If the NHS has not provided the communication support you need, you have the right to challenge it.
This guide explains what the Accessible Information Standard means in practice, when you can challenge it, and how to take action if your needs are not met.
What is the Accessible Information Standard?
The Accessible Information Standard is a legal requirement under the Health and Social Care Act 2012.
All NHS services in England must:
- Ask about your communication needs
- Record those needs clearly
- Flag them so staff can see them
- Share them when you are referred
- Meet those needs in practice
This can include:
- A Lipspeaker
- A BSL interpreter
- Speech to text support
- Clear written information
- Adjustments during appointments
What are your rights?
Your rights are also protected under the Equality Act 2010.
NHS services must make reasonable adjustments so you can access care safely and effectively.
You are not asking for a favour. You are exercising a legal right.
When can you challenge?
You can challenge when your communication needs are not met properly.
You can challenge if:
- No communication support was provided when needed
- You were told to “bring someone with you” instead
- An interpreter or Lipspeaker was booked but was not suitable
- Staff ignored or dismissed your recorded needs
- Information was not provided in an accessible format
- You missed or misunderstood important medical information due to access failure
You cannot usually challenge if:
- You declined support that was offered
- You did not inform the service of your needs (although they should still ask)
- The issue is preference rather than access (for example, wanting a specific individual rather than a qualified professional)
That said, there are grey areas. If poor communication affected your care, it is still worth raising.
Choosing how to challenge
There are three main routes. You do not need to follow these steps in order. Which route you start with is usually dependent on the situation.
Speak to staff or department
If you are already at an appointment, the quickest first step is to speak to someone directly.
You can talk to:
- Reception staff
- A nurse or clinician
- The ward manager
- The department running your appointment
This is often the fastest way to resolve immediate issues.
For example:
- Communication support such as a Lipspeaker or interpreter have not arrived or not been booked
- You cannot follow what is being said
- Information is not accessible
In many cases, staff can try to arrange support or adjust how they communicate straight away.
However, if:
- The issue is serious
- It affected your care
- It keeps happening
Then move to PALS or a formal complaint.
Informal support via Patient Advice and Liaison Service
If the issue is not resolved, or you need additional support, you can contact PALS.
PALS can:
- Speak to departments on your behalf
- Help resolve issues quickly
- Support you in raising concerns
This is still an informal route and does not involve a formal investigation.
They are useful for early-stage challenges, but they are not fully independent.
Formal complaint
All NHS services must have a complaints process.
You can:
- Complain directly to the NHS service (hospital, GP, clinic)
- Or complain to the organisation that commissioned the service
Most people start with the provider.
Steps:
- Contact the complaints team (often called PALS or Patient Experience)
- Submit your complaint:
- Online form
- Letter
- Clearly explain:
- What happened
- What communication support you needed
- What was missing or wrong
- The impact on you
- State what outcome you want
How long does it take?
Typical NHS complaint timelines:
- Acknowledgement: within 3 working days
- Investigation and response: usually within 25 to 40 working days
However:
- Complex cases can take longer
- Delays are common
You should be told if timelines change.
What outcomes can you expect?
Possible outcomes include:
- Apology
- Explanation of what went wrong
- Changes to your records
- Staff training or service improvements
- Agreement to provide appropriate communication support going forward
In some cases:
- Financial compensation may be considered (rare and usually linked to harm)
What if you are not satisfied?
You can escalate to the Parliamentary and Health Service Ombudsman.
They will:
- Review how your complaint was handled
- Decide if further action is needed
Important:
- You must usually complete the NHS complaints process first
- There are time limits (typically within 12 months of the issue)
Who can help you?
You do not have to do this alone. Support organisations include:
- RNID
- Healthwatch England
- SignHealth (links to a downloadable template to share your communications needs with your care provider)
They can:
- Provide advice
- Help you understand your rights
- Support you in making a complaint
Is it a postcode lottery?
In practice, it can be.
While the AIS is a national standard:
- Different NHS Trusts implement it differently
- Awareness and training vary
- Booking systems for communication support vary
- Some areas are proactive; others are inconsistent
This means:
- You may have very different experiences between hospitals
- Even departments within the same Trust can differ
Challenging poor access is not about complaining for the sake of it. It is about:
Ensuring safe, effective healthcare
Making sure your communication needs are respected
Improving services for others
FAQs
It should not. NHS services are required to treat you fairly regardless of complaints.
Whilst it is not essential, it can be extremely helpful. Examples:
- Appointment letters
- Emails
- Notes about what happened
You can request this. The NHS must provide accessible ways for you to raise a complaint.
Yes. If it is a reasonable adjustment for your communication needs.
Raise it immediately with the department or PALS so it can be addressed before your next appointment.