Enter and view: GP Practices NHS Accessible Information Standard

The NHS Accessible Information Standard (AIS) became law from 1st August 2016 and applies to all NHS services and publicly funded adult social care organisations. The Care Quality Commission is now including the AIS in their inspections of services1 (including hospitals, GP practices and dentists). The Standard sets out a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment or sensory loss. NHS England led a review of the Standard in early 2017 and found that although the principles of the Standard were widely supported and there were proven benefits to people using services and their carers, compliance varied across and within organisations. In May 2017, Healthwatch Shropshire decided to visit a number of GP practices in the county to find out what progress had been made locally in implementing the Standard and any challenges the practices faced.

Between November 2017 and June 2018 Healthwatch Shropshire Enter and View Authorised Representatives (volunteers) visited nine GP practices and spoke to a total of 82 services users (patients, carers and Patient Participation Group members) and 23 staff, including Practice Managers and reception staff, to find out what they knew about the Accessible Information Standard and how it has affected them. Visit teams also made observations of the practice environment, including how easy practices were to find and access, e.g. for disabled people.

They also looked at how information was shared with service users within the practices (e.g. notice boards, electronic screens, Tannoy systems, alarms) and through the PPGs and how effective these methods were. All practices are encouraged to learn from the examples of good practice identified during our visits and collated in this report. Please see the report for each practice available on the Healthwatch Shropshire website for the full details of each visit, including our findings and recommendations and the response we received. This report brings together our main findings from these reports and makes recommendations to all GP practices in Shropshire.

The main findings included, most patients, carers and Patient Participation Group members had not heard of the Accessible Information Standard at the time of our visit and did not know how it might affect them. Practice Managers had a varying degree of knowledge about the Standard and they were not all aware of the training module for staff on Blue Stream Academy. Six of the nine GP practices visited did not have an Accessible Information Policy. A large number of reception staff were not familiar with the term ‘Accessible Information’ or the five steps to meeting the Standard although some could talk about what their practice was doing to identify patients with a communication need and how this information was used internally and shared externally. Staff gave Healthwatch Shropshire conflicting information about whether practices could share information about a patient or carer’s communication needs with other services without the patients consent. Most practices relied on patients / carers to tell them if they had a communication need, using posters and pages on their website to tell patients that they wanted this information. This approach did not appear to take into the account that people might not be able to read or understand the poster or have access to the internet and so the message might not reach those people with a communication need. Information for patients produced by the individual practices and externally (e.g. by NHS England) did not always meet the tips for printed communication provided by NHS England in ‘Accessible Information: Implementation Guidance’ (2015). Most practices had provided Dementia Awareness sessions or training for staff and some were considering repeating this on a regular basis and having a Dementia Champion. We saw and heard about the work being done in some practices to make them more Dementia friendly.

The recommendations were in the themes of review the approach to meeting the Accessible Information Standard and check that they are meeting the implementation criteria, including having an Accessible Information Policy and gaining the necessary consent from patients to share their personal information outside the practice.