By 31st July 2016, all NHS and adult social care providers across England are required by law to meet the requirements of NHS England’s Accessible Information Standard (external link, opens in new window).
We’ve produced a special guide to explain your rights in relation to the Standard – and how to take practical action to make sure your GP, and other NHS services, meet these requirement.
We’ve also produced separate guidance for residential care homes.
What is the Accessible Information Standard?
NHS England’s Accessible Information Standard provides clear guidance, for NHS and publicly funded, adult social-care providers in England, on how to make their services accessible for people with disabilities and sensory loss, including people who are deaf or have hearing loss.
The Standard establishes a clear administrative process for providers to follow, to make sure people with disabilities and sensory loss can contact them when they need to, communicate well during appointments and understand any health information and correspondence they’re given. It takes into account the needs and entitlements of parents, guardians or carers.
If you have a disability and/or sensory loss, NHS and adult social-care providers must follow five steps to meet the requirements of the Standard, in order to make sure that you can fully access their services:
- Providers must ask you if you need help to contact them, communicate well or to understand letters or health information.
- They must record your communication and/or information needs in a standardised way so that they know how to support you without you having to request support each time you visit them or receive treatment and/or care. For example, if you cannot use the telephone and require an accessible alternative such as email or SMS text.
- They must ensure your communication and/or information needs are highly visible or linked to an electronic alert on your care record so they know when to take appropriate action. For example, to make sure a British Sign Language (BSL) interpreter is booked ahead of your check-up.
- They must share your communication and/or information needs if they refer you to another service, for example, a hospital specialist.
- They must ensure one or more accessible contact and/or communication methods are available for you to use, if you need them. For example, SMS text or Text Relay if you can’t use the telephone – and/or access to a BSL interpreter during your appointment.
How will the Standard help me?
People who are deaf or who have hearing loss frequently tell us that they struggle to access their local GP or other NHS services.
If you’re deaf or have hearing loss you may find it difficult – or impossible – to use the telephone to book an appointment or receive test results. You may benefit from other contact options such as email, SMS text or Text Relay.
During your appointment, you may struggle to understand what is being said if health professionals or other staff members don’t speak clearly – or if it’s difficult to read their lips. If you use hearing aids, you’d probably benefit from a hearing loop system but these aren’t often provided.
If a BSL interpreter isn’t booked in advance, people who use BSL may leave their appointment unclear about their health, leading to confusion over their diagnosis – and to less-effective treatment.
Our research shows that inaccessible healthcare is a real problem. Our Access All Areas report shows that one in seven (14%) of those who responded to our survey missed an appointment because they didn’t hear their name being called in the waiting room. After their appointment, more than a quarter (28%) said they didn’t understand their diagnosis and one in five (19%) were unsure about their medication. The situation is even worse for BSL users; around two-thirds (68%) who asked for a BSL interpreter didn’t get one.
The Accessible Information Standard aims to change this and make sure people who are deaf, or who have hearing loss, get the support they need to communicate, when they need it. The Standard makes clear that people should be able to decide for themselves what support they need, and sets out a clear administrative process to make sure this support is provided.
This guidance focuses on GPs and other NHS services. We’ve also produced guidance on how the Standard may help older people who are deaf or have hearing loss living in residential care homes.
What do I need to do?
Under the Accessible Information Standard, your GP or other NHS service must ask you when you next visit them or book an appointment if you need help to contact them, to communicate well during appointments or to understand letters or health information.
You should only be asked about this once, as the Standard states that GPs and other NHS services must record your requirements and anticipate the support you need when you next visit.
They’re legally obliged to do this, but we’ve created some resources to help you nudge them along. You may also want to contact them yourself – and let them know what support you need to help you communicate – especially if you haven’t had an appointment for a while. Taking action now will ensure they know how to support you from 1 August – when the Standard becomes a legal requirement across England.
A good place to start is to contact your GP to ask them to record your needs. This should also ensure your needs are shared with other services if you’re later referred elsewhere for treatment and/or care.
If you’re unsure about the support you may need, our factsheets and leaflets provide more information on the communication support, equipment and other support people who are deaf or have hearing loss may need to help them communicate.
You can contact your GP in one of two ways:
A template letter for you to fill in and send to your GP Practice Manager to formally notify your GP about the different forms of support you may need. You can search for the address of your GP here (external link, opens in new window).
- A card which you can print out, tick the boxes that apply to you and give to the GP receptionist in person. You can request a printed copy of the card by contacting our Information Line. The card is also available for download in Microsoft Word format.
We realise that both the letter and the card use fairly technical language, but this is deliberate: it’ll help your GP take the appropriate action. You don’t need to fill out both –and please don’t contact your GP twice. This may cause confusion and lead to your information being recorded incorrectly.
The template letter and the card already list the common forms of support people who are deaf or have hearing loss may need. If you need other forms of support – if you’ve got other disabilities and/or sight loss, for example – and need information in large print, Braille or EasyRead, add this to your letter or card or discuss it with your GP.
Find out more about the different forms of support available for people with sightloss (external link, opens in new window), deafblindess (external link, opens in new window) or learning disabilities (external link, opens in new window).
If you need support from a communication professional or advocate to notify services about your needs; for example, if you need support from a BSL interpreter, this should be arranged by your GP or other NHS service.
What happens next?
Once your requirements are recorded, your GP and other NHS services are responsible for meeting your communication and/or information needs – and for sharing these with other services if you’re later referred elsewhere for treatment and/or care, in line with Data Protection requirements.
You can also ask your GP to include information on your communication and/or information needs in the ‘additional information’ section of your Summary Care Record (SCR). This means that other health professionals will be able to access information on your needs if you’re visiting an urgent care centre or are admitted to hospital.
The Standard makes clear that GPs and other NHS services are responsible for meeting the costs of support and that support must be provided “promptly and without unreasonable delay”.
Please note that, if you require support from a communication professional such as a BSL interpreter, speech-to-text-reporter or notetaker, GPs and other NHS services are obliged to use professionals with the appropriate qualifications.
The best way to do this is make sure they’re NRCPD-registered (external link, opens in new window). GPs and other NHS services should be aware of this, but if not, you could request an NRCPD-registered professional for your appointment. The Our Health in Your Hands campaign has information on how to identify an NRCPD-registered professional.
The Standard makes clear that family and friends must not be used instead of professional communication support unless you explicitly ask for their help to communicate.
What if my GP or other NHS services refuse to identify or record my needs or provide appropriate support?
NHS England’s Accessible Information Standard is a legal requirement under section 250 of the Health and Social Care Act 2012.
GPs and other NHS services should be asking you already if you need help to communicate or understand written information and appropriate support must be provided by the 31 July.
If you’re unhappy with the response you receive, you could raise the issue with your GP or other NHS service. We have produced guidance to help you give feedback or make a complaint. If you’re a BSL user, the Our Health in Your Hands campaign provides detailed guidance on how to make a complaint
The Standard states that processes should be in place to make sure people who are deaf or have hearing loss can feed back about services in a way that’s accessible to them and provide appropriate support if necessary, such as a BSL interpreter.
We’d love to hear about your experiences – good or bad! Please email email@example.com (opens in new window) or contact our Information line:
Telephone: 0808 808 0123
Textphone: 0808 808 9000
SMS: 0780 0000 360
Email: firstname.lastname@example.org (opens in new window)
Resources and support
When you need to see a GP – guidance for patients and GPs
Access All Areas
Access to Health Policy statement
NHS England’s Accessible Information Standard (opens in new window, external link)
CHANGE's Easy Read guide to the Accessible Information Standard (opens in new window, external link)
Sense's Equal Access to Healthcare report (opens in new window, external link)