Accessible Information Standard - in the NHS e-Referral Service

The Accessible Information Standard (AIS), known officially as 'DCB1605 Accessible Information', makes sure that people who have a disability, impairment or sensory loss get appropriate information or communication support from NHS and adult social care services.

The AIS requires all applicable organisations to:

• identify - ask people if they have any information or communication needs, and find out how to meet their needs
• record - report and document needs clearly and in a set way
• flag - highlight or flag the person’s file or notes so it is clear that they have information or communication needs
• share - share people’s information and communication needs with other providers of NHS and adult social care, when they have consent to do so
• meet - ensure people receive information that they can access and understand, and receive communication support if they need it

In the context of e-RS, both referrer and service providers have responsibilities to meet patients' needs.

Referrers can, and should, record patients’ information or communication needs within e-RS so that those needs are shared with the provider.

Where needs are shared by referrers then providers must act upon them, ensuring that those needs are met.

The following process outlines a typical referral journey, detailing what steps can be taken to record, flag, share and meet the information or communication needs of your patients'.

The referrer and patient initiate the referral and select the appropriate services, based around the patient’s clinical needs. It is important to check the patient’s information or communication needs at this stage, ensuring that they are accurately recorded.

Accessibility information in e-RS can be updated by selecting the ‘update person’ button on the ‘check patient’s details’ prompt.

The update person screen allows the referrer to update the patient's:

• preferred contact method
• preferred written communication format

This information can be updated either at the first interaction or as part of ongoing routine interaction with the referring organisation by existing service users.

If appropriate, the referrer should record specific patient needs via additional requirements by selecting the ‘add additional requirements’ button on the ‘appointment request details – summary’ page.

This is where the referrer should record specific information or communication needs of the patient. These should be recorded under the ‘advocacy’ section of the additional requirements screen.

The patient’s support needs can be recorded using free text. This text should be in line with the Fully Specified Names (FSNs) associated with the four subsets defined by the AIS specification.

It is essential that records clearly indicate how the patient’s information or communication needs can be met, to enable the provider to take appropriate action.

For example, patient has:

• severe sight issues and requires correspondence in formats such as easy read or large print
• profound hearing loss and uses sign language to communicate. They will require support at appointments with a British Sign Language interpreter
• a speech impediment and prefers to communicate using text message, email or text relay/textphone

The referrer completes the referral process by adding clinical referral information, e.g. a referral letter, that should also state the patient’s accessibility needs in a prominent position.

It is a requirement that, where manual letters are produced, the accessibility information is included prominently in the script of these letters.

The patient follows booking instructions to access the e-RS patient booking website Manage Your Referral or the NHS App to select the place, date and time of their appointment.

Most GP practices also have staff available to help the patient select and book their appointment.

Patients can also use a dedicated Assisted Digital Service Line to make or amend a booking.

The Assisted Digital Service Line has textphone facilities and the ability to send out letters in braille, large print and language options.

The provider organisation should have an Additional Requirements Manager (ARM) who is responsible for ensuring that additional requirements are met when the patient attends the booked appointment.

Organisations that do not currently have an ARM should contact their Registration Authority (RA) to enable an individual to be assigned this role.

This ensures that they are able to view and act upon additional requirements identified by the referrer.

The patient attends the appointment of their choice, supported by accessible information and any communication support they need - thereby meeting the AIS.

Note to patients

If you have information or communication needs, make sure you ask your referring organisation to include details about them in e-RS and in relevant correspondence when they refer you to another NHS service.

Further information

For further information about the:

• Accessible Information Standard visit NHS England
• NHS e-Referral Service visit the NHS e-Referral Service website