45]} While many often recognise the onus is always upon them to advocate for their own needs and to educate others,^{[footnote 46]} this can prove to be yet another barrier for those already struggling with numerous other social challenges adding more effort on top of work.^{[footnote 47]} 

Career progression

If a disabled person does manage to maintain their employment, the challenges they’ve endured, due to their impairments, and society’s responses to it, will often be underestimated and unrecognised.^{[footnote 48]} For example, evidence suggests that autistic people may still struggle to earn equitable pay, to make progress, and to obtain leadership positions.^{[footnote 49]} This was found across a range of impairments and can be due to the belief that disabled people do not have the strength and stamina to be successful leaders^{[footnote 50]} and may contribute to why disabled workers state that there is a lack of career progression for disabled people and few positive disabled role models in organisations.^{[footnote 51]} 

Disabled people experience many different aspects to their engagement with, and participation in, employment. In this section, the following themes are explored:

• identity
• self-efficacy
• value
• navigating employment
• role models
• education

4.2 Identity 

Identity appears as a broad category within the literature base and as an overarching theme. Identity can be understood here as disabled identity, and/or as worker or occupational identity. This suggests that disabled identities can be meshed with occupational or worker identities and within a wider understanding of intersectionality.^{[footnote 52][footnote 53][footnote 54]} An intersectional approach understands that many factors, such as disability, race, and gender intersect and shape identity. Within the literature base, there is an absence of research which addresses how an intersectional approach may look. This is a limitation of the literature base that invites further investigation. 

When focusing on the role of service users moving into employment, people with energy limiting chronic illness discuss identity as a process to distinguish themselves as workers rather than as service users^{[footnote 55]} and one which requires a shift in their own understanding of who they are (social identity) and allows for integration of their experiences as a disabled person.^{[footnote 56]} Identity relates to professional identity and the challenges associated with changes to health which may lead to periods of sickness leave or career breaks, or withdrawal from employment which can negatively influence an individual’s identity if they are no longer able to continue in a role.^{[footnote 57][footnote 58][footnote 59][footnote 60][footnote 61][footnote 62][footnote 63][footnote 64]} Younger age diagnoses can limit opportunity and aspiration, and negatively shape engagement.^{[footnote 65]} 

Professional and worker identity is discussed and understood by much of the research as shaping people’s own sense of who they are, and any changes to their worker identity challenges this sense of self.^{[footnote 66]} Valued work should not just be conceptualised as paid work, which provides income, but that which can still encompass a professional or occupational identity for the individual and includes voluntary work.^{[footnote 67]} This diversity is important as many traditional conceptions of work may place paid work as the benchmark of achievement and as is shown for many disabled people within this analysis, work is understood as paid or voluntary work, or self-employment or entrepreneurial work.

Identity as understood through entrepreneurial activity^{[footnote 68]} places the focus on the ways in which people harness personal motivations to move forwards and engage with entrepreneurial activity (such as self or other types of employment). Identity then is noted as important as a central feature of the research as it crosses many areas. Within this research identity relates to the personal, social and employment activities of disabled people. It underpins much of what people do and how they experience work and employment. 

Identity can be stigmatised, due to constructions and perceptions of disability and a positive work identity is understood within the literature base as important to the individual yet can be conflicting and affected by these external and sometimes internalised constructions.^{[footnote 69]} 

There are some differences for those people who identify as disabled and have experienced this over their life course, in contrast to some who experience recent impairment.^{[footnote 70]} In a study carried out with people with systemic lupus erythematosus, it was noted that these respondents often covered up their impairment from their employers, or for those who did not, they were often working in roles they identified as having less seniority or in some cases a demotion after the development of Lupus. 

A career can be seen as a part of a person’s own identity but can be understood as requiring management including having to navigate employment, often losing previous roles or being required to completely change career after a new impairment developed or an existing impairment changed over time. Promotion chances for those with systemic lupus erythematosus  were often cited as being limited.^{[footnote 71]} This can be seen as the negotiation of a career as a disabled person, and seeking the environments and working practices most suited to the individual. Where disabled identities are championed within the workplace this can improve working practices and shape the experience of working for the individual.^{[footnote 72]} However, there remain many other factors at play which intersect and influence identity and the workplace and rely on the individual workplace or organisation.

Self-efficacy

Within the literature, there are references to an individual’s self-efficacy, which relates to feelings of having control over their employment, environment, and their own behaviours around work. Where people had little control over these factors it was harder to remain engaged with the workplace.^{[footnote 73]} 

This was often due to the external factors experienced, such as:

• discriminatory or prejudicial attitudes
• issues with reasonable adjustments
• inaccessible environments
• managing their own health considering the continued expectations of rigid work practices and expectations
• dealing with access issues such as support for travel
• support workers and other adjustments

The combination of discriminatory work environments and previous experiences can have an impact on an individual’s psycho-emotional self.^{[footnote 74]} Withdrawal from the role of worker can negatively influence people’s own feelings of self-efficacy.^{[footnote 75]} Non-participation within working environments can significantly reduce beliefs about self-efficacy. Previous experiences can similarly damage a person’s belief about their own self-efficacy^{[footnote 76][footnote 77]} which suggests that the experiences of the individual in the workplace can significantly affect their own feelings of general well-being and belonging in wider society. 

Self-efficacy can be understood through engaging in a meaningful occupation, not just paid employment but also volunteering, and can therefore affect self-belief and worth.^{[footnote 78]} Engagement with volunteering in relation to their own experiences of mental health can increase self-efficacy by challenging self-stigma and promoting self-worth and feeling of value.^{[footnote 79]} Therefore, self-efficacy can be seen as a component of the experiences of employment yet remains somewhat unexplored in relation to disabled people’s feelings of self-efficacy in relation to employment. Self-efficacy can then be seen as a vital and significant component of disabled people’s experiences in the workplace and forms an interlocking connection with the other aspects covered within this review. Self-efficacy is perhaps non-measurable but of equal importance in the factors which affect disabled people’s work experience.

Value 

Value can be considered as value to self,^{[footnote 80][footnote 81]} value to the organisation^{[footnote 82]} and value to the taxpayer. Value and values can indicate a feeling of self-worth (sometimes negative) for the individual and the ways in which organisations engage with their disabled staff can show a value judgement about disability and its inclusion in the workplace. What has become apparent, even with the limited studies within this analysis, is that certain types of roles are being noted as more empathetic to the needs of their disabled workers, such as health-related roles, working as peer mentors within healthcare or working in education and higher education.^{[footnote 83]} The perceived value of the employee to the organisation can shape their participation and retention in the workplace or to the employer,^{[footnote 84]} leading to aspects such as an agreement to more flexible working arrangements, for example, which can often relate to workers in higher status roles or those who are self-employed. 

Disabled people’s experiences in the workplace have shown that value is placed on their social relationships at work, workplace adjustments and flexibility, particularly when supported by colleagues, in formal and more informal ways.^{[footnote 85][footnote 86]} For many within the studies reviewed, these informal ways of working often went some way to tackling institutional, organisational, or socially constructed barriers within the working environment. However, this does not negate the need for generalised changes to these attitudes and practices on a much wider scale. 

With more representation and role modelling opportunities, the value of having disabled staff can improve.^{[footnote 87][footnote 88]} However there are many more factors which need to be addressed to create a cultural shift to a more inclusive and barrier-free way of working. Value is also related to the importance of supporting and retaining employees, as one report suggests which discusses the lived experience of employees with rheumatoid arthritis.^{[footnote 89]} This remains a common theme throughout the literature, related to identity generally, linking together the value of retaining employment and self-efficacy. Returning to work after illness or impairment can affect self-efficacy, in terms of the difficulty of tasks leaving them feeling incapable.^{[footnote 90]} Value identified as appreciating the importance of work, the value to the organisation and self-efficacy are tightly linked. 

Navigating employment and self-employment

For those seeking self-employment, this was often due to the difficulties in accessing either previous or desired roles. For some, this followed a recent development of an impairment, and for others, this was to do with finding work more suitable to their current situation which allowed them to work in ways which afforded their personal circumstances and impairment effects. This is combined with support for disabled people to seek self-employment routes.^{[footnote 91][footnote 92][footnote 93][footnote 94]} Positive experiences of self-employment or microenterprise initiatives were found when exploring the experiences of people with learning disabilities. This was combined with support to navigate business requirements, costs and management of the enterprise.^{[footnote 95]} For many however, within this local authority commissioned study, what additionally developed was a stronger sense of social inclusion and belonging for people with learning disabilities.^{[footnote 96]}

However, people with learning disabilities remain significantly underrepresented in self-employment and employment statistics more broadly.^{[footnote 97]} For people with visual impairments, there are similar disparities noted^{[footnote 98]} with a smaller number in a longitudinal study being in employment or self-employment and the remainder looking for work, studying or remaining unemployed. 

Self-employment is underexplored in the literature analysed here but is relevant as working practices may continue in more flexible ways. This may allow more people to turn towards new initiatives that allow them to work flexibly and in line with their own requirements.^{[footnote 99]} This type of employment may indicate areas for improvement and create a deeper understanding of those who are in any type of work (self-employment, employee roles or volunteering). It is noted that where there is good management and support from employers, the flexibility and suitability some may find within a self-employment route can be found within more traditional employee roles.^{[footnote 100]} 

Role models

Disabled people in the evidence associated disabled leadership as more inclusive and supportive. A lack of direct disabled role models within organisations often meant employees were often trailblazing and role model status was something that is attributed or perceived rather than deliberately sought.^{[footnote 101]} Having disabled role models can create a positive culture and understanding which allows for the development of careers and work practices.^{[footnote 102]} When exploring the experiences of disabled workers in higher education, there is either an absence of disabled role models or a lack of visibility of disabled role models in leadership positions within the organisation.^{[footnote 103]} This is important as it is found within other studies noting that in many professions disabled role models are also not apparent, such as in politics,^{[footnote 104]} the legal profession^{[footnote 105]} and volunteering roles more broadly.^{[footnote 106][footnote 107]} The importance of disabled learners being able to engage with role models is clear with dyslexic participants noting that they were able to follow what was being taught by their lecturers  and the teaching style also suited their own requirements.^{[footnote 108]} This shows that not only is it important for disabled workers to locate disabled role models, but it can improve how disabled workers feel when undertaking a role. In research with people with chronic pain, it is noted that working provides an opportunity for the individual to be that role model, be it for family or others.^{[footnote 109]} There is a significant lack of research in this area to draw out the debate further and requires further research. 

Education 

While there is less discussion around education in relation to employment, what is apparent is that equality and diversity training in organisations can be inadequate and has been identified as problematic.^{[footnote 110]} Issues have included colleagues and management not attending any training which has led to a lack of awareness at the base level of supporting disabled people within their employment and professional development. Volunteering, once within a suitable environment, allowed participants with mental health conditions to consider further training and educational needs that they identified to support their development.^{[footnote 111][footnote 112]}

Other factors discussed include inaccessible training and education or losing pay to re-attend a training course.^{[footnote 113]} Quality training for employers in recruitment and ongoing support for disabled employees is vital.^{[footnote 114]} Factors that help disabled people return to work can include training for managers about impairment and how to support workers.^{[footnote 115]} Education from those with lived experience can develop a cohesive understanding within the medical professions, particularly in their study, nurses and nursing associates.^{[footnote 116]} Disability awareness training, and equality and diversity training can reduce stigma and misunderstanding about chronic ill health.^{[footnote 117]} 

4.3 Discrimination 

This report, and other research beyond the scope of this report, demonstrates that the main barriers to employment for disabled people are located within the systems and structures of society, outside of the control of any individual, including employers and employees. These issues do not relate to the disabled individual and their impairment or illness but the barriers that they face in everyday life.

Systemic discrimination

By far the biggest theme within the category of discrimination is ‘systemic discrimination’. Systemic barriers included economic conditions, government policy, ideological factors, and legal issues.^{[footnote 118]} This systemic discrimination is largely beyond the control of the individual. For example, one text noted that disabled people frequently reported an organisational reluctance to adapt, reform, or address exclusionary practices and an unwillingness to listen to suggested practical adjustments based on their experiences.^{[footnote 119]} Some organisations have only a limited knowledge of the range of adjustments and equipment available on the market, because of the under-use of experienced providers and schemes.^{[footnote 120]}

Specific professions (for example the legal profession) are often recognised as being discriminatory in relation to their fixed assets – for example, buildings and rooms – which can be inaccessible, and practices are often unchangeable (due to historical “we have always done it this way” type reasons).^{[footnote 121]} There are also specific impairment groups who experience increased levels of systemic discrimination – for example, people with learning difficulties can feel excluded from society when the correct adjustments are made or provided. Employment can help social inclusion, though people need to be creative to enable work placements and employment. Everyone needs to work together to make the experience of work positive.^{[footnote 122]}

It is recognised that people with mild learning difficulties can face many structurally produced injustices through inadequate and counter-productive support, insufficient income, and disrespect. This can result in injustices, exploitation, and abuse.^{[footnote 123]} People with mental health conditions can experience systemic discrimination - at the heart of this discussion is the pressure to ‘perform’, as part of the employee role. Performance of ‘well’ and ‘normal’ at work feels to be a moral imperative as a good (healthy) employee.^{[footnote 124]} Workplace changes can contribute to employee stress and depression, while the application of employer policies and support is often patchy. Workplace pressures can also increase depressive experiences for people with mental health conditions.^{[footnote 125]} These issues also occurred across various impairment groups found in the evidence reviewed for this report. 

The evidence highlighted that people with psychotic illness are often stigmatised,^{[footnote 126]} and wheelchair users with any customer contact often face systemic discrimination, possibly due to aesthetic considerations, social norms, and stigma by association.^{[footnote 127]} To reduce systemic discrimination, the literature presents evidence that organisations rather than people must take more responsibility for facilitating disclosure and improving outcomes from it. The literature discusses how there is a need for ongoing commitment to organisation-wide disability equality training to reduce stigma and discrimination for disabled employees.^{[footnote 128]} 

Many disabled people experience a fear of disclosing their status as a disabled person at the very beginning of the job application process. In one study carried out with people working in the legal profession, 70% exclusively reported a non-visible impairment and an additional 20% identified as disabled people with both visible and non-visible impairments. However, only 50 to 60% said they disclosed their non-visible impairment when applying for training and jobs and, even in cases where an impairment was visible, the majority chose to conceal the non-visible impairment.^{[footnote 129]} This is a result of believing that society is ableist – those who identified as disabled or having a long-term medical condition at the point of application, were most disadvantaged when applying for training or employment. This can be exacerbated when people experience intersectionality, with double or triple simultaneous discrimination (with other protected characteristics).^{[footnote 130]} Research such as this study^{[footnote 131]} which looked at obstacles to elected office in the UK, found that the ideal candidate in the UK is a white, middle-aged, male professional without impairments. 

Care must be taken with organisational practices aimed at reducing systemic discrimination. For example, human resource management practices which, while intended to increase inclusion and reduce discrimination, can in fact inadvertently construct and shape disability for people with impairments in the workplace.^{[footnote 132]}

To help reduce systemic discrimination it is recommended to create a positive organisational culture and understanding, taking a strategic view to understand and highlight the value of all employees.^{[footnote 133]} 

Individual discrimination

The next largest theme is individual and interpersonal discrimination. In one report dealing with people living with psychosis, interpersonal barriers were defined as factors inherent in interpersonal interactions, including references to attitudes, perceptions, beliefs, expectations, emotional reactions, and behaviours applying to the employment of people living with psychosis. It included references to knowledge and understanding, stigma and discrimination, workplace management issues, and communication and collaboration.^{[footnote 134]}

In a worst-case scenario, individual discrimination can manifest as bullying and harassment.^{[footnote 135]} Individual ‘deservingness’ can be questioned by some employers and peers in work.^{[footnote 136]} In response, an individual develops personal strategies, including coping strategies. Employer support is required, as well as the willingness of colleagues and the workplace to understand.^{[footnote 137]}

Within this theme, there are also issues with which the disabled person must contend on a daily basis in relation to their impairments. For some people, work acts as a distraction from distress. To stay at work, they can feel under pressure to be at work even when unwell (this is also known as presenteeism). This pressure can come from peers, as well as the organisation as a whole.^{[footnote 138]}

Some people with mental health conditions said they experienced negative comments after sharing information about their impairments at work, while others said they had received the support they needed after talking about their impairments.^{[footnote 139]} This illustrates the importance of the lived experience of disabled people at work. The literature is clear that there does not need to be any discrimination at work towards a disabled person. Many disabled people benefit from, and value, supportive relationships with colleagues, and experience positive workplace adjustments.^{[footnote 140]}

Barriers 

Underpinning the issues relating to discrimination in employment in these texts is the notion of the barriers experienced by disabled people in their everyday lives.^{[footnote 141]} These barriers fall into 3 categories: 

• a lack of accessibility, including the built environment and documents
• a lack of resources to make events and activities accessible
• ableism, including openly expressed prejudices but also a lack of awareness and willingness to make processes inclusive

This literature notes that while people with different impairments face some distinct barriers, all disabled people have similar experiences of obstacles and exclusion which go beyond those faced by people from other under-represented groups.^{[footnote 142]}  

Other barriers experienced by disabled people in the world of work include the way that career paths can be more precarious and unpredictable for disabled people because of barriers including accessibility, location of premises, rigid working practices, health-related career interruptions, expectations of physical networking, and the unwillingness to make adjustments.^{[footnote 143]}

From the employer’s perspective,^{[footnote 144]} many disabling issues can seem too hard to overcome and well beyond their control. However, as an example, small adjustments can make working life easier for Deaf people - for example, windows indoors, and moving furniture around to extend visual reach. Failure to make small changes can result in feelings of being uninvolved by the employee. Small changes can increase collegiality and enhance inclusion.^{[footnote 145]}

These barriers can be seen as structural, big picture issues, largely beyond the control of any specific individual. At the daily, individual level, many disabled people experience negative treatment, bullying, or discrimination, associated with their impairment.^{[footnote 146]}

5. Conclusions

Several themes emerged from the literature review, despite limitations including small sample sizes and limited peer review

First, disabled people in the UK have an unemployment rate (6.9%) more than double that of non-disabled people (3.6%). Despite this, and the fact that the labour market needs more workers, access to employment is not easy. Disabled people continue to face many barriers to obtaining and maintaining employment. 

Second, people with learning disabilities remain significantly underrepresented in employment statistics. Research shows that disabled people who disclose their impairments are considered less employable. People with different impairments face different barriers, but all have similar experiences of obstacles and exclusion. These go beyond those faced by people from other under-represented groups. Also, the value of work goes beyond paid work. It can give disabled people a professional or occupational identity. It can also include voluntary work. 

Third, by far the biggest subtheme within the theme of discrimination is ‘systemic discrimination’. According to this subtheme, barriers to work stem from society, not from people and their impairments. Some of the barriers caused by employers are due to the views they hold about disabled people. Some managers’ negative attitudes affected disabled people’s employment, including the provision of reasonable adjustments. To reduce systemic discrimination, organisations have to make it easier for disabled people to disclose their impairments. They also have to take more responsibility for improving outcomes for disabled people.

Finally, disabled employees were affected by their colleagues’ negative perceptions, attitudes, and treatment. This can be reduced by having more disabled people in leadership roles. Disabled people say there is a lack of career progression for them, and too few positive disabled role models. More value needs to be placed on disabled employees. This will improve with more representation and role modelling opportunities. 

Disabled people’s experiences at work affect their general well-being and feelings of belonging. The perceived value of the employee to the organisation can shape their participation and retention in the workplace. Equality and diversity training in organisations can be inadequate and problematic. Some organisations have a culture that uses stereotypes of disabled people as being less productive. The literature shows that quality training for employers to recruit and support disabled employees is vital.

6. Glossary

6.1 Barriers

The social model of disability (1976) recognises that it is society which disables people with impairments through barriers which prevent their full participation in society. The removal of these barriers can greatly reduce, or even remove entirely, feelings of being disabled. 

6.2 Disabled people^{[footnote 147]}

The Equality Act (2010) defines disabled people as people with physical and mental conditions that have a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities. In this consultation, ‘disabled people’ also include people with chronic illnesses that have a substantial and long-term impact on everyday life and people who identify as neurodiverse.

6.3 Disabled people’s organisations^{[footnote 148]}

These are organisations that are run and controlled by disabled people.

6.4 Disclosure

This is the moment when a disabled person lets their employer, or prospective employer, know they are a disabled person. For people with ‘hidden impairments’ – impairments that are not visible to the outside world – this can be a real dilemma.

6.5 Fear of disclosure

Some disabled people are fearful of the consequences of disclosing that they have impairments because of the potential for discriminatory consequences. 

6.6 Impairment

The social model of disability (1976) for the first time separated the idea of disability from impairment. Impairment relates to the individual body, while disability relates to the experience of a person with impairments when they face some of the barriers in society.

6.7 Individual discrimination

This is direct discrimination between one individual and another. 

6.8 Intersectionality

This describes when an individual has more than one protected characteristic and can therefore experience discrimination on several fronts.

6.9 Neurodiversity^{[footnote 149]}

Neurodiversity recognises diversity in people’s brains and how brains and minds function. People who are neurodiverse include people with autism, Asperger’s syndrome, dyslexia and dyscalculia.

6.10 Protected characteristics^{[footnote 150]}

The Equality Act sets out 9 characteristics that it is unlawful to discriminate against. These characteristics are: age, disability, gender reassignment, marriage and civil partnership, pregnancy, race, religion or belief, sex, and sexual orientation.

6.11 Reasonable adjustments

The Equality Act (2010) states that employers must make reasonable adjustments in the workplace to ensure the full participation of disabled employees.

6.12 Systemic discrimination

Systemic barriers were conceptualised as broader social issues which affect a person’s ability to find and sustain employment.^{[footnote 151]}

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