Making digital communication accessible for every person in north east London

We say the NHS is for everyone. But is that true if someone can’t access or understand our communication?

What do we mean by “accessibility”?

Accessibility goes beyond making things “disability-friendly”. It means making sure people understand everything we share; whether on a web page, social post or a document.

This means:

• content that’s easy to read
• design that works with screen-readers or assistive technology
• factoring in someone has a condition like a visual impairment, is neurodiverse, or uses British Sign Language (BSL).
• formats that don’t exclude non-native English speakers or people with low literacy skills.

In recent years, we have twice been assessed by the Government Digital Service to ensure our website meets a minimum standard of accessibility.

For us, accessibility is both a legal duty and a moral imperative. If we fail, we not only risk fines under the Equality Act but, more importantly, we risk excluding the very people who need help most.

Our local context

In England, 42% of working-age adults struggle with everyday health information, and that figure rises to 61% when numbers are involved. Add to that the many people who are deaf or hard of hearing, blind or partially sighted, use BSL, or speak English as a second language and you can see the scale of the task.

In north east London we serve a diverse population, yet one with considerable health inequality challenges. Our communications must meet people where they are and not expect people to change to meet them.

How we learned

Over the past few years my digital communications team (including the brilliant Bethany Hankinson-Neal and Holly Garner) have devoted time to building our knowledge and embedding inclusive design. We completed training (including learning from Scope, content design training and health inequalities training), explored the Care Quality Commission Accessibility Hub, and visited Google’s Accessibility Discovery Centre to see accessible design in action.

It was incredible to see how Andrea James the rest of the team at the CQC, were dedicated to helping their staff reach their potential by proactively tackling accessibility issues. As an organisation, we hope to continue to learn from them to ensure all our staff can work to the best of their ability and use assistive technology to help them do this.

It was encouraging to meet the wider accessibility community, learning from people like Leanne Newell ACMI who help to implement accessibility every single day.

We were invigorated seeing how Google are using the latest technology to help patients. When they gave us a tour of their London office, Hans Zimmermann and Praneeth Reddy Chada explained how they prioritise progress over perfection to help as many people as possible.

We were inspired by how they test features with specific groups like the d/Deaf community, people with sight loss, neurodiverse users and many others. There are some exciting new developments regarding AI, and we want to use them to help more people read and understand healthcare information.

Turning learning into results

When we wanted to “improve how accessible we are”, we set out measurable goals and adopted an iterative, insight-driven approach, improving our tools, guidance and content through continuous testing and user feedback.

This included:

• creating templates, content guidelines and crib sheets rooted in plain English principles, targeting a reading age of nine, and training colleagues across the organisation in content design and accessibility best practice to ensure a consistent minimum standard.
• improving the accessibility of our external website, ensuring content meets WCAG 2.2 standards and is fully navigable for users relying on assistive technologies such as screen readers.
• embedding co-design and continuous improvement, working directly with residents and internal staff networks to co-produce and user test content, ensuring lived experience and audience insights shaped our decisions.

Five quick-wins for inclusive communications

You don’t need to be a digital accessibility expert to make a difference. Here are five simple steps:

1. Use plain English: aim for a reading age of around nine.
2. Break long text into short sentences and headings.
3. Avoid jargon (especially NHS jargon!), italics and ALL CAPS.
4. Prefer HTML pages over PDFs, and ensure uploaded documents are tagged for assistive technology.
5. Add captions to every video.

These steps might seem minor, but they can transform the experience of someone who is usually overlooked.

Why it matters

Accessibility reflects the core values of the NHS: fairness, inclusion, compassion.

When someone cannot access or understand our information, we risk leaving them behind. In doing so, we widen health inequalities rather than close them.

Our journey so far has shown what’s possible when the question isn’t “Can we make this accessible?”, but “What would inclusion look like?”

Now our challenge is to build upon this so that every person in north east London, regardless of language, background, ability or digital access, can engage fully with the care and services they need.

Next steps

We are excited to embark on innovative projects to harness the latest technology, including incorporating AI on our website so BSL readers can access our content in their native language.

We hope our story will help other communications practitioners ask stronger questions, learn from lived experience and build truly inclusive services.

For any questions or to discuss how we’re doing this in practice, please get in touch.

Joseph Groszewski, Digital Communications Lead, NHS North East London