The Accessible Information Standard: Towards mandatory equality in practice

This summer, we saw the Secretary of State, the Rt Hon Wes Streeting MP reiterate that the NHS was founded on the principle of equality. The publication of the long-awaited updated Accessible Information Standard (AIS) is a vital step in ensuring this principle rings true. The standard recognises what communities have told us for years; that real health equity starts with accessibility, understanding, and appropriate information and communication. 

What is AIS and why does it still matter? 

For those of you unfamiliar with the AIS, the standard sets out requirements to ensure that anyone with a disability, impairment, or sensory loss can access, understand, and communicate with and about NHS services. It is designed to ensure that providers identify, record, flag, share, meet, and regularly review information and communication requirements, for those who may have such information or communication support needs. This includes patients, service users, carers and family members who are involved in the individual’s care and have information or communication support needs themselves. This support can include information in alternative formats, longer appointments, or support from communication professionals as needed, such as BSL interpreters.  

Through my work with individuals with lived experience, our members, and wider third sector beneficiaries, I’ve seen first-hand how vital such support is if we are to tackle health inequality. If your GP’s instructions are in a format you don’t understand, or you are not communicated to in a way that reflects your needs, then NHS services are closed to you. 

A new sixth step 

Updated in late June, for clarity and easier implementation, the refreshed AIS incorporates legislative changes, learning from the COVID-19 pandemic, and now includes a review stage and a new sixth step in the form of a new Self-Assessment Framework (SAF) for the provider. The SAF, developed with feedback from pilot sites, will help providers monitor compliance and develop targeted improvement plans. 

Further changes include an expectation for providers to review an individual’s needs at regular points, to ensure ongoing improvement in how organisations meet the information and communication requirements of their patients. Equally, the updated standard also highlights the requirement for every region to have a dedicated staff member focused on implementing the AIS, and reinforces obligations under the Equality Act 2010. 

Within the context of the current landscape 

The updated AIS was published the same week as the NHS 10 Year Plan and Dash Review. If we are to move to a more innovative NHS, as intended in the plan through a shift in power from Whitehall to patients and communities, all patients must be able to contribute to this process.  

This means initiatives laid out in both the NHS 10 Year Plan and Dash Review must also be accessible to all. For example, the Be Part of Research promotion, intended to make it easier for patients to volunteer to participate in clinical trials, must equally uphold the AIS if we are to see improvements in the accessibility of clinical trials, and consequently, improved data and treatments for all communities.  

Similarly, the intention for patients to be able to directly refer themselves to more diagnostic services, recognising the power of patient agency, also needs to implement the AIS so that those with a disability, impairment, or sensory loss can equally benefit. 

Progress, but not yet enough 

The updated AIS makes welcome improvements. Updates directly reflect learning from the past few years; admin systems that don’t talk, front doors shut by inaccessible communication, and the impact of life or death consequences for those denied reasonable adjustments.  

At present, organisations that provide publicly funded NHS care or adult social care must have regard to this standard, as should commissioners of NHS or social care. Complying with the standard supports organisations to meet their obligations under the Equality Act 2010. However, the AIS is yet to become mandatory. In practice, this keeps vital equalities work sitting at the margins, at the mercy of local priorities or interest.  

It’s not enough to celebrate pockets of good practice. That is why National Voices is fully behind making the AIS mandatory, ensuring that accessible information is the backbone, not the afterthought, to health and care. A formal discovery phase must be catalysed as intended to develop the mandatory standard later this financial year. This discovery phase will explore the success of the initial stage of implementing the standard and is crucial for ensuring that individuals with a disability, impairment, or sensory loss receive information in accessible formats and communication support. A step towards a mandatory standard, in the shape of the discovery phase, will bring undeniable benefits to our members’ beneficiaries across services, seeing us collectively move towards a more equitable NHS. 

Get in touch 

I am always interested in understanding our members’ and the broader sector’s thoughts surrounding accessing health and care. Whether you are looking to understand the impact the AIS will have on your beneficiaries, wanting to keep up to date on the progress of the standard, or considering how best to engage with patients around this topic, please do get in touch.