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.
Background: Healthcare policy in the UK
Each nation in the UK has a different approach to accessible healthcare policy.
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. This is not just about accessibility; reasonable adjustments help to ensure deaf and disabled people get the right care.
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.
From 2018, the AIS also applies to all NHS Wales providers whose systems support the capture of patient communication needs.
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 Equality Act across the NHS in Great Britain and the Disability Discrimination Act in Northern Ireland.
- In England, compliance with the AIS is optional, with no enforcement mechanism in place.
- Low awareness and understanding of the AIS and the needs of deaf patients among healthcare professionals.
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 across the UK 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 a comprehensive system of accountability, awareness-raising, and enforcement to ensure that healthcare services across the UK makes reasonable adjustments to meet people’s communication needs.
Recommendation 1: 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 – with an equivalent role in each of the three devolved nations.
- 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.
- In Wales, where implementation oversight already exists, ensure annual progress reporting is maintained and made publicly available.
Recommendation 2: Make training on adjustments, communication support and deaf awareness mandatory for all NHS staff across the UK.
The national mandatory training curriculum across each nation should include:
- Training on the Equality Act (or Disability Discrimination Act) to ensure NHS staff understand their legal duties.
- Training on how to use the IT systems and the existing patient flags and information to identify which patients will need adjustments and communication support, and how this can be arranged.
- Deaf awareness training for all NHS staff.
Recommendation 3: Ensure digital and data developments within the NHS in all four nations are fit for purpose to drive forward accessibility for deaf people and people with hearing loss.
- NHS England and DHSC should be proactive in monitoring compliance with the Reasonable Adjustments Digital Flag Information Standard to ensure that communication needs are recorded, shared and acted upon across NHS England digital systems, including the Single Patient Record.
- Each country across the UK should ensure that its version of the NHS App enables 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 4: Strengthen the remit of the regulatory bodies that inspect NHS providers, so that adjustments and accessibility requirements are monitored and enforced.
- In England, the Care Quality Commission (CQC) should improve the process by which it considers the performance of organisations in meeting people’s accessible communication needs and the provision of reasonable adjustments under the Equality Act.
- 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.
- The CQC should publicly report non-compliance and require action plans with follow‑up scrutiny.
- Healthcare Inspectorate Wales, Healthcare Improvement Scotland and the Regulation and Quality Improvement Authority in Northern Ireland should also consider the way in which they inspect providers and monitor failures to meet patients’ communication needs.
- All four UK countries should ensure that the NHS complaints process is accessible to deaf people and people with hearing loss to ensure that concerns related to accessible information, and the accessibility of care across the UK are fully recorded and captured.
Why these changes will work
- Senior leadership ensures ongoing national focus rather than reliance on overstretched local teams.
- Mandatory training on obligations to make healthcare accessible and deaf awareness would help address severe knowledge gaps that limit frontline implementation and improve communication, reduce risk, and strengthen patient safety.
- Strengthened regulation ensures accountability where voluntary compliance has failed.