Credit:  Discrimination Law Association

Elaine Banton is a highly regarded barrister at Doughty Street Chambers, specialising in employment, equality, discrimination, and human rights law. She is a seasoned appellate advocate with over two decades of experience, and writes the chapter on ‘Human Rights’ in Tolley’s Employment handbook. Her work is underpinned by her ‘Equality by Design’ framework, built around the principle that fairness must be built into systems from the outset, rather than dependent on individuals challenging exclusion after harm has occurred.

When invisible conditions meet invisible assumptions

For decades, equality law has grappled with the question of ‘how does the law protect those with invisible disabilities? ’ Some barriers are physical and obvious: a step without a ramp, a door too narrow for a wheelchair. Others are hidden within systems where the barrier is not a missing ramp, but a missing belief.

Conditions such as endometriosis, adenomyosis, fibroids, polycystic ovary syndrome (PCOS), and chronic fatigue syndrome (CFS/ME) challenge the traditional model of sickness and recovery on which much employment practice (and disability discrimination law) was built. Symptoms fluctuate, and pain is concealed, often as a matter of professional survival. Individuals continue to perform at a high level while privately managing painful conditions until the system built on the ideal-worker paradigm finally catches up with them.

The question raised in the recent case of Pal v Accenture (UK) Ltd ^[1] is therefore larger than whether the claimant’s condition, endometriosis, met the statutory definition of disability under equality law. It asks whether our legal and workplace systems are capable of properly addressing chronic, fluctuating, invisible conditions – particularly those that disproportionately affect women.

I represented the appellant in Pal , a case that sits within a wider pattern of developing law that will apply to many of the above-mentioned conditions. But this is not only an employment law story. The same problem plays out in both the employment and social security tribunals, and those affected move between the two systems. This article addresses both dimensions.

The wider context is one in which clinicians, campaigners (and increasingly government) acknowledge the phenomenon now widely described as ‘medical misogyny’ : the historic and systemic treatment of women’s pain within healthcare systems.

The average diagnostic delay for endometriosis in the United Kingdom remains around nine years. If health systems have struggled to hear women, what chance do they have when they encounter workplace and benefits systems built around false assumptions?

These issues cannot be separated from the human rights dimension of dignity, bodily integrity and equal participation in working life. This article aims to draw those threads together: doctrine, evidence, and design.

The legal framework

Disability is defined under s6 Equality Act 2010 (EqA) as a ‘physical or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities’. Schedule 1 provides the definitions; long-term generally means lasting or likely to last 12 months, and substantia l means more than minor or trivial. Para 2(2) provides that where an effect ceases, it is treated as continuing if it is likely to recur.^[2]

The statutory guidance issued under section 6(5) EqA expressly addresses conditions with fluctuating or recurring effects, such as CFS. It warns that pain or fatigue may limit how an activity is carried out, whether it can be repeated, or can be performed at all. Para 5 of Schedule 1 further provides that a condition is to be treated as having the effect it would have without medical treatment or other measures (except for the use of spectacles or contact lenses).

This is extremely important for gynaecological and fluctuating conditions. A claimant who is successfully treated with surgery or hormonal medication, or is between flare-ups, is not disqualified from protection; instead, the statute requires the tribunal to look at the underlying impairment if untreated. It must also assess a recurring condition over its lifespan rather than at the moment the claimant happens to be in a tribunal chair.

The difficulty is not the statutory test itself but that the tribunals struggle with the distinction between a condition’s label and its functional effect, and with the proper treatment of coping mechanisms and ‘good days’. The legal framework focuses on what a person cannot do, rather than what they can do with pain management strategies.

Pal v Accenture, making invisible impairment visible

Ms Pal worked for Accenture for over a decade before her dismissal in 2019, following a prolonged period of ill health linked to endometriosis. She was dismissed under a progression-based, ‘up or elsewhere’ capability model, having been assessed as not ‘promotion ready ’. The ET found her dismissal procedurally unfair but applied a 100% Polkey reduction, concluding she would have been dismissed in any event with a fair process. The ET also rejected her disability discrimination claim, finding that endometriosis did not meet the s6 threshold.

The Employment Appeal Tribunal (EAT) allowed the appeal on all three grounds in January 2026. Three aspects stand out for the present purposes.

First, the EAT held that the tribunal’s reasoning on disability status was ‘wholly inadequate’ .^[3] They had not effectively engaged with the medical evidence, addressed the fluctuating and chronic nature of endometriosis, or considered the likelihood of recurrence.^[4] Second, the ET was found to have wrongly accepted the progression model as a capability process.^[5] Finally, the 100% Polkey reduction was found to rest on an error – the ET had assessed what the respondent would have done, rather than requiring it to prove the likely outcome of following its own procedures.^[6] The matter was remitted for fresh determination with a new ET panel.

This case illustrates what might be called the ‘competence paradox’. High-performing employees with invisible, fluctuating conditions frequently continue delivering, often at considerable personal cost, until they reach a point of crisis. Further, the EAT noted that the original panel had made highly adverse comments about the claimant’s credibility, to the extent of completely disregarding her impact statement.^[7] The EAT’s emphasis on the need for a proper, individualised analysis of medical evidence and functional impact highlights a recurring risk in legal decision-making of being too ready to treat ‘coping’ as proof of wellness.

Medical misogyny: from healthcare disbelief to workplace disbelief

The debate around medical misogyny is a useful context for understanding why cases like Pal may arise in the first place. Women with reproductive and gynaecological health conditions report that their symptoms are consistently normalised as ‘bad periods’ , their diagnosis is delayed by years, and their pain is minimised by clinicians. They are also repeatedly required to evidence their own experience to everyone, from doctors and medical specialists to workplace managers, and eventually tribunals.

Endometriosis is perhaps the starkest illustration of this, with patients often being told that their pain is simply a normal part of being a woman. Other conditions, such as adenomyosis, have historically been even less well recognised, sometimes diagnosed only following hysterectomy or in later life. Fibroids may cause profound symptoms, which are too frequently characterised by employers as routine ‘women’s issues ’ rather than as a potentially disabling impairment covered by the EqA. Meanwhile, PCOS, a complex hormonal condition, faces a particular legitimacy problem precisely because its presentation varies so widely between individuals.

The common thread is that conditions disproportionately affecting women have had to fight for legitimacy within medicine before they ever reach a workplace or a benefits assessment centre. The workplace frequently mimics the same pattern, to the extent that an employee who has spent years persuading clinicians that her pain is real then has to persuade a line manager, an occupational health adviser, and potentially a tribunal panel of precisely the same thing, this time under the added pressure of her job being at stake.

This is why the EAT’s emphasis in Pal on properly engaging with medical and impact evidence, rather than subjective credibility, matters so much. The original tribunal had described the claimant as an unreliable witness with her evidence as ‘demonstrably exaggerated’ ^[8] while making opposite generalised findings in the respondent’s favour. The habit of treating women’s first-hand accounts of their own bodies as less reliable than an institution’s account of its own processes is the workplace expression of medical misogyny, and it is precisely what s6 EqA is designed to guard against.

Beyond endometriosis: the developing case law

Endometriosis is not the only gynaecological condition to have reached appellate or tribunal scrutiny. In Centrepoint Soho Ltd v Omaboe ,^[9] the claimant had become seriously unwell with uterine fibroids and associated anaemia, leading to a prolonged period of sickness absence and eventual dismissal. The ET had found in her favour on a disability discrimination claim. On appeal, the EAT confirmed that fibroids and consequent anaemia were capable of engaging the disability discrimination provisions under the EqA, but found no discrimination had occurred.

In Mawema v Hertfordshire Partnership NHS Foundation Trust ,^[10] an ET recognised that a claimant with large uterine fibroids suffered severe and disabling symptoms. Whilst not legally binding, this first-instance decision sits usefully alongside Omaboe as evidence that tribunals are capable of properly engaging with medical evidence.

In Foster v Cardiff University, ^[11] chronic fatigue syndrome (CFS) was accepted as a disability, and the dispute concerned the adequacy of the employer’s adjustments. The EAT held that a tribunal is only required to focus on the effects of an impairment, not to investigate its underlying causes. Northumberland, Tyne and Wear NHS Foundation Trust v Ward, ^[12] is a similar case dealing with a CFS dismissal after the employer withdrew an adjustment to the sickness absence policy. The EAT upheld the tribunal’s finding that the dismissal was discriminatory, reasoning that it was difficult to see how removing an adjustment that had operated successfully for years, without any change in circumstances necessitating its withdrawal, could be justified. Ward is a particularly useful authority in the context of gynaecological conditions, because absence trigger points calibrated to standard, non-fluctuating illness patterns are precisely the kind of seemingly neutral workplace system most likely to disadvantage women.

PCOS and adenomyosis, by contrast, remain at the evidential frontier. In Divers v Balayage Hair and Beauty Salon ,^[13] an ET dismissed a claim of discrimination arising from disability where PCOS was the underlying condition. The absence of any developed legal analysis of the s6 EqA threshold in that decision shows that the law’s protection for these conditions currently depends almost entirely on the willingness and capacity of individual claimants to litigate impairment into legal visibility.

Fluctuating health conditions in the context of the social security system

As with employment law, the Social Security Tribunals are asked to assess conditions with inconsistent and variable symptoms. The legal tests differ, but the underlying conceptual difficulty is the same: systems are designed to produce fixed answers.

As noted above, the statutory guidance issued under section 6(5) EqA directly addresses impairments with fluctuating or recurring effects.^[14] What Pal , and the wider medical misogyny context in which it sits, demonstrates is that the gap lies not in the statute, but in its application. The risk of legal error, identified by the EAT in Pal , is to treat a good day as the truth and a bad day as an exceptional deviation.

The system for awarding the Personal Independence Payment (PIP) is a case in point: under reg 7 of the Social Security (Personal Independence Payment) Regulations 2013,^[15] the applicable descriptor for each activity is one that is satisfied on more than 50% of days across a 12-month period (starting three months before the date of claim and ending nine months after). Where a claimant meets two or more descriptors across different proportions of that period, the one that is satisfied for the greatest proportion of days applies.

Part 2 of the guidance on PIP provided by the Department for Work and Pensions (DWP) requires health professionals to choose descriptors based on this 12-month picture, expressly to: ‘iron out fluctuations and present a more coherent picture of disabling effects. ’^[16] Para 2.1.27 specifically requires assessors to consider how the claimant’s health condition fluctuates and to ask what the need is on the 'majority of days '. Paragraphs 2.2.17 and 2.2.18 go further, requiring assessors to consider whether an activity can be repeated on subsequent days, and directing them to take into account symptoms such as pain, fatigue and breathlessness as factors affecting whether an activity can be done as often as it is reasonably required.

The design intention here is sound. A 12-month window weighted toward recurring functional impact is better suited to capturing fluctuating conditions than a snapshot assessment. But the design depends entirely on the quality of what assessors actually do with it. An assessor who focuses on what a claimant can do on a good day and treats bad days as exceptional will likely make the same error regardless. The ‘majority of days’ test is only as good as the evidence about what those days actually look like.

The shared conceptual problem

Both systems share a conceptual difficulty that is not resolved by the formal legal framework alone. Neither system can use an average day to assess someone with endometriosis or CFS/ME, because there may be no such thing. There is a real risk of treating good days as the truth, when the lived reality is the opposite; the bad days are the condition, and the good days are the coping.

The DWP’s own research directly acknowledged this point. Its report on the impact of fluctuating conditions on assessment (October 2024) found ordinary tools to be inadequate.^[17] It concluded that participants found it deeply difficult to describe the physical, emotional and cognitive impacts of fluctuations to third parties such as the DWP. The report identified a five-part cycle (underlying condition, trigger, management, outcome, impact) which makes it difficult for people with fluctuating conditions to describe changing levels of disablement and acknowledges this causes ‘differing degrees of difficulty, frustration, fear, and a sense of inequality for applicants with such conditions ’. The report concludes with a number of recommendations, which represent structural reforms rather than individual adjustments, and they map directly onto the ‘Equality by Design’ approach.

The ‘proof’ problem, what the statistics reveal

The DWP’s official statistics to January 2026 show how much the current system is struggling in practice.^[18] Over a five-year period up to September 2025, 36% of completed mandatory reconsiderations went on to appeal, and the DWP itself overturned the original decision in 47% of those cases. Of those decisions that did proceed to a tribunal hearing, 80% were overturned. These figures deserve to be stated plainly. Nearly half of all appealed decisions in this category were conceded by the DWP before they ever reached a tribunal. And yet, the broader evidence shows that approximately 65% of claimants who receive an adverse mandatory reconsideration decision give up entirely and never appeal. The implication is clear: a significant proportion of initial decisions are wrong, and the only mechanism by which that error is corrected is one that a majority of claimants never access. The mandatory reconsideration and appeal process is not a peripheral remedy. It is, in fact, the primary route by which correct DWP decisions are finally reached.

For those managing these conditions, the burden of navigating that multistage process whilst enduring pain and diagnostic disbelief, along with the ordinary demands of daily life, is not a peripheral inconvenience – it is a systemic injustice. The data illustrate how the DWP is making a very large number of errors that might never be corrected without the persistence of those people already facing substantial disadvantage.

The ‘connected’ argument

ET and SST jurisdiction are potentially connected stages in a single person’s life. A disabled person who cannot obtain support via PIP may be less able to sustain paid employment. A person who loses employment because an employer fails to make reasonable adjustments may then need to rely on disability benefits, only to find, as Ms Pal did, that a system which failed to recognise her condition at work also struggles to assess it outside of work. The failures in one system are often the preconditions for vulnerability in the other. Any analysis that addresses only the ET dimension of these conditions risks being incomplete as an account of the law, and an inadequate map of the human experience of that law.

Invisible disability and the limits of traditional workplace design

Many workplace systems were built around an assumed ‘ideal worker’, consistently available, predictably productive, who can cleanly separate health from work, and progresses along a linear career trajectory. Chronic, fluctuating conditions do not operate within that design, and the mismatch generates four recurring areas of legal risk.

• Performance management is the first. Before treating reduced output as a capability failing, the question a manager should ask is whether there is an underlying health explanation that has not yet been disclosed or properly understood, precisely the kind of inquiry Accenture’s ‘up or elsewhere ’ model bypassed in Ms Pal’s case.
• Absence management is the second. Standard sickness absence triggers are poorly suited to recurring underlying conditions which produce multiple short absences. Ward demonstrates both the legal risk of withdrawing an adjusted trigger without proper justification, and the converse lesson; that adjusted triggers, properly maintained, are an effective and lawful tool.
• Promotion systems are the third, and the one most directly implicated by Pal . ‘Up or out ’ models assume uninterrupted, escalating contribution. They are can be structurally misaligned with anyone who produces a nonlinear pattern of output; a category disproportionately populated by women managing gynaecological conditions.
• Hybrid working and flexibility are the fourth. Supportive adjustments such as flexible start times or the ability to work from home are too often treated by organisations as exceptional concessions rather than ordinary features of inclusive design. Pal starkly demonstrates why employers must look behind surface presentation. The question is not whether an employee seems well on a given day, but whether the capability policies can recognise the reality and unpredictability of impairment over time.

The Menopause Employment Action Plan: what it means in practice

A parallel regulatory development, distinct from the case law but directly relevant to the issue of design, arose from the recent guidance on Gender Pay Gap and Menopause Action Plans published under the Employment Rights Act 2025.^[19] From April 2026, employers with 250 or more employees may voluntarily publish an action plan alongside their gender pay gap data, addressing both pay disparity and menopause support. From spring 2027, subject to secondary legislation, publication becomes mandatory. Employers must select at least one action from a government list of menopause support measures drawn from categories covering policy review, manager training, workplace adjustments and occupational health provision.

The action plan is a legislative endorsement of the design argument, applied to a gendered condition. It requires organisations to move away from informal, ad hoc accommodation towards documented, board-approved, publicly visible commitments.

For employers, the practical implications are threefold. First, menopause policies that exist on paper but are not embedded in manager training or absence procedures will not satisfy the spirit of the guidance, and tribunals are increasingly unwilling to tolerate the gap between policy and practice. Second, the action plan framework maps directly onto the reasoning in Ward , and employers would be well advised to expand their audit of sickness absence to include fluctuating, recurring conditions generally, rather than menopause alone. Third, and most significantly, the guidance itself acknowledges that good menopause support benefits employees with related conditions such as endometriosis, fibroids and PCOS, even though those conditions fall outside the formal reporting requirement. That acknowledgement may signal where the next phase of regulatory attention is likely to move.

The case for updating the EqA guidance

One further reform deserves particular attention because it goes to the root of the evidence gap identified above. The statutory guidance issued to assist tribunals in cases relating to the definition of disability was last published by the Office for Disability Issues in May 2011. It has not been substantively updated in 15 years, despite a developing body of case law and, as the DWP’s own research now makes clear, a far more sophisticated understanding of how fluctuating conditions actually operate.

Endometriosis and other specific gynaecological conditions are missing from the current guidance’s illustrative examples of fluctuating impairments, yet it expressly names CFS, a condition with the same defining legal characteristics. That omission leaves claimants, and indeed tribunals, relying on inference where parliament could instead make it explicit.

A petition calling on the government to add gynaecological conditions to the EqA guidance was started by my client, Ms Sanju Pal, on 26 March 2026.^[20] It has already surpassed the 10,000-signature threshold that triggers a formal government response. Whatever its ultimate parliamentary fate, the petition makes the same point as this article: that 15 years of silence in the statutory guidance has left tribunals, employers and claimants alike litigating each gynaecological condition’s legal status individually and from first principles. Updating the guidance to name these conditions, as it already names CFS, would not predetermine any individual tribunal’s assessment of substantiality or longevity. Rather, it would help to better frame discussions about disability adjustments at work, and ensure that the starting point no longer depends on whether a particular condition was medically visible in 2011.

Learning from other jurisdictions, is the UK falling behind?

Spain’s introduction of statutory menstrual leave represents a different policy choice; that some reproductive health conditions warrant specific, generalised recognition rather than individualised proof. The UK has instead typically relied on general disability discrimination law, which requires a case-by-case assessment of functional impact.

There are genuine advantages to the UK’s approach. Not everyone with endometriosis, fibroids or PCOS experiences the same degree of impairment, and the EqA’s evidential framework can, in theory, respond to that diversity with more precision than a blanket leave entitlement. But the weakness of a purely reactive model is structural rather than doctrinal. Recognition under the current framework typically arrives only after conflict. Battle lines are drawn: an employee must disclose her condition, gather and present medical evidence, request adjustments, challenge any refusal, and, if all else fails, litigate, before potentially navigating a parallel battle in the social security system.

The parliamentary petition and the Menopause Employment Action Plan are best understood as two responses, one bottom-up, one top-down, to a cumbersome reactive model. The question is not whether the UK should abandon the EqA’s individualised framework, but whether employers should be proactive in building systems that anticipate fluctuating, gendered health conditions before a claimant is forced to prove her pain in a witness box.

Human rights at work: dignity, participation and belonging

Employment is not simply an economic transaction; it is bound up with identity, autonomy, dignity and the capacity to participate fully in social and civic life. These are themes that deserve far more attention in discrimination practice than they typically get.

Article 8 of the European Convention on Human Rights protects private life, covering physical and psychological integrity, and an individual’s relationship with her own body and health. Article 14 prohibits discrimination in the enjoyment of Convention rights. The broader guarantees of equal participation found in international instruments addressing women’s lives provide a vocabulary that is often missing from domestic disability discrimination doctrine, but which plainly sits directly behind it.

A human rights approach asks a broader question than the one a tribunal applying s6 is required to answer. It is not simply ‘was discrimination proved ’, but ‘were the systems in place designed in a way that allowed this person to participate equally in working life ’. That reframing matters particularly for invisible conditions because exclusion in this context rarely takes the form of an overt, identifiable act. It happens with quiet, steely efficiency; the opportunity not offered because someone is assumed unreliable, the career quietly slowed rather than visibly ended, the talent lost to attrition rather than dismissal. And equally, in the social security context, the benefit refused because the snapshot on which the assessment rested happened to be taken on a good day.

Equality by Design: moving beyond reasonable adjustments

The framework for Equality by Design proceeds from a simple premise: the legal challenge for the future is not about better litigation, but better design. The growing backlogs in the justice system, coupled with the upturn in claims, support this conclusion.^[21] The duty to make reasonable adjustments under ss20-21 EqA remains an essential individual remedy. But it is designed to be reactive, dependent on a provision, criterion or practice which has already resulted in a substantial disadvantage.

Equality by Design asks that the sequence be inverted. Instead of asking what adjustments are needed for the struggling employee, the question becomes, ‘how do we design performance, absence, progression and assessment systems so that variations caused by fluctuating, gendered, chronic conditions are anticipated, rather than treated as an exception.’

In practical terms, that entails employers:

• building performance systems that distinguish capability from health-related variation before escalating to formal process
• training managers to recognise the patterns associated with fluctuating conditions
• reviewing absence trigger policies against the nonlinear pattern typical of gynaecological conditions
• ensuring transparent, documented decision-making in capability processes
• treating the Menopause Employment Action Plan framework as a template for gynaecological and chronic fatigue conditions generally
• exercising real caution regarding the deployment of workplace AI and algorithmic performance tools in the workplace, to avoid encoding the discriminatory assumptions this article has identified.

For the social security system, Equality by Design means taking the DWP’s research findings seriously and developing radically improved assessment tools. A system that creates a structural dependence on appeals as a corrective mechanism, at the expense of those least equipped to navigate them, has clearly failed.

Conclusion: believing pain before litigation proves it; invisible pain and visible rights

Pal v Accenture matters because it sits at the intersection of several conversations that equality lawyers too often conduct separately: women’s health, invisible disability, the future of work, human rights, and systemic design. Read alongside the developing legal authorities, the Menopause Employment Action Plan, the campaign to update Equality Act guidance and the damning social security statistics, it offers a doctrinal answer to a narrower question while pointing toward a larger one.

Pal restates and correctly applies the legal test under s6 and Schedule 1 EqA: that a fluctuating condition need not produce substantial adverse effects at all times, it is sufficient that those effects are substantial when they occur, and assessed across the relevant period as a whole. The law, properly read, already accommodates this case.

The larger question is whether people with invisible, chronic, fluctuating conditions must continue to make themselves visible exclusively through litigation and appeals, or whether the very legal systems supposed to recognise and protect them should be designed to do so from the outset. The substantive point is not whether the test is fit for purpose, but whether the systems for implementation are.

Pal is a useful lens and a compelling argument for better design. The next phase of equality law’s engagement with gendered, fluctuating, invisible conditions will be measured by how far the number of claims brought in both employment tribunals and social security tribunals can be reduced, and by systems properly designed from the outset to better serve the people who actually need them.

_{[1] Pal v Accenture (UK) Ltd [2026] EAT 12.
[2] Pal, at [103].
[3] Pal, at [103].
[4] Pal, at [104].
[5] Pal, at [67-70].
[6] Pal, at [83]-[84].
[7] Pal, at [115]. See also s6 and Schedule 1, paras 2(2) and 5 Equality Act 2010, and Goodwin v Patent Office [1999] ICR 302; SCA Packaging Ltd v Boyle [2009] ICR 1056; Sullivan v Bury Street Capital Ltd [2021] EWCA Civ 1694. For the statutory guidance see Equality Act 2010 Guidance on matters to be taken into account in determining questions relating to the definition of disability (Office for Disability Issues, May 2011), paras B7-B9 (fluctuating and recurring effects).
[8] Pal, at [16].
[9] Centrepoint Soho Ltd v Omaboe UKEAT/0129/17/BA, 30 January 2018.
[10] Mawema v Hertfordshire Partnership NHS Foundation Trust, ET Case No. 3304624/2018.
[11] Foster v Cardiff University UKEAT/0422/12/LA.
[12] Northumberland, Tyne and Wear NHS Foundation Trust v Ward [2019] UKEAT /0249/18/DA, 18 October 2019.
[13] Divers v Balayage Hair and Beauty Salon, ET Case No. 2305075/2019.
[14] Equality Act 2010 Guidance (Office for Disability Issues, (now the Disability Unit) May 2011), paras B7-B9; Schedule 1, para 2(2) Equality Act 2010.
[15] Regulation 7 of the Social Security (Personal Independence Payment) Regulations 2013 (SI 2013/377).
[16] PIP Assessment Guide Part 2: The Assessment Criteria (DWP, updated November 2024), paras 2.1.7, 2.1.27, and 2.2.17 to 2.2.18. DWP Research Report No. 1057, The Impact of Fluctuating Health Conditions on Assessment (October 2024). Research conducted January to April 2023 using a survey of 297 participants, a four-week diary study with 46 participants and in-depth interviews with 49 participants.
[17] DWP Research Report No. 1057, The Impact of Fluctuating Health Conditions on Assessment (October 2024). Research conducted January to April 2023 using a survey of 297 participants, a four-week diary study with 46 participants and in-depth interviews with 49 participants.
[18] DWP, Personal Independence Payment: Official Statistics to January 2026 (GOV.UK, 17 March 2026), award review outcomes following PIP assessment, October 2020 to September 2025.
[19] Government Equalities Office (2025), Gender Pay Gap and Menopause Action Plans: Guidance for Employers (GOV.UK, 4 March 2026).
[20] Add gynaecological conditions e.g. endometriosis to Equality Act 2010 Guidance – Petitions, created by Sanju Pal.
[21] Ministry of Justice Tribunal Statistics, show that single ET claims rose by 54% year on year in Q3 2025/26, while disposals decreased 34% in Q3 2025/26 (compared to the same period a year ago), contributing to a growing backlog.}