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Nigel's surgery 20: Making information accessible

  • Organisations we regulate

We have had questions about whether practices are expected to provide information in different formats, access to translation services (written communication) or to interpreters (verbal communications).

It is important to make the distinction between:

  • people who have a disability which makes communicating in spoken and/or written English difficult or impossible, and
  • people whose first language is not English.

In the Equality Act 2010 there are additional requirements to make reasonable adjustments for disabled people. This means that interpreting and providing written information in alternative formats such as large print on request are likely to be legal requirements for GP practices. Practices can consider the ‘reasonability’ of each case. There is no reasonable adjustments requirement in relation to interpreting and translation on the grounds of race or nationality. Whilst the Equality Act does not specifically mention people whose first language is not English, the GMC’s Good Medical Practice 2013 states that ‘you should make sure that arrangements are made, wherever possible, to meet patients’ language and communication needs’.

The Accessible Information Standard (AIS)

NHS England introduced the AIS to help clarify what is reasonable under the Equality Act. It aims to make sure that people who have a disability, impairment or sensory loss receive information that they can easily read or understand and get support so they can communicate effectively with health and social care services. It covers patients, their parents and carers.

Since 31 July 2016, providers of any NHS funded care must, by law:

  1. Identify: ask people if they have any information or communication needs, and find out how to meet their needs.
  2. Record those needs clearly and in a consistent way.
  3. Flag their file or notes so it is clear that they have information or communication needs and how to meet those needs.
  4. Share people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so.
  5. Meet needs: take steps to make sure people receive information which they can access and understand and receive communication support if they need it.

We will look at how services meet the AIS as part of our inspections. It is included in our new health assessment framework under key line of enquiry R1 “How do people receive personalised care that is responsive to their needs?”. 

Accessible information is also one of CQC’s Equality Objectives 2017-19.

Information in different languages

When looking at how caring GP practices are during inspections, one of our key lines of enquiry (C2) is: ‘Are people who use services and those close to them involved as partners in their care?’ Inspectors consider whether staff recognise when people who use services and those close to them need additional support to help them understand or be involved in their care and treatment, and enable them to access this. This could include providing language interpreters where appropriate or providing printed information in different languages.

However this does not necessarily mean that, for example, we would expect all GP practices to have information leaflets available in multiple languages. The key point is that services should be responsive to the needs of the population they serve and this will vary from practice to practice. A practice should be aware of the needs of the people on their patient list, including their language requirements. So if, for example, they serve a population with a large number of people whose first language is not English they should plan services appropriately; considering how they provide information about the services offered by the practice and how these people will be able to be involved in their care. This might mean making printed information available in different languages and/or ensuring that people who use services and those close to them are able to access interpretation services.

NHS England has published a draft principles framework for high quality interpreting and translating services in primary care. This covers both community language and British Sign Language (BSL) interpreting.

Further information

Meeting the accessible information standard

Accessible Information Standard (AIS) – NHS England website

Accessible Information Standard (AIS), detailed guidance and FAQs – BMA

Last updated:
19 June 2018