Accessible Information Standard self-assessment framework pilot

Healthwatch Leeds undertook an evaluation of a pilot to test the new NHS England refreshed Accessible Information Standard self-assessment framework.

The purpose of the SAF is to assess how effectively communication needs are being met when people use the service. Completing the SAF allowed organisations to review their AIS provision and compliance. It was a reflective process that many colleagues found valuable. However, feedback from pilot participants reveals significant challenges with the current framework and guidance. 29% of the 42 respondents found the framework fit for its intended purpose. In contrast, 71% found it either partly fit or not fit for purpose. This highlights the need for substantial improvements to ensure the framework is effective and user-friendly.

Completing the Self-Assessment Framework (SAF) enabled organisations to critically evaluate their information storage  and communication practices. It also encouraged organisations to identify areas for improvement and explore ways to integrate advancements into their practices to better address unmet AIS needs. However, completing the framework once a year was seen as unrealistic by many respondents. SAF’s value lies in its potential ability to inform actionable and measurable improvements over time rather than an annual repetition.

The binary scoring system (1 or 0) was a major point of contention. While 33% of 42 respondents felt the scoring system was helpful, 67% found it partially or entirely unhelpful. The current system does not allow for partial compliance, making it difficult to reflect the realities of organisations’ current practices. Furthermore, the overall rating, based on the total score from 13 questions, was seen as misleading, as it may not accurately capture an organisation’s strengths or areas for improvement. 

Respondents reported that while some questions were clear and answerable, many were problematic. Questions that focus on policies, evidence, staff training, feedback, and improvement plans are more effective as these align with areas where organisations often have existing or developing practice. However, issues arose with questions that combined multiple concepts, used subjective language (e.g. effectiveness) and inconsistent terminology. Additionally, critical areas such as information needs and intersectionality are overlooked (e.g., language and other accessibility requirements).

45% of 42 respondents found the guidance clear, but many struggled with linking it to the framework questions and demonstrating compliance. The guidance was appraised for being unclear, particularly in explaining how to meet the framework’s requirements. Additionally, it did not account for differences in organisational size or type, such as small care homes contrasted with large NHS trusts.

Some colleagues mentioned that the framework and guidance were not fully accessible, particularly for individuals with learning disabilities or sensory impairments. This lack of accessibility undermines the framework’s goal of promoting inclusivity.

The framework is not integrated into core processes, such as Care Quality Commission (CQC) evaluations, making it feel like an additional task rather than a core requirement. It is also disconnected from other NHSE evaluation frameworks, such as the Reasonable Adjustment and Learning Disability Standards.