Strengthening inclusive NHS England messaging

National Voices was commissioned by NHS England to strengthen the evidence base on how NHS messages can be designed and delivered in ways that prompt action while remaining inclusive for groups most at risk of exclusion.

The work focused on four target groups: older people, parents and carers, digitally excluded people, and people facing language barriers. The study aimed to identify the barriers that prevent people from receiving, understanding, trusting and acting on messages, alongside the conditions and practices that enable messaging to work well in real-world circumstances.

Findings showed that barriers often stem from systems assuming reliable digital access, confidence, and English-language understanding. Participants highlighted problems including confusing platforms, inaccessible or unclear messages, lack of recognition for carers and proxy users, and low trust in unexpected digital communications. Across all groups, there was strong support for clearer, more actionable messages, hybrid communication options, and accessible human support alongside digital channels.