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The accessible information standard: Recording patients' communication needs

From 1 April GP practices in England will be required to make a record of patient's information and communication needs under the accessible information standard. Medeconomics explains what this involves.

Practices should prioritise conversations with patients they know may have a communication need (Picture: iStock)
Practices should prioritise conversations with patients they know may have a communication need (Picture: iStock)

The accessible information standard requires NHS and social services organisations, including GP practices, to ensure disabled patients and carers receive information in formats that they can understand and appropriate support to help them communicate.

To comply with this, practices will need to have a process for identifying, recording, flagging, sharing and meeting the information and communication needs of patients and carers.

By 1 April 2016 practices must identify and record information and communication needs with patients either when they first register or during routine interactions with the practice.

By 31 July 2016 practices should have fully implemented and conform with the accessible information standard.

What is the accessible information standard?

The aim of the standard is to establish a framework so that patients can:

  • Make decisions about their health and wellbeing and about their care and treatment
  • Self-manage their condition
  • Access services appropriately and independently
  • Make choices about treatments and procedures including the provision or withholding of consent.

The following basic steps make up the standard:

  • Identify if an individual has any communication/information needs relating to a disability or sensory loss and if so what they are.
  • Record those needs in a clear, unambiguous and standardised way in the patient record and ensure this information is ‘highly visible’ whenever the individual’s record is accessed.
  • Share information about individuals’ information/communication needs as part of existing data sharing processes.
  • Take steps to ensure that individuals receive information which they can access and understand, and receive communication support if they need it.

This article looks at the first three of these steps. How practices can ensure individuals receive appropriate information and communication support that meets their needs is dealt with separately.

Tips to help practices implement the standard

NHS England has produced guidance to help NHS organisations implement the accessible information standard. Below are some tips for practices taken from this:

Asking about communication needs

One of the fundamental principles of the accessible information standard is that patients, carers and parents should be asked to self-define their information and/or communication support needs, and it is these needs (and not their disability) that should be recorded.

NHS England says individuals must be asked about their needs upon their first or next interaction with the practice. This could be over the telephone when calling for an appointment, results or repeat prescription, or face-to-face. Practices must start doing this by 1 April 2016.

Patients can also be asked to advise the practice of any communication or information needs via a generic letter, such as an invitation to attend a ‘flu jab’ clinic, newsletter, via posters or onscreen information in a waiting area, or through email or text message.

NHS England guidance suggests the following text might be used in such situations

Example text for an email, newsletter or in the waiting area

We want to get better at communicating with our patients. We want to make sure you can read and understand the information we send you. If you find it hard to read our letters or if you need someone to support you at appointments, please let us know. We want to know if you need information in braille, large print or easy read. We want to know if you need a British Sign Language interpreter or advocate. We want to know if we can support you to lipread or use a hearing aid or communication tool. Please tell the receptionist when you arrive for your next appointment, or call us on xxx between xx and xx. Thank you.

Example text communication

We’re improving how we communicate with patients. Please tell us if you need information in a different format or communication support.

The guidance also says it would be good practice to include a ‘standard line’ as part of all correspondence to encourage people to contact the service if they have any information or communication needs, for example: 'If you would like this letter or information in an alternative format, for example large print or easy read, or if you need help with communicating with us, for example because you use British Sign Language, please let us know. You can call us on xx or email xx.'

NHS England will be producing print-ready templates for letters and posters to support implementation later this year.

Practices should also consider how to identify people who are unable to read a letter or poster, for example people who are blind or deafblind. Staff knowledge of individuals as well as existing data that indicates patients are more likely to have a communication need, such as lists of patients who are blind or the learning disabilities register, should be used in such circumstances.

Once identified, these patients could be flagged to prioritise a conversation about their communication needs.

Recording and highlighting patients’ communication needs

Information relating to individuals’ communication needs should be recorded using the appropriate SNOMED CT, Read v2 or CTV3 code.

Any record of information or communication needs must be ‘highly visible’. This means it should be visible on every page of an electronic record (for example as an alert, flag or banner) or highlighted in some way on a paper record.

Any details recorded must be based on information from the individual themselves or their carer or parent. The patient, carer or parent should be made aware of the information that is being recorded in their notes, including to verify accuracy. 

Once the details are recorded practices should ensure this is regularly reviewed and if necessary updated. The purpose of a review is to identify if the individual’s needs have changed or if the most appropriate methods of meeting those needs have changed (for example due to advances in technology or a change in an individual’s access to particular technology).

Sharing information needs

Practices 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 services.

This should follow existing data-sharing processes, including governance protocols and processes for the obtaining and recording patient consent.

  • Fionnuala O'Donnell is a practice manager in Ealing, West London, and a CCG board member.

Read more: How to meet patient's communication needs

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