The NHS accessible information standard

NHS and social care organisations in England must comply with the new NHS accessible information standard in full from 31 July 2016, Martin Hodgson explains.

Compliance with the standard is a statutory duty under s.250 of the Health and Social Care Act 2012.

What is the new standard for?

The aim of the accessible information standard is to ensure that people who have a disability, impairment or sensory loss have adequate access to information about their treatment and care. It seeks to ensure that they get the information they need in a form they can understand, and that they receive any communication support that they need.

The accessible information standard includes making sure people get information in different formats if they need it, for example in large print, braille, easy read or through email. It also tells organisations how they should make sure that people get any support with communication that they need, for example support from a British Sign Language (BSL) interpreter, deafblind manual interpreter or an advocate.

The information standard includes information that is provided to NHS patients, social care services users, and to carers.

Why was the standard introduced?

The standard was introduced because, despite the existence of equal rights legislation such as the Equality Act 2010, in reality many patients and service users continue to receive information from health and social care organisations in formats which they are unable to understand. In addition, they do not receive the support they need.

Not having access to information puts someone at a substantial disadvantage when it comes to accessing health or social care services, and such a failure can have serious implications for some people, including:

  • preventing them from making informed decisions about their health and wellbeing, and about their care and treatment

  • preventing them from self-managing their conditions and accessing services appropriately and independently

  • affecting their ability to provide or withhold consent.

The failure also contravenes the law.

The Equality Act places a legal duty on all service providers to make “reasonable adjustments” in order to avoid putting a disabled person at a disadvantage when compared to a person who is not disabled. It specifically states that the provision of information in “an accessible format” is included in this requirement.

Who must follow the accessible information standard?

Compliance with the standard is required by all organisations in England that provide NHS or adult social care services, including NHS Trusts and Foundation Trusts, and GP practices. Commissioning organisations for NHS and adult social care services must also make sure that they support the standard.

What does the accessible information standard tell organisations to do?

All applicable organisations must have an accessible communications policy in place, and publicly available, which outlines how they comply with the standard, including how people’s needs are met.

The intention of NHS England is that the provision of “accessible Information” will become part of “business as usual” for all applicable organisations.

As part of the accessible information standard, organisations that provide NHS or adult social care must do five things.

  1. Ask people if they have any information or communication needs, and find out how to meet their needs.

  2. Record those needs clearly and in a set way.

  3. Highlight or flag the person’s file or notes so it is clear that they have information or communication needs and how to meet those needs.

  4. Share information about people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so.

  5. Take steps to ensure that people receive information which they can access and understand, and receive communication support if they need it.

The identification of patients’, service users’ or carers’ information and communication needs, where they relate to a disability, impairment or sensory loss, requires a consistent approach within health and social care organisations. Organisations must review their needs assessment practice and ensure that appropriate policies, procedures and training are in place. All staff should be made aware of the implications of the standard and should know how to ensure compliance.

Policies, procedures and systems should also be in place for the consistent and routine recording of any needs that are identified. Recording methods should ensure that the information is “highly visible” to staff. Needs should be appropriately “flagged” through the establishment and use of electronic flags or alerts — or their paper equivalents — to indicate that an individual has a recorded need. Such “flags” should prompt staff to take appropriate action or should trigger the auto-generation of information in an accessible format from information systems.

Individuals’ information or communication needs should be included as part of data-sharing processes between organisations and should be a routine part of referral, discharge and handover processes.

All GP practices must make sure that their information technology systems enable compliance with the standard.

NHS England implementation guidance states that all GP practices using a patient record or clinical management system from a supplier who is part of the GP Systems of Choice (GPSoC) should be able to record individuals’ information and communication support needs in line with the requirements of the standard.

Implementation Schedule

The new accessible information standard was originally agreed in June 2015. All organisations that provide NHS or publicly funded adult social care were given the following implementation schedule:

  • organisations should have started to prepare for implementation by September 2015

  • by 1 April 2016 organisations should have had systems in place to identify and record information and communication needs with service users at their first interaction or registration with their service and as part of ongoing routine interaction with service users

  • by 31 July 2016 organisations must have fully implemented the accessible information standard and conform to it.

In addition to their accessible information policy, all organisations to whom the law applies should have an implementation plan in place and a means by which compliance will be assured and measured.

The health and social care regulator in England, the Care Quality Commission, has confirmed that it will look at evidence of how services implement the accessible information standard during future inspections.

Further information

More information about the accessible information standard, including the standard specification, an implementation plan and an e-learning package, is available on the NHS England website.

The Information Standards Notice which is the formal document which tells organisations that they must follow the standard is published on the Health and Social Care Information Centre website.