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Accessibility

This website is run by the Health and Social Care Information Centre, operating as NHS Digital.  

We want as many people as possible to be able to use our website, and we have designed it to be accessible.

Accessibility

How you can use this website

On this website, you should be able to:

  • change colours, contrast levels, and fonts
  • zoom in up to 300% with text staying visible on the screen, and most images scaling without resolution loss
  • navigate most of the website using a keyboard
  • navigate most of the website using speech recognition software
  • read most of the website using a screen reader, including the latest versions of JAWS, NVDA, and VoiceOver
  • read most of the website on devices without a screen, like a braille computer
  • use the website even if Javascript is switched off

We've made the website text as simple as possible to understand, aiming for a reading age of a 12 year old.   

Some of our content is technical, and we use technical terms where there is no easier wording we could use without changing what the text means.

How accessible this website is

The majority of this website is fully accessible, and we run weekly audits to identify any new problems.

We know that some parts of the website aren't fully accessible:

  • we have a large number of old publication documents which are in PDF format, and haven't been designed for accessibility
  • some content is embedded in our website, such as maps and videos, and you cannot easily scale these on screen (but you can open a full screen version)
  • data visualisation tools in the website currently use inaccessible technologies such as PowerBI and Tableau

How to get information in an accessible format

If you have problems accessing information on this website, or would like any of our work in a different format like a more accessible PDF, large print, easy read, audio recording, or braille:

 

We'll consider your request, and aim to get back to you within 3 days.

Reporting accessibility problems

We're always looking to improve the accessibilty of the website.

If you find any problems which aren't listed on this page, or think that we're not meeting the requirements of the accessiblity regulations then please email web@nhs.net to let us know.

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing the accessibility regulations. If you’re not happy with how we respond to your complaint, contact the Equality Advisory and Support Service (EASS).

Technical information about this website's accessibility

The Health and Social Care Information Centre is committed to making its website accessible, in accordance with the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018.

This website is partially compliant with the Web Content Accessibility Guidelines version 2.1 AA standard, due to the non-compliances listed below.

Issues with technology

The vast majority of our website works correctly on any web technology.

For security reasons, we only support TLS 1.2 and higher security protocols, and this means that some older browsers will not show the site.

How our site looks and work is based on HTML5, and we test for and support the following browsers:

We also test in the Lynx browser to ensure that the site renders correctly for non-screen users.

You may experience unexpected behaviour in other browsers, although we use fully validated code which should work on any browser.

Issues with links

We are aware of the following issues within the links on our site:

  • some link text doesn't make sense when read on its own (for example 'click here')
  • on some pages there are multiple links with the same link text but different destinations on one page
  • many older PDF files contain broken links which do not resolve - we do not intend to resolve these as it is a disproportionate burden for files which are no longer in active use

We scan the site weekly for broken links, and look to fix them as soon as they are identified.  

The content team are working through the links which don't make sense on their own, and we aim to have fixed these by August 2019.

Issues with PDFs and other documents

PDFs are not able to comply with the requirements of the web accessibility standard, and we do not generally upload new PDFs. Where we do create new PDFs, we use the PDF/A standard which is more accessible.

Our site contains a large number of PDFs created in previous years, especially in our data and information publications.   

Where these are no longer being updated, we do not intend to recreate them in accessible versions as this would be a disproportionate burden. The accessibility regulations don’t require us to fix PDFs or other documents published before 23 September 2018 if they’re not essential to providing our services. 

By September 2020 we intend to have completed the process of converting PDFs and word documents still in active use into accessible web formats.

We do not generally add new PDFs to our site. There are some exceptions:

  • we add some PDFs as downloads of reports or publications, but where a web page version is also available
  • our annual reports, which must, by law, be laid before parliament in a printed version, and then appear unaltered
  • our directions and data provision notices which must, by law, include a signature in order to be valid
  • downloads intended for print purposes, such as posters

We also have a number of forms in Microsoft Word format, which are not accessible. We will either replace these with accessible HTML forms, or remove them, by September 2020.

Known word document forms
Word document forms
Word document form On web page
HSCN Internet Access form HSCN Technical guidance
Subject Access Request form How to make a subject access request
FGM Enhanced Dataset CAP user registration form FGM datasets Health professionals and NHS organisations 
Change request form 

Request changes to national GP IT systems

Organisation code request form

Generic medicines and special medicinal products (quarterly information)

Subject access request form  

How to make a subject access request

Accessibility

GDPR register 

Implementing Child Protection - Information Sharing (CP-IS) using the Summary Care Record application Implementing CP-IS using the Summary Care Record application
Short_form_PID_template_v1 (1).docx Paper switch off implementation pack
Hull and East Yorkshire paper rejection proforma Paper switch off implementation pack
Direct award order form

N3 overlays replacement guidance

Short form further competition order form  N3 overlays replacement guidance
Order form - general further competition N3 overlays replacement guidance
OC1 registration ODS download our forms
Organisation code request form  ODS download our forms 
Maternity Services data user certificate Strategic data collection service in the cloud 
Mental health services data user certificate Strategic data collection service in the cloud 
NPID user registration form

National pregnancy in diabetes audit

NPID data collection form National pregnancy in diabetes audit
NPID data collection form no consent National pregnancy in diabetes audit
NACR user registration form National audit of cardiac rehabilitation 
BCIR user registration form Breast and cosmetic implant registry
NBCA user registration form National bowel cancer audit
NOGCA user registration form 2018 National Oesophago-Gastric Cancer Audit
Data destruction form

Data dissemination - the Data Access Request Service team

Data Access Request Service (DARS): process

 

Clinical audit platform user registration form National diabetes audit 
Summary Care Record additional information form  Additional information in SCR
Vouching request form  Digital Redbook pilot tookit 
Digital Redbook authority to proceed form  Digital Redbook pilot tookit 
Disconnecting child health record form Digital Redbook pilot tookit 

HSCN internet access request form

HSCN internet access issues guidance

HSCN technical guidance
Health and Social Care Network  

 

 

Sandpit access request form  Set up NHS Identity's Sandpit Environment
User registration form  Breast and Cosmetic Implant Registry

Issues with images and video

We strive to make all of our content accessible. We are aware of the following issues with images and video on our site:

  • Video content uses automated closed captioning and transcripting, and this is often inaccurate. By September 2019 we will review these captions and ensure their accuracy manually.
  • Some of the images on our site are complex diagrams where suitable alt text is not possible. A list of these images is below. By September 2020 we intend to have reviewed all of these images, and where possible will have converted them to accessible format such as SVG, used a different visualisation method, built the visualisation in HTML5, or added detailed description text to the page
Known images with accessibility problems
Inaccessible images
Page containing inaccessible images Type and description
HSCN Quality of service overview Technical architecture illustrations
GP Connect specifications for developers Specification illustration
7 facts for 7 decades of the NHS Infographic
Our staff networks Timeline
Commercial and behavioural principles Principles diagram
Detailed specification for NHS Digital Reference Data Registers Future enhancements table
ITK Use of FHIR based APIs Interoperability status
Clinical information standards Several roadmap and vision images
Our workforce demographics 2018 Infographics (with alt text)
Birth Notification Application Quick Reference Guide Flow chart
Care Integration and Orchestration Architectural diagram
Clinical safety management Flowchart
Data Registers Service: supporting information Lifecycle diagram
Harnessing digital technology in maternity services Workstream goals diagram
EPS Guidance for developers: Electronic Prescription Service overview Architectural diagrams and operational flowcharts
EPS: Guidance for developers: Electronic Prescription Service (EPS) identifiers  Identifier design
ERS the future of the NHS e-referral service Roadmap
Falsified Medicines Directive Implementation Toolkits Process flows and various others
Falsified Medicines Directive GP Practice Toolkit Decision tree
Falsified Medicines Directive Out-of-hours GP Toolkit Decision tree and scope
Falsified Medicines Directive Secondary Care Toolkit Decision tree and options
Falsified Mediciness Directive Community Pharmacy Toolkit Decision tree and options
Social care DMS - additional messaging guidance Tables
HSCN/Transition Network DNS Architectural diagrams
HSCN QoS change requests Architectural diagrams
HSCN connectivity options Architectural diagrams
HSCN troubleshooting Architectural diagrams
HSCN Maintaining access to internet services after migrating to HSCN Architectural diagrams
HSCN private IT service provider connecting from outside England's borders policy Architectural diagrams
HSCN internet access issues guidance Architectural diagrams
HSCN N3 overlays replacement guidance Architecural diagrams
HSCN Types of remote access solutions Solutions illustration
HSCN Transition Network DNS Architectural diagrams
HSCN Microsoft DNS servers basic forwarding configuration Architectural diagrams
HSCN Test processes - HSCN consumer Screenshot labelling
HSCN Connecting to HSCN Decision tree
HSCN an introduction for social care Roadmap
HSCN customer journey for customer led procurements Roadmap
HSCN customer journey for aggregated procurements Roadmap
HSCN Private sector organisations: migration advice Roadmap
HSCN consumer handbook overview Architectural diagram
HSCN Consumer handbook: live HSCN Architectural diagram
HSCN consumer handbook: incident handling Architectural diagram
Indicator Governance Board - Chair's report 2017/18 Graphs, process flows
ITK Release 2.2 Architectural diagrams
Mobile technology investment toolkit: important considerations Flow diagrams
Mobile technology investment toolkit: Innovative use of mobile technology Flow diagrams
Mobile technology investment toolkit: Important considerations Flow diagrams
Public Key Infrastructure (PKI) documentation Architectural diagram
ERS: The future of the e-referral service Architectural diagram
ERS Processing Did Not Attend referrals Flow diagram
ERS Clinical Assessment Services (management) Flow diagram
ERS Restricted Services Supporting Alternative Care Pathways Flow diagrams/decision trees
NHS Identity: Set up NHS Identity's Sandpit Environment Decision trees, flow diagrams
NHS Identity: Requirements for NHS Identity Information table
NHS Identity: Using NHS Identity - process Decision trees
NHS Identity: Self-discovery Decision trees
NDOP: compliance implementation guide Flowcharts
ODS 2019 changes to regions Maps with text, org chart
ODS creating a baseline Architectural diagram
ODS ORD API implementation guide Architectural diagram
Path to live: Connect to a Path to Live environment Flow diagram
SMSP: Stage 1: Getting started quick start Architectural diagram
SMSP: Compliance process Flow diagram
SMSP Guidance and technical resouces for suppliers and end users Flow diagram
SMSP: Connecting to Personal Demographics Service via the spine mini service Flow diagram
Data Access Request Service (DARS) performance reporting Graphs
Blog: So, what is a Local Health and Care Record anyway? Infographics
DIS: Mental health team Team plan
DIS: The future of data, insights and statistics Architectural diagrams
DIS: Data, insights and statistics overview Architectural diagrams
DIS: Emergency care team Team plan
DIS: Primary care team Team plan
DIS: Secondment information pack - Adult Social Care Statistics Map
GPSOC: Pairing integration Architectural diagram
Fit for 2020: Developing our workforce to respond to demand Map
GPSoC agreements Flow diagram
HSCN IPv6 Architectural diagram
Fit for 2020: Appendix 1 - the Capability Review Roadmap
Fit for 2020: Modernising our delivery model Map
Fit for 2020: NHS Digital - our role in the health and care system Table
Fit for 2020: Appendix 2 - workforce planning Graph
HSCN Important protocols and methods Architectural diagram
ODS: APIs for the Organisation Data Service Architecural diagrams
NHSMail The benefits of NHSmail Service diagram

Issues with text and content

There are some issues with text and content which we are aware of:

  • some tables imported to the website do not have the correct header markup. We will resolve this by August 2019.
  • not all of our content reaches our target reading age of 12 years old. We are resolving this as content comes up through its review cycle, and this should be largely complete by September 2021.
  • some of our page titles are long, causing a technical fail on descriptive titles for web pages which requires titles to be short. In most cases, this is related to legal or formal names for publications. We are not going to fix this, as the content is still understandable, and changing titles might cause compliance issues.

Issues with interactive tools

We are aware that we have PowerBI and Tableau visualisations available on the website. Neither of these software items are accessible, and cannot be made accessible. In some cases the information is not easily available to users in an accessible format. We are currently investigating accessible visualisation tools. If you require information from these tools, then please contact us.

Pages with inaccessible interactive tools

How we test this website

This website undergoes automated testing against the W3C WAI Web Content Accessibility Guidelines version 2.1 using the automated Sitemorse tool weekly. This tool scans 100% of our web pages, and tests against all the criteria in the guidelines which are possible to automate.

The weekly report is reviewed by the website development team, with any actions taken and prioritised into our future work. We aim to fix all high priority issues with one week of them being identified.

In addition, we conduct internal testing against known accessiblity issues which are not able to be found through automated testing, on a sampled basis. We last conducted an accessiblity check on these areas in June 2019.   

Download the data for this chart
About this chart

This chart shows the compliance as measured by our automated testing tool, Sitemorse against the A, AA, and AAA standards of the WCAG 2.1 specficiation.

Each standard has its own points of compliance, so those scores are shown separately. 

However, you cannot claim a higher standard if you do not meet the lower ones, which means that the number of pages meeting AA or AAA is limited to the number of pages also passing the A standard.

What automated testing tells us

We use automated testing to drive most of our improvements to accessibility on the site.   

Automated testing can't find everything that could be improved, but is rarely wrong about what it does find.  

This means we have fixed tens of thousands of accessibility problems which manual checking would have missed.

We do also undertake manual testing,  including testing with real users with accessibility needs.   We follow best practice across the industry, and try to keep up with the latest techniques for making our site accessible.

Accessible features we test manually

There are a number of accessiblity features which we test manually, which include:

  • colour contrast, which is done at design stage by using tools to check we meet the AAA standard of a contrast ratio of 4.5:1
  • skip links, which feature across the site
  • suitability for cognitive disablility, including aiming for a reading age of 12
  • manual check against the W3C validator
  • ensuring that page elements render correctly at all sizes, including when zoomed to 500%
  • assessing content for readability using a mixture of tools which use mathematical methods to assess readability, and manual expert checking
  • checks of colour contrast
  • examining microdata markup and alt text using special tools
  • checking content in a text-only browser
  • using screen readers to read text aloud
  • using disability simulation tools to browse the website

What we are doing to improve

We are actively looking to improve the accessiblity on our website.  

The improvements below have been identified on our current work schedule.

Accessibility improvement roadmap
Target date Item of work Type of work Status
August 2019 Finish removing unclear links, like 'See more' Content Ongoing
May 2019 Remove deprecated markup from tables, in order to pass validation Developer Backlog
June 2019 Change background colour of website to grey in order to better serve dyslexic users Developer Backlog
Last edited: 12 September 2019 3:43 pm