Designing for inclusion: What we learned at Google

Digital exclusion is one of the key factors of inequality in health. It intersects closely with poverty, education, ethnicity, and age. This is why, through the NHS Framework for Action on Digital Inclusion, and the Core20PLUS5 approach, coupled with digital design maturity, we’re committed to ensuring that digital transformation reduces – not reinforces – health inequalities.

We’re looking beyond our own sector for models of good practice. Google’s Accessibility Discovery Centre (ADC) in London which inspired our own Accessibility Lab, offers one such example. While the ADC isn’t a health facility, the ethos behind it – creating immersive environments to better understand the needs of people with disabilities – reflects values we’re embedding across the NHS.

We’ve applied similar thinking through the creation of our own Accessibility Lab in Leeds. The lab provides an interactive space for staff to explore assistive technologies, understand barriers faced by people with disabilities, and carry out basic accessibility checks. It plays a vital role in supporting teams to build more inclusive, user-centred services from the outset.

The ADC brings together assistive technologies designed to support a wide range of access needs, including vision, hearing, mobility, speech and cognitive processing:

• live speech-to-text transcription helps people with hearing impairments follow real-time conversations, including in clinical settings
• Augmentative and Alternative Communication (AAC) boards enable non-verbal individuals to express their health needs
• braille displays and screen readers make platforms like the NHS App accessible for visually impaired users
• voice and gesture navigation supports people with limited dexterity in navigating digital content

These technologies are developed in partnership with organisations such as the Royal National Institute of Blind People (RNIB), the Royal National Institute for Deaf People (RNID), and individuals with lived experience. This model of co-production mirrors the user-centred approach we have embedded within NHS digital programmes.

Digital transformation is one of the government’s 3 major shifts: moving services from analogue to digital to improve access, efficiency and responsiveness. In line with this shift, digital tools are playing an increasingly central role in how people engage with NHS services.

But while digital services offer new opportunities, they must be designed inclusively. Without this, some people – particularly those with learning disabilities, sensory impairments or limited digital confidence – may face significant barriers. Inaccessible digital design doesn’t just create inconvenience; it risks deepening existing inequalities in access to care.

That’s why the NHS Framework for Action on Digital Inclusion makes clear that while digital services should be expanded, non-digital options must always be retained to ensure fair and equitable access for all.

There are already promising efforts across the NHS to tackle this. Inclusive design principles, user research and service design show that offering alternative routes is vital to equitable digital healthcare. For example, local libraries in Somerset – working with NHS partners – are training staff to help people navigate the NHS App.

Inclusive design is not simply about compliance – it’s about compassion, capability, and meeting people where they are. 

We must continue to learn from and work with those outside traditional healthcare – whether in tech, education or civil society – who are innovating in inclusive design. And we must bring those insights into our commissioning, service design and workforce training.

The ADC reinforces 3 key NHS design principles:

People with lived experience must be co-creators, not just end users. Inclusion can’t be retrofitted.

The ADC was built in partnership with disability organisations. We must continue to mirror this approach across NHS systems – working with local authorities, Voluntary, Community and Social Enterprises (VCSEs), and patient groups.

Digital innovation is powerful, but only if it reduces barriers. If it doesn’t, it risks reinforcing them.

Inclusive design is not a peripheral issue – it is central to the NHS’s commitment to equitable care. It isn’t about special adaptations; it’s about making systems work for everyone. Neither the NHS nor organisations like Google have all the answers – but by learning from one another, and from the communities we serve, we can build better, fairer digital services.