The NHS can be a chaotic and demanding place to work, especially for neurodivergent staff, whose brains process, store and interpret information differently to the neurotypical majority. Many autistic professionals face daily workplace hurdles that silently damage their health, cause severe exhaustion and limit their career progression.

Research consistently shows that employers and managers need a better, more practical understanding of autism to reduce discrimination and ensure autistic professionals feel supported and safe. Supporting autistic staff isn’t about rewriting national policy—line managers can dramatically improve team wellbeing and retention by working collaboratively with autistic colleagues to identify simple shifts in everyday workplace practices.

Autistic staff make a vital contribution to our healthcare system, but face significant barriers at all levels, from entry-level administrative jobs to senior clinical consultants. In my work as a neurodiversity coach, employees frequently tell me about the immense energy it takes to manage everyday workplace friction. This friction rarely stems from the core work itself, which they often love and excel at, but from misunderstandings, sensory overload, unannounced changes to routines and navigating the ambiguous ‘hidden rules’ of an organisation.

Earlier this year, I spent seven days on a busy, noisy and brightly lit hospital ward supporting my 90-year-old father. Being AuDHD (autistic and ADHD) and dyspraxic myself, I found the constant sensory stimulation — buzzing alarms, harsh fluorescent lighting, overlapping conversations and constant shift handovers — overwhelming. It wasn’t until I returned home that I realised how much it had affected my nervous system and left me physically drained. It made me wonder how autistic colleagues who actually work in this high-pressure environment manage on a day-to-day basis.

Before we can address the challenges, it’s important to understand the distinct strengths that autistic healthcare professionals bring to work, and how neurodiversity can be a major advantage in patient care.

There is a golden rule in neurodiversity: when you have met one person with autism, you have met one person with autism. Like everyone, each autistic employee has a completely unique cognitive profile.

The best research points to what psychologists call a ‘spiky profile’. We often hear that schoolchildren are either generally good at everything or struggle across the board. A spiky profile refutes that assumption: an individual might possess exceptionally high capabilities in specific professional areas while needing structured support and minor adjustments in others. When managers take time to understand the unique individual sitting opposite them and learn to harness these cognitive spikes, the benefits to delivery and team performance are profound:

Line managers are crucial to providing a psychologically safe, sensory-aware, predictable and clearly communicated team culture. There is one golden rule: staff should never be penalised or isolated for communicating differently.

Evidence shows that accommodations work best when treated as ordinary, good line management rather than special favours or exceptions. Here are eight practical, low-cost steps you can implement today:

We know far more about neurodiversity, reasonable adjustments and what makes people thrive at work, than when I started supporting autistic people 29 years ago.