NHS Easy Read: 5 Steps to Meet the Standard at Scale
The appointment letter looked perfectly ordinary. Three paragraphs, an NHS number, a clinic code and a stern note about parking. It sat on Michael’s kitchen table for eleven days. Michael has a learning disability. He can read, slowly, but the letter never explained what a “pre-operative assessment” was, whether his support worker could come, or what would happen if he ignored it. So he ignored it. The trust logged another missed appointment, the slot went unused, and his surgery drifted further away. It is a small story, but it captures exactly why NHS Easy Read communication matters.
Now multiply that letter by a health system. Mencap estimates that around 1.5 million people in the UK have a learning disability. Add people living with dementia, low literacy, or aphasia after a stroke, and the audience for NHS Easy Read information is far larger than most communications teams assume. When information fails, the costs land everywhere at once: missed appointments, avoidable escalations, complaints, and patients agreeing to treatment they never truly understood.
A standard with teeth, quietly under-delivered
None of this is a new discovery. The Accessible Information Standard has applied to all providers of NHS care and publicly funded adult social care since 2016, under section 250 of the Health and Social Care Act 2012. Its ask is deceptively simple. Organisations must identify, record, flag, share and meet the information and communication needs of patients and carers where those needs relate to a disability, impairment or sensory loss. For many people with a learning disability, meeting that need means Easy Read. Yet a working NHS Easy Read service remains the exception rather than the rule.
Ask any patient experience team why NHS Easy Read compliance remains rare and you will hear the same story. Easy Read is slow to produce. A four-page letter can take days when it goes out to an external agency, and agency budgets stretch only so far, so trusts ration Easy Read for a handful of flagship documents. Meanwhile the everyday material keeps flowing out in standard formats: appointment letters, discharge instructions, screening invitations, consent forms. The standard asks for a service. Most organisations can only afford artefacts.
What good NHS Easy Read actually involves
Easy Read is not simply “shorter sentences”. It pairs one idea per sentence with supporting images, generous white space and an order that respects how people actually make decisions. We have written before about what makes a good Easy Read document, and the craft matters. A badly converted document can be more confusing than the original, because it strips detail without adding clarity.
This is where the economics have always broken down. Doing the job properly by hand takes hours per document. Health information changes constantly, so conversions go stale. And the NHS produces a volume of patient-facing text that no in-house team could ever convert manually. The result is a quiet, persistent gap between what the standard requires and what actually reaches patients.
Where askVERA fits
askVERA was built for exactly this NHS Easy Read gap. Give it a standard document, a clinic letter, a patient information leaflet, a screening invitation, and it produces a draft Easy Read version in minutes: simplified language, one idea at a time, matched to a consistent image library and your organisation’s house style. Instead of choosing which five documents deserve accessibility this year, teams can put every routine communication through the same pipeline and spend their expertise on review rather than production.
That shift, from crafting each document by hand to reviewing machine-produced drafts, is the same pattern we have seen with councils tackling document accessibility and across public sector accessibility more widely. Automating the mechanical steps of Easy Read does not lower the standard. It makes NHS Easy Read affordable at the volume the health service actually operates at. The same approach carries over to adjacent work too, such as supporting disabled people into employment, where clear communication is just as decisive.
What askVERA will not do
An honest word before anyone gets carried away. askVERA will not sign off clinical accuracy. Simplification can shift meaning, and in healthcare that matters more than anywhere else, so a person who understands the clinical context must review every output before it reaches a patient.
It will not replace user testing either. The gold standard is still involving people with lived experience of a learning disability in shaping the information written for them, and no software substitutes for that.
And it will not repair broken source content. If the original letter never says what the patient should actually do next, no NHS Easy Read version can invent it. askVERA compresses production time dramatically; judgement, testing and ownership stay with your team, where they belong.
There is also a wider duty in play. NHS England’s own guidance is clear that the standard is not optional good practice but a legal requirement, and Care Quality Commission inspections increasingly ask how communication needs are identified and met. Integrated care boards, under pressure to reduce health inequalities, are starting to ask providers the same question. A trust that can point to a working Easy Read pipeline, with named reviewers and measurable turnaround times, has a far stronger answer than one pointing to a policy document.
Accessibility, in other words, is moving from the communications team’s wish list to the governance agenda, and the organisations that treat it as infrastructure rather than an annual project will be the ones that cope when scrutiny arrives.
Starting small
The encouraging news is that a credible NHS Easy Read pilot does not need a transformation programme. Five steps are enough to get NHS Easy Read working in one service:
- Pick one high-volume document type. Outpatient appointment letters are a strong candidate.
- Involve your learning disability liaison nurses from day one, because they already know where communication fails.
- Make sure communication needs are recorded and flagged in your patient administration system, as the standard requires.
- Run the chosen documents through an Easy Read pipeline for a single service, with named clinical reviewers.
- Baseline did-not-attend rates for patients with a flagged need, then compare after three months.
Small pilots make the case better than policy papers. A trust that can show NHS Easy Read cutting missed appointments in one clinic has a story its board will fund; a trust with a fifty-page accessibility strategy and no changed letters does not.
Michael eventually got his assessment, because a support worker happened to spot the letter and explain it. Compliance by coincidence is not a system. If you would like to see what your own letters look like as NHS Easy Read documents, email us at hello@askelie.com or visit www.askelie.io. We are happy to start with a single document.