RNIB (The Royal National Institute of Blind People) asks why in a world in which we routinely receive text message confirmations for everything from a hair appointment to a dinner reservation, can we not receive our health information in an accessible format as well?
All too often in health and social care, it can appear that making a meaningful difference to patient outcomes requires major investment of resources, or significant structural change.
It can seem like an almost insurmountable task. Imagine if you could focus on one aspect of the patient experience, and in doing so, potentially deliver improvements in attendance at appointments, treatment adherence, medicines safety, public health messaging, health inequalities, access to screening services and early diagnosis, patient centred care, consent, advance care planning, and patient dignity and autonomy. These are just some of the benefits of investing in accessible health information.
“As a blind person, I believe the one thing that makes the most difference to my independence as an adult man living in Northern Ireland today is, access to information in a format that works for me. Sometimes that’s accessible websites, sometimes that’s services that will email or text you, instead of inaccessible print and, sometimes, it’s just asking the question, what would work for you?” This was the view of one individual who contributed to RNIB Northern Ireland’s Community Report in 2020.
The sight loss community was clear then and remains clear now, that sending notification of health appointments by text, email or large print letter, would be simple, but highly effective solutions to address the ongoing issue of inaccessible health communication. Indeed, in a world in which we routinely receive text message confirmations, it would seem almost unfathomable that this option is not routinely available. In 2025, it is hardly the provision of what would be considered cutting edge technology. Sadly, all too often blind and partially sighted patients find themselves in an inaccessible, analogue world, while living in a digital era. They receive vital letters which they are unable to read, or which require the involvement of a third party, thus compromising their right to privacy in matters of their health.
Additionally, it’s important to note that the provision of accessible information isn’t something that would be nice to do in an ideal world. It’s something that must be done. Everyone in Northern Ireland, has the right to receive information in a format that they can access, and understand.
The duty to make reasonable adjustments is contained in the Disability Discrimination Act 1995. In Northern Ireland, Health and Social Care organisations are also bound by the Quality Standards for Health and Social Care (Department of Health, Social Services and Public Safety 2006). This requires them to consider the diverse needs of the public, services users, carers and staff alike, in any information and communication.
Five standards were also introduced in the publication Improving the Patient & Client Experience. One of those was the Communication Standard, which was defined as: “all health and social care staff communicate in a way which is sensitive to the needs and preferences of patients and clients.”
Additionally, there is a legal requirement under the Human Rights Act 1998; Section 75 of the Northern Ireland Act 1998; Race Relations Order 1997; the Disability Discrimination Order 2006 and the Health and Social Services (Reform) Northern Ireland Act 2009, to ensure that health and social care make their services, including information, accessible.
RNIB has continued to lobby for the introduction of an Accessible Information Standard in Northern Ireland. We believe that this is a vital step in establishing, benchmarking and monitoring best practice. Our work has ensured that key stakeholders, including the Northern Ireland Executive, Government Departments, local councils, the Health Trusts, Sensory Support Teams, voluntary and community sector colleagues and the media, are aware of the importance of this issue and of the simple steps they can take to ensure that key information and guidance supplied to the public is accessible for blind and partially sighted people.
We have been greatly encouraged by the willingness of our health and social care colleagues to proactively engage on this issue, but there is widespread recognition that much more needs to be done. While we hope that the roll out of Encompass, the digitising of patient records in Northern Ireland, may offer an opportunity to address important aspects of accessibility, it remains the case that too often essential information is offered to patients only via hard copy leaflets, or printed factsheets.
Appointment dates and times and the results of clinical tests arrive in an inaccessible format. It is assumed that a patient will have a family member, friend or carer, who can communicate this information, or assist with a process or procedure, and that the patient is content with this arrangement. Time pressure may mean that explanations can be truncated, or communication stifled. We must act to address these issues and to continue to challenge practices which are resulting in manifest inequality and could, in some circumstances, be contrary to the interests of patient safety.
RNIB remains fully committed to working with a range of partners, to effect positive change. We are here to help, to support, and to seek solutions, which ensure that all our citizens can access the healthcare they need, in a manner which respects their privacy, dignity and autonomy. The provision of accessible health information is vital to that goal.
Gillian Clifford, NHS Engagement Manager, RNIB Northern Ireland
