The document discusses making NHS e-referral services more accessible to vulnerable patients. It describes consulting with organizations representing various groups to understand their needs, such as ensuring information is at appropriate reading levels and clinics can accommodate disabilities. Wireframes were developed for updating patient details and selecting clinics with accessibility in mind. The presentation reviews progress implementing accessibility standards and improving assisted digital support in line with user requirements.

1. Accessible Information
in the NHS e-Referral Programme
25th February 2016
presented by Dr Michelle Durham NHS e-Referral Programme

2. The NHS e-Referral Vision – March 2015
NHS e-Referral Service will be so simple and intuitive to use that
both patients and professionals will want to use it for all transactions
and succeed in doing so, first time – every time.
Referrals throughout health and social care will be initiated and
processed using modern technology.
A familiar and user-friendly interface and assisted digital support will
provide ‘access for all’ and will fully support vulnerable patients,
those with disabilities and those who rely on carers and interpreters.
The HSCIC NHS e-referral team (formerly Choose and Book)
started working with NHS England in 2014 looking at how we could
deliver equality in healthcare, through improving accessibility of
information for all patient groups.

3. Consulting with users
In 2014 we held consultations with organisations to find out how vulnerable
patients felt we could best support them (through workshops, discussions
and surveys): These organisations included:
• The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust
• Darlington Deaf Centre
• Safer Places, Harlow and Essex
• London Connect
• Sense, the deafblind charity
• East Kent Patient Participation Groupos
• The WI
• City of Bradford Metropolitan District Council
• Locally delivering your NHS across North Derbyshire
• Strategic Disability Partnership
• North Derbyshire CCG
• 21st Century Lay Reference Group
• The learning disabilities Steering Group
• Northumberland Low Vision Action Group
Harlow
Essex

4. • The average reading age of the UK population is 9 years.
• The Guardian Newspaper has a reading age of 14 years.
• The Sun Newspaper has a reading age of 8 years.
• Choose and Book Letters had a reading age of 16 years.
Users needed all information to be in an
accessible format enabling the user to make
an informed choice.
Caring - Effective - Responsive - Safe
User needs for accessible information in e-RS

5. Users needed
to know that a
clinic could
accommodate
their disabilities
or sensory
impairment
needs.
Caring - Effective - Responsive - Safe
User needs for accessible information in e-RS

6. Users needed to be able to organise their appointments
using modern technology, with settings to help overcome
any sensory disability.
Caring - Effective - Responsive - Safe
User needs for accessible information in e-RS

7. 1. Ask people if they have any information or communication
needs, and find out how to meet their needs.
2. Record those needs in a set way
3. Highlight a person’s file, so it is clear that they have
information or communication needs, and clearly explain
how those needs should be met.
4. Share information about a person’s needs with other NHS
and adult social care providers, when they have consent
or permission to do so.
5. Make sure that people get information in an accessible
way and communication support if they need it.
Accessible Information Standards July 2015

8. Benefits of implementing the accessible standards
• Convenient for patients
• Gives patients choice and the time to explore that choice
• Reduced DNA’s
• Cost saving to the NHS - Time
- Printing costs
- Telephone appointment line
• Cost savings to patient - if the patient chooses to use
modern technology (smartphone, tablet etc.)

9. Wireframes Professionals – ‘Happy Path’

10. Update patient details
1. Ask people if they have any information or communication needs, and find
out how to meet their needs.
2. Record those needs in a set way
3. Highlight a person’s file, so it is clear that they have information or
communication needs, and clearly explain how those needs should be met.
4. Share information about a person’s needs with other NHS and adult social
care providers, when they have consent or permission to do so.

11. Update patient details

12. Update patient details

13. Update patient details

14. 5. Make sure that people get information in an accessible way and
communication support if they need it.
Supply patient with short list

15. Supply patient with short list

16. Supply patient with short list

17. Wireframe Patient Web App – ‘Happy Path’

18. Tried to include wants and needs

19. Clickable Demo

20. Back to the drawing board
• Research & Design
• Sketching ideas
• Mapping User Journey
• Needs not wants

21. Desktop (Mobile) Research
21
Multiple Filters Sort/Filter/Map ‘Hero items’
Give Blood Travel Supermarket Travel Supermarket USwitch
Availability

22. Wireframe Patient Web App – ‘Happy Path’

23. Wireframe Review – ‘Happy Path’

24. Select Clinic – Overlay pages
24
Choice
Informative
Filter/Sort/Map
Hero Items

25. Where are we now?
• The NHS e-Referral service went live in June 2015 with
initial delivery focus on performance improvements and
stability, working with our users to ensure the service
supported their core requirements whilst reviewing the
backlog developed prior to go live.
• The NHS e-Referral Delivery roadmap was reviewed at
the January 2016 NHS e-RS Delivery Board
• The accessible information and assisted digital steering
group now has a revised, robust plan to implement the
accessible information standards and improve assisted
digital uptake has been agreed.

26. Where are we now?

27. Next step?

28. Next step?

29. Any questions?
Please try our latest demo!
https://nhsers.herokuapp.com
michelle.durham1@hscic.gov.uk