Our reports suggest only the adjustments we consider necessary for effective working and compassionate support, based on need rather than wish – and with a vigilant eye to cost-effectiveness. We have detailed knowledge of workplaces and the physical and ergonomic adjustments which employees find most effective. Most of the adjustments we recommend are low cost and we question assessors who recommend costly but un-evidenced adjustments. High cost chairs are rarely justified while perching stools and height-adjustable desks can be surprisingly comfortable and cost effective – allowing longer hours of work and higher levels of productivity. We recommend only keyboards and mice which we have used and have stood the test of time. We recommend a phased return to work only where the employee is currently unfit for full hours/shifts and where they are likely to be fully fit at the end of the phasing in period. Long absence alone is not a reason to support a phased return.