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Accessibility in digital tools and services

The NHS is for everyone, and those of us designing digital services for the NHS have a responsibility to ensure that everyone can access them. Find out what we are doing to ensure that our digital tools and services are accessible.

By Dean Vipond, 5 April 2018


Accessibility can mean all sorts of things, from ensuring buildings can be used by wheelchair users, to providing printed material in different languages. But there are also lots of things we can do to ensure digital tools and services can be used by people with a range of access needs.

It is easy to assume that work like this should be the job of researchers, designers and developers, but it is everyone’s responsibility to make our services accessible.

Accessibility is a complex field and it can be difficult to know what to do, if you are doing it right, and whose responsibility it is. For digital tools and services, it is possible to ensure they can be used by people with, for example, visual impairments, problems with movement, trouble reading and understanding information, and many other things.

Recently, we arranged for a newly-formed project team (made up of project managers, analysts, designers, developers and more) to attend training, to understand how everyone can contribute to making accessible services.

We were lucky to have Chris Bush from accessibility specialists Sigma, and accessibility consultant Molly Watt, come to Leeds and explain what accessibility means to people.

Molly has Ushers Syndrome, which means she has very limited vision. Imagine looking at your phone, and only being able to see a little more than one app icon at a time – that’s a bit like what Molly experiences. She also uses hearing aids, as she has reduced hearing. She gave us a fascinating insight into what it means to live with these conditions, and how technology helps her live the life she wants to. It was so important for us at NHS Digital to hear this, and understand how Molly uses the technology at her disposal. She also reminded us that whilst she has certain access needs right now, we will all, as we grow older, develop more complex access needs. Designing for accessibility means designing for everyone, eventually.

Accessibility has a lot of detailed guidelines, and Chris stressed the importance of approaching things from the point of view of the user’s experiences and needs, rather than mere compliance. It is one thing to design a ‘compliant’ service, and another to ensure you’ve made a service that helps people with unique needs. Quite often, approaching design for better access can result in something that benefits everyone.

After the initial presentation, we had some practical sessions, looking at the accessibility features found on smartphones and computers. Screen readers are software that reads out the contents of a web page. They allow people with visual or cognitive impairments to listen to a web page or app and use a keyboard or the device’s touchscreen to interact. Many websites and apps can get this wrong, so we examined some best-in-class examples (and some poorer examples). This was a good way of learning the software, whilst also seeing what simple things websites, including our own, can do to make it easier to interact in this way. Writing sentences a certain way, coding the website so a screen reader reads it out logically, designing the site’s structure in a simple way, all help make sites accessible.

During this session, we also got to try on special glasses that simulate Molly’s condition, and also some gloves which restrict your fingers’ movement. This helped you understand how tricky simple interactions might be for some people.

This training was important for a number of reasons. Firstly, to bring an entire team together in understanding why accessibility has to be considered right at the start of new projects. Secondly, to break down some of the preconceptions about accessibility, that it is just the responsibility of a couple of team members, and that it is a dry, technical subject. Thirdly, that everyone on the team now has the skills to test something and easily pinpoint things that we could do to keep making things easier for everyone.

Thanks to Chris for his in-depth technical knowledge and for presenting it in a simple and approachable way. Thanks to Molly for her honesty and her contagious passion for making simple, accessible services.

And last of all, thanks to Bella, Molly’s guide dog, for being a very good girl.

Molly guide dog

Last edited: 25 September 2018 8:02 am