A to Z of writing

The first time you use an abbreviation or acronym explain it in full unless it’s well known, like NHS, GP, BBC, UK and US. Then refer to it by initials. Do not use full stops in abbreviations or acronyms: ‘BBC’, not ‘B.B.C.’ 

If readers might not see your first use, introduce the full version again.  

Do not capitalise words just because they are being used in an acronym. For example: ‘In 2022, integrated care boards (ICBs) replaced clinical commissioning groups (CCGs).’  

Try to minimise the use of abbreviations and acronyms, as block capitals are difficult for people to read.

See also capitals.

Use the active voice. This will help us write concise, clear content. 

See How we write in the NHS digital service manual.

See first person.

Punctuate addresses when you write them horizontally:

NHS Digital, 7 and 8 Wellington Place, Leeds, West Yorkshire, LS1 4AP.

Do not punctuate when you write them vertically:

NHS Digital
7 and 8 Wellington Place
Leeds
West Yorkshire
LS1 4AP

Avoid using an ampersand, except in 'A&E'. Use 'and' instead.

Used for:

• possessives, for example: the NHS's services
• missing letters, for example: it's, we're, we've, they've

See contractions on the Punctuation page of the NHS digital service manual.

An application for a mobile device or computer. Lowercase unless referring to the official name of the ‘NHS App’.

See NHS App in the NHS digital service manual.

Use an apostrophe but no hyphen.

Use 2 words when talking about an article published on a blog. A blog is the site on which a blog post is published.

Lower case unless it’s part of a proper title or you are referring to our Board, 'the Board'. For example, ‘board minutes and papers are published after the Board meets'.

See also capitals.

See guidance on how we use bold on the Formatting page of the NHS digital service manual.

See Great Britain.

Find out how we use bullet points in the guidance on lists on the Formatting page of the NHS digital service manual.

Abbreviate ‘byte’ to B (for example: ‘a 180GB hard drive’).

Use MB for anything over 1MB: 4MB not 4096KB.

Use KB for anything under 1MB: 569KB not 0.55MB.

We do not use block capitals as they're difficult for people to read. Always use sentence case, even in page titles. The exceptions to this are: ​

•  proper nouns ​

•  official titles of organisations ​

•  names of directorates – see also directorates​

•  names of programmes – see also programme ​

•  trade names ​

•  the first letter of a page or heading in a document (but not the following words unless they take a capital for other reasons) ​

•  religious holidays and festivals (‘Christmas’, ‘Easter’, ‘Eid’) but use lower case for seasons (‘summer’ and ‘autumn’) 

• specific job titles (but not generic job roles) –  for example: ‘Melanie White, Product Manager, NHS England’ but 'Melanie is a product manager at NHS England’ 

• names of political parties

Use a hyphen in both the full and acronym form.

Lower case.

See the guidance on how we use contractions on the Punctuation page of the NHS digital service manual.

Lower case.

See guidance on COVID-19 in the NHS digital service manual.

See guidance on how we use hyphens and dashes on the Punctuation page of the NHS digital service manual.

We treat ‘data’ as a singular noun (for example, ‘the data is stored on a secure server’) rather than a plural noun (‘The data are stored on a secure server’) when talking to the public and to non-specialist audiences.

Understanding Patient Data researched the public’s comprehension of these terms and recommended using the singular. This is consistent with the Government Digital Service’s advice.

But take a flexible and practical approach. The Oxford Dictionaries website says both usages are acceptable in standard English and notes that some technical audiences still prefer the plural. If you are talking to a group of specialists and feel that using the singular will get in the way of communication, use the plural.

Should always be 2 words.

Dates are written ‘day month year’ with no punctuation: ‘22 April 2024’.

Avoid using ‘nd’ ‘st’ ‘th’ and ‘rd’ except when referring to centuries, anniversaries or positions.

In general, use ‘to’ for date ranges, not hyphens or dashes (for example: ‘10 November to 21 December’). However, to refer to a financial year, use a hyphen (for example: ‘2023-24’).

See times.

See guidance on death in the NHS digital service manual.

Lowercase the word 'directorate' (for example: 'the Transformation directorate').

Use positive and active language that respects people living with a disability or condition.

The NHS digital service manual’s guidance on disabilities and conditions gives more information. 

Only use double quotes when you’re quoting someone directly. 

For example: Melanie White said: “More people are using our services.” 

See single quotes.

‘E.g.’ can sometimes be read aloud as “egg” by screen reading software. Instead, use ‘for example’, ‘such as’, ‘like’ or ‘including’.

‘Etc.’ can usually be avoided. Try using ‘for example’, ‘such as’, ‘like’ or ‘including’.

‘I.e.’ isn’t always well understood. Try writing sentences to avoid the need to use it. If that isn’t possible, use an alternative such as ‘meaning’ or ‘that is’.

Write email addresses in full, in lower case and as active links.

See e.g., etc and i.e.

Only refer to people's ethnic background or religion if it's relevant to the content.

The NHS digital service manual’s guidance on ethnicity, religion and nationality provides more information.

See How we write in the NHS digital service manual.

Although not appropriate in all contexts, we prefer to talk in the first person when describing what we do and to address our readers directly: ‘we’, ‘us’ and ‘you’.

See active, passive. 

See guidance on numbers, measurements, dates and time in the NHS digital service manual.

The language around sex, gender and sexuality changes all the time.

The NHS digital service manual’s guidance on sex, gender and sexuality has more information.

See byte, kilobyte, megabyte, gigabyte, terabyte.

Lower case unless it’s a full title. For example: ‘UK government’, but ‘His Majesty’s Government of the United Kingdom of Great Britain and Northern Ireland’.

Lower case except when in the title: 'the Department of Health and Social Care’.

‘GP’ can be used interchangeably with ‘general practitioner’. Don’t capitalise the spelled-out version. It is not necessary to spell out the abbreviation on first use if the meaning is clear.

Do not capitalise ‘general practice’.

For more information see GP entries in the NHS digital service manual.

Use UK and United Kingdom in preference to Britain or Great Britain and British.

Great Britain refers only to England, Scotland and Wales and does not include Northern Ireland.

Our work is focused on the NHS in England. Take care not to refer to UK, Britain or Great Britain when you mean England.

See guidance on headings on the Formatting page of the NHS digital service manual.

An honorific is a title used when addressing a person, for example, ‘Mr’, ‘Mrs’ or ‘Professor’.

Do not abbreviate ‘Professor’ to ‘Prof’.

Do not use full stops in honorifics: write ‘Mr’ not ‘Mr.’.

See guidance on how we use hyphens and dashes on the Punctuation page of the NHS digital service manual.

See e.g., etc and i.e.

Create content for and about people in a way that is inclusive and respectful. 

The NHS digital service manual’s guidance on inclusive content has more information.

Lower case when spelt out in full, except when you are referring to a particular ICB. For example: Anytown Integrated Care Board.

We treat integrated care systems (ICSs) and integrated care partnerships (ICPs) the same way.

Jargon is a type of language that is used in a particular group and is difficult for others to understand. Try to explain things so that anyone can clearly understand what you are saying.

Technical terms are not necessarily jargon, but you should explain what they mean when you use them.

Research shows that even people with specialised knowledge prefer plain English.

GOV.UK provides more guidance about writing well for specialists.

See capitals.

See byte, kilobyte, megabyte, gigabyte, terabyte.

See guidance on links in the NHS digital service manual.

Find out how we use lists in the guidance on lists on the Formatting page of the NHS digital service manual.

See log in and log out in the NHS digital service manual.

See guidance on numbers, measurements, dates and time in the NHS digital service manual.

See byte, kilobyte, megabyte, gigabyte, terabyte.

Do not use decimals unless pence are included: ‘£75.50’ but not ‘£75.00’.

Write out ‘pence’ in full: ‘Calls will cost 4 pence per minute from a landline’.

See also guidance on numbers, measurements, dates and time in the NHS digital service manual.

See NHS 111 online in the NHS digital service manual.

See NHS App in the NHS digital service manual.

See also app.

‘e-Referral Service’ is an acceptable abbreviation.

Write ‘login’ in lower case and as one word: 'NHS login lets people see their personal health information online'.

See also log in and log out in the NHS digital service manual.

See NHS website, nhs.uk and NHS.UK in the NHS digital service manual.

Do not use a space between ‘NHS’ and ‘mail’.

Find out how we use numbered lists in the guidance on lists on the Formatting page of the NHS digital service manual.

See guidance on numbers, measurements, dates and time in the NHS digital service manual.

Upper case.

See guidance on numbers, measurements, dates and time in the NHS digital service manual.

See phone and phone numbers in the NHS digital service manual.

Refer to companies and organisations in the singular.

Some nouns are always plural, such as ‘police’ and ‘people’.

Lower case: ‘NHS DigiTrials programme’. 

See double quotes and single quotes. 

Formal references are not always needed in web content. Instead, use descriptive hyperlinks to direct users to the source content. 

If you do need to use a reference in your content, NHS England does not have a preferred referencing style (for example, Harvard or Vancouver). However, you should follow the guidance below. 

When writing a reference: 

• do not use italics 
• use single quotation marks around titles 
• write out abbreviations in full: ‘page’ not ‘p’, ‘Nutrition Journal’ not ‘Nutr J’ 
• use plain English. For example, use ‘and others’ not ‘et al’ 
• do not use full stops after initials or at the end of the reference 
• use a consistent style throughout the content you are creating 

If the reference is available online, make the title a link and include the date you accessed the online version. 

For example: ‘Corallo AN and others. ‘A Systematic Review of Medical Practice Variation in OECD Countries’ Health Policy 2014: volume 114, pages 5-14 (viewed on 18 November 2024)’ 

GOV.UK provides more guidance on using references and footnotes.  

Use single quotes:

• for unusual terms
• to highlight a term, word or phrase that is being discussed or defined
• when referring to publications (for example: ‘Download the publication ‘Understanding Our Statistics’)

Only use double quotes when you’re quoting someone directly.

See double quotes.

Use a single space after a full stop rather than 2.

See jargon and technical language.

See phone and phone numbers in the NHS digital service manual.

See byte, kilobyte, megabyte, gigabyte, terabyte.

Use:

• ‘5:30pm’ (not ‘1730hrs’)
• ‘midnight’ (not ‘00:00’)
• ‘midday’ (not ‘12 noon’, ‘noon’ or ‘12pm’)
• ‘6 hours 30 minutes’ (not 6.5 hours)
• ‘to’ in time ranges, not hyphens or dashes: ‘10am to 11am’ (not ‘10-11am’)

Midnight is the first minute of the day, not the last. You should consider using ‘11:59pm’ to avoid confusion.

For example, ‘You must register by 11:59pm on Tuesday 14 June’ can only be read one way. ‘You must register by midnight on Tuesday 14 June’ can be read in two ways (the end of Monday 13 or end of Tuesday 14).

For titles, headlines and headings, see guidance on headings on the Formatting page of the NHS digital service manual.

See honorifics for personal titles and forms of address.

Lower case unless you are referring to the full name of a foundation trust (‘NHS trusts’, ‘Bolton NHS Foundation Trust’, 'the trust').

See also capitals.

See Great Britain.

See guidance on numbers, measurements, dates and time in the NHS digital service manual.

With a hyphen.