RNID uses evidence to inform our work to change the lives of individuals, systems and services, and society and public attitudes. This policy statement draws on insights from our evidence review and work with deaf people and people with hearing loss to explore the changes we want to see, and how we can make that a reality.
Each nation in the UK has a different approach to accessible healthcare policy. This policy statement focuses on the Accessible Information Standard, which applies in England and has been absorbed into Standards in Wales.
Background: Healthcare policy in the UK
Under the Equality Act (2010) and the Disability Discrimination Act (1995) in Northern Ireland, people who are deaf or have hearing loss have the right to equal access to NHS health and social care services.
In 2016, the Accessible Information Standard (AIS) was introduced in England, providing guidance for professionals on what must be done to make NHS and social care services accessible. It sets out a requirement under the Equality Act (2010) for services to make “reasonable adjustments” to remove barriers faced by disabled people when accessing care.
In Wales, the All-Wales Accessible Communication and Information Standards (ACIS) were published in 2025 strengthening the existing 2013 Standards. The purpose of these Standards is to ensure that healthcare services in Wales are accessible to people with sensory loss or additional communication and information needs.
There is currently no specific guidance in place in Scotland or Northern Ireland to support health and care services in meeting the communication needs of patients.
The Health and Care Act 2022 made it mandatory for NHS bodies to comply with information standards – but this only applies to new or revised standards published after the commencement of the Act. So, if an updated version of the AIS was published, its enforcement would be strengthened under this legislation.
The problems
- Persistent non-compliance with the Accessible Information Standard
- Low awareness of the AIS among healthcare professionals
- Compliance with the AIS is optional, with no enforcement mechanism in place
What we want to achieve
Everyone who is deaf or has hearing loss should be able to access NHS services on an equal basis, with their communication needs identified, recorded, and met consistently across the health system.
What we’re doing
RNID is campaigning to make sure health services meet their legal obligations to provide fully accessible care for patients who are deaf or have hearing loss.
RNID’s recommendations for driving meaningful change
We are calling for comprehensive system of accountability, awareness-raising, and enforcement to ensure the AIS is implemented consistently in England.
Recommendation 1: Make compliance with the AIS binding under legislation on information standards
- The Government should commit to updating and republishing the AIS within the next 2–3 years so it falls under the Health and Care Act 2022 provision, strengthening the requirement for NHS provider to comply with the AIS.
- Making the AIS a mandatory information standard could drive investment in training, IT systems, and accessible pathways.
Recommendation 2: Assign a senior lead within the Department of Health and Social Care (DHSC) to oversee AIS implementation and broader efforts to make the NHS more accessible.
- A dedicated senior official should coordinate implementation across the NHS and DHSC, ensuring accountability, consistency, and cross‑system leadership.
- With the abolition of NHS England, system stewardship must sit clearly within DHSC to avoid fragmented oversight.
Recommendation 3: Make AIS training and deaf awareness mandatory for all NHS staff
The national mandatory training curriculum should include:
- AIS awareness training for all NHS staff, including legal duties under the Equality Act 2010
- Deaf awareness training for all NHS staff
Recommendation 4: Ensure that existing developments within the NHS, such as the single patient record, NHS App and virtual hospitals can be used to drive accessibility for deaf people and those with hearing loss
- Communication needs should be recorded, shared and acted upon across NHS digital systems, including the Single Patient Record.
- The NHS App should enable patients to manage their communication needs and request reasonable adjustments.
- Virtual hospitals and remote care services must provide accessible communication support, including captions, BSL interpretation and non-telephone contact options.
Recommendation 5: Strengthen the role of the Care Quality Commission (CQC)
- The CQC should improve the process by which it considers the performance of organisations in meeting people’s accessible communication needs. It should require that providers submit their self-assessment frameworks evidencing compliance with the AIS.
- A specific section on the AIS should be included in both the CQC single assessment frameworks and the new set of supporting questions currently being developed by the CQC.
- CQC should publicly report non-compliance and require action plans with follow‑up scrutiny.
Why these changes will work
- Making the AIS a mandatory information standard would strengthen its legal standard, ensuring providers prioritise accessible communication.
- Senior leadership ensures ongoing national focus rather than reliance on overstretched local teams.
- Mandatory training on the AIS and deaf awareness would help address severe knowledge gaps that limit frontline implementation, address the finding that one in three clinicians are unaware of the AIS, and improve communication, reduce risk, and strengthen patient safety.
- Strengthened regulation ensures accountability where voluntary compliance has failed.