An NHS drive to increase the number of staff with disabilities will include a national survey to establish the extent of discrimination at board level.

The review - due to issue its findings in the autumn - follows publication today of Looking Beyond Labels: widening the employment opportunities for disabled people in the New NHS , which is designed to support government targets. The guidance says 6 per cent of all staff working in trusts and health authorities have disabilities, compared with 8 per cent of staff in local government.

The figures - from the winter 19992000 Labour Force Survey - compare with statistics for the previous year indicating that 18 per cent of the working age population have a disability.

The Department of Health issued an equalities framework last month, committing all NHS organisations to guarantee an interview to qualified disabled applicants by April 2001, under the Employment Service's 'two ticks'disability scheme.

The new supporting guidance spells out the extent to which organisations are expected to invest resources in attracting and keeping staff with disabilities by making 'a reasonable adjustment' to workplace and employment arrangements.

Stephen Pugh, acting director of human resources at Nottingham City Hospital trust, was one of a handful of managers who contributed to drafts of the guidance. He said that trusts' own figures - which were generally lower than the 6 per cent found in the Labour Force Survey - were distorted by under-reporting.

'It is really a question of changing the culture on something like that - we found that many staff just don't see the benefits of telling us about their disability.'

Mr Pugh said his trust's proactive stance had meant it was able to make practical adjustments, such as installing induction loops and ramps.

It had also been able to pre-empt awkward situations and had taken on a man 'with an absolutely abysmal attendance record' once his medical history had been explained.

Fellow contributor Pami Bal, inequalities adviser for North Mersey Community trust, said 'flexibility' was as important as funding in attracting and retaining staff with disabilities.She gave as an example requirements that job application forms should be available in Braille and on audio tape.

From user to insider Emma Harding is project manager of the user employment programme at South West London and St George's Mental Health trust.

A former healthcare assistant, Ms Harding was contacted initially by the programme when she was facing disciplinary action because of work absences linked to her mental health problems.She found the support 'incredibly useful'.She was offered a secondment to work for the programme, where she is now employed on a permanent basis.

Looking Beyond Labels: widening the employment opportunities for disabled people in the New NHS. www.doh.gov.uk