Accessible Documents
All content we publish digitally though our website or apps must meet Web Content Accessibility Guidelines (WCAG 2.1) AA. The standard we must achieve is WCAG 2.1 level AA, for further details on what this involves, please visit the Gov website – Understanding WCAG 2.1.
This means, when we are producing documents, it is important that the content is accessible and can be read and understood by as wide an audience as possible. If the content is being published digitally on our website or through apps, it must meet the WCAG standards. It is good practice to ensure any documentation (Word, Excel, PowerPoint, Outlook emails and PDFs) are accessible to any audience regardless of whether it is being published digitally externally or for internal use only, as we will have colleagues who are visually impaired.
Microsoft Word has a Check Accessibility function, this can be found by going to Review – Check Accessibility. This will highlight any errors in the document and allow you to enter Alt Text for images which can be read by screen readers. For further details on making documents created using Microsoft Office accessible, please visit the Microsoft Support website. You can also check the accessibility of your document by selecting file, clicking on the info tab, next to inspect document there is a drop down box where you can select check accessibility.
To ensure the accessibility checker is always running while you work, right click over the review tab and click customise ribbon. On the list of options that appear select the accessbility tab and ensure the top option is ticked (See screenshot below).
Video guide for accessible documents
See the video below for guide on checking accessibility of a word document.
The table below includes Microsoft best practices for creating Word documents that are accessible to people with disabilities:
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What to fix |
How to find it |
Why fix it |
How to fix it |
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Avoid common accessibility issues such as missing alternative text (alt text) and low contrast colors. |
Use the Accessibility Checker. |
Make it easy for everyone to read your documents. |
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In general, avoid tables if possible and present the data another way. If you have to use tables, use a simple table structure for data only, and specify column header information. |
To ensure that tables don't contain split cells, merged cells, or nested tables, use the Accessibility Checker. Visually scan your tables to check that they don't have any completely blank rows or columns. |
Screen readers keep track of their location in a table by counting table cells. If a table is nested within another table or if a cell is merged or split, the screen reader loses count and can’t provide helpful information about the table after that point. Blank cells in a table could also mislead someone using a screen reader into thinking that there is nothing more in the table. |
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Use built-in headings and styles. |
To check that the order of headings is logical, visually scan your document's table of contents. |
To preserve tab order and to make it easier for screen readers to read your documents, use a logical heading order and the built-in formatting tools in Word. You can also use paragraph banners to organize your content. |
Use built-in title, subtitle, and heading styles |
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Include alt text with all visuals. |
To find missing alt text, use the Accessibility Checker. |
Alt text helps people who can’t see the screen to understand what’s important in images and other visuals. |
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Add meaningful hyperlink text and ScreenTips. |
To determine whether hyperlink text makes sense as standalone information and whether it gives readers accurate information about the destination target, visually scan your document. |
People who use screen readers sometimes scan a list of links. |
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Ensure that color is not the only means of conveying information. |
To find instances of color-coding, visually scan your document. |
People who are blind, have low vision, or are colorblind might miss out on the meaning conveyed by particular colors. |
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Use sufficient contrast for text and background colors. |
To find insufficient color contrast, use the Accessibility Checker. You can also look for text in your document that’s hard to read or to distinguish from the background. |
If your document has a high level of contrast between text and background, more people can see and use the content. |
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Avoid writing important information in the Header or Footer sections of the document. |
Headers and Footers are visible only in the Print Layout view and the Print Preview. Double-click the Header or the Footer to activate and edit its content. |
People who use screen readers miss out on important information as screen readers do not scan Headers or Footers. |
Use built-in title, subtitle, and heading styles to include titles, subtitles, page numbers, and all other important information in the main body of the document. Include any redundant information in the Header or Footer section. |
If you are converting a Word document to a PDF after correcting any accessibility issues. Ensure that the following options are selected in the PDF creation settings:
Creating a tagged PDF is especially important for accessibility as it ensures that information about document structure such as headings, lists and alternative text will be available within the PDF document.
If you are using Adobe Acrobat Pro to create PDF documents, there’s an Accessibility checker under Tools, this will highlight errors and suggest fixes which will be automatically applied to the document. Further details on running an Accessibility check on PDFs can be found on the Adobe website Accessibility features on PDFs.
The AbilityNet website is an excellent good resource with information on creating accessible documents.
There's also guidance on .Gov relating to publishing accessible documents.
If you have any further question on accessibility, please email trust.communications@nca.nhs.uk