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Creating content

This guide is for anyone involved in creating content for NHS England websites to help make things clear, consistent and accessible. It’s important that our content is useful and easy to find, read and understand. 

Find out what users need

Research tells us that the majority of our users visit the site to complete a specific task. Our content must help users complete those tasks.

We publish only what someone needs to know so they can complete their task. Nothing more. 

Content will be most effective if we understand who we're producing it for. 

User research

When producing new or improving existing content, user research or evidence gathering should be done to find out:

  • who the likely users are
  • what they're trying to do
  • what users need to achieve their goal - their goal could be to complete a transaction or to just gain knowledge
  • how they currently do it
  • the problems or frustrations they experience while doing so
  • what language they use to express their need

How to find out what users need

Examples include:

  • getting feedback - using surveys and interviews for example
  • using analysis of enquiries made to your team
  • using analytics to establish how users are interacting with content
  • getting feedback from colleagues that work with users

Usability and accessibility

Our content needs to be easy to read and understand.

It needs to be designed in a way that people with different needs and abilities can use it.

Use HTML rather than PDFs

PDFs and other office documents do not meet the same level of accessibility as well-designed web content. Public sector bodies, including the NHS, should not use PDFs or office documents to communicate information, except in a few very limited circumstances, as doing so is unlawful.

Content should always be presented in HTML (web page) format.

Do not use frequently asked questions (FAQs)

We do not include FAQs on our website or intranet. If you write clear content that is easy to navigate and answers the questions your readers have,  you will not need FAQs. 

FAQs are discouraged because they:

  • mean that content is not where people expect to find it
  • are too slow to use and create more work for users - questions take longer to scan and understand than simple headings which can be 'front-loaded' with the most important words that users are looking for 
  • lead to duplication - content should be structured clearly so you do not need another page repeating the same information in a different way

Avoid unnecessary formatting

We do not use presentation features such as colour, bold, italics or alignment. 

Rich content

Images

People who cannot see an image need an alternative to consume the content - add 'alt-text' to explain what's in the image.

Keep alt-text to a sentence or 2 and no longer than 250 characters.

Imagine you were reading the page out to a friend. How would you describe the image?

Video and multimedia

Consider using video as well as written content. Some people find it easier to understand.

All videos published on NHS England websites must comply with accessibility regulations.  

We need to ensure that if the user cannot see a video or hear it, they can still understand it. 

Before publishing on the website, all videos must have the following: 

  • accurate closed captions (not ‘burnt in’ subtitles) 
  • accurate transcript (provided in .srt file, Word or text format)

Closed captions 

Closed captions can be turned on and off by the user. 

Open captions or ‘burnt in’ subtitles are embedded into the video and are permanently visible. These are not accessible. 

Always use closed captions, not burnt in subtitles. 

Audio description 

If the soundtrack/voiceover does not explain the visual information in the video, for example diagrams or animated text, a separate audio description will need to be provided. 

Graphics, diagrams and flowcharts

Flowcharts and diagrams can be useful sometimes. Some people may find the content easier to understand if it's presented in a visual way. However, if we use a visual element such as a flowchart, we must provide an explanation of it using text.

Visual elements should be simple. They are best presented in SVG format so users can magnify the content. The design should not rely on colour to distinguish individual elements.

Use tables to show relationships between data

Use a table to make it easier for users to compare and scan information. Tables make it easier for users to understand logical relationships between bits of data or information.

Only use tables when there is a relationship between the 'header' cells and the 'data' cells in the grid. Assistive technologies announce the header with the data it refers to.

Use a table to let users compare information in rows and columns.

Do not duplicate your content

Have you checked the website to make sure the content does not exist already? Duplicate content confuses users and affects search results. It also becomes difficult to maintain and keep up to date.

If it already exists, link to it.


Writing your content

Write content that's easy to understand

Clear content helps everyone and it's the most important thing you can do to make things accessible. It will help more people than any other accessibility requirement.

Use simple language and formatting, for example:

  • write in short, clear sentences and paragraphs
  • avoid using unnecessarily complex words and phrases
  • expand acronyms on first use, for example, Web Content Accessibility Guidelines (WCAG)
  • use list formatting as appropriate

Refer to the NHS digital service manual's content guide for how to write for NHS services.

Our A-Z of writing gives additional, detailed guidance on NHS England's written style.

Keep sentences and paragraphs short

Long sentences are not as easy to understand as shorter ones.

Research tells us that users read quickly and scan the content of your page. If users do not find what they need quickly, they leave the page and look elsewhere.

It’s in your interests to ensure users get what they’re looking for, so do not write more than you need to.

Choose simple words

‘Buy’ is shorter and easier to understand than ‘purchase’ and means the same thing. Plain language is not just about not using jargon, it's about using language that is clear to your audience.

Being clear in your language is the fastest route to making someone else understand what you are trying to communicate. 

Avoid jargon

Do not use jargon when parts of your audience may not understand it. Explain technical language when you need to use it.

Use active language

This means writing ‘The Spine supports the IT infrastructure for health and social care in England’ not ‘The IT infrastructure for health and social care in England is supported by The Spine', unless you have a good reason for using the passive voice.

Also, avoid turning verbs into nouns: ‘We discussed the schedule’ is usually better than ‘We had a discussion about the schedule.’

Use 'you' and 'we'

It is not always appropriate, but addressing your reader directly will usually make your communications more direct and engaging.

Avoid inventing acronyms

Acronyms like ‘the NHS’ work because everybody understands them. Many acronyms are not generally understood and get in the way of clear communication.

Use bullet points

Bullets should be used to present items in a list. They are good for users because they:

  • make text quicker to read
  • make the page less dense
  • bring out the most important points without adding other design elements that might clutter your page

Avoid using bullet lists within bullet lists - this makes the content difficult to read.

Use numbered lists to show the steps in a process.

The NHS digital service manual's guidance on lists gives more information.

Write as you would speak to the reader

  1. Think of someone you know who is in your target audience
  2. Imagine them sitting right in front of you 
  3. Read what you're writing out to them
  4. Would you talk to this person like this?

Writing for your reader will influence not only the words you choose but the content and structure of your messages.

Provide informative, unique page titles

A good page title helps users find what they want and recognise they're in the right place. It's the link that shows in search results and the first thing a screenreader will read out when the user lands on a page.

Each page title must be unique and descriptive. Keep it concise and consider putting important keywords near the beginning.

Use headings to convey meaning and structure

Everyone relies on meaningful headings to navigate a page, but they are especially important for some people with access needs. 

Good headings:

  • provide an outline of the content and tells users exactly what information they're going to get and if they're on the right page
  • break up the text and make it easier to read and find the information users need

Think about putting the most important word(s) at the start of the heading. This will make it easier and quicker for readers to understand the content. 


Inclusive language

Think about the different audiences your content is for aimed at and who it is about. Your content should be inclusive and respectful and not alienate anyone.

Disabilities and mental health

Use positive language and do not label people with disabilities and conditions.

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

Ethnicity

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.

Sex and gender

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.


Contact us

For further help about creating content, or for feedback on how we can improve this guide, contact [email protected].


Useful resources

Last edited: 10 March 2025 2:44 pm