Accessible Information Standard Toolkit

There are five basic steps which make up the Accessible Information Standard.

1. Ask: identify / find out if an individual has any communication / information needs relating to a disability or sensory loss and if so, what they are.
2. Record: record those needs in a clear, unambiguous and standardised way in electronic and / or paper-based record / administrative systems / documents.
3. Alert / flag / highlight: ensure that recorded needs are ‘highly visible’ whenever the individual’s record is accessed, and prompt for action.
4. Share: include information about individuals’ information / communication needs as part of existing data sharing processes (and in line with existing information governance frameworks).
5. Act: take steps to ensure that individuals receive information which they can access and understand and receive communication support if they need it.
   

There is no requirement for a retrospective search or ‘trawl’ of records to identify patients with needs, although this would be considered good practice.

Communication and / or information needs MUST be identified at registration / upon first contact with the service or as soon as is practicable thereafter. These initial questions may be asked over the telephone, face-to-face at a reception desk, as part of a registration or admission form or through an alternative process.

The Standard has suggested questions which may be used to identify if an individual has any information and / or communication support needs, and the nature of these needs. Specific additional or follow-up questions which it may be relevant to use as prompt or follow-up questions when communicating with particular individuals and / or in particular care settings are as follows:

Do you have difficulty hearing, or need hearing aids, or need to lip-read what people say?
Do you have difficulty with memory or ability to concentrate, learn or understand?
Do you have difficulty speaking or using language to communicate or make your needs known?

To ensure you explore all options during your conversation with the patient and effectively record the answers a detailed checklist this may be useful. It helps to separate information into ‘communication’ and ‘correspondence’ categories and to also consider flow both ways between you and the person.

It is expected that multiple categories will be selected for many individuals. Whatever the format used, communication and information needs MUST be recorded using the data items associated with the subsets defined by the Accessible Information Standard or their human readable definitions / categories.

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Identifying Information and Communication Needs

Information and communication support needs must be recorded in a clear, unambiguous, and consistent way either electronically or using paper records. It is important that the information is meaningful and can be acted upon.

Where electronic systems are used, technical details in the full AIS Guidance document should be referred to.

In electronic systems which use SNOMED CT, read v2 or CTV3 codes, information must be recorded using the coded data items associated with the subsets defined by the Standard.

In electronic systems which use other coding systems or terminologies, or where paper records are used, such information MUST be recorded in line with the human readable definitions / categories associated with the data items.

It is the responsibility of the IT systems supplier or organisational lead to ensure that all electronic coding used is current and up to date.

In recording additional information about patients, service users, carers and parents, organisations should be mindful of their duties under the Data Protection Act 2018, including ensuring that information is ‘relevant’ and ‘not excessive’ (to the purpose of recording it).

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Implementation Guide

Recording Information and Communication Needs

Electronic and paper records of communication and support needs must be made ‘highly visible’ to relevant staff and professionals. ’Highly visible’ means:

• Obvious and overtly apparent
• Visible on the cover, title and / or ‘front page’ of a document, file or electronic record
• Visible on every page of an electronic record (for example as an alert, flag or banner)
• Highlighted in in some way on a paper record to draw attention to the information as being of particular importance using larger or bolder fonts, or different colours.

If a patients’ notes, file or record has multiple volumes, these support needs must be visible on the front cover and/or front page of every volume.

Information or communication support needs data must be regularly reviewed and, if necessary, updated by staff. The purpose is two-fold; firstly, to identify whether service user’s needs have changed (such as in the level of sensory loss); and secondly, to identify whether the most appropriate method used to meet those needs has changed (through technology advances or in the service user’s access to technology).

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Flagging information and communication needs

All applicable organisations should include information about individuals’ information and communication support needs as a routine part of referral and handover communication, and as part of other data-sharing processes with other professionals and services involved (or soon to be involved) in an individual’s care.

Information as shared should be formatted in line with relevant Read v2, CTV3 or SNOMED CT codes or using the associated ‘human readable’ definitions /categories.

All information-sharing as part of this Standard should utilise existing data-sharing processes, including following existing information governance protocols and processes for the obtaining and recording of patient / service user consent.

Information about individuals’ information and / or communication needs should be included as part of referrals both within and between organisations, including (but not limited to) referrals from primary into secondary care, transfers and handovers between wards or units, and discharge from an inpatient setting into the community.

Data recorded as part of this standard should be included (with consent) as part of shared and integrated records and using existing systems for the sharing of patient information with other services such as the Summary Care Record and NHS eReferral Service.

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Sharing information and communication needs

Services must provide one or more communication or contact methods which are accessible to and useable by the patient, service user, carer or parent. The method(s) must enable the individual to contact the service, and staff must use this method to contact the individual. Examples of accessible communication / contact methods include email, text message, telephone and text relay.

Appropriate action must be taken to enable patients, service users, carers and parents to communicate, including through staff modifying their behaviour and / or supporting the use of aids or tools. This includes provision of communication support for individuals accessing both outpatient and inpatient services, including long-term care, and those in receipt of publicly-funded social and / or NHS care whilst resident in a nursing or care home.

The provisions cover:

• Response times
• Requirements to make reasonable adjustments for disabled people
• Specific contact method
• Specific information format
• Use of ‘large print’
• Use of communication professionals
• Use of health and social care staff as communicators/interpreters
• Use of family members, friends or carers as interpreters
• Requests for the use of specific professionals
• Remote access to communication support
• Communication support
• Key word signing including Makaton
• Longer appointments

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Information about using email and text messages for communicating with patients

Information about different types of communication support

CQC

In March 2017, the Care Quality Commission (CQC) published their Equality Objectives for 2017-2019, including an objective on ‘accessible information and communication’. In order to meet this objective, one of their commitments is that “From October 2017, all inspection reports include how providers are applying the standard.”

Further information about the CQC’s Equality Objectives

Non-compliant organisations risk complaints and legal challenge, as well as patient safety and other implications. Commissioners (including CCGs) must also seek evidence from providers of their compliance. It is a requirement of the NHS Standard Contract.

More information

NHS England information

NHS England’s Top Implementation tips

NHS providers – The Accessible Information Standard – are you compliant?

Essex County Council links

North East Essex

Mid & South Essex

West Essex

South Essex